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Ina Rochayati
Akurasi pulse oksimetri fingertip dibandingkan pulse oksimetri generasi baru dalam deteksi dini penyakit jantung bawaan kritis pada bayi baru lahir: penelitian pendahuluan = Comparison between fingertip and new generation pulse oximetry accuracy in early detection of critical congenital heart disease in the newborn: preliminary study
"Latar belakang. Peningkatan morbiditas dan mortalitas pada bayi baru lahir dengan penyakit jantung bawaan (PJB) kritis berkaitan dengan diagnosis yang terlambat. Skrining pulse oksimetri sebelum bayi baru lahir pulang dari rumah sakit dapat membantu menegakkan diagnosis dini. Pulse oksimeter fingertip diharapkan menjadi alternatif pilihan alat pemeriksaan oksimetri karena murah, mudah, dan dapat digunakan secara luas.
Tujuan. Penelitian ini bertujuan menilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), rasio kemungkinan negatif (RKN), pre-test probability, dan post-test probability pemeriksaan pulse oksimetri fingertip dibandingkan oksimetri generasi baru untuk deteksi dini PJB kritis pada bayi baru lahir sebelum pulang dari rumah sakit.
Metode. Penelitian ini merupakan uji diagnostik yang dilakukan di Ruang Rawat Gabung RSCM pada semua bayi baru lahir bugar dengan usia gestasi ≥37 minggu dan berusia 24-72 jam. Pemeriksaan pulse oksimetri fingertip dan pulse oksimetri generasi baru dilakukan di tangan kanan (preduktal) dan kaki (postduktal). Subjek dengan saturasi oksigen <95% atau beda saturasi oksigen >3% antara tangan kanan dan kaki memerlukan pemeriksaan lebih lanjut. Ekokardiografi dikerjakan untuk diagnosis pasti.
Hasil. Penelitian dilakukan selama enam bulan pada 442 bayi baru lahir bugar. Mayoritas subjek diperiksa pada usia 24-48 jam (59%), median usia gestasi 38 minggu. Terdapat enam subjek dengan kelainan kongenital. Tidak ada subjek dengan riwayat keluarga menderita PJB, didiagnosis PJB saat antenatal maupun melalui pemeriksaan fisis. Perolehan saturasi oksigen preduktal menggunakan dua jenis pulse oksimetri bervariasi secara statistik (Uji Bland-Altman) namun tidak bermakna secara klinis (hasil deteksi negatif 100%). Tidak ada subjek dengan hasil deteksi positif dan didiagnosis PJB kritis melalui pemeriksaan oksimetri. Pemeriksaan pulse oksimetri fingertip pada bayi baru lahir dipengaruhi gerakan bayi (67,6%) dan faktor alat (sinyal tidak terbaca dan hasil tidak stabil) 24,8%.
Simpulan. Uji diagnostik pulse oksimetri fingertip dibandingkan generasi baru untuk deteksi dini PJB kritis pada penelitian ini belum dapat dinilai. Pemeriksaan kedua jenis pulse oksimetri tersebut memberikan hasil deteksi yang sama.
Background. Late diagnosis in the newborn with critical congenital heart disease (CCHD) is associated with increased morbidity and mortality. Pulse oximetry screening of newborn before hospital discharge can help early diagnosis. Fingertip pulse oximeter is expected to be an alternative option oximetry screening tool because it is affordable, easy, and can be widely used.
Objective. To estimate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), pretest odds, positive likelihood ratio (LR+), negative likelihood ratio (LR-), post-test odds, and post-test probability of fingertip pulse oximetry screening compared to a new generation to detect CCHD in the newborn before hospital discharge.
Methods. This is a diagnostic study held in newborn nursery of Cipto Mangunkusumo Hospital involving asymptomatic newborns aged 24-72 hours and gestational age ≥37weeks. Examination of fingertip and new generation pulse oxymetri was done in right hand (preductal) and foot (postductal). Subject had oxygen saturation <95% or difference of oxygen saturation between right hand and foot >3% requires further investigation. Echocardiography was performed for definitive diagnosis.
Results. The study was conducted during six months in 442 asymtomatic newborns. The majority of subjects were examined at age 24-48 hours (59%) and gestational age 38 weeks. There were six subjects with congenital abnormalities. No subjects with a family history of CHD nor diagnosed through antenatal and physical examination. Obtaining preductal oxygen saturation using two types pulse oximetry varied statistically (Bland-Altman test) but not clinically significant (100% negative detection results). No subject had positive detection result and was diagnosed CCHD through screening oximetry. Newborn examination using fingertip pulse oximetry were affected by movement (67.6%) and tool factors (signal unreadable and unstable results) 24.8%.
