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"Pseudomonas aeruginosa infection on wounds, especially burn wounds can cause prolonged healing and may lead to sepsis. Framycetin, an aminoglycoside, can be impregnated into paraffin based-dressing used in wound management to prevent wound infection. Inhibitory potential of framycetin dressing against Pseudomonas aeruginosa needs to be evaluated in order to find out whether this dressing can prevent pseudomonas wound infection or not. This research aims to determine inhibitory potential of framycetin dressing against Pseudomonas aeruginosa compared to paraffin dressing. In vitro test was conducted by exposing suspension of Pseudomonas aeruginosa to framycetin dressing and paraffin dressing. The suspension was diluted in ten time serial dilution. Plating on agar plates was done in duplo at exposure time of 0, 30 minutes, 2, 4, 6, and 24 hours. Growth of colonies on medium was evaluated and colonies on plates that are 10-150 in number were counted. The test was done in triplicate. Inhibitory potential of dressing is defined as its ability to inhibit bacterial growth, indicated by lower colony number in dressing exposed groups compared to positive control. The result of this experiment showed that framycetin dressing exhibited inhibitory potential at exposure time of 4, 6, and 24 hours. Optimal inhibitory potential of framycetin dressing was exhibited after 4 hours of exposure, when the only decrease in colony number throughout the incubation occured. Paraffin dressing exhibited its potential at 4 and 24 hours. The colony number of framycetin dressing exposed suspension was signifficantly lower than that of paraffin dressing after exposure time of 4 and 6 hours. In conclusion, framycetin dressing has better inhibitory potential compared to paraffin dressing especially within 4 to 6 hours of exposure. This result implicates that framycetin dressing may have the ability to prevent Pseudomonas aeruginosa infection. "

"Pseudomonas aeruginosa merupakan salah satu patogen terpenting yang menyebabkan infeksi nosokomial. Isolat P. aeruginosa sudah banyak yang resisten terhadap carbapenem yang juga berkaitan dengan resistensi terhadap antibiotik lain. Adanya P. aeruginosa yang resisten multiobat menyebabkan kesulitan dalam memilih pengobatan yang tepat. Terapi kombinasi dapat menjadi salah satu alternatif untuk menanggulangi keterbatasan monoterapi. Tujuan penelitian ini untuk mengetahui adanya sinergisme pada beberapa kombinasi antibiotik yang digunakan pada penelitian ini terhadap bakteri P. aeruginosa resisten carbapenem. Spesimen klinis yang terdiri dari sputum, bilasan bronkoalveolar, apusan luka, dan urin diambill dari ruang perawatan intensif Rumah Sakit Cipto Mangunkusumo. Isolat bakteri yang berasal dari spesimen klinis kemudian diidentifikasi dan diuji kepekaan. Isolat yang memenuhi kriteria inklusi diuji dengan metode checkerboard mikrodilusi untuk mempelajari efek kombinasi antibiotik antara amikacin dan ceftazidime, ceftazidime dan ciprofloxacin, serta amikacin dan ciprofloxacin. Dari 187 spesimen yang berasal dari 140 pasien diperoleh 16 isolat P. aeruginosa resisten carbapenem. Dari 16 Isolat P. aeruginosa yang resisten carbapenem yang diperiksa dengan uji checkerboard mikrodilusi sebanyak 13 isolat. Sebanyak 3 isolat yang terpapar kombinasi ceftazidime dan amikacin menunjukkan sinergisme dan 1 isolat yang terpapar kombinasi ceftazidime dan ciprofloxacin. Pada semua isolat yang terpapar kombinasi amikacin dan ciprofloxacin memperlihatkan indifference. Tidak ada antagonisme ditemukan pada ketiga kombinasi antibiotik ini. Berdasarkan penelitian ini, kombinasi ceftazidime dan amikacin masih dapat dipertimbangkan pada pasien dengan infeksi P. aeruginosa resisten carbapenem.

