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SKROFULODERMA PADA ANAK USIA 12 TAHUN DENGAN TUBERKULOSIS PARU, EFUSI PLEURA, PNEUMONIA DAN MALNUTRISI BERAT: LAPORAN KASUS Oliviany, Windy; Faisal, Imam Agus
Medical and Health Journal Vol 4 No 1 (2024): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2024.4.1.12976

Background: Tuberculosis (TB) is a human disease caused by Mycobacterium tuberculosis. The disease primarily attacks the lungs, making pulmonary disease the most common symptom. Other organ systems frequently affected include the respiratory system, gastrointestinal (GI) system, lymphoreticular system, skin, central nervous system, musculoskeletal system, reproductive system, and liver. Scrofuloderma is rarely found in children. Late diagnosis and inappropriate treatment can lead to poor prognosis and complications. Case report: A 12 year old girl was referred from the regional hospital with complaints of shortness of breath since 3 days before admission. Accompanied by gasping, productive cough with difficulty coming out of phlegm, accompanied by an enlarged stomach and swollen legs, and fever fluctuating since 1 week before admission. Starting with a history of lumps on the neck since 6 months and have started tuberculosis therapy for 1 week before admission. Physical examination revealed multiple lymphadenopathy in the right and left cervical regions, decreased sounds in both lungs, and severe malnutrition. The results of a chest x-ray examination showed a massive pleural effusion. Laboratory results showed hypoalbuminemia, positive rivalta test in effusion fluid, and uncompensated respiratory acidosis. Management of this patient consists of oxygen, correction of hypoalbuminemia, antibiotics, anti-tuberculosis drugs, management of malnutrition, and water seal drainage (WSD). Conclusion: Although rare, scrofuloderma can be found in children. Therefore, collection of tissue specimens from specific extrapulmonary locations is necessary. Late diagnosis and inappropriate treatment can lead to poor prognosis and antimicrobial resistance. Delayed diagnosis and treatment will also cause complications such as the spread of infection to the lungs and other organs, severe malnutrition and stunting. Infections in the lungs and pleura can cause respiratory failure.

IMPACT OF MATERNAL WEIGHT GAIN AND INFLAMMATORY MARKERS ON NEONATAL IRON DEFICIENCY: A CROSS-SECTIONAL STUDY FROM A PEDIATRIC PERSPECTIVE Santosa, Qodri; Oliviany, Windy; Hafiidhaturrahmah, Hafiidhaturrahmah; Pratidina, Wening Gelar; Hapsari, Ariadne Tiara; Priyanto, Edy; Muntafiah, Alfi
Medical and Health Journal Vol 4 No 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.4.2.14481

Background: Maternal health during pregnancy is crucial for neonatal outcomes, particularly regarding iron status. This study investigates the impact of maternal weight gain and inflammatory markers on neonatal iron deficiency in a cohort of mothers and their newborns. Methods: A cross-sectional study was conducted involving spontaneously delivered infants from single, full-term pregnancies, with Apgar scores ≥7 at the first minute and normal birth weights (≥2,500 to <4,000 grams). Maternal weight gain was categorized as "appropriate" or "inappropriate" based on the 2009 Institute of Medicine (IOM) recommendations. Maternal blood samples were collected during the third trimester, and infant iron status was assessed through hematological parameters and serum iron levels. Statistical analyses included the Mann-Whitney test and independent t-tests, with significance set at p < 0.05. Results: A total of 59.5% of mothers did not achieve appropriate weight gain, and 57.1% exhibited positive CRP levels, indicating inflammation. Infants born to mothers with appropriate weight gain had significantly better hematological parameters, including higher erythrocyte counts, hemoglobin, and hematocrit levels (p < 0.05). Conversely, infants of mothers with positive CRP levels demonstrated lower erythrocyte counts and hemoglobin levels, indicating a potential negative impact of maternal inflammation on iron transfer (p < 0.05). No significant differences in neonatal iron status were observed between infants born to anemic and non-anemic mothers. Discussion: The findings underscore the importance of monitoring maternal nutritional status and inflammatory markers during pregnancy. Adequate weight gain according to IOM guidelines is associated with improved neonatal iron status, while maternal inflammation negatively impacts iron transfer to the fetus. These results highlight the need for targeted interventions, including nutritional education and management of inflammatory conditions, to enhance maternal and neonatal health outcomes. Conclusion: This study contributes to the understanding of the relationships between maternal weight gain, inflammatory markers, and neonatal iron status. By addressing these factors, healthcare providers can improve outcomes for mothers and their newborns, ultimately promoting healthier populations.

