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Developing a Management Model of Early Education Services for Children With Autism Putranti, Alifiani Hikmah; Florentinus, Totok Sumaryanto; Sugiharto, Dwi Yuwono Puji; Herini, Elisabeth Siti
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29891

Early education services for children with autism are a place for early intervention for autistic children of pre-school age as a bridge to further education. Autism is a neurological development disorder under the age of 3 years with characteristics of communication and behavioral disorders. Pre-school age is a period of rapid brain development so early intervention or early education for children with autism is an attempt to reduce the manifestation of autism clinics. Development of early education service management for children with autism aims to intervene with autism from an early age in a comprehensive manner and in accordance with their growth and development. This study applies the Research and Development approach through four stages, namely (1) preliminary research, (2) model development, (3) validation, and (4) final model. Data were drawn using open and closed questionnaires and interviews in four early education service institutions for children with autism in Semarang. The data were processed using descriptive analysis, percentage, average, and qualitative analysis. The final model of early education service management for children with autism focuses on aspects of management which consist of (1) comprehensive planning based on the standard parameters by considering comorbidities and health status and (2) early education for children with autism carried out comprehensively and sustainably between teachers, parents, and medical personnel.

Developing a Management Model of Early Education Services for Children With Autism Putranti, Alifiani Hikmah; Florentinus, Totok Sumaryanto; Sugiharto, Dwi Yuwono Puji; Herini, Elisabeth Siti
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29891

Early education services for children with autism are a place for early intervention for autistic children of pre-school age as a bridge to further education. Autism is a neurological development disorder under the age of 3 years with characteristics of communication and behavioral disorders. Pre-school age is a period of rapid brain development so early intervention or early education for children with autism is an attempt to reduce the manifestation of autism clinics. Development of early education service management for children with autism aims to intervene with autism from an early age in a comprehensive manner and in accordance with their growth and development. This study applies the Research and Development approach through four stages, namely (1) preliminary research, (2) model development, (3) validation, and (4) final model. Data were drawn using open and closed questionnaires and interviews in four early education service institutions for children with autism in Semarang. The data were processed using descriptive analysis, percentage, average, and qualitative analysis. The final model of early education service management for children with autism focuses on aspects of management which consist of (1) comprehensive planning based on the standard parameters by considering comorbidities and health status and (2) early education for children with autism carried out comprehensively and sustainably between teachers, parents, and medical personnel.

Neurodevelopmental disorder risk in babies with history of hyperbilirubinemia Baginda Hutahaean; Alifiani Hikmah Putranti; Kamilah Budhi Rahardjani
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Neurodevelopmental disorder (ND) is defined asfailure to attain normal neurological function. Indirect bilirubinhas essential role because its neurotoxic properties. Neonates withhyperbilirubinemia carry the risk to develop ND.Objective To determine the association between neonatal indirecthyperbilirubinemia and the risk of ND.Methods Neonates with indirect serum bilirubin (SIB) level >10mg/dL, admitted in the period of October 2004-August 2005, wereincluded in this study. They were followed-up and screened usingBayley Infant Neurodevelopmental Screener (BINS) at three, sixand nine months. Mann-Whitney test was used to test thehypothesis.Results Forty-eight neonates were included in the study. MeanSIB level of subjects with ND risk was 20.5 mg/dL (SD=6.06;p<0.001). Mean SIB level of subjects who developed ND at three,six and nine months was 31.6 mg/dL (SD=4.02), 18.4 mg/dL(SD=2.92) and 18.4 mg/dL (SD=5.41), respectively. There wasstatistically significant correlation between SIB level and NDrisk (R=+0.64; P<0.001). There was also statistically significantcorrelation between SIB level and the onset of ND (R=-0.63;P< 0.001).Conclusion There is a correlation between neonatal SIB leveland the risk of ND in babies.

Ketogenic Diet for Treatment 2-Year 9 Month Old Boy With Intractable Epilepsy Wijaya, I Made Ananta; Putranti, Alifiani Hikmah; Mexitalia, Maria
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 2 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background:The ketogenic diet (KD) is a high-fat, low-carbohydrate, and normal-protein diet that has been used for the treatment of medically refractory childhood epilepsy since the 1920s.The KD includes 80% fat, 15% protein, and 5% carbohydrate; the ratio of fat to carbohydrate plus protein ranges from 2:1 to 4:1.The purpose of the case report was to learn benefits and factors that influence the administration of the ketogenic diet in intractable epilepsy. Case:A 2-years 9 months old boy since 3 month of age the child begins seizure. Five month the child was diagnosed with epilepsy received one type of anti epileptic drug (AED). Seven months of age the child began control in outpatient clinic Neurology Department of Dr. Kariadi Hospital with a diagnosis of general epilepsy, were given 2 type of AEDs. Since10 month of age the child was given 3 type of AEDs. The child still often seizure, at 15 months was diagnosed intractable epilepsyand at 29monthof age, was programed to have long term EEG and KD during hospitalization. Conclusion:The administration of KD in 2-years9 months old boy with intractable epilepsyshowed benefits in reducing the frequency of seizures. Key word : Ketogenic Diet, Intractable Epilepsy, Child