Conclusion. Diagnostic test of fingertip compared with new generation pulse oximetry in early detection of CCHD in this study can not be assessed. These two modalities show the same result of detection."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tugas Akhir  Universitas Indonesia Library
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Dedi Wilson MCH Puar
Massa dan Fungsi Ventrikel Kiri pada Anak dengan Diabetes Melitus Tipe-1 = Mass and Left Ventricle Function in Children with Diabetes Mellitus Type-1
"Latar belakang. Pengaruh Diabetes Melitus Tipe-1 (DMT1) terhadap massa dan fungsi ventrikel kiri pada anak masih menjadi perdebatan.
Tujuan. Untuk mengetahui gambaran massa dan fungsi ventrikel kiri pada anak DMT1.
Metode. Dilakukan penelitian potong lintang dengan membandingkan massa, fungsi diastolik dan sistolik ventrikel kiri 30 anak DMT1 berusia 4 sampai dengan 18 tahun dengan 30 anak sehat sebagai kontrol yang bersesuaian jenis kelamin dan umur. Massa dan fungsi ventrikel kiri diperiksa dengan ekokardiografi.
Hasil. Massa ventrikel kiri anak DMT1 lebih besar dari pada anak sehat, perbedaan ini bermakna. Faktor yang berhubungan dengan peningkatan massa tersebut adalah lama sakit dan tekanan darah. Fungsi diastolik pada anak dengan DMT1 berbeda bermakna dibanding anak sehat. Pola perubahan parameter fungsi diastolik anak DMT1 sesuai dengan gambaran disfungsi diastolik gangguan pola relaksasi. Faktor yang berhubungan dengan perubahan fungsi diastolik pada anak DMT1 adalah lama sakit. Untuk fungsi sistolik tidak ditemukan perbedaan yang bermakna.
Kesimpulan. Pada anak dengan DMT1 terdapat peningkatan massa ventrikel kiri dan gangguan diastolik pola relaksasi. Perubahan massa jantung dan gangguan fungsi diastolik tersebut berhubungan dengan lama sakit dan tekanan darah.
Background. The impact of Diabetes Mellitus type 1 (DMT1) on the left ventricular mass and functions in children remains controversial.
Objective: The aim of the study is to measure the left ventricular mass and function in children with DMT1.
Methods. A cross-sectional study was conducted to compare the mass and diastolicsystolic function of the left ventricle of 30 children with DMT1 and normal children aged 4 to 18 years that matched in sex and age. The left ventricular mass and diastolic-systolic function was assessed by echocardiography.
Results. Ventricular mass of children with DMT1 were significantly heavier than healthy ones. Factors associated with increased mass were the duration of illness and blood pressure. Diastolic functions in children with DMT1 were significantly different compared to healthy children. The patterns of changes were appropriate with the relaxation pattern of diastolic dysfunction. The factor associated with the change of diastolic parameters is the duration of illness. Significant differences were not found in the systolic function.
Conclusion. In children with DMT1 there was an increase of left ventricular mass and also diastolic dysfunction with the relaxation pattern. Changes in cardiac mass and diastolic dysfunction are associated with duration of illness and blood pressure."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tugas Akhir  Universitas Indonesia Library
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Cut Nurul Hafifah, supervisor
Insidens dan faktor risiko pneumonia aspirasi pada anak dengan palsi serebral = Incidence and risk factors of aspiration pneumonia in children with cerebral palsy
"[ABSTRAK
Latar Belakang Masalah saluran napas yaitu pneumonia aspirasi merupakan masalah utama berkaitan dengan kualitas hidup morbiditas dan mortalitas pada anak palsi serebral PS Faktor yang berperan terhadap timbulnya pneumonia aspirasi antara lain adalah kelemahan otot napas gangguan koordinasi menelan refluks gastro esofagus status gizi dan imunitas yang kurang baik Namun hingga kini belum ada data seberapa besar insidens pneumonia aspirasi pada anak dengan PS di Indonesia dan faktor risiko yang berhubungan Tujuan Mengetahui insidens pneumonia aspirasi pada anak dengan PS dan hubungan faktor risiko dengan kejadian pneumonia aspirasi Metode Penelitian ini adalah studi kohort prospektif untuk menilai insidens pneumonia aspirasi dan studi potong lintang untuk menilai faktor risiko pneumonia aspirasi Penelitian ini dilakukan di Ruang Rawat Inap dan Klinik Neurologi Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangukusumo Waktu rekrutmen penelitian 1 Maret 31 Maret 2015 Waktu pengamatan tanggal 1 April 30 September 2015 Terhadap subyek dilakukan anamnesis termasuk penilaian faktor risiko dengan Dysphagia Disorder Survey pemeriksaan fisis dan R ntgen toraks sebagai data awal selanjutnya subyek