Neti Nurani
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan Universitas Gadjah Mada/ Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta

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Risk factors in childrenwith platelet refractoriness Neti Nurani, Teguh Triyono, Jonliberti Purba Sri Mulatsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.51 KB) | DOI: 10.19106/JMedScie004501201305

Abstract

Platelet transfusions are often performed in pediatric patients. Nevertheless, platelet transfusion has its own risk and it alsoincrease the cost of care. Therefore,its effectiveness needs to be evaluated. This study aimed to assess the clinical risk factors namely sepsis, splenomegaly, DIC, severe bleeding and the history of platelet transfusion in the incidence of refractory platelets. This was a case-control study conducted during the period of August 2010 to September 2011.From a total of 1403 cases of transfusion, there were 86 incidences of refractory and 86 of nonrefractory. From the bivariate analysis, it was obtained that sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegaly [OR 2.82 (1.32-6.04.12), p = 0006] heavy bleeding [OR 8:41 (4.19-16.871), p = 0.000 ], DIC [OR 22.96 (6.73-78.35), p = 0.000] and the history of platelet transfusions [OR 5:33 (2.78-10.23), p = 0.000] increase the risk of refractory platelets. On multivariate analysis, sepsis (OR 2.96 [95% CI: 1:19 to 7:32], p = 0019), splenomegaly (OR 3.94 [95% CI: 2:21 to 16:00], p = 0.000), severe bleeding (OR 3:53 [95% CI : 1.40-8.89], p = 0.008), DIC (5:54 OR [95% CI: 1.29-22.75], p = 0021) and platelet transfusion the history (OR 2.84 [95% CI: 2.74-9.77], p = 0.001) were the independent risk factors for the occurrence of children refractory. In conclusion, sepsis, splenomegaly, severe bleeding, DIC, andthe history of platelet transfusion are the risk factors in pediatric patients refractory platelets. ABSTRAKTransfusitrombositseringdilakukanpadapasienanak.Transfusitrombositsendirimemilikirisikoterhadappasiendanmenambahbiayaperawatan, sehinggaperludievaluasiefektifitasnya.Menilaifaktorrisikoklinisyakni sepsis, splenomegali, DIC, pendarahanberatdanriwayattransfusitrombositterhadapkejadianrefraktertrombosit.Penelitianinimerupakanpenelitiankasuskontroluntukmenilaifaktorrisikoterjadinyarefraktertrombositseperti sepsis, DIC, splenomegali, pendarahanberat, riwayattransfusitrombosit.SelamaperiodeAgustus 2010 sampai September 2011 terdapat 1403 kasustransfusi, darikeseluruhankasustersebutdiambil 86 kejadianrefrakterdan 86 non refrakter. bivariatdidapatkan sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegali [OR 2.82 (1.32- 6.04.12), p = 0.006] pendarahanberat [OR 8.41(4.19-16.871), p = 0.000], DIC [OR 22.96 (6.73- 78.35), p = 0.000] riwayattransfusitrombosit [OR 5.33(2.78-10.23), p = 0.000] meningkatkanrisikorefraktertrombosit. Padaanalisismultivariat sepsis (OR 2.96 [95%IK; 1.19-7.32], p = 0.019), splenomegali (OR 3.94 [IK 95%;2.21-16.00], p = 0.000), pendarahanberat (OR 3.53 [95% IK; 1.40-8.89], p = 0.008), DIC (OR 5.54 [95% IK; 1.29-22.75], p =0.021) danriwayattransfusitrombosit(OR 2.84 [95% IK; 2.74-9.77], p =0.001) merupakanfaktorrisikoindependenterjadinyarefrakterpadaanak. Sepsis, splenomegali, pendarahanberat, DIC danriwayattransfusitrombositmerupakanfaktorrisikoterjadinyarefraktertrombositpadapasienanak. Keywords:refractory platelets - CCI - number of platelets – children(istilah CCI belum pernah muncul dalam abstrak dan tiba2 ada dalam keywords, mohon ditanyakan ke penulis)
Risk factors in childrenwith platelet refractoriness Jonliberti Purba; Sri Mulatsih; Neti Nurani; Teguh Triyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.51 KB) | DOI: 10.19106/JMedScie004501201305

