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"Latar Belakang: Anemia defisiensi besi (ADB) merupakan jenis anemia yang tersering pada remaja. Dampak defisiensi besi mulai dari berkurangnya kemampuan kerja fisis hingga gangguan fungsi kognitif. Pada saat memasuki kehamilan, ADB dapat meningkatkan mortalitas dan morbiditas pada ibu maupun pada bayi. Faktor risiko ADB pada remaja multifaktorial.Tujuan: Mengetahui status besi, prevalens dan faktor risiko ADB pada remaja perempuan usia 12-15 tahun di Jakarta Pusat.Metode: Studi potong lintang pada remaja perempuan usia 12-15 tahun di Sekolah Menengah Pertama (SMP). Subjek dibagi menjadi kelompok status sosial ekonomi (SSE) menengah-keatas dan menengah-kebawah. Pada subjek dinilai status gizi, status dan karakteristik menstruasi, pekerjaan, pendidikan, dan penghasilan orangtua, serta asupan besi. Pada subjek juga dilakukan pemeriksaan laboratorium hematologis, biokimia besi, dan (C-reactive protein) CRP. Uji tuberkulin dilakukan untuk menyingkirkan APK akibat tuberkulosis, penyakit kronik tersering di Indonesia.Hasil: Diantara 163 subjek, prevalens status besi normal sebesar 69,3%. Prevalens defisiensi besi non anemia lebih tinggi (17,2%, berupa deplesi (3,1%) dan defisiensi besi (14,1%) dibandingkan prevalens ADB (13,5%). Prevalens ADB pada kelompok status sosial ekonomi (SSE) menengah-keatas lebih rendah daripada SSE menengah-kebawah (11,5% dan 15,8%). Tidak didapatkan hubungan yang bermakna antara prevalens ADB dengan status gizi, status dan karakteristik menstruasi, SSE, dan pendidikan maupun penghasilan orangtua. Asupan besi bioavailable pada seluruh subjek kurang dari angka kecukupan gizi (AKG), namun tidak didapatkan hubungan yang bermakna dengan prevalens ADB.Simpulan: Prevalens deplesi dan defisiensi besi yang lebih tinggi dari prevalens ADB berpotensi meningkatkan prevalens ADB pada masa mendatang. Meskipun tidak didapatkan hubungan yang bermakna antara prevalens ADB dengan faktor risikonya, namun asupan besi yang kurang dari AKG pada seluruh subjek perlu diperhatikan. Suplementasi besi sesuai rekomendasi Ikatan Dokter Anak Indonesia perlu dilaksanakan dalam upaya pencegahan dan penanggulan defisiensi besi pada remaja.

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Background: Iron deficiency anemia (IDA) is the most common anemia in adolescents. Iron deficiency cause decreased physical performance as well as cognitive impairment. In pregnancy, IDA increases maternal and fetal mortality and morbidity. Risk factors of IDA in adolescents are multifactorials.

Objectives: To identify iron status, prevalence dan risk factors of IDA in 12 to 15-year old adolescents girls in Central Jakarta.

Methods: Cross-sectional study in 12 to 15-year old adolescent girls who study in Junior High School. Subjects were classified into higher and lower social economy status (SES). Assessment of nutritional status, menstruation status and characteristics, occupation, parents education level and income, as well as iron intake. Subjects were undergo supporting examinations, such as hematological, iron parameters and C-reactive protein (CRP). Tuberculin test was done to rule out anemia of chronic disease due to tuberculosis, the most common chronic disease in Indonesia.

Results: Out of 163 subjects, prevalence of normal iron status was 69,3%. Non anemia iron deficiency prevalence was higher (17,2%, consists of 3,1% iron depletion and 14,1% iron deficiency) than IDA prevalence (13,5%). Prevalence of IDA in higher SES was lower than that in lower SES (11,5% and 15,8%). There was no significant association betwen prevalence of IDA and nutritional status, menstruation status and characteristics, SES, as well as parents’ education level and income. Bioavailable iron intake in all subjects was less than RDA, no significant association betwen bioavailable iron intake and IDA prevalence.

