Dampak Pandemi COVID-19 Pada Anak

AbstractCOVID-19 (Corona Virus Infection Disease 2019) is an acute infectious disease caused by avirus called SARS-CoV-2, which stands for Severe Acute Respiratory Syndrome Coronavirus-2. This disease is generally characterized by symptoms of acute respiratory infection (ARI)such as fever, cough, painful swallowing and disorders of other organs such as the heart,kidneys, digestive system, nerves, eyes, skin, ENT, and others. It can also occur withoutsymptoms at all. At first the disease was discovered in Wuhan City, Hubei Province, China atthe end of December 2019. In Indonesia the first cases of COVID-19 were reported on March2, 2020.The impact of the Pandemic on children needs special attention. Based on the causes,SARS-CoV-2 infection in children is distinguished, limited access to health services, decreasedfamily economic capacity and due to school closures or distance learning. In the short term,the impact of a pandemic can increase the number of morbidity or disease, increase themortality rate due to late diagnosis and treatment, reduce immunization coverage, and reducenutritional or nutritional compliance. Meanwhile, in the long term disease outbreaks that canbe prevented by immunization can arise, increasing the prevalence of stunted and veryunderweight children, developmental disorders, including psycho-social and mentaldevelopment and future generations with loss of the actual learning period.Keywords : COVID-19, children, impact of pandemi

Magnetic resonance cholangiopancreatography as a diagnostic tools to diagnose biliary atresia at Dr.Soetomo hospital

ABSTRACT Cholestasis jaundice results from diminished bile flow and/or excretion, and caused by a number of disorders such as biliary atresia (BA). Magnetic resonance cholangiopancreatography (MRCP) is widely accepted as one of the modalities for biliary system imaging; however, liver biopsy still generally used for BA diagnosis, especially in developing countries. This aim study was to evaluate the diagnostic value of biliary atresia from MRCP compared to the result of a liver biopsy. A cross-sectional for diagnostic study documented of hospitalized patients from June 2014 to June 2015. All patients had MRCP and liver biopsy examination. The collection of data including age, gender, clinical manifestation and the result of MRCP and liver biopsy with ROC to evaluate the sensitivity and specificity was done. Liver biopsy revealed of biliary atresia was made based on proliferation, degeneration, and fibrosis of bile ducts. ROC to evaluate the sensitivity and specificity was done. The sensitivity, specificity, negative predictive value, positive predictive value of MRCP in diagnosing BA were calculated. There were 16 patients enrolled in this study with a median age of diagnosis was 6 months old (range 3-11). There were nine female patients out of the 16 patient. The median age of jaundice onset was 5 days (range 2-14 days). All patients had hepatomegaly and splenomegaly. Histopathology from liver biopsy revealed biliary atresia in 12 patients. From the ROC curve, the sensitivity of MRCP was 87.5% and specificity 62.5% with PPV 70% and NPV 80%. Five patients underwent a Kasai procedure and revealed biliary atresia. MRCP is sensitive but not specific for diagnosing BA, and MRCP has moderate sensitivity and specificity for BA diagnosis.Keyword: biliary atresia, magnetic resonance cholangiopancreatography, liver biopsy, diagnostic test.Correspondence: [email protected] ABSTRAKIkterus dikarenakan kolestasis terjadi akibat berkurangnya aliran empedu dan/ atau ekskresi, dan dapat disebabkan oleh sejumlah gangguan seperti atresia biliaris (BA). Magnetic resonance cholangiopancreatography (MRCP) secara luas diterima sebagai salah satu modalitas untuk pencitraan sistem empedu, namun biopsi hati masih secara umum digunakan untuk diagnosis BA, terutama di negara berkembang. Studi ini bertujuan untuk mengevaluasi nilai diagnostik atresia biliaris dari MRCP ke hasil biopsi hati. Sebuah cross sectional untuk studi diagnostik didokumentasikan pasien rawat inap dari Juni 2014 hingga Juni 2015. Semua pasien menjalani MRCP dan pemeriksaan biopsi hati. Data usia, jenis kelamin, manifestasi klinis dan hasil MRCP dan biopsi hati dengan ROC untuk mengevaluasi sensitivitas dan spesifisitas dilakukan. Biopsi hati mengungkapkan atresia biliar dibuat berdasarkan proliferasi, degenerasi dan fibrosis saluran empedu. ROC untuk mengevaluasi sensitivitas dan spesifisitas yang dilakukan. Dilakukan perhitungan sensitivitas, spesifisitas, nilai prediktif negatif, nilai prediksi positif MRCP dalam mendiagnosis BA. Terdapat 16 pasien yang terdaftar dalam penelitian ini dengan median usia diagnosis adalah 6 (kisaran 3-11) bulan. Terdapat 9 perempuan dari 16 pasien tersebut. Usia rata-rata onset penyakit kuning adalah 5 (kisaran 2-14) hari. Semua pasien mengalami hepatomegali dan splenomegali. Histopatologi dari biopsi hati mengungkapkan atresia bilier pada 12 dari 16 pasien. Dari kurva ROC, sensitivitas MRCP adalah 87,5% dan spesifisitas 62,5% dengan PPV 70% dan NPV 80%. Lima pasien menjalani prosedur Kasai dan mengungkapkan atresia bilier. MRCP sensitif namun tidak spesifik untuk mendiagnosis BA dan MRCP memiliki sensitivitas dan spesifisitas sedang untuk diagnosis BA.Kata kunci: biliary atresia, magnetic resonance cholangiopancreatography, liver biopsy, diagnostic test.Korespondensi: [email protected]

