Darfioes Basir
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Uji Tuberkulin pada Bayi BBLR yang Mendapat BCG Segera Setelah Lahir dan yang Menunggu Berat Badan > 2500 Gram

Sari Pediatri Vol 9, No 4 (2007)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

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Abstract

Latar belakang. Vaksinasi BCG pada bayi BBLR (berat badan lahir rendah) belum menjadi kesepakatandalam program imunisasi nasional di Indonesia. Beberapa penelitian sebelumnya melaporkan efektifitasBCG pada bayi BBLR/preterm dengan menggunakan uji tuberkulin 27% sampai 83%.Tujuan. Menilai efektifitas BCG pada bayi BBLR dengan uji tuberkulin di RS.Dr. M. Djamil PadangMetode. Penelitian bersifat randomized clinical trial pada bayi BBLR 2000gram-<2500gram yang lahirdan/atau dirawat di Sub Bagian Perinatologi Bagian Ilmu Kesehatan Anak, dari bulan Juni sampaiNovember 2006. Setiap subjek yang masuk penelitian, diberikan informed concent, dikelompokkan dalam2 kelompok dengan simple random sampling. Kelompok 1 diberikan BCG segera setelah lahir, maksimal3 hari. Sedangkan kelompok 2 ditunda pemberian BCG sampai berat badan >2500 gram. Kedua kelompokdi dilakukan uji tuberkulin dan pemeriksaan parut 12 minggu setelah vaksinasi BCG serta mengisi kuisioner.Data penelitian diolah dengan SPSS 13.0 for Windows dan di analisis dengan t-test, X2 test (kai-kuadrat)dan uji mutlak Fischer dengan α= 0,05.Hasil. Selama 6 bulan, telah lahir dan/atau dirawat 107 bayi BBLR berat 2000gram - <2500gram. 60 bayimemenuhi kriteria inklusi dan 44 bayi menyelesaikan penelitian. Rerata diameter indurasi tuberkulinpada kelompok 1 4,91 ± 2884 mm dan kelompok 2 5,41 ± 2,085 mm yang secara statistik tidak berbedabermakna dengan p=0,510. Nilai konversi uji tuberkulin pada kelompok 1 sebesar 63,6% dan kelompok 281,8% tidak menunjukan perbedaan p=0,310.Kesimpulan. Vaksinasi BCG bayi BBLR berat 2000gram-<2500gram segera setelah lahir memberikanefektifitas sama dengan yang ditunda.

Perbandingan Uji Tuberkulin dengan Kadar Interferon Gamma pada Kultur Sel Limfosit Anak Tersangka TB

Sari Pediatri Vol 16, No 4 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

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Latar belakang. Tuberkulosis (TB) pada anak masih merupakan penyakit utama yang menyebabkan kesakitandan kematian. Sampai saat ini, diagnosis TB anak masih menjadi masalah. Uji tuberkulin atau tuberculinskin test (TST) merupakan metode yang masih dijadikan pedoman, tetapi mempunyai sensitivitas yangrendah. Uji interferon-􀁊 (IFN-􀁊) merupakan pemeriksaan yang lebih spesifik untuk mendukung diagnosisinfeksi TB anak.Tujuan. Mengetahui kesesuaian TST dengan IFN-􀁊 pada kultur sel limfosit anak tersangka TB.Metode. Penelitian cross sectional pada anak berusia 3 bulan-14 tahun tersangka TB atau memiliki kontakerat dengan penderita TB paru BTA(+) dewasa yang datang ke poliklinik anak RS dr. M. Djamil Padangpada bulan Februari-November 2012. Semua sampel dilakukan pemeriksaan TST dan IFN-􀁊 kemudiandilakukan uji kesesuaian (kappa=K).Hasil. didapatkan 34 9 (26,5%) sampel memiliki TST positif dan 16 (47,1%) memiliki uji IFN-􀁊 positif.Didapatkan uji kesesuaian 38,2%(􀁎=0,27).Kesimpulan. Pemeriksaan uji IFN-􀁊 memiliki angka kesesuaian cukup dibandingkan TST sehingga belumperlu digunakan sebagai uji diagnostik infeksi TB pada anak tersangka TB.

