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"Latar belakang. Gangguan tidur pada remaja memiliki prevalens yang tinggi dan dapat memengaruhi prestasi akademik di sekolah. Namun, sejauh ini di Indonesia, belum terdapat studi yang meneliti prestasi akademik pada remaja dengan gangguan tidur serta faktor yang berhubungan.Tujuan. Penelitian ini untuk mengetahui: (1) prevalens dan pola gangguan tidur berdasarkan SDSC, (2) proporsi murid SMP dengan gangguan tidur yang memiliki prestasi akademik di bawah rerata, (3) hubungan antara: jenis kelamin, motivasi dan strategi belajar, nilai IQ, tingkat pendidikan ibu, tingkat sosial ekonomi keluarga, struktur keluarga, pendidikan di luar sekolah, adanya TV/komputer di kamar tidur, durasi tidur di hari sekolah, perbedaan waktu tidur dan bangun, dan prestasi akademik murid SMP dengan gangguan tidur.Metode. Penelitian potong lintang analitik di lima SMP di Jakarta pada bulan Januari hingga Maret 2013. Skrining gangguan tidur dengan kuesioner Sleep Disturbance Scale for Children dilakukan terhadap 491 orang murid SMP di Jakarta. Murid yang memenuhi kriteria gangguan tidur diminta mengisi kuesioner motivasi dan strategi pembelajaran. Peneliti meminta nilai IQ subjek penelitian.Hasil. Terdapat 129 subjek yang memenuhi kriteria gangguan tidur. Empat orang subjek di drop-out karena tidak memiliki nilai IQ. Prevalens gangguan tidur sebesar 39,7% dengan jenis gangguan tidur terbanyak adalah gangguan memulai dan mempertahankan tidur (70,2%). Sebanyak 47,6% subjek memiliki prestasi akademik di bawah rerata. Sebagian besar subjek perempuan (71%), termasuk sosial ekonomi menengah ke bawah (58,9%), memiliki motivasi dan strategi belajar yang cukup (72,6%), dan mengikuti pendidikan di luar sekolah (87,9%). Tiga belas subjek yang memiliki nilai IQ di bawah rata-rata tidak diikutsertakan dalam analisis bivariat dan multivariat. Berdasarkan uji regresi logistik, faktor yang paling berhubungan dengan prestasi akademik di bawah rerata secara berurutan, yaitu pendidikan di luar sekolah (> 2 jenis, non-akademik), nilai IQ rata-rata, dan jenis kelamin lelaki.Simpulan. Prevalens gangguan tidur pada murid SMP di Jakarta adalah 39,7% dengan jenis gangguan tidur terbanyak adalah gangguan memulai dan mempertahankan tidur. Sebanyak 47,6% subjek memiliki prestasi akademik di bawah rerata. Faktor yang terbukti berhubungan dengan prestasi akademik di bawah rerata adalah pendidikan di luar sekolah (> 2 jenis, non-akademik), nilai IQ rata-rata, dan jenis kelamin lelaki.

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Background. Sleep disorders are prevalent in adolescents and may influence their academic achievement at school. However, in Indonesia, no research has ever been done to study academic achievement in students with sleep disorders and related factors.

Objectives. This study aimed to define: (1) the prevalence of sleep disorders and their patterns based on the SDSC questionnaire, (2) the proportion of junior high school students having low average academic achievement, (3) the relationship between factors; i.e gender, motivation and learning strategies, IQ level, mothers' educational level, socioeconomic level, family structure, non-formal education, TV/computer set inside the bedroom, sleep duration during schooldays, bedtimewakeup time difference; and the academic achievement in junior high school students with sleep disorders.

Method. This was an analytical cross-sectional study, performed at five junior high schools in Jakarta between January to March 2013. Screening for sleep disorders, based on the Sleep Disturbance Scale for Children questionnaires, was done in 491 junior high school students. Students who fulfilled the criteria of sleep disorders, were asked to fill in the Motivated Strategies for Learning Questionnaire (MSLQ). The IQ level of each subjects was also measured.

Results. There were 129 subjects who fulfilled the sleep disorders criteria. Four subjects were dropped out due to they didn?t have IQ level. The prevalence of sleep disorder in this study was 39.7%, mostly difficulty in initiating and maintaining sleep (70.2%). There were 47.6% subjects had low average academic achievement. As many as 13 subjects had low average IQ level and were not included in bivariate and multivariate analysis. Subjects mostly female (71%), with middle-low income (58.9%), had moderate motivation and learning strategies (72.6%), and attended non-formal education (87.9%). Based on the logistic regression analysis, the most influencing factors to the low average academic achievement are consecutively: the non-formal education ( > 2 types, non-academic), the average IQ level, and male sex.

