Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Hipotiroid kongenital (HK) adalah kelainan bawaan yang dapat menimbulkan dampak berupa retardasi mental permanen. Pemberian levothyroxine dengan dosis tepat pada usia sedini mungkin, dapat mencegah gangguan pertumbuhan dan perkembangan. Sayangnya, bayi baru lahir tidak menunjukkan gejala HK. Kalaupun ada, berarti sudah ada gangguan pertumbuhan. Perlu skrining hipotiroid kongenital (SHK) untuk menemukan kasus bayi yang menderita HK. Meski sudah dilakukan sejak 2006, baru pada tahun 2014 dikeluarkan Permenkes tentang pelaksanaan SHK di Indonesia. Penelitian evaluasi ekonomi program SHK tahun 2014-2015 ini mencakup analisis biaya skrining dan terapi dini, sedangkan outcome didapat dari systematic review (SR). Asumsi dikembangkan berdasarkan data riil pasien skrining SHK di 2 laboratorium rujukan di Jakarta dan Bandung. Dari total 56.186 bayi yang melakukan skrining, diperoleh 24 pasien positif menderita HK. Hasil SR menyatakan bahwa semakin dini onset terapi, semakin adekuat dosis inisiasi dan semakin kontinyu terapi dapat memberikan hasil yang baik. Hasil Tersebut berupa pencegahan terhadap komplikasi HK lebih jauh dan perbaikan pada penyimpangan tumbuh kembang. Dari hasil penelitian, didapatkan informasi bahwa baru pada tahun kedua terlihat adanya keuntungan ekonomis SHK. Hal ini berhubungan dengan patologi gejala HK yang umumnya muncul pada usia 3-6 bulan. Orang tua baru mencari pertolongan medis pada tahun kedua dan mengeluarkan lebih banyak biaya. Biaya skrining dan terapi dini menjadi sepadan dibandingkan dengan kerugian yang dapat dicegah akibat gejala gangguan tumbuh kembang.

---

ABSTRACT
Congenital hypothyroidism (CH) is a congenital disorder that can have an impact in the form of permanent mental retardation. Giving the right dose of levothyroxine at the earliest possible age, can prevent the disruption of growth and development. Newborns do not show symptoms of CH, and unfortunately the symptoms appear in the late period and in many cases it shows growth disorders. The congenital hypothyroidism screening (CHS) program has been implemented to find infant cases with CH, and followed up with treatment. Although it has been made since 2006, Minister of Health just issued the regulation in 2014 on the implementation of CHS in Indonesia. This economic evaluation of the CHS program in 2014-2015 was done using cost analysis, while outcome obtained from the systematic review (SR). The assumptions used in the analysis were developed based on real data from a CHS screening program in two referral laboratories in Jakarta and Bandung. Out of 56.186 screened babies, 24 babies were found as CH positive cases. The result of the SR revealed that the earlier onset of initiation therapy, the more adequate dose and the more continuous therapy given to the patient, the better result will be achieved. It will prevent the patients from severe complications of CH and will improve the quality of thegrowth and development. The study found that the economic benefit is achieved in the second year of CH treatment, since the pathological symptoms generally appear at the age of 3-6 month and parents seek care in the second year. Consequently, cost to treat patients will increase. The cost of screening and early treatment was found worthy as compared to economic loss resulting from growth disorders

