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INTRODUCTION: The rising global epidemic of childhood obesity is a major public health challenge. Despite the urgency, there is a lack of data on the awareness and implementation of preventative measures. The aim of this study was to identify areas for improvement in the prevention and management of childhood obesity worldwide. METHODS: A cross-sectional electronic survey was distributed to 132 members of national pediatric societies of the International Pediatric Association. RESULTS: Twenty-eight (21.2%) participants, each from a different country across six World Health Organization (WHO) regions completed the survey. Most participants reported that national prevalence data of childhood obesity is available (78.6%), and the number increased during the Coronavirus disease-2019 pandemic (60.7%). In most countries (78.6%), the amount of sugar and salt in children's products is provided but only 42.9% enacted regulations on children-targeted advertising. Childhood obesity prevention programs from the government (64.3%) and schools (53.6%) are available with existing support from private or non-profit organizations (71.4%). Participants were aware of WHO's guidance concerning childhood obesity (78.6%), while fewer were aware of The United Nations International Children's Emergency Fund's (UNICEF) guidance (50%). Participants reported that WHO/UNICEF guidance acted as a reference to develop policies, regulations and national programs. However, progress was hindered by poor compliance. Lastly, participants provided suggestions on tackling obesity, with responses ranging from developing and reinforcing policies, involvement of schools, and prevention across all life stages. DISCUSSION AND CONCLUSION: There are different practices in implementing prevention measures to counter childhood obesity globally, particularly in statutory regulation on food advertising and national programs. While support and awareness was relatively high, implementation was hindered. This reflects the need for prompt, country-specific evaluation and interventions.

Objective:The Indonesia Basic Health Research 2018 indicates that Indonesian children are still among the shortest in the world. When referred to World Health Organization Child Growth Standards (WHOCGS), the prevalence of stunting reaches up to 43% in several Indonesian districts. Indonesian National Growth Reference Charts (INGRC) were established in order to better distinguish between healthy short children and children with growth disorders. We analyzed height and weight measurements of healthy Indonesian children using INGRC and WHOCGS.Methods:6972 boys and 5800 girls (n=12,772), aged 0-59 months old, from Bandung District were measured. Z-scores of length/height and body mass index were calculated based on INGRC and WHOCGS.Results:Under 5-year-old Indonesian children raised in Bandung are short and slim. Mean height z-scores of boys is -2.03 [standard deviation (SD) 1.31], mean height z-scores of girls is -2.03 (SD 1.31) when referred to WHOCGS indicating that over 50% of these children are stunted. Bandung children are heterogeneous, with substantial subpopulations of tall children. Depending on the growth reference used, between 9% and 15% of them are wasted. Wasted children are on average half a SD taller than their peers.Conclusion:WHOCGS seriously overestimates the true prevalence of undernutrition in Indonesian children. The present investigation fails to support evidence of undernutrition at a prevalence similar to the over 50% prevalence of stunting (WHOCGS) versus 13.3% (INGRC). We suggest refraining from using WHOCGS, and instead applying INGRC that closely mirror height and weight increments in Bandung children. INGRC appear superior for practical and clinical purposes, such as detecting growth and developmental disorders.

Background: Indonesia has a high number of COVID-19 cases and mortalities relative to not only among the Asia Pacific region but the world. Children were thought to be less affected by the virus compared to adults. Most of the public data reported combined data between adults and children. The Indonesian Pediatric Society (IPS) was involved in the COVID-19 response, especially in the area of child health. One of IPS's activities is collecting data registries from each of their chapters to provide a better understanding of COVID-19 in children.Objective: The objective of this study was to share the data of suspected and confirmed COVID-19 cases in children from IPS's COVID-19 data registry.Method: This is a retrospective study from the IPS's COVID-19 registry data. We collected the data of COVID-19 in children during March to December 2020 from each of the IPS chapters. We analyzed the prevalence, case fatality rate (CFR), age groups, diagnosis, and comorbidities of the children diagnosed with COVID-19.Result: As of December 21, 2020, there were 35,506 suspected cases of children with COVID-19. In total, there were 522 deaths, with a case fatality ratio (CFR) of 1.4. There were 37,706 confirmed cases with 175 fatalities (CFR 0.46). The highest mortality in confirmed COVID-19 cases was from children ages 10–18 years (42 out of 159 cases: 26%). The most common comorbidity and diagnosis found were malignancy (17.3%) and respiratory failure (54.5%).Conclusion: The CFR of confirmed COVID-19 cases in children in Indonesia is high and should be a major public concern.

