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All Journal MEDIA MEDIKA INDONESIANA Jurnal Kedokteran Brawijaya Medical Journal of Indonesia Folia Medica Indonesiana Sari Pediatri Universa Medicina Paediatrica Indonesiana Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Cermin Dunia Kedokteran MEDICINUS

Darto Saharso

Divisi Syaraf Anak, Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Airlangga - RSUD Dr. Soetomo, Jl. Mayjen Prof. Dr. Moestopo 6-8, Surabaya, Indonesia

Author-ID : 368364

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Seizure increases electroencephalographic abnormalities in children with tuberculous meningitis Gunawan, Prastiya Indra; Saharso, Darto
Universa Medicina Vol 34, No 3 (2015)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2015.v34.161-167

BackgroundTuberculous meningitis (TBM) is a severe intracranial infection with fatal outcomes, permanent disabilities, and electroencephalographic (EEG) abnormalities. Seizures may occur in TBM. The EEG findings in TBM vary according to the site of the inflammatory process. There are few studies describing the EEG patterns and clinical manifestations of TBM. The objective of this study was to investigate the correlation between clinical findings and EEG patterns in children with TBM. MethodsA study of cross-sectional design using medical records was conducted on 12 children with TBM, with their EEG patterns classified as abnormal and normal. Clinical manifestations such as seizures, altered consciousness, headache or fever were collected. A positive cerebrospinal fluids Mycobacterium tuberculosis culture was considered to indicate definitive TBM. Abnormal EEG descriptions were classified into abnormal I, II or III. Correlation between EEG pattern and clinical manifestation were analyzed with Fisherâ€™s exact test. ResultsThe study found cases of 12 children with TBM, the majority presenting with seizures, decreased consciousness and fever. Abnormal EEGs were found in 75% of children and 77% of them showed epileptogenic activities. The EEG results mostly described epileptogenic potentials in the frontotemporal region. There was a significant correlation between EEG abnormality and seizures in children with TBM (p<0.05).ConclusionsThe EEG pattern in children with TBM varies, and EEG abnormalities were more frequently localized in the frontotemporal region. Seizures were associated with EEG abnormalities in children with TBM. EEG abnormalities occurring simultaneously with seizures may predict the occurrence of seizures.

Reducing severe spasticity in cerebral palsy following meningoencephalitis by botulinum toxin Gunawan, Prastiya I.; Saharso, Darto
Medical Journal of Indonesia Vol 26, No 1 (2017): March
Publisher : Faculty of Medicine Universitas Indonesia

A 3-year-old boy diagnosed with diplegic cerebral palsy had received Botulinum toxin injection to reduce severe spasticity. There was an improvement of muscles tone and motor function including better ability of limb flexion of the knees and hip, adduction of the hip, flexion of the toes, and plantar flexion of the foot. No side effect was observed after the procedure.

Parameter Praktis dalam upaya Skrining dan Diagnotis Autism Saharso, Darto; Emy, Emy
Jurnal Kedokteran Brawijaya Vol 18, No 1 (2002)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1649.4 KB)

Autism merupakan penyakit yang banyak dijumpai pada anak dengan angka kejadian berkisar 1 pada 500 anak. Sering tidak diketahui dan tidak terdiagnosis hingga usia prasekolah karena skrining perkembangan anak secara rutin dan skrining khusus untuk autism tidak tersedia. Identifikasi dini, intervensi dini dan intensif selama masa balita usia prasekolah dikatakan mampu memperbaiki hasil akhir autism pada sebagian besar anak-anak. Parameter praktis memberikan rekomendasi spesifik untuk meng identifikasi anak-anak dengan autism.