Abstrak :
Latar Belakang: Celah bibir dan palatum merupakan salah satu kelainan kongenital yang paling sering terjadi. Kelainan ini dapat menyebabkan kendala dalam berbicara, abnormalitas telinga tengah, masalah psikologis, serta kelainan dental seperti anodontia parsial dan supernumerary teeth. Perawatan autologous alveolar bone grafting yang diambil dari tulang ilium pasien merupakan standar perawatan bagi pasien celah bibir dan palatum. Namun, pengambilan tulang tersebut bersifat invasif dan memiliki tingkat morbiditas dan mortalitas yang tinggi. Teknik rekayasa jaringan yang terdiri dari scaffold, faktor pertumbuhan, dan sel punca dapat menjadi solusi untuk masalah tersebut. Sumber donor sel punca yang tidak invasif bisa didapatkan dari sel punca pulpa gigi sulung (SHED) dan sel punca pulpa gigi permanen (DPSCs). Salah satu syarat dapat digunakannya suatu sel punca adalah memiliki kapasitas proliferasi yang baik. Perbandingan antara kapasitas proliferasi SHED dan DPSCs pada pasien normal telah diketahui, namun pada pasien celah palatum belum pernah diteliti. Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan kapasitas proliferasi sel punca pulpa gigi sulung dan sel punca pulpa gigi permanen pasien celah bibir dan palatum. Metode: SHED dan DPSCs pasien celah bibir dan palatum dikultur hinga tingkat confluency 70-80%, setelah itu sel dipanen dan dilakukan Uji PDT pada sel yang telah dikultur selama 7 hari. Hasil: SHED pasien celah bibir dan palatum menunjukkan nilai PDT yang lebih tinggi dibandingkan dengan DPSCs, namun secara statistik perbedaan tersebut tidak berbeda bermakna. Kesimpulan: SHED dan DPSCs penderita celah bibir dan palatum memiliki kapasitas proliferasi yang sama baiknya. ......Background: Cleft lip and palate is one of the most common congenital abnormalities. This disorder can cause speech impediments, middle ear abnormalities, psychological problems, and dental abnormalities such as partial anodontia and supernumerary teeth. Treatment of autologous alveolar bone grafting taken from the patient's ilium bone is the standard of care for cleft lip and palate patients. However, bone removal is invasive and carries a high rate of morbidity and mortality. Tissue engineering techniques consisting of scaffolds, growth factors, and stem cells can be a solution to the problem that. Sources of non-invasive stem cell donors can be obtained from primary dental pulp stem cells (SHED) and permanent dental pulp stem cells (DPSCs). One of the conditions for the use of a stem cell is to have a good proliferative capacity. Comparison between the proliferative capacity of SHED and DPSCs in normal patients known, but in cleft palate patients it has not been studied. Objective: This study was aimed to compare the proliferative capacity of pulp stem cells of primary teeth and pulp stem cells of permanent teeth in cleft lip and palate patients. Methods: SHED and DPSCs of cleft lip and palate patients were cultured to level 70-80% confluency, after that the cells were harvested and PDT test was performed on cells that had been cultured for 7 days. Results: SHED of cleft lip and palate patients showed a higher PDT value than DPSCs, but statistically the difference was not significantly different. Conclusion: SHED and DPSCs patients with cleft lip and palate have the same good proliferative capacity.

