Kejang demam adalah penyebab kejang paling umum pada anak dan sering menjadi penyebab rawat inap di rumah sakit secara darurat. Studi pendahuluan pada anak menunjukkan bahwa jaringan sitokin diaktifkan dan mungkin berperan dalam patogenesis kejang demam namun, signifikansi klinis yang tepat masih belum jelas. Penelitian ini bertujuan untuk membuktikan hubungan antara kadar TNF-α plasma dengan kejang demam sederhana. Penelitian cross sectional dilakukan pada Maret-April 2014 di Departemen Ilmu Kesehatan Anak Rumah Sakit Umum dr. Saiful Anwar Malang. Terdapat 38 subjek yang memenuhi kriteria inklusi, 19 pasien kejang demam sederhana dan 19 pasien demam tanpa kejang (usia 6 bulan-5 tahun). Kadar TNF-α plasma diperiksa dengan ELISA. Analisis Independent t test menunjukkan tidak terdapat perbedaan bermakna karakteristik subjek, suhu rektal dan kadar lekosit. Analisis Mann-Whitney menunjukkan tidak terdapat perbedaan bermakna karakteristik subjek jenis kelamin dan kadar CRP. Kejang demam lebih banyak ditemukan pada usia yang lebih muda dibandingkan demam tanpa kejang. Hasil Independent t test juga menunjukkan terdapat perbedaan bermakna antara kadar TNF-α plasma kelompok kejang demam sederhana dan kelompok demam tanpa kejang (p=0,002). Hasil uji Spearman menunjukkan terdapat korelasi negatif sedang yang bermakna antara kadar TNF-α plasma kelompok kejang demam sederhana dan kelompok demam tanpa kejang (r=-0,533; p=0,001). Dapat disimpulkan bahwa terdapat hubungan antara kadar TNF-α plasma dengan terjadinya kejang demam sederhana.

Background. Seizures are a common clinical manifestation in the emergency room. Nearly 5% of children aged under 16 years. Seizures are important as a sign of neurological disorders. Members of interferon are widely studied with seizures and epileptogenesis is interferon-γ. In a study by Choi in 2011, a study of seizures in humans showed that the condition of status epilepticus increased levels of interferon-γ which is quite high compared to patients not status epilepticus seizures. In response to the aftermath of the seizure, Interferon-γ system induces the formation of IL-10 acts as an anti-inflammatory agent that aims to put an end to the action of Interferon-γ. Objective. To know role of Interferon-γ and IL-10 in children with status epilepticus. Methods. This research using cross sectional design with recruiting 30 study sample consisted of 15 children in the seizure group SE and 15 children in the group without SE seizures. Measured levels of IFN-γ and interleukin-10 by ELISA. Results were analyzed with the Mann-Whitney and corelation Spearman to see the relationship levels of IFN-γ and IL-10 in children with status epilepticus with SPSS-23. Results. The results showed significant differences between groups SE and convulsive seizures non SE ;IL-10 (p = 0.000) and IFN-γ (p = 000). Conclusion. There are significant correlation between the levels of IFN-γ and IL-10 with status epilepticus.

Acute bronchial asthma is a common medical emergency the world over. There now exists compelling evidence of a role for Th2-Th1 paradigm in the pathogenesis of asthma in children. We hypothesized that childhood asthma is associated with the activation of Th2-Th1 lymphocytes whose products regulate at least in part, the expression of IgE, IFN-γ and IL-4 and thereby disease severity. Our aims, therefore were to compare the level of total IgE, total IL-4 and total IFN-γ in serum from asthmatic and non asthmatic control children matched for age and sex, and to attempt to correlate the IgE, IL-4, and IFN-γ total level of serum in the asthmatics children with disease severity. Fifty one children with acute asthma exacerbation were compare with thirty one no asthmatics normal children matched for age and sex. The level of IgE, IL-4, and IFN-γ were measured using Elisa. Asthma severity was assessed by a symptom score and spirometri. The level of IgE and Il-4 in the serum of the asthma were elevated as compared to the non asthmatic normal controls, whereas the IFN-γ was decreased. There was a significant correlation between elevated levels of IgE and IL-4 with the acute asthma exacerbation severity, whereas the decreased level of IFN-γ was not. Conclusions. The increased levels of IgE , IL-4 and the ratio of IL-4/IFN-γ play a crucial role in the acute asthma exacerbation severity. PENDAHULUANProses inflamasi saluran nafas mempunyai peran utama dalam patogenesis manifestasi klinis asma. Proses inflamasi ini ditandai oleh gambaran yang karakteristik yaitu adanya destruksi sel epitel, hipertropi otot polos, penebalan membran basal dan infiltrasi oleh sel-sel radang terutama sel eosinofil, sel mast, dan sel limfosit T (1). Selama proses inflamasi bermacam mediator dilepas dan menimbulkan kerusakan jaringan. Sitokin sel Th2 seperti IL-4, IL-13, dan IL-15 mendominasi temuan yang ada pada hasil biopsy dan pemeriksaan sekret dari bronkoalveolar penderita asma (1,2,3). Dibuktikan pula bahwa terjadinya asma pada anak-anak oleh karena timbulnya gangguan keseimbangan antara sel Th1 dan Th2 dengan terjadinya pergeseran kearah sel Th2. Pergeseran pelepasan sitokin dari kedua tipe sel Th tersebut menentukan terjadinya proses inflamasi dan timbulnya asma (2,3,4).Walaupun demikian masih belum banyak diteliti adanya hubungan antara kadar sitokin dengan beratnya derajat obstruksi yang terjadi didalam saluran nafas penderita asma yang sedang mengalami serangan. Ada beberapa penelitian hasil otopsi dari penderita yang meninggal karena status asma menunjukkan adanya proses inflamasi yang konsisten dengan paradigma sel Th2 dan ditemukannya sel eosinofil dan sel limfosit dalam jumlah besar (3).Tujuan penelitian ini untuk mencari hubungan antara derajat obstruksi serangan akut asma dengan kadar IgE dan sitokin serum penderita asma. Penelitian ini merupakan studi cross-sectional. Pada hari pertama masuk rumah sakit segera di ukur faal paru, pengambilan darah melalui vena untuk menghitung kadar IgE, IL-4 dan IFN-γ total dalam serum dengan ...