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Pseudomonas aeruginosa is one of the important nosocomial pathogens. Currently, many P. aeruginosa isolates are resistant to carbapenem and other antibiotics. The occurrence of multidrug resistance in P. aeruginosa, causes difficulties in choosing the appropriate treatment of infection by this bacteria. Combination therapy could be an alternative to overcome the limitations of monotherapy. The objective of this study is to observe the occurrence of synergistic effect in the antibiotic combinations that are used in this study in carbapenem resistant P. aeruginosa. Clinical specimens consisting of sputum, bronchoalveolar lavage, wound swab, blood and urine were obtained from the ICU of Cipto Mangunkusumo Hospital. Bacterial isolates from the clinical specimens were identified and examined for susceptibility pattern. Isolates that fulfill inclusion criteria was tested with checkerboard microdilution method to study the antibiotic combination effect between amikacin and ceftazidime, ceftazidime and ciprofloxacin, amikacin and ciprofloxacin. There From 187 specimens that were collected from 140 patients, 16 carbapenem resistant P. aeruginosa isolates were obtained. From 16 carbapenem resistant P. aeruginosa isolates, there were 13 isolates that tested with checkerboard microdilution method. The results showed synergistic effect in 3 isolates that were exposed to ceftazidime and amikacin combination, and in 1 of the isolates that were exposed to ceftazidime and ciprofloxacin combination. Indifference was observed in all isolates that were exposed to amikacin and ciprofloxacin combination. No antagonism was found among the three antibiotic combinations. Based on this study, ceftazidime and amikacin combination could be considered in patient with carbapenem resistant P. aeruginosa infection."

"Gangguan pemusatan perhatian dan hiperaktivitas GPPH merupakan sebuah gangguan yang bersifat kronik. GPPH merupakan penyakit yang disebabkan oleh berbagai faktor, seperti genetik dan lingkungan. Pola asuh orang tua diduga sebagai salah satu faktor risiko dari GPPH. Tujuan: Mengetahui hubungan antara pola asuh orang tua dengan GPPH pada siswa sekolah dasar di daerah Jakarta Pusat. Metode: Studi case control dilakukan terhadap 376 siswa SD Kenari 01,03, dan 05 pada periode tahun ajaran 2015-2016. Hasil: 108 28,7 siswa SD mengalami GPPH dan sebanyak 268 71,3 tidak mengalami GPPH. 314 83,5 orang tua menerapkan pola asuh demokratis dan sisanya sebanyak 62 16,5 orang tua menerapkan pola asuh lainnya pada anak. Secara statitstik tidak terdapat hubungan bermakna antara pola asuh orang tua dengan GPPH p = 0,464, uji chi square . Kesimpulan: Tidak terdapat hubungan bermakna antara pola asuh orang tua dengan GPPH pada siswa sekolah dasar.

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Introduction Attention deficit hyperactivity disorder ADHD is one of neurobehavioral chronic disorders and caused by some factors, including genetic and environment cause including parenting style. The objective of this study is to find whether parenting style applied by parents is related with ADHD. Methods case control study was done involving 376 elementary students in SD Kenari 01,03,05 on school year 2015 ndash 2016 using questionnaires given to parents and teachers to determine the parenting style used and presentation of ADHD. Results 108 28,7 elementary school students suffer from ADHD. 314 83,5 of parents apply authoritative parenting style to their children. There was no correlation statistically between parenting style and ADHD p 0.464 , chi square test . Conclusion Parenting style is not related with ADHD on elementary students. "