Latar belakang. Sejak tahun 2000 hingga kuartal I tahun 2005 angka kunjungan pasien rawat jalan mengalami penurunan secara gradual di Unit Rawat Jalan Departemen Ilmu Kesehatan Anak Rumah Sakit Umum Pusat Dr. Cipto Mangunkusumo (URJ Departemen IKA RSUP CM) Jakarta. Kecenderungan penurunan angka kunjungan pasien merupakan indikator bagi pengelola untuk meninjau kembali strategi pelayanan di Pediatri Rawat Jalan. Tujuan Penelitian. Meneliti tingkat kepuasan orangtua pasien yang membawa anaknya berobat jalan di URJ Departemen IKA RSCM. Metoda penelitian. Studi survai deskriptif dengan metode potong lintang (cross sectional) dilakukan di URJ Departemen IKA RSCM dalam kurun waktu Agustus – Nopember 2005. Pengumpulan data primer menggunakan kuesioner yang terstruktur berisi 30 pertanyaan. Hasil penelitian. Dari 144 orang tua pasien, enam puluh dua persen orangtua pasien merasa puas terhadap kualitas pelayanan, skor kepuasan total terhadap dimensi kualitas pelayanan 3,55 (puas). Bukti fisik (tangibility) memberi skor kepuasan tertinggi sedangkan kehandalan pelayanan (reliability) memberi skor kepuasan terendah bagi orangtua pasien. Kesimpulan. Kualitas pelayanan di URJ Departemen IKA RSCM memuaskan (skor 3,55) dan persentase orangtua pasien yang puas 62%.

Latar belakang. Diabetes melitus tipe-1 (DM tipe-1) merupakan penyakit kronis yang dapat mempengaruhi emosi dan perilaku anak dan remaja. Pasien mengalami tekanan yang berhubungan dengan bagaimana mengontrol metabolik dan tumbuh kembang yang sedang berlangsung. Tujuan. Mengetahui gangguan perilaku pasien DM tipe-1 dan faktor-faktor yang berhubungan dengan gangguan perilaku. Metode. Penelitian dilakukan secara potong lintang pada bulan Agustus 2006 di poliklinik Endokrinologi Departemen IKA FKUI RSCM. Subjek penelitian adalah pasien DM tipe-1 umur 4-18 tahun yang diambil secara purposive sampling. Sumber data diperoleh dari orangtua/ wali responden dengan wawancara terpimpin, menggunakan Pediatric Symptom Check List-17 (PSC-17) dan Kuesioner Masalah Mental Emosional (KMME). Hasil. Prevalensi gangguan perilaku pasien DM tipe-1 dijumpai kemungkinan gangguan psikososial 45,8%, paling banyak adalah gangguan internalisasi (33,3%). Kemungkinan gangguan mental emosional 41,7%. Lama sakit lebih dari 5 tahun dan pernah mengalami komplikasi memiliki risiko lebih besar mengalami gangguan mental emosional. Kesimpulan. Kemungkinan gangguan perilaku pada diabetes tipe-1 45,8%. Skrining gangguan perilaku pada pasien DM tipe-1 perlu dilakukan secara rutin di pusat pelayanan kesehatan sehingga dapat segera dievaluasi lebih lanjut.

