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Cynthia Utami
Uji kesahihan dan keandalan kuesioner childhood asthma control test versi Indonesia pada pasien asma usia 4-11 tahun = Validity and reliability of Indonesian version of childhood asthma control test on patients with asthma aged 4-11 years old / Cynthia Utami
"ABSTRAK
Latar belakang: Fokus terapi asma adalah mencapai terkendalinya asma secara
adekuat. Childhood Asthma Control Test (CACT) merupakan kuesioner
penilaian terkendalinya asma pada anak yang cepat dan mudah digunakan.
Penggunaan CACT di Indonesia masih terbatas karena kendala bahasa dan
budaya. Sampai saat ini belum ada kuesioner CACT versi Indonesia (terjemahan
CACT ke dalam bahasa Indonesia) yang terbukti sahih dan andal.
Tujuan: Mengetahui kesahihan (validity) dan keandalan (reliability) kuesioner
CACT versi Indonesia.
Metode: Menerjemahkan tujuh pertanyaaan kuesioner CACT menjadi kuesioner
CACT versi Indonesia. Studi potong lintang dilakukan terhadap 66 subjek usia
4-11 tahun yang dipilih secara konsekutif. Semua subjek menjalani uji fungsi paru
dan pemeriksaan peak expiratory flow berkala. Analisis statistik menggunakan
uji Cronbach?s  dan uji korelasi Pearson/ Spearman.
Hasil: Rerata usia subjek penelitian adalah 7,89 tahun (5,25 -11,83 tahun) dengan
proporsi jenis kelamin lelaki lebih tinggi dibandingkan anak perempuan. Sebagian
besar subjek penelitian yaitu 60,4% memiliki status asma tidak terkendali (nilai
kuesioner CACT ≤19). Kuesioner CACT versi Indonesia mempunyai keandalan
(Cronbach?s  0,762) dan kesahihan konstruksi (r= 0,384-0,545) yang baik.Tidak
terdapat korelasi bermakna antara kuesioner CACT versi Indonesia dengan nilai
FEV1 (r =-0,024; p=0,846) dan nilai variabilitas mingguan PEF (r=-0,218;
p=0,079).
Simpulan: Kuesioner CACT versi Indonesia mempunyai kesahihan dan
keandalan yang baik untuk menilai terkendalinya asma. Kuesioner ini tidak
mempunyai korelasi dengan uji fungsi paru sehingga CACT tidak dapat
menggantikan peran uji fungsi paru sebagai salah satu komponen penilaian
terkendalinya asma.
ABSTRACT
Background: The goal of asthma treatment is to achieve control over the asthma
adequately. The Childhood Asthma Control Test (CACT) is a quick and easy-touse
questionnaire for assessing asthma control on children. The usage of CACT in
Indonesia is limited due to the language and culture barrier. To date, there is no
Indonesian version of CACT questionnaire that is proven to be reliable and valid.
The aim of this study was to validate the Indonesian version of this test.
Objectives: To learn the validity and reliability of the Indonesian version of
Childhood Asthma Control Test (I-CACT).
Methods: Translation of the established seven-item questionnaire into the ICACT.
Cross-sectional study was conducted among 66 participants aged 4-11
years old which were recruited consecutively. All patient undergone pulmonary
function test and measured peak expiratory flow (PEF) regularly. The reliability
of I-CACT was assessed using the internal consistency (Cronbach?s ) and the
validity was assesed by the Pearson/Spearman correlation test.
Results: The mean age was 7.89 years (5.25-11.83y) with predominantly boys.
Sixty percent of participants had uncontrollable asthma (score I-CACT ≤19). Both
the internal consistency reliability (Cronbach?s  0.762) and the constructed
validity (r= 0.384-0.545 ) of the I-CACT were good. No significant correlation
was found between the I-CACT score with the FEV1 (r =-0.024; p=0.846) and the
variability of PEF (r=-0.218; p=0.079) respectively.
Conclusions: I-CACT is a valid and reliable test for assessing asthma control.
However, I-CACT does not correlate well with the pulmonary function test and
therefore is not a substitute to the role of pulmonary function in assessing asthma
control."
Fakultas Kedokteran Universitas Indonesia, 2013
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Siregar, Marsintauli Hasudungan
Gambaran klinis radiologis histopatologis dan faktor prognostik tumor otak pada anak = Clinical radiology histopathology features and prognostic factor of child brain tumor
"[ABSTRAK
Tumor otak (TO) merupakan penyebab kematian kedua dari
semua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologis
dan histopatologis yang sangat bervariasi karena proses pengembangan sel-sel
jaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TO
pada anak masih sedikit.
Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktor
prognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr.
Ciptomangunkusumo Jakarta periode tahun 2010 - 2015.
Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TO
primer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RS
Dr. Ciptomangunkusumo Jakarta.
Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari
3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan
47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dan
kejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebral
ventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yang
terbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usia
lebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan
(65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum
(24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yang
terbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%).
Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yang
bermakna.
Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologis
letak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenis
tumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkan
faktor prognostik TO pada anak.
ABSTRACT
Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.]"
2016
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Alvi Lavina
Faktor-faktor yang memengaruhi gangguan perilaku pada anak epilepsi = Factors related to behavior problems in children with epilepsy
"Latar belakang. Gangguan perilaku pada anak epilepsi memiliki prevalens yang tinggi dan dapat menyebabkan dampak psikososial pada anak. Namun sejauh ini di Indonesia belum terdapat studi yang meneliti gangguan perilaku pada anak epilepsi serta faktor-faktor yang berhubungan.
Tujuan. Penelitian ini untuk mengetahui: (1) proporsi dan jenis gangguan perilaku pada anak epilepsi berdasarkan child behavior checklist (CBCL), (2) hubungan antara: usia awitan kejang, frekuensi kejang, durasi epilepsi, obat anti epilepsi, tingkat sosial ekonomi, dan pendidikan orangtua, dengan gangguan perilaku pada anak epilepsi, (3) adaptasi keluarga dalam menghadapi anak epilepsi.
Metode. Penelitian potong lintang di Klinik Neurologi Anak FKUI RSCM. Skrining gangguan perilaku dengan kuesioner CBCL dilakukan pada 30 anak epilepsi tanpa defisit neurologis dan disabilitas intelektual. Studi kualitatif untuk menilai adaptasi keluarga dalam menghadapi anak epilepsi.
Hasil. Terdapat tiga dari tiga puluh anak epilepsi yang mengalami gangguan perilaku, dengan jenis gangguan perilaku eksternalisasi (perilaku melanggar aturan dan agresif), masalah sosial dan gangguan pemusatan perhatian. Faktor usia awitan kejang (p=0,280), frekuensi kejang (p=0,007; RP 0,036; IK95% 0,005-0,245), durasi epilepsi (p=1,000), obat anti epilepsi (p=0,020; RP 0,019; IK95% 0,001-0,437), tingkat sosial ekonomi (p=0,251), dan pendidikan orangtua (p=1,000), tidak berisiko meningkatkan gangguan perilaku. Terdapat sikap dan reaksi, serta persepsi dan stigma orangtua yang negatif dalam menghadapi anak epilepsi yang mengalami gangguan perilaku. Terdapat masalah keluarga sejak anak mengalami epilepsi dan gangguan perilaku. Orangtua tidak dapat menerapkan pola asuh displin dan kemandirian pada anak dengan gangguan perilaku.
Simpulan. Proporsi gangguan perilaku pada anak epilepsi tanpa defisit neurologis dan disabilitas intelektual tidak tinggi. Tidak terdapat faktor-faktor yang memengaruhi gangguan perilaku. Adaptasi keluarga baik dalam menghadapi anak epilepsi tanpa gangguan perilaku, dibandingkan dengan keluarga anak epilepsi yang mengalami gangguan perilaku.
Background. Behavior problems are prevalent in children with epilepsy and have psychosocial impact in children. However, in Indonesia, no research has ever been done to study behavior problems in children with epilepsy and related factors.
Objectives. This study aimed to define: (1) proportion behavior problem and type of behavior disorder based on child behavior checklist (CBCL), (2) the relationship between factors: age at seizure onset, seizure frequency, epilepsy duration, antiepileptic drug, socio-economic, and parents education, with behavior problems in epileptic children, (3) family adaptation on managing children with epilepsy.
Method. A Cross sectional study in Pediatric Neurology Clinic FKUI RSCM. Screening for behavior problems with CBCL questionnaires in 30 children with epilepsy without neurologic deficit and intellectual disability. A qualitative study examined family adaptation on managing children with epilepsy.
Results. There were three of thirty children with epilepsy, who have behavior problems, with externalizing disorder (delinquent and agressive behavior), social and attention problems. Age at seizure onset (p=0,280), seizure frequency (p=0,007; PR 0,036; CI95% 0,005-0,245), epilepsy duration (p=1,000), anti epileptic drug (p=0,020; PR 0,019; CI95% 0,001-0,437), socio-economic (p=0,251), dan parents education (p=1,000), are not risk factors for development of behavior problems. Parents’ behavior and reaction, their perception and stigma are negative on managing children with epilepsy and behavior problems. There are family problems since their children have epilepsy and behavior problems. Parents are unable to discipline children with behavior problems and teach them to be independent.
