Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAK Latar Belakang. Kemajuan dalam penanganan bayi prematur menyebabkan angka kesintasan meningkat. Akibatnya, angka kesakitan bayi prematur jugameningkat, salah satunya adalah osteopenia of prematurity (OOP). Pemeriksaankadar kalsium, fosfat, dan fosfatase alkali serum saat usia kronologis 4 minggudigunakan sebagai indikator awal sebelum osteopenia tampak secara klinis.Diagnosis sedini mungkin dan pengendalian faktor risiko perlu dilakukansehingga komplikasi dapat dicegah.Tujuan. Mengetahui prevalens dan faktor risiko terjadinya OOP.Desain Penelitian. Penelitian dengan desain potong lintang ini dilaksanakanpada bayi prematur dengan usia gestasi ≤32 minggu di Divisi Perinatalogi RS Dr.Cipto Mangunkusumo. Subyek diperiksa kadar kalsium serum, fosfat inorganikserum, dan fosfatase alkali serum. Pada subyek dilakukan pencatatan faktor risikoOOP untuk menilai hubungan antar variabel dan dilakukan analisis bivariatdengan uji chi square. Hasil Penelitian. Terdapat 80 subyek yang memenuhi kriteria penelitian.Delapan dari 80 subyek (10%) ditemukan menderita OOP. Faktor risiko yangdianalisis dalam penelitian ini ditemukan tidak memiliki hubungan bermaknadengan kejadian OOP, yakni lama penggunaan nutrisi parenteral total (p=0,457),lama penggunaan metilsantin (p=1,000), berat lahir (p=0,459), preeklampsiaberat pada ibu (p=0,344), korioamnionitis pada ibu (p=0,261), dan pemberiannutrisi enteral (p=0,797).Simpulan. Prevalens OOP di RS Dr. Cipto Mangunkusumo adalah 10%. Faktorlama penggunaan nutrisi parenteral total, penggunaan metilsantin, berat lahir,preeklampsia berat pada ibu, korioamnionitis, dan pemberian nutrisi enteral tidak memiliki hubungan bermakna dengan kejadian OOP.ABSTRACT Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium,phosphate, and alkaline phosphatase at the chronological age of 4 weeks is usedas early indicator before osteopenia become clinically appearant. Early diagnosisand risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP.Methods. A cross sectional study was done in premature infants <32 weeks ofgestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital.Laboratory examination of serum calcium, phosphate, and alkalinephosphatasewere conducted toward these subjects. Risk factors of OOP were alsoevaluated. Bivariat analysis was analysed by chi square test.Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects(10%) was diagnosed as OOP. No risk factors have significant relationship withOOP incidence, which include duration of total parenteral nutrition (p=0,457),duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severepreecalampsia in the mother (p=0,344), chorioamnionitis in the mother(p=0,261), and enteral nutrition (p=0,797).Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. Thereare no significant relationship between OOP incidence and duration of totalparenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition.;Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium,phosphate, and alkaline phosphatase at the chronological age of 4 weeks is usedas early indicator before osteopenia become clinically appearant. Early diagnosisand risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP.Methods. A cross sectional study was done in premature infants <32 weeks ofgestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital.Laboratory examination of serum calcium, phosphate, and alkalinephosphatasewere conducted toward these subjects. Risk factors of OOP were alsoevaluated. Bivariat analysis was analysed by chi square test.Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects(10%) was diagnosed as OOP. No risk factors have significant relationship withOOP incidence, which include duration of total parenteral nutrition (p=0,457),duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severepreecalampsia in the mother (p=0,344), chorioamnionitis in the mother(p=0,261), and enteral nutrition (p=0,797).Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. Thereare no significant relationship between OOP incidence and duration of totalparenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition."