A case of juvenile dermatomyositis responding to methotrexate and steroid Gunawan, Prastiya Indra; Saharso, Darto
Cermin Dunia Kedokteran Vol 44, No 6 (2017): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

A 4-year-old patient presented with skin rash and weakness. She was diagnosed with juvenile dermatomyositis based on Bohan and Peter criteria and laboratory result. The treatment consist of steroid combined with methotrexate. The response is good.Pasien anak perempuan berusia 4 tahun dengan keluhan bercak kemerahan di kulit dengan kelumpuhan. Pasien didiagnosis juvenile dermatomyositis berdasarkan kriteria Bohar dan Peter dan hasil laboratorium. Pasien mendapat terapi steroid dikombinasi dengan methotrexate, menunjukkan hasil baik.

Faktor Risiko Kejang Demam Berulang pada Anak Prastiya Indra Gunawan; Darto Saharso
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (195.507 KB)

Risk factors of recurrent febrile seizures in childrenBackground: Febrile seizures (FS) are the most common seizure disorder in childhood. Recurrent febrile seizures (RFS) occur in one third of children who experience a first FS. About nine percent had three or more recurrence. Little is known about predictors of recurrence. The aim of this study is to determine the incidence and the risk factors of RFS in children with FS at Dr. Soetomo Hospital Surabaya.Method: This is a cohort prospective study. Data was taken from all children with first FS aged 6 month-old to 5 year-old who were admitted at pediatric ward Dr. Soetomo Hospital from August 2009 to November 2010. They were observed for one year period to ascertain wether FS recurred. Logistic regression statistic was used to analyze those variables including sex, age, body temperature during the fever episode, family history of seizures, diagnosis at the first onset, maternal illness, abnormal delivery and recurrence ofFS.Results: Recurrent FS occured in 65% of the 100 children at one year observation, and 26% of them had further attack. Male to female ratio was 2:1. Thirty-one (77.5%) of subjects were less than 12 months-old. Body temperature ≤38.5OC (OR=5.50, 95%CI, p=0.019) and complex FS (OR 5.03, 95%CI, p=0.025) were related to increase risk of reccurence.Conclusions: The risk of RFS increased with body temperature ≤38.5OC and diagnosed as complex FS at the first FS.Keywords: Children, risk factors, recurrent febrile seizures ABSTRAKLatar belakang: Kejang demam (KD) adalah kasus kejang yang sering dialami anak-anak. KD berulang terjadi pada sepertiga anak yang mengalami KD pertama. Sekitar 9% dari penderita KD mengalami tiga atau lebih kejadian berulang. Hanya sedikit yang diketahui tentang prediktor berulangnya KD. Tujuan penelitian untuk mengetahui angka kejadian KD berulang dan menentukan faktor risiko terjadinya KD berulang pada anak yang mengalami KD di RSUD Dr. Soetomo Surabaya.Metode: Studi kohort prospektif dilakukan pada bulan Agustus 2009 sampai November 2010. Subyek diambil dari anak usia 6 bulan sampai 5 tahun yang menderita KD pertama yang MRS di RSUD Dr. Soetomo. Subyek diamati selama 1 tahun untuk menentukan apakah KD terjadi berulang. Analisis antar variabel jenis kelamin, usia, suhu badan saat terjadi demam, riwayat kejang pada keluarga, diagnosis awal, penyakit ibu, kelahiran yang tidak normal dan kejadian KD berulang, dilakukan dengan regresi logistik.Hasil: KD berulang terjadi 65% pada 100 anak yang diobservasi selama 1 tahun pertama dan 26% mengalami KD lebih dari 2 kali. Rasio laki-laki dibanding perempuan adalah 2:1. Tiga puluh satu (77,5%) anak berusia kurang dari 12 bulan. Faktor risiko suhu badan ≤38,5OC (OR=5,50, 95%CI, p=0,019) dan KD komplikata (OR 5,03, 95%CI, p=0,025) bermakna secara signifikan untuk kejadian berulangnya KD.Simpulan: Risiko KD berulang pada anak meningkat pada suhu badan ≤38,5OC dan diagnosis KD komplikata pada saat KD pertama.

