Dedi Rachmadi
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung

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Perbedaan Myocardial Performance Index-Tissue Doplpler Imaging Ventrikel Kanan pada Bayi Kurang Bulan dan Bayi Cukup Bulan Nopita, Ineu; Rachmadi, Dedi; Rahayuningsih, Sri Endah
Sari Pediatri Vol 13, No 2 (2011)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (77.061 KB) | DOI: 10.14238/sp13.2.2011.105-10

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Latar belakang.Bayi kurang bulan merupakan masalah di negara maju maupun negara berkembang. Pada bayi kurang bulan tahanan vaskular paru masih tinggi, sehingga tekanan di ventrikel kanan tinggi. Pengukuran fungsi ventrikel kanan sulit dilakukan dengan ekokardiografi standar karena bentuk geometri ventrikel kanan yang berbentuk “bulan sabit” dan trabekuler yang kasar.Myocardial performance index tissue doppler imaging (MPI-TDI) adalah cara pengukuran fungsi ventrikel kanan yang baru dikembangkan, merupakan penilaian fungsi ventrikel kanan pada fetus, anak, dan dewasa dengan berbagai penyakit jantung. Tujuan.Menilai apakah MPI-TDI pada bayi cukup bulan lebih tinggi dibandingkan dengan kurang bulan dan bagaimana korelasi antara MPI-TDI dan usia kehamilan.Metode.Penelitian dilakukan terhadap 36 bayi (17 bayi kurang bulan dan 19 bayi cukup bulan), berusia kehamilan 33–42 minggu, yang menjalani pemeriksaan MPI-TDI dengan menggunakan ekokardiografi, di Instalasi Pelayanan Jantung RS Dr. Hasan Sadikin periode Juli–Oktober 2010 dengan rancangan potong lintang. Analisis statistik yang digunakan adalah one wayANOVA untuk menilai perbedaan MPI-TDI bayi cukup bulan dan kurang bulan serta uji korelasi rankSpearman untuk menilai korelasi antara MPI-TDI dan usia kehamilan dengan kemaknaan hasil uji bila didapatkan p<0,05.Hasil.Didapatkan rerata MPI-TDI untuk bayi usia kehamilan <34 minggu adalah 0,31 (0,03), bayi usia kehamilan 34–36 minggu 0,32 (0,03) dan bayi usia kehamilan >37 minggu adalah 0,30 (0,03) (p=0,03). Nilai korelasi antara MPI-TDI dan usia kehamilan adalah (0,24) dengan nilai p=0,378. Kesimpulan.Didapatkan perbedaan MPI-TDI ventrikel kanan antara bayi kurang bulan dan cukup bulan. Tidak ada korelasi antara MPI TDI dan usia kehamilan.
Perbedaan Kadar Leptin pada Anak yang Menderita Infeksi Dengue Rizqiamuti, Anggia Farrah; Rahayuningsih, Sri Endah; Rachmadi, Dedi; Budi, Rachmat
Sari Pediatri Vol 15, No 1 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.244 KB) | DOI: 10.14238/sp15.1.2013.1-4

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Latar belakang. Infeksi dengue merupakan infeksi akut yang dapat mempengaruhi kadar leptin. Perbedaan spectrum klinis infeksi dengue menyebabkan perbedaan kadar interleukin-6 (IL-6) dan tumor necrosis factor-α(TNF-α). Tujuan. Mengetahui perbedaan kadar leptin pada anak yang menderita infeksi dengue.Metode.Penelitian analitik dengan rancangan potong lintang. Subjek penelitian adalah pasien DB, DBD, dan SSD (pascasyok) yang memenuhi kriteria klinis dan telah dibuktikan melalui pemeriksaan serologis. Analisis data menggunakan uji Kruskal Wallis dan Mann-Whitney untuk menentukan perbedaan kadar leptin pada DB dengan DBD dan SSD.Hasil. Pasien infeksi dengue 48 anak terdiri dari 27 DB, 11 DBD, dan 10 SSD. Terdapat perbedaan bermakna kadar leptin antara DB dengan DBD, dan SSD p=0,002. Rerata kadar leptin pada DD 703,4 (374,1–3616,7), DBD 2.172 (554,3–16631,1), dan SSD 1.321 (250,5–4.714,6). ng/mL Kadar leptin DBD lebih tinggi dibandingkan dengan DD (p<0,001), namun kadar leptin antara DBD dan SSD tidak berbeda bermakna (p=0,132) dan kadar leptin antara SSD (postsyok) dan DD tidak berbeda bermakna (p=0,158).Kesimpulan. Kadar leptin pada DBD lebih tinggi dibandingkan dengan DD, sedangkan kadar leptin antara DBD dan SSD (postsyok) tidak berbeda.
Hubungan Usia, Jenis Kelamin, Pendidikan Orangtua, Status Sosioekonomi Keluarga, dan Dosis Kumulatif Prednison dengan Masalah Psikososial Pasien Sindrom Nefrotik Idiopatik Suryanagara, Mahesa; Rachmadi, Dedi; Setiabudiawan, Budi
Sari Pediatri Vol 15, No 6 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.084 KB) | DOI: 10.14238/sp15.6.2014.415-9

