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"Latar Belakang : Ensefalitis adalah suatu infeksi cairan otak atau proses peradangan yang melibatkan parenkim otak yang berasosiasi dengan bukti klinis disfungsi otak (Gilroy, 2000). Ensefalitis masih merupakan masalah kesehatan yang serius, sehingga memerlukan diagnosis awal, terapi yang efektif, dan kontrol terhadap penanganannya. Di Indonesia infeksi susunan saraf pusat menduduki urutan ke-10 dari urutan prevalensi penyakit, dengan angka kematian anak ensefalitis berkisar antara 18-40% dengan angka kecacatan berkisar antara 30-50% (Saharso dan Hidayati, 2000). Keterlambatan dan penanganan yang tidak optimal dapat memperparah keadaan sehingga dapat menyebabkan kematian dan kecacatan pada pasien. Penelitian tentang skoring prognosis ensefalitis akut pada pasien anak belum pernah dilakukan. Sehingga penelitian ini akan membuat suatu model prognostik yang akan memprediksi luaran pasien anak dengan ensefalitis.Metode : Penelitian kohort retrospektif dengan data sekunder rekam medis. Data yang terdiri dari beberapa variabel yang dikumpulkan secara retrospektif dari catatan medis pasien. RS di Jawa Tengah, Indonesia. Pengambilan data dilakukan pada bulan Oktober- November 2014. Jumlah sampel yang diambil sebanyak 299 pasien. Analisis yang dilakukan meliputi analisis univariat, bivariat, dan analisis multivariate cox proportional hazard dengan model matematis yang selanjutnya akan dibuat model skoring. Analisis roctab digunakan untuk menentukan nilai cut-off setiap variabel numerik.Hasil : Variabel kejang, tingkat kesadaran, dan status gizi merupakan faktor protektif outcome, sedangkan variabel peningkatan tekanan intrakranial, kadar elektrolit natrium dan klorida, serta terapi diuretik merupakan faktor resiko untuk terjadinya outcome kematian pada pasien ensefalitis anak.Berdasarkan hasil analisis multivariat skoring didapatkan urutan faktor prognostik yang dominan menyebabkan kematian, yaitu peningkatan tekanan intrakranial (HR = 9.6, skoring 16), hiperklorida (HR = 1.5, skoring 6), terapi diuretik (HR=0.2, skoring 4), status gizi (HR=0.7, skoring 1), frekuensi kejang (HR=0.3, skoring -3), hipernatremia (HR=0.7, skoring -4), dan tingkat kesadaran yang dinilai dengan pediatric coma scale (HR=0.8, skoring -6). Dari hasil multivariat yang telah dilakukan sebelumnya, apabila skor <-108 tidak ada resiko untuk mengalami kematian, skor -54 s/d -39.9 resiko rendah untuk mengalami kematian, skor -40 s/d -24.0 resiko sedang untuk mengalami kematian, dan skor >-25 adalah resiko tinggi untuk mengalami kematian.Kesimpulan : Model skoring prognosis yang telah terbentuk ini mampu memprediksi 81% faktor yang berhubungan dengan prognosis ensefalitis. Apabila dari 100 anak ensefalitis dengan adanya semua variabel pembentuk model skoring maka 73 anak akan di prediksi meninggal dan apabila dari 100 anak ensefalitis tanpa adanya semua variabel tersebut maka 27 anak akan meninggal."