The difference in severity and management between children and adult's cases of COVID-19

AbstractCOVID-19 (Coronavirus Disease 2019) has been started in Wuhan, China, and spread worldwide and resulting in many cases of death. COVID-19 attacks the respiratory tract acutely and infected both children and adults. The number of cases in children is less than in adults. By seeing from the clinical aspect, the COVID-19 case in children is milder. There are differences in immunology responses in children and adults where children have higher immunology response of COVID-19 than adults. Meanwhile, if the immunology response is slow in adults, it may cause them infected by COVID-19 with severe symptoms. There are some relations between immunization with immunology response to SARS-CoV-2 where children who already have BCG vaccination has lower infection rates of acute respiratory tract case. This study aims to know the difference between COVID-19 cases that infected adults and children seen in various aspects.Keywords                     : COVID-19,SARS-CoV-2, children, adult, severity, managementCorrespondence         : [email protected]

The Effect of Dobutamine Administration on Oxygen Saturation in Infant's Persistent Pulmonary Hypertension of The Newborn (PPHN)

Background: PPHN of infants are severe cases because the rate of disability and death in infants is relatively high, reaching around 10-20% of cases. Therefore, prompt, accurate, and rational management is needed to reduce cases number of records and deaths. The incidence of PPHN is 2-6 out of 1000 live births; in Surabaya, the incidence was 42 babies per 1000 live births from April to September 2017. Dobutamine is an effective therapy that can support good morbidity and mortality. Therefore, therapeutic options in infants with PPHN in the form of dobutamine are often used.Objective: To determine the effect of dobutamine administration on oxygen saturation in infants with persistent pulmonary hypertension of the newborn (PPHN)Method: A cross-sectional design with a consecutive sampling of 50 infants with PPHN who received dobutamine therapy at the Hospital of Siti Khodijah Muhammadiyah Sepanjang. Data collection using medical records. Results: The average increase in oxygen saturation before and after being given dobutamine was 36.0%. No difference in the increase in oxygen saturation based on the duration of dobutamine administration. The dobutamine dose's effect on the oxygen saturation increase in infants with PPHN.Conclusion: The results of this study indicate a significant effect of dobutamine administration on increasing oxygen saturation in PPHN infants