Abstrak :
ABSTRACT
Congenital hypothyroidism is the most treatable cause of mental retardation. It is also the most prevalent congenital endocrine disorder in childhood. A dramatic improvement can be made by early detection, diagnosis, and adequate treatment of levothyroxine in patients with congenital hypothyroidism. Severe cognitive impairment is associated with persistent disease in patients who have delayed or no treatment at all. In a modern era with complete healthcare facilities in a big city like Jakarta, the prevalence late-diagnosed congenital hypothyroidism is supposed to be very low. Since many districts have their own public healthcare facilities to screen and diagnose congenital hypothyroidism in children at very young age, a delayed diagnosis in adulthood is actually a rare case. In this medical illustration, we report a case of 21 year-old woman who came to our hospital with abdominal pain. She had mental retardation with no capability to communicate well with other person. She had a short stature (her height was less than 1 meter). She also had mongoloid face with big lips and a very big tongue. There was no goiter or lump on her neck. Her motoric performance was very weak and frail. During abdominal examination, we could see an umbilical bulging on her abdominal wall and on palpation, we could feel an umbilical hernia. By abdominal ultrasound, we could see the umbilical hernia. Unfortunately, no diagnosis of congenital hypothyroidism had been made when she was a newborn, there was also no past or known history of thyroid disease of her and her family. She had a diagnosis of mental retardation with no specific etiology since she was 5-years old. Based on the results of her laboratory examination, we had a confirmed diagnosis of primary hypothyroidism with T4 10,56 nmol/L (normal 60-120 nmol/L) and TSH > 100 mIU/mL. We provided her treatment using levothyroxine based on her body weight (25 mg daily). We arranged her to have abdominal CT Scan and digestive surgery as further management for her umbilical herniation. Some defects are correlated with congenital hypothyroidism when the disease is not treated properly and adequately. Neurocognitive, neuromotoric, growth, and development are some areas which can be disrupted by long-term hypothyroidism condition for patients who had the disease since their early years of life. Congenital hypothyroidism appears to be associated with an increased risk of congenital malformations. Several congenital malformations associated with congenital hypothyrodism are umbilical hernia, congenital heart disease, neurologic abnormalities, genitourinary malformations, cleft palate, and Downs syndrome. Studies concluded that severity of the congenital hypothyroidism has more important role than timing of treatment initiation on long-term cognitive and motor outcomes. Detrimental effects on developmental outcomes in congenital hypothyroidism patients may persist over time; however, early treatment for patients at very early ages may bring the best cognitive outcomes and neuromotoric development. Regardless of the treatment options, we can say that it is a loss case and a very late diagnosis and treatment of congenital hypothyroidism. The unusual age of detection, delayed diagnosis and treatment are some reminders for primary care physicians in our society to pay greater attention to screening programs. 6 Early detection and prompt treatment is an essential part of measures to reduce burden of mental retardation in our society. Delayed diagnosis of congenital hypothyroidism case, which is diagnosed at adulthood, indicates failure in screening program. Early diagnosis and treatment are necessary to prevent long-term catastrophic effects. This a wake-up call of attention and awareness for general public and primary care physicians in our country.

Abstrak :
ABSTRAK
Hipotiroid kongenital (HK) adalah kelainan bawaan yang dapat menimbulkan dampak berupa retardasi mental permanen. Pemberian levothyroxine dengan dosis tepat pada usia sedini mungkin, dapat mencegah gangguan pertumbuhan dan perkembangan. Sayangnya, bayi baru lahir tidak menunjukkan gejala HK. Kalaupun ada, berarti sudah ada gangguan pertumbuhan. Perlu skrining hipotiroid kongenital (SHK) untuk menemukan kasus bayi yang menderita HK.

Meski sudah dilakukan sejak 2006, baru pada tahun 2014 dikeluarkan Permenkes tentang pelaksanaan SHK di Indonesia. Penelitian evaluasi ekonomi program SHK tahun 2014-2015 ini mencakup analisis biaya skrining dan terapi dini, sedangkan outcome didapat dari systematic review (SR). Asumsi dikembangkan berdasarkan data riil pasien skrining SHK di 2 laboratorium rujukan di Jakarta dan Bandung. Dari total 56.186 bayi yang melakukan skrining, diperoleh 24 pasien positif menderita HK.

Hasil SR menyatakan bahwa semakin dini onset terapi, semakin adekuat dosis inisiasi dan semakin kontinyu terapi dapat memberikan hasil yang baik. Hasil tersebut berupa pencegahan terhadap komplikasi HK lebih jauh dan perbaikan pada penyimpangan tumbuh kembang.

Dari hasil penelitian, didapatkan informasi bahwa baru pada tahun kedua terlihat adanya keuntungan ekonomis SHK. Hal ini berhubungan dengan patologi gejala HK yang umumnya muncul pada usia 3-6 bulan. Orang tua baru mencari pertolongan medis pada tahun kedua dan mengeluarkan lebih banyak biaya. Biaya skrining dan terapi dini menjadi sepadan dibandingkan dengan kerugian yang dapat dicegah akibat gejala gangguan tumbuh kembang.

