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Taralan Tambunan
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Comparisons of bone mineral density in steroid dependent, frequent relapse, and infrequent relapse nephrotic syndrome children Lies Dewi Nurmala; Taralan Tambunan; Idham Amir
Paediatrica Indonesiana Vol 50 No 4 (2010): July 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.355 KB) | DOI: 10.14238/pi50.4.2010.193-8

Abstract

Background Children with nephrotic syndrome, especially those with steroid dependent and frequent relapse are at greater risk of reduced bone mineral density (BMD).Objective To determine bone mineral density (BMD) in steroid dependent and frequent relapse compared to infrequent relapse nephrotic syndrome.Methods We conducted a cross-sectional study at the Child Health Department, Cipto Mangunkusumo Hospital, from August until November 2009. Subjects were 5 to 18 year-old children with steroid dependent nephrotic syndrome (SDNS), frequent relapsenephrotic syndrome (FRNS), or infrequent relapse nephrotic syndrome (IRNS). Ionized calcium level, vitamin 25(OH)D3 level, and BMD were measured us ng dual energy x-ray absorptiometry (DEXA).Results 11 SDNS and 11 FRNS cbildren (group I) were compared with 22 IRNS children (Group II). Children of SDNS and FRNS had significantly longer duration of illness, more relapses, longer steroid therapy duration, and greater cumulative steroid dose compared to group 11 (IRNS). There were no differences between  the two groups with regard to mean ionized calcium level and vitamin 25(OH)D3 level. Children in group I had lower z-scores compared to group lI, but the difference was not statistically significant r mean (SD) -1.182 (1.21) vs. -0.795 (1.25), P=0.305]. Subgroup analysis showed that SDNS children had lower z-scores than FRNS [-1.791 (1.17) vs. -0.57 (0.94), P=0.019] and IRNS [-1.791 (1.17) vs. -0.795 (1.25), P=O.026].Conclusion Children with SDNS have significantly lower BMD z-scores compared to those with FRNS and IRNS.
Brainstem auditory evoked potentials features in thalassemia major Jimmy Passat; Bulan Ginting Munthe; Fauzi Mahfuzh; Taralan Tambunan
Paediatrica Indonesiana Vol 41 No 5-6 (2001): May 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (123.7 KB) | DOI: 10.14238/pi41.3.2001.166-70

Abstract

Patients with thalassemia major are at high risk for hearing impairment. The objective of the study is to determine the prevalence, grade and type of hearing impairment according to brainstem auditory evoked potentials (BAEP) investigation in thalassemia major. A descriptive cross sectional study was conducted between December 1999 until August 2000 in 72 thalassemic patients between 3 and 18 years of age. Only 65 patients were evaluated, because of time limitation. The results showed the prevalence of hearing impairment in thalassemia major was 29.2%. Most of them were moderate to severe unilateral sensorineural hearing impairments. Mild sensorienural hearing impairment occured in only 12.3%. Conductive  hearing impairment was only found in 1 patient. Hearing impairment was frequently found between 7 to 12 years of age (41.5%). Conclusion: the prevalence of hearing impairment in thalassem a major according to BAEP investigation is high and BAEP examination should be done regularly in all of thalassemic patients to investigate early detection and treatment of hearing impairment. 
Urinary incontinence in children in Cipto Mangunkusumo Hospital, Jakarta: a serial case report Taralan Tambunan
Paediatrica Indonesiana Vol 41 No 5-6 (2001): May 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.091 KB) | DOI: 10.14238/pi41.3.2001.171-4

Abstract

Urinary incontinence in children is a complex problem of varying causes. Most children brought to physician for evaluation of difficulties with urinary control will have single or diurnal enuresis, or will be experiencing urgency associated with functional or organic incontinence. To find out the magnitude of urinary incontinence problems in Child Health Department Cipto Mangunkusumo Hospital Jakarta, we retrospectively looked at medical report of such cases between the years of 1989-2001. During eleven years there were 20 cases, consisted of 10 males and 10 females, aged ranged between 3 months up to 16 years. Nineteen children showed significant bacteriuria defined as a urinary tract infection. Ten children were diagnosed as having neurogenic bladder, all had spinal lesions; 7 children had spinal dysraphyism while 3 others had osteolityc lesions in vertebrae due to malignancy. Non neurogenic bladder was defined in 6 children, while in other 4 children we defined that urinary incontinence was caused by anatomical abnormalities. Vesico-ureteral reflux in various degree were found in 9 children, while 11 out of 20 (55%) cases were experiencing chronic renal failure on their first visit. Although the annual incidence of urinary incontinence is low, these difficult cases causing many problems. Breakthrough infection was almost unpreventable and in most cases had progressed to renal failure. Many factors such as invasive procedures and prolonged treatment causing fear and frustration to the patients and their parents leading to poor compliance and lost to follow up. In summary we can conclude that urinary incontinence in children is a complex problem include medically, economically, and socially, not only for the patient and their parents, but also for medical profession.
A child with pheochromocytoma and malignant hypertension Abidin S.; Alatas H.; I. G. N Wila Wirya; Taralan Tambunan
Paediatrica Indonesiana Vol 21 No 11-12 (1981): November - December 1981
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi21.11-12.1981.240-9