Abstract

Platelet transfusions are often performed in pediatric patients. Nevertheless, platelet transfusion has its own risk and it alsoincrease the cost of care. Therefore,its effectiveness needs to be evaluated. This study aimed to assess the clinical risk factors namely sepsis, splenomegaly, DIC, severe bleeding and the history of platelet transfusion in the incidence of refractory platelets. This was a case-control study conducted during the period of August 2010 to September 2011.From a total of 1403 cases of transfusion, there were 86 incidences of refractory and 86 of nonrefractory. From the bivariate analysis, it was obtained that sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegaly [OR 2.82 (1.32-6.04.12), p = 0006] heavy bleeding [OR 8:41 (4.19-16.871), p = 0.000 ], DIC [OR 22.96 (6.73-78.35), p = 0.000] and the history of platelet transfusions [OR 5:33 (2.78-10.23), p = 0.000] increase the risk of refractory platelets. On multivariate analysis, sepsis (OR 2.96 [95% CI: 1:19 to 7:32], p = 0019), splenomegaly (OR 3.94 [95% CI: 2:21 to 16:00], p = 0.000), severe bleeding (OR 3:53 [95% CI : 1.40-8.89], p = 0.008), DIC (5:54 OR [95% CI: 1.29-22.75], p = 0021) and platelet transfusion the history (OR 2.84 [95% CI: 2.74-9.77], p = 0.001) were the independent risk factors for the occurrence of children refractory. In conclusion, sepsis, splenomegaly, severe bleeding, DIC, andthe history of platelet transfusion are the risk factors in pediatric patients refractory platelets. ABSTRAKTransfusitrombositseringdilakukanpadapasienanak.Transfusitrombositsendirimemilikirisikoterhadappasiendanmenambahbiayaperawatan, sehinggaperludievaluasiefektifitasnya.Menilaifaktorrisikoklinisyakni sepsis, splenomegali, DIC, pendarahanberatdanriwayattransfusitrombositterhadapkejadianrefraktertrombosit.Penelitianinimerupakanpenelitiankasuskontroluntukmenilaifaktorrisikoterjadinyarefraktertrombositseperti sepsis, DIC, splenomegali, pendarahanberat, riwayattransfusitrombosit.SelamaperiodeAgustus 2010 sampai September 2011 terdapat 1403 kasustransfusi, darikeseluruhankasustersebutdiambil 86 kejadianrefrakterdan 86 non refrakter. bivariatdidapatkan sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegali [OR 2.82 (1.32- 6.04.12), p = 0.006] pendarahanberat [OR 8.41(4.19-16.871), p = 0.000], DIC [OR 22.96 (6.73- 78.35), p = 0.000] riwayattransfusitrombosit [OR 5.33(2.78-10.23), p = 0.000] meningkatkanrisikorefraktertrombosit. Padaanalisismultivariat sepsis (OR 2.96 [95%IK; 1.19-7.32], p = 0.019), splenomegali (OR 3.94 [IK 95%;2.21-16.00], p = 0.000), pendarahanberat (OR 3.53 [95% IK; 1.40-8.89], p = 0.008), DIC (OR 5.54 [95% IK; 1.29-22.75], p =0.021) danriwayattransfusitrombosit(OR 2.84 [95% IK; 2.74-9.77], p =0.001) merupakanfaktorrisikoindependenterjadinyarefrakterpadaanak. Sepsis, splenomegali, pendarahanberat, DIC danriwayattransfusitrombositmerupakanfaktorrisikoterjadinyarefraktertrombositpadapasienanak.
Prevalence of hypertension and its risk factors among obese adolescents in Yogyakarta, Indonesia Neti Nurani; Navilah Hidayati; Delvira Anggraini; Nurkharisma Kusumawardani; Retno Palupi-Baroto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (203.199 KB) | DOI: 10.19106/JMedSci005303202103

