Sonographic measurement of splenic length in children at Cipto Mangunkusumo Hospital

Objectives The aim of this study was to determine the 10 th and 90 th percentiles and medians of normal splenic lengths of Indone- sian children at Cipto Mangunkusumo Hospital by ultrasonogra- phy using a method introduced by Rosenberg et al . Methods The maximum splenic length was obtained in longitudi- nal coronal plane with the splenic hilum visualized. The age of the patients were recorded. The medians and 10 th and 90 th percen- tiles for each age group were determined. Results Sixty-nine boys and 46 girls were examined at our institu- tion. The youngest subject was one month old and the oldest was 15 years old. The 10 th percentile, median, and 90 th percentile splenic length in the 1-3 months age group were 3.421 cm, 3.795 cm, and 4.343 cm, respectively. In the 3-6 month age group these measurements were 3.689 cm, 4.29 cm, and 5.094 cm, respec- tively; in the 6-12 month age group 4.016 cm, 4.72 cm, and 5.366 cm, respectively; in the 1-2 years age group 4.558 cm, 5.04 cm, and 5.502 cm, respectively; in the 2-4 year age group 5.151 cm, 6.225 cm, and 6.816 cm, respectively; in the 4-6 year age group 5.774 cm, 6.415 cm, and 7.82 cm, respectively; in the 6-8 year age group 6.077 cm, 7.505 cm, and 8.228 cm, respectively; in the 8-10 years age group 6.354 cm, 7.77 cm, and 8.602 cm, respectively; in the 10-12 years age group 6.354 cm, 7.77 cm, and 8.602 cm, respectively; and in the 12-15 year age group 7.934 cm, 9 cm, and 9.919 cm, respectively. In all age groups, the 10 th percentiles, medians, and 90 th percentiles were smaller than those of Ameri- can children as reported by Rosenberg et al. Conclusion The normal splenic lengths of Indonesian children are smaller than those of American children as reported by Rosenberg et al

Plain abdominal radiograph appearance in children with abdominal pain

Background Abdominal pain is a common condition in children. Plain abdominal radiograph is recommended routinely in the evaluation of children with abdominal pain. Methods A retrospective study was done to evaluate radiographic abnormalities in children with abdominal pain at the Department of Child Health Cipto Mangunkusumo Hospital from January 1, 1994 to December 31, 1998. Results Of the 76 patients with abdominal pain, there were 38 females and 38 males. Forty-five patients were in the >5-12 years age group. Thirty-five out of 76 patients showed radiographic abnormalities. The most common radiographic abnormality was stones (found in 13 patients), followed by uneven distribution of bowel air in 8 patients. Conclusion A plain abdominal radiograph is still required as a diagnostic tool for children with abdominal pain, especially in the acute stage

Abses Hati pada Anak

Diagnosis abses hati pada seorang anak laki-laki berusia 7 tahun ditegakkan berdasarkan nyeri perut kanan atas yang semakin hebat, demam, nafsu makan yang menurun, riwayat diare, hepatomegali. Pada pemeriksaan fisik teraba masa di daerah perut kanan atas yang makin membesar serta terasa nyeri; pemeriksaan ultrasonografi hati tampak gambaran sesuai dengan abses hati. Jenis abses hati pasien ini kemungkinan adalah abses hati piogenik pada pasien ini didukung ditemukannya bakteri batang gram negatif pada pemeriksaan sediaan langsung pus abses, namun biakan bakteri terhadap pus negatif. Kemungkinan abses hati amuba masih perlu dipikirkan karena di negara sedang berkembang seperti Indonesia lebih sering ditemukan abses hati amuba. Terapi dengan obat golongan sefalosforin (sefotaksim) dan metronidazol memberi respon yang baik, terlihat dari berkurangnya gejala demam dan nyeri perut dalam dua hari, mengecilnya hati serta tidak terlihat lagi adanya gambaran abses setelah lima hari pemberian antibiotik. Adanya kekambuhan (gambaran abses pada ultrasonografi) setelah pengobatan metronidazol dihentikan, menguatkan dugaan diagnosis abses hati amub

Periventricular leucomalacia in premature infants in neonatal ward, Cipto Mangunkusumo Hospital: A preliminary study

