Latar belakang. Perkembangan anak meliputi aspek motorik halus, motorik kasar, bahasa/berbicara, personal sosial, kognitif, dan aktivitas sehari-hari. Keterlambatan perkembangan global (KPG) adalah keterlambatan bermakna pada lebih dari dua domain perkembangan. Etiologi sangat bervariasi, angka kejadian sekitar 1%-3% anak-anak di seluruh dunia, sedangkan di Indonesia sampai saat ini belum pernah dilaporkan.Tujuan. Mengetahui prevalensi, karakteristik, etiologi, dan faktor-faktor yang berhubungan dengan etiologi KPG di RS Dr. Cipto Mangunkusumo Jakarta.Metode. Penelitian retrospektif dilakukan pada 151 anak KPG di Poliklinik Neurologi anak RS Dr. Cipto Mangunkusumo Jakarta pada Januari 2006-Juli 2008. Kriteria inklusi anak didiagnosis KPG, berumur <5 tahun.Hasil. Prevalensi KPG di Poliklinik Neurologi Anak RS Dr. Cipto Mangunkusumo Jakarta pada Januari 2006-Juli 2008 didapatkan pada 151(2,3%) dari 6487 kunjungan. Keluhan terbanyak, belum bisa berjalan dan berbicara 71 (47,1%) kasus, 84 (55,6%) laki-laki, dan rerata umur (21,8 ± 13,1) bulan. Riwayat kelahiran 33(21,9%) kurang bulan, 45(29,8%) BBLR, 125(79,2%) lahir pervaginam, 46(30,%) tidak segera menangis. Gangguan perkembangan dalam keluarga ditemukan pada 20(13,2%) kasus. Karakteristik klinis 81(53,6%) mikrosefali, 67 (44,4%) kasus gizi kurang dan gizi buruk. Gambaran dismorfik 19 (12,6%) kasus, riwayat kejang 57(37,7%) kasus. Etiologi dapat diidentifikasi pada 97(64,2%) kasus. Lima etiologi terbanyak 33(21,9%) disgenesis cerebral, 18(11,9%) palsi cerebral, 15(9,9%) infeksi TORCH, 11(7,3%) sindrom genetik, dan 7(4,6%) kelainan metabolik kongenital. Analisis bivariat, ditemukan perbedaaan bermakna pada riwayat kejang, jenis kelamin, mikrosefali, dan gambaran dismorfik antara etiologi yang diketahui dan etiologi tidak diketahui dengan p=0,025; 0,016; 0,018; <0,0001. Analisis multivariat, ada hubungan bermakna antara keberhasilan identifikasi etiologi dengan jenis kelamin, mikrosefali, dan gambaran dismorfik dengan p=0,003; <0,0001 dan 0,006.Kesimpulan. Prevalensi keterlambatan perkembangan global di poliklinik anak RS Dr. Cipto Mangunkusumo Jakarta 2,3%. Karakterisitik klinis yang berhubungan bermakna dengan keberhasilan identifikasi etiologi adalah jenis kelamin laki-laki, mikrosefali, dan adanya gambaran dismorpik.
Background Obesity can result in emotional and behavior problems in school-age children. Child Behavior Checklist (CBCL) is a standard instrument for evaluating behavior problems, however it is considered not practical. The 17-item Pediatric Symptom Checklist (PSC-17) is a more simple instrument but its diagnostic value has never been evaluated in obese children.Objectives To evaluate the diagnostic value of PSC-17 compared to CBCL as the gold standard.Methods This cross-sectional study was done in May - June 2009. Children aged 6-12 years with obesity were included. Parents filled the CBCL and PSC-17 questionnaires. Sensitivity, specificity, predictive values, and likelihood ratios were calculated for PSC-17.Results Most subjects aged 6-9 years (83%). Boys out numbered girls. Emotional and behavior problems detected by CBCL and PSC-17 were identified in 28% and 22% subjects, respectively. The most common problem was internalization (withdrawal, somatic complaints, anxiety/depression). The PSC-17 had sensitivity and specificity of 69.2% and 95.6% respectively. Positive and negative predictive values were 85.7% and 89%, whereas positive and negative likelihood ratios were 15.7 and 0.32.Conclusions The prevalence of emotional and behavior problems detected using CBCL and PSC-17 in obese children was 28% and 22%, respectively. The PSC-17 has moderate sensitivity to screen emotional and behavior problem in obese children.[Paediatr Indones. 2010;50:42-8].
Objective: Over the past few years, an integrated approach of palliative care (PC) to chronic and/or life-threatening conditions care has been widely used. Home-based PC (HBPC) service is developed to meet the needs of patients at home; however, it has not been used widely. This study is aimed at determining the benefits of integrated HBPC for the quality of life (QoL) and symptoms intensity in Indonesian children with malignancies. Method: A randomized controlled trial was carried out to compare the quality of life between patients who were given PC (a three-month home visit) and those who did not receive PC (control group). Each group was constituted of thirty children with cancer and aged 2-18 years old and were consulted by a palliative team. The participants were randomly allocated to two groups. In the first and twelfth weeks of the intervention, all patients were assessed using the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0 (report by proxy or self-report). Symptoms intensity (pain, anorexia, sleep disturbance) were scored by using Edmonton Symptoms Assessment Scale (ESAS). The mean score and each dimension score of both groups were compared and analyzed using bivariate analysis. Results: In total, fifty participants were included in the study. A significant difference was found between the two groups in terms of the mean total score in control group 62.39 and intervention group 81.63 (p<0.001). The QoL was improved in the intervention group, while it was declined in the control group as the disease progressed. The main improvements were in the pain and nausea aspects (p<0.001), followed by procedural anxiety (p=0.002), treatment anxiety (p=0.002), and worry (p=0.014). Palliative intervention significantly reduced sleep disturbances (p=0.003) and anorexia (p<0.001). Conclusion: Home-based PC improved several aspects of QoL and caused better symptom management in children with malignancies. An early intervention concurrent with the underlying treatment can improve QoL in these children.
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