Abstract

Obesity and overweight are considerable health problems with increasing prevalence among adolescents. In Indonesia, basic health research data from Riskesdas shows an increase in the prevalence of obesity in adolescents aged 13-15 y.o, from 2.6% in 2010 to 6.7% in 2013. This high prevalence of overweightand obesity is related to various factors. This study aimed to determine the factors associated with hypertension and obesity in adolescents. This study was conducted on an overweight population, obese, and super-obese adolescents aged 13-15 year in the Yogyakarta City, Indonesia. Demographic data included the history of breastfeeding, birth weight, gender, history of premature birth, lifestyle, and physical activity were gathered. Anthropometric data included the weight, height, and body mass index (BMI) were also measured and gathered. Hypertension was measured using a manual sphygmomanometer. The relationship was analyzed using Pearson chi-squareand the risk value was demonstrated from the odds ratio (OR). A significant relationship between gender and diastolic hypertension was observed (OR= 2.4; 95%CI = 1.23 – 5.09; p < 0.021). A significant difference related to the number of boy subjects between the 2 groups of overweight and obesity was also observed Compared with girls, boys had a higher risk of obesity (OR = 3.23). Other factors including breastfeeding, history of premature birth, low birth weight, and physical activity were not statistically significant between two groups in this study (p>0.05). in conclusion, there is a relationship between gender and diastolic hypertension incidence among obese adolescents. Boys are more at risk of obesity compared to girls.
Faktor Risiko Refrakter Trombosit pada Anak Jonliberti Purba; Sri Mulatsih; Neti Nurani; Teguh Triyono
Sari Pediatri Vol 15, No 3 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.091 KB) | DOI: 10.14238/sp15.3.2013.190-4

Abstract

Latar belakang. Transfusi trombosit sering dilakukan pada pasien anak. Namun transfusi trombosit memiliki risiko terhadap pasien dan menambah biaya perawatan, sehingga perlu dievaluasi.Tujuan. Menilai faktor risiko klinis yakni sepsis, splenomegali, DIC, perdarahan berat dan riwayat transfusi trombosit terhadap kejadian refrakter trombosit.Metode. Penelitian kasus kontrol untuk menilai faktor risiko terjadinya refrakter trombosit seperti sepsis, DIC, splenomegali, perdarahan berat, dan riwayat transfusi trombosit.Hasil. Selama periode Agustus 2010 sampai September 2011 terdapat 1403 kasus transfusi dari keseluruhan kasus tersebut ditentukan 86 kejadian refrakter dan 86 nonrefrakter. Analisis bivariat mendapatkan sepsis [OR 5,91 (2,90-12,05), p=0,000], splenomegali [OR 2,82 (1,32-6,04.12), p=0,006] perdarahan berat [OR 8,41(4,19-16,871), p=0.000], DIC [OR 2,96 (6,73-78,35), p=0,000] riwayat transfusi trombosit [OR 5,33(2,78-10,23), p=0,000] meningkatkan risiko refrakter trombosit. Pada analisis multivariat sepsis (OR 2,96 [95%IK; 1,19-7,32], p=0,019), splenomegali (OR 3,94 [IK 95%;2,21-16,00], p=0,000), perdarahan berat (OR 3,53 [IK 95%; 1,40-8,89], p = 0.008), DIC (OR 5,54 [IK 95%; 1,29-22,75], p=0,021) dan riwayat transfusi trombosit(OR 2,84 [IK 95%; 2,74-9,77], p=0,001) merupakan faktor risiko independen terjadinya refrakter pada anak.Kesimpulan. Sepsis, splenomegali, perdarahan berat, DIC dan riwayat transfusi trombosit merupakan faktor risiko terjadinya refrakter trombosit pada pasien anak.
Audit Tata laksana Meningitis Bakterialis pada Anak di RSUP Dr. Sardjito I Putu Ardika Yuda; Sunartini Sunartini; Neti Nurani
Sari Pediatri Vol 16, No 2 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp16.2.2014.115-20