Metode Pemeriksaan Kualitas General moveÂ ments Meningkatkan Nilai Prediksi UltrasonoÂ grafi Kepala untuk Memprediksi Perkembangan Bayi Kurang Bulan dari Ibu Preeklamsia Berat Nur Rochmah; Ahmad Suryawan; Moersintowarti BN; Darto Saharso; Fatimah Indarso
Sari Pediatri Vol 14, No 1 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Kelahiran kurang bulan dan preeklamsia berat merupakan faktor risiko penyimpangan perkembangan. Deteksi dini perkembangan sangat penting. Hal tersebut memberi peluang intervensi awal dengan hasil optimal. Pemeriksaan ultrasonografi kepala mempunyai keterbatasan dalam memprediksi outcome perkembangan bayi kurang bulan. Pemeriksaan general movementslebih murah dan dapat digunakan di negara berkembang dengan sarana diagnostik yang terbatas. Penambahan pemeriksaan kualitas general movementsdapat meningkatkan nilai prediksi dibandingkan dengan pemeriksaan ultrasonografi kepala saja. Tujuan. Melakukan analisis nilai prediksi ultrasonografi kepala, pemeriksaan general movements,dan kombinasi keduanya untuk memprediksi status perkembangan bayi kurang bulan.Metode. Studi longitudinal diagnostik, dilakukan di RS Dr Soetomo Surabaya pada bulan Desember 2009 sampai Juni 2010. Pemeriksaan ultrasonografi kepala dilakukan pada usia 2 minggu pertama, general movementspada usia 52 minggu gestasi, dan status perkembangan dievaluasi dengan Denver II pada usia 4 bulan usia koreksi. Data dianalisis menggunakan SPSS 12.0. Persetujuan kelaikan etik dikeluarkan oleh RS Dr Soetomo, Surabaya. Hasil.Delapan belas bayi kurang bulan (<37 minggu gestasi) mengikuti penelitian.mempunyai nilai sensitivitas (SN), spesivisitas (SP), nilai prediksi positif (NPP), nilai prediksi negatif (NPN), dan likelyhood ratio(LR) ultrasonografi kepala (0,2;1,0;1,0;1;0,50;5,0), sedangkan general movements (0,90;0,75;0,82;0,86;3,60). Kombinasi kedua pemeriksaan tersebut mempunyai nilai prediksi (0,80;0,50;0,67;0,67;1,60). Kesimpulan.Penambahan pemeriksaan kualitas general movementsdapat meningkatkan sensitivitas outcomeperkembangan bayi kurang bulan dibandingkan hanya pemeriksaan ultrasonografi kepala saja.

Akurasi Diagnostik Prokalsitonin Sebagai Petanda Serologis untuk Membedakan Infeksi Bakteri dan Infeksi Virus pada Anak Dominicus Husada; I Gusti Ngurah Twi Adnyana; Retno Asih Setyoningrum; Darto Saharso; Ismoedijanto Ismoedijanto
Sari Pediatri Vol 13, No 5 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang.Deteksi dini infeksi bakteri dan infeksi virus pada anak sangat penting untuk tata laksana antibiotik lebih dini. Prokalsitonin (PCT) merupakan suatu temuan baru sebagai petanda serologis yang bisa dipercaya. Belum banyak informasi tentang akurasi diagnostik PCT untuk spektrum penyakit infeksi di negara berkembang.Tujuan.Melakukan akurasi diagnostik PCT sebagai petanda serologis untuk membedakan infeksi bakteri dan infeksi virus pada anak. Metode.Penelitian prospektif dengan desain potong lintang dilakukan di Departemen Ilmu Kesehatan Anak RSU Dr. Soetomo Surabaya, dari September 2009 sampai November 2010. Pasien dibagi dalam kelompok infeksi bakteri dan infeksi virus (sebagai kontrol). Data demografi, pemeriksaan darah tepi, CRP and PCT dievaluasi. Analisis statistik menggunakan uji studentt dan uji Mann Whitney U dengan interval kepercayaan 95% dan bermakna jika nilai p<0,05. Dilakukan perhitungan sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN) dan rasio kemungkinan (RK) Hasil.Di antara 130 pasien yang terkumpul didapatkan 54 sampel untuk tiap kelompok. Ditemukan perbedaan kadar PCT yang bermakna antara kelompok infeksi bakteri dibandingkan infeksi virus (rerata 18,34 dan 0,22 ng/ml, p<0,0001). Dengan menggunakan kadar 0,5 ng/ml sebagai kadar ambang (sesuai penelitian sebelumnya) didapatkan sensitivitas 88,9%, spesifisitas 94,4%, NDP 94,1%, NDN 89,4% dengan RK positif 15,87 dan RK negatif 0,09.Kesimpulan.Prokalsitonin merupakan petanda serologis dengan akurasi diagnostik yang tinggi untuk membedakan infeksi bakteri dan infeksi virus pada anak.

