Muhammad Sholeh Kosim, Muhammad Sholeh
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Faktor Risiko Air Ketuban Keruh Terhadap Kejadian Sepsis Awitan Dini pada Bayi Baru Lahir Kosim, Muhammad Sholeh; Rini, Arsita Eka; Suromo, Lisyani B
Sari Pediatri Vol 12, No 3 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.3.2010.135-41

Abstract

Latar belakang. Sepsis neonatorum merupakan masalah utama dan penyebab kematian terbanyak di negaraberkembang. Air ketuban keruh bercampur mekonium merupakan salah satu faktor risiko sepsis bayi barulahir dan terjadi pada sekitar 10%-20% seluruh kelahiran.Tujuan. Membuktikan air ketuban keruh merupakan faktor risiko kejadian sepsis awitan dini pada bayibaru lahir.Metode. Penelitian menggunakan desain kohort. Subjek adalah bayi dengan kriteria inklusi dan lahirdengan air ketuban keruh bercampur mekonium di RS Dr. Kariadi bulan Oktober 2009 – Maret 2010.Bayi lahir dengan air ketuban jernih sebagai kontrol. Air ketuban diambil pada hari ke-1, biakan darah,dan pemeriksaan darah tepi pada hari ke-5. Analisis statistik menggunakan chi square, Mann Whitney, danrisiko relatif (95% confidence interval).Hasil. Subjek 70 bayi lahir dengan air ketuban keruh berisiko 10x lebih tinggi mengalami sepsis (95%CI=1,3-74,0; p=0,003). Risiko relatif adanya kuman pengecatan Gram (+) di dalam air ketuban terhadapterjadinya sepsis 1,4 (95%CI=0,3-6,8;p=0,6) dan adanya kedua jenis kuman Gram (+) dan (-) 2,4 (95%CI=0,7-7,7; p=0,2). Risiko relatif bayi dengan air ketuban mengandung biakan E coli mempunyai risikokejadian sepsis 3,8 (95%CI=0,8-17,0;p=0,057) dan biakan non E coli 2,4 (95% CI=0,4-13,1; p=0,4).Faktor risiko lain adalah adanya kuman dalam biakan darah, berisiko 6,3 x lebih tinggi mengalami sepsis(95% CI=1,4-29,3; p=0,02).Kesimpulan. Air ketuban keruh merupakan faktor risiko terjadinya sepsis bayi baru lahir awitan dini. Jeniskuman pengecatan Gram dan biakan kuman dalam air ketuban bukan merupakan faktor risiko terjadinyasepsis awitan dini
Chest x-ray findings and outcomes of children with suspected ventilator-associated pneumonia Sumarni, Neni; Kosim, Muhammad Sholeh; Supriatna, Mohammad; Sudijanto, Eddy
Paediatrica Indonesiana Vol 52 No 4 (2012): July 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (184.108 KB) | DOI: 10.14238/pi52.4.2012.233-8

Abstract

Background Ventilator-associated pneumonia (VAP) is anosocomial infection in patients who have received mechanicalventilation (MV), either by endotracheal intubation ortracheostomy, for more than 48 hours. YAP represents 80% ofall hospital-acquired pneumonias. VAP incidence varies from5.1 %-33.3%. The modified clinical pulmonary infection scoreis a criteria for diagnosing suspected YAP and typically includesradiographic evidence. YAP is associated with significantmorbidity and mortality.Objective To determine the relationship between chest x-rayfindings and outcomes in children Mth suspected VAP.Methods This retrospective study was held in Dr. Kariadi Hospitalfrom January - December 2010. Data was collected from medicalrecords of pediatric ICU (PICU) patients with suspected VAP.Chest x-ray findings and patient outcomes were recorded. X-rayfindings were assessed by the on-duty radiologist. Chi square testwas used for statistical analysis.Results Subjects were 30 children consisting of 14 males and 16females. Patient outcomes were 23 patients survived and 7 patientsdied. Chest x-ray findings were categorized into the followinggroups and compared to patient survivability: diffuse infiltrates76.7% (OR=0.694; P=0.532; 95% CI 0.102 to 4.717), localhedinfiltrates 13.3% (OR=4.200; P=0.225; 95% CI 0.470 t037.49),and no infiltrates 10% (OR=1.222; P=0.436; 95% CI 0.593 to0.926). None of the x-ray findings had a significant correlationto patient outcomes.Conclusion There was no significant relationship between chestx-ray findings and outcomes in children with suspected VAP.[Paediatr rndones. 2012;52:233-8].
Prognostic factors for success in the Kangaroo Mother Care method for low birth weight babies Pratiwi, Rina; Kosim, Muhammad Sholeh; Wijayahadi, Noor
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (259.134 KB) | DOI: 10.14238/pi55.3.2015.142-6