Conclusions: Non anemic iron deficiency prevalence that was higher than prevalence of IDA is potensial to increase prevalence of IDA in the future. Altough there is no significant association betwen IDA and its risk factors, iron intake that is less than RDA in all subjects requires more attention. Iron supplementation based on Indonesian Pediatric Society need to be reinforced to prevent and overcome iron deficiency in adolescent."

"Latar Belakang: Anak dengan leukemia limfoblastik akut ALL yang bertahan hidup cenderung mengalami obesitas, yang meningkatkan risiko ALL relaps. Obesitas dipengaruhi oleh pemberian kortikosteroid dan kemoterapi, namun juga oleh faktor-faktor lain yang hubungannya dengan obesitas pada ALL belum secara konsisten dibuktikan. Tujuan: Penelitian ini bertujuan mengetahui hubungan usia saat diagnosis ALL, jenis kelamin, status gizi saat diagnosis ALL, kelas layanan kesehatan, kelompok risiko ALL, dosis kumulatif L-asparaginase dan jenis steroid, dengan kejadian obesitas setelah pengobatan ALL fase induksi. Metode: Penelitian ini merupakan studi observasional dengan desain potong lintang yang menggunakan data rekam medis pasien ALL tahun 2014-2016 di RSUP Dr. Cipto Mangunkusumo, Jakarta. Hasil: Dari 94 pasien ALL, 84,0 berusia.

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Background: Child survivors of acute lymphoblastic leukemia ALL showed a tendency to become obese, increasing the risk of relapse. Obesity is influenced not only by administration of corticosteroid and chemotherapeutic agents, but also by other factors with which the relationships have not been consistently proven.

Purpose: This study aims to investigate the relationships between age at ALL diagnosis, sex, nutritional status at diagnosis, class of service, ALL risk group, cumulative dose of L asparaginase and type of steroid, and post induction obesity.

Method: This is an observational, cross sectional study, using data from medical records of ALL pediatric patients during the years 2014 2016 at Cipto Mangunkusumo Hospital, Jakarta.

Results: Out of 94 ALL patients, 84.0 were aged "

"Latar Belakang: Retinoblastoma adalah keganasan intraokular paling sering dan juga salah satu tumor padat tersering pada anak-anak. Di negara berkembang dimana terdapat perawatan dan deteksi dini yang baik, prognosis umumnya baik dengan tingkat kesintasan tinggi. Sayangnya, di negara berkembang termasuk Indonesia diagnosis umumnya tertunda dan kesintasan masih rendah. Hitung darah lengkap merupakan uji yang secara relative mudah dan murah serta dikatakan dapat memberikan informasi prognostik yang bernilai dan membantu menilai kesintasan pada berbagai jenis kanker. Namun, studi mengenai hal tersebut masih sangat sedikit pada kasus retinoblastoma. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi hubungan antara profil darah tepi pada presentasi awal dan kesintasan pada retinoblastoma. Metode: Penelitian ini menggunakan desain potong lintang retrospektif dengan cara mengumpulkan rekam medis pasien retinoblastoma yang didiagnosis sejak Januari 2011 sampai Desember 2013 di Rumah Sakit Ibu dan Anak Cipto Mangunkusumo 'Kiara'. Demografi dan profil klinis pasien dikumpulkan dan keluaran dikategorikan menjadi event mati dan censored tidak mati . Analisis kesintasan dilakukan menggunakan metode Kaplan Meier dengan SPSS. Hasil: Analsis survival dengan metode Kaplan-Meier dan log-rank test menunjukkan tidak ada perbedaan signifikan antar kesintasan pasien, baik berdasarkan status hemoglobin p=0,219 , status leukosit p=0,903 , dan status trombosit p=0,649 sebelum menerima terapi sistemik. Namun demikian, terlihat ada trend kesintasan.

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Background: Retinoblastoma is the most common intraocular malignancy and is also one of the most common solid tumors in children. In developed countries where treatment is good and early detection is available, the prognosis and survival is good. Unfortunately, in developing countries including Indonesia diagnosis is still often delayed and survival is still low. Complete blood count as a relatively accessible and affordable test has been studied to provide valuable prognostic information and help in assessing the survival in various types of cancers. However, such studies is still very limited in retinoblastoma cases.