---

ABSTRACT
Congenital hypothyroidism (CH) is a congenital disorder that can have an impact in the form of permanent mental retardation. Giving the right dose of levothyroxine at the earliest possible age, can prevent the disruption of growth and development. Newborns do not show symptoms of CH, and unfortunately the symptoms appear in the late period and in many cases it shows growth disorders. The congenital hypothyroidism screening (CHS) program has been implemented to find infant cases with CH, and followed up with treatment.

Although it has been made since 2006, Minister of Health just issued the regulation in 2014 on the implementation of CHS in Indonesia. This economic evaluation of the CHS program in 2014-2015 was done using cost analysis, while outcome obtained from the systematic review (SR). The assumptions used in the analysis were developed based on real data from a CHS screening program in two referral laboratories in Jakarta and Bandung. Out of 56.186 screened babies, 24 babies were found as CH positive cases.

The result of the SR revealed that the earlier onset of initiation therapy, the more adequate dose and the more continuous therapy given to the patient, the better result will be achieved. It will prevent the patients from severe complications of CH and will improve the quality of thegrowth and development..

The study found that the economic benefit is achieved in the second year of CH treatment, since the pathological symptoms generally appear at the age of 3-6 month and parents seek care in the second year. Consequently, cost to treat patients will increase. The cost of screening and early treatment was found worthy as compared to economic loss resulting from growth disorders.

Abstrak :
ABSTRAK
Penyakit jantung bawaan (PJB) mengakibatkan morbiditas yang signifikan pada anak dan merupakan penyebab kematian utama dari antara kelainan kongenital lainnya. Usaha preventif PJB dengan cara identifikasi faktor risiko maternal diharapkan dapat menurunkan morbiditas dan mortalitas PJB. Tujuan. Penelitian ini bertujuan untuk mengetahui: (1) karakteristik (usia saat pertama kali terdiagnosis, jenis kelamin, status gizi, dan status ekonomi keluarga) penderita PJB anak di Poliklinik Kardiologi Ilmu Kesehatan Anak (IKA) Rumah Sakit Cipto Mangunkusumo (RSCM), (2) faktor risiko maternal yang diperkirakan mempengaruhi terjadinya PJB pada anak, yaitu: merokok aktif dan pasif selama kehamilan, diabetes melitus, obesitas, infeksi rubela saat kehamilan, usia saat kehamilan, dan pendidikan. Metode. Penelitian kasus kontrol dengan consecutive sampling dilakukan di Poliklinik Kardiologi IKA RSCM pada bulan Januari-Maret 2014. Pemeriksaan klinis, ekokardiografi, dan wawancara dilakukan terhadap 68 subjek PJB (kelompok kasus) dan 68 subjek anak sehat (kelompok kontrol). Hasil. Jumlah subjek penelitian sebanyak 136 subjek, dengan perbandingan kasus:kontrol adalah 1:1. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebesar 80,9% terdiagnosis saat berusia kurang dari 1 tahun. Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dengan 7,4% di antaranya merupakan gizi buruk, dan memiliki status ekonomi keluarga menengah ke bawah (76,5%). Defek PJB non sianotik terbanyak adalah defek septum ventrikel (44,1%) dan PJB sianotik terbanyak adalah Tetralogi Fallot (14,7%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah. Faktor risiko merokok aktif dan pasif saat kehamilan, obesitas, dan usia ibu saat kehamilan tidak terbukti berhubungan dengan PJB anak, sedangkan faktor diabetes melitus dan infeksi rubela saat kehamilan tidak dapat dianalisis pada penelitian ini. Simpulan. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebagian besar subjek terdiagnosis saat berusia kurang dari 1 tahun (80,9%). Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dan 7,4% di antaranya merupakan gizi buruk, dengan status ekonomi keluarga menengah ke bawah (76,5%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah.