"Keselamatan pasien harus diajarkan sejak dini pada mahasiswa di bidang layanan kesehatan dan seharusnya menjadi bagian kurikulum. Penerapan pembelajaran keselamatan pasien berkaitan erat dengan manajemen pasien yang dihadapi, karena itu pembelajarannya perlu dilakukan pada tahap klinik pendidikan dokter gigi. Penelitian ini dilakukan untuk menganalisis proses pembelajaran keselamatan pasien di tahap klinik pendidikan kedokteran gigi FKG UNHAS. Penelitian ini merupakan penelitian kualitatif dengan rancangan studi kasus dengan melakukan analisis dokumen terkait rancangan pengajaran modul-modul praktik klinik, wawancara mendalam terhadap pengelola pendidikan, pengelola modul dan staf pengajar serta Focus Group Discussion FGD pada kelompok mahasiswa tahap klinik kedokteran gigi. Penelitian dilakukan pada bulan Februari-Mei 2016. Didapatkan bahwa tidak ada dokumen kurikulum yang lengkap mencantumkan pembelajaran keselamatan pasien dalam modul. Pengelola pendidikan dan staf pengajar menyadari pentingnya pembelajaran keselamatan pasien sejak tahap preklinik kemudian diaplikasikan pada tahap klinik. Variasi metode pembelajaran dan evaluasi hasil pembelajaran saat ini sulit disimpulkan karena sasaran pembelajaran terkait keselamatan pasien tidak eksplisit. Mahasiswa memahami keselamatan pasien berdasarkan pengalaman menjalani proses kepaniteraan tahap klinik dan dapat diajarkan kepada mahasiswa dengan beragam metode. Mahasiswa membutuhkan evaluasi formatif untuk mengasah dan mengukur kemampuan keselamatan pasien. Peningkatan kapasitas bagi para staf pengajar khususnya mengenai pembelajaran keselamatan pasien dan penyusunan modul agar pembelajaran keselamatan pasien menjadi komponen tertulis dalam kurikulum perlu dilakukan.

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Patient safety must be taught early to all students of health professions and should be a part of learning process in formal curriculum. The practice of patient safety learning is very relevant with patient care therefore, patient safety learning must be conducted in clinical years of dental education. This research is carried out to assess the process of patient safety learning in clinical years of dental education in the Faculty of Dentistry, Hasanuddin University.This is a qualitative research with case study design. The study utilizes document analysis on clinical practice modules, deep interviews with faculty administrators, modules administrators, lecturers, and Focused Group Discussion with clinical years dental students. The research is held on February May 2016. We find that there is no curriculum document which includes clear patient safety learning in the clinical modules . Faculty administrators and lecturers realize about the importance of patient safety learning since the preclinical year to be applied in the clinical years. Variety of the learning methods and the evaluations of leaning outcomes are inconclusive due to that the learning outcomes related to patient safety are not explicit. The students identified patient safety subjects through experience during their clinical years and the subjects are taught to them in many methods. The students also need formative evaluation to measure and sharpen their abilities in patient safety. Capacity building for academics on patient safety learning and explicitly written patient safety curriculum are needed."