Objectives: This study aims to identify the relation between peripheral blood profile on first presentation and survival in retinoblastoma.

Methods: This study uses retrospective cross sectional study design by collecting medical records of retinoblastoma patients diagnosed from January 2011 to December 2013 in Cipto Mangunkusumo Children and Maternal Hospital 'Kiara'. The demography and clinical profile of patients is collected and outcome is categorized into event dead and censored not dead. Survival analysis is done using Kaplan Meier with SPSS.

Results: Survival analysis using Kaplan Meier method and log rank test shows no significant difference in survival between patients, either according to hemoglobin status p 0,219 , leukocyte status p 0,903 , and thrombocyte status p 0,649 before receiving systemic therapy. Nevertheless, there seem to be a trend of lower mean survival in group with abnormal Hb and leukocyte, although such relation is not seen in thrombocyte.Conclusion Although there is no significant relation, there seem to be a trend in which patients with worse peripheral blood profile has worse survival."

"ABSTRAKLatar belakang. Proses timbulnya inhibitor bersifat multifaktorial baik genetik maupun lingkungan. Beberapa studi telah dilakukan untuk mengetahui faktor risiko terbentuknya inhibitor namun masih terdapat kontroversial pendapat. Tidak seperti di negara maju, di Indonesia skrining inhibitor tidak rutin dilakukan karena keterbatasan biaya dan alat sehingga diperlukan suatu penelitian yang dapat dijadikan acuan pemeriksaan inhibitor selektif.Tujuan. Mengetahui prevalens, karakteristik klinis dan faktor risiko timbulnya inhibitor pada anak dengan hemofilia A di departemen IKA- RSCM.Metode. Uji potong lintang dilakukan pada anak usia ≤18 tahun dengan perdarahan akut di pusat hemofilia terpadu IKA-RSCM. Pada subjek dilakukan pengambilan darah vena dan dilakukan pemeriksaan inhibitor menggunakan metode Bethesda assay. Orangtua diminta mengisi kuesioner mengenai usia saat pertama kali didiagnosis hemofilia, mendapat terapi faktor VIII, jenis terapi pengganti, derajat hemofilia, jenis perdarahan, dan suku bangsa ibu penderita. Analisis bivariat dilakukan dengan uji Fisher. Analisis multivariat tidak dilakukan karena tidak memenuhi syarat.Hasil penelitian. Dari 40 subjek penelitian, didapatkan prevalens inhibitor sebanyak 37,5% (15/40) dengan inhibitor high responder sebanyak 3/15 dan low responder 12/15. Median (rentang) usia subjek penelitian adalah 10 (1,5-18) tahun. Median usia saat diagnosis hemofilia pertama kali ditegakkan dan saat pertama kali mendapat terapi faktor VIII pada inhibitor positif adalah 8 dan 9 bulan. Hampir seluruh subjek (39/40) mendapat terapi konsentrat plasma, 11/15 subjek dengan inhibitor positif mendapat terapi pertama kali sebelum berusia 1 tahun, 14/15 subjek merupakan hemofilia berat dan sebagian besar (12/15) mendapat manifestasi perdarahan sendi. Suku bangsa ibu Jawa lebih sering ditemukan pada inhibitor positif (8/15). Tidak ditemukan hasil yang bermakna secara statistik antara faktor risiko dengan timbulnya inhibitor.Simpulan. Prevalens inhibitor pada penelitian ini sebesar 37,5%. Inhibitor positif lebih sering ditemukan pada penderita hemofilia berat yang mendapat terapi pertama kali sebelum berusia 1 tahun. Penelitian ini tidak berhasil membuktikan faktor risiko bermakna untuk timbulnya inhibitor pada anak dengan hemofilia A.