Abstract

Latar belakang. Sindrom nefrotik idiopatik (SNI) merupakan penyakit kronik yang memerlukan pengobatan steroid jangka panjang. Pada penyakit kronik lain telah diteliti pemberian steroid jangka panjang dan faktor yang berpengaruh terhadap terjadinya masalah psikososial.Tujuan. Menganalisis hubungan faktor usia, jenis kelamin, tingkat pendidikan orangtua, status sosioekonomi, dan dosis kumulatif prednison dengan terjadinya masalah psikososial.Metode. Penelitian cross sectional dilaksanakan dari Januari 2013 sampai Mei 2013 melibatkan 26 subjek. Masalah psikososial dinilai dengan kuesioner Pediatric Symptom Checklist (PSC)-17. Analisis statistik dengan uji chi-square dan regresi logistik ganda.Hasil. Terdapat 13 dari 26 subjek mengalami masalah psikososial. Hasil analisis bivariabel mendapatkan usia 10-14 tahun RP 2,56 (IK95% 1,16−5,64); p=0,016, jenis kelamin perempuan RP 2,86 (IK 95% 1,02−8,04); p=0,016, pendidikan dasar orangtua RP 3,60 (IK 95% 1,50-8,62); p=0,004, status sosioekonomi keluarga rendah RP 1,25 (IK95% 0,54−2,89); p=0,001, dan dosis kumulatif prednison ≥3.640 mg RP 4,714 (IK 95% 1,292−17,201); p=0,002. Analisis multivariabel didapatkan usia RP 25,17 (IK95% 1,01-629,71); p=0,050, sosioekonomi RP 7,80 (IK95% 1,26-48,50); p=0.032, dan dosis kumulatif prednison RP 39,34 (IK 95% 1,89-818,93); p=0,018.Kesimpulan. Faktor usia, jenis kelamin, tingkat pendidikan orangtua, status sosioekonomi, dan dosis kumulatif prednison berhubungan dengan masalah psikososial pasien SNI. Dosis kumulatif prednison merupakan faktor paling dominan terhadap terjadinya masalah psikososial pasien SNI.
Hubungan Kadar Seng Plasma dengan Derajat Penyakit Pneumonia Winarni, Paramita Diah; Rachmadi, Dedi; Sekarwana, Nanan
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (662.426 KB)