"[ABSTRAKLatar Belakang: Cedera otak traumatika akibat kecelakaan lalu lintas masih merupakan salah satu penyebab kematian dan kecacatan utama pada kelompok usia produktif. Cedera otak sekunder dideskripsikan sebagai konsekuensi gangguan fisiologis, seperti iskemia, reperfusi, dan hipoksia pada area otak yang beresiko, beberapa saat setelah terjadinya cedera awal (cedera otak primer). Cedera otak sekunder sensitif terhadap terapi dan proses terjadinya dapat dicegah dan dimodifikasi. Metode: Penelitian kohort retrospektif dengan data primer rekam medis. Data yang terdiri dari beberapa variabel yang dikumpulkan secara retrospektif dari catatan medis pasien. RS. Hasan Sadikin, Bandung Jawa Barat, Indonesia. Pengambilan data dilakukan pada 2011-2014. Jumlah sampel yang diambil sebanyak 647 pasien. Analisis yang dilakukan meliputi analisis univariat, bivariat, dan analisis multivariate cox proportional hazard dengan model matematis yangselanjutnya akan dibuat model skoring. Analisis roctab digunakan untuk menentukan nilai cut-off setiap variabel numerik. Hasil: Variabel perdarahan otak, tingkat kesadaran, dan edema serebri merupakanfaktor resiko outcome, sedangkan variabel peningkatan tekanan intrakranial, kadar elektrolit natrium dan klorida, serta terapi diuretik merupakan faktor resiko untuk terjadinya outcome kematian pada pasien ensefalitis anak. Berdasarkan hasil analisis multivariat skoring didapatkan urutan faktor prognostik yang dominan menyebabkan kematian, yaitu Variabel usia memilik HR sebesar 1,00, natriummempunyai HR 0,8, Perdarahan otak pada CT Scan kepala mempunyai HR sebesar 1,73, edema serebri mempunyai HR 2,53, hipoksia mempunyai HR sebesar 2,13, farktur maksillofascial mempunyai HR sebesar 0,6, hipotensi memiliki HR 0,7 dan pembedahan/trepanasi mempunyai HR 0,388 Berdasarkan analisis tersebut maka natrium, GCS, hipotensi, pembedahan dan MFS fraktur merupakan faktor proteksi outcome sedangkan usia, perdarahan otak pada CT Scan, edema serebri, hipoksia merupakan faktor resiko terjadinya outcomekematian pada pasien cedera kepala berat. Dari hasil mulitvariat yang telah dilakukan sebelumnya apabila skor -69 s/d -47 mengalami resiko rendah untuk mengalami kematian, skor -46 s/d -20 mengalami resiko sedang untuk terjadinya kematian dan skor >-19 akan mengalami resiko tinggi terjadinya kematian. Kesimpulan: Model skoring prognosis yang telah terbentuk ini mampu memprediksi sebesar 84,75 % faktor faktor yang berhubungan dengan prognosis cedera otak traumatika berat. Apabila ada 100 pasien cedera kepala berat dengan adanya semua variabel maka 76 pasien akan meninggal dan bila 100 pasiencedera kepala berat tanpa adanya semua variabel maka 25 pasien akan meninggal.

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ABSTRACTBackground: Severe traumatic brain injury caused by traffic accidents is still one of the major causes of death and disability in the productive age group. Secondary brain injury is described as a physiological disorders, such as ischemia, reperfusion, and hypoxia in brain areas at risk, some time after the initial injury (primary brain injury). Secondary brain injury is sensitive to therapy it can be preventable and modifiable.Methods: This cohort study with primary data medical records. The data consists of multiple variables collected retrospectively from patient medical records at Hasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in 2011-2014. The number of samples was 647 patients. Analysis was conducted on univariate, bivariate, and multivariate Cox proportional hazards analysis with a mathematical model which would then be created scoring models. Roctab analysisis used to determine the cut-off value of any numeric variable.Results: Variable brain hemorrhage, level of consciousness and cerebral edema is a risk factor outcomes, while variable increased intracranial pressure, electrolyte levels of sodium and chloride, as well as diuretic therapy is a risk factor for the occurrence of mortality outcomes in patients with severe traumatic brain injury. Based on the results of the multivariate analysis of prognostic factors scoring sequence obtained the dominant cause of death, the age variable having an HR of 1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73, had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388, based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgery and outcome protection factor whereas age, brain hemorrhage on a CT scan, cerebral edema, hypoxia is a risk factor for mortality outcomes in patients with severe head injury. From the results multivariate analysis has score of -69 s/d -47experiencing low risk to experience death, a score of -46 s / d -20 experiencing moderate risk for the occurrence of death and a score of > -19 will experience a high risk of death. Conclusions: This Prognostic model scoring has capable to predict 84.75% factors related to the prognosis of severe traumatic brain injury. If there were 100 patients with severe traumatic brain injury in the presence of all variables and 76 patients will die and when 100 patients with severe traumatic brain injury in the absence of all variables that 25 patients will die., Background: Severe traumatic brain injury caused by traffic accidents is still oneof the major causes of death and disability in the productive age group. Secondarybrain injury is described as a physiological disorders, such as ischemia,reperfusion, and hypoxia in brain areas at risk, some time after the initial injury(primary brain injury). Secondary brain injury is sensitive to therapy it can bepreventable and modifiable.Methods: This cohort study with primary data medical records. The data consistsof multiple variables collected retrospectively from patient medical records atHasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in2011-2014. The number of samples was 647 patients. Analysis was conducted onunivariate, bivariate, and multivariate Cox proportional hazards analysis with amathematical model which would then be created scoring models. Roctab analysisis used to determine the cut-off value of any numeric variable.Results: Variable brain hemorrhage, level of consciousness and cerebral edema isa risk factor outcomes, while variable increased intracranial pressure, electrolytelevels of sodium and chloride, as well as diuretic therapy is a risk factor for theoccurrence of mortality outcomes in patients with severe traumatic brain injury.Based on the results of the multivariate analysis of prognostic factors scoringsequence obtained the dominant cause of death, the age variable having an HR of1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73,had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388,based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgeryand outcome protection factor whereas age, brain hemorrhage on a CT scan,cerebral edema, hypoxia is a risk factor for mortality outcomes in patients withsevere head injury. From the results multivariate analysis has score of -69 s/d -47experiencing low risk to experience death, a score of -46 s / d -20 experiencingmoderate risk for the occurrence of death and a score of > -19 will experience ahigh risk of death.Conclusions: This Prognostic model scoring has capable to predict 84.75%factors related to the prognosis of severe traumatic brain injury. If there were 100patients with severe traumatic brain injury in the presence of all variables and 76patients will die and when 100 patients with severe traumatic brain injury in theabsence of all variables that 25 patients will die]"

