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All Journal Althea Medical Journal Majalah Kedokteran Gigi Indonesia Sari Pediatri Paediatrica Indonesiana Padjadjaran Journal of Dental Researchers and Students
Dzulfikar Djalil Lukmanul Hakim
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Unpad,Rumah Sakit Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Skull and Posterior Rib Fractures with Respiratory Failure caused by Child Abuse Hakim, Dzulfikar Djalil Lukmanul; Noviani, Elza
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (650.71 KB)

Abstract

Background: Presence of multiple fractures suggests child abuse. Skull fractures rarely occurred but posterior rib fractures are commonly found and have high specificity as a radiological finding in child abuse. A respiratory failure can occur as a result of the damage to the osseous structure of the thorax that destabilizes the rib cage and impairs spontaneous breathing mechanism.Methods: A case report of a 6-month-old boy who presented with respiratory failure, multiple bilateral parietal and occipital bone fractures, and also fractures of right rib 5–8. The patient required ventilatory support for 9 days in the Pediatric Intensive Care Unit, Dr.HasanSadikin General Hospital.Results: The patient was on ventilatory support for 9 days, and was given antibiotics for 2 weeks. Next,   the patient was referred to the High Care Unit (HCU) after the condition was stabilized, and then referred to the ward, for treatment by the Social Pediatric Division. The patient was still having issues about his foster care. Conclusions: Recognition of presence of fractures is important in early diagnosis and treatment of  child abuse. [AMJ.2017;4(1):107–10] DOI: 10.15850/amj.v4n1.1030
Skull and Posterior Rib Fractures with Respiratory Failure caused by Child Abuse Dzulfikar Djalil Lukmanul Hakim; Elza Noviani
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (650.71 KB)

Abstract

Background: Presence of multiple fractures suggests child abuse. Skull fractures rarely occurred but posterior rib fractures are commonly found and have high specificity as a radiological finding in child abuse. A respiratory failure can occur as a result of the damage to the osseous structure of the thorax that destabilizes the rib cage and impairs spontaneous breathing mechanism.Methods: A case report of a 6-month-old boy who presented with respiratory failure, multiple bilateral parietal and occipital bone fractures, and also fractures of right rib 5–8. The patient required ventilatory support for 9 days in the Pediatric Intensive Care Unit, Dr.HasanSadikin General Hospital.Results: The patient was on ventilatory support for 9 days, and was given antibiotics for 2 weeks. Next,   the patient was referred to the High Care Unit (HCU) after the condition was stabilized, and then referred to the ward, for treatment by the Social Pediatric Division. The patient was still having issues about his foster care. Conclusions: Recognition of presence of fractures is important in early diagnosis and treatment of  child abuse. [AMJ.2017;4(1):107–10] DOI: 10.15850/amj.v4n1.1030
Korelasi antara tingkat kecukupan gizi dengan indeks massa tubuh siswa sekolah dasar kelas 4, 5, dan 6Correlation between nutritional adequacy levels with body mass index of elementary school students grades 4, 5, and 6 Dida Akhmad Gurnida; Nanan Nur'aeny; Dzulfikar Djalil Lukmanul Hakim; Fransisca Sri Susilaningsih; Dewi Marhaeni Diah Herawati; Iis Rosita
Padjadjaran Journal of Dental Researchers and Students Vol 4, No 1 (2020): April 2020
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjdrs.v4i1.25763