Conclusion. The proportion of behavior problems in children with epilepsy without neurologic deficit and intellectual disability, are not high. There are no risk factors for development of behavior problems. Family adaptation on managing children with epilepsy without behavior problems are better than family who have children with epilepsy and behavior problems."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tugas Akhir  Universitas Indonesia Library
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Pricilia Gunawan H.
Peran pelayanan paliatif terhadap kualitas hidup, intensitas gejala, dan frekuensi kunjungan unit gawat darurat pasien anak dengan penyakit keganasan = Palliative intervention to improve quality of life, symptomps intensity, and emergency admission in children with malignancy
"ABSTRAK
Pendekatan integrasi antara terapi paliatif dan perawatan penyakit kronik dan atau mengancam jiwa telah banyak digunakan dalam beberapa tahun terakhir. Hingga saat ini, masih banyak yang beranggapan bahwa terapi paliatif hanya ditujukan untuk pasien dengan penyakit berat yang sudah berada di stadium terminal atau akhir hidupnya, namun pada kenyataannya banyak pasien mendapatkan manfaat dari terapi paliatif sedini mungkin. Penelitian ini merupakan uji klinis acak terkontrol yang bertujuan untuk mengetahui manfaat integrasi terapi paliatif pada pasien anak dengan penyakit keganasan. Pasien terdiri dari anak dengan penyakit keganasan usia 2-18 tahun yang dikonsulkan kepada tim paliatif. Pasien dibagi menjadi dua kelompok secara acak, yakni kelompok kontrol (30 anak) dan kelompok intervensi (30 anak). Intervensi berupa kunjungan rumah, komunikasi dua arah antara tenaga terlatih dengan pasien dan orang tua, dibagi menjadi 6 sesi (1 sesi setiap 2 minggu) yang berfokus pada edukasi penyelesaian masalah, manajemen gejala, perawatan diri sendiri, komunikasi, pembuatan keputusan dan pendampingan rencana perawatan lanjutan. Pasien diikuti dan dilakukan penilaian kualitas hidup dengan kuesioner Pediatric Quality of Life Innitiative (PedsQLTM) modul kanker 3.0, intensitas gejala dinilai dengan Edmonton Symptoms Assesment Score (ESAS), frekuensi kunjungan unit gawat darurat (UGD) pasien anak dengan penyakit keganasan dicatat selama periode penelitian dan dibandingkan dengan sebelum penelitian. Kelompok intervensi memiliki kualitas hidup lebih tinggi bermakna (81,63) dibandingkan kelompok kontrol (62,39), p<0,001. Ranah kualitas hidup yang paling meningkat secara signifikan adalah ranah nyeri, mual, kecemasan prosedur, kecemasan tata laksana, dan khawatir. Intervensi paliatif dapat menurunkan intensitas gangguan tidur (p=0,003) dan anoreksia pada pasien (p<0,001). Intervensi paliatif dapat menurunkan kunjungan UGD sebanyak 4,77 kali pada pasien anak dengan penyakit keganasan (OR 4,77, 95% IK 1,29-17,65; p=0,018).
ABSTRACT
In these last few years, an integrated approach between palliative care and chronic and/or life-threatening conditions care have been widely used. Many people think that palliative care is only intended for those with end stage of disease or in the end of life period. In fact, many patients had benefit from early palliative integration. This study is aimed to know the role of palliative intervention in child with malignancy. A randomized controlled trial comparing patients who were given palliative care (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 patients. Patients consisted of children with cancer aged 2-18 years old who were consulted to palliative team. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention (report by proxy or self-report). Interventions were given in 6 sessions (1 session every 2 weeks) focusing on problems solving education, symptoms management, self-care, communication, decision making, and long-term care plan assistance. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0. Symptomps intensity were assessed by Edmonton Symptoms Assesment Score (ESAS). Emergency room admissions from the last 3 months were noted before patients were enrolled in the study. During the follow up period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed to see the effect of interventions on outcomes in this study. A significant difference of quality of life was found between the two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). Most significant increased domains were pain, nausea, procedural anxiety, treatment anxiety, and worry. Intensity of sleep disturbance (p=0.003) and anorexia (p<0.001) were decreased significantly in intervention group. Emergency room admissions were reduced by 4.7 times in intervention group (OR 4.77, 95% CI 1.29-17.65; p=0.018)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tugas Akhir  Universitas Indonesia Library
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Iffa Ahsanur Rasyida