---

ABSTRACT
Congenital heart defects (CHD) cause significant morbidities and are the leading cause of death among other congenital anomalies. Preventive measures with identification of maternal risk factors are expected to decrease morbidity and mortality rate in children due to CHD. Objectives. This study aimed to define: (1) characteristics (age at diagnosis, gender, nutritional status, and family’s economy status) of CHD patients in Pediatric Cardiology Clinic Cipto Mangunkusumo Hospital (CMH), (2) maternal risk factors that may influence CHD in children, namely: active and passive smoking in pregnancy, diabetes mellitus, obesity, rubella infection in pregnancy, age at pregnancy, and education. Method. Case-control study with consecutive sampling was performed in Pediatric Cardiology Clinic CMH in January-March 2014. Clinical examination, echocardiography, and interview were performed in 68 CHD subjects (case group) and 68 healthy subjects (control group). Results. Total subject in this study was 136, with ratio of case:control is 1:1. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and 80.9% were diagnosed in the first year of age. Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). The most prevalent non cyanotic CHD was ventricle septal defect (44.1%), and the most prevalent cyanotic CHD was Tetralogy of Fallot (14.7%). Maternal risk factor that was significantly associated with CHD was low maternal education. Active and passive smoking in pregnancy, obesity, and maternal age at pregnancy were not associated with CHD, whereas diabetes mellitus and rubella infection in pregnancy could not be analyzed in this study. Conclusion. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and mostly were diagnosed in the first year of age (80.9%). Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). Maternal risk factor that was significantly associated with CHD was low maternal education.

Abstrak :
Latar Belakang. Kondisi hipoksia kronik pada pasien dengan penyakit jantung bawaan sianotik akan menurunkan oksigenasi jaringan sehingga terjadilah mekanisme adaptasi yaitu eritrositosis sekunder. Besi merupakan substrat yang penting dalam produksi hemoglobin dan cadangan besi untuk menjaga kadar hemoglobin yang adekuat. Namun 50% pasien dengan kelainan penyakit jantung bawaan sianotik mengalami defisiensi besi dan kondisi ini dikaitkan dengan gangguan kapasitas fungsional akibat berkurangnya pengiriman oksigen dan efeknya terhadap metabolisme pada otot rangka. Kadar feritin serum merupakan pemeriksaan yang paling awal dan akurat untuk menilai defisiensi besi. Studi ini bertujuan untuk mengetahui hubungan antara kadar feritin serum dengan kapasitas fungsional pada pasien Tetralogi Fallot (TF). Metode. Studi potong lintang dilakukan di Departemen Kardiologi dan Kedokteran Vaskular Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, Jakarta pada pasien TF usia 4-8 tahun yang belum menjalani operasi paliatif dan atau operasi definitif. Dilakukan pengumpulan karakteristik dasar, kadar feritin serum, ekokardiografi, serta uji jalan 6 menit. Dilakukan uji korelasi dan analisis multivariat menggunakan uji regresi. Hasil. Diteliti sebanyak 20 pasien TF dengan rentang usia 51 hingga 98 bulan. Nilai tengah kadar feritin serum adalah 39.75 g/L (kadar terendah 5g/L, kadar tertinggi 246g/L). Nilai tengah kadar hemoglobin adalah 16.4 g/dL, kadar terendah 12 g/dL dan kadar tertinggi 20 g/dL. Limapuluh persen pasien memiliki kadar feritin serum di bawah normal (< 40 g/L). Pada uji korelasi antara kadar feritin serum dengan jarak uji jalan 6 menit didapatkan nilai r = 0.23 dengan nilai p = 0.34. Pada uji regresi linear pada 2 kelompok, ditemukan perbedaan rerata jarak uji jalan 6 menit pada kelompok dengan kadar feritin lebih tinggi (> 40 g/L, n = 10) sebesar 46,83 m dibandingkan dengan kelompok feritin rendah (< 40 g/L, n = 10) dengan koefisien β = 46,83; IK 95 -47,81- 141,47 p = 0,307. Kesimpulan. Secara klinis terdapat kecenderungan pasien TF dengan kadar feritin serum yang lebih tinggi mampu menempuh jarak uji jalan 6 menit yang lebih jauh walaupun secara satistik tidak bermakna. ...... Background. Chronic hypoxia in cyanotic congenital heart disease (CCHD) result in reduced of tissue oxygenation, therefore stimulates adaptive mechanism of secondary erythrocytosis. Iron is a vital substrate for hemoglobin production and sufficient iron stores are necessary to achieve and maintain adequate levels of hemoglobin. Unfortunately, 50% of patients with cyanotic CHD are iron-deficient and this condition is associated with exercise intolerance through reduced oxygen delivery and its effect on skeletal muscle cell metabolism Ferritin serum level is the most accurate test to determine iron deficiency. Aim of this study is to evaluate the association between ferritin serum level and functional capacity in patient with Tetralogy of Fallot (TOF). Methods. A cross-sectional study was done in Department Cardiology and Vascular Medicine, Faculty Medicine Universitas Indonesia / National Cardiovascular Center Harapan Kita, Jakarta in patients with TOF aged 4-8 years old before the palliatif and or definite operation. The data collected from patients including basic characteristic, ferritin serum level and erythocyte index and six minute walk test result. Statistical analysis was done using correlation test and multivariat analysis using regression test. Result. Twenty subjects of TF aged 51 to 98 months was collected. Median level of ferritin serum level was 39.75 g/L (the lowest level 5g/L, the highest level 246g/L). Median level of hemoglobin level was (the lowest level 12 g/dL, the highest level 20 g/dL). Fifty percent of patients had abnormal feritin serum level (< 40 g/dL). There was a correlation coefficient (r) of 0,23 with p value of 0,34 found on the correlation between ferritin serum level and six minute walk test distance. However, on linear regression test between 2 groups of ferritin serum, 46,83 m mean difference of six minute walk test distance found between higher level of ferritin serum group (> 40 g/d, n = 10), and lower level of ferritin serum group (< 40 g/d, n = 10) with β = 46,83; IK 95 -47,81- 141,47 p = 0,307. Conclusion. Clinically in patients with higher level of feritin serum there is a tendency able to walk farther on six minute walk test, although statitically not significant.