diamati selama 6 bulan untuk mengevaluasi adanya pneumonia aspirasi Hubungan bivariat antara kejadian aspirasi dan faktor risiko dilakukan dengan uji Fisher dan Mann Whitney sedangkan analisis multivariat dilakukan dengan regresi logistik Hasil Total subjek penelitian adalah 40 anak dengan PS Dua subjek mengalami drop out karena meninggal dunia dan dua subjek loss to follow up sehingga terdapat 36 pasien yang berhasil diamati hingga enam bulan Sebanyak 8 dari 36 22 2 pasien pada penelitian ini mengalami kejadian aspirasi baik silent aspiration 5 5 maupun pneumonia aspirasi secara klinis 19 4 Derajat beratnya PS berhubungan dengan pneumonia dan silent aspiration p 0 040 sedangkan pneumonia dan silent aspiration tidak berhubungan dengan gangguan koordinasi menelan p 0 2 dan status gizi p 0 107 Simpulan Insidens pneumonia aspirasi pada anak PS adalah 22 2 dengan derajat beratnya PS sebagai faktor risiko terjadinya PS ABSTRACT Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor , Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Suri Nurharjanti Harun
Pasien Asma dengan Alergi Makanan di Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangunkusumo Jakarta
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2008
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
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Amanda Soebadi
Faktor Risiko Kardiovaskular pada Anak Usia 9-12 Tahun dan Faktor-Faktor yang Memengaruhi dengan Perhatian Khusus pada Berat Lahir = Cardiovascular Risk Factors in Children 9-12 Year Old and Influencing Factors With Specific Attention to Birth Weight
"Latar belakang. Faktor risiko PJK dapat terjadi sejak masa kanak-kanak dan dapat dicegah. Gangguan pertumbuhan intrauterin dapat meningkatkan kemungkinan timbulnya faktor risiko PJK. Penelitian sebelum11Ya menunjukkan hasil yang tidak konsisten. Hanya satu penelitian serupa yang pernah dilaporkan di Indonesia. Tujuan. Mengidentifik.asi faktor-faktor risiko kardiovaskular pada anak usia 9-12 tahun dan mengetahui faktor-faktor yang memengaruhinya, dengan perhatian khusus pada berat lahir. Metode. Studi potong lintang dilakukan pada anak usia 9-12 tahun di 4 sekolah dasar di Jakarta Pusat. Berat lahir didapatkan dari catatan kelahiran yang dimiliki orangtua. Pada subjek dilakukan pemeriksaan fisis dan antropometris, pengukuran massa lemak tubuh, dan pengambilan darah vena untuk pemeriksaan glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida. Pada subjek dilakukan juga analisis diet dengan metode three-day food recall dan penilaian tingkat aktivitas fisis dengan Physical Activity Questionnaire for Children (PAQ-C). Orangtua diminta mengisi kuesioner mengenai riwayat pemberian ASI dan kondisi sosioekonomi. Proporsi obesitas, hipertensi, glukosa puasa terganggu, dan dislipidemia ditentukan. Koefisien korelasi antara berat lahir dengan indeks massa tubuh (IMT), tekanan darah sistolik, tekanan darah diastolik, massa lemak tubuh., glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida ditentukan dengan uji Spearman. Korelasi yang bermakna diuji dengan analisis multivariat dengan mengikutsertakan faktor kovariat durasi pembcrian ASI, durasi ASI eksklusif, asupan nutrisi, tingkat aktivitas fisis, dan penghasilan keluarga. · Hasil. Didapatkan 85 subjek, 49 (57,6%) perempuan. Median (rentang) berat lahir subjek 3000 (1500-4300) g; 6 (7,1%) subjek memiliki berat lahir <2500 g. Proporsi obesitas, hipertensi sistolik, hipertensi diastolik, glukosa puasa terganggu, dan dislipidemia berturut-turut 10,6%; 2,4%; 4%; 2,4%; dan 31,8%. Terdapat korehsi lemah yang bermakna secara statistika antara berat lahir dengan z-swre IMT (p=0,265; p=O,Ol4) dan persentil massa lemak tubuh (p=0,216; p=0,047). Tidak. ditemukan korelasi yang bermakna secara statistika antara berat lahir dengan variabel-variabel lainnya. Fak.tor kovariat yang memenuhi syarat untuk analisis multivariat adalah durasi total pemberian ASI, durasi ASI eksklusif, persentase asupan protein terhadap AKG, dan penghasilan keluarga. Pada regresi linear multipel, berat lahir masih berpengaruh terhadap z-score IMT (P=O,OOl; p=0,008) dan persentil massa lemak. tubuh (p=0,017; p=0,043) pada usia 9-12 tahun. Sim.pulan. Terdapat korelasi positif lemah yang bermak.na secara statistika antara berat lahir dengan IMT dan massa lemak. tubuh. Pengaruh berat lahir terhadap IMT dan massa lemak. tubuh tetap bermak.na apabila faktor pemberian ASI, asupan nutrisi, dan penghasilan keluarga diperhitungkan. Diperlukan penelitian kohort prospektif dengan memperhitungkan usia gestasi untuk menentukan dengan lebih tepat pengaruh berat lahir rendah, khususnya perturnbuhanjanin terganggu, terhadap faktor risiko kardiovaskular.
