Bambang Permono
And Department Of Child Health, Universitas Airlangga Medical School/Dr. Soetomo General Hospital, Surabaya, East Java

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RISK FACTORS OF MORTALITY IN CHILDREN WITH WILMS’ TUMOR AT SOETOMO HOSPITAL SURABAYA Shanty, Maria Christina; Yuniarchan, Sherly; Andarsini, Mia Ratwita; Ugrasena, I Dewa Gede; Permono, Bambang; Prasetyo, Risky Vitria
Indonesian Journal of Urology Vol 26 No 2 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i2.469

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Objective: Wilms’ tumor is the most common childhood renal tumor for about 6% of pediatric malignant disease. The 5-year survival rate in United States increased from approximately from 70% (1970-1973) to 92% (1989-1996). This study was aim to analyze the risk factors of mortality in children with Wilms’ tumor. Material & Methods: A cross-sectional study was conducted in children with Wilms’ tumor at Soetomo Hospital during 2006-2011. The data of demographic, clinical profile, complete blood count, blood urea nitrogen, glomerular filtration rate, histological type, disease stage, metastases and relapse were analyzed as risk factors of mortality using logistic regression. Results: There were 37 Wilms’ tumor children and 5 children were excluded because of incomplete data. The mean age was 3.0 (SD 2.6) years, and male-to-female ratio was 2.5 : 1. There were 5/32 children in stage I, 7/32 children in stage II, 8/32 children in stage III, 11/32 children in stage IV, and 1/32 children in stage V. There were 15/32 children underwent operation. Complete remission occurred in 12/32 children and 1/32 children relapsed. There were 20/32 children died, associated with anemia (P=0.033, OR=6.111, 95% CI=1.056-35.352) and advanced stage (P=0.021, OR=8.000, 95% CI=1.575-40.632). The risk of mortality increased 3.284 folds with every increased stage (P=0.007, 95% CI=1.338-7.775). Conclusion: Disease stage is the significant risk factor of mortality in children with Wilms’ tumor.  
Luaran Pengobatan Fase Induksi Pasien Leukemia Limfoblastik Akut pada Anak di Rumah Sakit Umum Dr. Soetomo Surabaya Widiaskara IM; Bambang Permono; Ugrasena IDG; Mia Ratwita
Sari Pediatri Vol 12, No 2 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.2.2010.128-34

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Latar belakang. Kasus baru leukemia limfoblastik akut (LLA) menduduki peringkat pertama keganasanpada anak di RSU Dr. Soetomo – SurabayaTujuan. Mengetahui gambaran klinis, laboratorium, dan melihat hasil aspirasi sumsum tulang pada faseinduksi pada pasien LLAMetode. Penelitian menggunakan rancangan deskritif, secara retrospektif menggunakan catatan medisterhadap 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. Pengobatanmenggunakan 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%, splenomegali52,4%. 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 pulangpermintaan keluarga 8 pasien.Kesimpulan. Aspirasi sumsum tulang fase induksi didapatkan remisi 48,5 %, meninggal 36,8% dan nonremisi 14,7%. Pasien LLA dengan risiko tinggi mempunyai angka kematian 2 kali lebih tinggi daripadarisiko standar, dan penyebab kematian tersering adalah infeksi 19 (76%).
Pengaruh Kadar Feritin Serum terhadap Fungsi Ventrikel Kiri pada Thalassemia Mayor yang Mendapat Transfusi Multipel Renny Suwarniaty; Teddy Ontoseno; Bambang Permono; Sudigdo Sastroasmoro
Sari Pediatri Vol 9, No 3 (2007)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp9.3.2007.178-84

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Latar belakang. Thalassemia adalah penyakit darah yang bersifat diturunkan, transfusi darah secara teraturmerupakan satu-satunya cara untuk memperpanjang hidup.Tujuan. Untuk mengetahui pengaruh kadar feritin serum terhadap fungsi ventrikel kiri pada pasienthalassemia mayor yang mendapatkan transfusi multipel.Metode. Penelitian dengan rancang bangun cross sectional. Dilakukan di Divisi Hematologi - OnkologiRS Dr Sutomo Surabaya dari bulan Agustus-November 2006. Pengambilan sampel secara konsekutif,dibagi menjadi 3 kelompok berdasarkan jumlah transfusi darah yang telah diterima.Hasil. Subjek penelitian 61 anak rerata kadar serum feritin pada kelompok 1: 768,7, kelompok 2: 2338,8,kelompok 3: 5207,3. Hasil ekokardiografi EF < 64% kelompok 1: 3 dari 18 anak (16,7%), kelompok 2: 2dari 15 anak (13,3%), kelompok 3: 8 dari 28 anak (28,6%). Rasio E/A < 1,5 kelompok 1: 6 dari 18 anak(33,3%), kelompok 2: 3 dari 15 anak (20,0%), kelompok 3: 12 dari 28 anak (42,9%). Rasio E/A > 2,5kelompok 1: 1 dari 18 anak (5,6%), kelompok 2: 1 dari 15 anak (6,7%), kelompok 3: 4 dari 28 anak(9,8%). Dengan analisis regresi logistik, ternyata tidak ada hubungan bermakna antara kadar feritin serumdengan gangguan fungsi ventrikel kiri pada subyek penelitian. (p > 0,05)Kesimpulan. Terdapat hubungan antara lama transfusi dengan rasio E/A yang > 2,5, namun tidakdidapatkan hubungan antara kadar serum feritin dengan gangguan fungsi ventrikel kiri pada pasientallasemia mayor yang mendapatkan transfusi secara multipel.
Malignant osteopetrosis in a child Annie Kusumadewi; Moersintowati B. Narendra; Bambang Permono
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (736.538 KB) | DOI: 10.14238/pi47.5.2007.238-43