Faktor faktor yang berhubungan dengan fungsi kognitif pada anak diabetes melitus tipe 1 = Factors relating to cognitive ability in children with type 1 diabetes
"[ABSTRAK
Latar Belakang Diabetes melitus DM tipe 1 paling banyak ditemukan pada masa anak dan remaja dengan prevalens sebesar 1 500 anak Hiperglikemia kronik pada diabetes menyebabkan komplikasi pada berbagai organ Komplikasi ini berhubungan dengan kadar HbA1C sebagai faktor yang memengaruhi fungsi kognitif Pasien DM tipe 1 juga dapat mengalami komplikasi hipoglikemia berat sehingga mengakibatkan atrofi neuron di otak Identifikasi dini terhadap risiko gangguan fungsi kognitif penting untuk intervensi klinis dan psikoedukasi terhadap anak Tujuan Mengidentifikasi prevalens anak DM dengan fungsi kognitif di bawah normal di Indonesia dan menganalisis korelasi antara usia awitan DM durasi sakit DM ketoasidosis diabetikum KAD HbA1C dan hipoglikemia berat dengan fungsi kognitif anak DM tipe 1 Metode Penelitian ini merupakan studi yang mempelajari faktor risiko dengan metode potong lintang dilakukan di Jakarta pada Mei sampai dengan Juni 2015 Pemeriksaan fungsi kognitif menggunakan instrumen the Wechsler Intelligence Scale for Children WISC IV Subyek pada penelitian ini adalah pasien DM tipe 1 yang berusia 5 ndash 18 tahun Analisis statistik dilakukan untuk mencari korelasi antara fungsi kognitif dengan usia awitan durasi sakit kadar HbA1C dan frekuensi kejadian KAD Analisis statistik komparasi dilakukan untuk mencari rerata perbedaan full scale intelligence quotient IQ pasien dengan riwayat hipoglikemia berat dan tidak Hasil Penelitian dilakukan terhadap 58 subyek dengan hasil rerata full scale IQ adalah 100 16 Terdapat 26 subyek dengan full scale IQ di bawah normal Korelasi bermakna secara statistik didapatkan antara fungsi kognitif dengan usia awitan r 0 285 p 0 030 kadar HbA1C r 0 270 p 0 041 dan frekuensi riwayat kejadian KAD r 0 289 p 0 028 Tidak didapatkan korelasi antara durasi sakit dengan full scale IQ dan tidak didapatkan perbedaan full scale IQ antara kelompok dengan riwayat hipoglikemia berat dan kontrol Simpulan Terdapat korelasi negatif antara full scale IQ dengan usia awitan frekuensi KAD dan kadar HbA1C Durasi sakit dan riwayat hipoglikemia berat tidak memengaruhi full scale IQ Kata kunci faktor fungsi kognitif DM tipe 1 ABSTRACT Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes;Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes, Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Pricilia Gunawan Halim
Peran pelayanan paliatif terhadap kualitas hidup, intensitas gejala, dan frekuensi kunjungan unit gawat darurat pada pasien anak dengan penyakit keganasan = Role of palliative care of children with malignancy focusing on quality of life, intensity of symptoms, and emergency unit admission
"Pendekatan integrasi antara terapi paliatif dan perawatan penyakit kronik dan atau mengancam jiwa telah banyak digunakan dalam beberapa tahun terakhir. Hingga saat ini, masih banyak yang beranggapan bahwa terapi paliatif hanya ditujukan untuk pasien dengan penyakit berat yang sudah berada di stadium terminal atau akhir hidupnya, namun pada kenyataannya banyak pasien mendapatkan manfaat dari terapi paliatif sedini mungkin. Penelitian ini merupakan uji klinis acak terkontrol yang bertujuan untuk mengetahui manfaat integrasi terapi paliatif pada pasien anak dengan penyakit keganasan. Pasien terdiri dari anak  dengan penyakit keganasan usia 2-18 tahun yang dikonsulkan kepada tim paliatif. Pasien dibagi menjadi dua kelompok secara acak, yakni kelompok kontrol (30 anak) dan kelompok intervensi (30 anak). Intervensi berupa kunjungan rumah, komunikasi dua arah antara tenaga terlatih dengan pasien dan orang tua, dibagi menjadi 6 sesi (1 sesi setiap 2 minggu) yang berfokus pada edukasi penyelesaian masalah, manajemen gejala, perawatan diri sendiri, komunikasi, pembuatan keputusan dan pendampingan rencana perawatan lanjutan. Pasien diikuti dan dilakukan penilaian kualitas hidup dengan kuesioner Pediatric Quality of  Life Innitiative (PedsQLTM) modul kanker 3.0, intensitas gejala dinilai dengan Edmonton Symptoms Assesment Score (ESAS), frekuensi kunjungan unit gawat darurat (UGD) pasien anak dengan penyakit keganasan dicatat selama periode penelitian dan dibandingkan dengan sebelum penelitian. Kelompok intervensi memiliki kualitas hidup lebih tinggi bermakna (81,63) dibandingkan kelompok kontrol (62,39), p<0,001. Ranah kualitas hidup yang paling meningkat secara signifikan adalah ranah nyeri, mual, kecemasan prosedur, kecemasan tata laksana, dan khawatir. Intervensi paliatif dapat menurunkan intensitas gangguan tidur (p=0,003) dan anoreksia pada pasien (p<0,001). Intervensi paliatif dapat menurunkan kunjungan UGD sebanyak 4,77 kali pada pasien anak dengan penyakit keganasan (OR 4,77, 95% IK 1,29-17,65; p=0,018).