Prevalens dan insidens diabetes mellitus tipe 2 (DMT2) pada anak terus mengalami peningkatan di seluruh dunia. Data di Indonesia menunjukkan prevalens diabetes pada anak di daerah perkotaan Jakarta meningkat dari 1,7% pada tahun 1982 menjadi 5,7% pada tahun 1995, namun sayangnya tidak ada data lebih lanjut mengenai prevalens DMT2. Sampai saat ini, obat anti diabetik oral yang sudah disetujui penggunaannya pada anak oleh oleh Food and Drug Administration (FDA) hanya metformin. Sedangkan obat anti diabetik oral golongan lain masih dalam perdebatan. Dari penelusuran literatur didapatkan bahwa secara umum mekanisme kerja obat-obat tersebut dalam mengontrol kadar gula darah yaitu dengan meningkatkan sekresi insulin seperti obat golongan sulfonylurea, menurunkan resistensi insulin seperti obat golongan biguanid dan menurunkan absorpsi glukosa postprandial seperti obat golongan inhibitor􀀀􀁁-glucosidase. Keberhasilan terapi dinilai berdasarkan kadar glukosa darah, kadar HbA1c, dan sindrom metabolik yang menyertainya seperti obesitas, hipertensi dan hiperlipidemia. Sampai saat ini belum ada data mengenai efektifitas dan keamanan penggunaan obat anti diabetik oral selain biguanid metformin. Uji klinis mengenai penggunaan obat-obatan anti diabetik oral selain metformin pada anak dengan DMT2 masih perlu dilakukan untuk dapat dijadikan suatu rekomendasi terapi. Selain mengontrol kadar gula darah, tata laksana DMT2 juga meliputi modifikasi gaya hidup dan mengatasi gejala sindrom metabolik yang menyertainya.

Latar belakang. Diabetes mellitus tipe 1 (DM tipe-1) adalah kelainan metabolik yang disebabkan oleh reaksi autoimun yang menyebabkan kerusakan sel β pankreas dan terjadi pada hampir semua anak yang menderita diabetes. Dalam perjalanan DM tipe-1, sering timbul komplikasi jangka pendek dan jangka panjang. Tujuan. Mengetahui frekuensi komplikasi jangka pendek yaitu ketoasidosis dan jangka panjang yaitu nefropati dan retinopati berdasarkan kontrol metabolik, lama menderita diabetes, dan biaya pengobatan. Metode. Penelitian deskriptif pada 39 pasien yang terdaftar di IKADAR(Ikatan Keluarga Penyandang Diabetes Anak dan Remaja) selama September – Oktober 2007 di Departemen Ilmu Kesehatan Anak Divisi Endokrin FKUI/ RSCM Jakarta dengan melakukan anamnesis, pemeriksaan laboratorium HbA1c, mikroalbuminuria, dan evaluasi mata di poliklinik mata FKUI RSCM. Hasil. Dari 39 pasien yang diteliti antara umur 5-31 tahun, rerata diagnosis diabetes ditegakkan pada umur (9,8±4,1) tahun, HbA1c (10,1±2,3) % dan menderita diabetes selama (5,6±5,8) tahun, dengan dosis insulin yang dipakai (0,9±0,2) IU/kg/hari. Komplikasi yang ditemukan adalah ketoasidosis diabetik selama sakit pada 30 pasien (76,9 %) dan pada 12 minggu terakhir pada 3 pasien (7,9%), mikroalbuminuria pada 3 pasien (7,9%), sedangkan retinopati tidak ditemukan. Rerata pasien memeriksakan HbA1c 3-4 kali pertahun, memeriksa gula darah secara mandiri 1-2 kali/hari dan sebagian besar berobat dengan biaya sendiri. Kesimpulan. Tidak banyak perubahan karakteristik pasien dibandingkan penelitian yang lalu. Rerata kadar HbA1c masih kurang baik dibandingkan dengan rerata HbA1c di negara maju. Di negara maju sudah banyak perubahan pada cara pemberian insulin dan lebih ditingkatkannya perhatian dan pengetahuan pada pasien dan keluarga pasien diabetes.