Background. Risk factors of CHD may develop since childhood and are preventable. Intrauterine growth disturbance leads to programming of metabolic and endocrine systems, causing CHD risk factors to arise. Previous studies have shown inconsistent results. Only one such study has been reported in Indonesia Objectives. To identify cardiovascular risk factors in children 9-12 years old and their influencing factors, with specific attention to bi.rth weight. Methods. A cross-sectional study was done in 9-12-year-old children from 4 elementary schools in Central Jakarta. Birth weight was obtained from birth records submitted by parents. Physical examination, anthropometric measurement, determination of body fat percentage, and venous blood sampling were done to determine fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Dietary analysis was done by a three-day food recall. Subjects' physical activity level was assessed using the Physical Activity Questionnaire for Children (P AQ-C). Parents completed a questionnaire regarding breastfeeding history and socioeconomic conditions. The proportions of obesity, hypertension, impaired fasting glucose, and dyslipidernia were calculated. The Spearman test was done to determine the correlation between birth weight and body mass index (BMI), systolic and diastolic blood pressure, body fat percentage, fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Significant correlations were subjected to multivariate analysis incorporating total breastfeeding duration, exclusive breastfeeding duration, nutritional intake, physical activity level, and family income. Results. We obtained 85 subjects, 49 (57,6%) of which were female. Median (range) birth weight was 3000 (1500-4300) g; 6 (7,1%) had birth weight of <2500 g. The proportion of obesity, systolic hypertension, diastolic hypertension, impaired fasting glucose, and dyslipidemia was 10,6%; 2,4%; 4%; 2,4%; and 31,8%, respectively. A weak positive correlation was obtained between birth weight and BMI z-score (p=0,265; p=0,014); and between birth weight and body fat percentile (p=0,216; p=0,047). There was no statistically significant correlation between birth .veight and other variables. Covariates fulfilling significance criteria were total breastfeeding duration, exclusive breastfeeding duration, percentage protein intake to the local RDA, and family income. On multiple linear regression analysis, birth weight was still significantly related to BMI z-score (~=0,001; p=0,008) and body fat percentile (~=0,017; p=0,043) at 9-12 years of age when the covariates were considered. Conclusions. Birth weight is weakly and positively correlated with BMI and body fat percentage. The influence of birth weight on BMI and body fat percentage remains significant when breastfeeding history, nutritional intake, and family income are considered. A prospective cohort study incorporating gestational age is needed to determine the influence of low birth weight, particularly due to intrauterine growth disturbance, on cardiovascular risk factors."
Jakarta: Fakultas Kedokteran Universitas Indonesia , 2011
T58258
UI - Tesis Membership  Universitas Indonesia Library
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Alvina Christine
Faktor risiko maternal dan karakteristik pada penyakit jantung bawaan anak = Maternal risk factors and characteristics in pediatric congenital heart defects / Alvina Christine
"ABSTRAK
Penyakit jantung bawaan (PJB) mengakibatkan morbiditas yang signifikan pada anak dan merupakan penyebab kematian utama dari antara kelainan kongenital lainnya. Usaha preventif PJB dengan cara identifikasi faktor risiko maternal diharapkan dapat menurunkan morbiditas dan mortalitas PJB.