Conclusion. The prevalence of sleep disorders in junior high school students in Jakarta are 39.7%, mostly difficulty in initiating and maintaining sleep. There were 47.6% subjects had low average grade. Factors related to the low average academic achievement are non-formal education ( > 2 types, non-academic), the average IQ level, and male sex."

" ABSTRAKLatar Belakang: Thalassemia merupakan hemoglobinopati herediter yang menyebabkan anemia kronis, sehingga pasien membutuhkan transfusi darah secara rutin yang dapat menyebabkan kelebihan besi. Kelebihan besi dapat memicu beberapa komplikasi, salah satunya adalah gangguan pertumbuhan. Tujuan: Mengetahui hubungan antara kadar hemoglobin dan profil besi dengan gangguan pertumbuhan pada pasien thalassemia. Metode: Studi cross-sectional pada 102 pasien thalassemia di Pusat Thalassemia RSCM Jakarta. Hasil: Empat puluh lima 44,1 subjek adalah perempuan dan 57 55,9 subjek adalah lelaki dengan rentang usia 9-14 tahun. Tiga puluh sembilan 38,2 subjek memiliki perawakan pendek dan 63 61,8 subjek memiliki perawakan normal. Nilai median kadar feritin serum pada pasien perawakan pendek adalah 2062 318-8963 ng/mL dan pada pasien perawakan normal adalah 3315 422,9-12269 ng/mL p.

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ABSTRACTBackground Thalassemia is a hereditary hemoglobinopathy which causes chronic anemia, thus the patients need regular blood transfusion which can cause iron overload. It leads to some complications, one of them is growth retardation. Aim To determine the association between hemoglobin level and iron profile with growth retardation on thalassemia patients. Methods cross sectional study on 102 patients in Thalassemia Center of RSCM Jakarta. Results Forty five 44.1 subjects are girls and 57 55.9 subjects are boys. Their age range was 9 14 years old. Thirty nine 38.2 subjects had short stature and 63 61.8 subjects had normal stature. Median of serum ferritin level in the short stature patients was 2062 318 8963 ng mL and normal stature was 3315 422.9 12269 ng mL p 0.001 . Median of transferrin saturation in the short stature patients was 88 19 100 and normal stature was 83 35 100 p 0.94 . Mean of pra transfusion hemoglobin level in the short stature patients was 8.14 SD 0.93 g dL and normal stature was 8.07 SD 0.86 g dL p 0.68 . Conclusion there is a significant association between serum ferritin level and growth retardation, but there is no significant association between transferrin saturation and pra transfusion hemoglobin level with growth retardation."

"ABSTRAKLatar belakang: Thalassemia merupakan suatu penyakit gen tunggal yang disebabkan oleh kerusakan pada gen dalam mengontrol produksi protein sehingga sel darah merah akan mudah pecah dan pengikatan oksigen terganggu. Hal ini akan memicu terjadinya anemia dan membutuhkan transfusi darah secara rutin dan seumur hidup. Transfusi darah rutin menyebabkan terjadinya akumulasi besi yang memicu beberapa komplikasi, salah satunya adalah gangguan pada fungsi pankreas. Tujuan: Untuk mengetahui hubungan antara profil besi dengan gangguan fungsi pankreas berupa diabetes mellitus dan gangguan toleransi glukosa pada subjek thalassemia mayor. Metode: Desain potong-lintang pada 79 subjek thalassemia mayor di Pusat Thalassemia RS Cipto Mangunkusumo Jakarta. Hasil: Dua 2,53 subjek mengalami gangguan toleransi glukosa dan 77 97,47 subjek dengan nilai toleransi glukosa normal. Nilai median feritin serum pada kelompok gangguan toleransi glukosa yakni 5595,5 2062,0-9199,0 ng/mL sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 3309,0 487,0-11247,0 ng/mL p= 0,574 . Nilai median saturasi transferin pada subjek gangguan toleransi glukosa yakni 76 52-100 sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 89 11-100 p= 0,827 . Kesimpulan: Tidak didapatkan adanya hubungan yang signifikan antara kadar feritin serum dan saturasi transferin terhadap gangguan fungsi pankreas.