HUBUNGAN STATUS GIZI ANAK BALITA DENGAN KEJADIAN STUNTING DI PUSKESMAS KENJERAN SURABAYA

Jawa Timur merupakan salah satu provinsi dengan prevalensi stunting yang tinggi. Intervensi penanganan stunting harus dimulai semenjak janin dalam kandungan hingga anak berumur dua tahun. Pemeriksaan antropometri dilakukan sebagai upaya untuk menetukan status gizi anak balita Indonesia dengan mengukur berat badan dan panjang badan. Mengetahui hubungan status gizi anak balita dengan kejadian stunting di Puskesmas Kenjeran Surabaya. jenis penelitian yang digunakan dalam penelitian ini yaitu analitik observasional desain cross-sectional. Sebanyak 92 sampel diperoleh menggunakan total sampling dengan melakukan pemeriksaan antropometri selanjutnya dianalisis menggunakan kurva WHO yang memenuhi kriteria inkulsi dan eksklusi kemudian menggunakan uji korelasi Spearman. Dari 92 subjek, Interpretasi status gizi anak balita dengan gizi baik (80,4%) gizi kurang (6,5%) gizi buruk (4.3%) dan gizi lebih (4,3%) risiko gizi lebih (3,3%) sedangkan obesitas (1.1%). Interpretasi Stunting adalah normal (70,7%) pendek (stunted) (17,4%) sedangkan sangat pendek (severely stunted) (8,7%) dan tinggi (3,3%). Hasil analisis uji korelasi Spearman menunjukkan terdapat hubungan status gizi anak balita dengan kejadian stunting dengan tingkat signifikansi 0.005 <alpha (0.05). Terdapat hubungan yang signifikan antara hubungan status gizi anak balita dengan kejadian stunting.Kata Kunci : Status gizi, balita,stuntin

HUBUNGAN STATUS GIZI DAN KOMORBID IBU SAAT HAMIL DENGAN KEJADIAN STUNTING DI BULAK, PUSKESMAS KENJERAN, KOTA SURABAYA

Kehamilan adalah masa terjadinya perubahan fisiologis dan kebutuhan nutrisi pada masa kehamilan cenderung meningkat untuk menjaga metabolisme dan mendukung pertumbuhan serta perkembangan janin. Begitu juga dengan kondisi kesehatan ibu seperti penyakit penyerta atau komorbid yang dialami oleh ibu selama kehamilan. Hal tersebut dapat menjadi faktor-faktor yang mempengaruhi bayi atau janin nantinya bisa berkembang baik atau memiliki resiko stunting. Stunting adalah kejadian pada balita yang memiliki perawakan pendek akibat kurangnya asupan nutrisi. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara status gizi dan komorbid ibu selama kehamilan dengan kejadian stunting balita di Bulak, Puskesmas Kenjeran, Kota Surabaya. Desain penelitian yang digunakan adalah analitik observasional dengan jenis studi cross sectional. Terdapat sebanyak 30 sample diperoleh dengan menggunakan total sampling dengan memberikan kuesioner mengenai riwayat penyakit penyerta serta faktor-faktor yang ada pada ibu selama kehamilan serta mengecek penambahan berat badan selama kehamilan di buku KIA ibu dan mencocokannya dengan grafik di buku KIA. Melalui uji multivariat yang menentukan hubungan antara status gizi dan komorbid ibu dengan kejadian stunting anak, tidak ditemukan adanya hubungan yang signifikan dengan nilai P = 0,3 (>0,05) antara status gizi ibu selama kehamilan dengan kejadian stunting balita, dan nilai P = 0,4 (>0,05) antara status komorbid ibu selama kehamilan dengan kejadian stunting balita.Tidak adanya hubungan antara status gizi ibu dan komorbid selama kehamilan dengan kejadian stunting balita di Bulak, Puskesmas Kenjeran, Kota Surabaya.Kata Kunci: Status Gizi Ibu, Komorbid Ibu, Kehamilan, Balita, Stunting