Abstract

Pneumonia merupakan masalah kesehatan utama anak di dunia dan sebagai penyebab terbanyak morbiditas dan mortalitas anak di negara berkembang. Anak dengan defisiensi mikronutrien termasuk seng berisiko tinggi terjadi pneumonia, karena gangguan sistem imun. Penelitian ini bertujuan mengetahui hubungan kadar seng plasma dengan pneumonia, pneumonia berat, dan sangat berat pada anak usia 2–59 bulan. Penelitian observasi analitik dengan rancangan potong lintang dilakukan bulan Agustus sampai November 2009 di Departemen Ilmu Kesehatan Anak RS Dr. Hasan Sadikin Bandung, RS Ujung Berung, dan RS Cibabat. Subjek harus memenuhi kriteria diagnosis klinis pneumonia menurut World Health Organization (WHO) Indonesia dan berusia 2–59 bulan. Pengambilan sampel darah untuk pemeriksaan kadar seng plasma dilakukan saat penderita datang. Analisis data menggunakan uji eksak Fisher dan untuk melihat hubungan kadar seng plasma dengan derajat pneumonia menggunakan uji Mann-Whitney. Dari total 42 subjek yang memenuhi kriteria inklusi, didapatkan 1 (2%) anak pneumonia, 32 (76%) pneumonia berat, dan 9 (22%) pneumonia sangat berat. Terdapat perbedaan bermakna (p=0,032) kadar seng plasma antara kelompok pneumonia berat dan sangat berat dengan median 96,685 μg/dL (57,32–195,66 μg/dL) untuk penumoia berat dan 80,240 μg/dL (63,01–111,84 μg/dL) untuk pneumonia sangat berat. Penelitian ini menunjukkan bahwa bahwa kadar seng plasma memiliki hubungan dengan pneumonia berat dan sangat berat pada anak usia 2–59 bulan. [MKB. 2012;44(4):213–17].Kata kunci: Pneumonia, seng plasma, sistem imun Association Plasma Zinc Level with Severity of PneumoniaPneumonia is a major health problem affecting children all over the world and remains a major cause of childhood morbidity and mortality in developing countries. Children with micronutrients deficiency including zinc, which might cause immune system disorder, have higher risk to have pneumonia. The aim of this study was to investigate the association between plasma zinc level and pneumonia, severe, and very severe pneumonia in children aged 2–59 months. This observational analytic with cross-sectional study was performed at the Pediatric Department of Dr. Hasan Sadikin General Hospital, Ujung Berung Hospital and Cibabat Hospital, in August to November 2009. Subjects of this study were 2–59-month-old children who meet the WHO Indonesian classification for pneumonia. Blood samples for plasma zinc examination were collected on admission. Data were analysed using exact Fisherand Mann-Whitney test for the association between plasma zinc level and severity of pneumonia. A total of 42 subjects were enrolled, 1 (2%) child were classified as having pneumonia, 32 (76%) children with severe, and 9 (22%) with very severe pneumonia. There were significant differences (p=0.032) in plasma zinc levels between severe and very severe pneumonia with a median of 96.685 μg/dL (57.32–195.66 μg/dL) for severe pneumonia and 80.240 μg/dL (63.0–111.84 μg/dL) for very severe pneumonia. This study shows an association between plasma zinc levels and severe and very severe pneumonia in children aged 2–59 months. [MKB. 2012;44(4):213–17].Key words: Pneumonia, plasma zinc, immune system DOI: http://dx.doi.org/10.15395/mkb.v44n4.177
A Study of Hypoalbuminemia and Pleural Effusionin Pediatric Nephrotic Syndrome Perinandika, Tovan; Rachmadi, Dedi; Dwiyatnaningrum, Fenny
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (155.886 KB) | DOI: 10.15850/amj.v4n2.1075

Abstract

Background: Nephrotic syndrome (NS) is a kidney disease that is most often found in children. Hypoalbuminemia in NS can cause a decrease in oncotic pressure causing extravasation of fluid into the interstitial space. In conditions of severe hypoalbuminemia, fluid extravasation may cause occurrence of pleural effusion. The objectives of this study was to analyze the correlation between hypoalbuminemia and pleural effusion in children with NS. Methods: An analytical study was conducted on 69 medical records of pediatric nephrotic syndrome from 1 January 2008–31 December 2013 in dr. Hasan Sadikin General Hospital. Inclusion criteria were pediatric patients between 1-14 years old with NS. Exclusion criteria were patients who already had albumin transfusion, malnutrition, patients with chronic disease, and incomplete medical record information. Contingency coefficient test was carried out to discover the correlation between variables. Results: Out of 89 samples, 69 samples were included. Characteristics of the included patients are male (n=48), female (n=21), age 1–5 (n=24), 6–10 (n=22), 11–14 (n=23), mild hypoalbuminemia (n=3), moderate hypoalbuminemia (n=27), severe hypoalbuminemia (n=39), patients with pleural effusion (n=23), and non-pleural effusion (n=46). There was a significant correlation between  hypoalbuminemia and pleural effusion with p=0.000 (p<0.05) and moderate correlation (r=0.437). Conclusions: Hypoalbuminemia has correlation with pleural effusion in pediatric nephrotic syndrome.Keywords: Hypoalbuminemia, pediatric nephrotic syndrome, pleural effusionDOI: 10.15850/amj.v4n2.1075
A Study of Hypoalbuminemia and Pleural Effusionin Pediatric Nephrotic Syndrome Perinandika, Tovan; Rachmadi, Dedi; Dwiyatnaningrum, Fenny
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (155.886 KB) | DOI: 10.15850/amj.v4n2.1075