"Pendahuluan. Kematian akibat luka bakar di Indonesia mencapai 195.000 kasus setiap tahunnya. Berdasarkan data dari Kementerian Kesehatan Republik Indonesia, insidensi luka bakar didominasi usia 1—4 tahun. Mortalitas luka bakar pediatrik di rumah sakit tersier mencapai 37,26%. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor prognostik mortalitas pada kasus luka bakar pediatrik di karakteristik populasi Indonesia.Metode. Desain penelitian ini adalah analitik retrospektif meliputi seluruh pasien luka bakar pediatrik di RSUPN Dr. Cipto Mangunkusumo pada periode 1998 hingga 2010. Fokus penelitian ini adalah mengatami variabel pemeriksaan dalam 72 jam pertama pascaadmisi dan diekstraksi dari rekam medis.Hasil. Dari 609 luka bakar pediatrik, insidensi mortalitas adalah 37,8%. Variabel yang berhubungan bermakna dengan mortalitas adalah TBSA, cedera inhalasi, lama rawat inap, kadar hemoglobin 0-jam, hematokrit 24-jam dan 48-jam, INR 0-jam, dan 48-jam, keseimbangan cairan 24-jam, defisit basa, serum laktat, edema pulmonal, systemic inflammatory response syndrome (SIRS) + multiorgan failure(MOF), dan acute coronary syndrome (ACS) (p <0,05). Berdasarkan analisis multivariat, variabel yang bermakna adalah lama rawat inap <14 hari, SIRS+MOF, kadar hematokrit 0-jam, dan kadar laktat serum abnormal.Kesimpulan. Semakin banyak faktor prognostik yang teridentifikasi pada pasien akan meningkatkan risiko mortalitas. Selain itu, resusitasi cairan yang berlebih dapat meningkatkan risiko edema pulmonal, SIRS+MOF, dan komplikasi ACS, yang berujung dengan peningkatan risiko mortalitas.

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Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. According to data from the Ministry of the Health Republic of Indonesia, the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics.

Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted from the medical record.

Results. Of 609 pediatric burns, the mortality rate is 37.8%. Some contributing variables significantly associated with the mortality were TBSA, inhalation injury, length of hospitalization, hemoglobin 0-h level, hematocrit 24-h and 48-h level, INR 0-h, and 48-h, fluid balance 24-h, base deficit, serum lactate, pulmonary edema, systemic inflammatory response syndrome (SIRS) + multiorgan failure (MOF), and acute coronary syndrome (ACS) (p <0.05). On multivariate analysis, the significant variable was length of hospitalization <14 days, SIRS+MOF, abnormal hematocrit 0-h level, and abnormal serum lactate level.