Tujuan. Penelitian ini bertujuan untuk mengetahui: (1) karakteristik (usia saat pertama kali terdiagnosis, jenis kelamin, status gizi, dan status ekonomi keluarga) penderita PJB anak di Poliklinik Kardiologi Ilmu Kesehatan Anak (IKA) Rumah Sakit Cipto Mangunkusumo (RSCM), (2) faktor risiko maternal yang diperkirakan mempengaruhi terjadinya PJB pada anak, yaitu: merokok aktif dan pasif selama kehamilan, diabetes melitus, obesitas, infeksi rubela saat kehamilan, usia saat kehamilan, dan pendidikan.
Metode. Penelitian kasus kontrol dengan consecutive sampling dilakukan di Poliklinik Kardiologi IKA RSCM pada bulan Januari-Maret 2014. Pemeriksaan klinis, ekokardiografi, dan wawancara dilakukan terhadap 68 subjek PJB (kelompok kasus) dan 68 subjek anak sehat (kelompok kontrol).
Hasil. Jumlah subjek penelitian sebanyak 136 subjek, dengan perbandingan kasus:kontrol adalah 1:1. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebesar 80,9% terdiagnosis saat berusia kurang dari 1 tahun. Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dengan 7,4% di antaranya merupakan gizi buruk, dan memiliki status ekonomi keluarga menengah ke bawah (76,5%). Defek PJB non sianotik terbanyak adalah defek septum ventrikel (44,1%) dan PJB sianotik terbanyak adalah Tetralogi Fallot (14,7%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah. Faktor risiko merokok aktif dan pasif saat kehamilan, obesitas, dan usia ibu saat kehamilan tidak terbukti berhubungan dengan PJB anak, sedangkan faktor diabetes melitus dan infeksi rubela saat kehamilan tidak dapat dianalisis pada penelitian ini.
Simpulan. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebagian besar subjek terdiagnosis saat berusia kurang dari 1 tahun (80,9%). Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dan 7,4% di antaranya merupakan gizi buruk, dengan status ekonomi keluarga menengah ke bawah (76,5%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah.
ABSTRACT
Congenital heart defects (CHD) cause significant morbidities and are the leading cause of death among other congenital anomalies. Preventive measures with identification of maternal risk factors are expected to decrease morbidity and mortality rate in children due to CHD.
Objectives. This study aimed to define: (1) characteristics (age at diagnosis, gender, nutritional status, and family’s economy status) of CHD patients in Pediatric Cardiology Clinic Cipto Mangunkusumo Hospital (CMH), (2) maternal risk factors that may influence CHD in children, namely: active and passive smoking in pregnancy, diabetes mellitus, obesity, rubella infection in pregnancy, age at pregnancy, and education.
Method. Case-control study with consecutive sampling was performed in Pediatric Cardiology Clinic CMH in January-March 2014. Clinical examination, echocardiography, and interview were performed in 68 CHD subjects (case group) and 68 healthy subjects (control group).
Results. Total subject in this study was 136, with ratio of case:control is 1:1. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and 80.9% were diagnosed in the first year of age. Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). The most prevalent non cyanotic CHD was ventricle septal defect (44.1%), and the most prevalent cyanotic CHD was Tetralogy of Fallot (14.7%). Maternal risk factor that was significantly associated with CHD was low maternal education. Active and passive smoking in pregnancy, obesity, and maternal age at pregnancy were not associated with CHD, whereas diabetes mellitus and rubella infection in pregnancy could not be analyzed in this study.
Conclusion. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and mostly were diagnosed in the first year of age (80.9%). Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). Maternal risk factor that was significantly associated with CHD was low maternal education."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Dimple Gobind Nagrani
Status pertumbuhan dan kualitas hidup pasien dengan defek septum atrium, defek septum ventrikel, dan duktus arteriosus paten sebelum dan sesudah koreksi = Growth status and quality of life in patients with atrial septal defect ventricular septal defect and patent ductus arteriosus before and after correction / Dimple Gobind Nagrani
"ABSTRAK
Latar belakang: Penyakit jantung bawaan (PJB) yang tersering adalah defek septum ventrikel (DSV), defek septrum atrium (DSA) dan duktus arteriousus paten (DAP). Keterlambatan koreksi defek dapat menyebabkan gangguan tumbuh kembang dan kualitas hidup.
Tujuan: Mengetahui perbedaan status gizi dan kualitas hidup pada anak PJB asianotik sebelum dan 6 bulan-2tahun setelah koreksi dan apakah terdapat hubungan dengan jenis PJB, status gizi awal, metode dan usia koreksi.
Metode: Penelitian kohort retrospektif pada 79 anak berusia 0?18 tahun dengan DSV, DSA, DAP, dan kombinasi ketiganya. Usia, jenis kelamin, jenis PJB, usia koreksi, metode koreksi, BB dan TB dinilai sebelum dan setelah koreksi.