Abstract

Background: Nephrotic syndrome (NS) is a kidney disease that is most often found in children. Hypoalbuminemia in NS can cause a decrease in oncotic pressure causing extravasation of fluid into the interstitial space. In conditions of severe hypoalbuminemia, fluid extravasation may cause occurrence of pleural effusion. The objectives of this study was to analyze the correlation between hypoalbuminemia and pleural effusion in children with NS. Methods: An analytical study was conducted on 69 medical records of pediatric nephrotic syndrome from 1 January 2008–31 December 2013 in dr. Hasan Sadikin General Hospital. Inclusion criteria were pediatric patients between 1-14 years old with NS. Exclusion criteria were patients who already had albumin transfusion, malnutrition, patients with chronic disease, and incomplete medical record information. Contingency coefficient test was carried out to discover the correlation between variables. Results: Out of 89 samples, 69 samples were included. Characteristics of the included patients are male (n=48), female (n=21), age 1–5 (n=24), 6–10 (n=22), 11–14 (n=23), mild hypoalbuminemia (n=3), moderate hypoalbuminemia (n=27), severe hypoalbuminemia (n=39), patients with pleural effusion (n=23), and non-pleural effusion (n=46). There was a significant correlation between  hypoalbuminemia and pleural effusion with p=0.000 (p<0.05) and moderate correlation (r=0.437). Conclusions: Hypoalbuminemia has correlation with pleural effusion in pediatric nephrotic syndrome.Keywords: Hypoalbuminemia, pediatric nephrotic syndrome, pleural effusionDOI: 10.15850/amj.v4n2.1075
The value of urinalysis in presumptive diagnosis of urinary tract infection in children Rachmadi, Dedi; Setyastuti, Andaningrum
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.199-203

Abstract

Background Definite diagnosis of urinary tract infection (UTI)should only be established based on culture of urine specimen,otherwise it would be considered presumptive. Since urinalysisprovides more rapid information than urine culture, cliniciansshould consider to utilize urinalysis as a decision-making tool forinitiating treatment of UTI.Objective To determine the sensitivity, specificity, predictive val-ues, and accuracy of several urinalysis parameters, namely the ni-trite, leukocyte esterase (LE), Gram staining, and methylene bluereductase (MBR) tests, in supporting the diagnosis of UTI.Methods This diagnostic test was done on 30 subjects with pyuriaduring the period of April to June 2004. The sensitivity, specific-ity, positive predictive value (PPV), negative predicitve value(NPV) as well as the accuracy were calculated for each urinalysisparameter with urine culture as the gold standard. The relation-ship between categorical variables was analyzed by Fishers exacttest or chi square test.Results The sensitivity, specificity, PPV, NPV and accuracy fornitrite test, leukocyte esterase (LE) test, Gram staining, and MBRtest were respectively as follows: nitrite test showed 90.5%, 66. 7%,86.4%, 75%, and 83.3%; LE test yielded 95.2%, 33.3%, 76.9%,75%, and 76.4%; Gram staininglOO%, 44.4%, 80.8%, 100%, and83.3%; and MBR test 85.7%, 100%, 100%, 75%, and 90%.Conclusions The MBR, among other urinalysis routine tests, hasthe highest specificity and accuracy as well as high sensitivity inestablishing a presumptive diagnosis of UTI
Effect of oral zinc on hyperbilirubinemia in full term neonates Patton, Patton; Rachmadi, Dedi; Sukadi, Abdurachman
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.107-10