"Latar belakang: Selama proses pendidikan, mahasiswa pendidikan dokter diharapkan mampu mengembangkan kemampuan critical thinking berpikir kritis , clinical reasoning penalaran klinis dan problem solving penyelesaian masalah . Perangkat kognitif tersebut ditopang oleh kemampuan metakognisi. Mahasiswa dengan metakognisi yang baik mampu mensinergikan pengetahuan yang dimiliki saat ini dengan strategi refleksi diri agar mencapai target belajar yang dikehendaki. Salah satu cara untuk mengetahui tingkat metakognisi mahasiswa adalah dengan Metacognition Awareness Inventory MAI . Sebelum menggunakan MAI dalam konteks pendidikan dokter, instrumen tersebut perlu divalidasi terlebih dahulu. Tujuan penelitian ini adalah untuk melakukan uji validitas dan reliabilitas MAI hasil adaptasi Bahasa Indonesia.Metode: Penelitian potong lintang untuk menilai gambaran MAI adaptasi Bahasa Indonesia pada mahasiswa pendidikan dokter tahap akademik. Penelitian ini melalui 3 tahap yaitu adaptasi bahasa, uji coba, dan penelitian utama. Penelitian melibatkan seluruh mahasiswa FK Universitas Malahayati Bandar Lampung pada semester 2, 4, dan 6. Data diperoleh dengan menyebarkan 1200 kuesioner MAI hasil adaptasi Bahasa Indonesia selama bulan Mei 2014. Data yang diperoleh dianalisis menggunakan SPSS dengan exploratory factor analysis EFA untuk mengetahui jumlah subskala baru sekaligus uji validitas dan reliabilitas.Hasil: Kuesioner yang memenuhi syarat analisis sebanyak 757 eksemplar. Hasil uji validitas konstruk bernilai bagus, dengan hanya 1 butir kuesioner yang drop out dari 52 butir. Nilai koefisien korelasi ke 51 butir berada pada rentang 0,158 s/d 0,561 diatas nilai ambang >0,074 df-2: 755 dengan taraf signifikansi 5 . Ekstraksi 5 komponen kognitif persiapan, pengawasan, pengelolaan, strategi, dan penilaian menggunakan analisis point of inflexion pada scree plots dengan metode ekstraksi principal component analysis PCA dan rotasi promax. Hasil koefisien alfa kuesioner MAI hasil adaptasi Bahasa Indonesia bernilai sangat baik pada 0.904.Kesimpulan: MAI hasil adaptasi Bahasa Indonesia memenuhi: 1 kriteria validitas konstruk, baik dari segi isi, proses respon, konsistensi internal, hubungan antar variabel, dan konsekuensi, 2 kriteria reliabilitas baik secara keseluruhan maupun persubskala. MAI hasil adaptasi Bahasa Indonesia valid dan reliabel untuk digunakan sebagai instrumen penilaian metakognisi dalam konteks pendidikan kedokteran tahap akademik.

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Background During educational process, medical students are expected to develop critical thinking, clinical reasoning, and problem solving. These cognitive attributes are supported by student rsquo s metacognition. Students with good metacognition are able to synergize the knowledge possessed today with a strategy of self reflection in order to achieve the desired learning targets. There are several ways to measure student rsquo s metacognition, one of which is Metacognition Awareness Inventory MAI . Before conducting research using MAI in the context of medical education, the instrument needs to be validated first. The purpose of this study was to test the validity and reliability of Indonesian version of MAI.

Method A cross sectional study was conducted to assess Indonesian version of MAI in academic phase of medical student. This research divided into three stages language adaptation, pilot study, and main research. The study involved all students of the Faculty of Medicine University of Malahayati Bandar Lampung from semester 2, 4, and 6. Data obtained by distributing 1200 questionnaires May of 2014. The data were analyzed using SPSS with exploratory factor analysis EFA to know the number of factor extraction new subscale and at the same time to test the validity and reliability of the questionnaire.

Result Remaining 757 questionnaires were eligible for analysis. Construct validity of the questionnaire are good. Only one item of the questionnaire was drop out. The correlation coefficient of the remaining 51 items are in the range of 0.158 to 0.561 which is beyond threshold value of 0.074 df 2 755 , significance level of 5 . A point of inflexion analysis on scree plots were used to decide the number of component to be extracted. Extraction method is principal component analysis PCA with promax rotation. The 5 extracted components are preparation, monitoring, regulation, strategy, and assessment of cognitive. Chronbach of the Indonesian version of MAI is very good at level of 0,904.

Conclusion Indonesian version of MAI not only meet the criteria for selected construct validity content and internal structure but also the criteria for reliable questionnaire as a whole set and some subscales. Indonesian version of MAI is valid and reliable to be used as an instrument for metacognition assessment in the context of medical education at academic phase."