Background Childhood obesity is a global health problem, with the prevalence is differed in each country and affected by many factors, such as lifestyle and physical activity. Insulin resistance (IR) as a basic mechanism of several metabolic diseases in obesity, is related with metabolic syndrome (MetS) along with its long term complications, such as type 2 diabetes mellitus (T2DM). Several factors are known to be associated with IR, and the presence of acanthosis nigricans (AN) has an important meaning in predicting IR. Objectives To assess the prevalence of IR, MetS in obese adolescents and its potentially associated factors, such as gender, signs of AN, and family history of metabolic diseases. Methods A cross-sectional study was performed in obese adolescents, aged 12-15 years, over a two-month period. Fasting blood glucose, insulin, and lipid profiles were measured. Obesity was defined using body mass index (BMI). Insulin resistance was quantified by the homeostasis model assessment for IR (HOMA-IR) . Metabolic syndrome was defined according to the International Diabetes Federation (IDF) 2007 criteria. Results Of92 obese adolescents, IR was found in 38% of subjects, with females predominating (57.2%). Signs of AN were seen in 71. 4% of subj ects and a positive family history of metabolic diseases was found in 82.8% of subjects, including family history of obesity, type 2 diabetes mellitus (T2DM), and hypertension. Less than 10% of subjects were considered to be in a prediabetic state, and none had T2DM. No statistical significance was found between gender, family history, or signs of AN and IR (P>0.05). Metabolic syndromes was found in 19.6% of subjects, with the fo llowing prevalences for each component: 34.8% for hypertension, 78.3% for central obesity, 8.7% for impaired fasting glucose (IFG), 22.8% for low levels of HDL, and 2 1. 7% for high triglyceride levels. A strong correlation was found between IR and IFG with OR= 5 .69 (95%CI 1.079 ~ 29.993, P= D.04). Conclusion We find a high prevalence ofIRin obese adolescents, and IR increases the risk of prediabetes. Thus, prevention strategies are needed to overcome the long term impact of obesity on health.

Background Type 1 diabetes mellitus (T1DM) is an emerging disease worldwide. Glycemic control in pediatric T1DM patients is a challenge in diabetes management. Attending diabetic camp has been associated with improved glycemic control in diabetic children and adolescents. Objective To determine the effect of diabetic camp attendance on glycemic control in children and adolescents with T1DM Methods A cross-sectional, non-experimental study was done in December 2010 at a diabetic camp held in Bogor, Indonesia. The two-day camp educated diabetics about T1DM, including insulin use, meal planning, exercise, monitoring and complications. The diabetic camp was attended by 28 children and adolescents, consisting of 5 boys and 23 girls, aged 7 – 18 years. Eighteen participants completed the requested data for our study. Glycosylated hemoglobin (HbA1c) was measured before and 3 months after subjects attended the camp. Participants also filled the Pediatric quality of life (PedsQL) questionnaire. We compared HbA1c levels before camp and 3 months after, by Stata 19. Results Before camp, the mean HbA1c was 9.18% (SD 2.48) and 3 months after camp it was 8.67% (SD 1.62), a statistically significant improvement (P=0.004). The PedsQL revealed that none of the subjects had poor quality of life. Conclusion Glycemic control in T1DM children and adolescents was significantly improved 3 months after attending diabetic camp compared to that before attending camp. According to subjects’ self-assessment by PedsQL questionnaire, no subjects indicated a poor quality of life for the duration of their illness. [Paediatr Indones. 2011;51:294-7].