A Toddler with Juvenile Ocular Myasthenia Gravis: Clinical Experience Putranti, Alifiani Hikmah; Septieningtyas, Rr.Kartika Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background:Myasthenia gravis is an extremely rare autoimmune disorder affecting the neuromuscular junction. The incidence rate is 0.9-2.0 cases per 1 million children per year.Ocular myasthenia gravispresents as ptosis with extraocular motility restriction and is prone to be misdiagnosed as third nerve palsy and is difficult to diagnose in very young children. Case: A girl aged 2 years 6 months with clinical features with bilateral ptosis and was diagnosed as juvenile ocular myastenia gravis based on history, physical examination and other diagnostic proceduressuch as chest X-raywithin normal limit and no thymoma, the ice test showed positive result, electromyography (EMG) showed decrement response >10%,progstigmin test showed positive result, andserum acetylcholine receptor antibody levels was 0.43 nmol/L (reference range : positive as >0.40 nmol/L). Conclusion:Juvenile ocular myastenia gravis diagnostics can be established using simple examinations such as ice tests,prostigmin test to sophisticated examinations as systemic acetylcholinesterase antibodies. Management begins with a first-line drug, pyridostigmine, that is safe and effective. Disease monitoring and looking for etiology are very important for successful treatment.

NEUROLOGIC MANIFESTATIONS ASSOCIATED WITH COVID-19 IN PEDIATRIC PATIENTS AT DR. KARIADI HOSPITAL SEMARANG Sareharto, Tun Paksi; Dania Emeralda Firdausy; Santoso Jaeri; Alifiani Hikmah Putranti
Berkala Ilmiah Kedokteran Duta Wacana Vol. 9 No. 2 (2024): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21460/bikdw.v9i2.840

Background: Coronavirus Disease-19 (COVID-19), a severe acute respiratory syndrome, stems from a novel coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The common symptoms and signs of COVID-19 are fever, cough, diarrhea, and myalgia as well as neurological manifestations. Neurological manifestations of COVID-19 in adult patients have been well recognized, unfortunately, there is limited evidence of neurological manifestations of COVID-19 in children, especially in Indonesia, so herewith we describe neurological manifestations in children, to contribute to the knowledge in the fields of pediatric health and neurology, particularly their correlation with COVID-19. Objective: To determine the neurological manifestations in children with COVID-19. Method: An observational analytic study among 124 pediatric patients with COVID-19 at Dr. Kariadi Hospital Semarang. Demographic and clinical data were obtained from medical records. To determine risk factors for the occurrence of neurological manifestation, the chi-square test, Fisher exact test, and Mann-Whitney U-test were performed. Results: Out of 124 subjects, 49 (39.5%) developed neurological manifestations, including headache (10%), seizure (23%), weakness (5%), dizziness (0.8%), vision impairment (0.8%), ataxia (0.8%), coma (11.3%), paresthesia (0.8%), acute encephalopathy (3.2%), sympathetic storming (0.8%), and others (9.7%). Diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) was found in 10 (8.1%) patients, in addition, there was a significant association between the diagnosis of MIS-C, comorbid conditions, and outcomes among patients and neurological manifestations. Conclusion: The most common neurological manifestation experienced by pediatric patients with COVID-19 in this study was seizures. Patients with MIS-C and pre-existing conditions are at higher risk of experiencing neurological manifestations. Children with neurological manifestations more frequently presented with worse outcomes.

Vitamin D3 and seizure frequency in children with epilepsy using polypharmacy Aprilyani, Setya Puspa Dewi; Putranti, Alifiani Hikmah; Sareharto, Tun Paksi; Rahmadi, Farid Agung; Pratiwi, Rina
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.122-8

Background Children with epilepsy usually need vitamin D administration, primarily due to the effects of antiepileptic drugs (AEDs). The use of AEDs, particularly polypharmacy, can reduce serum 25(OH)D levels. Vitamin D improves the function of neurotransmitters furthermore boosting the seizure threshold. There has been relatively little study investigating the effects of vitamin D3 treatment on seizure frequency. Objective To compare seizure frequency before and after administering vitamin D3 to the children with epilepsy who used polypharmacy. Methods Sixteen children with epilepsy and polypharmacy, aged 2-18 years, from the Pediatric Neurology Clinic, Dr. Kariadi Hospital, Semarang, were studied using a quasi-experimental approach with one group pretest-posttest. The vitamin D3 was given orally for two months with different dosages according to age andsubjects’ pretest serum 25(OH)D levels. Children with vitamin D insufficiency or deficiency were giventherapy dosage, and the normal vitamin D status were given supplementation dosage.Seizure frequency, serum 25(OH)D levels, and vitamin D status were assessed before and after treatment. Results Seizure frequency was significantly lower after vitamin D treatment for the entire group compared to pre- administration (P=0.019). For subjects with hypo-vitamin D levels pre-treatment, median seizure frequency was significantly decreased following normalization of vitamin D levels at one month (P=0.016) and two months (P=0.018) of vitamin D treatment. Using mean data, seizure frequency also significantly decreased at one month and at two months post-treatment. Conclusion Vitamin D3 administration is associated with an increase in serum 25(OH)D levels, as well as a decrease in seizure frequency. Vitamin D3 administration can significantly reduce seizure frequency in epilepsy patients undergoing polypharmacy who are vitamin D deficient.

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