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ABSTRACTBackground Thalassemia is a single gene disease that is caused by defect on gene which controls the protein production that eventually leads to red blood cell lysis and defect on oxygen binding capacity. Therefore, the patient needs regular blood transfusion during his lifetime. Regular blood transfusion causes iron accumulation that leads to complications such as defect on pancreas function. Aim To know the association between iron profile and defect on pancreas function such as diabetes mellitus and glucose intolerance in major thallassemia subjects. Methods Cross sectional design on 79 major thalassemia subjects in Thalassemia Center of RS Cipto Mangunkusumo, Jakarta. Results Two 2.53 subjects were glucose intolerant and 77 97,47 subject has a normal blood glucose. Median value of serum ferritin level in glucose intolerant subjects was 5595.5 2062,0 9199,0 ng mL meanwhile the median value of serum ferritin level in normal glucose level subjects was 3309.0 487,0 11247,0 ng mL p 0.574 . The median value of transferrin saturation in glucose intolerant patients is 76 52 100 meanwhile the median value of tranferrin saturation level in normal glucose level subjects is 89 11 100 p 0,827 . Conclusion There is no significant association between serum ferritin level and transferrin saturation and defect of pancreas function."

"Transfusi darah berulang pada subjek thalassemia mayor berpotensi menyebabkan transmisi virus hepatitis B dan / atau C. Infeksi dapat menyebabkan perubahan kadar feritin serum. Penelitian ini bertujuan untuk mengetahui prevalensi infeksi varian virus hepatitis dan hubungannya dengan kadar feritin serum. Penelitian potong-lintang dilakukan dengan membandingkan kadar feritin serum antar kelompok subjek terinfeksi varian virus hepatitis pada subjek thalassemia mayor di RS Cipto Mangunkusumo Kiara Jakarta antara tahun 2006-2015. Hasil penelitian menyebutkan bahwa prevalensi infeksi hepatitis keseluruhan sebesar 10,06 subjek dan didapatkan nilai p < 0,050 dari uji komparasi antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis. Pevalensi infeksi hepatitis keseluruhan pada penelitian ini lebih rendah dibandingkan dengan penelitian lain dan terdapat hubungan yang bermakna antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis.

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Regular blood transfusion in major thalassemia subjects potentially mediates infection of hepatitis B and or C virus. Infection can change serum ferritin level. This research intends to know the prevalence of hepatitis virus variant infection and its association with serum ferritin level. This research used cross sectional method to compare serum ferritin level within each hepatitis virus variant infection subject's groups on major thalassemia subjects in RS Cipto Mangunkusumo Kiara Jakarta within 2006 2015. Results showed that prevalence of hepatitis in total was 10.06 subjects and p value from comparison test of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis is p 0,050. Prevalence of hepatitis in total was lower than prevalence value in the other studies and there were significant association of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis."

"ABSTRAKPubertas terlambat merupakan salah satu komplikasi utama pada pasien thalassemia mayor. Penyebab utama pubertas terlambat pada pasien thalassemia mayor adalah penumpukan besi pada kelenjar hipofisis. Selain itu, anemia kronis pada pasien thalassemia mayor juga dapat menyebabkan pubertas terlambat. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara profil besi dan kadar hemoglobin pra-transfusi dengan status pubertas pasien thalassemia mayor remaja di Pusat Thalassemia RSCM. Metode: Penelitian ini merupakan studi cross-sectional yang melibatkan 47 pasien thalassemia mayor dengan rentang usia 13-18 tahun untuk pasien perempuan dan 14-18 tahun untuk pasien lelaki di Pusat Thalassemia RSCM. Profil besi subjek ditentukan dari kadar feritin serum dan saturasi transferin subjek. Status pubertas subjek ditentukan berdasarkan Tanner Staging. Hasil & Diksusi: Berdasarkan kadar feritin serum, terdapat 47 (100%) subjek yang mengalami kelebihan besi, dengan 35 (75%) diantaranya mengalami kelebihan besi berat. Nilai median feritin serum subjek adalah 3645 (1415-12636) ng/mL. Berdasarkan saturasi transferin, sebesar 36 (77%) subjek mengalami kelebihan besi, dengan nilai median saturasi transferin sebesar 85 (28-100)%. Terdapat 42 (89%) subjek yang mengalami anemia, dengan nilai median kadar hemoglobin pra-transfusi sebesar 8,0 (4,8-9,5) g/dL. Pubertas terlambat ditemukan pada delapan (17%) subjek. Secara statistik, tidak terdapat hubungan yang bermakna antara feritin serum dengan status pubertas (p = 0,183), saturasi transferin dengan status pubertas (p = 0,650), dan kadar hemoglobin pra-transfusi dengan status pubertas (p = 0,932). Berdasarkan hasil tersebut, profil besi dan kadar hemoglobin pra-transfusi tidak berhubungan dengan status pubertas pasien thalassemia mayor remaja di Pusat Thalassemia RSCM.