Faktor Risiko Asma Pada Murid Sekolah Dasar Usia 6-7 Tahun di Kota Padang

Jurnal Kesehatan Andalas Vol 1, No 3 (2012)
Publisher : Fakultas Kedokteran Universitas Andalas

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Abstract

Abstrak Latar belakang : Asma merupakan penyakit kronik yang sering dijumpai pada anak. Dilaporkan bahwa prevalens asma meningkat pada anak maupun dewasa. Usia 6-7 tahun merupakan periode dimana prevalens asma dan angka kunjungan ke rumah sakit karena asma lebih tinggi. Terjadinya asma dianggap sebagai interaksi yang kompleks antara faktor genetik dan faktor lingkungan. Faktor genetik sudah dibuktikan dari penelitian-penelitian sebelumnya, tetapi karakteristik faktor risiko lingkungan pada asma belum jelas. Apabila melihat derajat peningkatan kejadian asma, tidak mungkin hanya faktor genetik yang berperan, tetapi peran faktor lingkungan justru yang lebih besar. Tujuan : Untuk mengetahui prevalens dan faktor risiko asma pada anak SD usia 6-7 tahun di Kota Padang.Metoda : Suatu penelitian cross sectional di 20 SD di Kota Padang pada bulan Juni – November 2009 dengan jumlah sampel 879 orang. Terhadap setiap subjek dilakukan penelitian yaitu pembagian kuisioner ISAAC (international study of asthma and allergies in childhood) untuk orang tua. Analisis data dilakukan dengan uji chi-square untuk variabel katagorik dan analisis multivariat dengan regresi logistik. Data dianalisis menggunakan peranti lunak komputer.Hasil : Prevalens asma pada murid SD usia 6-7 tahun di Kota Padang berdasarkan kuisioner ISAAC sebesar 8%. Faktor yang paling dominan berpengaruh terhadap kejadian asma adalah atopi ayah atau ibu, diikuti faktor berat badan lahir dan kebiasaan merokok pada ibu serta pemberian obat parasetamol. Sedangkan pemberian ASI dan kontak dengan unggas merupakan faktor protektif terhadap kejadian asma. Kata kunci: faktor risiko, asma, sekolah dasar Abstract Background: Background Asthma is a common chronic disease in children. It had been reported that the prevalence of asthma in children and adults was increasing. The age of 6-7 years is the period where the prevalence and the number of visits to the hospital because of asthma are higher. The occurrence of asthma is considered as a complex interaction between genetic factors and environmental factors. Genetic factors have been proved to be the risk factor for asthma, but not for the characteristic of environmental that factors that were still unclear. If seeing the increased incidence of asthma, genetic factors might not play a role solely, but the environmental factors might play moreObjective The aim of this study was to determine the prevalence and the risk factors of asthma in elementary school children aged 6-7 years in Padang.Methods This research is cross sectional study in 20 elementary schools in Padang during June until November 2009, total sample of 879 students. To each respondent the ISAAC (international study of asthma and allergies in childhood) questionnaire was given to be fulfilled. Data were analyzed using computer software. Results The prevalence of asthma in elementary school students aged 6-7 years in Padang based on ISAAC questionnaire was 8%. The most dominant factor influencing the incidence of asthma is atopic in father or mother, followed by factors of birth weight and maternal smoking habits and drug administration of paracetamol, while breastfeeding and poultry contact were protective factors. Keywords:risk factors, asthma, elementary school

Kadar Interferon Gamma Kultur Sel Limfosit pada Anak yang Mendapat Vaksinasi BCG

Sari Pediatri Vol 18, No 1 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

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Abstract

Latar belakang. Vaksinasi BCG mempunyai efek proteksi yang bervariasi, menurun dengan bertambahnya umur anak. Perkembangan pengetahuan di bidang biologi molekuler telah mengembangkan pemeriksaan IFN-γ untuk mendeteksi respon vaksinasi.Tujuan. Mengetahui lamanya efek proteksi BCG dan hubungan kadar IFN-γ dengan umur, status gizi, umur mendapatkan vaksinasi BCG dan sarana kesehatan tempat vaksinasi.Metode. Suatu studi cross sectional, stratified random sampling, pada anak yang telah mendapat vaksinasi BCG. Kadar IFN-γ diukur dari sel limfosit yang telah dikultur. Analisis statistik menggunakan uji Anova dan Independent sample t tes.Hasil. Kadar IFN-γ tertinggi pada kelompok umur 4-11 bulan. Terdapat perbedaan bermakna kadar IFN-γ antara kelompok umur 4-11 bulan dengan 1-4 tahun dan 1-4 tahun dengan 5-9 tahun. Tidak terdapat perbedaan bermakna antara status gizi, umur mendapatkan vaksinasi BCG, sarana kesehatan tempat vaksinasi BCG dengan kadar IFN-γ.Kesimpulan. Kadar IFN-γ yang tinggi menunjukkan vaksinasi BCG efektif pada anak, tetapi efektifitasnya menurun seiring dengan pertambahan umur. Sari

Neonatal Urinary Ascites due to Kinking of the Right Ureter

Paediatrica Indonesiana Vol 18 No 9-10 (1978): September 1978
Publisher : Indonesian Pediatric Society

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Abstract

A case of neonatal urinary ascites in a female newborn infant due to kinkingof the right ureter is presented. The diagnosis was based on the following findings: clinically, the presence of ascites which was confirmed radiologically,and by abdominal parfacentesis; by I.V.P. and operatively. After operative relief of the obstruction, the ascites disappeared and on the 8th day after operation she was discharged in a good condition.