Abstrak :
Usia pasien dan lokasi striktur uretra penting untuk menentukan sebagian besar penyebab dari striktur uretra. Striktur uretra paling sering timbul pada pars bulbosa. Kashefi et al. dalam penelitiannya menunjukkan bahwa diperkirakan 3,2 striktur uretra per 1000 pasien rawat inap disebabkan oleh trauma oleh kateter. Pada pasien berusia di atas 45 tahun, TURP dan prostatektomi radikal adalah penyebab paling umum dari striktur/kontraktur uretra. Penelitian ini bertujuan untuk memberikan gambaran pasien striktur uretra di rumah sakit H. Adam Malik Medan serta penanganan yang dilakukan.Penelitian ini adalah penelitian retrospektif, deskriptif mengenai pasien striktur uretra di Medan, Indonesia. Penelitian dilakukan di rumah sakit H. Adam Malik antara bulan Mei dan Juni 2017, Medan dengan mengumpulkan data dari rekam medis. Data yang dikumpulkan meliputi nama, usia, gejala klinis, lokasi striktur, panjang striktur, dan jenis tindakan yang dilakukan. Data dianalisis menggunakan SPSS 20 mengenai rerata usia, lokasi striktur tersering, rerata panjang striktur, dan jenis tindakan yang digunakan untuk menangani panjang striktur tertentu atau lokasi striktur tertentu. Penyebab striktur paling banyak pada penelitian ini adalah trauma sebanyak 35 pasien dari 60 pasien (58,3%). keluhan tidak dapat BAK menjadi mayoritas penyebab mereka datang ke rumah sakit (46,7%), diikuti dengan BAK sulit ataupun tidak lancar (masing-masing 25%), dan hal yang paling jarang dikeluhkan adalah nyeri saat BAK Penelitian ini menyatakan bahwa karakter pasien striktur uretra di Indonesia tidak berbeda jauh dengan penelitian-penelitian yang ada sebelumnya. Penelitian ini juga menunjukkan bahwa urethrotomy(Sachse) lebih banyak digunakan dibandingkan urethroplasty, serupa dengan diluar negeri meskipun urethroplastymemiliki efektifitas yang lebih baik. ......The age of the patient and the location of urethral stricture are important for determining most of the causes of urethral stricture. Urethral stricture most often occurs in bulbous pars. Kashefi et al. in their study showed that an estimated 3.2 urethral strictures per 1000 inpatients were caused by trauma by the catheter. In patients over 45 years, TURP and radical prostatectomy are the most common causes of urethral stricture/contracture. This study aims to provide an overview of urethral stricture patients at H. Adam Malik Hospital in Medan as well as the treatment performed. This study is a retrospective, descriptive study of urethral stricture patients in Medan, Indonesia. The study was conducted at H. Adam Malik Hospital between May and June 2017, Medan by collecting data from medical records. Data collected included name, age, clinical symptoms, stricture location, stricture length, and type of action performed. Data were analyzed using SPSS 20 regarding age averages, location of the most common strictures, mean length of strictures, and types of actions used to deal with certain strictures or locations of certain strictures. The most common causes of stricture in this study were trauma in 35 patients from 60 patients (58.3%). BAK complaints cannot be the majority of the reasons they come to the hospital (46.7%), followed by difficult or non-BAC (25% each), and the most rarely complained of is pain when BAK This study states that the patient's character Urethral stricture in Indonesia is not much different from previous studies. This study also shows that urethrotomy (Sachse) is more widely used than urethroplasty, similar to abroad even though urethroplasty has better effectiveness.