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ABSTRACTBackground. Several factors may influence inhibitor incidence including genetics and environment. Several studies have been conducted to determine the risk factors for inhibitor formation but there is still a controversial opinion. Unlike in developed countries, in Indonesia inhibitor screening is not routinely performed due to limited funds thus required a research that can be used as reference checks selective inhibitors.Objective. To find out the prevalence, clinical characteristics and risk factors of factor VIII inhibitor in children with hemophilia A in Child Health Department- Cipto Mangunkusumo HospitalMethods. A cross sectional descriptive study conducted in children aged ≤ 18 years old with acute bleeding at the National Hemophilia Care Center, Cipto Mangukusumo Hospital. All the subjects performed venous blood sampling and the examination of inhibitor using the Bethesda assay. Parents were asked to fill out questionnaires on age at first diagnosis of hemophilia, treated with factor VIII replacement therapy type, degree of hemophilia, types of bleeding, and the patient's mother tribes. Bivariate analysis performed by Fisher's test. Multivariate analysis was not performed because it does not qualify.Results. Out of 40 children study, showed prevalence inhibitor 37.5% (15/40) with a high responder inhibitor 3/15 and low responders 12/15. Median (range) age of subjects was 10 (1.5 to 18) years. The median age at diagnosis of hemophilia was first established and the first time the subjects get a factor VIII inhibitor therapy positive was 8 and 9 months. Almost all subjects (39/40) treated with plasma concentrates, 11/15 subjects with a positive inhibitor therapy gets first time before age 1 year, 14/15 subjects is severe hemophilia and most (12/15) of them had joint bleeding manifestations. Java native tribes more often found in the positive inhibitor (8/15). No results found a statistically significant association between the risk factors with the onset of inhibitor.Conclusion. The prevalence of inhibitors in this study was 37.5%. Positive inhibitors was more frequent in patients with severe hemophilia who received therapy for the first time before the age of 1 year old. This study failed to prove significant risk factor for the onset of inhibitors in children with hemophilia A."

"Latar Belakang. Infeksi jamur invasif (IJI) merupakan salah satu penyebab penting morbiditas dan mortalitas pada pasien dengan keganasan. Penelitian di beberapa negara mengenai kejadian IJI pada anak dengan populasi beragam mendapatkan hasil yang bervariasi, antara 5%-14%. Sampai saat ini belum ditemukan publikasi di Indonesia mengenai prevalens, karakteristik pasien anak dengan leukemia akut yang menderita IJI, spesies jamur penyebab maupun angka kematian akibat IJI. Tujuan. Mengetahui prevalens, manifestasi klinis, spesies jamur penyebab, dan mortalitas infeksi jamur invasif pada anak usia 1 bulan -18 tahun dengan leukemia akut yang mendapat kemoterapi dan mengalami neutropenia. Metode. Penelitian retrospektif deskriptif dengan menggunakan data sekunder dari rekam medis Januari 2010 sampai Desember 2011 dilakukan pada pasien anak dengan leukemia akut yang mendapat kemoterapi dan mengalami neutropenia, dan dirawat di Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangunkusumo (IKA-RSCM). Infeksi jamur invasif ditetapkan berdasarkan kriteria European Organization for Research and Treatment of Cancer (EORTC) 2002. Hasil. Besar sampel diperoleh 218 episode perawatan dari 102 pasien yang memenuhi kriteria inklusi. Prevalens IJI pada perawatan anak dengan leukemia akut dan neutropenia yang mendapat kemoterapi adalah 12 (5,5%) dari 218 perawatan. Kejadian IJI lebih sering pada pasien dengan jenis kelamin laki-laki, usia di atas 6 tahun, leukemia myeloid akut (LMA), dan kemoterapi fase induksi. Faktor pejamu yang paling banyak ditemukan adalah neutropenia>10 hari dengan manifestasi klinis tersering berupa infeksi saluran napas bawah dan lesi kulit. Spesies jamur penyebab IJI yang ditemukan adalah Candida sp. Mortalitas IJI sebesar 8/12 dengan penyebab kematian terbanyak syok sepsis. Kematian yang disebabkan infeksi jamur tidak dilaporkan. Simpulan. Prevalens IJI pada perawatan anak dengan leukemia akut dan neutropenia yang mendapat kemoterapi 5,5%. Spesies jamur penyebab IJI yang ditemukan adalah Candida sp. Tidak semua pasien dengan demam neutropenia dilakukan pemeriksaan biakan jamur. Hal ini dapat mempengaruhi angka kejadian IJI yang sebenarnya sehingga perlu penelitian lebih lanjut yang dilakukan secara prospektif untuk mendapatkan gambaran IJI yang lebih pasti.