Abstract

Pendahuluan:  Usia anak merupakan masa yang penting dalam kehidupan manusia dengan ditandai oleh proses tumbuh kembang. Pertumbuhan dan perkembangan anak perlu didukung oleh asupan makanan yang seimbang. Salah satu parameter peisnilaian status gizi adalah indeks massa tubuh (IMT). Tujuan penelitian ini adalah untuk menganalis korelasi antara tingkat asupan dan kecukupan gizi dengan IMT. Metoda: Jenis penelitian analitik observasional dengan desain korelasional dilaksanakan di SDN 1 Tempuran Karawang pada Bulan Oktober 2018. Subjek penelitian adalah siswa kelas 4, 5 dan 6 sebanyak 62 anak yang dilakukan secara konsekutif. Pengumpulan data melalui pengukuran berat badan, tinggi badan dan pengisian form food frequency questionnaire (FFQ). Analisis data dengan uji korelasi pearson product moment Hasil: Kebanyakan subjek adalah siswa perempuan (55%), berusia 11 tahun (45%), IMT normal (47%), tingkat kecukupan energi dan zat gizi defisit tingkat berat (65%). Uji korelasi antara tingkat kecukupan energi, protein, karbohidrat dan lemak dengan IMT menunjukkan korelasi lemah dalam arah negatif dan tidak signifikan yaitu -0,200 (p= 0,120), -0,188 (p=0,143), -0,162 (p=0,209), dan -0,179 (p=0,163) secara berurutan. Simpulan: Tingkat kecukupan gizi yang terdiri dari energi, protein, karbohidrat dan lemak dengan IMT menunjukkan korelasi lemah dalam arah negatif pada siswa kelas 4,5 dan 6.Kata kunci: Indeks massa tubuh, korelasi, siswa sekolah dasar, tingkat kecukupan gizi. ABSTRACTIntroduction: Childhood age is an important period in human life marked by the process of growth and development. Growth and development of children need to be supported by balanced food intake. One parameter for assessing nutritional status is the body mass index (BMI). The purpose of this study was to analyse the correlation between the level of intake and nutritional adequacy with BMI. Method: This study was an observational analytic study with a correlational design carried out at Tempuran 1 Public Elementary School Karawang in October 2018. The research sample consisted of 62 students from grade 4, 5, and 6, taken by consecutive sampling. Data collected through measurements of body weight, height, and filling out the food frequency questionnaire (FFQ) form. Data analysis was performed with the Pearson product-moment correlation test. Results: Female students (55%), aged 11 (45%), normal BMI (47%), the level of energy and nutrient adequacy showed a severe deficit level (65%) and the correlation test between the level of adequacy energy, protein, carbohydrate and fat with BMI showed a weak correlation in a negative direction and not significant, namely -0.200 (p = 0.120); -0.188 (p = 0.143); -0.162 (p = 0.209), and -0.179 (p = 0.163) ) sequentially. Conclusion: The level of nutritional adequacy of grades 4, 5, and 6 elementary students consisting of energy, protein, carbohydrates, and fats shows a weak correlation in a negative direction with BMI.Keywords: Nutrition adequacy level, body mass index, students, elementary school.
The correlation between trauma and poor diet in oral ulceration: an online-based survey Nanan Nur'aeny; Dida Akhmad Gurnida; Dzulfikar Djalil Lukmanul Hakim; Fransisca Sri Susilaningsih; Dewi Marhaeni Diah Herawati
Majalah Kedokteran Gigi Indonesia Vol 6, No 3 (2020): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.54275

Abstract

The most common oral ulceration in the community might be as recurrent as aphthous stomatitis (RAS) or traumatic ulcer. The aim of this study was to report and analyze the characteristics of oral ulceration and risk factors based on an online survey. A questionnaire using Google forms containing a total of 34 questions. Four questions wereabout personal details, whereas 30 questions related to oral ulceration were recorded and presented descriptively. The chi square test was carried out to determine the relationship between several questionnaire variables. A total of 208 respondents were involved, consisting of 162 female and 46 male. Respondents were in the age range of 0–50 year old with >23 year old as the age group with the highest number of respondents (53%). Oral ulceration data showed no recurrence in 157 respondents (75%), rare recurrence/ once in a year (52%), frequent recurrence in the labial mucosa in 121 respondents, single ulcer (86%), round shape (75%), risk factor due to trauma (biting/friction) in 165 respondents, ulcer untreated (64 %), and ulcer recovery of less than 7 days (70%). The respondents had no symptoms of anemia (73%), and were not on a vegan diet (98%). Chi square test indicated that there was a significant correlation between trauma and the poor diet (p= 0.001). The data in this present study indicate that the characteristics of oral ulceration might lead to RAS or traumatic ulcers and this might be attributed to local (trauma) and systemic (diet) factors.
Korelasi Positif antara Neutrophil Lymphocyte Count Ratio dan C-Reactive Protein pada Pasien Sepsis Anak Adri Zamany Anwary; Dzulfikar Djalil Lukmanul Hakim; Djatnika Setiabudi
Sari Pediatri Vol 23, No 1 (2021)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp23.1.2021.1-5