Abstrak :
Latar belakang: Society of Thoracic Surgeons – European Association of Cardiothoracic Surgeons (STS-EACTS) mortality score dan category merupakan sistem stratifikasi risiko terbaru yang dikembangkan sebagai prediktor mortalitas dan morbiditas pascaoperasi penyakit jantung bawaan (PJB). Namun belum pernah divalidasi di Indonesia. Tujuan: Melakukan validasi eksternal STS-EACTS mortality score dan category pada populasi Indonesia. Metode: Uji validasi dengan studi potong lintang, menggunakan data dari Rumah Sakit Pusat Jantung Nasional Harapan Kita bagian bedah jantung anak dan kongenital dari Januari 2015 – Desember 2019. Nilai sensitivitas, spesifisitas, dan area under curve – receiving operator characteristic (AUC-ROC) menjadi luaran utama dalam menilai kemampuan prediksi mortalitas dan pemanjangan lama rawat pascoperasi (PLRP). Hasil: Penelitian melibatkan 4139 subjek dengan tingkat mortalitas 5,4% (230 subjek). STS-EACTS score memiliki sensitivitas dan spesifisitas sebesar 65% dan 68% dalam memprediksi mortalitas, dengan 62% dan 71% dalam memprediksi PLRP. STS-EACTS category memiliki sensitivitas dan spesifisitas sebesar 63% dan 68% dalam memprediksi mortalitas, dengan 61% dan 75% dalam memprediksi PLRP. STS-EACTS category memperlihatkan kemampuan diskriminasi yang baik untuk mortalitas dan PLRP (AUC-ROC 0,704 dan 0,701). Sementara pada mortality score hanya memberikan hasil cukup untuk PLRP (AUC-ROC 0,704 dan 0,679). Kesimpulan: STS-EACTS category merupakan prediktor yang baik dalam menilai luaran mortalitas dan PLRP pascaoperasi PJB. ...... Introduction: Society of Thoracic Surgeons – European Association of Cardiothoracic Surgeons (STS-EACTS) mortality score and category were the latest risk stratification for congenital heart disease (CHD) surgery, but it hasn't been validated in Indonesia. Aim: Validate STS-EACTS score and category in Indonesian population. Methods: Cross-sectional validation study was done using the dataset of Paediatric and Congenital Heart Surgery Department, National Cardiovascular Center Harapan Kita Indonesia, from January 2015 – December 2019. Sensitivity, specificity and area under curve – receiving operator characteristic (AUC-ROC) are used to assess its ability to predict mortality and PHLOS. Results: This study enrolled 4139 subjects with 5.4% mortality rate. The STS-EACTS score have the sensitivity and specificity of 65% and 68% to predict mortality, with 62% and 71% to predict PHLOS. The STS-EACTS category have the sensitivity and specificity of 63% and 68% to predict mortality, with 61% and 75% to predict PHLOS. The STS-EACTS category shows good discrimination ability in predicting mortality and PHLOS (AUC-ROC 0.704 and 0.701), whereas the mortality score only gives sufficient results in predicting PHLOS (AUC-ROC 0.704 and 0.697). Conclusions: The STS-EACTS category is a good predictor that can be used in Indonesian population to predict mortality and PHLOS following CHD surgery.

