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"Palsi serebral PS adalah gangguan fungsi motorik dan postur akibat gangguan perkembangan otak Anak PS sering mengalami kesulitan makan yang disebabkan gangguan tersebut Anak dengan gangguan fungsi motorik yang berat akan lebih besar kemungkinan mengalami kesulitan makan Kesulitan makan akan menyebabkan capaian kalori berkurang yang dapat mengakibatkan terjadinya malnutrisi Tujuan Mengetahui prevalensi faktor risiko skala GMFCS dengan kesulitan makan pada anak PS serta pengaruh intervensi Metode Penelitian ini merupakan studi potong lintang terhadap pasien palsi serebral yang datang di poliklinik neurologi anak RSUD Dr Moewardi pada Januari sampai September 2015 Anak PS akan diperiksa skala GMFCS status gizi dan kesulitan makan Skala GMFCS diukur menggunakan instrument pengukuran Gross Motor Function Measure 88 GMFM 88 Status gizi antropometri diukur menggunakan kurva CDC NCHS 2000 Pasien PS dengan tipe spastik kuadriplegi dilakukan pengukuran antropometri ulang menggunakan kurva Krick Penentuan status gizi berdasarkan kriteria klasifikasi Waterlow Capaian kalori diukur dengan analisis diet recall selama 3 hari dan dinilai cukup apabila memenuhi 13 9 kkal cm TB 10 Kesulitan makan dinilai dari anamnesis pemeriksaan fisik dan observasi kemampuan makan Hasil Didapatkan 80 anak PS pada penelitian ini sebagian besar subjek adalah PS tipe spastik 96 dengan tipe spastik kuadriplegi dan spastik diplegi dan mempunyai skala GMFCS V Prevalensi malnutrisi pada anak PS sebesar 68 Tujuh puluh delapan persen diantaranya mengalami kesulitan makan 30 dari yang menderita kesulitan makan adalah anak PS dengan skala GMFCS V Simpulan Prevalensi gizi kurang pada anak PS di RSUD Dr Moewardi sebesar 68 dan prevalensi gizi buruk sebesar 10 Skala GMFCS dan tipe PS spastik merupakan faktor risiko kesulitan makan pada anak PS Pemberian terapi oromotor dan postural berpengaruh secara signifikan memperbaiki kelainan oromotor dan kontrol postur.

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Background Cerebral palsy CP is a motor and postural disorder due to an insult on the developing brain Children with CP often have feeding difficulties due to their disabilities Children with severe motor impairment are likely to experience greater feeding difficulties This results in inadequate calorie intake which finally leads to malnutrition Objective To determine the prevalence and the relationship between the GMFCS and feeding difficulties in CP Methods A cross sectional study was done from January to September 2015 in the neurology pediatric outpatient clinic of Dr Moewardi Hospital Children with CP underwent the GMFCS scale nutritional and feeding difficulties assessment The GMFCS was evaluated by Gross Motor Function Measure 88 GMFM 88 Nutritional status was determined by the ratio of body weight to body height standardized to CDC NCHS 2000 growth curve and were classified based on Waterlow Spastic quadriplegics CP patients were also compared to CP growth curve of Krick Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13 9 kcal cm BH 10 Feeding difficulties assessment included history taking physical examination and observation of feeding skill in the outpatient clinic Results Eighty children with CP were included in this study most of them were spastic type 96 mainly spastic quadriplegic and diplegic CP and were in GMFCS level V Malnutrition was found in 78 subject Feeding difficulties were found in 78 subject 30 with GMFCS level V Conclusion The prevalence of undernourished and severe malnutrition in children with CP is 68 and 10 respectively The GMFCS scale and CP with spastic type are risc factor for feeding difficulties in children with CP The effect of oromotor and postural theraphy on improvement of oromotor and postural control are significant."

"ABSTRAKLatar belakang:Bayi laringomalasia primer memiliki komorbiditas yang tinggi akibat silent aspiration. Hingga saat ini, belum diketahui prevalensi disfagia dan data mengenai gambaran fungsi menelan bayi laringomalasia primer. Tujuan penelitian: Mengetahuiprevalensi disfagia dan gambaran fungsi menelanpada bayi laringomalasia primersertamengetahui kesesuaian antara SEES dan FEES.Metode: Penelitiancross-sectional yang bersifat deskriptifdan analitik komparatif terhadap 34subjek bayi laringomalasia primersecara konsekutif di RS Dr. Cipto Mangunkusumoperiode Januari-Maret 2020. Hasil:Prevalensi disfagiapada bayi laringomalasiaprimersebanyak 9 dari 34 subjek (26,5%). Gejala disfagia pada bayi< 6 bulan tersering adalah regurgitasi dan apneasaat menyusu (5/6), sedangkan pada bayi>6 bulan adalah terdengar banyak lendir di tenggorok (3/3). Komorbid terbanyak adalah kelainan genetikdan PRGE(3/9). Komplikasi terseringadalah pneumonia aspirasi (6/9). Pada pemeriksaan awal FEES, kontrol postural terganggu(7/9) merupakantanda yang paling sering ditemukan. Pada pemeriksaan FEES, preswallowing leakagedidapatkan pada konsistensi puree, tim saring, dan tim kasar. Pada pemeriksaan SEES dan FEES, residu, penetrasi,dan aspirasipalingbanyak didapatkan pada konsistensi susu. Silent aspirationdidapatkan pada4 dari 9subjek dengan disfagia. Pemeriksaan SEES memiliki kesesuaian dengan FEES berdasarkanuji McNemarpadaparameter ada tidaknya penetrasi, residu, dan aspirasi.Kesimpulan:Prevalensi disfagia pada bayi laringomalasia primersebanyak 9 dari 34 subjek(26,5%), penetrasi dan aspirasi didapatkan pada konsistensi air dan susuterutama pada bayi< 6 bulan, dan SEES memiliki kesesuaian dengan FEESdalam menilai fungsi menelanberdasarkan parameter ada tidaknya residu, penetrasi, dan aspirasi.