"Latar belakang: Leukemia limfoblastik akut LLA merupakan jenis kanker tersering pada anak. Faktor penyakit dan kemoterapi dapat menyebabkan ketidakseimbangan nutrisi makro maupun mikro. Zinc adalah salah satu nutrien mikro yang memiliki banyak peran fisiologis dalam tubuh, namun kadarnya berkurang pada penyakit limfoproliferatif. Defisiensi zinc cenderung meningkatkan morbiditas pada anak LLA, salah satunya infeksi. Tujuan: Penelitian ini bertujuan untuk mencari proporsi defisiensi zinc pada LLA anak serta hubungannya dengan kejadian infeksi. Pasien dan metode: Disain penelitian potong lintang deskriptif-analitik, tempat pelaksanaan di Departemen Patologi Klinik dan Departemen Ilmu Kesehatan Anak RSUPN Dr. Cipto Mangunkusumo, Jakarta. Jumlah subjek 81 anak LLA, yang terdiri dari 26 pasien baru dan 55 pasien pada berbagai fase kemoterapi. Kadar zinc diukur menggunakan prinsip kolorimetri dengan alat spektrofotometer otomatis. Hasil: Proporsi defisiensi zinc pada pasien yang baru terdiagnosis sebesar 65.4 n= 26 dan pada pasien kemoterapi sebesar 49 n= 55 . Terdapat hubungan bermakna antara defisiensi zinc dengan kejadian infeksi p= 0.003; RR= 3.2, 95 CI 1.33 ndash; 7.69 Kesimpulan: Defisiensi zinc ditemukan pada anak dengan LLA sebelum kemoterapi dimulai, maupun pada berbagai fase kemoterapi. Risiko infeksi lebih besar pada anak LLA yang mengalami defisiensi zinc. Suplementasi zinc dapat dipertimbangkan untuk meningkatkan prognosis, namun perlu dilakukan penelitian lebih lanjut mengenai efektivitasnya.

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Background: Acute lymphoblastic leukemia ALL is a most common malignancy in children. Disease factors and chemotherapy effects may cause both macro or micro nutritional imbalance. Zinc is one of the micro nutrients that has many physiological roles in the body, but the levels may decrease in ALL. Zinc deficiency tend to increase morbidity in children with ALL, including infection.

Objective: The present study was done in order to find the proportion of zinc deficiency in pediatric ALL patients and to identify its relationship with the incidence of infection.

Patients and methods: This cross sectional study was carried out in the Departement of Clinical Pathology and Department of Paediatric Health, RSUPN Dr. Cipto Mangunkusumo, Jakarta. We conducted 81 paediatric ALL patients, consisted of 26 newly diagnosed and 55 in various phases of chemotherapy. Zinc levels were measured using colorimetric method by an automatic spectrophotometer.

Results: The proportion of zinc deficiency is 65.4 in newly diagnosed patients and 49 in children with various chemotherapy phases. There is a significant association between zinc deficiency and the incidence of infection p 0.003 RR 3.2, 95 CI 1.33 ndash 7.69.

Conclusion: zinc deficiency was found in children with LLA, and has significant association with the risk of infection. Zinc supplementation may be considered to improve the prognosis, however futher study of safety and side effect is necessary. "

"Latar Belakang: Anak dengan leukemia limfoblastik akut ALL yang bertahan hidup cenderung mengalami obesitas, yang meningkatkan risiko ALL relaps. Obesitas dipengaruhi oleh pemberian kortikosteroid dan kemoterapi, namun juga oleh faktor-faktor lain yang hubungannya dengan obesitas pada ALL belum secara konsisten dibuktikan. Tujuan: Penelitian ini bertujuan mengetahui hubungan usia saat diagnosis ALL, jenis kelamin, status gizi saat diagnosis ALL, kelas layanan kesehatan, kelompok risiko ALL, dosis kumulatif L-asparaginase dan jenis steroid, dengan kejadian obesitas setelah pengobatan ALL fase induksi. Metode: Penelitian ini merupakan studi observasional dengan desain potong lintang yang menggunakan data rekam medis pasien ALL tahun 2014-2016 di RSUP Dr. Cipto Mangunkusumo, Jakarta. Hasil: Dari 94 pasien ALL, 84,0 berusia.

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Background: Child survivors of acute lymphoblastic leukemia ALL showed a tendency to become obese, increasing the risk of relapse. Obesity is influenced not only by administration of corticosteroid and chemotherapeutic agents, but also by other factors with which the relationships have not been consistently proven.