Hasil: Subyek penelitian berusia 0?15 tahun dengan mayoritas 1?5 tahun, diagnosis terbanyak adalah DSV (58,2%), dan status nutrisi awal adalah gizi kurang (50,6%). Secara keseluruhan terdapat kenaikan persentil BB/U (p<0,001), TB/U (p=0,004), dan BB/TB (p<0,001) yang bermakna sebelum dan sesudah koreksi. Tidak ada perubahan status gizi yang bermakna sebelum dan sesudah koreksi (p=0,851). Tidak ada hubungan perubahan status gizi dengan status gizi awal (p=0,451), metode koreksi (p=0,454), dan usia tindakan (p=0,861). Terdapat hubungan antara perubahan status gizi dengan ukuran defek (p=0,035). Sebanyak 29,1% memiliki gangguan kualitas hidup, 45,4% memiliki gangguan aspek emosi. Tidak ada hubungan antara gangguan kualitas hidup dengan diagnosis, metode koreksi, dan ukuran defek.
Simpulan: Status gizi awal terbanyak anak dengan PJB asianotik adalah gizi kurang. Terdapat peningkatan persentil BB/U, TB/U, dan BB/TB yang bermakna 6 bulan-2 tahun setelah koreksi. Terdapat hubungan antara perubahan status gizi dengan ukuran defek. Sepertiga subyek memiliki gangguan kualitas hidup setelah koreksi. Hampir separuhnya memiliki gangguan aspek emosi.
ABSTRACT
Background: The most common congenital heart disease (CHD) is ventricular septal defect (DSV), atrial septal defect (ASD), and patent ductus arteriosus (DAP). Delayed correction is correlated with disturbance of growth, development and quality of life (QOL).
Aim: To determine the difference in nutritional status and QOL for acyanotic CHD before and after 6 months-2 years correction and its association with diagnosis, initial nutritional status, method and age of correction.
Metode: A retrospective cohort study on 79 children aged 0?18 years old with DSV, ASD, DAP, and a combination of the 3. Age, gender, type of CHD, age and method of correction, weight and height before and after correction were evaluated.
Result: The subjects are aged 0-15 years with majority of 1?5 years, most common diagnosis is DSV (58.2%) and initial nutritional status is moderate malnutrition (50.6%). There is significant increase in weight/age (p<0.001), height/age (p=0,004) and weight/height (p<0.001) percentiles. There is no increment of nutritional status (p=0.851). There is no association between nutritional status and initial nutritional status before correction (p=0.451), method (p=0.454) and age (p=0.861) of correction. There is a statistically significant association between growth status and defect size (p=0.035). Twenty nine percent have decreased QOL, 45.4% on emotional aspect. Decreased QOL was not associated with diagnosis, method of correction and defect size.
Conclusion: The most common nutritional status in acyanotic CHD children is moderate malnutrition. There is a statistically significant increase in the percentiles 6 months-2years post correction. There is an association between changes in growth status and defect size. One third of patients have decreased QOL after correction and almost half on emotional aspect."
2016
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UI - Tesis Membership  Universitas Indonesia Library
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Dimple Gobind Nagrani
Status Pertumbuhan dan Kualitas Hidup Pasien dengan Defek Septum Atrium, Defek Septum Ventrikel, dan Duktus Arteriosus Paten Sebelum dan Sesudah Koreksi = Growth status and quality of Life in patients with atrial septal defect ventricular septal defect and patent ductus arteriosus before and after correction
"ABSTRAK
Latar belakang: Penyakit jantung bawaan (PJB) yang tersering adalah defek septum ventrikel (DSV), defek septrum atrium (DSA) dan duktus arteriousus paten (DAP). Keterlambatan koreksi defek dapat menyebabkan gangguan tumbuh kembang dan kualitas hidup.
Tujuan: Mengetahui perbedaan status gizi dan kualitas hidup pada anak PJB asianotik sebelum dan 6 bulan-2tahun setelah koreksi dan apakah terdapat hubungan dengan jenis PJB, status gizi awal, metode dan usia koreksi.
Metode: Penelitian kohort retrospektif pada 79 anak berusia 0-18 tahun dengan DSV, DSA, DAP, dan kombinasi ketiganya. Usia, jenis kelamin, jenis PJB, usia koreksi, metode koreksi, BB dan TB dinilai sebelum dan setelah koreksi.