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Background. Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in patients with malignancies. Prevalence of IFIs in children in different countries varies between 5%-14%. There has been no published data of prevalence, characteristics, causative fungi, and mortality rate in children with acute leukemia and chemotherapy-induced neutropenia in Indonesia.

Objectives. To find the prevalence, clinical manifestations, fungal cause, and mortality rate of IFIs in children aged 1 month-18 years with acute leukemia and chemotherapy-induced neutropenia in Indonesia.

Methods. This was a retrospective descriptive study using medical records of children with acute leukemia and chemotherapy-induced neutropenia admitted to Cipto Mangunkusumo Hospital’s Pediatric Department from January 2010-December 2011. Invasive fungal infection was diagnosed according to European Organization for Research and Treatment of Cancer (EORTC) 2002 criteria.

Results. A total of 218 admissions from 102 patients met the inclusion criteria. Prevalence of IFIs in acute leukemia children with chemotherapy-induced neutropenia was 12 (5.5%) from 218 admissions. IFIs were more prevalent in boys, age >6 years old, acute myeloid leukemia (AML), and induction phase of chemotherapy. The most common host factor was neutropenia >10 days, with lower repiratory tract infections and skin lesions as the most common clinical manifestations. Fungal pathogen found was Candida sp. Mortality rate was 8/12 with septic shock as the most common cause of death. IFI related mortality was not reported.

Conclusion. Prevalence of IFIs in children admitted with acute leukemia and chemotherapy-induced neutropenia was 5.5%. Fungal pathogen found was Candida sp. Fungal culture was not done in all patients with febrile neutropenia and this factor could influence the prevalence of IFIs. Further prospective research is needed to find more accurate IFIs characteristics."

"Pasien anak dengan keganasan dapat mengalami episode demam neutropenia. Etiologi bakterimia pada demam neutropenia berbeda-beda pada tiap pusat pelayan kesehatan dan berubah secara periodik. Antibiotik empiris diberikan pada pasien demam neutropenia berdasarkan klasifikasinya. Skor Rondinelli mengklasifikasikan pasien demam neutropenia menjadi risiko rendah dan risiko tinggi. Luaran dengan menggunakan skor Rondinelli belum pernah dilaporkan. Tujuan : Mengetahui karakteristik etiologi dan perjalanan klinis demam neutropenia pada anak dengan keganasan yang dirawat inap di Departemen Ilmu Kesehatan Anak RSCM. Metode : Penelitian ini adalah deskriptif retrospektif. Sampel diambil dari data sekunder berupa rekam medis pasien anak dengan keganasan yang mengalami demam neutropenia yang menjalani rawat inap di bangsal Departemen IKA FKUI/RSCM mulai bulan Januari 2010 hingga bulan September 2013. Hasil : Penelitian dilakukan pada 86 pasien anak yang mengalami 96 episode demam neutropenia yang memenuhi kriteria inklusi dan eksklusi. Prevalensi bakterimia pada episode demam neutropenia pada anak dengan keganasan adalah 17%. Proporsi kuman penyebab terbanyak bakterimia pada demam neutropenia adalah Staphylococcus sp (25%), Pseudomonas aeruginosa (25%), Klebsiella pneumonia (19%) dan Escherichia coli (13%). Penelitian ini mendapatkan luaran episode demam neutropenia pada anak dengan keganasan adalah 40% memiliki luaran sembuh, 49% memiliki luaran tidak sembuh dan 6% meninggal dunia. Berdasarkan skor Rondinelli didapatkan 30 (61%) episode demam neutropenia risiko rendah memiliki luaran sembuh dan hanya 13 (28%) episode demam neutropenia risiko tinggi yang memiliki luaran sembuh. Simpulan : Sebagian besar hasil kultur darah pada demam neutropenia adalah steril. Kuman gram negatif penyebab terbanyak bakterimia pada demam neutropenia. Demam neutropenia memiliki morbiditas yang tinggi. Skor Rondinelli dapat digunakan untuk mengklasifikasikan demam neutropenia pada anak dengan keganasan.