Conclusion. The more identified prognostic factors a patient finds, the more the mortality risk. In addition, excessive fluid resuscitation leads to a high likelihood of pulmonary edema, SIRS+MOF, and ACS complications, followed by increased mortality risk."

"ABSTRAKPendahuluan: Ensefalitis pada anak lebih sering dijumpai daripada dewasa dan luaran buruk terjadi pada 60% subjek yang terkena. Hingga saat ini belum ada data mengenai profil dan luaran pasien ensefalitis anak di Indonesia.Tujuan: Mengetahui profil dan luaran pasien ensefalitis akut pada anakMetode: Penelitian retrospektif ini menggunakan data rekam medis tahun 2014- 2018 di 3 rumah sakit pendidikan (RSCM, RSU Tangerang, RSUP Fatmawati). Gejala klinis awal, pleositosis CSS, abnormalitas neuroimaging, abnormalitas elektrofisiologis (EEG) dicatat dan luaran dinilai saat pasien pulang/meninggal dan dinyatakan sebagai luaran baik atau buruk.Hasil: Terdapat 657 pasien yang memenuhi kriteria ICD X sesuai kriteria inklusi dari 3 rumah sakit, dan data dari 190 subjek dianalisis dalam penelitian ini. Subjek penelitian didominasi oleh anak usia > 1 tahun (83%). Kejang didapatkan pada 87% subjek yang diteliti dan 80%nya merupakan kejang umum. Defisit neurologis fokal terdapat pada 47% subjek (90 pasien). Pemeriksaan penunjang yang menunjukkan abnormalitas tertinggi adalah EEG (90%). Kriteria diagnostik probable terpenuhi pada 62% subjek. Mortalitas didapatkan pada 23% subjek, dengan proporsi terbanyak berasal dari RSU Tangerang. Kejang fokal dan usia > 1 tahun merupakan faktor risiko yang berperan meningkatkan luaran buruk saat pulang 3 kali lipat (p: 0,006 dan p: 0,03).Simpulan: Profil ensefalitis akut pada anak lebih banyak dijumpai pada usia > 1 tahun, dengan gejala yang sering dijumpai saat awal adalah demam, dan kejang. Pemeriksaan penunjang EEG adalah pemeriksaan tertinggi yang menunjukkan hasil positif pada pasien dugaan ensefalitis. Kejang fokal dan usia > 1 tahun merupakan faktor risiko luaran buruk.

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ABSTRACTIntroduction: Encephalitis in pediatric population is more frequent than adult. The outcome has been reported to have poor prognosis in 60% of cases. No data of peidatric encephalitis in Indonesia has been reported yet.Objectives: Evaluate pediatric acute encephalitis profile and factors that influence its outcome.Methods: This retrospective research used medical records data from year 2014- 2018 in 3 teaching hospitals (RSCM, RSU Tangerang, RSUP Fatmawati). We documented clinical presentation at admission, pleocytosis CSF, neuroimaging abnormality, electrophysiologic abnormality (EEG), and outcome at discharge which classified as good vs. poor outcome.Results: Among 657 patients identified using ICD X in all 3 hospitals, there were a total of 190 subjects included in this study. Eighty three percent of subjects aged > 1 years. Seizure was present in 87% subjects, and 80% of those subjects experienced generalized seizure. Focal neurological deficits was shown in 47% subjects (90 patients). Among investigation, EEG shown positive results in 90% examined subjects, while CT scan were the most prevalent. We found probable diagnostic criteria in majority of subjects (62%). Mortality was 23%, and RSU Tangerang was the major contributor. Focal seizure and age > 1 year were the risk factors associated with 3 times increased risk of poor outcome (p: 0,006 and p: 0,03).Conclusions: Age > 1 year is more prevalent in pediatric acute encephalitis. Among most common clinical presentation are fever and seizure. Abnormal EEG finding in suspected encephalitis cases give the most positive result. Focal seizure and age > 1 year were the risk factors for poor outcome"