Abstract

Background Low birth weight (LBW) is closely related to neonatal morbidity and mortality. Management of LBW infants in developing countries remains limited, due to the low availability of incubators. The Kangaroo Mother Care (KMC) method has been shown to be effective for newborns, especially LBW infants, in which skin-to-skin contact may be conducive for infants’ weight gain, thermoregulation, and heart rate stability.Objective To determine the prognostic factors for KMC success in LBW babies.Methods This cohort study included LBW infants at Dr. Kariadi General Government Hospital, Semarang, by a consecutive sampling method. Success of KMC was assessed by infant weight gain, as well as stabilization of temperature, heart rate, and respiration. Prognostic factors for KMC success that we assessed were birth weight, gestational age, KMC duration, age at KMC onset and maternal education level. Statistical analyses used were Chi-square and relative risk (RR) tests.Results Of 40 LBW infants, 24 were successful in KMC. Birth weight ≥ 1500 grams (RR 0.4; 95%CI 0.23 to 0.73; P=0.001)], gestational age ≥ 34 weeks (RR 0.94; 95%CI 0.46 to 1.89; P=1.00), KMC duration ≥ 65 minutes (RR 1.44; 95%CI 0.76 to 2.75; P= 0.215), high maternal education level (RR 1.25; 95%CI 0.76 to 2.04; P=0.408), and age at KMC onset >10 days (RR 2.69; 95%CI 1.14 to 6.32; P=0.003), were factors that related to the successful of KMC.Conclusion Age at KMC onset > 10 days was a prognostic factor for KMC success in low birth weight babies.
ERITROSIT BERINTI SEBAGAI ALAT PENUNJANG DIAGNOSIS ASIDOSIS PADA ASFIKSIA NEONATORUM Rahmadi, Farid Agung; Kosim, Muhammad Sholeh; Santosa, Gatot Irawan
Media Medika Muda Vol 1, No 1 (2016)
Publisher : Faculty of Medicine Diponegoro University

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Abstract

Latar belakang: Asfiksia neonatorum merupakan penyebab utama kematian neonatus sebesar 19% dari lima juta bayi lahir hidup di dunia setiap tahun. Asfiksia mengakibatkan hipoksia, hiperkapnia, dan asidosis. Baku emas pemeriksaan asidosis adalah dengan pH darah arteri yang belum dapat dilakukan di tempat dengan sarana yang terbatas. Hipoksia memicu terjadi peningkatan jumlah eritrosit dan eritrosit berinti. Peningkatan jumlah ini bertujuan untuk meningkatkan oksigenasi jaringan dan berbanding lurus dengan semakin beratnya hipoksia. Pemeriksaan jumlah eritrosit berinti dapat dilakukan di tempat dengan sarana terbatas dengan pembacaan preparat darah apus. Penelitian ini bertujuan untuk membuktikan jumlah eritrosit berinti dapat menjadi alat penunjang diagnosis asidosis pada asfiksia neonatorumMetode: Penelitian ini merupakan penelitian uji diagnostik. Asfiksia ditentukan dengan nilai Apgar, asidosis ditentukan dengan pH dari pemeriksaan analisis gas darah, dan eritrosit berinti diperiksa menggunakan preparat darah apus. Analisis statistik menggunakan uji Spearmans, ROC, X2, sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif. Analisis data menggunakan program komputer.Hasil: Subyek penelitian berjumlah 49 neonatus asfiksia dengan jumlah bayi yang mengalami asidosis sebanyak 23. Terdapat hubungan yang bermakna antara jumlah eritrosit berinti dengan asidosis (p<0,0001), dengan nilai korelasi sedang (r = -0,516). Jumlah eritrosit berinti 7/100 leukosit memiliki sensitivitas dan spesifisitas sebesar 82,6% dan 69,2%, NDP dan NDN sebesar 70,4% dan 81,8%.Simpulan: Terdapat hubungan sedang negatif antara jumlah eritrosit berinti dengan asidosis. Jumlah eritrosit berinti 7/100 leukosit dapat digunakan sebagai alat penunjang diagnosis asidosis pada asfiksia neonatorum.Kata kunci: Eritrosit berinti, asidosis, asfiksia
RISK FACTORS FOR OROFACIAL CONGENITAL ANOMALIES IN NEONATES Radityo, Adhie Nur; Kosim, Muhammad Sholeh; Budhi, Kamilah; Santosa, Gatot Irawan; Rini, Arsirta Eka
Media Medika Muda Vol 1, No 1 (2016)
Publisher : Faculty of Medicine Diponegoro University