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ABSTRAKIntroduction Delayed puberty is a major complication in thalassemia major patients. Delayed puberty occurs due to accumulation of iron in the pituitary gland. In addition, chronic anemia in thalassemia major patients can cause delayed puberty.Objectives This study aims to find the association between iron profile and pre transfusion hemoglobin level with pubertal status in adolescent thalassemia major patients in Thalassemia Centre RSCM.Methods This was a cross sectional study that involved 47 thalassemia major patients aged 13 to 18 years for female patients and 14 to 18 years for male patients in Thalassemia Centre RSCM. Iron profile was determined from serum ferritin level and transferrin saturation. Pubertal status was determined by Tanner Staging.Results Discussion Based on serum ferritin level, 47 100 subjects had iron overload, in which 35 75 subjects had severe iron overload. The median of serum ferritin level was 3645 1415 12636 ng mL. Based on transferrin saturation, 36 77 subjects had iron overload. The median of transferrin saturation was 85 28 100 . Forty two 89 subjects were found anemic. The median of pre transfusion hemoglobin level was 8,0 4,8 9,5 g dL. Delayed puberty occurred in eight 17 subjects. Statistically, no significant associations were found between serum ferritin level and pubertal status p 0.183 , transferrin saturation and pubertal status p 0.650 and pre transfusion hemoglobin level and pubertal status p 0,932 . Based on the results, iron profile and pre transfusion hemoglobin level are not associated with pubertal status in adolescent thalassemia major patients in Thalassemia Centre RSCM."

"Latar belakang. Jumlah pasien keganasan anak di Indonesia tertinggi di Asia Tenggara dan pneumonia merupakan komplikasi infeksi tersering serta memiliki luaran yang lebih berat. Namun, hingga saat ini belum ada penelitian mengenai prevalens, karakteristik, dan faktor risiko kejadian pneumonia pada pasien keganasan anak di IndonesiaTujuan. Mengetahui prevalens, karakteristik, dan faktor-faktor yang memengaruhi kejadian pneumonia pada pasien keganasan anak di RSCM.Metode. Penelitian ini merupakan studi deskriptif analitik dengan metode potong lintang retrospektif menggunakan data rekam medis pasien. Subjek yang diteliti ialah seluruh pasien keganasan berusia 1 bulan-18 tahun yang dirawat inap di IGD, PICU, dan bangsal anak RSCM dari Januari 2021 sampai Desember 2023. Faktor risiko yang dianalisis, antara lain usia, jenis keganasan, status imunisasi, status gizi, tipe terapi keganasan, neutropenia, dan riwayat rawat inap ≥ 14 hari.Hasil. Terdapat 162 subjek yang memenuhi kriteria inklusi dan eksklusi dalam penelitian. Prevalens pneumonia pada pasien keganasan anak di RSCM sebesar 43,2% (70/162) subjek, terdiri dari 78,5% (55/70) kasus pneumonia terkait RS dan 21,4% (15/70) kasus pneumonia komunitas. Karakteristik subjek dengan pneumonia, antara lain median usia 5,3 tahun (min-mak 0,2-17,5 tahun), median usia awitan keganasan 4,7 tahun (min-mak 0-17,3 tahun), jenis kelamin lelaki 57,1% subjek, pengidap leukemia 55,7% subjek, imunisasi tidak lengkap 38,6% subjek, status gizi kurang/buruk 54,3% subjek, terapi keganasan berupa kemoterapi 61,4% subjek, neutropenia 65,7% subjek, dan riwayat rawat inap ≥14 hari 34,3% subjek. Profil klinis dan pemeriksaan penunjang pada subjek dengan pneumonia, yakni 37,1% subjek mengalami pneumonia sangat berat, terapi oksigen dengan kecepatan  >6 lpm 40% subjek, 52,8% subjek tidak terdapat leukositosis, kadar CRP meningkat pada 80% subjek, kadar PCT meningkat pada 71,4% subjek, dan rontgen dada kesan sugestif pneumonia pada 82,9% subjek. Hasil analisis multivariat faktor yang memengaruhi kejadian pneumonia dan pneumonia terkait RS adalah status gizi kurang/buruk (AOR 3,24; IK 95% 1,49-7,05; p=0,003 dan AOR 2,98; IK 95% 1,24-7,17; p=0,015), neutropenia (AOR 4,15; IK 95% 1,94-8,84; p<0,001 dan AOR 4,59; IK 95% 1,94-10,86; p<0,001), serta riwayat rawat inap (AOR 8,48; IK 95% 2,63-27,31; p<0,001 dan AOR 12,34; IK 95% 3,71-41,09; p<0,001).Simpulan.Faktor yang memengaruhi kejadian pneumonia, khususnya pneumonia terkait RS pada pasien keganasan anak adalah status gizi kurang/buruk, neutropenia, dan riwayat rawat inap ≥ 14 hari.