Profile of Cerebral Palsy Patients in Dr. Soetomo General Hospital Surabaya, Indonesia Qorina Nadya Salfi; Darto Saharso; Atika Atika
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Introduction: Limited profile data of Cerebral Palsy (CP) patients in Indonesia leads CP to be a less-known disease. The aim of this study is to describe CP patient’s characteristics, including demographic aspect, gestation and birth history, and CP related condition in Dr. Soetomo General Hospital Surabaya, Indonesia.Methods: Cross-sectional study using medical records of CP patients in Dr. Soetomo General Hospital (Surabaya, Indonesia) Outpatient Installation for Pediatric Neurology from January 2016 to June 2018. Data processed descriptively.Results: From total 107 patients, 50 subjects met inclusion criteria. Mean age was 6.16 years old, with domination of male (3:2), live in Surabaya (56%), malnourished (24%), normal birth weight (80.9%), term age of birth (66.7%), spontaneous labor (60%), and also prenatal events as causes of Cerebral Palsy (69.5%). Pneumonia was found to be most among postnatal events leading to Cerebral Palsy (30%). Most of the type was spastic (9:1) with quadriplegic as the dominating one (64%). Congenital malformation was rarely found (38%), but co-morbidities were found in almost all sample (92%).Conclusion: Gestation and birth history of CP patients are mostly ranged normal. Prenatal etiology is found dominating as the cause of CP, therefore emendation in antenatal care (ANC) shall be considered. Analytical study about CP in Indonesia also must be improved because it is still hardly found.

Juvenile myasthenia gravis Prastiya I. Gunawan; Darto Saharso
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Tuberous sclerosis complex in a child: diagnosis and management Prastiya Indra Gunawan; Aminuddin Harahap; Darto Saharso
Paediatrica Indonesiana Vol 50 No 3 (2010): May 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.3.2010.181-6

Tuberous sclerosis complex (TSC) is a multisystem, autosomal dominant disorder affecting children and adults, resulted from mutations in one of two genes, TSC1 (encoding hamartin) or TSC2 (encoding tuberin) genes located on chromosomes 9 and 16 respectively.1,2 Synonyms of TSC are Bourneville Pringle syndrome, epiloia, or tuberosclerosis. This disorder is characterized by seizures, mental disability, and small noncancerous tumors on the skin and other body tissues, such as brain, eye, lung, and kidney. The classic triad are seizures, mental retardation, and cutaneous angiofibromas.3

Co-Authors Ahmad Suryawan Aminuddin Harahap Aryati Aryati Atika Atika Dominicus Husada Emy, Emy Erny Erny Fatimah Indarso Ferdy Royland Marpaung Hapsari Kusumawardani Haroen Noerasid I Gusti Ngurah Twi Adnyana Ismail, Chasan Ismoedijanto Liek Djupri Melawati Olevianingrum, Melawati Moersintowarti BN Niluh Suwasanti Nun Zairina, Nun Nur Rochmah Pitono Soeparto Prastiya I. Gunawan Prastiya I. Gunawan, Prastiya I. Prastiya Indra G Prastiya Indra Gunawan Qorina Nadya Salfi Ratih Dwi Andini Retno Asih Setyoningrum Roedi Irawan Yulistiani Yulistiani, Yulistiani

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