In these last few years, an integrated approach between palliative care and chronic and/or life-threatening conditions care have been widely used. Many people think that palliative care is only intended for those with end stage of disease or in the end of life period. In fact, many patients had benefit from early palliative integration. This study is aimed to know the role of palliative intervention in child with malignancy. A randomized controlled trial comparing patients who were given palliative care (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 patients. Patients consisted of children with cancer aged 2-18 years old who were consulted to palliative team. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention (report by proxy or self-report). Interventions were given in 6 sessions (1 session every 2 weeks) focusing on problems solving education, symptoms management, self-care, communication, decision making, and long-term care plan assistance. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0. Symptomps intensity were assessed by Edmonton Symptoms Assesment Score (ESAS). Emergency room admissions from the last 3 months were noted before patients were enrolled in the study. During the follow up period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed to see the effect of interventions on outcomes in this study. A significant difference of quality of life was found between the two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). Most significant increased domains were pain, nausea, procedural anxiety, treatment anxiety, and worry. Intensity of sleep disturbance (p=0.003) and anorexia (p<0.001) were decreased significantly in intervention group. Emergency room admissions were reduced by 4.7 times in intervention group (OR 4.77, 95% CI 1.29-17.65; p=0.018)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T58736
UI - Tesis Membership  Universitas Indonesia Library
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Henni Wahyu Triyuniati
Luaran keterlambatan perkembangan dengan uji capute scales pada anak dengan riwayat prematur dan perdarahan intraventrikel = Neurodevelopmental delay using Capute scales test in children with history of prematurity and intraventricular hemorrhage
"Latar belakang: Keterlambatan perkembangan adalah morbiditas jangka panjang akibat prematur dan perdarahan intraventrikel (PIV). Uji Capute scales merupakan alat perkembangan yang praktis dan dapat menegakkan keterlambatan perkembangan. Tujuan: mengetahui luaran keterlambatan perkembangan dengan uji Capute scales pada anak dengan riwayat prematur dan PIV. Metode: Studi potong lintang dilakukan terhadap 96 anak usia koreksi 6-36 bulan di RSCM. Penelitian ini mencari prevalens dan jenis keterlambatan perkembangan dengan uji Capute scales antara kelompok prematur dengan PIV sedang-berat dan kelompok PIV ringan. Analisis dilakukan untuk mengetahui hubungan antara derajat PIV, usia gestasi, berat lahir, apneu of prematurity (AOP), ventilator mekanik dini, resusitasi aktif, dan patent ductus arteriosus (PDA) terhadap keterlambatan perkembangan. Hasil: Prevalens keterlambatan perkembangan pada kelompok anak dengan prematur dan PIV adalah 19,8%. Kelompok anak dengan riwayat prematur dan PIV sedang berat memiliki 2,56 kali mengalami keterlambatan perkembangan umum dibandingkan dengan kelompok prematur dan PIV ringan (IK95% 1,176-5,557; nilai p=0,037). Jenis keterlambatan perkembangan kognitif/visual-motor didapatkan peningkatan risiko tertinggi (rasio prevalens 4,73 (IK95%1,92-11,69; nilai p=0,001) dibandingkan keterlambatan perkembangan bahasa. Analisis multivariat menunjukkan apneu of prematurity (AOP) adalah faktor risiko independen yang berhubungan dengan luaran keterlambatan perkembangan pada kelompok prematur dan PIV (OR 4,01 (IK95%1,37-11,75); nilai p=0,011). Kesimpulan: Derajat PIV berperan sebagai salah satu komorbid yang mempengaruhi luaran keterlambatan perkembangan.