Bacterial pneumonia score to identify bacterial pneumonia

Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

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Abstract

Background Pneumonia is caused by either bacterial or viraletiologies, with similar symptoms in children. The bacterialpneumonia score (BPS) is a clinical assessment comprised ofseveral investigations: age, assessment of axillary temperature,absolute neutrophil count, band neutrophil percentage, andinterpretation of radiological examination. The score will use todifferentiate the etiology of pneumonia.Objective To determine the sensitivity, specificity, positivepredictive value, and negative predictive value of BPS inidentifying bacterial pneumonia in children.Methods This diagnostic study was performed at Dr. M. DjamilHospital, Padang, West Sumatera where subjects were selected byconsecutive sampling. Fifty-seven patients were diagnosed withpneumonia. Three patients suffered from ventricular septal defects,8 patients refused to provide blood specimens and 3 patients’chest X-rays could not be interpreted, hence, 43 subjects wereincluded in the study. Chest X-rays were interpreted by a pediatricpulmonology consultant. Leukocyte and differential counts wereperformed by a clinical pathology consultant. Subjects’ BPS scoreswere compared to multiplex PCR examinations of blood specimens,as the gold standard.Result Of 43 subjects, 27 (62.79%) were male. Subjects’ mean age was 29.3 (SD 21.5) months. Twenty (46.51%) subjects had good nutritional status, 4 (9.31%) subjects had axillary temperature ≥39°C, and 22 (51.16%) subjects had absolute neutrophil counts ≥8.000/mm3. Bacterial pneumonia score (BPS) had 69% sensitivity, 60% specificity, 42% positive predictive value, and 81% negative predictive value.Conclusion In this study, BPS has low sensitivity and specificityfor identifying bacterial pneumonia.

Tuberculosis score chart signs and symptoms in children with positive tuberculin skin tests

Paediatrica Indonesiana Vol 52 No 2 (2012): March 2012
Publisher : Indonesian Pediatric Society

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Background The Indonesian Pediatrics Respirology WorkingGroup (IPRWG) developed the tuberculosis (TB) scorechart to assist in diagnosing TB in community health centers(Puskesmas).Objectives To document signs and symptoms of the IPRWG TBscore chart, to analyze various combinations of these signs andsymptoms, and to compare these combinations in children withTB to those without TB, based on a TB score chart.Methods We performed a cross-sectional study from July toOctober 2008, in Padang, Bukittinggi and Pasaman. We recruitedchildren with known positive tuberculin skin tests (TST) from a2006 tuberculin survey. Questionnaires on signs and symptoms(IPRWG TB score chart) were completed and chest radiographswere obtained for all children. Subjects fulfilling a total score ofsix or more were considered to have a diagnosis of TB.Results We diagnosed TB in 78/285 (27.3%) subjects. A scorevalue of3 for the category of household contact (HHC) positivesmears was added in 21/78 subjects. However, the highest risk forTB disease was found in those diagnosed with no clear history ofHHC (58.9%; OR 192, 95% CI 22 to 1679). The highest riskfactors for TB were suggestive chest X-ray (34.6%; OR 9.2, 95%CI 3.6 to 23 .4) and fever lasting > 2 weeks (17.9%; OR 8, 95%CI 2.2 to 29.1), respectively. Of 46 children with TB diagnosisbut without HHC, the combination of undernourishment, lymphnode enlargement and suggestive chest X-ray was highest (28.2%).Individual or dual combination signs and symptoms were alsofound in children without TB diagnosis.Conclusion Various combinations of signs and symptoms couldlead to fulfillment of scoring for TB diagnosis. [Paediatr lndones.2012;5 2: 78-85].

Hodgkin's Disease

Paediatrica Indonesiana Vol 18 No 1-2 (1978): January 1978
Publisher : Indonesian Pediatric Society

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Abstract

A case of Hodgkin's disease in an 8-year-old Indonesian boy is presented. The treatment was stanted 2½ years after the first onset of the symptoms,consisting of vincristine, cyclophosphamide and prednisone. It seemed that this combination gave good results; after 12 weeks of treatment the lymphnodes disappeared and no new swellings developed. Despite the good results, continuous observation is necessary.