Health Status Condition on Children with Leukemia Through Family Centered Empowerment Model

Family-centered empowerment (FACE) is a nursing intervention by increasing family filial values, which consist of responsibility, respect, and family care. The objective of the study applied a family-centered empowerment model (FACE) to the health status of children suffering from leukemia. The study used quasi-experiment design, with the sample being 30 families with children suffering from leukemia treated in Soetomo Hospital Surabaya. Independent variable is family-centered empowerment (FACE) model and the dependent variable is health status condition of children suffering from leukemia. There is influence of FACE model to health indicator of children suffering from leukemia, consisting of child weight p = 0.000 (<0.05), leukocyte p = 0.002 (<0.05), and bleeding incidence p = 0.041 (<0.05). The Family Centered Empowerment (FACE) model is applied to families with children suffering from leukemia by nurses as an intervention of family filial value enhancement in increasing responsibility, respect and care so that families can develop their family appraisal skills to provide the best care while facing the challenge of treating children with leukemia. The family-centered empowerment model can improve family ability in treating children with leukemia, which impacts on child health indicator. Keyword: Family, Empowerment, leukemia, childre

METS-IR vs. HOMA-AD on Obese adolescents

Purpose : Obesity is associated with chronic low-grade inflammation in which is the key in the pathogenesis Insulin Resistance (IR) and Metabolic Syndrome (MetS). Homeostasis model assessment of insulin resistance (HOMA-IR) has been validated as a surrogate measure of IR. The combination of HOMA and adiponectin, known as HOMA-AD was proposed to measure IR in adults. However, study on these indicators in obese adolescents is still limited. This study aims to analyse METS-IR and HOMA-AD to determine MetS and IR in obese adolescents. Methods : A cross-sectional study was conducted on obese adolescents who looked healthy from secondary schools in Surabaya and Sidoarjo, East Java, aged 12-18 years. Subjects were selected randomly and grouped into 2, namely MetS and non-MetS based on IDF 2000. Anthropometric examination and blood measurements, such as fasting blood glucose levels, lipid profiles, insulin, and adiponectin level were carried out according to standards. HOMA-IR, HOMA-AD, AND METS-IR were calculated using formula. Spearman’s Rho correlation were conducted between assessment tools (METS-IR and HOMA-AD) to identify the correlation with MetS component (lipid profile, FBG, and blood pressures). A receiving operation curve (ROC) performed to find area under curve (AUC) and cut-off points based on the biggest Youden index. Result : A total of 250 subjects were enrolled the study, and found 103 subjects had MetS. METS-IR correlates with all lipid profile and blood pressures (p < 0.05). While HOMA-AD correlated with TG (r = 0.356, p = 0.000), systolic-BP (r = 0.188, p = 0.003), and HDL-c levels (r=-0.249, p = 0.000). Cut-off point for METS-IR to determines MetS in obese adolescents was ≥ 46.53 (sensitivity of 64.24% and specificity of 75.76%), while HOMA-AD was ≥ 0.43 (sensitivity of 71.52% and specificity of 59.60%). Cut-off point for METS-IR index to determines IR was ≥ 52.01 (sensitivity of 83.44% and specificity of 44.44%). Cut-off point for HOMA-AD to determine IR was ≥ 0.37 (sensitivity of 74.17% and specificity of 84.85%). Conclusion : METS-IR is better surrogate to determine MetS with cut-off point of ≥ 46.53, while HOMA-AD is better to determine IR with cut-off point ≥ 0.37 in obese adolescents

Purpura Trombositopenik Idiopatika pada Anak (patofisiologi, tata laksana serta kontroversinya)

Purpura trombositopenik idiopatika (ITP) merupakan kelainan perdarahan didapat pada anak yang paling sering dijumpai, ITP merupakan kelainan otoimun yang menyebabkan munculnya suatu autoantibodi terhadap trombosit. Diagnosis ITP ditegakkan dengan menyingkirkan kemungkinan penyebab trombositopenia yang lain. Pemeriksaan aspirasi sumsum tulang tidak rutin dilakukan pada ITP, hanya untuk kasus yang meragukan. Pada anak umumnya ITP bersifat akut dan dapat sembuh spontan dalam waktu kurang dari 6 bulan. Tata laksana ITP khususnya ITP akut pada anak masih kontroversial. Pengobatan umumnya dilakukan hanya untuk meningkatkan jumlah trombosit, namun tidak menghilangkan risiko terjadinya perdarahan intrakranial dan perjalanan menjadi ITP kronis. Pengobatan juga potensial menimbulkan efek samping yang cukup serius. Perlu dilakukan suatu studi prospektif acak yang meneliti manfaat secara klinis berbagai pengobatan ITP pada anak. Pemahaman yang tepat tentang perjalanan alamiah ITP kronis pada anak sangat bermanfaat bagi suatu pengobatan yang rasional