"Latar belakang: Chemotheraphy induced nausea and vomiting (CINV) merupakan efek samping kemoterapi yang dapat menurunkan kualitas hidup dan kepatuhan pengobatan. Emetogenisitas kemoterapi merupakan prediktor utama terjadinya CINV. Di samping itu terdapat faktor risiko lain yang berperan terhadap kejadian CINV. Pada pasien kanker anak yang menjalani kemoterapi, sistem skoring berdasarkan faktor risiko diperlukan untuk mengklasifikasikan individu berisiko agar mendapatkan profilaksis antiemetik yang adekuat untuk mengontrol terjadinya CINV.Metode: Penelitian ini merupakan studi kohort prospektif yang bertujuan untuk mngembangkan sistem skoring dari faktor risiko CINV pada anak berusia 0-17 tahun yang menjalani kemoterapi di RSCM pada Desember 2023 – Maret 2024. Analisis bivariat dilanjutkan multivariat dilakukan untuk menentukan faktor risiko utama CINV akut, delayed dan CINV derajat ≥ 2 menurut skor common terminology criteria for adverse events (CTCAE) National Cancer Institute. Selanjutnya dilakukan pembobotan skor dari faktor risiko utama CINV derajat ≥ 2 dengan regresi logistik. Akurasi sistem skoring dilakukan dengan analisis kurva receiver-operating characteristic (ROC).Hasil: Sebanyak 198 subjek. Secara keseluruhan CINV terjadi pada 42,93% pasien dengan 32,3% subjek mengalami CINV derajat ≥ 2. CINV akut dan delayed dialami oleh masing-masing 26.77% dan 35,35% pasien. Berdasarkan analisis multivariat faktor risiko utama terjadinya CINV derajat ≥ 2 adalah riwayat mual/ muntah pada siklus kemoterapi sebelumnya, mendapatkan kemoterapi sisplatin dan terapi opioid. Analisis ROC menunjukkan akurasi yang cukup baik untuk memprediksi luaran dengan area under-the-curve (AUC) 0,669, p=0,034 IK 95% (0,602 – 0,736). Pasien dengan skor total 3-4 sebelum siklus kemoterapi diberikan, diklasifikasikan sebagai risiko tinggi untuk mengalami CINV derajat ≥ 2.Simpulan: Sistem skoring ini dapat digunakan dalam praktek klinis untuk memprediksi risiko CINV sebagai dasar pemberian profilaksis antiemetik yang adekuat

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Introduction: Chemotherapy-induced nausea and vomiting (CINV) are significant adverse effects of chemotherapy that can negatively impact quality of life and treatment adherence. The emetogenicity of chemotherapy is the main predictor of CINV. Apart from that, there are other risk factors that play a role in the incidence of CINV. In pediatric oncology patients undergoing chemotherapy, a risk factor-based scoring system is essential to identify high-risk individuals. This classification enables the administration of appropriate antiemetic prophylaxis to effectively manage and control CINV.

Methods: This research is a prospective cohort study conducted to develop risk scoring system for CINV on children aged 0-17 years undergoing chemotherapy at dr. Cipto Mangunkusumo Hospital (RSCM) from December 2023 to March 2024. Bivariate followed by multivariate analysis was performed to identify the main risk factors for acute, delayed and ≥ grade 2 CINV according to common terminology criteria for adverse events (CTCAE) scores National Cancer Institute. Subsequently, a scoring weight for the main risk factors of CINV grade ≥ 2 was determined using logistic regression. The accuracy of the scoring system was evaluated using receiver-operating characteristic (ROC) curve analysis.

Results: A total of 198 subjects were included in the study. Overall CINV occurred in 42.93% of patients with 32.3% of subjects experiencing CINV grade ≥ 2. Acute CINV and delayed CINV were experienced by 26.77% and 35.35% of patients, respectively. Multivariate analysis identified the main risk factors for CINV of grade ≥ 2 as a history of nausea/vomiting in previous chemotherapy cycles, receiving cisplatin chemotherapy, and opioid therapy. ROC analysis indicated a moderately good accuracy for predicting outcomes with an area under-the-curve (AUC) of 0.669, p = 0.034, 95% CI (0.602 – 0.736). Patients with a total score of 3-4 before each cycle of chemotherapy would be considered at high risk for developing ≥ 2 grade CINV.

Conclusion: This scoring system can be implemented in cli"

"[ABSTRAKTumor otak (TO) merupakan penyebab kematian kedua darisemua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologisdan histopatologis yang sangat bervariasi karena proses pengembangan sel-seljaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TOpada anak masih sedikit.Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktorprognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr.Ciptomangunkusumo Jakarta periode tahun 2010 - 2015.Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TOprimer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RSDr. Ciptomangunkusumo Jakarta.Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dankejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebralventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yangterbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usialebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan(65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum(24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yangterbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%).Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yangbermakna.Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologisletak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenistumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkanfaktor prognostik TO pada anak.