"Latar belakang: Hipotermia merupakan penyebab utama morbiditas dan mortalitas pada bayi, terutama pada bayi prematur dan atau dengan berat lahir kurang. Membungkus bayi menggunakan plastik terbukti mengurangi hipotermia. Saat ini terdapat Neohelp suatu plastik dengan desain baru yang diharapkan lebih efektif mencegah hipotermia. Tujuan: Mengetahui angka kejadian hipotermia bayi baru lahir dan waktu yang dibutuhkan untuk mencapai normotermia pada resusitasi bayi prematur menggunakan plastik polietilen lembaran dibandingkan dengan plastik Neohelp, serta mengetahui faktor risiko dan komplikasi hipotermia. Metode: Dilakukan randomized controlled trial pada 48 bayi baru lahir usia gestasi ≤ 32 minggu, pada 5 rumah sakit. Faktor lingkungan berupa suhu ruangan, kelembaban, waktu transport dari ruang bersalin ke ruang perawatan serta penggunaan 2 macam plastik untuk mencegah hipotermia, dianalisis secara bivariate menggunakan Uji Chi-square, Fisher exact, t-test dan Man-Whitney test. Hasil: Didapatkan nilai angka hampir sama antara kelompok plastik poietilen lembaran dibanding Neohelp untuk mencapai normotermi di ruang bersalin (4,5 menit vs 5 menit), serta rerata suhu tubuh ketika tiba di ruang perawatan (35,6⁰C vs 35,4⁰C). Suhu dan kelembaban ruangan, waktu tempuh dari ruang bersalin ke ruang perawatan, dan 2 jenis plastik tidak terbukti merupakan faktor risiko terjadinya hipotermia. Kesimpulan: Plastik Neohelp tidak terbukti lebih unggul dibanding polietilen lembaran dalam mencegah hipotermia. Peranan petugas kesehatan sangat besar dalam mencegah hipotermia, apapun jenis plastik yang digunakan.

---

Background: Hypothermia is one of the primary causes of morbidity and mortality in newborn period, particularly preterm and low birth weight babies. Prevention of hypothermia by wrapping newborns with plastic sheets has been proven helpful. Neohelp is a specially designed plastic wrap for neonates to prevent hypothermia. Aim: We aimed to determine the prevalence of hypothermia of the newborn and time to reach normothermia on preterm newborn resuscitation using polyethylene plastic sheet compared to Neohelp. We also aimed to determine the risk factors and complications of hypothermia following the resuscitation. Method: This is a randomized control trial of 48 newborn ≤ 32 weeks age of gestation in 5 hospitals. The environmental factors assessed were room temperature, humidity, time of travel from delivery room to the care unit and the use of two types of plastic wrap to prevent hypothermia. All of the variables were analyzed using Chi-square, Fischer exact, t-test, and Mann-Whitney. Result: We found only slight difference between polyethylene plastic sheet and Neohelp to reach normothermia in delivery room (4.5 minutes vs 5 minutes). Average temperature on arrival in care unit was not also not significantly different (35.6 centigrade vs 35.4 centigrade). Room temperature, humidity, time of travel from delivery room to care unit, and the type of plastic wrap used were not proven as risk factors of hypothermia. Conclusion: Neohelp was not proven to be superior to polyethylene sheet in preventing hypothermia. Skill of the healthcare personnel has been the biggest role in preventing hypothermia, regardless of the type of plastic used."

"

Latar belakang: Penggunaan aminofilin intravena masih merupakan terapi pilihan untuk mengatasi apnea of prematurity (AOP) pada bayi prematur di Indonesia karena obat tersebut lebih mudah diperoleh dan harganya lebih murah walaupun mempunyai jendela terapi yang sempit. Pemeriksaan kadar teofilin serum perlu dilakukan untuk menilai efektifitas dan keamanan obat tersebut. Faktor-faktor yang memengaruhi efektifitas dan keamanan penggunaan aminofilin intravena pada bayi prematur dalam pengobatan apnea of prematurity di unit Neonatologi belum jelas. 

Tujuan: Mengetahui efektifitas dan keamanan penggunaan aminofilin sebagai terapi apnea of prematurity dan faktor-faktor yang memengaruhinya.

Metode: Penelitian ini merupakan penelitian analitik dengan desain cohort prospektif. Subjek penelitian adalah 40 bayi prematur dengan usia gestasi kurang atau sama dengan 30 minggu di Unit Neonatologi Rumah Sakit Cipto Mangunkusumo (RSCM) di Jakarta pada bulan April 2019 hingga Oktober 2019. Bayi tersebut mendapat terapi aminofilin intravena dosis rumatan sebanyak lima kali dan dilakukan pemeriksaan kadar teofilin serum dengan menggunakan metode reversed phase high performance liquid chromatography diode array detector (RP-HPLC-DAD). Selanjutkan dilakukan pemantauan efektifitas dan efek samping yang terjadi selama pemberian aminofilin intravena. Analisis data dengan uji Kai kuadrat dan regresi logistik, hasil signifikan bila nilai p < 0,05.