Abstract

Herein we report a boy of 13 years old who suffered from pheochromocytoma with malignant hypertension. No metastasis was found and surgical approach was done successfully. Histopathologic examination showed pheochromocytoma of the left suprarenal gland with pleomorphism in the primary tumor.Postoperatively the blood pressure returned to normal within one month and remained so within 3 years follow up.
Pattern of infectious diseases in acute leukemia during induction therapy Sri Rezeki Harun; Debbie Latupeirissa; Taralan Tambunan
Paediatrica Indonesiana Vol 39 No 7-8 (1999): July - August 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (771.382 KB) | DOI: 10.14238/pi39.7-8.1999.211-20

Abstract

An prospective study was conducted to determine risk factors and pattem of infectious diseases in acute leukemia during induction therapy. The study subjects were all new acute leukemia patients of J month to 17 years old diagnosed between August 1, 1997 and July 31, 1998 in the  Department of Child Heallb, Cipto Mangunkusumo Hospital, Jakarta. Subjects were categorized into Group with and without infection. Of the 39 subjects studied (23 boys and 16 girls), 22 subjects were infected (10 boys and 12 girl ). Most of the subjects were 1-4 year-old age group and 14 subjects of that group were infected. lt was found that there were  relationships between incidence of infection with leukocyte count below 5000/µL (p=0.02), neutrophil count below 1x109/L (p=0.01), and evidence of presumptive site of infection (p=0.0005). Children under 5 years old, sex, ANLL type, malnutrition, or neutropenia of more than 2 weeks had no relationships with incidence of infection. Besides fever, pattem of infection diseases in acute leukemia patients during induction therapy, were only 36% and 38% of subjects had clinical manifestations evidence andmicrobiologically documented, respectively. Most of the laboratory findings were leukopenia or neutropenia, while serum aminotransferase was normal in both groups. Serum CRP serum was devated in those with infection. All of the isolated bacteriae were Gram-negative; 52.4% of infected subjects had responded to empirical therapy, and 72.7% of the antibiotics used was sefotaxime.
Correlation of Birth Weight/Length Ratio to Skinfold Thickness in Full-Term Newborns Asril Aminullan; Yuliatmoko Suryatin; Taralan Tambunan
Paediatrica Indonesiana Vol 39 No 9-10 (1999): September - October 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4282.341 KB) | DOI: 10.14238/pi39.9-10.1999.259-67

Abstract

The determination of child/neonatal nutritional status based on their skinfold thickness has been widely known and accepted, but its daily implementation is quite difficult since this procedure needs specific tools and skills. Although still debatable, some anthropometric measurements, i.e., birth weight/length ratio were currently used as a mean to determine one's nutritional status. To find out the correlation of birth weight/length ratio to skinfold thickness of newborn babies based on gender, a cross-sectional study was conducted on 352 full-term infants (194 males, 158 females) born at the Cipto Mangunkusumo Hospital between June 14 to July 17, 1998. Of the male infants, their birth weight/length ratio showed a strong correlation to triceps and subscapular thickness (r=0.65 and 0.68, respectively); while the females revealed a strong correlation of birth weight/ length ratio to the triceps thickness (r=0.51) and a moderate correlation to the subscapular skin fold thickness (r=0,49). It was also found that the triceps and subscapular skinfold thickness in male infants were significantly lesser than  the females, with p values of 0.02 and 0.04, respectively. This study revealed that the birth weight/length ratio can be used as a mean to assess neonatal nutritional status.
Co-Authors Abidin S. Alatas H. Asril Aminullan Bulan Ginting Munthe Debbie Latupeirissa Fauzi Mahfuzh I. G. N Wila Wirya Idham Amir Jimmy Passat Lies Dewi Nurmala Sri Rezeki Harun Yuliatmoko Suryatin