Analysis Of Service Quality Factors On Patient Satisfaction In The Pediatric Department Rsi At-Tin Husada Purbalingga Oliviany, Windy; Kadarisman, Sumeidi; Utoyo, Widjajanti
At-tijaroh: Jurnal Ilmu Manajemen dan Bisnis Islam Vol 10, No 2 (2024): DESEMBER 2024
Publisher : Universitas Islam Negeri Syekh Ali Hasan Ahmad Addary Padangsidimpuan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24952/tijaroh.v10i2.14713

The quality of health services reflects the performance of health workers and affects community satisfaction. This study evaluates the impact of service quality on patient satisfaction at the RSI At-Tin Husada Purbalingga Children's Polyclinic. A quantitative approach using multiple linear regression analysis, examines five key service quality aspects: reliability, assurance, responsiveness, empathy, and physical evidence. Data were collected via a survey of 68 child patient companions, utilizing a tested questionnaire. Results indicate that the assurance dimension most significantly influences patient satisfaction, followed by empathy and reliability, all rated very good. While responsiveness and physical evidence also affect satisfaction, their influence is smaller. The study emphasizes the importance of a personalized approach and the need for improved facilities. Enhancing service quality across the five SERVQUAL dimensions can improve patient satisfaction, particularly in empathy and reliability. Key improvement areas include service timeliness, hospital reputation, complaint responsiveness, personalized care, standardization, and overall comfort. Recommendations include optimizing scheduling, strengthening public communication, implementing a responsive complaint system, enhancing patient recognition through training, adhering to uniform standards, and redesigning waiting areas for comfort. These insights support ongoing improvements in pediatric outpatient services and affirm the relevance of SERVQUAL in healthcare.

Mitral and Tricuspid Valve Regurgitation as a Subclinical Manifestation of Rheumatic Heart Disease: A Pediatric Case Report Oliviany, Windy; Aristya, Davina Aqiilah
Medical and Health Journal Vol 5 No 1 (2025): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.5.1.17120

Background: Rheumatic heart disease (RHD) accounts for approximately 15.6 million cases globally, with 282,000 new cases and 471,000 episodes of acute rheumatic fever (ARF) annually, predominantly affecting children aged 5–15 years in the Pacific region. In 2015, the incidence in Indonesia reached 1.18 million cases, mostly among children and young adults. RHD results from valvular damage due to an autoimmune inflammatory response to Group A Streptococcus (GAS) infection. It primarily affects the mitral valve (75%), aortic valve (25%), and rarely the tricuspid valve. ARF typically precedes RHD, marked by valvular abnormalities. Initial symptoms include sore throat, progressing in 2–4 weeks to fever and clinical signs such as polyarthralgia, polyarthritis, chorea, and erythema marginatum. Complications may include infective endocarditis, heart failure, stroke, and atrial fibrillation. The World Heart Federation recommends prophylactic administration of Benzathine benzylpenicillin G (BPG) every 3–4 weeks to prevent recurrent streptococcal infections. Case Report: An 8-year-old boy presented with left-sided chest pain described as pressure-like and non-radiating, along with fatigue, nausea, and joint pain for four days. He had a history of recurrent pharyngitis beginning a year earlier. A positive Anti-Streptolysin O (ASTO) test was previously recorded. Due to persistent joint pain and chest discomfort, the patient was referred to a tertiary hospital and hospitalized for four days. Physical examination showed a body weight of 20.5 kg, height 119 cm, with no murmur or tachycardia, but arthritis and erythema marginatum were observed. Laboratory findings indicated leukocytosis (14,110/mm³), and echocardiography revealed mild mitral and tricuspid regurgitation consistent with RHD. He was treated with intramuscular BPG (600,000 IU) and oral aspirin. The patient continues monthly outpatient follow-ups for BPG injections. Conclusion: RHD remains a significant contributor to childhood morbidity and mortality. This case highlights an atypical subclinical presentation without murmur, identified through echocardiography showing dual mild valvular insufficiency. Treatment included BPG and aspirin.