Hasil: Pemberian aminofilin intravena 67,5% efektif sebagai terapi AOP pada bayi usia gestasi kurang dari 30 minggu. Faktor-faktor yang memengaruhi efektifitas penggunaan aminofilin intravena sebagai terapi AOP adalah berat lahir dan kadar teofilin serum dengan nilai p = 0,006 dan 0,022. Efek samping yang ditemukan pada pemberian aminofilin intravena adalah takikardi (37,5%) dan peningkatan diuresis (27,5%) pada kadar teofilin serum lebih dari 12 mg/mL. Faktor yang memengaruhi keamanan penggunaan terapi aminofilin intravena pada bayi prematur adalah kadar teofilin serum dengan nilai p < 0,001. 

Simpulan: Pemberian aminofilin intravena sebagai terapi AOP pada bayi prematur dengan usia kurang dari 30 minggu efektif dan aman. Namun perlu dilakukan pemantauan kadar teofilin serum mengingat pemberian aminofilin intravena sering menimbulkan efek samping.

 

Keywords: apnea of prematurity, aminofilin, efektifitas dan keamanan

---

Background: Intravenous aminophylline still plays the role as the therapy of choice for apnea of prematurity (AOP) in Indonesia because the drug is easier
to obtain and the price is cheaper despite having a narrow window of therapy. An examination of serum theophylline levels needs to be performed to assess the effectiveness and safety of the drug. Factors that influence the effectiveness and safety in the treatment of apnea of prematurity in the Neonatology Unit remain unclear.

Aim: To determine the effectiveness and safety of using aminophylline as apnea of prematurity therapy and their influencing factors.

Methods: This research is an analytical study with a prospective cohort design. Subjects were 40 premature infants with gestational age less than or equal to 30 weeks in the Neonatology Unit of Cipto Mangunkusumo Hospital (RSCM) in Jakarta from April 2019 to Oktober 2019. The infants received intravenous 
aminophylline maintenance dosages five times and the levels of serum theophylline were examined using the reversed phase high performance liquid chromatography diode array detector (RP-HPLC-DAD) method. The follow up was set to monitor the effectiveness and side effects that occur during intravenous aminophylline administration. Data were analyzed using the Chi-square test and logistic regression. The results were considered significant if the p-value < 0,05.

Results: The administration of intravenous aminophylline 67.5% was effective as AOP therapy in infants of less than 30 weeks gestation. Factors that 
influence the effective use of intravenous aminophylline as AOP therapy are birth weight and serum theophylline levels with p = 0,006 and 0,022. Side effects that occurred were tachycardia (37.5%) and increased diuresis (27.5%) in serum theophylline levels of more than 12 mcg/mL. Factors that influence the safety of the use of intravenous aminophylline therapy in preterm infants are serum theophylline levels with p < 0,001.

Conclusion: Administration of intravenous aminophylline as AOP therapy in premature infants less than 30 weeks of age is effective and safe. However, it is necessary to monitor serum theophylline levels due to its frequent side 
effects occurence.

 

Keywords: apnea of prematurity, aminophylline, effectiveness and safety

"

"[ABSTRAKLatar belakang: Persalinan prematur sekarang ini menjadi tantangan dibidangobstetri. Ini terlihat dari tingginya angka prematur di dunia. Dua hal yang harusdiperhatikan dalam kehamilan prematur yaitu kontraksi dan pemberian kortikosteroiduntuk pematangan paru, maka dibutuhkan suatu penanganan dengan menggunakanobat tokolitik. Saat ini telah banyak digunakan terbutalin sulfat yang merupakangolongan agonis beta dan juga nifedipine yang merupakan golongan penyekat kanalkalsium. Namun penggunaan agonis beta menyebabkan efek yang kurang baik padaibu seperti takikardi, dispnoe dan ansietas sehingga penggunaannya sekarang mulaiterbatas. Tujuan: Tesis ini bertujuan mengetahui perbandingan efektifitas nifedipineoral dibandingkan dengan terbutalin sulfat sebagai tokolitik dalam kehamilanprematur. Metode: Penelitian ini merupakan uji klinis randomisasi tanpa penyamaranpada ibu hamil prematur di kurang dari 34 minggu di RSUPN Cipto mangunkusumo.Hasil: dari 60 subyek yang diikutsertakan dengan consecutive sampling, didapatkan56 subyek (93,3%) hilang kontraksi dengan rincian 27 subyek (90,0%) padakelompok nifedipin dan 29 subyek (96,7%) pada kelompok terbutalin (p=0,61).Kelompok yang diberikan nifedipin hilang kontraksi dengan median waktu 1,25(0,67-2,00) jam sementara kelompok yang diberikan terbutalin hilang kontraksi lebihcepat dengan median waktu 0,50 (0,50-1,50) jam (p<0,001). Tidak ada perbedaan efek samping yang ditemukan pada kedua kelompok. Simpulan: Nifedipin dan terbutalin memiliki efektifitas yang sama pada kehamilan prematur.