Hasil: Subyek penelitian berusia 0-15 tahun dengan mayoritas 1-5 tahun, diagnosis terbanyak adalah DSV (58,2%), dan status nutrisi awal adalah gizi kurang (50,6%). Secara keseluruhan terdapat kenaikan persentil BB/U (p<0,001), TB/U (p=0,004), dan BB/TB (p<0,001) yang bermakna sebelum dan sesudah koreksi. Tidak ada perubahan status gizi yang bermakna sebelum dan sesudah koreksi (p=0,851). Tidak ada hubungan perubahan status gizi dengan status gizi awal (p=0,451), metode koreksi (p=0,454), dan usia tindakan (p=0,861). Terdapat hubungan antara perubahan status gizi dengan ukuran defek (p=0,035). Sebanyak 29,1% memiliki gangguan kualitas hidup, 45,4% memiliki gangguan aspek emosi. Tidak ada hubungan antara gangguan kualitas hidup dengan diagnosis, metode koreksi, dan ukuran defek.
Simpulan: Status gizi awal terbanyak anak dengan PJB asianotik adalah gizi kurang. Terdapat peningkatan persentil BB/U, TB/U, dan BB/TB yang bermakna 6 bulan-2 tahun setelah koreksi. Terdapat hubungan antara perubahan status gizi dengan ukuran defek. Sepertiga subyek memiliki gangguan kualitas hidup setelah koreksi. Hampir separuhnya memiliki gangguan aspek emosi.
ABSTRACT
Background: The most common congenital heart disease (CHD) is ventricular septal defect (DSV), atrial septal defect (ASD), and patent ductus arteriosus (DAP). Delayed correction is correlated with disturbance of growth, development and quality of life (QOL).
Aim: To determine the difference in nutritional status and QOL for acyanotic CHD before and after 6 months-2 years correction and its association with diagnosis, initial nutritional status, method and age of correction.
Method: A retrospective cohort study on 79 children aged 0-18 years old with DSV, ASD, DAP, and a combination of the 3. Age, gender, type of CHD, age and method of correction, weight and height before and after correction were evaluated.
Result: The subjects are aged 0-15 years with majority of 1-5 years, most common diagnosis is DSV (58.2%) and initial nutritional status is moderate malnutrition (50.6%). There is significant increase in weight/age (p<0.001), height/age (p=0,004) and weight/height (p<0.001) percentiles. There is no increment of nutritional status (p=0.851). There is no association between nutritional status and initial nutritional status before correction (p=0.451), method (p=0.454) and age (p=0.861) of correction. There is a statistically significant association between growth status and defect size (p=0.035). Twenty nine percent have decreased QOL, 45.4% on emotional aspect. Decreased QOL was not associated with diagnosis, method of correction and defect size.
Conclusion: The most common nutritional status in acyanotic CHD children is moderate malnutrition. There is a statistically significant increase in the percentiles 6 months-2years post correction. There is an association between changes in growth status and defect size. One third of patients have decreased QOL after correction and almost half on emotional aspect"
2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Annisa Nur Aini
Hubungan status nutrisi maternal terhadap risiko kardiovaskular pada bayi baru lahir : perhatian khusus pada ketebalan tunika intima-media aorta abdominalis = Correlation between maternal nutritional status and cardiovascular risks in the newborns particularly aortic intima media thickness
"ABSTRAK
Latar belakang: Deteksi dini aterogenesis diperlukan untuk mencari faktor risiko gangguan kardiovaskular pada neonatus.Tujuan: 1 mengetahui sebaran nilai ketebalan tunika-intima aorta abdominalis aIMT pada bayi baru lahir; 2 mengetahui hubungan antara status nutrisi maternal dan berat lahir bayi terhadap aIMT bayi baru lahir.Metode: Penelitian potong lintang pada 86 bayi usi 2-3 kali nilai aIMT menggunakan ultrasonografi vaskular bertransduser linear 13 MHz dengan piranti lunak automatis, kemudian diambil nilai reratanya. Rerata aIMT kemudian dihubungkan dengan indeks massa tubuh ibu trimester pertama kehamilan dan berat lahir.Hasil: Rerata aIMT bayi baru lahir di Unit Perinatologi RSCM adalah 0,621 mm 0,110 mm. Tidak ditemukan korelasi antara indeks massa tubuh ibu trimester pertama kehamilan dengan aIMT bayi r = 0,137, p = 0,207 . Tidak ditemukan korelasi antara berat lahir bayi dengan aIMT bayi r = 0,036, p = 0,742 .Simpulan: Rerata aIMT bayi baru lahir di Unit Perinatologi RSCM adalah 0,621 mm 0,110 mm. Tidak didapatkan korelasi antara indeks massa tubuh ibu maupun berat lahir bayi terhadap aIMT bayi baru lahir. Deteksi dini risiko kardiovaskular pada neonatus melalui aIMT belum perlu dilakukan dalam praktik sehari-hari.Kata kunci: nutrisi maternal, risiko kardiovaskular, ketebalan tunika intima-media aorta