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ABSTRACTPrimary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.]"

"Latar belakang: Sepsis sulit dibedakan dengan respon inflamasi non infeksi secara klinis dan kultur darah yang merupakan gold standar diagnosis sepsis memiliki banyak keterbatasan. Presepsin merupakan suatu biomarker baru namun belum banyak data tentang efektifitas penggunaanya pada anak.Tujuan: Mengetahui nilai diagnostik dan prognostik presepsin dibandingkan dengan leukosit, PCT dan CRP pada pasien anak yang dicurigai sepsis

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Method: The latitude cut study was conducted during March-December 2020 at RSCM Jakarta on 56 patients aged 2 months - 10 years with suspicion of sepsis Diagnosis of sepsis is established based on the criteria of sepsis-3 and blood culture. Biomarker examination and PELOD-2 score are performed at the beginning and after 72 hours, mortality assessment is conducted on day 7. Presepsin levels are checked using the PATHFAST® method.

Result: The median value of precessine levels in the proven sepsis group (1183 pg/ml was higher than that of the unproven group of sepsis (369 pg/ml, p=0.001). Precessine has a good diagnostic value (AUC of 0.862), with a cut of 711 pg/ml having a sensitivity of 75.8%, specificity of 82.6%, positive guess value of 86.2% and negative guess value of 70.4%, better than leukocytes, PCT, and CRP. Presepsin levels increased linearly with the severity of sepsis and were moderately correlated with PELOD-2 scores (r=0.548; p=0.001). Survival analysis showed precessine levels of ≥ 1,250 pg/ml were significantly associated with early mortality (HR 6.31; 95%CI; 1.67-23.83; p=0.007). Presepsin levels after 72 hours of antibiotic therapy decreased significantly in the improved sepsis group and increased in the worsening sepsis group.

Inference: Presepsin is a reliable biomarker and can be used to help diagnose sepsis, predict severity, death and evaluate therapies in tertiary hospital services."

"Latar Belakang: Kanker tiroid adalah keganasan yang paling sering terjadi pada sistem endokrin. Kanker tiroid yang paling sering terjadi adalah karsinoma tiroid papiler (KTP), dengan sebagian besar kasus dapat disembuhkan dengan angka kesintasan >95% selama 20 tahun. Namun, apabila terjadi kekambuhan, maka angka mortalitasnya yang meningkat. Skoring prognostik penting sebagai penentu pengobatan yang bertujuan untuk mengelompokkan pasien ke dalam kelompok risiko yang sesuai sehingga memungkinkan pasien untuk mendapatkan optimalisasi modalitas pengobatan. Skoring prognosis yang umum digunakan adalah skoring AMES, MACIS, dan AGES. Mutasi gen BRAF V600E dihubungkan dengan prognosis yang buruk karena persistensi dan kekambuhan penyakit. Suatu studi menambahkan pemeriksaan mutasi BRAF V600E kedalam skoring prognosis dan bermakna secara statistik sedangkan studi lainnya tidak memiliki kemaknaan secara statistik. Metode: Studi ini merupakan studi potong lintang terhadap pasien KTP di RSUPN Cipto Mangunkusumo menggunakan data sekunder berupa status mutasi BRAF V600E dan data untuk mengkalkulasi skoring prognosis (Usia, USG preoperatif, CT-Scan atau MRI, data histopatologi, dan data laporan pembedahan). Parameter yang diukur meliputi proporsi dan hubungan antara mutasi BRAF V600E dengan skoring prognosis (AMES, MACIS, dan AGES). Hasil: Proporsi mutasi BRAF V600E pada skoring prognosis yaitu: Skoring AMES: High Risk: 71,4% dan Low Risk: 28,6%, Skoring MACIS: Skor ³ 8: 38,1%; Skor 7 – 7,99: 9,5%; Skor 6 – 6,99: 19%; dan Skor < 6: 33,3%, dan Skoring AGES: Skor ³ 6: 61,9%; Skor 5 – 5,99: 0%; Skor 4 – 4,99: 4,8%; dan Skor < 4: 33,3%. Analisis bivariat menunjukan mutasi BRAF V600E bermakna secara statistik dengan skoring MACIS dengan Odd Ratio (OR) 2,96 (p Value = 0,044, Confidence Interval (CI) 95% = 1,01 – 8,64), sedangkan skoring AMES dan AGES tidak bermakna secara statistik. Kesimpulan: Mutasi BRAF V600E dengan hasil positif meningkatkan prognosis buruk pada skoring MACIS sebanyak 2,96 kali.