---

ABSTRACTBackground: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. , Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ]"

"Pendahuluan: Penggunaan kafein lebih direkomendasikan dalam tatalaksana apnoe of prematurity (AOP) karena selain memberikan efektivitas yang tidak berbeda, namun juga memiliki keuntungan terapeutik lain dibandingkan teofilin atau aminofilin. Dalam kondisi ketersediaan kafein yang masih terbatas di Indonesia, RSAB Harapan Kita mengupayakan penggunaan sediaan kafein oral terhadap pasien bayi prematur yang dirawat di unit perawatan intensif neonatologi. Penelitian ini bertujuan untuk mengetahui capaian kadar kafein dalam plasma neonatus prematur yang mendapatkan kafein oral tersebut.Metode: Penelitian potong lintang ini mengumpulkan data rekam medis serta mengambil sampel darah untuk mengukur kadar kafein dalam darah neonatus prematur selama periode Maret – Agustus 2022 di RSAB Harapan Kita Jakarta dengan kriteria insklusi neonatus dengan usia gestasi 35 minggu atau kurang yang mendapat terapi kafein. Jenis kafein yang digunakan adalah caffeine base oral dengan dosis inisial 10mg/kgBB dan dilanjutkan dengan dosis rumatan 2,5 mg/kgBB/hari. Pengukuran kadar kafein dalam darah dilakukan setelah hari terapi kelima dengan menggunakan metode GCMS/MS.Hasil: Terdapat 33 subjek neonatus prematur yang diobservasi secara klinis serta dilakukan pemeriksaan kadar kafein dalam darah, dengan median usia gestasi 32 minggu (kisaran 25 – 34 minggu) dan rerata berat badan lahir 1296,8 (±307,8) gram. Sebanyak 97% subjek mencapai kisaran kadar terapeutik kafein pada keadaan steady state (4,49 – 20,63 mg/L). Subjek yang mengalami gejala AOP di hari terapi kafein ketujuh sebanyak 30,3%, mayoritas (27,2%) merupakan apnea tipe campuran. Efek samping yang paling banyak ditemui pada subjek penelitian ini adalah peningkatan diuresis.Kesimpulan: Mayoritas neonatus prematur yang mendapat caffeine base oral mencapai target kadar kafein darah 5 – 25 mg/L disertai penurunan kejadian AOP. Efek samping yang tersering adalah peningkatan diuresis namun tidak disertai kemaknaan klinis.

---

Introduction: The use of caffeine is more recommended for the management of apnea of ​​prematurity (AOP) because, in addition to providing no difference in effectiveness, it also has other therapeutic advantages over theophylline or aminophylline. Because of the limited availability of caffeine in Indonesia, Harapan Kita National Women and Children Health Center seeks to use oral caffeine preparations for premature infants treated in the neonatology intensive care unit. This study aims to determine the achievement of caffeine levels in the plasma of premature neonates who received oral caffeine.

Methods: This cross sectional study collected medical records and took blood samples to measure blood caffeine levels of preterm infants born in the period March – August 2022 at RSAB Harapan Kita Jakarta who fulfilled the inclusion criteria of neonates with a gestational age of 35 weeks or less and received caffeine therapy. The type of caffeine used was an oral caffeine base with an initial dose of 10mg/kg and continued with a maintenance dose of 2.5 mg/kg/day. Measurement of caffeine levels in the blood was carried out after the fifth day of therapy using the GCMS/MS method.