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Background:Silent aspiration is oftenunrecognized comorbidity in infants with congenital laryngomalacia with serious medical consequence. However, prevalence of dysphagia and characteristic of dysphagia ininfants with congenital laryngomalacia is still unknown. Aim: To find the prevalence and the overview of swallow function in infants with congenital laryngomalacia and also to know the conformity between SEES and FEES in assessing swallow function. Methods:This is a descriptive cross-sectional and comparative analytic study involving 34 infants with congenital laryngomalacia who came consecutivelytoDr. Cipto Mangunkusumo Hospitalon January-March 2019. Results: The prevalence of dysphagia was 9 out of 34 subjects (26,5%).Dysphagia symptom in infants<6 months was regurgitation and apneawhile bottle/breast feeding (5/6). Meanwhile, in infants>6 monthswaswet sounding voice (3/3). The comorbidities found mostly were geneticanomaly and GERD(3/9). The complication mostly was aspiration pneumonia (6/9). In pre-FESS examination, poor postural controlwas dominant(7/9). In FEES examination, preswallowingleakagewas found in puree, soft steam porridge, and rough steam porridge. In FEES and SEES examination, residue, penetration, and aspirationwas mostly found inthick liquid. Silent aspiration was found in 4 out of 9subjects with dysphagia. SEES has a conformity to FEES based on McNemar test in the presence of residue, penetration, and aspiration. Conclusion: The prevalence of dysphagia in infants with congenital laryngomalaciawas9 out of 34 subjects(26,5%). In FEES examination, penetration,and aspiration were found mostly in thin liquid, <6months of age predominantly.SEES has a conformity to FEES based on presence of residue, penetration, and aspiration in assessing swallow function."

"Anak sindrom Down memiliki risiko komorbiditas yang tinggi akibat silent aspiration yang persisten. Hingga saat ini, belum ada data secara khusus mengenai gambaran disfagia pada anak sindrom Down dengan menggunakan instrumen FEES. Tujuan penelitian: Mengetahui gambaran disfagia pada anak sindrom Down dengan melihat prevalensi, karakteristik subjek dan gambaran disfagia berdasarkan parameter FEES. Metode: Penelitian cross-sectional yang bersifat deskriptif terhadap 43 anak sindrom Down dengan kecurigaan disfagia di RSUPN Cipto Mangunkusumo dengan pemeriksaan FEES periode November 2019–Januari 2020. Hasil: Prevalensi disfagia didapatkan 13 dari 43 subjek (30,2%). Gejala disfagia pada anak ≤6 bulan adalah apnea saat menyusu (2/2), pada anak >6 bulan adalah hanya makan makanan tertentu atau lebih menyukai cairan kental (8/11). Komorbid yang paling banyak menyertai adalah kelainan jantung dan tiroid (6/13). Komplikasi yang sering terjadi adalah pneumonia aspirasi (4/13). Pada pemeriksaan awal FEES didapatkan lip seal lemah (12/13). Pada pemeriksaan FEES, Preswallowing leakage, residu, penetrasi dan aspirasi paling sering terjadi pada konsistensi air dan susu. Standing secretion (6/13) dan silent aspiration (1/13). Kesimpulan: Prevalensi disfagia sebesar 30,2% dan pada pemeriksaan FEES penetrasi dan aspirasi pada konsistensi cair terutama terjadi pada usia ≤24 bulan.

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Background: Persistent silentaspiration is an often unrecognized comorbidity in children with Down syndrome. However, there is still limited study on the characteristic of dysphagia in children with Down syndrome using FEES.

Aim : To find the prevalence and the characteristics of the subjects and dysphagia in children with Down syndrome using FEES’ parameters.

Methods: This is a descriptive cross-sectional study involving 43 Down syndrome children with dysphagia suspicion in Dr. Cipto Mangunkusumo National General Hospital from November 2019–January 2020.

Results: The prevalence of dysphagia was 13 out of 43 subjects (30,2%). Dysphagia symptom in children ≤ 6 months was apnoea while bottle/breast feeding (2/2). Meanwhile, in children > 6 months was food texture selectivity or liquid consistency food preferred (8/11). The comorbidities found mostly were heart anomaly and congenital hypothyroid (6/13). The complication mostly was aspiration pneumonia (4/13). In pre-FESS examination, poor lip sealed was dominant (12/13). In FEES examination, pre-swallowing leakage, residue, penetration, and aspiration were more common in thin and thick liquid. Standing secretion (6/13) and silent aspiration (1/13).

Conclusion: The prevalence of dysphagia was 30,2% and in FEES examination, penetration and aspiration were found mostly in thin liquid, ≤24 months of age predominantly."