Abstract

Background Oral zinc has been shown to reduce serum unconjugated bilirubin in animals, adolescents and low birth weight neonates. However, studies in healthy tenn neonates given oral zinc showed no reduction in hyperbilirubinemia based on time measurement in days. In order to improve accuracy, hyperbilirubinemia may be determined based on time measurements in hours.Objective To determine the effect of oral zinc on hyperbiliru-binemia in full term neonates, based on time measurement in hours, rather than days.Methods We conducted a randomized, double-blind clinical trial on healthy term neonates born spontaneously or through elective caesarean section in Hasan Sadikin Hospital from June to July 2010. Subjects were randomized into two groups: those receiving 5 mg of zinc sulphate and those receiving a placebo, sucrose, each twice daily. Serum total bilirubin level was examined at discharge and upon follow􀁂up at day 5 of life. Factors which may be related to hyperbilirubinemia such as maternal age, infants gender, umbilical cord bilirubin levels and type of feeding, were analyzed by Chi-square test. Hyperbilirubinemia persistence and comparison of survival distributions were analyzed by Kaplan-Meier survival analysis and Logrank test.Results Out of 60 subjects, 26 had hyperbilirubinemia. The mean duration of hyperbilirubinemia in the 15 subjects in the zinc group and 11 in the placebo group were 116.5 hours and 117.3 hours, respectively. There was no significant difference in hyperbilirubinemia duration between the two groups ( P=0.496, 95% CI 111.5 to 122.7). In addition, Chi-square analysis of factors which may be related to hyperbilirubinemia showed no significant difference between the two groups (P &gt; 0.05).Conclusions Oral zinc 5 mg tMce daily made no significant difference in hyperbilirubinemia duration in full tenn neonates despite measuring in hours.
Nephropathy and Encephalopathy in an Indonesian Patient with Dengue Viral Infection Rachmadi, Dedi; Anggara, Mohamad Yanuar
International Journal of Integrated Health Sciences Vol 1, No 1 (2013)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To describe unusual manifestation of dengue virus infection that has been increasing in number and elucidate the indirect effect of dengue infection on the central nervous system which may explain the occurence of dengue encephalopathy. Methods: A case report of 6-year-old boy who was admitted with a history of fever for three days, accompanied with decreased consciousness, hypertension, and edema is presented. Laboratory examination showed hemoconcentration, thrombocytopenia, with positive anti dengue Immunoglobulin G (IgG) and IgM, microscopic glomerular hematuria, and proteinuria as well as normal creatinine serum level. He was treated with supportive treatment. Results: After six days, the consciousness was improved and blood pressure was normal.  Proteinuia was alleviated by Day 11 and completely negative on Day 19.  Microscopic glomerular hematuria was negative after 6 months.Conclusions: Recognition of unusual dengue manifestations is important in early diagnosis and effective treatment of the disease.Keywords: Dengue virus infection, encephalopathy, nephropathy DOI: 10.15850/ijihs.v1n1.108
Role of Hearth Program with Undernutrition Incidence among Toddlers in Tangerang City Gizella, Gizella; Hilmanto, Dany; Rachmadi, Dedi
Jurnal Kesehatan Masyarakat Nasional Volume 11, Issue 1, August 2016
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1536.946 KB) | DOI: 10.21109/kesmas.v11i1.757

Abstract

Toddler is a group at risk of undernutrition in which World Health Organization (WHO) stated that toddler mortality because of undernutrition was 54% in 2002. In Indonesia, the prevalence increased from 17.9% in 2010 to 19.6% in 2013. In Tangerang City, there was 1.43% of toddlers suffering from undernutrition in 2013. This study aimed to prove in valid the correlation between Hearth Program covering food-providing behavior, toddler’s hygiene behavior, health care seeking behavior and toddler parenting behavior with undernutrition incidence among toddlers. This study was quantitative, cross sectional, using primary data, analyzed in univariate, bivariate and multivariate in a month on September. Samples were taken by total sampling as many as 60 toddlers suffering from undernutrition in Tangerang City. Results showed that 12 (20%) of 60 toddlers suffered from very underweight nutrition and the remaining amounted to 48 toddlers (80%) suffered from underweight nutrition. There was a correlation between food providing behavior and health care seeking behavior with undernutrition among toddlers. Variable food-providing behavior was the dominant factor influencing undernutrition among toddlers with OR = 4.655 (CI = 1.052 – 20.6) after controlled by the variable health care seeking behavior. Improvement on food providing and health care seeking is hopefully able to improve and decrease undernutrition among toddlers.AbstrakKelompok yang rentan terhadap gizi kurang adalah balita. World Health Organization (WHO) menyatakan kematian anak bawah lima tahun (balita) akibat gizi kurang sebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% pada tahun 2010 menjadi 19,6% pada tahun 2013. Di Kota Tangerang, terdapat 1,43% balita yang mengalami gizi buruk pada tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan antara Program Pos Gizi yang meliputi perilaku pemberian makan, perilaku kebersihan balita, perilaku mencari pelayanan kesehatan dan perilaku pengasuhan balita dengan kejadian gizi kurang pada balita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta dianalisis secara univariat, bivariat, dan multivariat selama satu bulan pada bulan September 2015. Sampel diambil secara total sampling sebanyak 60 balita yang mengalami gizi kurang di Kota Tangerang. Hasil menunjukkan bahwa dari 60 balita yang mengalami gizi kurang, sebanyak 12 balita (20%) mengalami gizi sangat kurus dan sisanya sejumlah 48 balita (80%) mengalami gizi kurus. Terdapat hubungan antara perilaku pemberian makan dan perilaku mencari pelayanan kesehatan dengan gizi kurang pada balita. Variabel perilaku pemberian makan merupakan faktor dominan yang memengaruhi gizi kurang pada balita dengan OR = 4,655 (CI = 1,052 – 20,6) setelah dikontrol oleh variabel perilaku mencari pelayanan kesehatan. Perbaikan pemberian makan dan pencarian pelayanan kesehatan diharapkan mampu memperbaiki dan menurunkan gizi kurang pada balita.