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All Journal The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana JURNAL ETIKA KEDOKTERAN INDONESIA

Setyanto, Darmawan Budi

Department Of Child Health, Faculty Of Medicine, Universitas Indonesia/Cipto Mangunkusumo National General Hospital, Jl. Salemba Raya No.6, Jakarta

Author-ID : 3451809

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Articles

Increased Risk of Recurrent Acute Respiratory Infections in Children with Congenital Heart Disease: A Prospective Cohort Study Mulyadi Muhammad Djer; Emilda Osmardin; Badriul Hegar; Darmawan Budi Setyanto
The Indonesian Biomedical Journal Vol 12, No 4 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i4.1262

BACKGROUND: There is a lack of local data about recurrent acute respiratory infections in children with congenital heart disease (CHD). This study aims to investigate the incidence and recurrence of acute respiratory infection (ARI) in left-to-right shunt CHD.METHODS: This prospective cohort study investigated children with left-to-right shunt CHD, aged three months to five years, at Dr. Cipto Mangunkusumo Hospital between September 2012 and April 2013. Age and sex-matched participants without CHD were recruited as reference. The occurrence of ARI was observed for six months. Acyanotic CHD patients from 2015 to 2019 were also evaluated to determine the proportion of ARI among this population.RESULTS: A total of 100 subjects were enrolled in the study, 50 in the CHD group and 50 in the non-CHD group, six of whom were later excluded. The monthly incidence of ARI in the CHD group ranged between 40-60% (p=0.027). Subjects with CHD had a cumulative increased risk of 10% for acquiring ARI (RR=1.1; 95% CI=1.02-1.2, p=0.027). The proportion of subjects with a high recurrence of ARI was also higher in the CHD compared to the non-CHD group (67% vs. 30 %, p<0.001). The mean frequency of and median duration of ARI episodes was also higher in CHD compared to the non-CHD group, 3 vs. 1.5 episodes (p<0.001), and 7 vs. 5 days, respectively.CONCLUSION: Children with CHD are at an increased risk of ARI, with more episodes and longer duration compared to children without CHD.KEYWORDS: non-cyanotic CHD, left-to-right shunt, acute respiratory infections

Evaluasi Kualitatif Antibiotik Metode Gyssens dengan Konsep Regulasi Antimikroba Sistem Prospektif RASPRO pada Pneumonia di Ruang Rawat Intensif Anak Rinna Wamilakusumayanti Sundariningrum; Darmawan Budi Setyanto; Ronald Irwanto Natadidjaja
Sari Pediatri Vol 22, No 2 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.2.2020.109-14

Latar belakang. Pneumonia masih paling sering sebagai infeksi primer maupun infeksi sekunder dalam perawatan anak di ruang rawat intensif. Penggunaan antibiotik yang tidak tepat dapat meningkatkan morbiditas, mortalitas, pengobatan lebih mahal, dan resistensi antibiotik.Tujuan. Mengevaluasi penggunaan antibiotik secara kualitatif pada pasien pneumonia menggunakan metode Gyssens dengan konsep RASPRO.Metode. Penelitian deskriprif retrospektif berdasarkan data rekam medis pasien pneumonia di ruang intensif anak RS Hermina Bekasi, periode bulan Mei sampai Oktober 2019. Antibiotik dievaluasi secara kualitatif menggunakan metode Gyssens dengan konsep RASPRO.Hasil. Didapatkan 51 (14,46%) pasien dengan pneumonia berat. Digunakan 119 antibiotik; terdiri dari 90 (75,63%) empiris dan 29 (24,37%) definitif. Ampisilin sulbaktam merupakan antibiotik paling banyak digunakan (15,98%), diikuti sefotaksim (15,12%), meropenem (13,44%), azithromisin (11,78%), dan seftriakson (10,92%). Berdasarkan metode Gyssens dengan konsep RASPRO, penggunaan antibiotik tepat (kategori 0) sebanyak 63,02%, sedangkan tidak tepat, yaitu 1,68% kategori IVa (alternatif lebih efektif), 22,69% kategori IIIa (durasi terlalu panjang) 9,24% kategori IIIb (durasi terlalu singkat), dan 3,36% kategori IIa (tidak tepat dosis).Kesimpulan. Pemakaian antibiotik tepat didapatkan hasil cukup baik, yaitu 63,03%. Konsep RASPRO dapat digunakan untuk mengurangi bias subyektifitas dalam penilaian antibiotik secara kualitatif dengan metode Gyssens pada pneumonia di ruang intensif anak.Â