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Cancer children could have febrile neutropenia (FN) episodes. The bacteremia etiology of FN from each health center was different and periodically changed. Empirical antibiotic was given to the patient according to the classification. Rondinelli’s score classify FN patient to low risk and high risk. Outcome of Rondinelli’s score is not yet reported.

Purpose: To know the clinical pathway and characteristic of etiology FN in cancer children in Department of Child Health RSCM ward.

Methods: The retrospective descriptive study. Samples were taken from secondary data in medical report of a cancer child with FN in ward in Department of Child Health FKUI/RSCM from January 2010 to September 2013.

Results: There were 86 children with 96 FN episodes that fulfill the inclusion and exclusion criteria. Bacteremia prevalence in cancer child with FN episodes was 17%. The most frequent proportion bacteria as FN etiology were Staphylococcus sp (25%), Pseudomonas aeruginosa (25%), Klebsiella pneumoniae (19%), and Escherichia coli (13%). The outcome of cancer children with FN were 40% recover, 49% not recover, and 6% pass away. Rondinelli's score outcome showed 30 (61%) episodes of low risk FN recover and only 13 (28%) episodes of high risk FN recover.

Conclusions: Most of blood culture result of FN was sterile. Gram negative bacteria were the most frequent etiology for FN. FN has high morbidity."

"Latar belakang: Bayi prematur rentan kekurangan zat besi karena cadangan besi ibu rendah, kebutuhan besi untuk pertumbuhan dan pengambilan sampel laboratorium. Risiko tersebut meningkat saat bayi prematur berusia 2 bulan. Kecukupan zat besi tubuh dinilai dengan kadar feritin, besi serum (SI), saturasi transferin (Tfsat), total iron binding capacity (TIBC) dan Hb.Tujuan: Mengetahui profil besi pada bayi prematur usia kronologis 2 bulan.Metode: Studi potong lintang dilakukan terhadap bayi usia 2 bulan yang lahir usia gestasi (UG) 32-36 minggu saat berkunjung ke klinik tumbuh kembang. Pemeriksaan darah tepi lengkap, apusan darah tepi, SI, TIBC, Tfsat dan feritin dilakukan pada sampel darah vena. Data lain diperoleh dari wawancara dan telaah rekam medik.Hasil : Studi diikuti oleh 83 subjek yang terdiri dari 51% lelaki dan 93% lahir dari ibu berusia >20 tahun. Berat lahir terkecil adalah 1.180 g dan terbesar adalah 2.550 g. Prevalens ADB sebesar 6% dan DB sebesar 10%. Subjek ADB memiliki kadar Hb terendah 6,8 g/dL dan feritin terendah 8,6 ng/mL. Median kadar SI adalah 48 μg/dL; TIBC 329 μg/dL dan Tfsat 17%. Bayi ADB sebagian besar lelaki (5/5), kenaikan BB ≥2x berat lahir (4/5), tidak disuplementasi besi (3/5), latar belakang pendidikan ibu rendah (3/5) dan golongan sosial-ekonomi rendah- menengah ke bawah (3/5).Simpulan: Prevalens ADB sebesar 6% dan DB sebesar 10%. Sebagian besar subjek yang mengalami DB dan ADB memiliki kadar SI, Tfsat dan feritin rendah serta TIBC meningkat. Subjek lelaki dengan kenaikan BB ≥2x berat lahir, tidak disuplementasi besi, latar belakang pendidikan ibu rendah dan golongan sosial ekonomi rendah-menengah ke bawah lebih banyak yang mengalami ADB.