Pedigree analysis of glucose-6 phosphate dehydrogenase (G6PD) deficiency of a Javanese Chinese family in Indonesia

The molecular and pedigree analyses in a Javanese Chinese family were carried oul on glucose-6-phosphate dehydrogenase deficiencies. By method of  MPTP scanning without the sequencing steps, those variants could be confirmed. Two out of three sons were clinically jaundiced at birth due to G6PD deficiency and identified to have a G to T nucleotide change al 1376th nucleotide 01 the G6PD gene (GI376T), corresponding to G6PD Canton. Another son was also identified to have a C to T nucleotide change at 1311st nucleotide 01 the G6PD gene (CI311T), corresponding to a Silent mutation. Their father was normal, but their mother obsorved to have the heleromutation 01 G1376T (G6PD Canton and C1311T (a Silent mutation)

Buku Ajar Hematologi Onkologi Anak

iii.331 hal 23 c

Luaran Pengobatan Fase Induksi Pasien Leukemia Limfoblastik Akut pada Anak di Rumah Sakit Umum Dr. Soetomo Surabaya

Latar belakang. Kasus baru leukemia limfoblastik akut (LLA) menduduki peringkat pertama keganasan pada anak di RSU Dr. Soetomo – Surabaya Tujuan. Mengetahui gambaran klinis, laboratorium, dan melihat hasil aspirasi sumsum tulang pada fase induksi pada pasien LLA Metode. Penelitian menggunakan rancangan deskritif, secara retrospektif menggunakan catatan medis terhadap pasien LLA selama 1 tahun (1 Januari 2006 s/d 31 Desember 2006). Semua pasien berumur <15 tahun yang pertama kali didiagnosis sebagai LLA dan belum mendapat terapi sitostatik. Pengobatan menggunakan protokol Indonesia tahun 2006. Hasil. Didapatkan 82 pasien baru, umur 4 bulan – 15 tahun, sebagian besar berumur antara 2 – 5 tahun. Gambaran klinis berupa demam 70,7%, pucat 50%, perdarahan 62,1%, hepatomegali 60,9%, splenomegali 52,4%. Pada aspirasi sumsum tulang fase induksi didapatkan remisi 33(48,5%), non remisi 10 (14,7%) dan meninggal 25 (36,8%), sisanya tidak dikerjakan oleh karena menolak sitostatik 6 pasien dan pulang permintaan keluarga 8 pasien. Kesimpulan. Aspirasi sumsum tulang fase induksi didapatkan remisi 48,5 %, meninggal 36,8% dan non remisi 14,7%. Pasien LLA dengan risiko tinggi mempunyai angka kematian 2 kali lebih tinggi daripada risiko standar, dan penyebab kematian tersering adalah infeksi 19 (76%)

Gambaran Hematologi Anemia Defisiensi Besi pada Anak

Latar belakang.Anemia defisiensi besi (ADB) menjadi masalah kesehatan di dunia, baik di negara maju maupun negara berkembang seperti di Indonesia. Sekitar 30% penduduk dunia menderita anemia dan lebih dari setengahnya merupakan anemia defisiensi besi. Dampak negatif yang diakibatkan oleh anemia defisiensi besi pada anak balita sangat serius. Tujuan.Mengetahui gambaran hematologis anemia defisiensi besi pada anak yang dirawat di RSUD Wangaya Denpasar. Metode.Penelitian deskritif potong lintang, pada anak yang dirawat di RSUD Wangaya Denpasar pada periode Januari – Juni 2009, umur 6-59 bulan. Diagnosis anemia defisiensi besi berdasarkan kriteria WHO, diberikan pengobatan bagi yang menderita ADB dengan sulfas ferosus (SF) selama 1 bulan. Hasil.Didapatkan 75 anak usia 6–59 bulan yang dirawat di RSUD Wangaya dengan anemia. Sebagian besar (52%) laki-laki, terbanyak usia 12 – 35 bulan (46,7%) dan 65,3 % menderita dengan rerata kadar Hb, MCHC, SI, TIBC, saturasi transferin berturut-turut adalah 9,9 g/dl , 31,8 g/dl, 37,9 Ug/dl, 361 Ug/dl dan 12,3 %, HCT 30,7% dan feritin serum 75,6 ug/L. Pengobatan dengan SF selama 1 bulan menunjukkan peningkatan Hb 1 gr/dl dan HCT 2,8%. Kesimpulan.Anak yang dirawat dengan anemia 65,3% anemia defisiensi besi dan. sebagian besar (57,1%) mempunyai status besi yang kurang. Selama 1 bulan pengobatan dengan sulfas ferosus terjadi peningkatan Hb 1 gr % dan HCT 2,8