Abstract

Latar belakang. Angka kematian dan disabilitas pasien meningitis bakterialis masih cukup tinggi serta berhubungan dengan kualitas pelayanan. Audit medis perlu dilakukan sebagai salah satu upaya meningkatkan patient safety.Tujuan. Mengetahui kesesuaian antara praktik tata laksana meningitis bakterialis pada anak yang dirawat di bangsal anak RSUP Dr. Sardjito dengan pedoman pelayanan medis berdasarkan standar pelayanan medis (SPM) RSUP Dr. Sardjito 2005 dan (Pedoman Pelayanan Medis) PPM IDAI 2010.Metode. Audit retrospektif dengan menggunakan pedoman audit berdasarkan SPM RSUP Dr. Sardjito tahun 2005 dan PPM IDAI tahun 2010. Subjek penelitian adalah anak usia 1 bulan-18 tahun dengan diagnosis meningitis bakterialis yang dirawat di bangsal anak RSUP Dr. Sardjito pada 1 Januari 2011 sampai dengan 31 Mei 2013.Hasil. Terdapat 114 anak dengan diagnosis meningitis bakterialis. Rata-rata lama waktu penanganan di UGD adalah 89 menit dengan median 78 menit. Median lama waktu dilakukannya pungsi lumbal sejak pasien masuk adalah 4,5 jam (rata-rata 13,9 jam, rentang interkuartil 2,3–18,2 jam). Enampuluh dua pasien (54,4%; 95%CI: 49,7-59, 1%) yang mendapatkan antibiotik dosis intrakranial dalam waktu 6 jam sejak pasien masuk. Namun, defisiensi ini tidak terbukti memengaruhi outcome kematian (OR: 0,7; 95%CI: 0,18-3,0; p=0,480) maupun terjadinya sekuel (OR: 1,1; 95%CI: 0,4-2,5; p=0,839). Pemeriksaan uji fungsi pendengaran dengan Brainstem Evoked Respons Audiometri (BERA) hanya dilakukan pada 26/63 (41,3%; 95%CI: 29,1-53,5%) pasien.Kesimpulan. Belum semua kasus tata laksana meningitis bakterialis memenuhi standar mutu sesuai pedoman. Perlu diadakan pelatihan atau workshop tata laksana meningitis bakterialis pada anak di RSUP Dr. Sardjito.
Berat Badan Lahir Rendah sebagai Faktor Risiko Stunted pada Anak Usia Sekolah Aulia Fakhrina; Neti Nurani; Rina Triasih
Sari Pediatri Vol 22, No 1 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.1.2020.18-23

Abstract

Latar belakang. Stunted pada usia sekolah menyebabkan kemampuan kognitif rendah, fungsi fisik tidak optimal, dan produktivitas masa depan yang rendah.Tujuan. Mengidentifikasi apakah berat badan lahir rendah (BBLR) merupakan faktor risiko stunted pada anak usia sekolah. Metode. Kami melakukan penelitian kasus-kontrol dari bulan Mei – Desember 2016 yang melibatkan siswa sekolah dasar berusia 6-7 tahun yang dipilih secara cluster random sampling di lima kabupaten di Daerah Istimewa Yogyakarta. Stunted didefinisikan sebagai nilai Z score untuk tinggi badan menurut usia <-2 standar deviasi berdasarkan kriteria WHO 2005. Data klinis dan demografi diperoleh menggunakan kuesioner yang diisi oleh orang tua. Hasil. Kejadian stunted adalah 11,8%. Riwayat BBLR (adjusted Odd Ratio (aOR) 3,38; IK 95% 2,03 -5,63), jenis kelamin laki-laki (aOR 1,62; IK 95% 1,160-2,27), usia kehamilan kurang bulan (aOR 4,23; IK 95% 2,18-8,24), pola pemberian MPASI dini (aOR 1,65; IK 95% 1,11-2,45) dan tinggal di daerah pedesaan (aOR 1,68; IK 95% 1,01-2,62) merupakan faktor risiko terjadinya stunted pada usia sekolah. Stunted pada usia sekolah tidak berhubungan dengan pemberian ASI eksklusif dan tingkat pendidikan orang tua.Kesimpulan. Anak-anak yang lahir dengan BBLR berisiko mengalami stunted pada masa sekolah.
Korelasi Derajat Obesitas dengan Prestasi Belajar Siswa Sekolah Dasar Kadek Hartini; Soetjiningsih Soetjiningsih; Neti Nurani
Sari Pediatri Vol 16, No 1 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.414 KB) | DOI: 10.14238/sp16.1.2014.41-6

Abstract

Latar belakang. Kejadian obesitas saat ini meningkat di seluruh dunia. Semakin berat derajat obesitas, komorbid yang dialami oleh anak obesitas juga semakin banyak. Obesitas menimbulkan stigma pada masyarakat, bahwa anak obesitas adalah anak yang malas, jelek dan bodoh. Hubungan yang jelas antara obesitas dengan prestasi belajar anak di sekolah belum dapat dibuktikan.Tujuan. Mengetahui hubungan derajat obesitas pada siswa sekolah dasar (SD) dengan prestasi belajar di sekolah.Metode. Potong lintang analitik dan pemilihan sampel penelitian dilakukan dengan acak bertingkat. Penelitian dilakukan pada siswa sekolah dasar yang berusia 6-13 tahun di Denpasar, dari Januari 2011 sampai dengan Juni 2011.Hasil. Penelitian dilakukan pada 1305 siswa SD yang disurvei, didapatkan 211 (16,1%) anak menderita obesitas. Didapatkan 60% berjenis kelamin laki-laki dengan rentangan umur 7 sampai 12 tahun dan rentangan IQ 81 sampai dengan 119. Analisis regresi linier menunjukkan bahwa penurunan nilai rerata bahasa Indonesia 23% dan penurunan nilai rerata matematika 15% berhubungan dengan peningkatan persentase derajat obesitas.Kesimpulan. Derajat obesitas berhubungan dengan prestasi belajar siswa sekolah dasar. Derajat obesitas ditemukan berhubungan lebih kuat dengan penurunan nilai rerata bahasa Indonesia dibandingkan dengan matematika.
Corticosteroids and obesity in steroid-sensitive and steroid-resistant nephrotic syndrome Nina Lestari; Neti Nurani; Madarina Julia
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (91.656 KB) | DOI: 10.14238/pi55.4.2015.194-8