ABSTRACT
Background Early detection of atherogenesis is needed to evaluate cardiovascular risk factors in newborns.Aim 1 knowing aortic intima media thickness aIMT distribution value in newborns 2 evaluate correlation between maternal nutritional status and birth weight to newborn aIMT.Method A cross sectional study was performed in 86 newborns, aged 0 7 days, with median gestational age of 35 weeks. All aIMT subjects were measured using a 13 MHz linear transducer vascular ultrasound with automatic software. Mean aIMT then correlated with first trimester maternal body mass index and birth weight.Results Newborn mean aIMT in Perinatology division Cipto Mangunkusumo Hospital was 0,621 mm SD 0,110 mm . There was no significant correlation between first trimester maternal body mass index and newborns aIMT r 0,137, p 0,207 . There was no significant correlation between birth weight and newborns aIMT r 0,036, p 0,742 .Conclusions Newborn mean aIMT in Perinatology division Cipto Mangunkusumo Hospital was 0,621 mm SD 0,110 mm . There were no correlations between first trimester maternal body mass index and birth weight to newborns aIMT. Early detection of atherogenesis in newborns through aIMT measurement were not recommended for daily practice yet.Keywords Maternal nutrition, newborns cardiovascular risks, aortic intima media thickness"
2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Agnes Tri Harjaningrum
Penilaian kualitas hidup anak demam reumatik dan penyakit jantung reumatik menggunakan pediatric quality of life inventory tm pedsqltm 3.0 modul jantung = Assessment of quality of life in children with rheumatic fever and rheumatic heart disease using pediatric quality of life inventorytm pedsqltm 3 0 cardiac module
"ABSTRAK
Latar belakang:.Demam reumatik DR dan penyakit jantung reumatik PJR merupakan penyakit kronis yang berdampak terhadap fisik, psikososial, dan akademik. Penting menilai kualitas hidup anak DR dan PJR serta faktor-faktor yang memengaruhinya, untuk mengetahui prioritas masalah. Tujuan: Mengetahui gambaran kualitas hidup anak DR dan PJR serta faktor-faktor yang memengaruhinya. Metode: Studi potong lintang pada April-Agustus 2017, dengan subyek anak berusia 5-18 tahun. Data didapatkan secara consecutive sampling menggunakan kuesioner PedsQL trade; 3.0 modul jantung dan rekam medis retrospektif. Hasil: Kualitas hidup baik ditemukan pada 53 laporan anak dan 52 laporan orangtua subyek. Skor median laporan anak 79,70 29,7-100 , dan laporan orangtua 77,31 45,03-99,40 . Kepatuhan berobat merupakan kunci penyebab membaiknya kualitas hidup. Tidak ada faktor sosiodemografi yang berhubungan dengan kualitas hidup. Faktor klinis yang berhubungan dengan kualitas hidup adalah rute antibiotik. Anak DR dan PJR yang mendapat antibiotik intramuskuler, 3,2 kali laporan anak memiliki kemungkinan kualitas hidup lebih baik dibandingkan yang mendapatkan antibiotik oral p ABSTRACT
Background Rheumatic fever RF and rheumatic heart disease RHD are chronic diseases that affect physical, psychosocial, and academic. Assessment of quality of life in children with RF and RHD and the factors affecting it, is important to identify problems. Objective To identify quality of life in children with RF and RHD and the factors influencing it. Method A cross sectional study on RF and RHD patients aged 5 18 years old, using PedsQLTM 3.0 Cardiac Module questionnaire and retrospective medical records from April 2017 until August 2017. Result High quality of life was found in 53 child report and 52 parent report of subjects. Median score from children rsquo s reports and parents rsquo reports are, 79,70 29,7 100 , and 77,31 45,03 99,40 respectively. Compliance was the key to cause quality of life to increase. Clinical factors affecting quality of life included the route of antibiotic administration, and there were no sociodemographic factors. By child report, children with RF and RHD who received intramuscular antibiotics were 3.2 times more likely to have higher quality of life than children who received oral antibiotics p "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
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UI - Tugas Akhir  Universitas Indonesia Library
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