Guillain Barre Syndrome is one of the leading diseases from Acute Flaccid Paralysis after the decrease in poliomyelitis. In Guillain Barre Syndrome, the motoric muscles becomes weak and it could also attack the respiratory muscle which is life threatening to patients. The objective of this study is to report Guillain Barre Syndrome cases from June 1999 until June 2005 based on the clinical manifestation and laboratory in children care unit of dr. Saiful Anwar hospital. In this research there were 38 Guillain Barre Syndrome cases which were diagnosed using the Gilroy and Meyer criteria. 22 patients (57,9%) were male, 16 patients (42,1%) were female. 18 patients (43,36%) were below 5 years of age, 13 patients (34,21%) were between 5 to 10 years of age and 7 patients (18,42%) were between the age of 10 to15 years. The most common infection that precedes was upper respiratory infenction which amounts to 32 cases (84,21%). The latent phase between 8 to 14 days were 11 patients (28,94%) and 15 to 21 days were 22 patients (57,89%). The progresive phase 1 to 7 days occured in 17 patients (44,73%), 8 to 14 days also in 17 patients (44,73%).The clinical features were paresthesias followed by weakness to 23 patients (60,52%) and weakness only in 15 patients (39,47%). The pattern of weakness by tetraparese in 5 patients (13,15%) and paraparese in 33 patients (86,84%). The distribution of weakness was more towards the distal extremities then the upper extremities which amounts to 37 patients (97,36%). Laboratories examination of the cerebro spinal fluid revealed protein above 46 mg/dl in 31 patients (81,57%) and below 45 mg/dl in 7 patients (18,42%). One of the patients was on a ventilator because of respiratory muscle paralysis. Complete recovery in this research between 3 to 6 months. Guillain Barre Syndrome is clinically fully recovered although special precautions has to be taken due to the effect towards the respiratory muscle. The characteristic of the laboratory examination is an albuminocytologic dissociation

Dengue shock syndrome (DSS) is a clinical emergency case with still high mortality rate. During five years period (1January 1997-31 December 2001) total case of SSD triaded in PICU room Medical Faculty Brawijaya University/ Saiful Anwar Hospital Malang were thirty two patients. They were referred from Malang regency 9 patients (28%), Malang city 23 patients (72%). The most group age 6-10 years 14 patients (44%), < 5 years 13 patients (41%), 11-14 years 5 patients (15%). SSD is devided in DBD grade III 14 patients (44%), DBD grade IV 18 patients (56%). Laboratory finding total leucocyt count < 4000/mm 3 8 patients (25%), 4000-10000/mm 3 24 patients (75%). Total thrombocyt < 50000 / mm 3 22 patients (69%), 50000-100000/ mm 3 10 patients (31%). Hematocrit > 42% all patients (100%). Clinical sign found in SSD patients quickly and fine pulse 14 patients (44%), cold extremities 32 patients (100%), pulse not palpable 18 patients (56%). Blood tension : unmeasured 18 patients (56%), hypotension 18 patients (56%). Death patients 13 (41%) recovery patients 19 (59%). All SSD patients (100%) were death by complication of occult bleeding, pulmonary edema, respiratory failure.