Background Congenital adrenal hyperplasia (CAH) is the most common cause of ambiguous genitalia in children and 90-95% cases show 21-hydroxylase deficiency. More than 100 mutations have been described and of these, four mutations have been frequently reported in Asia. Those mutations are deletion/large gene conversion (LGC), intron2 splice mutation (I2 splice), point mutations at codon 172 (I172N) and codon 356 (R356W). Genotyping is very valuable since close correlation observed between genotype and phenotype. Objective To identify phenotype and genotype characteristics of CAH due to 21-hydroxylase deficiency (CAH-21OH) and correlation between them. Methods From June to November 2006 we analyzed 37 confirmed CAH-21OH patients treated at the Department of Child Health, Cipto Mangunkusumo Hospital during the period of 1990-2006. Polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) analysis or amplification-created restriction site (ACRS) were performed. We first identified deletion/ LGC and I172N mutation that had been mostly reported in salt wasting (SW) and simple virilizing (SV) form patients respectively. Results There were 37 patients, consisted of 6 males and 31 females with the ratio 1:5.2. Of those, 25, 10, 2 patients were SW, SV and non-classic (NC) form, respectively. PCR-RFLP or ACRS was performed to detect two mutations in 32 patients (64 alleles). Deletion/LGC was found in 6 alleles while I172N mutations in two. All deletion alleles showed SW phenotype but I172 mutated alleles showed SW and SV phenotype. Conclusion There is a consistent close association between genotype and phenotype in our CAH-21OH patients.

The incidence rate of IDDM in our clinic during the period from 1989 to 1998 was 0.028%. There were twentyfour IDDM patients with duration of illness of more than 2 years, with a male to female ratio of 1: 1.5. Most of these patients had no diabetic family history and had good nutritional status. The insulin dosage used by these patients ranged between 0.67 - 0.72 IU/kg/day with a mean of 1.06 IU/kg/day. The average frequency of blood glucose home monitoring was less than ideal. Twenty-two out of the 24 patients were fully controlled metabolically; however, these patients still have polyuria, polydipsia, and polyphagia.

In Indonesia report on the natural history of premature thelarche is very limited. Daily practice requires physicians to have some basic practical knowledge, among others the natural history of premature thelarche, in order to manage these patients properly. We reviewed data of 85 premature thelarche patients who visited our department from January 1989 until December 1998. Only 60 patients met the study criteria. The mean chronological age of the patients at diagnosis was 43.4 months. About half of these patients (31/60) were diagnosed before they were 2 years old. Half of the patients had bilateral breast involvement. The hormonal pattern showed 24/48 follicle stimulating hormone predominant-response. Most patients (33/47) showed normal plasma estradiol level. Bone age analysis was normal in 46/57 patients, and only 9 showed accelerated bone age. Pelvic ultrasonography showed prepubertal reproduction organs in 26/35. Vaginal smears showed signs of estrogenization with various degree of stimulation in 13 patients. At the end of observation the outcome of premature thelarche were: 31 regressed, 19 persisted, 6 had progressive breast development and 4 progressed to central precocious puberty. The initial clinical and laboratory characteristics of those who developed CPP varied. Among 31 premature thelarche patients who regressed, 21 had onset of breast enlargement before age of 2 years. In most of the regressed patients (20/31), regression occurred completely within the first year. Most premature thelarche patients with onset before 2 years will regress within one year after diagnosis.