Results: There were 33 preterm infants who were clinically observed and tested for caffeine levels in the blood, with a median gestational age of 32 weeks (range 25-34 weeks) and a mean birth weight of 1296.8 (±307.8) grams. A total of 97% of subjects reached the therapeutic range of caffeine levels at a steady state (4.49 – 20.63 mg/L). Subjects who experienced AOP symptoms on the seventh day of caffeine therapy were 30,3%, the majority (27,2%) were mixed type apnoe. The most common side effect found in the subjects of this study was an increase in diuresis.

Conclusion: Most of the preterm infants who received oral caffeine base achieved targeted blood caffeine levels of 5 – 25 mg/L with reduced incidence of AOP. The most common side effect was increased diuresis but there was no clinical significance."

"Bayi prematur adalah bayi yang lahir dengan usia kehamilan kurang dari 37 minggu yang memiliki sistem saraf dan organ-organ yang belum sempurna sehingga lebih beresiko mengalami berbagai masalah kesehatan. Salah satu masalah kesehatan yang dapat terjadi adalah pada organ mata yang merupakan organ penting dalam perkembangan bayi. Retinopathy of Prematurity (ROP) merupakan salah satu penyakit mata yang terjadi pada bayi prematur yang disebabkan oleh pembentukan pembuluh darah retina yang tidak normal. Proses diagnosis yang dilakukan oleh dokter mata belum bisa mengatasi kenaikan jumlah kasus ROP, sehingga disini penulis menggunakan pendekatan deep learning untuk melakukan klasifikasi tingkat keparahan ROP pada citra fundus retina. Metode deep learning yang digunakan adalah Convolutional Neural Network (CNN) dengan arsitektur ResNet50. Data yang digunakan pada penelitian ini merupakan data sekunder yang diperoleh dari online database Kaggle berupa 90 data citra fundus retina yang terbagi atas 38 citra bukan penderita ROP, 19 citra penderita ROP Stage 1, 22 citra penderita ROP Stage 2, dan 11 citra penderita ROP Stage 3. Pada tahap persiapan data, dilakukan perbaikan kontras citra menggunakan Contrast Limited Adaptive Histogram (CLAHE) dan image masking. Kemudian dilakukan resize citra menjadi ukuran 224×224. Data kemudian diaugmentasi menggunakan teknik flip horizontal dan rotation agar data menjadi lebih banyak yang kemudian dibagi menjadi 80% data training dan 20% data testing. Dari 80% data training, diambil 20% untuk data validation. Training model dilakukan menggunakan model dengan arsitektur ResNet50 dengan hyerparameter model yaitu batch size 64, learning rate 0.001, dan epoch sebanyak 30, fungsi optimasi Adam (Adaptive moment estimation), dan fungsi loss categorical cross entropy. Proses modelling dilakukan sebanyak 5 kali percobaan dan berhasil memperoleh nilai rata-rata kinerja training model sebesar 99.714% dan 92.85% pada akurasi training dan akurasi validation-nya, selain itu diperoleh nilai 0.01864 dan 0.18434 pada loss training dan loss validation. Sedangkan rata-rata kinerja testing model berhasil memperoleh akurasi testing sebesar 97.352%, testing loss sebesar 0.0986374, dan AUROC sebesar 0.0955. Selain melakukan evaluasi kinerja, peneliti juga akan menggunakan GradCAM untuk menampilkan visualisasi ciri-ciri yang dianggap penting untuk nantinya membantu dokter dalam mengevaluasi ROP.