Variabilitas Pola Perdarahan Anak Hemofilia A yang Mendapat Terapi On-demand di Rumah Sakit Cipto Mangunkusumo Novie Amelia Chozie; Yuniasti Evitasari; Darmawan Budi Setyanto
Sari Pediatri Vol 20, No 4 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Gejala perdarahan pada hemofilia A bergantung pada kadar faktor VIII, namun pada kadar faktor koagulasi yang sama dapat terjadi perbedaan karakteristik dan luaran klinis. Tujuan. Mengidentifikasi pola perdarahan, terapi dan komplikasi pada anak hemofilia A. Metode. Penelitian kohort retrospektif pada anak â‰¤18 tahun di RSCM. Data diambil dari rekam medis (Januari 2014 â€“ Juni 2016) meliputi data usia awitan perdarahan sendi, usia saat diagnosis, kekerapan perdarahan, lokasi perdarahan, penggunaan faktor VIII, dan komplikasi yang dialami. Hasil. Terdapat 109 anak lelaki terdiri dari 2,8% hemofilia A ringan, 27,5% hemofilia A sedang, dan 69,7% hemofilia A berat. Perdarahan tersering ditemukan pada sendi (60,6%) terutama pada lutut (37,2%). Dibandingkan hemofilia A ringan dan sedang, anak hemofilia A berat menunjukkan usia awitan perdarahan sendi lebih dini (median 12,5 (4-120) bulan), kekerapan perdarahan sendi lebih sering (median 8 (1-44) kali/tahun), dan menggunakan konsentrat faktor VIII lebih banyak (median 712 (131-1913) IU/kg/tahun). Komplikasi terbanyak adalah artropati dan sinovitis kronik (46,8%) serta inhibitor faktor VIII (7,3%). Terdapat 9 dari 71 (12,6)% subjek hemofilia A berat menunjukkan karakteristik klinis lebih ringan. Kesimpulan. Pola perdarahan pada anak hemofilia A sesuai kadar faktor VIII, tetapi pada hemofilia A berat terdapat variabilitas subjek dengan gejala klinis lebih ringan.

Efficacy of sputum induction from lower respiratory tract in children Madeleine Ramdhani Jasin; Darmawan Budi Setyanto; Sri Rezeki Hadinegoro; Lisnawati Lisnawati; Pramita Gayatri; Nia Kurniati
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Although sputum is a good specimen for variousexaminations, such as cytology and microbiological culture,sputum induction (SI) is not a routine procedure in children.Objective To identify the efficacy of SI to obtain specimen fromlower respiratory tract in children, identify side effects of SI, andthe results of microbiological examination.Methods A cross sectional study was performed in children (aged1 month to 18 years) who underwent SI. Sputum induction wasperformed by inhalation with hypertonic solution, consisted ofsalbutamol for 15 minutes continued with NaCl 3% solutionfor another 15 minutes. Sputum specimens were examined fornumber of alveolar macrophage cell, surfactant protein A (SP-A)concentration, also acid-fast bacili smear, and M. tuberculosisculture, or aerobic microbial culture.Results Forty subjects with lower respiratory tract infectionparticipated in this study, and SI was succesfully performed inall subjects. Youngest subject was 2 month old, the eldest was 16year 7 month old. Median duration of SI was 45 minutes, andmajority of volume was 3 or 4 mL. Side effects were nosebleeds(40%) and vomiting (2.5%). Macrophage alveolar more than 5cells in one specimen was found in 97.5% subjects. Surfactantprotein A examination was performed in 30 specimens, and SP-Awas detected in all specimens (median concentration 264.528 pg/mL). Culture for M. tuberculosis was positive in 1 of 27 subjects,while acid fast bacili smear was negative in all examined subjects.Aerobic microbial culture was positive in 5 of 13 subjects.Conclusions Sputum induction has good efficacy in obtaininglower respiratory tract specimen and it is safe to perform inchildren. Specimen from sputum induction yields good positiveresult for aerobic microbial cultures.