Latar belakang: kriptorkismus merupakan kelainan organ seksual lelaki yang sering ditemukan. Sampai berapa tahun terapi hormonal dan pembedahan dilakukan masih kontroversial. Tujuan: penelitian ini bertujuan untuk mengetahui umur saat berobat pertama kali, asal rujukan, lokasi testis, peran perabaan, penyakit penyerta, dan peran terapi hormonal pada kriptorkismus. Cara kerja: Penelitian dilakukan secara retrospektif dari semua pasien baru yang didiagnosis kriptorkismus di Poliklinik Endokrinologi Anak RSCM selama 5 tahun (Januari 1998 – Desember 2002). Hasil: diteliti 63 pasien baru, 58 pasien diantaranya dengan kriptorkismus murni, dan 5 pasien testis retraktil. Didapat 22,4% kriptorkismus bilateral, 77,6% kriptorkismus unilateral, kriptorkismus kanan dan kiri jumlahnya hampir sama. Pasien yang dirujuk oleh spesialis anak 33,3%. Umur pertama datang di poliklinik 9 bulan-2 tahun 24,1%, dan >2 tahun 56,9%. Pada perabaan, lokasi testis paling banyak tak teraba 74,1%, setelah dikonfirmasi dengan USG 75% hasilnya sama dengan perabaan. Kriptorkismus disertai skrotum bifidum dan hipospadia 12,6%, mikropenis 11,1%, sindrom Prader Willi, sindrom Noonan, sindrom Kallmann masingmasing 1,6% dan merupakan penyakit dasar kriptorkismus. Keberhasilan Terapi hormonal 65% ( inguinal 77,8% dan pada testis tak teraba 50%) , terapi dimulai sejak umur 9 bulan. Kesimpulan: sebagian besar pasien datang pada umur >2 tahun, sedangkan terapi hormonal dimulai pada umur 9 bulan dengan keberasilan 65%. Pemeriksaan fisik sama akurat dibandingkan dengan pemeriksaan USG. Terapi hormonal pada kriptorkismus umur 6 bulan - 2 tahun masih efektif sebelum terapi bedah dilakukan.

Diabetes Mellitus tipe-1 merupakan salah satu penyakit kronis yang sampai saat ini belum dapat disembuhkan. Walaupun demikian, berkat kemajuan teknologi kedokteran kualitas hidup pasien DM tipe-1 dapat terpelihara. Sebagian besar kasus DM pada anak termasuk di dalam DM tipe-1, namun sedikit sekali tulisan di Indonesia mengenai karakteristik klinis dan laboratorium DM tipe-1. Hal ini mengakibatkan banyak tenaga medis yang tidak mengetahuinya sehingga sering sekali salah dalam mendiagnosis pasien DM tipe-1. Pasien DM tipe-1 sebagian besar mempunyai riwayat perjalanan klinis, dengan poliuria, polidipsia, polifagia, dan berat badan yang cepat menurun. Untuk mengurangi keterlambatan diagnosis maka kewaspadaan terhadap DM tipe-1 merupakan kata kunci. Telah dilakukan penelitian deskriptif retrospektif pada semua pasien DM tipe-1 yang berobat ke Bagian IKA-RSCM antara tahun 1989-1999. Seluruh subyek penelitian diambil dari catatan medis dan didapat 41 kasus dengan DM tipe-1 dengan sebagian besar anak perempuan. Usia terbanyak saat datang pertama kali ke Bagian IKA-RSCM pada usia 5-10 tahun (56%). Dari 41 kasus DM tipe-1, hanya 31% yang mempunyai keturunan keluarga DM. Saat datang ke Bagian IKA-RSCM 66% dengan katoasidasis diabetik, 71% menderita gizi kurang dan seluruh pasien datang dengan keluhan poliuria, polidipsia, polifagia dan adanya penurunan berat badan yang progresif. Gangguan kesadaran juga menyertai pasien dengan KAD. Kadar gula darah pasien DM tipe-1 terbanyak antara 300-500 mg/dl (51%). Semua pasien pada saat awal diagnosis kadar HbA1c di atas normal dan C-peptida di bawah normal.