---

Premature infants are babies born with a gestational age of less than 37 weeks, and they have underdeveloped nervous systems and organs, making them more susceptible to various health issues. One of the health problems that can occur involves the eye, which plays a crucial role in the baby's development. Retinopathy of Prematurity (ROP) is one of the eye diseases that affects premature infants and is caused by abnormal blood vessel formation in the retina. The current diagnostic processes performed by ophthalmologists have not been effective in addressing the increase in ROP cases. Therefore, in this study, the author employs a deep learning approach to classify the severity of ROP in retinal fundus images. The deep learning method utilized is the Convolutional Neural Network (CNN) with the ResNet50 architecture. The research data consists of 90 retinal fundus images obtained from the online database Kaggle, comprising 38 images of non-ROP cases, 19 images of ROP Stage 1, 22 images of ROP Stage 2, and 11 images of ROP Stage 3. In the data preparation phase, the image contrast is enhanced using Contrast Limited Adaptive Histogram (CLAHE) and image masking techniques. Subsequently, the images are resized to 224×224 dimensions. Data augmentation is performed using horizontal flip and rotation techniques to increase the dataset, which is then split into 80% training data and 20% testing data. From the 80% training data, 20% is further allocated for validation data. The model is trained using the ResNet50 architecture with hyperparameters set to batch size 64, learning rate 0.001, and 30 epochs. The optimization function used is Adam (Adaptive Moment Estimation), and the loss function is categorical cross-entropy. The modeling process is repeated five times, and the average performance of the training model is achieved at 99.714% for training accuracy and 92.85% for validation accuracy, with training and validation losses of 0.01864 and 0.18434, respectively. As for the average performance of the testing model, the testing accuracy is 97.352%, the testing loss is 0.0986374, and the AUROC (Area Under the Receiver Operating Characteristic) is 0.0955. In addition to evaluating the model's performance, the researcher also employs GradCAM to visualize important features, which can assist doctors in evaluating ROP cases."

"Prematuritas merupakan salah satu penyebab terbesar morbiditas dan mortalitas bayi termasuk kematian neonatal. Penelitian ini bertujuan mengetahui besar hubungan prematuritas dengan kematian neonatal di Indonesia setelah seluruh variabel confounding (umur ibu, urutan kelahiran, jarak kelahiran, komplikasi kehamilan, komplikasi persalinan, tingkat pendidikan ibu, pekerjaan ibu, status ekonomi ibu, frekuensi ANC, komponen ANC 5T plus, penolong persalinan, tempat persalinan, jenis persalinan, dan wilayah tempat tinggal ibu) dikendalikan dan mengetahui besar PAR (Population Attributtable Risk) prematuritas terhadap kematian neonatal di Indonesia tahun 2010. Desain studi penelitian ini adalah kasus kontrol (1:4) dengan analisis multivariat regresi logistik ganda menggunakan data sekunder Riskesdas 2010. Jumlah sampel dalam penelitian ini adalah 120 kasus dan 480 kontrol. Hasil penelitian menunjukkan bahwa besar hubungan prematuritas dengan kematian neonatal setelah dikendalikan variabel confounding (komplikasi kehamilan, komplikasi persalinan, frekuensi ANC) yaitu OR sebesar 9,31 (95% CI : 4,63-18,70) dan PAR sebesar 19,96%. Untuk menurunkan kematian neonatal, diharapkan pemerintah dan masyarakat dapat berperan aktif dalam penurunan dan penanggulangan prematuritas sedini mungkin dengan peningkatan pelayanan antenatal.

---

Prematurity is one of the biggest main cause of morbidity and mortality of infant including the neonatal death. Aims of this research are to know how big the relationship between prematurity and neonatal death in Indonesia after all variables of confounding (age of mother, turn of birth, gap of birth, complication of pregnancy, complication of labor, mother’s education level, mother's job, mother's economic status, frequency of ANC, component of ANC 5T plus, labor helper, place of labor, kind of labor and mother’s region) have been controlled and to know how big the PAR (Population Attributtable Risk) of prematurity and neonatal death in Indonesia on 2010. The design of this research is case control (1:4) with multiple logistic regression to multivariate analysis using secondary data of Riskesdas 2010. The number of sample in this research is 120 cases and 480 controls. The result of this research shows the strong relation between prematurity and neonatal death after controlled by variables of confounding (complication of pregnancy, complication of labor, frequency of ANC) is OR as 9,31 (95% CI : 4,63-18,70) and PAR as 19,66%. To decrease the neonatal death, hopefully the government and public will actively support in decreasing and preventing the prematurity by improving the effectiveness of ANC."