Gross motor dysfunction as a risk factor for aspiration pneumonia in children with cerebral palsy Cut Nurul Hafifah; Darmawan Budi Setyanto; Sukman Tulus Putra; Irawan Mangunatmadja; Teny Tjitra Sari; Haryanti Fauziah Wulandari
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Respiratory problems, such as aspiration pneumonia, are major causes of morbidity and mortality in children with cerebral palsy (CP) and greatly affect the quality of life of these children. Nevertheless, there is limited data on the incidence and risk factors of aspiration pneumonia in children with CP in Indonesia. Objective To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy.Methods In children with CP aged 1-18 years, incidence of pneumonia was studied prospectively for 6 months and the prevalence of the risk factors was studied cross-sectionally. At baseline, we evaluated subjectsâ€™ by history-taking, physical examination, risk factors, and chest X-ray to assess the incidence of silent aspiration. Subjects were followed-up for six months to determine the incidence of overt or silent aspiration pneumonia.Results Eight out of 36 subjects had one or more episodes of aspiration, consisting of silent aspiration (2/36) and clinically diagnosed aspiration pneumonia (7/36). Subjects with more severe gross motor dysfunction experienced more episodes aspiration pneumonia, although it was not statistically significant (p = 0.06), while dysphagia (P=0.2) and nutritional status (P=0.11) were not associated with pneumonia or silent aspiration.Conclusion Twenty-five percent of children with CP experienced aspiration pneumonia during the 6-month study period, with gross motor dysfunction as a possible risk factor.

The use of topical zinc in tuberculin test Anisa Rahmadhany; Darmawan Budi Setyanto; Partini Pudjiastuti Trihono
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

with under-diagnosis or over-diagnosis commonly occurring. The tuberculin test as a supporting examination for tuberculosis infection has a false negative value rate of 10-25%. Also, a majority of children with tuberculosis have lower plasma zinc levels than healthy children. Zinc deficiency may impair the immune response, leading to more false negative skin-test results.Objective To evaluate the effectiveness of topical zinc for augmenting the diameter of tuberculin induration in children with tuberculosis.Methods This unblinded, clinical trial was performed from October to December 2012 in subjects matched with themselves. Subjects were children with tuberculosis aged 2-18 years at the Department of Child Health at Cipto Mangunkusumo Hospital and Persahabatan Hospital. Every subject was injected tuberculin in volar region of left and right arm. Test sites then were covered with topical zinc cream on the right arm and placebo cream on the left arm. Indurations were measured after 72 hours. The difference of tuberculin diameter of 3 mm was considered as clinically significant. Data analysis was performed with Wilcoxon signed rank test.Results There were 47 subjects in this study. The majority of subjects were well-nourished (53%). Subjectsâ€™ median treatment duration was < 6 months, median age was 72 months and 47% of subjects were under the age of five years. Sixteen subjects had a median 1 mm difference in tuberculin induration diameter between the zinc arm and placebo arm (P<0.001), but this was clinically insignificant. Twenty-two subjects (43%) had Koch reaction after zinc cream application, but the placebo cream did not cause Koch reaction.Conclusion Application of topical zinc does not increase tuberculin induration compared to placebo.

Assessing the quality of life of asthmatic children using the PedQLâ„¢ Yulia Wigoeno; Rini Sekartini; Darmawan Budi Setyanto; Sri Rezeki Hadinegoro
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Background Asthma is the most common chronic respiratory illness in childhood. Its prevalence in Indonesia is 6.7 - 10%. Asthma influences growth, development and quality of life in affected children. Studies abroad have shown that children with asthma have a decreased quality of life (QoL), yet such data is limited in Indonesia.Objective To assess quality of life of asthmatic children in Indonesia, the influence of sociodemographic and medical characteristics on QoL, and to compare child self-reporting to their parentsâ€™ proxy-reporting.Methods This descriptive analysis, cross-sectional study was conducted from May to July 2010. We assessed the quality of life of asthmatic children aged 2-18 years using the PedsQLTM 4.0 generic scale.Results A total of 100 asthmatic children and their parents were included, with 43% of the subjects aged 8-12 years and a male to female ratio of 1.7:1. We observed that 26.8% of children who self-reported had impaired QoL, while 35% of children who reported by proxy had impaired QoL. In a multivariate analysis, we found the following characteristics to independently influence QoL: male gender (P 0.018 OR 0.26 95% CI 0.08 to 0.9) based on child self-report, and having partly controlled/uncontrolled asthma based on self-report and proxy-report (P 0.013 OR 6.24 95% CI 1.48 to 26.37 and P 0.018 OR 3.43 95% CI 1.24 to 10.05, respectively). There was good correlation between the self-report and the proxy-report on emotional and social functioning (r > 0.5), yet we found physical and school functioning to be weakly correlated (r < 0.5).Conclusions We observed a relatively high (26.8-35%) impaired QoL in asthmatic patients. Parental assessment of their childâ€™s QoL was generally lower than the childâ€™s self-assessment. Male gender is a protective factor against impaired QoL, but having partly controlled/uncontrolled asthma is a risk factor for lower QoL. [Paediatr Indones. 2011;51:245-51].