Abstract

Background Children with nephrotic syndrome need high-dose corticosteroids to achieve remission. Studies have estimated a 35-43% risk of obesity in these patients after corticosteroid treatment.Objective To determine the prevalence of obesity in children who received corticosteroids for nephrotic syndrome, and to compare the risk of obesity in children with steroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS).Methods We performed a retrospective cohort study in 50 children with SSNS or SRNS who received corticosteroid treatment. Obesity was defined to be a BMI-for-age Z-score above +2.0 SD, according to the WHO Growth Reference 2007. Central obesity was defined to be a waist-to-height ratio > 0.50.Results The overall prevalence of obesity was 22%, with 29% and 14% in the SSNS and SRNS groups, respectively. The overall prevalence of central obesity was 50%, with 54% and 46% in the SSNS and SRNS groups, respectively. The cumulative steroid doses in this study were not significantly different between the SSNS and SRNS groups. There were also no significant differences between groups for risk of obesity (RR 2.53; 95%CI 0.58 to 10.99) or central obesity (RR 1.39; 95%CI 0.45 to 4.25).Conclusion In children with nephrotic syndrome who received corticosteroids, the prevalence of obesity is 22% and of central obesity is 50%. In a comparison of SSNS and SRNS groups, cumulative steroid dose as well as risks of obesity and central obesity do not significantly differ between groups.
Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum Diana Bancin; Elisabeth S. Herini; Pungky Ardani Kusuma; Neti Nurani
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (393.695 KB) | DOI: 10.14238/pi55.1.2015.59-64

Abstract

Congenital obstructive posterior urethral membranes (COPUM) is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This congenital anomaly of urinary tract potentially causes hydroureteronephrosis that is often associated with recurrent urinary tract infections and, ultimately, one of the most common causes of end-stage renal disease in children.1,2 Congenital hypertrophy of the verumontanum as part of COPUM is very rare. Only a few reports have been written on congenital hypertrophy of the vermontanum causing congenital obstructive uropathy.3-6
Effect of egg avoidance diet by nursing mothers on the incidence of atopic dermatitis in infants Neti Nurani; Endy Paryanto Prawirohartono; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (365.707 KB) | DOI: 10.14238/pi48.2.2008.71-5

Abstract

Background The prevalence of allergic and atopic diseases hasincreased rapidly and remains a social as well as an economicproblem for the patients on account of its chronic nature. In orderto decrease the atopic diseases, especially atopic dermatitis ininfants, nursing mothers should avoid allergenic foods as apreventive sensitization. Egg allergy is the most common cause offood allergy, and is closely related to atopic dermatitis in children.Objective To determine whether egg avoidance diet by nursingmothers could decrease the incidence of atopic dermatitis ininfants.Method We conducted a parallel randomized-controlled trial.Seventy-nine subjects eligible for the study were divided into twogroups: egg avoidance and non-egg avoidance group. Blockrandomization is used for random allocation. Intervention startedsince mothers had had delivery until their children were 4 monthsold. The primary outcomes were clinical atopic dermatitis.Result Atopic dermatitis incidence in maternal egg avoidancegroup was significantly lower than non-avoidance group. Non-avoidance, family history of asthma, and maternal allergy are thefactors significantly influencing atopic dermatitis incidence (OR6.17; OR 4.73; OR 0.14), respectively.Conclusion Egg avoidance by nursing mothers could decrease theincidence of atopic dermatitis in infants. Non-egg avoidance andasthma in the families are factors significantly inducing the incidenceof atopic dermatitis.