"ABSTRAK Penelitian ini bertujuan untuk menilai akurasi skrining ROP bayi prematur dengan menggunakan wide field retinal imaging system (RetCamvi ®) yang dilakukan olehdokter umum terlatih dibandingkan dengan menggunakan oftalmoskopi indirekbinokuler (BIO). Penelitian ini merupakan penelitian potong lintang dan bersifat ujidiagnostik. Semua bayi prematur yang memenuhi kriteria skrining menurut workshopROP dan bayi prematur di Indonesia diikutsertakan pada penelitian ini. Padapenelitian ini didapatkan hasil bahwa WFDRI (RetCam®) yang dilakukan oleh dokterumum yang terlatih secara baku sama akuratnya dengan oftalmoskopi indirekbinokuler (BIO) dalam skrining ROP pada bayi lahir prematur.ABSTRACT The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam®) conducted by trained general practitioner in comparison withbinocular indirect ophthalmoscopy (BIO). The design of this study was a crosssectional, diagnostic trial study. Preterm infants that met the inclusion criteriaaccording to Indonesia retinopathy of prematurity workshop were included in thestudy. The result of this study revealed that the accuracy of WFDRI (RetCam)performed by trained general practitioner were similar to those performed using BIOin ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam®) conducted by trained general practitioner in comparison withbinocular indirect ophthalmoscopy (BIO). The design of this study was a crosssectional, diagnostic trial study. Preterm infants that met the inclusion criteriaaccording to Indonesia retinopathy of prematurity workshop were included in thestudy. The result of this study revealed that the accuracy of WFDRI (RetCam)performed by trained general practitioner were similar to those performed using BIOin ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam®) conducted by trained general practitioner in comparison withbinocular indirect ophthalmoscopy (BIO). The design of this study was a crosssectional, diagnostic trial study. Preterm infants that met the inclusion criteriaaccording to Indonesia retinopathy of prematurity workshop were included in thestudy. The result of this study revealed that the accuracy of WFDRI (RetCam)performed by trained general practitioner were similar to those performed using BIOin ROP screening.;The aim of this study was to evaluate the accuracy of wide field digital retinal imaging (RetCam®) conducted by trained general practitioner in comparison withbinocular indirect ophthalmoscopy (BIO). The design of this study was a crosssectional, diagnostic trial study. Preterm infants that met the inclusion criteriaaccording to Indonesia retinopathy of prematurity workshop were included in thestudy. The result of this study revealed that the accuracy of WFDRI (RetCam)performed by trained general practitioner were similar to those performed using BIOin ROP screening."

"Latar Belakang. Lupus Eritematosus Sistemik merupakan suatu penyakit inflamasi sistemik kronik yang banyak terjadi pada usia reproduktif. Kehamilan pada LES adalah kehamilan risiko tinggi dengan kemungkinan luaran kehamilan buruk pada maternal dan fetal/neonatal. Belum ada data dalam 5 tahun terakhir di RSCM mengenai proporsi luaran kehamilan buruk tersebut.Tujuan. Mengetahui proporsi luaran kehamilan buruk maternal dan fetal/neonatal pada pasien LES di RSUPN Cipto Mangunkusumo serta faktor-faktor yang berhubunganMetode. Dilakukan studi cohort retrospective melalui telaah rekam medis pada pasien LES mulai 1 Januari 2015-Mei 2021. Dilakukan analisis bivariat dengan chi square untuk variabel kategorik. Variabel yang bermakna selanjutnya dilakukan analisis multivariat menggunakan uji regresi logistik. Analisis bivariat dan multivariat dilakukan dengan menggunakan SPSS.Hasil. Dari 173 subjek dengan 150 kehamilan, didapatkan luaran kehamilan buruk maternal sebanyak 47,4% (flare 43,3%, preeklamsia/eklamsia 12,1%, kematian maternal 3,6%). Luaran kehamilan buruk fetal/neonatal 65,3% (kelahiran prematur 31,2%, BBLR 32%, still birth 8,1%, SGA 34%, IUGR 16,2%, abortus 19,5%). Berdasarkan analisis multivariat terdapat 2 faktor yang berhubungan dengan kejadian luaran kehamilan buruk maternal yaitu aktivitas LES tinggi OR: 2,25 (IK95% [1,199-4,225], p=0,012) dan hipertensi OR 3,007 (IK95% [1,425-6,341), p=0,004). Sedangkan hasil analisis multivariat pada luaran kehamilan buruk fetal/neonatal, ditemukan aktivitas LES tinggi OR: 2,40 (IK95% [1,041-5,534], p=0,040) dan hipertensi OR: 5,988 (IK95% [1,640-21,870], p=0,007) berhubungan dengan kejadian luaean kehamilan buruk fetal/neonatal.Kesimpulan. Proporsi luaran kehamilan buruk maternal dan fetal/neonatal pada pasien LES di RSUPN Cipto Mangunkusumo cukup tinggi. Aktivitas LES tinggi dan hipertensi merupakan faktor yang berhubungan dengan luaran kehamilan buruk maternal dan fetal/neonatal.