Abstrak :
Latar Belakang: Penyakit jantung bawaan (PJB) dikoreksi dengan bedah jantung terbuka dengan bantuan alat mesin pintas jantung paru (cardiopulmonary bypass). Namun teknik ini dapat menyebabkan inflamasi pada paru yang menghasilkan kondisi Acute Respiration Dysfunction Syndrome (ARDS). Meskipun insidensinya pada pasien bedah dengan mesin pintas jantung paru hanya rendah, tingkat mortalitasnya dapat mencapai 50%.

Tujuan: Mengetahui hubungan antara durasi penggunaan mesin jantung paru dengan insidensi ARDS pada pasien anak dengan PJB pasca bedah jantung terbuka.

Metode: Studi kohort retrospektif dilakukan terhadap 194 anak yang menjalani bedah jantung terbuka atas indikasi PJB di Unit Pelayanan Jantung Terpadu (UPJT) RSCM periode Januari 2014-September 2015.

Hasil: 64 (32,99%) pasien mengalami ARDS pasca bedah jantung terbuka dan sisanya sebanyak 130 (67,01%) tidak mengalami ARDS. Median penggunaan mesin pada golongan ARDS dan non-ARDS masing-masing sebesar 80 menit (23-219, IK90%) dan 70 menit (18-320, IK90%). Insidensi ARDS pada kelompok dengan durasi pendek (≤60 menit) adalah 27,5% dan dengan durasi panjang (> 60 menit) adalah 36%. Secara statistik dan klinis tidak terdapat hubungan bermakna antara durasi penggunaan mesin dengan munculnya ARDS (p = 0,298, uji chi square).

Kesimpulan: Tidak terdapat hubungan bermakna antara durasi penggunaan mesin pintas jantung paru dengan kejadian ARDS pada pasien PJB pasca bedah jantung terbuka.

---

Background: Congenital heart disease (CHD) is corrected by open thoracic surgery with the help of cardiopulmonary bypass machine (CPB). This technique can cause pulmonary inflammation resulting in Acute Respiratory Distress Syndrome (ARDS). Even though its incidence is low, the mortality rate of is up to 50%.

Aim: To find whether the duration of CPB using is related with incidence of ARDS in pediatric patients underwent open thoracic surgery.

Methods: Retrospective cohort study was done involving 194 pediatric patients underwent open thoracic surgery with CHD indication at Unit Pelayanan Jantung Terpadu (UPJT) RSCM within January 2014 and 2015 September.

Results: 64 (32,99%) patients had ARSD after open thoracic surgery. The mean of CPB machine duration was 80 minutes (23-219, CI90%) in patients with ARDS and 70 minutes (18-320, CI90%) in patients with no ARDS. The incidence of ARDS in patients with short duration of CPB (≤60 minutes) was 27.5% and long duration (>60 minutes) was 36%. There was no such correlation statistically and clinically between duration of CPB and ARDS occurence (p = 0.298, chi square test).

Conclusion: Duration of CPB using is not related with ARDS occurrence in pediatric patients with CHD underwent open thoracic surgery.