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Background. The number of pediatric malignancies in Indonesia is the highest in Southeast Asia. Pneumonia is the most common infection in childhood cancer and also has more severe outcomes than normal children. However, there has been no research regarding the prevalence, characteristics, and risk factors influencing pneumonia in pediatric patients with malignancy in Indonesia

Objectives. To determine the prevalence, characteristics, and risk factors influencing pneumonia in pediatric patients with malignancy at RSCM.

Method. This research was a descriptive-analytical study with a retrospective cross-sectional design using medical records. The subjects studied were all malignancy patients aged 1 month-18 years who were hospitalized in the ER, PICU, and RSCM pediatric wards from January 2021 to December 2023. The risk factors which studied were age, type of malignancy, immunization status, nutritional status, type of malignancy therapy, neutropenia, and a history of hospitalization ≥ 14 days.

Result. 162 subjects met the inclusion and exclusion criteria in the study. The prevalence of pneumonia in pediatric malignancy patients at RSCM was 43,2% (70/162) subjects, consisting of 78,5% (55/70) cases of hospital-acquired pneumonia and 21,4% (15/70) cases of community-acquired pneumonia. Basic characteristics of the subjects, including median age 5,3 years (min-max 0,2-17,5 years), median age of malignancy onset 4,7 years (min-max 0-17,3 years), male 57,1% subjects, leukemia 55,7% subjects, incomplete immunization 38,6% subjects, malnutrition 54,3% subjects, chemotherapy in 61,4% subjects, neutropenia in 65,7% subjects, and history of hospitalization ≥ 14 days in 34,3% subjects. The clinical profiles and laboratory examinations in subjects with pneumonia, including 37,1% subjects had very severe pneumonia, 40% subjects had oxygen therapy >6 lpm, 52,8% subjects had no leukocytosis, CRP level increased in 80% subjects, PCT level increased in 71,4% subjects, and chest x-ray impression suggestive of pneumonia in 82,9% subjects. Multivariate analyses result of risk factors influencing pneumonia and hospital-acquired pneumonia are moderate/severe malnutrition (AOR 3,24; 95% CI 1,49-7,05; p = 0,003 and AOR 2,98; 95% CI 1,24-7,17; p = 0,015), neutropenia (AOR 4,15; 95% CI 1,94-8,84; p <0,001 and AOR 4,59; 95% CI 1,94-10,86; p <0,001) and history of hospitalization (AOR 8,48; 95% CI 2,63-27,31; p <0,001 and AOR 12,34; 95% CI 3,71-41,09; p <0,001).

Conclusion. Moderate/severe malnutrition, neutropenia, and a history of hospitalization ≥14 days are risk factors for pneumonia, especially hospital-acquired pneumonia in pediatric patients with malignancy."

