Hyperbilirubinemia in the newborn occurs more frequently in Indonesia. Therefore, it is important that pediatric residents in Indonesia acquire adequate knowledge of hyperbilirubinemia management. This study aims to determine the pediatric residents' knowledge on hyperbilirubinemia management, whether they follow recommended guidelines, and whether differences exist between five large Indonesian teaching hospitals. We handed out a 25-question questionnaire on hyperbilirubinemia management to pediatric residents at five teaching hospitals. A total of 250 questionnaires were filled in completely, ranging from 14 to 113 respondents per hospital. Approximately 76% of the respondents used the Kramer score to recognize neonatal jaundice. Twenty-four percent correctly plotted the total serum bilirubin levels (TSB) on the phototherapy (PT) nomograms provided by the American Academy of Pediatrics (AAP) and the National Institute for Health and Care Excellence (NICE) for full-term and nearly full-term infants. Regarding preterm infants <35 weeks' gestational age, 66% of the respondents plotted TSB levels on the AAP nomogram, although this nomogram doesn't apply to this category of infants. Seventy percent of residents knew when to perform an exchange transfusion whereas 27% used a fixed bilirubin cut-off value of 20 mg/dL. Besides PT, 25% reported using additional pharmaceutical treatments, included albumin, phenobarbitone, ursodeoxycholic acid and immunoglobulins, while 47% of the respondents used sunlight therapy, as alternative treatment. The limited knowledge of the pediatric residents could be one factor for the higher incidence of severe hyperbilirubinemia and its sequelae. The limited knowledge of the residents raises doubts about the knowledge of the supervisors and the training of the residents since pediatric residents receive training from their supervisors.
Latar belakang. Sepsis neonatal merupakan salah satu penyebab utama morbiditas dan mortalitas padaneonatus. Pasien sakit kritis, terutama kondisi sepsis, sering dilaporkan terjadi gangguan regulasi kalsiumberupa hipokalsemia.Tujuan. Mengetahui hubungan antara hipokalsemia dengan prognosis buruk sepsis neonatal.Metode. Penelitian dengan desain potong lintang dilaksanakan bulan Maret–Mei 2014 di RS Dr. HasanSadikin Bandung, dan RS Kota Bandung. Subjek neonatus cukup bulan usia <28 hari yang memenuhikriteria sepsis neonatal, yaitu terdapat dua atau lebih kriteria systemic inflammatory response syndrome (SIRS)disertai bukti tanda infeksi berupa hasil kultur darah positif atau tersangka infeksi. Pemeriksaan kadar ionkalsium darah dilakukan saat hari pertama perawatan.Hasil. Terdapat 40 subjek yang memenuhi kriteria inklusi, faktor yang berhubungan dengan prognosis buruk,yaitu kadar ion kalsium (p=0,012), onset sepsis (p=0,002), dan berat badan bayi (p=0,045). Analisis denganmetode regresi logistik ganda menunjukkan faktor risiko kejadian prognosis buruk pada sepsis neonatal adalahhipokalsemia (p=0,015; POR 36,17; IK95% 2,01–650,19), sepsis awitan lanjut (p=0,003; POR 44,86; IK95% 3,66–549,98), dan berat badan <2500 gram (p=0,032; POR 12,21; IK95% 1,35–110,29).Kesimpulan. Terdapat hubungan antara hipokalsemia dan prognosis buruk pada sepsis neonatal (p<0,05).