METS-IR vs. HOMA-AD and Metabolic Syndrome in Obese Adolescents

Abstract Purpose : Obesity is associated with chronic low-grade inflammation in which is the key in the pathogenesis Insulin Resistance (IR) and Metabolic Syndrome (MetS). Homeostasis model assessment of insulin resistance (HOMA-IR) has been validated as a surrogate measure of IR. The combination of HOMA and adiponectin, known as HOMA-AD was proposed to measure IR in adults. However, study on these indicators in obese adolescents is still limited. This study aims to analyse METS-IR and HOMA-AD to determine MetS and IR in obese adolescents. Methods : A cross-sectional study was conducted on obese adolescents who looked healthy from secondary schools in Surabaya and Sidoarjo, East Java, aged 12-18 years. Subjects were selected randomly and grouped into 2, namely MetS and non-MetS based on IDF 2000. Anthropometric examination and blood measurements, such as fasting blood glucose levels, lipid profiles, insulin, and adiponectin level were carried out according to standards. HOMA-IR, HOMA-AD, AND METS-IR were calculated using formula. Spearman’s Rho correlation were conducted between assessment tools (METS-IR and HOMA-AD) to identify the correlation with MetS component (lipid profile, FBG, and blood pressures). A receiving operation curve (ROC) performed to find area under curve (AUC) and cut-off points based on the biggest Youden index. Result : A total of 250 subjects were enrolled the study, and found 103 subjects had MetS. METS-IR correlates with all lipid profile and blood pressures (p?<?0.05). While HOMA-AD correlated with TG (r?=?0.356, p?=?0.000), systolic-BP (r?=?0.188, p?=?0.003), and HDL-c levels (r=-0.249, p?=?0.000). Cut-off point for METS-IR to determines MetS in obese adolescents was???46.53 (sensitivity of 64.24% and specificity of 75.76%), while HOMA-AD was???0.43 (sensitivity of 71.52% and specificity of 59.60%). Cut-off point for METS-IR index to determines IR was???52.01 (sensitivity of 83.44% and specificity of 44.44%). Cut-off point for HOMA-AD to determine IR was???0.37 (sensitivity of 74.17% and specificity of 84.85%). Conclusion : METS-IR is better surrogate to determine MetS with cut-off point of???46.53, while HOMA-AD is better to determine IR with cut-off point???0.37 in obese adolescents. J. Med. Invest. 70 : 7-16, February, 202

METS-IR vs. HOMA-AD and Metabolic Syndrome in Obese Adolescents

Purpose: Obesity is associated with chronic low-grade inflammation in which is the key in the pathogenesis Insulin Resistance (IR) and Metabolic Syndrome (MetS). Homeostasis model assessment of insulin resistance (HOMA-IR) has been validated as a surrogate measure of IR. The combination of HOMA and adiponectin, known as HOMA-AD was proposed to measure IR in adults. However, study on these indicators in obese adolescents is still limited. This study aims to analyse METS-IR and HOMA-AD to determine MetS and IR in obese adolescents. Methods: A cross-sectional study was conducted on obese adolescents who looked healthy from secondary schools in Surabaya and Sidoarjo, East Java, aged 12-18 years. Subjects were selected randomly and grouped into 2, namely MetS and non-MetS based on IDF 2000. Anthropometric examination and blood measurements, such as fasting blood glucose levels, lipid profiles, insulin, and adiponectin level were carried out according to standards. HOMA-IR, HOMA-AD, AND METS-IR were calculated using formula. Spearman's Rho correlation were conducted between assessment tools (METS-IR and HOMA-AD) to identify the correlation with MetS component (lipid profile, FBG, and blood pressures). A receiving operation curve (ROC) performed to find area under curve (AUC) and cut-off points based on the biggest Youden index. Result: A total of 250 subjects were enrolled the study, and found 103 subjects had MetS. METS-IR correlates with all lipid profile and blood pressures (p?<?0.05). While HOMA-AD correlated with TG (r?=?0.356, p?=?0.000), systolic-BP (r?=?0.188, p?=?0.003), and HDL-c levels (r=-0.249, p?=?0.000). Cut-off point for METS-IR to determines MetS in obese adolescents was???46.53 (sensitivity of 64.24% and specificity of 75.76%), while HOMA-AD was???0.43 (sensitivity of 71.52% and specificity of 59.60%). Cut-off point for METS-IR index to determines IR was???52.01 (sensitivity of 83.44% and specificity of 44.44%). Cut-off point for HOMA-AD to determine IR was???0.37 (sensitivity of 74.17% and specificity of 84.85%). Conclusion: METS-IR is better surrogate to determine MetS with cut-off point of???46.53, while HOMA-AD is better to determine IR with cut-off point???0.37 in obese adolescents. J. Med. Invest. 70 : 7-16, February, 2023