Background: Neurodevelopmental delay is among one of long-term morbidities for children with history of prematurity and intraventricular hemorrhage (IVH). The Capute scales test is a practical developmental tool with diagnostic value for neurodevelopmental delay. Objective: To investigate neurodevelopmental delay outcome using Capute scales test. Methods: It is a cross-sectional study involving 96 children at 6-36 months corrected age with history of prematurity and IVH in RSCM Jakarta. This study measures prevalence and characteristics of neurodevelopmental delay among children with prematurity and IVH mild-severe IVH group compared with mild IVH group. Analysis was done to determine relationship between IVH grades, gestational age, birth weight, apneu of prematurity (AOP), early mechanical ventilator use, active resuscitation history, and patent ductus arteriosus (PDA) and neurodevelopmental delay. Results: Prevalens of neurodevelopmental delay in children with history of prematurity and IVH is 19,8%. Premature children with mild-severe IVH group showed greatest risk in cognitive/visual-motor delay (PR 4,73 (95%CI 1,92-11,69; p=0,001) than language delay. Multivariate analysis showed AOP is the only independent risk factor related to neurodevelopmental delay in children with history of prematurity and IVH (OR 4,01 (95%CI 1,37-11,75); p=0,011). Conclusion: IVH grades contribute as one of comorbidities which influence neurodevelopmental delay."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Lucyana
Gambaran klinis dan faktor yang memengaruhi luaran pasien ensefalitis akut pada anak = Clinical profile and factors associated with outcome in paediatric acute encephalitis / Lucyana
"ABSTRAK
Pendahuluan: Ensefalitis pada anak lebih sering dijumpai daripada dewasa dan luaran buruk terjadi pada 60% subjek yang terkena. Hingga saat ini belum ada data mengenai profil dan luaran pasien ensefalitis anak di Indonesia.
Tujuan: Mengetahui profil dan luaran pasien ensefalitis akut pada anak
Metode: Penelitian retrospektif ini menggunakan data rekam medis tahun 2014- 2018 di 3 rumah sakit pendidikan (RSCM, RSU Tangerang, RSUP Fatmawati). Gejala klinis awal, pleositosis CSS, abnormalitas neuroimaging, abnormalitas elektrofisiologis (EEG) dicatat dan luaran dinilai saat pasien pulang/meninggal dan dinyatakan sebagai luaran baik atau buruk.
Hasil: Terdapat 657 pasien yang memenuhi kriteria ICD X sesuai kriteria inklusi dari 3 rumah sakit, dan data dari 190 subjek dianalisis dalam penelitian ini. Subjek penelitian didominasi oleh anak usia > 1 tahun (83%). Kejang didapatkan pada 87% subjek yang diteliti dan 80%nya merupakan kejang umum. Defisit neurologis fokal terdapat pada 47% subjek (90 pasien). Pemeriksaan penunjang yang menunjukkan abnormalitas tertinggi adalah EEG (90%). Kriteria diagnostik probable terpenuhi pada 62% subjek. Mortalitas didapatkan pada 23% subjek, dengan proporsi terbanyak berasal dari RSU Tangerang. Kejang fokal dan usia > 1 tahun merupakan faktor risiko yang berperan meningkatkan luaran buruk saat pulang 3 kali lipat (p: 0,006 dan p: 0,03).
Simpulan: Profil ensefalitis akut pada anak lebih banyak dijumpai pada usia > 1 tahun, dengan gejala yang sering dijumpai saat awal adalah demam, dan kejang. Pemeriksaan penunjang EEG adalah pemeriksaan tertinggi yang menunjukkan hasil positif pada pasien dugaan ensefalitis. Kejang fokal dan usia > 1 tahun merupakan faktor risiko luaran buruk.
ABSTRACT
Introduction: Encephalitis in pediatric population is more frequent than adult. The outcome has been reported to have poor prognosis in 60% of cases. No data of peidatric encephalitis in Indonesia has been reported yet.
Objectives: Evaluate pediatric acute encephalitis profile and factors that influence its outcome.
Methods: This retrospective research used medical records data from year 2014- 2018 in 3 teaching hospitals (RSCM, RSU Tangerang, RSUP Fatmawati). We documented clinical presentation at admission, pleocytosis CSF, neuroimaging abnormality, electrophysiologic abnormality (EEG), and outcome at discharge which classified as good vs. poor outcome.
Results: Among 657 patients identified using ICD X in all 3 hospitals, there were a total of 190 subjects included in this study. Eighty three percent of subjects aged > 1 years. Seizure was present in 87% subjects, and 80% of those subjects experienced generalized seizure. Focal neurological deficits was shown in 47% subjects (90 patients). Among investigation, EEG shown positive results in 90% examined subjects, while CT scan were the most prevalent. We found probable diagnostic criteria in majority of subjects (62%). Mortality was 23%, and RSU Tangerang was the major contributor. Focal seizure and age > 1 year were the risk factors associated with 3 times increased risk of poor outcome (p: 0,006 and p: 0,03).