Introduction Periventricular leucomalacia (PVL) is a major cause of neurodevelopment delay in premature infants, so early detec- tion of the preterm infant at high risk for the subsequent develop- ment of this lesion is critical. Objectives To determine the prevalence of PVL in premature in- fants hospitalized in neonatal ward, Cipto Mangunkusumo Hospi- tal using cranial ultrasound scans and define its characteristics Methods Premature infants hospitalized in the neonatal ward from January to July 2003 were included in this study. Clinical features were retrieved from medical charts. Ultrasound scan was performed once, after the age of 7 days and interpretations were read sepa- rately by two consultants of the radiology division. Results Fifty-one infants were included, 21 with <32-week gesta- tion, 30 with >32-week gestation; birth weight range were 1000 to 2600 gram. Nineteen infants had cystic lesion and/or dilatation of the ventricle from the cranial ultrasound scan. The prevalence of PVL in gestational age (GA) of <32 weeks was 6/21 and that in GA of >32 weeks was 13/30. Risk factors found in infants with PVL were maternal infection, respiratory distress, sepsis and circula- tory failure. Conclusion The prevalence of PVL in preterm infants in Cipto Mangunkusumo neonatal ward was higher than that was reported in developed countries. Maternal infection, respiratory distress, sepsis, and circulatory failure which were commonly found in these infants were factors to be considered as risks for PV

Uji Klinis Tersamar Acak Ganda Pemberian Parasetamol Pasca Imunisasi DTwP-Hep B-HIB

Latar belakang. Demam, pengurangan waktu tidur, nyeri, dan reaksi lokal adalah beberapa kejadian ikutan pasca imunisasi. Untuk mencegah hal tersebut, profilaksis parasetamol pasca imunisasi diberikan oleh tenaga medis maupun orang tua. Peraturam Menteri Kesehatan Republik Indonesia dan Pedoman Imunisasi IDAI belum menetapkan secara tegas boleh atau tidaknya pemberian profilaksis parasetamol pasca imunisasi. Tujuan. Mengetahui efektivitas pemberian profilaksis parasetamol oral untuk mencegah kejadian ikutan pasca imunisasi kombinasi DTwP-Hep B-Hib. Metode. Uji klinis tersamar acak ganda (double blind randomized control trialI) dengan pemberian parasetamol dan plasebo pada pasien pasca imunisasi kombinasi DTwP-Hep B-Hib di Puskesmas Kecamatan Kramat Jati dan Kelurahan Batu Ampar selama September 2015 sampai Oktober 2015. Satu hari pasca imunisasi, kelompok perlakuan diberikan parasetamol (40-50 mg/kgBB/hari) yang terbagi empat dosis, sedangkan kelompok kontrol mendapatkan plasebo. Selama empat hari pasca imunisasi dilakukan pengukuran suhu aksila, lama tidur, dan reaksi inflamasi lokal. Hasil. Subjek terdiri atas 100 bayi yang mendapatkan imunisasi kombinasi DTwP-Hep B-Hib ketiga. Karakteristik dasar meliputi usia, jenis kelamin, dan status gizi tidak berbeda di kedua kelompok. Subjek penelitian mendapatkan profilaksis parasetamol (50 subjek) dan profilaksis plasebo (50 subjek). Seluruh subjek penelitian tidak demam, tidak mengalami gangguan tidur, dan tidak ditemukan reaksi lokal. Pemberian parasetamol 24 jam pasca imunisasi DTwP-Hep B-Hib menunjukkan penurunan suhu 0,1OC - 0,2OC yang bermakna secara statistik (p0,05) pada lama tidur. Kesimpulan. Pemberian parasetamol profilaksis pasca imunisasi DTwP-Hep B-Hib selama satu hari dapat menurunkan suhu tubuh pada 24 jam pasca imunisasi

Sensitisasi Alergen Makanan dan Hirupan pada Anak Dermatitis Atopik Setelah Mencapai Usia 2 Tahun

Latar belakang. Dermatitis atopik (DA) merupakan manifestasi awal atopic marchyang berhubungan dengan alergi makanan. Alergen penyebab dan faktor risiko yang memengaruhi penting diketahui. Tujuan. Mengetahui sensitisasi dan faktor risiko alergi pada DA setelah usia 2 tahun. Metode. Penelitian deskriptif potong lintang terhadap 35 subjek DA sejak Januari-Maret 2011. Sensitisasi diketahui dengan uji tusuk kulit. Hasil. Sensitisasi terjadi pada 29 subjek dari 35 subjek, dengan faktor risiko pajanan asap rokok ditemukan pada 21 subjek, faktor risiko alergi sedang dan tinggi 19 subjek, tidak mendapat ASI eksklusif 9 subjek, dan makanan padat usia dini 21 subjek. Sensitisasi alergen makanan ditemukan pada 26 subjek. Kesimpulan. Sebagian besar subjek DA mengalami sensitisasi oleh alergen makanan. Faktor risiko pajanan asap rokok, faktor risiko alergi sedang dan tinggi, tidak mendapat ASI eksklusif, dan mendapat makanan padat usia dini ditemukan lebih sering pada anak D

Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

<p>Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. <em><strong>(Med J Indones 2008; 17: 107-13)</strong></em></p><p><strong>Keywords:</strong> <em>cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia</em></p