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Introduction: Thyroid cancer is the most common malignancy of the endocrine system. The most common type of thyroid cancer is papillary thyroid carcinoma (PTC), and most cases are curable, with a 20-year survival rate of more than 95%. However, when it recurs, it has a high mortality rate. Prognostic scoring systems are important as treatment determinants that aim to classify patients into appropriate risk groups to optimize treatment modalities. Commonly used prognostic scoring systems are the AMES, MACIS, and AGES. Mutation of BRAF V600E is associated with a poor prognosis due to disease persistence and recurrence. One study added the BRAF V600E mutation to the prognosis scoring, and it was statistically significant, while another study showed no statistical significance. Methods: This study was a cross-sectional study of PTC patients at Cipto Mangunkusumo Hospital using secondary data, such as BRAF V600E mutation status and data to calculate prognosis scoring systems. Parameters measured included the proportion and association between the BRAF V600E mutation and prognosis scoring systems (AMES, MACIS, and AGES). Results: The proportion of BRAF V600E mutations in prognosis scoring systems was as follows: AMES - High Risk: 71.4% and Low Risk: 28.6%; MACIS Scoring - Score ≥ 8: 38.1%; Score 7–7.99: 9.5%; Score 6–6.99: 19%; and Score < 6: 33.3%; and AGES - Score ≥ 6: 61.9%; Score 5–5.99: 0%; Score 4–4.99: 4.8%; and Score < 4: 33.3%. Bivariate analysis showed that the BRAF V600E mutation was statistically significant with MACIS scoring, with an Odd Ratio (OR) of 2.96 (p Value = 0.044, Confidence Interval (CI) 95% = 1.01–8.64), while AMES and AGES scoring were not statistically significant. Conclusion: A positive BRAF V600E mutation result increases the poor prognosis on MACIS scoring by 2.96 times."

"Latar Belakang: Rendahnya ketepatan kultur bakteriologis dan kurangnya fasilitas pencitraan terutama di daerah perifer, mendiagnosis meningitis tuberkulosis (MTB) pada anak menjadi suatu tantangan.Tujuan: untuk membentuk sistem skor yang terdiri dari manifestasi klinis dan pemeriksaan laboratorium sederhana untuk membantu diagnosis MTB pada anak.Metode: Studi retrospektif menggunakan model prediktif diagnostik multivariabel dengan anak usia 3 bulan hingga 18 tahun terdiagnosis meningitis, dirawat inap selama periode Juli 2011 hingga November 2021 di rumah sakit tersier.Hasil: Dari 10 variabel yang memiliki signifikansi statistik dengan TBM, diperoleh 8 variabel untuk membangun model prediksi untuk mengidentifikasi TBM. Variabel ini dibagi menjadi dua bagian skoring yang keduanya memiliki diskriminasi dan kalibrasi yang baik, sistem skoring sistemik (4 parameter, batas nilai skor ³3, sensitivitas 78,8%, spesifisitas 86,6% dengan AUC 89,9% (p<0,001) ) dan sistem skoring neurologis (4 parameter, batas nilai skor ³2, sensitivitas 61,2%, spesifisitas 75,2% dengan AUC 73,3% (p<0,001). Sistem skoring ini bila digunakan bersamaan dan memenuhi batas nilai skor masing-masing, dapat memprediksi diagnosis TBM pada anak dengan baik (sensitivitas 47,1%, spesifisitas 95,1%, dan nilai prediksi positif 90,9%).Kesimpulan: Sistem skoring klinis yang terdiri dari dua bagian, skor sistemik dan skor neurologis, memiliki kemampuan yang baik dalam memprediksi diagnosis TBM pada anak.

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Due to the low accuracy of culture techniques in bacteriological confirmation and the lack of brain imaging facilities especially in peripheral areas, diagnosing tuberculous meningitis (TBM) in children become a challenge

Objective : to establish scoring systems consisting of clinical manifestations and simple laboratory examination to help diagnosing TBM in children.