"Latar belakang: Thalassemia merupakan kelainan hemoglobinopati yang cukup banyak di Indonesia. Terapi utama thalassemia mayor adalah transfusi seumur hidup. Transfusi berulang memiliki efek samping. Salah satunya adalah terbentuknya aloantibodi sel darah merah. Prevalens dan faktor-faktor yang memengaruhi aloantibodi pada pasien thalassemia masih belum ada di Indonesia. Uji Coombs sebagai standar diagnosis merupakan pemeriksaan yang mahal dan hanya tersedia di pusat tertentu. Metode lain yang lebih mudah diperlukan untuk memprediksi terbentuknya aloantibodi tersebut. Tujuan: Untuk mengetahui prevalens aloantibodi sel darah merah di populasi Indonesia dan mendapatkan faktor-faktor yang memengaruhinya. Membuat sistem skoring untuk memprediksikan probabilitas terbentuknya aloantibodi sel darah merah berdasarkan faktor-faktor tersebut. Metode: Analisis terhadap 162 rekam medis subjek yang telah dilakukan uji Coombs di Pusat Thalassemia Jakarta pada tahan 2005-2013. Hasil: Dari 162 subjek didapatkan 31 (19%) subjek memiliki aloantibodi dan 4 (2,4%) subjek menderita AIHA. Jenis aloantibodi terbanyak yang terdeteksi adalah anti-M (29%). Faktor-faktor yang memengaruhi terbentuknya aloantibodi adalah tingginya volume transfusi, jarak antar transfusi, lama transfusi, kadar leukosit dan pajanan PRC biasa. Berdasarkan faktor-faktor risiko tersebut, sistem skoring didisain untuk memprediksi kemungkinan terbentuknya aloantibodi. Kesimpulan: Prevalens aloantibodi pada pasien thalassemia di Indonesia cukup tinggi. Pemberian PRC leukodeplesi pelu direkomendasikan pada pasien dengan transfusi berulang. Prediksi terbentuknya aloantibodi dapat dilakukan melalui sistem skoring terutama di tempat yang tidak tersedia uji Coombs.

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Background: Thalassemia major is a common genetic disease in Indonesia. The principal treatment of thalassemia major is lifelong blood transfusion, which is frequently complicated by alloantibody. Limited data are available on the frequency of RBC alloantibody and factors influencing in major β-thalassemia patients. Coombs test, as a standard tool to diagnose alloantibody, is only available on particular Red Cross Centre. Therefore, it is necessary to find another tool to predict the probability of alloantibody formation.

Aim: To investigate the prevalence of RBC alloantibody among thalassemia major patients in Thalassemia Centre Jakarta. To describe factors influencing RBC alloantibody production and develop scoring system to predict its probability.

Methods: We analyzed the clinical and transfusion records of 162 thalassemia major patients who have been examined for Coombs test. All of the patients were registered in Thalassemia Center, Cipto Mangunkusumo hospital from 2005 until 2013.

Results: Of the 162 subjects, 31 (19%) developed RBC alloantibody and four patients (2,4%) developed autoimmune hemolytic anemia. The most common alloantibody was anti-M (29%).Several factors were found to contribute to high alloantibody rate in this study, including high volume of transfusion, duration of transfusion, white blood count level, transfusion interval, and PRC exposure. From those factors, scoring system has been developed to predict alloantibody formation in thalassemia patients.

Conclusion: We concluded that there is a high rate of RBC alloantibody in major thalassemia patients in our center. We also suggest that leukocyte-poor PRC should be given to all patients with multiple transfusions. In remote area where Coombs test is not available, scoring system can be used to predict the probability of alloantibody formation."

"[ABSTRAKLatar Belakang: Angka kejadian trombositopenia pada neonatus dilaporkan antara 22-35%, dan salah satu komplikasinya adalah perdarahan intraventrikular (PIV). Penelitian sebelumnya di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta melaporkan angka kejadian PIV masih tinggi pada bayi usia gestasi < 35 minggu sebesar 43,47%. Perdarahan intraventrikular menyebabkan dampak yang berat pada perkembangan neurologis dan mortalitas. Di Indonesia, belum ada penelitian mengenai hubungan trombositopenia dan PIV. Tujuan: Mengetahui hubungan trombositopenia dengan PIV pada bayi usia gestasi < 35 minggu dan korelasi antara derajat berat trombositopenia dan derajat berat PIV. Metode: Penelitian potong lintang dengan penelusuran rekam medis dilakukan di Divisi Neonatologi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RSCM pada subjek yang dirawat pada bulan Januari 2012 sampai Desember 2014 dengan diagnosis PIV. Subjek dibagi menjadi kelompok PIV ringan sedang (derajat ≤ 2) dan berat (derajat > 2). Nilai trombosit dicatat pada hari yang sama dengan diagnosis PIV. Digunakan uji Pearson?s chi-square, Fischer, analisis multivariat, dan korelasi untuk analisis data. Hasil: Angka kejadian PIV berat dengan trombosit < 100.000/uL sebesar 28,2% dibanding 10,4% pada nilai trombosit ≥ 100.000/uL (p=0,014). Berdasarkan analisis multivariat, faktor yang memiliki pengaruh terhadap terjadinya PIV berat adalah usia gestasi < 32 minggu dan penggunaan alat bantu napas berupa ventilator dan high frequency oscillatory ventilation (HFOV). Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV (koefisien korelasi 0,21). Simpulan: Trombositopenia tidak memiliki peranan pada terjadinya PIV berat. Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV.