Abstract

Latar belakang. Sepsis merupakan penyebab utama morbiditas dan mortalitas utama pada anak di seluruh dunia. C-reactive protein (CRP) merupakan penanda infeksi yang paling banyak digunakan, tetapi parameter tersebut terkendala tingkat sensitivitas, spesifisitas, ketersediaan alat, dan biaya. Neutrophil-lymphocyte Count Ratio (NLCR) merupakan pemeriksaan yang mudah dan murah, serta banyak digunakan sebagai penanda diagnostik pada berbagai proses inflamasi.Tujuan. Menganalisis korelasi antara NLCR dan CRP pada pasien sepsis anak.Metode. Studi analitik observasional menggunakan data sekunder dari register sepsis anak di RSUP Dr. Hasan Sadikin Bandung periode Januari 2019–Desember 2019. Pengambilan data berupa karakteristik pasien, nilai NLCR, dan CRP, didapatkan data tidak berdistribusi normal( uji Kolmogorov-Smirnov) maka analisis korelasi dilakukan menggunakan uji Rank Spearman dengan nilai kemaknaan p<0,05.Hasil. Sebanyak 80 subjek memenuhi kriteria inklusi. Median nilai NLCR subjek 2,98 (rentang 0,12-19,38) dan nilai median CRP subjek 2,44 (rentang 0,01-34,04) Nilai NLCR memiliki korelasi bermakna dengan CRP (r=0,310; p=0,005). Kesimpulan. Terdapat korelasi positif yang bermakna antara neutrophil-lymphocyte count ratio dengan CRP pada pasien sepsis anak.
Korelasi Feritin Serum dengan Neopterin Serum pada Penyandang Talasemia-β Mayor Anak di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Idham Fadhillah; Susi Susanah; Dzulfikar Djalil Lukmanul Hakim
Sari Pediatri Vol 20, No 2 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (822.719 KB) | DOI: 10.14238/sp20.2.2018.85-89

Abstract

Latar belakang. Penyandang talasemia-β mayor berisiko lebih tinggi mengalami infeksi akibat disfungsi sistem imun karena kelebihan besi. Beban besi tubuh dapat ditunjukkan oleh kadar feritin serum (FS) sementara kadar neopterin serum (NS) merupakan penanda sensitif imunitas seluler tubuh.Tujuan. Mengetahui korelasi kadar FS dengan NS pada penyandang talasemia-β mayor anak.Metode. Studi potong lintang dilakukan pada penyandang talasemia-β mayor anak secara konsekutif yang telah mengalami kelebihan besi di Klinik Talasemia Anak RSUP Dr Hasan Sadikin pada Februari 2018. Subjek penelitian dipilih secara konsekutif. Kadar FS diperiksa dengan metoda immunoassay (CLIA), sedangkan NS dengan ELISA. Analisis statistik menggunakan korelasi rank Spearman, kemaknaan ditentukan berdasarkan nilai p<0,05. Hasil. Empat puluh anak memenuhi kriteria penelitian, terdiri dari 58% laki-laki dan 48% berusia lebih dari 10 tahun. Median kadar FS dan NS adalah 3391,1 ng/mL dan 0,57 nmol/L dengan rentang FS dan NS, yaitu 1038,1–7490,2 ng/mL dan 0,118–2,220 nmol/L. Secara keseluruhan korelasi kadar FS dengan NS diperoleh r= -0,474; p=0,002, sementara pada kadar FS <2000ng/mL didapatkan korelasi positif (r= 0,250).Kesimpulan. Kadar neopterin serum berkorelasi dengan kadar feritin serum, FS tidak dapat digunakan untuk memprediksi status imun pada penyandang talasemia-β mayor anak.
Waist circumference and waist-hip ratio as screening tools for hypertension in children aged 6–11 years Esti Istiqomah; Dida A. Gurnida; Dany Hilmanto; Dzulfikar Djalil Lukmanul Hakim; Prima Nanda Fauziah
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.952 KB) | DOI: 10.14238/pi59.5.2019.265-70

Abstract

Background Hypertension in children is associated with obesity. 7 The renin-angiotensin-aldosterone system has been associated with intra-abdominal fat tissue. Anthropometric parameters for determining nutritional status include waist circumference and waist-hip ratio. Many studies have shown that waist circumference and waist-hip ratio are more precise to determine overweight or obese. Objective To determine the usefulness of waist circumference and waist-hip ratio as hypertensive screening tools for children aged 6-11 years. Methods This analytical study with cross-sectional design and multistage cluster sampling method was conducted in August-September 2017 at a primary school in Bandung, West Java, Indonesia. Subjects underwent height, weight, waist circumference, hip circumference, and blood pressure measurements. Receiver operating characteristic (ROC) curve analysis was done to obtain the area under curve (AUC), cut-off point, sensitivity, specificity, and prevalence ratio. Results Subjects were 325 children consisting of 187 males and 138 females. Hypertension was diagnosed in 47 children (37 males and 10 females). Mean waist circumference and waist-hip circumference ratio were significantly higher in the hypertensive group than in the normotensive group. The hypertensive group had a mean waist circumference of 72.6 (SD 12.8) cm, AUC 0.779 (95%CI 0.730 to 0.823; P<0.001), cut-off point >65 cm, sensitivity 66.0%, specificity 76.3%, and prevalence ratio 4.55. This group had mean waist-hip ratio of 0.94 (SD 0.10), AUC 0.724 (95%CI 0.672 to 0.772; P<0.001), waist-hip ratio cut-off >0.91, sensitivity 59.6%, specificity 77.0%, and prevalence ratio 3.73. Conclusion Waist circumference >65 cm or waist-hip ratio >0.91 can be used to screen for hypertension in children aged 6-11 years with negative predictive values of 92.0% and 91.8%, respectively.
Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis Robby Godlief; Dzulfikar Djalil Lukmanul Hakim; Dwi Prasetyo
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.149-54