Method: Retrospective study using a multivariable diagnostic predictive model with children diagnosed as meningitis aged 3 months to 18 years, hospitalized during July 2011 until November 2021 period in a tertiary hospital.

Result: From 10 variables that have statistical significance with TBM, 8 variables were obtained for establishing the predictive model to identify TBM. These variables divided into two scoring parts which both had good discrimination and calibration, the systemic scoring system (4 parameters, total cut-off score ³3, sensitivity of 78.8%, specificity of 86.6% with AUC of 89.9% (p<0.001)) and the neurological scoring system (4 parameters, total cut-off score ³2, sensitivity of 61.2%, specificity of 75.2% with AUC of 73.3% (p<0.001)). Furthermore, these scoring systems when used together and met the cut-off score respectively, can predict the diagnosis of TBM in children well (sensitivity 47.1%, specificity 95.1%, and positive predictive value 90.9%).

Conclusion: a clinical scoring systems consist of two parts, systemic score and neurological score, have good ability in predicting the diagnosis of TBM in children."

"Studi analitik kohort untuk membuktikan peningkatan sensitivitas PNI preoperatif ditambah hemoglobin akan lebih tinggi diibandingkan PNI preoperatif dalam memprediksi kesintasan 1 tahun kanker ovarium tipe epitel yang dilakukan pembedahan (complete surgical staging atau optimal debulking) dilanjutkan kemoterapi menggunakan Carboplatin dan Paclitaxel di RSCM, RSP, RSF dan RS Dharmais pada Januari 2017 sampai Desember 2018. Hasil penelitian adalah dari 32 sampel didapatkan 6 sampel mengalami rekurensi dalam 1 tahun pasca pembedahan dan kemoterapi. Secara karakteristik didapatkan kanker ovarium terbanyak terjadi pada usia > 50 tahun (62,5 %), paritas 0 (46,87 %), dengan histopatologi tersering clear cell carcinoma (31,25 %), derajat diferensiasi terbanyak adalah derajat berat (56,25 %) dan stadium terbanyak adalah stadium I-II (56,25 %). Sensitivitas PNI penelitian ini lebih rendah dibandingkan penelitian sebelumnya dan penambahan hemoglobin penelitian ini tidak dapat digunakan untuk dapat meningkatkan sensitivitas. Tidak didapatkan hubungan yang bermakna antara PNI preoperatif, Hb preoperatif, PNI + Hb preoperatif dengan kesintasan 1 tahun kanker ovarium tipe epitel. Kesimpulan adalah penambahan hemoglobin pada PNI preoperatif tidak dapat digunakan untuk menentukan sensitivitas dalam memprediksi kesintasan 1 tahun kanker ovarium tipe epitel. Tidak terdapat hubungan bermakna antara PNI preoperatif, Hb preoperatif, PNI + Hb preoperatif dengan kesintasan 1 tahun kanker ovarium tipe epitel.

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An analytic cohort study to prove sensitivity of hemoglobin level added to PNI will be higher comparing to PNI only in predicting 1 year survival in epithelial ovarian cancer underwent surgery (complete surgical staging or optimal debulking) and chemotherapy (Carboplatin and Paclitaxel) at Cipto Mangunkusumo Hospital, Persahabatan Hospital, Fatmawati Hospital and Dharmais Cancer Hospital on January 2017 until December 2018. The result was from 32 samples, recurrences occurred in 6 samples within 1 year after surgery and chemotherapy. From characteristic finding we found epithelial ovarian cancer occurred mostly in age > 50 years old (62,5 %), parity 0 (46,87 %), histopathology clear cell carcinoma (31,25 %), poor differentiation (56,25 %) and I-II (56,25 %). Sensitivity of PNI is lower comparing to previous studies. Addition of hemoglobin level cannot be used to measure the sensitivity level. There was no statistical correlation between preoperative PNI, preoperative hemoglobin level, and PNI + Hb with the survival. The conclusion was addition of hemoglobin level to preoperatif PNI cannot be used to measure the sensitivity level in predicting epithelial ovarian cancer survival. There was no statistical correlation between preoperative PNI, preoperative hemoglobin level, and PNI + Hb with 1-year survival in epithelial ovarian cancer."