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Langerhans’ cell histiocytosis: difficulty in establishing diagnosis (a case report) Annie Kusumadewi; Landia Setiawati; Bambang Permono
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1755.261 KB) | DOI: 10.14238/pi48.1.2008.49-53

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A case of Langerhans’ cell histiocytosisthat previously diagnosed as tuberculous osteomyelitis,focusing on difficulty in diagnosis.
Assessment of the quality of general movements in newborn infants: a tool to predict developmental disorders at an early age Ahmad Suryawan; Bambang Permono; Komang Ayu Witarini; Risa Etika; Fatimah lndarso; Moersintowarti B. Narendra
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (126.968 KB) | DOI: 10.14238/pi48.5.2008.292-8

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Background Nowadays, quality assessment of general movements(GMs) in infants can be used as a tool to predict developmentaloutcome. Until now, there is no published study in this field inIndonesia.Objectives The aim of this study was to evaluate the quality ofGMs of newborn infants.Methods A prospective study was done at neonatal ward, Dr.Soetomo Hospital in Surabaya, between December 2006 andJanuary 2007. A single supine position video recording of newbornsat GMs preterm and writhing age was made using Precthl's method.Infants were chosen consecutively among singletons above 28week gestational age. The quality of GMs was assessed by meansof Gestalt perception by one of the authors, who had been trainedand certified in GMs. GMs were classified into: normal-optimal,normal-suboptimal, mildly-abnormal, and definitely-abnormal.Correlation tests were used to assess the relationship betweenperinatal conditions and the quality of GMs.Results 106 videos were recorded, and 100 were assessedcompletely. Abnormal GMs were found in both 35 pretermage (normal-optimal 2.9%; normal-suboptimal 28.6%; mildly-abnormal45. 7o/o; definitely-abnormal22.9o/o) and 65 writhing age(3.1 o/o; 41.5%; 41.5%; 13.8%, respectively) (P=0.285). There wasa weak negative correlation between birth weight and the qualityofGMs (r=-0.20, P=0.044).Conclusions The quality ofGMs in Indonesian newborn infants inour study was predominantly abnormal, which puts these infantsat high risk for later developmental disorders. The lower theinfants'birth weight, the more likely for abnormal GMs.
The discrepancy between manual and computerized leukocyte and thrombocyte counts Bambang Permono; Retno Asih; I Dewa Gede Ugrasena
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.091 KB) | DOI: 10.14238/pi43.3.2003.95-8

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Background Discrepancy between results of leukocyte and throm-bocyte count by computerized and manual examination may existObjective To determine the discrepancy between computerizedand manual leukocyte and thrombocyte count.Methods The design was a randomized sampling cross sectionalstudy. The blood sample was examined with computerized CellDyn 1400 instrument for the leukocyte and thrombocyte count. Formanual examination, blood smear was performed to measurethrombocyte while leukocyte was measured in Improved Neubauerhemocytometer. The results of computerized examination wereused as gold standard. Sensitivity, specificity, predictive values ofmanual count were calculated. The agreement of Kappa and McNemar test were determinedResults Blood specimens drawn from 100 patients with differentkinds of diagnoses were examined using computerized and manualmethods. In computerized group, 66% had normal leukocyte and55% had normal thrombocyte count. In the manual group, 78% ofsubjects had normal leukocyte and 82% had normal thrombocytecount. From leukocyte examination, the sensitivity of manual countwas 87.9%, specificity was 41.2%, and positive predictive valuewas 74.36 with the agreement of Kappa of 0.32 and Mc Nemarvalue of 0.036. From thrombocyte examination, the sensitivity was96.4%, specificity was 35.6%, and positive predictive value was64.6 with the agreement of Kappa of 0.41 and Mc Nemar value of0.41.Conclusion The result of manual thrombocyte count was in ac-cordance with computerized with the agreement of Kappa of 0.41.On the other hand, there was a discrepancy between manual infavor of computerized leukocyte count with the agreement of Kappaof 0.32
Hereditary Spherocytosis : A Clinical Experience F. X. Santoso; Sukardi Sukardi; Bambang Permono; Netty R. H. T.; S. Untario
Paediatrica Indonesiana Vol 28 No 1-2 (1988): January - February 1988
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (658.798 KB) | DOI: 10.14238/pi28.1-2.1988.27-35