Abstract

Background Sepsis-associated liver injury (SALI) is one of the main clinical manifestations of sepsis, as well as an independent risk factor for multiple organ dysfunction syndrome and mortality in pediatric sepsis. The early warning biomarkers for identifying SALI remain poorly defined. Objective To analyze the relationship between aspartate aminotransferase to platelet ratio index (APRi) and liver injury occurrence in pediatric sepsis, as well as determine the APRi cutoff value for early identification of SALI. Methods This retrospective study used secondary data derived from January 2019 to August 2020. The study population comprised admitted children aged 1 month to <18 years who met the criteria for sepsis, and had aspartate aminotransferase (AST) and platelet laboratory parameters checked in the first 24 hours of sepsis and before administration of antibiotics. Pearson’s Chi-square test was used to analyze for correlations. Estimation of the APRi cutoff value in the early occurrence of SALI was performed with logistic regression analysis and receiver operating characteristic (ROC) curve. Results Of the 112 subjects, 94.6% were categorized as having septic shock and 48.2% had SALI. Logistic regression revealed that APRi was a significant predictor of SALI, as indicated by cut-off 4.726 [OR 1.098; 95%CI 1.002 to1.203; P=0.045]. The area under the curve (AUC) was 0.831 or 83.1%, which was classified as strong (80-90%). Conclusion The APRi is a reliable early predictor of SALI in pediatric sepsis, as indicated by an increase in APRi (> 4.726) within the first 24 hours of sepsis.
Hubungan Kadar Resistin dengan C-Reactive Protein dan Prokalsitonin pada Anak dengan Sepsis Dwi Andriyani; Dzulfikar Djalil Lukmanul Hakim; Anggraini Alam
Sari Pediatri Vol 24, No 3 (2022)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp24.3.2022.196-202

Abstract

Latar belakang. Sepsis merupakan penyebab utama morbiditas dan mortalitas pada layanan kesehatan anak di seluruh dunia. Resistin merupakan salah satu hormon peptida yang berpotensi sebagai penanda dalam sepsis didasari dari aktivitas resistin dalam sekresi mediator inflamasi. Tujuan. Penelitian ini bertujuan menilai korelasi kadar resistin dengan CRP dan PCT pada anak yang terdiagnosis sepsis.Metode. Penelitian cross-sectional dilakukan pada pasien anak berusia usia >1 bulan – 18 tahun yang dirawat di RSHS periode September – Desember 2021. Data yang diambil berupa karakteristik dasar, kadar resistin, CRP, dan PCT. Analisis statistik dilakukan dengan menggunakan uji korelasi Rank Spearman dan analisis multivariat regresi linier.Hasil. Sebanyak 60 pasien yang terdiri atas 31 (51,7%) perempuan dan 29 (48,3%) laki-laki. Sebagian besar usia berada pada rentang 1-6 tahun (53,3%), dengan median usia sebesar 5,5 tahun dengan IQR sebesar 8,9 tahun. Status gizi pada riset ini sebagian besar normal sebanyak 25 anak (41,7%) dan malnutrisi berat sebanyak 15 (25,0%). Hasil analisis bivariat terdapat korelasi positif lemah antara resistin dengan CRP (r=0,225; p=0,042), tidak terdapat korelasi resitin dengan PCT (r=0,114; p=0,193), serta terdapat korelasi positif sedang antara CRP dengan PCT (r=0,442; p<0,001).Kesimpulan. Penggunaan resistin sebagai penanda sepsis pada anak-anak harus dikonfirmasi lebih lanjut dengan penelitian lain.
Co-Authors Adri Zamany Anwary Anggraini Alam Dany Hilmanto Dewi Marhaeni Diah Herawati Dida A. Gurnida Dida Akhmad Gurnida Dida Akhmad Gurnida Djatnika Setiabudi Dwi Andriyani Dwi Prasetyo Elza Noviani Elza Noviani, Elza Esti Istiqomah Fransisca Sri Susilaningsih Fransisca Sri Susilaningsih Idham Fadhillah Iis Rosita Nanan Nur&#039;aeny Nanan Nur&#039;aeny Prima Nanda Fauziah Robby Godlief Susi Susanah