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Background: Preterm infants are vulnerable to iron deficiency (ID) due to lack of maternal iron stores, phlebotomy and increasing demand during growth. Risk of ID increases when hemoglobin (Hb) level started to decrease at 2 months of age. Iron body adequacy is measured by examining feritin, serum iron (SI), transferrin saturation, total iron binding capcity (TIBC) and Hb.Objective: To describe iron profile in preterm infants at 2 months of chronological age (CA).Methods: A cross-sectional study was conducted to 2 months old infants born at 32-36 gestational age visiting Growth and Development Clinics. Parents interview and medical record review were taken at visit. Complete blood count, blood smear, SI, TIBC, Tfsat and ferritin level were performed.Results: Eighty three subjects were enrolled in this study. Mostly were male (51%) and born from mother >20 years old (93%). The lowest birth weight was 1,180 g and the highest was 2,550 g. Prevalence of IDA is 6% and ID is 10%. The lowest Hb level found in IDA infants was 6.8 g/dL and ferritin level was 8.6 ng/mL. Median of SI level was 48 μg/dL; TIBC 329 μg/dL; and Tfsat 17. Subjects with IDA were mostly men (5/5), achieved more than twice birth weight (4/5), non-iron supplemented (3/5), born from low education background mother (3/5) and has low socio-economic status (3/5).Conclusions: Prevalence of IDA is 6% and ID is 10%. Most subjects with ID and IDA have low SI, high TIBC, low Tfsat and low ferritin level. Male subjects who weigh ≥twice birth weight, non-iron supplemented, born form low educational background and socioeconomic status mother were mostly suffer from IDA."

"ABSTRAKLatar belakang: Peran utama matriks metalloproteinase-9 (MMP-9) adalah mendegradasi matriks ekstraseluler sehingga menyebabkan terjadinya invasi dan infiltrasi sel tumor. Tujuan utama penelitian ini adalah menilai kadar MMP-9 pada pasien leukemia limfoblastik akut-L1 (LLA-L1).Metode: Penelitian dengan metode kohort prospektif telah di lakukan di RSUP Dr Wahidin Sudirohusodo, Makassar dari bulan Augustus sampai Desember 2014. Jumlah pasien LLA sebanyak 20 orang yang dikelompokkan menjadi risiko tinggi (RT) dan risiko biasa (RB). Luaran pasien di kelompokkan menjadi remisi dan tidak remisi setelah kemoterapi fase induksi.Hasil: Pada kelompok LLA dengan RT dan RB masing-masing terdiri dari 6(30%) dan 14(70%). Hasil analisis statistik menunjukkan tidak terdapat perbedaan bermakna kadar MMP-9 antara kelompok RT dan RB sebelum dan sesudah kemoterapi fase induksi dengan nilai p=0.216 dan 0.68, perubahan kadar MMP-9 antara RT dan RB sebelum dan sesudah kemoterapi fase induksi dengan nilai p=0.60 dan 0.975, kadar MMP-9 sebelum kemoterapi fase induksi antara kelompok remisi dan yang tidak remisi dengan nilai p=0.614 dan kadar MMP-9 sebelum kemoterapi fase induksi antara kelompok RT dan RB dengan nilai p=0.402 (p>0.05).Kesimpulan: Tidak terdapat perbedaan bermakna kadar MMP-9 antara kelompok RT dan RB sebelum dan sesudah kemoterapi fase induksi, perubahan kadar MMP-9 pada kelompok RT dan RB sebelum dan sesudah kemoterapi fase induksi, kadar MMP-9 sebelum kemoterapi fase induksi anrata kelompok remisi dan tidak remisi, kadar MMP-9 pada yang remisi antara kelompok RT dan RB.