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Although hereditary spherocytosis is a common cause of hemolytic anemia among whites of Northern European descent, it is uncommon in Asia. In the past 8.5 years (from December 1978 to June 1987), we found only six cases of hereditary spherocytosis. They were 3 males and 3 females, and their ages ranged from 3 months to 8 years, with a mean age of 3.3 years. The most common presenting complaint was anemia (6 cases) followed by jaundice (4 cases) and splenomegaly (4 cases). Other symptoms were fever, abdominal pain and hepatomegaly. The mean hemoglobin concentration of these patients was 7.5 g/dl, in which 2 patients had severe anemia (less than 6 g/dl). Reticulocyte count ranged from 1.9% to 10% (mean 5.9%). All patients were found to have spherocytosis in their peripheral blood smears and an increased red blood cell fragility. Splenectomy was performed in one patient. There was no significant complication after operation in a 7-month follow up. The clinical manifestation returned to normal and the mean hemoglobin concentration increased. The existence of hereditary spherocytosis could not be proven in almost all parents of the patients. Based on this fact, is 'congenital spherocytosis' a more suitable term instead of hereditary spherocytosis?
ACQUIRED β−THALASSEMIA IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) Maria Christina Shanty Larasati; Mangihut Rumiris; Mia Ratwita Andarsini; I Dewa Gede Ugrasena; Bambang Permono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.444

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Thalassemias are heterogeneous group of genetic disorders. β-thalassemia is existed due to impaired production of beta globins chains, which leads to a relative excess of alpha globin chains. The abnormalities of haemoglobin synthesis are usually inherited but may also arise as a secondary manifestation of another disease, most commonly haematological neoplasia. This article presenting two cases of acquired β-thalassemia in children with ALL focusing on the diagnosis and the possible relationship between the two haematological diseases. The first case is a four (4) year old boy with ALL-L1 type at maintenance phase of chemotherapy, he suffered from anaemia with Hb 8.0 g/dL, WBC 22,600/mm3 and platelets count of 200,000/mm3, peripheral blood smear revealed anisocytosis, polychromes, hypochromia, basophilic stippling, and normoblastocytes. The result of Hb electrophoresis of Hb A of 54.9%, Hb F of 29.4%, Hb E of 13.4% and Hb A2 of 2.3%. The patient was diagnosed as ALL-L1 type and β-thalassemia. The second case, is a 13 year old girl with remission ALL-L1 type after chemotherapy, she suffered from anaemia with Hb 6.7 g/dL, WBC 12,400/mm3, platelet count was 200,000/mm3, and peripheral blood smear obtained anisocytosis, hypochromia, normoblastocytes, myelocytes and basophilic stippling. The result of Hb electrophoresis are: Hb F 0.41%, Hb A1c 0.78%, Hb A2 2.95% with the conclusion of a β-thalassemia trait, this patient was diagnosed with ALL-L1 type remission + β-thalassemia trait. The case reviewers assume that acquired β-thalassemia which happened in those patients were the altered expression of globin chain which mechanism for this syndrome might be the acquisition of a mutation that affects RNA or proteins involved in β-globin gene regulation and resulting the reduction of the (α/β)-globin biosynthetic ratios, or/and associated with chemotherapy-inducement.
Antibiotic Resistance Control Program in Pediatric Hematology and Oncology Patients at Dr. Soetomo Hospital in 2006–2007 Andarsini, Mia Ratwita; Ugrasena, I Dewa Gede; Permono, Bambang
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 2 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.357 KB) | DOI: 10.20473/ijtid.v1i2.2173

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Antibiotic resistance has been increasing since the first years of the clinical usage. It caused by inappropriate usage and uncontrol of antibiotic drugs. Therfore an Antibiotic Resistance Control Program (ARCP) is needed to overcome the problem. The purpose of this study is to know microorganism pattern and evaluate antibiotic use. Phase 1 (before ARCP), retrospective study by medical record of pediatric hematology-oncology patients with suspision of infection and admitted at dr Soetomo Hospital from June–August 2006 was carried out. Phase 2 (during ARCP), a prospective observational study was done from November 2006 to January 2007. We were evaluated the isolated microorganism, quantity of antibiotic were determined by Defined Daily Doses (DDD)/100 patients-days, quality of antibiotics usage were assessed with Glyssen classification, and the cost calculation of antibiotic therapy. Twenty seven patients were enrolled in phase 1 and 28 patients in phase 2. Coagulase-negative Staphylococci and Acinetobacter Sp as isolated microorganism was reported. Phase 1, the most sensitive antibiotic was Cefoperazone-Sulbactam and the most resistant was Penicillin G. Phase 2, Meropenem was the most sensitive antibiotic and Cotrimoxazole was the most resistant antibiotic. The use of antibiotics were decreased 6 vs 12 and DDD/100 patients-days were 14.52 vs 45.04. There were improving of Glyssen classification. The cost calculation of antibiotics therapy were decreased. ARCP can improve antibiotic use in pediatric hematology-oncology patients.