Integrasi Edukasi Mikrobiota Usus, Skrining Antropometri, dan Pemanfaat Probiotik sebagai Upaya Pencegahan Stunting di Desa Watuagung Pauzi, Rizqi Yanuar; Ihtiaringtyas, Suci; Yunika, Novia; Nur’aini, Indah; Oliviany, Windy
Linggamas: Jurnal Pengabdian Masyarakat Vol 3 No 1 (2025): Linggamas: Jurnal Pengabdian Masyarakat
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.linggamas.2025.3.1.17703

Prevalensi stunting di Desa Watuagung, Kabupaten Banyumas (18,58%), masih menjadi masalah gizi kronis yang signifikan. Salah satu faktor penyebab yang teridentifikasi adalah rendahnya pengetahuan masyarakat mengenai gizi seimbang dan peran mikrobiota usus dalam optimalisasi penyerapan nutrisi. Kegiatan pengabdian ini bertujuan untuk meningkatkan pengetahuan ibu balita dan keterampilan kader Posyandu serta melakukan deteksi dini stunting sebagai upaya pencegahan. Metode yang diterapkan adalah participatory action research yang melibatkan 48 ibu balita dan 11 kader Posyandu. Intervensi terdiri dari tiga kegiatan utama: (1) penyuluhan interaktif mengenai stunting, gizi seimbang, dan peran mikrobiota usus; (2) pelatihan dan pendampingan kader dalam melakukan pengukuran antropometri standar; serta (3) skrining status gizi pada 38 balita. Peningkatan pengetahuan diukur menggunakan pre-test dan post-test, sedangkan status gizi dianalisis berdasarkan standar WHO Child Growth Standards. Hasil pre-test dan post-test menunjukkan terjadi peningkatan pengetahuan peserta secara signifikan, dengan skor rata-rata naik dari 85,22 menjadi 92,61 dan nilai N-Gain sebesar 0,50 yang termasuk kategori efektivitas sedang. Hasil skrining antropometri pada 38 balita menunjukkan prevalensi stunting (TB/U <-2 SD) yang tinggi, yaitu sebesar 45% (17 anak), dan underweight (BB/U <-2 SD) sebesar 24% (9 anak). Adapun prevalensi wasting (BB/TB <-2 SD) lebih rendah, yaitu 6% (2 anak). Edukasi terstruktur dan deteksi dini melalui pemberdayaan kader terbukti efektif sebagai strategi awal pencegahan stunting. Tingginya angka stunting yang ditemukan menegaskan urgensi intervensi lanjutan berbasis data skrining yang akurat.

Bersinergi Menurunkan Angka Stunting Kabupaten Banyumas Melalui Pendampingan Keluarga Santosa, Qodri; Hapsari, Ariadne Tiara; Oliviany, Windy; Agustina, Nenden Nursyamsi; Muntafiah, Alfi; Windiya, Fajar; Syamsiedi, Naluri Widyaningsih; Susilarto, Aris Dwi
Linggamas: Jurnal Pengabdian Masyarakat Vol 1 No 1 (2023): Linggamas: Jurnal Pengabdian Masyarakat
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.linggamas.2023.1.1.9382

Keluarga sebagai lingkungan utama tumbuh kembang anak, memiliki peran sentral dalam memberikan dukungan dan perawatan optimal bagi anak. Dalam pelaksanaannya, keluarga seringkali menghadapi berbagai permasalahan dan tantangan yang berpotensi mempengaruhi status gizi dan kesehatannya sehingga terjadi stunting. Tujuan kegiatan ini untuk memberikan pendampingan kepada keluarga stunting. Melalui pendampingan langsung, tim pengabdi dapat lebih mendalam memahami tantangan dan kebutuhan keluarga. Metode kegiatan dilakukan dengan pendekatan holistik dan berbasis partisipatif, yang melibatkan interaksi langsung dengan sejumlah 187 keluarga stunting di wilayah Puskesmas Purwokerto Timur I, II dan kembaran I. Pendekatan ini diharapkan dapat menciptakan perubahan positif dan berkelanjutan dalam mengatasi stunting Kegiatan meliputi kunjungan rumah, pemeriksaan fisik, Tes Deteksi Dini (TDD), Kuesioner Pra Skrining Perkembangan (KPSP), dan pemeriksaan Denver II. Kegiatan diakhiri dengan pemberian rekomendasi untuk mengarahkan intervensi yang sesuai dengan kebutuhan masing-masing anak. Melalui kegiatan ini, keluarga diharapkan mendapatkan dukungan yang efektif dalam meningkatkan status gizi dan perkembangan anaknya.