Latar belakang. Anemia merupakan masalah kesehatan global di dunia. Penyebab tertinggi anemia adalah defisiensi besi, umumnya terjadi setelah usia 6 bulan saat masa penyapihan. Dinegara berkembang, orangtua lebih sering memberikan MPASI buatan rumahan yang seringkali tidak dapat memenuhi kebutuhan zat mikronutrien dibandingkan MPASI berfortifikasi buatan pabrik karena alasan ekonomi.Tujuan. Mendapatkan gambaran perbedaan kadar Hemoglobin (Hb) bayi yang diberikan MPASI buatan pabrik dengan buatan rumahan.Metode. Penelitian analitik komparatif potong lintang dilaksanakan pada Mei-Juni 2018 di wilayah kerja Puskesmas Garuda kota Bandung pada bayi usia 7-8 bulan secara consecutive sampling yang memenuhi kiteria inklusi untuk masing-masing kelompok MPASI buatan pabrik dan buatan rumahan. Dilakukan pengukuran kadar Hb dan recall pemberian makanan dalam 7 hari terakhir. Uji statistik dilakukan menggunakan uji t dan Mann Whitney dengan tingkat kemaknaan p<0,05.Hasil.Terdapat 36 bayi terbagi dalam 2 kelompok. Rerata kadar Hb bayi kelompok MPASI buatan pabrik 11,48 g/dL (0,85 SD), kelompok buatan rumahan 10,8 g/dL (1,2 SD). Didapatkan perbedaan yang bermakna antara jenis MPASI dengan kadar Hb (p<0.03).Kesimpulan.Kadar hemoglobin bayi yang mendapatkan MPASI buatan pabrik lebih tinggi dibandingkan bayi yang mendapatkan MPASI buatan rumahan. MPASI berfortifikasi buatan pabrik dapat diberikan sebagai salah satu upaya pencegahan anemia.
Prematurity and low birth weight are some of the causes of neonatal death and significant health problem. This study aimed to determine the influence of gestational age and birth weight on neonatal mortality at the Al Islam Hospital Bandung in 2015–2019. It was a case-control retrospective observational analysis using medical records of the Al Islam Bandung Hospital from January 1, 2015, to December 31, 2019. The inclusion criteria for infants were born alive. Exclusion criteria had severe congenital abnormalities and gestational age <26 weeks. The chi-square test evaluated the univariate comparison test of risk factors between 2 groups. Multiple logistic regression to assess neonatal mortality's predictive factors and the percentage contribution of the influence was calculated (Nagelkerke’s R2 analysis). The number of infants enrolled in 2015–2019 was 6,791 neonates, and who died was 56 neonates (0.82%). In premature infants and low birth weight there was a very significant relationship with neonatal mortality, respectively p=0.000 (p<0.05) OR=30.397 (CI=16.506–55.976), and p=0.000 (p<0.05) OR=41.206 (CI=18.611–91.233). In the multiple logistic regression test, p=0.000 (p<0.05), with a Nagelkerke’s R2 value of 0.344 or 34.4%. This presence that gestational age and birth weight significantly affects neonatal mortality, either partially or simultaneously. The percentage contribution of the influence of gestational age and birth weight to neonatal mortality was 34.4%. PENGARUH USIA GESTASI DAN BERAT BADAN LAHIR TERHADAP KEMATIAN NEONATUSPrematuritas dan berat badan lahir rendah merupakan beberapa penyebab kematian neonatus dan masalah kesehatan yang signifikan. Penelitian ini bertujuan mengetahui pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus di RS Al Islam Bandung tahun 2015–2019. Penelitian ini merupakan penelitian observasional retrospektif kasus kontrol menggunakan data rekam medis RS Al Islam Bandung periode 1 Januari 2015 hingga 31 Desember 2019. Kriteria inklusi bayi lahir hidup. Kriteria eksklusi bayi dengan kelainan kongenital berat dan usia gestasi <26 minggu. Uji chi-square mengevaluasi perbandingan univariat faktor risiko antara 2 grup. Regresi logistik multipel untuk mengevaluasi faktor prediktif kematian neonatus dan persentase kontribusi pengaruh dihitung (Analisis R2 Nagelkerke). Jumlah bayi yang dirawat tahun 2015–2019 sebanyak 6.791 dan yang meninggal sebanyak 56 (0,82%). Pada bayi lahir prematur dan berat badan lahir rendah terdapat hubungan sangat bermakna terhadap kematian neonatus, berturut-turut p=0,000 (p<0,05) OR=30,397 (CI=16,506–55,976) dan p=0,000 (p<0,05) OR=41,206 (CI=18,611–91,233). Pada uji regresi logistik multipel, p=0,000 (p<0,05) dengan nilai R2 Nagelkerke sebesar 0,344 atau 34,4%. Usia gestasi dan berat badan lahir berpengaruh bermakna terhadap kematian neonatus, baik secara parsial maupun simultan. Persentase sumbangan pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus sebesar 34,4%.
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