HUBUNGAN NEUTROPHIL LYMPHOCYTE RATIO (NLR) TERHADAP INFEKSI DENGUE ANAK DI INSTALASI RAWAT INAP ANAK RSUD RA BASOENI KABUPATEN MOJOKERTO

Pendahuluan : Infeksi dengue adalah penyakit yang disebabkan oleh virus dengue melalui vektor nyamuk Aedes. Infeksi dengue bisa ditegakkan dengan menggunakan NS1 dan serologi IgG dan IgM anti dengue bagi fasilitas kesehatan yang menyediakan. Namun, bisa digantikan dengan pemeriksaan darah lengkap seperti trombosit, hematokrit, leukosit. Hasil NLR juga dapat digunakan sebagai pendukung diagnosis pada infeksi dengue. Tujuan: Mengetahui karakteristik pasien dan hubungan nilai NLR pada pasien anak dengan simtomatik infeksi virus dengue  di Instalasi Rawat Inap RSUD RA Basoeni Mojokerto Metode: desain penelitian ini adalah analitik observasional dengan metode cross sectional dan menggunakan teknik total sampling, yaitu mengambil seluruh data rekam medis pasien anak infeksi dengue di RSUD RA Basoeni Kabupaten Mojokerto periode Januari 2019 – Desember 2020. Penelitian diuji dengan Independent T-test. Hasil: penelitian ini didapatkan sampel berjumlah 80 pasien. Usia terbanyak adalah 1-5 tahun, jenis kelamin terbanyak yaitu perempuan, status gizi baik. Trombositopenia DD terbanyak 20%. Nilai NLR pada DD dan DBD terbanyak 0,55 – 1,75. Hasil uji Independen T-test adalah 0,141 (p>0,05). Simpulan: Didapatkan tidak ada hubungan antara nilai NLR terhadap infeksi dengue pada anak di RSUD RA Basoeni Kabupaten Mojokerto.Kata kunci: Infeksi dengue, NLR

Identification of Hub Genes and Potential Biomarkers for Childhood Asthma by Utilizing an Established Bioinformatic Analysis Approach

Childhood asthma represents a heterogeneous disease resulting from the interaction between genetic factors and environmental exposures. Currently, finding reliable biomarkers is necessary for the clinical management of childhood asthma. However, only a few biomarkers are being used in clinical practice in the pediatric population. In the long run, new biomarkers for asthma in children are required and would help direct therapy approaches. This study aims to identify potential childhood asthma biomarkers using a genetic-driven biomarkers approach. Herein, childhood asthma-associated Single Nucleotide Polymorphisms (SNPs) were utilized from the GWAS database to drive and facilitate the biomarker of childhood asthma. We uncovered 466 childhood asthma-associated loci by extending to proximal SNPs based on r2 > 0.8 in Asian populations and utilizing HaploReg version 4.1 to determine 393 childhood asthma risk genes. Next, the functional roles of these genes were subsequently investigated using Gene Ontology (GO) term enrichment analysis, a Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and a protein–protein interaction (PPI) network. MCODE and CytoHubba are two Cytoscape plugins utilized to find biomarker genes from functional networks created using childhood asthma risk genes. Intriguingly, 10 hub genes (IL6, IL4, IL2, IL13, PTPRC, IL5, IL33, TBX21, IL2RA, and STAT6) were successfully identified and may have been identified to play a potential role in the pathogenesis of childhood asthma. Among 10 hub genes, we strongly suggest IL6 and IL4 as prospective childhood asthma biomarkers since both of these biomarkers achieved a high systemic score in Cytohubba’s MCC algorithm. In summary, this study offers a valuable genetic-driven biomarker approach to facilitate the potential biomarkers for asthma in childre