Gejala klinis hipotiroidisme kongenital pada neonatus seringkali tidak begitu jelas dan baru terdeteksi setelah 6-12 minggu. Diagnosis dini sangat penting untuk mencegah timbulnya retardasi mental atau meringankan derajat retardasi mental. Penelitian ini bertujuan untuk mengetahui gambaran klinis awal, laboratorium dan respons terapi awal natrium levotiroksin pada pasien hipotiroidisme kongenital. Data dikumpulkan dari catatan rekam medik kasus-kasus hipotiroidisme kongenital yang berkunjung ke Poliklinik Endokrinologi Anak dan Remaja FKUI/RSCM Jakarta selama kurun waktu 1992-2002. Dalam kurun waktu tersebut terdapat 30 pasien baru, 21 anak (70%) perempuan dan 9 anak (30%) laki-laki. Sebagian besar (53,3%) didiagnosis pada umur 1-5 tahun. Berdasarkan status antropometri menurut NCHS-WHO ditemukan gizi buruk pada 53,3% kasus (berat badan/umur), perawakan pendek paa 90% kasus (tinggi badan/ umur), dan pada 70% kasus perbandingan berat badan/tinggi badan adalah normal. Gejala klinis tersering saat diagnosis adalah perkembangan motorik terlambat (83,3%), konstipasi (73,3%), aktivitas menurun (70%), makroglosia (70%), dan pucat (70%). Ditemukan maturasi tulang terlambat (95,5%), gangguan pendengaran (22,7%), gangguan sistem neuromuskular (16,7%), dan retardasi mental (62,5%). Pada pemeriksaan skintigrafi dijumpai agenesis tiroid pada 11,1% kasus. Sebagian besar (26,7%) mendapat terapi awal dosis tinggi (8-10 mg/kg/hari). Gejala klinis berkurang (36,7%) dalam 4 minggu dan fungsi tiroid kembali normal (33,3%) dalam 1-3 bulan setelah terapi awal.

Latar belakang.Salah satu komplikasi jangka panjang diabetes melitus tipe 1 (DM tipe 1) pada anak adalah nefropati diabetik. Lama menderita diabetes serta masa pubertas merupakan faktor yang mempengaruhi terjadi komplikasi tersebut. Kejadian nefropati diabetik pada umumnya akan disertai gejala peningkatan tekanan darah. Tujuan.Mengetahui gambaran tekanan darah anak dengan DM tipe 1 berdasarkan umur, jenis kelamin, lama sakit, dan kadar HbA1c. Metode.Studi observational retrospektif pada register nasional DM tipe 1 UKK Endokrin Anak IDAI sampai tahun 2010. Variabel yang diteliti adalah umur, jenis kelamin, lama sakit, kadar HbA1c, serta tekanan darah sistolik (TDS) dan diastolik (TDD). Hasil.Di antara 177 anak dengan DM tipe 1, 118 (66,7%) perempuan dan 59 (33,3%) laki-laki. Rerata umur saat pertama kali didiagnosis adalah 11,8 tahun. Dijumpai 1 (0,6 % ) anak perempuan yang menderita DM tipe 1 lebih dari 5 tahun mempunyai tekanan darah sistolik dan diastoik di atas persentil 95. Kesimpulan. Sebagian besar tekanan darah anak dengan DM tipe 1, normal. Terdapat 0,6% kasus dengan hipertensi (>95 persentil) yaitu seorang anak perempuan yang telah menderita DM lebih dari 5 tahun

Latar belakang. Dermatitis atopik (DA) merupakan manifestasi awal atopic marchyang berhubungan dengan alergi makanan. Alergen penyebab dan faktor risiko yang memengaruhi penting diketahui. Tujuan. Mengetahui sensitisasi dan faktor risiko alergi pada DA setelah usia 2 tahun. Metode. Penelitian deskriptif potong lintang terhadap 35 subjek DA sejak Januari-Maret 2011. Sensitisasi diketahui dengan uji tusuk kulit. Hasil. Sensitisasi terjadi pada 29 subjek dari 35 subjek, dengan faktor risiko pajanan asap rokok ditemukan pada 21 subjek, faktor risiko alergi sedang dan tinggi 19 subjek, tidak mendapat ASI eksklusif 9 subjek, dan makanan padat usia dini 21 subjek. Sensitisasi alergen makanan ditemukan pada 26 subjek. Kesimpulan. Sebagian besar subjek DA mengalami sensitisasi oleh alergen makanan. Faktor risiko pajanan asap rokok, faktor risiko alergi sedang dan tinggi, tidak mendapat ASI eksklusif, dan mendapat makanan padat usia dini ditemukan lebih sering pada anak DA