Pemberdayaan Kader Posyandu Untuk Gencarkan Imunisasi Wujudkan Desa Zero Kasus Penyakit yang Dapat Dicegah Dengan Imunisasi (PD3I) Muntafiah, Alfi; Inayati, Nor Sri; Fadlilah, Synta Haqqul; Oliviany, Windy; Santosa, Qodri
Linggamas: Jurnal Pengabdian Masyarakat Vol 1 No 2 (2024): Linggamas: Jurnal Pengabdian Masyarakat
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.linggamas.2024.1.2.9800

Imunisasi merupakan upaya pencegahan dan pemberantasan penyakit paling cost effective melalui pemberian kekebalan tubuh. Upaya ini perlu dilaksanakan kontinyu, menyeluruh, dan sesuai standar sehingga mampu memberikan perlindungan kesehatan dan memotong rantai penularan. Hasil penelitian melalui kuesioner dan wawancara terhadap kader di desa binaan didapatkan adanya hambatan kader dalam imunisasi di Posyandu diantaranya masalah acceptance publik mengenai imunisasi. Masih banyak ibu balita yang tidak mau anaknya diimunisasi karena berbagai alasan. Hal ini dikhawatirkan dapat menurunkan cakupan imunisasi dan memunculkan kerawanan KLB di masa mendatang. Keterbatasan pengetahuan dan keterampilan mengenai imunisasi juga dialami kader. Kegiatan ini dilakukan dengan sasaran kader Linggasari. Metode kegiatan: 1) Edukasi imunisasi; 2) Pelatihan skill konseling imunisasi. Hasil edukasi menunjukkan peningkatan signifikan hasil pre-post test, yang menjadi bukti bahwa kegiatan ini berhasil mencapai tujuan dalam meningkatkan pengetahuan kader. Melalui kegiatan pelatihan konseling, kader diharapkan dapat membantu masyarakat memahami manfaat imunisasi dan mengatasi kekhawatiran dan keraguan masyarakat.

Stunting severity and developmental outcomes in early childhood in Central Java, Indonesia Santosa, Qodri; Hapsari, Ariadne Tiara; Agustina, Nenden Nursyamsi; Oliviany, Windy; Roestijawati, Nendyah; Muntafiah, Alfi
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background Stunting in early childhood remains a critical global health issue, particularly in low- and middle-income countries such as Indonesia. Defined by height-for-age below -2 standard deviations from the WHO growth standards, stunting indicates chronic malnutrition and is linked to impaired developmental outcomes, including cognitive and motor delays. Objective To elucidate the specific areas of development most affected by stunting and to identify potential sociodemographic and health-related factors that may contribute to the observed developmental disparities among these children. Methods A cross-sectional comparative study was conducted in Central Java, Indonesia, involving 144 stunted children. Stunting severity was categorized as stunted or severely stunted. Standardized anthropometric measurements and developmental assessments using the Denver II tool were performed, focusing on four domains: personal-social interaction, fine motor skills, language acquisition, and gross motor skills. Data were analyzed using the Mann-Whitney and Chi-square tests with a significance level of P < 0.05. Results Children in the severely stunted group exhibited a significantly higher prevalence of fine motor delays compared to the stunted group (17.0% vs. 4.1%, respectively; P=0.013). No significant differences were observed in other developmental areas. Sociodemographic and health factors were comparable across both groups. Conclusion Severe stunting is significantly associated with delayed fine motor development. Furthermore, as sociodemographic and health factors are comparable across groups, these findings underscore the urgency of implementing targeted nutritional interventions and routine developmental monitoring to mitigate the adverse effects of stunting on early childhood growth and development.

Beyond Survival: Multisystem Life-Threatening Illness in an Infant with Congenital Heart Disease and Sepsis Oliviany, Windy; Pratidina, Rr. Wening Gelar; Kinanti, Luhung Sekar
Medical and Health Journal Vol 5 No 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.5.2.19603

Introduction: Congenital malformations are a leading cause of infant disability and mortality. Congenital infections, particularly cytomegalovirus (CMV) and Toxoplasma gondii, are associated with structural abnormalities of multiple organ systems, including congenital heart disease (CHD). In utero infection may disrupt cardiac organogenesis, increasing the risk of heart failure. Infants with CHD are also highly susceptible to sepsis, frequently requiring pediatric intensive care. Managing life-threatening conditions in infants presents significant clinical challenges, including complex therapeutic decisions, drug dosing, and multidisciplinary care. Case Report: A 1-month-old male infant presented with poor feeding and lethargy. He had been previously diagnosed with failure to thrive and CHD consisting of atrial septal defect (ASD) and ventricular septal defect (VSD). Further evaluation revealed heart failure (Ross III), congenital CMV and toxoplasmosis infections, sepsis, bronchopneumonia, prolonged jaundice, and hydrocele dextra. The patient required PICU admission for 6 days followed by 7 days of inpatient care. Clinical improvement was achieved following comprehensive medical management, and the patient was discharged in stable condition. Conclusion: Congenital infections may play a critical role in the development and clinical severity of CHD, contributing to heart failure and increased susceptibility to sepsis. Early recognition and integrated multidisciplinary management are essential to improve outcomes in infants with multiple life-threatening conditions, emphasizing care that extends beyond survival toward functional recovery..

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