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Abstract

ABSTRACTBackground. Orofacialanomalies are anatomical and physiological abnormalities in the structure of organs in the face which are present since birth. Previous studies found that 40-60% the cause of birth defects was unclear.Objective. To determine the risk factors for orofacial congenital anomalies in neonates.Methods. Retrospective observational study using case-control design based on medical records within January 2009-June 2013 in Kariadi Hospital was done. Subjects were selected by purposive sampling and simple randomize sampling. Risk factors studied were risky maternal age, intrauterine infection, lack of folic acid supplementation, low antenatal care and family history of orofacial anomalies. Statistical analysis were using Chi-square test, Mann-Whitney test, Kolmogorov-Smirnov test and unpaired t-test.Results. Subjects were 48 neonates, which 24 of them with orofacial anomalies. We found that significant factors of orofacialanomalies occurrence are risky maternal age (p = 0.000; OR = 11.667, 95% CI = 2.696-50.490), intrauterine infection (p = 0.000; OR = 15.400, 95% CI = 2.930-80.951), lack of folic acid supplementation (p = 0.003; OR = 7.000, 95% CI = 1.822-26.887) and low antenatal care (p = 0.000; OR = 38.333, 95% CI = 4.395-334.382) and they become not significant after had multivariate analysis.Conclusion. Maternal age, intrauterine infection, lack of folic acid supplementation and low antenatal care are risk factors for orofacial anomalies in neonates Keywords:orofacialanomalies, risk factor
Predicting PICU patient survival prognosis: Pediatric Logistic Organ Dysfunction vs Pediatric Index of Mortality scores Winiarti, Edwina; Kosim, Muhammad Sholeh; Supriatna, Mohammad
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.362 KB) | DOI: 10.14238/pi52.3.2012.165-9

Abstract

Background Determining prognosis of patients using scoringsystems have been done in many pediatric intensive care units(PICU). The scoring systems frequently used are pediatric logisticorgan dy sfunction (PELOD), pediatric index of mortality (PIM)and pediatric risk of mortality (PRISM).Objective To compare the performance of PELOD and PIM scoresin predicting the prognosis of survival vs death in PICU patients.Methods A prognostic test in this prospective, cohort study wasconducted in the PICU of the Kariadi General Hospital, Semarang.PELOD and PIM calculations were performed using formulae frompreviously published articles. Statistical analyses included receiveroperating curve (ROC) characteristics to describe discriminationcapacity, sensitivity, specificity, positive predictive value, negativepredictive value and accuracy.Results Thirty-three patients fulfilling the inclusion criteria wereenrolled in the study. PELOD score for area under the ROCwas 0.87 (95% CI 0.73 to 1.0; P=0.003), while that for PIMwas 0.65 (95% CI 0.39 to 0.90; P=0.2). PELOD scores showedsensitivity 85.7% (95% CI 59.8 to 100), specificity 84.6% (95%CI 70.7 to 98.5), positive predictive value 60.0% (95% CI 29.6to 90.4) negative predictive value 95.6% (95% CI 87.3 to 100)and accuracy 84.8%. PIM scores showed sensitivity 85.7% (95%CI 59.8 to 100), specificity 50.0% (95% CI 30.8 to 69.2), positivepredictive value 31.6% (95% CI 10,7 to 52.5), negative predictivevalue 92.9% (95% CI 79.4 to 100) and accuracy 57.6%.Conclusion PELOD scoring had better specificity, positive predictivevalue, negative predictive value, accuracy and discrimination capacitythan PIM scoring for predicting the survival prognosis of patients inthe PICU. [Paediatr Indones. 2012;52:165-9].
The relationship between pleural effusion index and mortality in children with dengue shock syndrome Hawarini, Novianti; Kosim, Muhammad Sholeh; Supriatna, Mohammad; Istanti, Yusrina; Sudjanto, Eddy
Paediatrica Indonesiana Vol 52 No 4 (2012): July 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (184.108 KB) | DOI: 10.14238/pi52.4.2012.239-42