Latar belakang. Sindrom Turner adalah kumpulan gejala dengan karakteristik fisik dan hilangnya satu kromosom X baik secara komplit maupun parsial, dan sering pula berupa sel mosaik. Tujuan. Untuk mengetahui karakteristik pasien sindrom Turner yang meliputi kariotip, umur saat diagnosis, perawakan, kelainan penyerta, status pubertas, kadar follicle stimulating hormone (FSH), dan usia tulang. Metode. Penelitian merupakan studi deskriptif. Data diperoleh dari Perkumpulan Turner Jakarta dan catatan medik pasien yang berkunjung ke Poliklinik Endokrin Anak RSCM dari tahun 1997-2006. Hasil. Dari 20 kasus yang berhasil dikumpulkan, 17 di antaranya dengan kariotip 45,X, sisanya mosaik. Rerata umur saat diagnosis adalah 7,75 tahun (rentang 0-15 tahun); rerata berat lahir 2590 gram; perawakan pendek 18 pasien (18/20). Terdapat 8 pasien dengan kelainan penyerta yaitu 4 anak kelainan jantung, 3 gangguan telinga, dan 1 orang dengan hipertensi. Saat diagnosis tujuh pasien, mengalami pubertas terlambat. Rerata kadar FSH dari 16 pasien adalah 82,94 IU/liter (rentang 13,8-188 IU/liter). Data usia tulang (16 pasien) menunjukkan retarded (11 pasien), dan sisanya average. Kesimpulan. Pada penelitian ini karakteristik utama sindrom Turner adalah kariotip 45,X dengan karakteristik fisik perawakan pendek dan pubertas terlambat disertai kelainan penyerta

The condition of 5-alpha-reductase type 2 deficiency (5-ARD) is an inherited disorder resulting in the inability to convert testosterone to dihydrotestosterone (DHT). This disorder was previously termed as familial incomplete male pseudohermaphroditism type 2, pseudovaginal perineoscrotal hypospadias. Clinical manifestation of 5-ARD is limited to male genetic. The affected males are usually identified as female in childhood but undergo striking virilization at puberty. While overall incidence for various countries are not established, increased incidence is reported in the Dominican Republic, some highland tribes in New Guinea, Lebanon and Turkey. This was the first documented case in Cipto Mangunkusumo (CM) Hospital.

Background Children with steroid resistant nephrotic syndrome (SRNS) generally survive, although during the course of disease their kidney function may decrease, leading to end-stage renal disease (ESRD). There have been few studies reporting on the survivals of children with SRNS. Objectives To determine patient and kidney survival rates in children with SRNS at the first, second, third, fourth, and fifth years; and to evaluate the effects of age at onset, initial kidney function, hypertension, and type of resistance, on the survivals of children with SRNS. Methods This retrospective cohort study was performed using secondary data obtained from medical records of patients with SRNS in Department of Child Health, Cipto Mangunkusumo Hospira~ between 2004-2011. The outcomes of kidney survivals were defined in two ways: lack of doubling of base creatinine levels and lack of ESRD. Results There were 45 children with SRNS in our study. Their median duration ofillness was 24 (range 12-95) months. Twenty percent of the subjects died, 31.1 % had a doublingofbase creatinine levels, and 13.4% developed ESRD. Life survival rates of subjects at the first, second, third, fourth, and fifth years after diagnosis were 93 %, 84%, 80"/ri, 7 2% ,and 61 %, respectively. Kidney survival rates determined by the lack of doubling of base creatinine levels at the first, second, third, fourth and fifth years were 92%, 72%, 56%, 42%, and 34%, respectively, while kidney survival rates determined by the lack ofESRD were 97%, 88%, 81 %, 70"/o, and 58%, respectively. Age at onset, initial kidney function, hypertension at onset, and type of resistance, did not significantly affect the survivals of children with SRNS. Conclusion Children with SRNS are prone to develop a doubling of base creatinine levels and ESRD. Factors such as age, initial kidney function, hypertension at onset, and type ofresistance, do not significantly affect both, life and kidney survivals of children with SRNS.