---

Background. Systemic Lupus Eritematosus is a chronic systemic inflamatory disease found in reproductive age. Pregnancy in SLE patients is a high risk pregnancy mainly with the possibility of adverse outcome in maternal and fetal/neonatal. There is no data in last 5 years about proportion of adverse pregnancy outcome at Cipto Mangunkusumo Hospital.

Aim. To determine proportions of adverse pregnancy outcomes of maternal and fetal/neonatal in Systemic Lupus Eritematosus patients at Cipto Mangunkusumo Hospital and it’s related factors.

Method. A retrospective cohort study was done through medical records study in medical record installation at SLE Patient from 1 January 2015 to Mei 2021. Bivariate analysis was done with chi square for categorical variable. Statistically significant variable then analyzed with multivariate analysis with logistic regression analysis. Bivariat and Multivariate analysis was done using SPSS.

Result. Of the 173 subjects with 150 pregnancies, the maternal outcome was 47.4% (43.3% flare, 12.1% preeclampsia/eclampsia, 3.6%). Fetal/neonatal poor pregnancy outcome was 65.3% (31.2% premature birth, 32% LBW, 8.1% still birth, 34% SGA, 16.2% IUGR, 19.5% abortion). Based on multivariate analysis, there were 2 factors associated with maternal adverse pregnancy outcomes, namely high LES activity OR: 2.25 (CI 95% [1.199-4.225], P = 0.012) and hypertension OR 3.007 (CI 95% [1.425-6.341), p =0.004). Meanwhile, the results of multivariate analysis on the outcome of poor fetal/neonatal pregnancy, found high LES activity OR: 2.40 (CI 95% [1.041-5.534], P=0.040) and hypertension OR: 5.988 (CI 95% [1.640-21.870], p= 0.007) associated with fetal/neonatal pregnancy outcome.

Conclusion. The proportion of maternal and fetal/neonatal adverse pregnancy outcomes in SLE patients at Cipto Mangunkusumo General Hospital is quite high. High SLE disease activity and hypertension are factors associated with poor maternal and fetal/neonatal outcomes."

"Praktek kerja profesi di Rumah Sakit Pusat Angkatan Darat RSPAD Gatot Soebroto Ditkesad bertujuan untuk memahami peranan, tugas dan tanggung jawab apoteker di rumah sakit sesuai dengan ketentuan dan etika pelayanan farmasi dan pelayanan kesehatan, memiliki wawasan, pengetahuan, keterampilan, dan pengalaman praktis untuk melakukan praktek kefarmasian di rumah sakit, memiliki gambaran nyata tentang permasalahan praktik kefarmasian di rumah sakit serta mempelajari strategi dan kegiatan-kegiatan yang dapat dilakukan dalam rangka pengembangan praktek kefarmasian di rumah sakit. Praktek profesi dilaksanakan selama dua bulan yaitu Bulan September dan Oktober tahun 2016, dengan tugas khusus yaitu melakukan identifikasi drug related problem pada pasien prematuritas, bblsr, dan gemelli dengan sindrom gagal nafas, sepsis neonatorum, perdarahan saluran cerna, dan enterokolitis nekrotikans di unit NICU RSPAD Gatot Soebroto Ditkesad.

---

The professions internship at Central Hospital Of The Army Gatot Soebroto Ditkesad aims to understand the role, duties and responsibilities of pharmacists in hospital in accordance with the rules and ethics of pharmacy services and health care, having insight, knowledge, skills, and practical experience to carry out the practice of pharmacy at the hospital, has a vivid description about problems in pharmaceutical practice in hospitals and learn the strategies and activities that can be implemented to develop the practice of pharmacy at the hospital. Professions internship held for two months in September and October 2016, with the specific task is to do identification of drug related problems in patients prematurity, vlbw infants, and gemelli with respiratory distress syndrome, neonatal sepsis, gastrointestinal bleeding and necrotizing enterocolitis in unit NICU Central Army Hospital Gatot Soebroto Ditkesad."