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ABSTRACTBackground: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson?s chi-squared, Fischer's tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn?t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH., Background: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson’s chi-squared, Fischer’s tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn’t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH.]"

"ABSTRAKLatar belakang: Thalassemia merupakan kelainan genetik terbanyak di dunia, termasuk Indonesia. Pasien thalassemia mayor berisiko mengalami gangguan fungsi neurokognitif akibat anemia kronik dan penumpukan besi. Tujuan: mengetahui prevalens abnormalitas hasil EEG dan tes IQ, menganalisis faktor-faktor yang diduga berhubungan dengan gangguan fungsi neurokognitif pada anak dengan thalassemia mayor usia saat diagnosis, lama transfusi, pendidikan pasien, rerata Hb pra-transfusi, kadar feritin serum, saturasi transferin, dan komplians terhadap obat kelasi besi , serta untuk mengetahui apakah gangguan neurokognitif dapat memengaruhi fungsi sekolah. Metode: Penelitian potong lintang deskriptif analitik antara April 2016-April 2017. Pengukuran tes IQ menggunakan WISC-III. Hasil: Total subyek adalah 70 anak thalassemia mayor berusia antara 9 hingga 15,5 tahun. Prevalens hasil EEG abnormal adalah 60 dan prevalens skor IQ abnormal

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ABSTRACTBackground Thalassemia is the most common hereditary disorders worldwide, including Indonesia. Chronic anemia and iron overload in thalassemia major lead to several risk factors including neurocognitive problems. Aim To investigate the prevalence of abnormal EEG and IQ test, to identify the factors related to neurocognitive function in children with thalassemia major age at diagnosis, years of transfusion, patients education, pre transfusion haemoglobin level, ferritin, transferrin saturation, and compliance to chelation , and to identify whether neurocognitive dysfunction affects child rsquo s school performance. Methods A cross sectional descriptive analitic study. Subjects were recruited from April 2016 April 2017. Cognitive function assessed by the WISC III. Results A total 70 children aged from 9 to 15.5 years old were recruited. The prevalence of abnormal EEG and abnormal IQ score "

"ABSTRAKDarah merupakan sumber daya yang tidak tergantikan. Menurut Hall (2013), diUniversity Hospitals of Leicester UK, dari 507 unit darah yang di-crossmatchhanya 283 unit darah yang ditransfusikan. Terdapat 25% darah terbuang padaRumah Sakit Publik Guyana (Kurup, 2016). Penelitian ini merupakan penelitiandeskriptif dengan metode kualitatif. Berdasarkan analisis diperoleh hasil, yaitu35.79% unit darah yang tidak ditransfusikan, capaian CT Ratio 2.12 (dari 3536unit darah yang dicrossmatch, hanya 1670 unit darah yang ditransfusikan),Penyebab darah terbuang adalah kadaluarsa 98.4%, selang habis, kantong bocor,darah rusak dll. Penggunaan MSBOS dapat menurunkan angka ketidakterpakaiandarah pada pasien operasi elektif sebesar 35.64%.

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ABSTRACTBlood is an irreplaceable resource. According to Hall (2013), at UniversityHospitals of Leicester UK, from 507 units of crossmatched blood, only 283 unitswere used. There is 25% discharge blood at Guyana Public Hospital (Kurup,2016). This research is a descriptive case study with qualitative method. Based onthe analysis, 35.79% of the blood units were not transfused, the CT ratio was 2.12(from 3536 unit of crossmatched blood, only 1670 unit were transfused). Thecause of blood wastage is expired 98.4%, blood tube runs out, blood bag leak,blood damaged and unidentified causes. The use of MSBOS may decrease the rateof blood units wastage in elective surgery patients by 35.64%."