Conclusions: Age > 1 year is more prevalent in pediatric acute encephalitis. Among most common clinical presentation are fever and seizure. Abnormal EEG finding in suspected encephalitis cases give the most positive result. Focal seizure and age > 1 year were the risk factors for poor outcome"
2019
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UI - Tesis Membership  Universitas Indonesia Library
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Rondonuwu, Cherry Alisa Lidya
Profil dan luaran kejang pada neonatus serta faktor-faktor yang memengaruhinya = Clinical profile, outcomes, and factors associated with neonatal seizure
"ABSTRAK
Kejang pada neonatus merupakan gejala yang paling sering ditemukan dari gangguan neurologis pada periode neonatus. Kejang pada neonatus dapat terjadi sebagai akibat dari etiologi yang beragam dan ini sering menandakan adanya kerusakan atau malfungsi dari sistem saraf pusat yang belum berkembang sempurna. Penelitian bertujuan untuk mengetahui profil dan luaran kejang pada neonatus serta faktor-faktor yang memengaruhinya. Studi retrospektif dari data sekunder rekam medis Unit Perinatologi RS Cipto Mangunkusumo (RSCM) pada periode Januari 2015 sampai Juni 2019. Semua neonatus di RSCM dengan usia kronologis ≤ 28 hari pada neonatus aterm atau ≤ 44 minggu sejak konsepsi pada neonatus prematur, dengan riwayat kejang atau mengalami kejang minimal satu kali selama perawatan, diikutkan dalam penelitian ini. Subjek dieksklusi bila terdapat kecurigaan kelainan bawaan dan rekam medis tidak lengkap. Pencatatan terhadap subjek meliputi riwayat antenatal, gejala klinis, hasil EEG dan neuroimaging, serta luaran. Studi dilakukan terhadap 108 subjek dan didapatkan jenis kelamin lelaki sebesar 59,3%, usia gestasi aterm sebesar 55,6%, serta berat lahir normal sebesar 52,8%. Kematian terjadi pada 38 (35,2%) subjek. Insidens kejang pada neonatus di Unit Perinatologi RSCM sebesar 3,3%. Karakteristik neonatus yang mengalami kejang adalah jenis kelamin lelaki, aterm, persalinan dengan bedah kaisar, riwayat resusitasi aktif, dan respons dengan pemberian obat anti kejang tunggal. Luaran meninggal pada penelitian ini sebesar 35,2% dengan faktor-faktor yang memengaruhinya yaitu usia gestasi, berat lahir, frekuensi kejang, dan penyakit penyerta sepsis.
ABSTRACT
Neonatal seizures are the most common manifestation of neurological disorders in the newborn period. Neonatal seizures may arise as a result of diverse etiologies and these events frequently signify serious damage or malfunction of the immature developing central nervous system. The study is aimed to determine neonatal seizures profile and factors that influence its outcome. This was a retrospective cohort study from secondary medical record data at Neonatology Unit of Cipto Mangunkusumo General Hospital (CMGH) between January 2015-Juni 2019. All neonates in CMGH with a chronological age of ≤ 28 days in a term infant or ≤ 44 weeks from conception in a preterm infant, with seizure or history of seizure were included in the study. Subjects were excluded if they were suspected of having congenital disorders or incomplete medical records. Data collected from the subjects include antenatal history, clinical symptoms, EEG findings, neuroimaging results, and outcome at discharge. A total of 108 subjects were included in the study and among neonates with seizures, 59,3% were male, 55,6% were born term, and 52,8 % had normal birth weight. Death occurred in 38 cases (35,2%). Incidens of neonatal seizure in Neonatology Unit of CMGH was 3,3%. Neonates who developed seizure characterized by male gender, term birth, delivered by section cesarean, history of active resuscitation, and respons to single antiepileptic drug. The mortality rate in this study was 35,2% with gestational age, birth weight, frequency of seizure, and sepsis being the factors that influence the outcome."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
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Sita Ariyani
Profil klinis dan pemeriksaan penunjang pada penyakit Kawasaki = Clinical and supportive examination profiles of Kawasaki disease
"Latar belakang: Penyakit Kawasaki (PK) merupakan vaskulitis akut sistemik yang belum diketahui penyebabnya dan mempunyai predileksi pada arteri koroner terutama bayi dan anak balita. Sebanyak 20-40% kasus PK yang tidak diobati akan mengalami kelainan arteri koroner. Masalah PK di Indonesia saat ini adalah masih banyak kasus yang underdiagnosis dan terlambat didiagnosis, serta beberapa kasus overdiagnosis. Sejauh ini belum ada publikasi penelitian tentang PK di Indonesia.