Sikap Dokter terhadap Konsultasi Seks Pasien Usia Remaja Hadjat S Digdowirogo; Mohammad Baharuddin; Darmawan Budi Setyanto
Jurnal Etika Kedokteran Indonesia Vol 4, No 2 (2020)
Publisher : Majelis Kehormatan Etik Indonesia PBIDI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26880/jeki.v4i2.51

Masa remaja adalah masa peralihan dari masa anak-anak ke masa dewasa. Remaja perlu dijaga kesehatan reproduksinya agar bebas dari gangguan yang dapat memengaruhi kualitas generasi yang dihasilkan. Oleh karena itu, diperlukan edukasi seks yang meliputi aspek pencegahan dan aspek penanganan gangguan yang ada. Dokter yang menerima konsultasi seks remaja harus mampu membangun komunikasi dokter-pasien dan bertindak secara profesional. Upaya aktif untuk menjaga marwah dokter harus dilakukan dengan berbagai cara sesuai keadaan.

Etika Melayani Pasien Muslim pada Stadium Terminal Hadjat S Digdowirogo; Darmawan Budi Setyanto; Pukovisa Prawiroharjo
Jurnal Etika Kedokteran Indonesia Vol 3, No 1 (2019)
Publisher : Majelis Kehormatan Etik Indonesia PBIDI

Semua orang pasti akan mati. Bagi muslim, mati dalam keadaan Islam adalah tujuan terpenting akhir hidup karena hal itu diperintahkan oleh Allah SWT dalam Al-Quran. Sakaratul maut merupakan saat kritis peralihan dari kehidupan ke kematian. Saat tersebut sangat penting bagi pasien muslim dan keluarganya. Bila pada saat terakhir kehidupan, seseorang mengucapkan kalimat tauhid ‘Laailahailallah’ maka terbuka peluang masuk surga. Mengucapkan kalimat tauhid saat sakaratul maut bukan hal yang mudah. Untuk itu perlu dibimbing dan dituntun oleh keluarga pasien stadium terminal, suatu upaya yang disebut talkin. Rumah Sakit sebagai penyedia layanan kesehatan paripurna, perlu memberikan fasilitas dan kemudahan kepada pasien stadium terminal dan keluarganya untuk melakukan talkin sesuai kepercayaannya tersebut. Adanya perhatian pihak rumah sakit terhadap hal itu akan meningkatkan kepuasan dan kepercayaan pasien.

Scrofuloderma in a 1-year-old girl with severe malnutrition: a case report Jasin, Madeleine Ramdhani; Neldy, Fahreza Aditya; Setyanto, Darmawan Budi; Nugroho, Gufron; Sunhaji, Valerie; Ham, Maria Francisca
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.511-6

Tuberculosis (TB) remains a global burden and a leading cause of mortality due to infectious diseases worldwide. In 2020, 845,000 new TB cases (312 per 100,000 population) were diagnosed, with 96,000 deaths, including 4,700 deaths of TB with HIV. Tuberculosis typically affects the lungs, but it can also affect other organs, a condition termed extrapulmonary TB. In 2020, 16% of all TB cases had extrapulmonary manifestations.1 The first case of TB affecting the skin was reported in 1826.2,3 There are many types of cutaneous TB; one of the most common is scrofuloderma, more often found in children and young adults.4 Scrofuloderma starts with a lesion in a lymph node, bone, muscle, or tendon that spreads to the skin.5 The lesion progresses very slowly and is usually not painful. Therefore, many patients wait to seek treatment until an advanced stage, leading to poor prognosis.3 In this report, we present a case of a severely malnourished one-year-old girl with scrofuloderma.

Co-Authors Anisa Rahmadhany Badriul Hegar Cut Nurul Hafifah Emilda Osmardin Hadjat S Digdowirogo Hadjat S Digdowirogo Ham, Maria Francisca Haryanti Fauziah Wulandari Irawan Mangunatmadja Jasin, Madeleine Ramdhani Lisnawati Lisnawati Mohammad Baharuddin Mulyadi Muhammad Djer Natadidjaja, Ronald Irwanto Neldy, Fahreza Aditya Nia Kurniati Novie Amelia Chozie Nugroho, Gufron Partini Pudjiastuti Trihono Pramita Gayatri Pukovisa Prawiroharjo Rini Sekartini Rinna Wamilakusumayanti Sundariningrum Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sukman Tulus Putra Sunhaji, Valerie Teny Tjitra Sari Yulia Wigoeno Yuniasti Evitasari

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