Abstract

Background Dengue shock syndrome (DSS) mortality rate is stillhigh. The extent of plasma effusion in dengue shock syndromecan be identified in the right lateral decubitus position on chestx????ray, and quantified by the pleural effusion index (PEl). It isthought that PEl value can be used to predict DSS mortality inchildren. Pleural effusion in DSS patients can cause respiratoryfailure and death.Objective To determine the relationship bet ween PEl andmortality in children \\lith DSS.Methods This cross????sectional, retrospective study was held in theDr. Kariadi Hospital, Semarang, Indonesia. Data was taken frommedical records of pediatric intensive care unit (PICU) patientswith DSS from January 2009 to January 2011. DSS diagnosiswas confirmed by clinical and radiological manifestations. PEldiagnosis was established by the presence of fluid in the pleuralcavity on pulmonary radiological examinations. X????rays wereinterpreted by the radiologist on duty at the time. Chi square andlogistic regression tests were used to analyze the data.Results There were 48 subjects with DSS, consisting of 18 males(37.5 %), and 30 females (62.5%). Twenty????nine subjects (60.4%)survived and 19 (39.6%) died. One patient (2.1 %) had PEl &lt;6%,4 (8.3%) had PEl 6-15%, 17 (35.4%) had PEl 15-30%, and26 (54.2%) had PEl&gt; 30% on their x????rays. The mortality rateof DSS with PEl 15-30% was 11.8% (95% CI 0.021 to 0.564;P&lt;0.005) and PEl &gt;30% was 65.4 % (95% CI 3,581 to 99,642;P &lt;0.005).Cone-lution PEl&gt; 15% was a risk factor for mortality in childrenwith DSS. [Paediatr lndanes. 2012;52:239-42].
Meconium-stained amniotic fluid viscosity and chest x-ray findings Rajagukguk, Ricki; Kosim, Muhammad Sholeh; Rini, Arsita Eka; Mardiana, Mardiana
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (140.084 KB) | DOI: 10.14238/pi52.6.2012.336-40

Abstract

Background Approximately 8-15% of all infants are born withevidence of meconium-stained amniotic fluid (MSAF). Manyof these infants rapidly initiate a good respiratory response andare othenvise vigorous. Other infants present v.ith a variety ofrespiratory distress. Chest x-ray imaging is the main test done toevaluate respiratory distress in order to differentiate pulmonaryand extrapulmonary etiologies.Objective To determine the relationship between viscosity ofMSAF and chest x-ray imaging results.Methods This cross-sectional study was held from January to June2011, as a continuation of a previous study from August 2009 toMay 2010 at Kariadi Hospital, Semarang, Indonesia. Data wastaken from medical records of babies who were born v.ith MSAF.MSAF viscosity measurements by the investigator and laboratorytechnician were assessed by Kappa test in the previous study witha result of 0.7 4. X-ray findings were determined by the radiologiston duty at that time. Chi square and logistic regressiontests wereused for statistical analysis.Results There were 48 subjects consisting of 26 males and 22females. Chest x-ray imaging results showed normal findings in33.3% of subjects, pneumonia in 58.3% of subjects and meconiumaspiration syndrome in 8.3% of subjects. Thick viscosity MSAFwas significantly correlated to abnormal x-ray imaging (RR= 2.046;P=0.004; 95%CI 1.12 t03.72).Conclusion Thick MSAF viscosity significantly increased therisk of abnormal chest x-ray findings. [Paediatr Indones.2012;52:336-40].