Tujuan: Mengetahui profil klinis dan pemeriksaan penunjang PK pada anak di Indonesia.
Metode: Penelitian deskriptif potong lintang. Data diperoleh dari rekam medis pasien anak 0-18 tahun dengan diagnosis PK selama periode 1 Agustus 2011 hingga 31 Juli 2012 di 3 rumah sakit di Jakarta dan Tangerang.
Hasil: Terdapat 66 subjek yang sesuai dengan diagnosis PK. Sebanyak 77% subjek berusia balita dengan usia tersering 1-2 tahun. Proporsi anak lelaki lebih tinggi dibandingkan perempuan dengan perbandingan 2:1. Seluruh subjek mengalami demam dengan gambaran klinis paling sering adalah perubahan pada bibir dan rongga mulut seperti eritema, bibir pecah-pecah, lidah stroberi, dan eritema difus mukosa orofaring (100%), ruam polimorfik (89%), dan injeksi konjungtiva tanpa eksudat (88%). Gambaran klinis paling jarang adalah limfadenopati servikal unilateral (53%). Anemia dan leukositosis sering terjadi pada fase akut, sedangkan trombositosis mulai terjadi pada minggu kedua. Peningkatan LED dan CRP terjadi pada fase akut, namun pada 15% subjek peningkatan LED tidak disertai oleh peningkatan CRP atau sebaliknya. Hipoalbuminemia terjadi pada 70% subjek. Gambaran infiltrat pada foto toraks didapatkan pada 71% subjek. Aneurisma arteri koroner pada ekokardiografi saat awal diagnosis didapatkan pada 30% subjek. Sebagian besar merupakan aneurisma kecil, 3% aneurisma sedang, dan 1% aneurisma raksasa.
Simpulan: Gambaran klinis paling sering selain demam adalah perubahan pada bibir dan rongga mulut, ruam polimorfik, dan injeksi konjungtiva tanpa eksudat, sedangkan yang paling jarang adalah limfadenopati servikal unilateral. Pemeriksaan LED dan CRP sebaiknya dilakukan bersamaan untuk mendukung diagnosis. Hipoalbuminemia dan gambaran infiltrat pada foto toraks mungkin dapat dipertimbangkan sebagai alat bantu diagnosis PK pada anak di Indonesia, namun masih membutuhkan penelitian lebih lanjut untuk membuktikannya.
Background: Kawasaki disease (KD) is an acute systemic vasculitis with unknown cause. The main predilections are the coronary arteries, especially in infants and children under five. As many as 20-40% of untreated KD will develop coronary problems. Currently, many of the KD cases in Indonesia are still under- or late diagnosed, and some cases are even overdiagnosed. However, there has not been any research publication on KD in Indonesia.
Objective: To describe the clinical and supportive examination profiles of KD in Indonesian children.
Method: A cross-sectional observational study of children under 18 years old with KD diagnosed within August 1st 2011 and July 31st 2012 was performed. Data were obtained from the medical records of patients from 3 hospitals in Jakarta and Tangerang.
Results: Of 66 subjects diagnosed of KD, 77% subjects were children aged 1-2 years old, with male and female ratio was 2:1. All subjects had fever with common clinical profiles were: changes in lips and oral cavity such as erythema, lips cracking, strawberry tongue and diffuse erythema of oropharyngeal mocosae; polymorphic rashes; and non-exudative conjunctival injection (100%, 89%, and 88%, respectively). Unilateral cervical lymphadenopathy was seen in 53% subjects. Anemia and leukocytosis were frequently seen in acute phase, while thrombocytosis developed during the second week. The ESR and CRP also increased during acute phase. However, in 15% subjects with increased ESR, the CRP remained normal, and vice versa. Hypoalbuminemia occured in 70% subjects, and infiltrate on chest xray appeared in 71% subjects. The incidence of coronary artery aneurysm at initial echocardiography was 30%, with small aneurysm were predominant, 3% considered moderate, and 1% was categorized as giant aneurysm.
Conclusion: Changes in lips and oral cavity, polymorphic rashes, and non-exudative conjunctival injection are the most common clinical profiles, besides fever. Unilateral cervical lympadenopathy is the least frequent manifestation. The ESR and CRP examinations should be done to support the diagnosis of KD. Hypoalbuminemia and infiltrate findings on chest xrays might be considered as an aid in diagnosing KD in Indonesian children. However, further study is needed for validation."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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