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ABSTRACTBack ground: The main role of matrix metalloproteinase-9 (MMP-9) in invasive and infiltration is degradation of extracellular matrix. The objective of this study was to evaluate the serum level of MMP-9 in children with acute lymphoblastic leukemia-L1 (ALL-L1) as prognostic marker.Methods: A prospective cohort study was conducted in Dr Wahidin Sudirohusodo General Hospital, Makassar from August to December to 2014. Twenty patients were enrolled and devided into high risk (HR) and standard risk (SR) ALL group. In terms of outcome, patients were classified into remission and non-remission induction phase of chemotherapy.Result: High risk and SR ALL group consisted of 6(30%) and 14(70%) patients respectively. Statistical analysis showed no significant differences levels of MMP-9 between HR and SR groups before and after induction phase of chemotherapy with p=0.216 and 0.68, changes levels of MMP-9 between HR and SR groups before and after induction phase of chemotherapy with p=0.60 and 0.975, levels of MMP-9 before induction phase of chemotherapy between remission and non-remission groups with p=0.614 and levels of MMP-9 before induction phase chemotherapy in remission between HR and SR groups with p=0.402 (p>0.05).Conclusion: MMP-9 expression was no significant difference in HR and SR groups before and after induction phase of chemotherapy, changes MMP-9 expression between HR and SR before and after induction phase of chemotherapy, MMP-9 expression between remission and non-remission groups and MMP-9 expression in remission between HR and SR groups.;"

"Latar belakang: Leukemia limfoblastik akut LLA merupakan jenis kanker tersering pada anak. Faktor penyakit dan kemoterapi dapat menyebabkan ketidakseimbangan nutrisi makro maupun mikro. Zinc adalah salah satu nutrien mikro yang memiliki banyak peran fisiologis dalam tubuh, namun kadarnya berkurang pada penyakit limfoproliferatif. Defisiensi zinc cenderung meningkatkan morbiditas pada anak LLA, salah satunya infeksi. Tujuan: Penelitian ini bertujuan untuk mencari proporsi defisiensi zinc pada LLA anak serta hubungannya dengan kejadian infeksi. Pasien dan metode: Disain penelitian potong lintang deskriptif-analitik, tempat pelaksanaan di Departemen Patologi Klinik dan Departemen Ilmu Kesehatan Anak RSUPN Dr. Cipto Mangunkusumo, Jakarta. Jumlah subjek 81 anak LLA, yang terdiri dari 26 pasien baru dan 55 pasien pada berbagai fase kemoterapi. Kadar zinc diukur menggunakan prinsip kolorimetri dengan alat spektrofotometer otomatis. Hasil: Proporsi defisiensi zinc pada pasien yang baru terdiagnosis sebesar 65.4 n= 26 dan pada pasien kemoterapi sebesar 49 n= 55 . Terdapat hubungan bermakna antara defisiensi zinc dengan kejadian infeksi p= 0.003; RR= 3.2, 95 CI 1.33 ndash; 7.69 Kesimpulan: Defisiensi zinc ditemukan pada anak dengan LLA sebelum kemoterapi dimulai, maupun pada berbagai fase kemoterapi. Risiko infeksi lebih besar pada anak LLA yang mengalami defisiensi zinc. Suplementasi zinc dapat dipertimbangkan untuk meningkatkan prognosis, namun perlu dilakukan penelitian lebih lanjut mengenai efektivitasnya.

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Background: Acute lymphoblastic leukemia ALL is a most common malignancy in children. Disease factors and chemotherapy effects may cause both macro or micro nutritional imbalance. Zinc is one of the micro nutrients that has many physiological roles in the body, but the levels may decrease in ALL. Zinc deficiency tend to increase morbidity in children with ALL, including infection.

Objective: The present study was done in order to find the proportion of zinc deficiency in pediatric ALL patients and to identify its relationship with the incidence of infection.

Patients and methods: This cross sectional study was carried out in the Departement of Clinical Pathology and Department of Paediatric Health, RSUPN Dr. Cipto Mangunkusumo, Jakarta. We conducted 81 paediatric ALL patients, consisted of 26 newly diagnosed and 55 in various phases of chemotherapy. Zinc levels were measured using colorimetric method by an automatic spectrophotometer.

Results: The proportion of zinc deficiency is 65.4 in newly diagnosed patients and 49 in children with various chemotherapy phases. There is a significant association between zinc deficiency and the incidence of infection p 0.003 RR 3.2, 95 CI 1.33 ndash 7.69.

Conclusion: zinc deficiency was found in children with LLA, and has significant association with the risk of infection. Zinc supplementation may be considered to improve the prognosis, however futher study of safety and side effect is necessary. "

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"