Purpose: This study aims to investigate the relationships between age at ALL diagnosis, sex, nutritional status at diagnosis, class of service, ALL risk group, cumulative dose of L asparaginase and type of steroid, and post induction obesity.

Method: This is an observational, cross sectional study, using data from medical records of ALL pediatric patients during the years 2014 2016 at Cipto Mangunkusumo Hospital, Jakarta.

Results: Out of 94 ALL patients, 84.0 were aged "

"Screen time pada anak semakin meningkat seiring berkembangnya teknologi. Peningkatan screen time tersebut dapat menyebabkan sejumlah dampak, salah satunya adalah gangguan pola tidur. Penelitian ini menggambarkan hubungan screen time dengan pola tidur anak sekolah dasar di SDN Beji 1 Depok. Penelitian ini menggunakan studi potong lintang. Instrumen yang digunakan adalah Sleep Disturbance Scale for Children (SDSC) yang disebar ke seluruh murid SDN Beji 1 Depok dan diisi oleh orang tua atau pengasuh dengan tingkat pendidikan minimal Sekolah Menengah Pertama. Pengambilan sampel dilakukan secara acak dari 183 data sehingga didapat 100 data yang dianalisis. Hasil analisis Chi-Square menunjukkan adanya hubungan berbeda bermakna secara statistik antara screen time berlebih dengan gangguan pola tidur pada anak (p = 0,024). Anak dengan screen time berlebih memiliki peluang mengalami gangguan pola tidur 2,6 kali lebih tinggi dibandingkan anak dengan screen time tidak berlebih (OR = 2,6 dan IK 95% = 1,123-6,243). Berdasarkan hasil tersebut, disimpulkan bahwa terdapat hubungan antara screen time dengan pola tidur anak. Oleh karena itu, perlu dilakukan pembatasan screen time untuk mengurangi peluang terjadinya gangguan pola tidur.

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Screen time for children is increasing as technology develops. The increase in screen time can cause a number of impacts, one of which is a sleep pattern disorder. This study describes a screen time relationship to the sleep patterns of elementary school children at SDN Beji 1 Depok. A cross-sectional study was used for this research along with the Sleep Disturbance Scale for Children (SDSC) instrument, which was filled by parents and/or caregivers with a minimum educational background of junior high school. A total of 183 datasets collected, and 100 of those were sampled for analysis.

The results of Chi-square analysis showed a statistically significant relationship between screen time and sleep pattern disorder (p = 0.024). Children with excessive screen time have 2.6 times higher risk of having sleep pattern disorder (OR = 2.6 and IK 95% = 1.123-6.243). Based on these results, it can be concluded that there is a relationship between screen time and childrens sleep pattern. Therefore, screen time restriction is needed to reduce the chance of sleep pattern disorder."

"Tingginya screen time anak telah meningkatkan kesadaran masyarakat mengenai dampak negatif dari screen time. Beberapa penelitian mengasosiasikan gejala gangguan pemusatan perhatian dan hiperaktivitas (GPPH) dengan screen time berlebih. Penelitian ini bertujuan untuk melihat hubungan antara screen time dengan gejala GPPH pada anak. Penelitian ini menggunakan desain potong lintang dan kuesioner Skala Penilaian Perilaku Anak Hiperaktivitas Indonesia (SPPAHI) yang diisi oleh orang tua dengan latar belakang pendidikan minimal SMP atau sederajat. Kuesioner disebarkan ke seluruh murid SD Negeri Beji 1 Depok dan didapatkan total 227 data, data yang ada lalu dipilih secara acak dan didapatkan 95 data untuk dianalisis. Hasil analisis Chi-Square menunjukkan adanya hubungan yang bermakna secara statistik antara screen time dengan gejala GPPH pada anak (p = 0,035). Anak dengan screen time berlebih memiliki peluang mengalami GPPH 3,1 kali lebih tinggi dibandingkan anak dengan screen time tidak berlebih (IK 95% = 1,051-9,174). Oleh karena itu, perlu dilakukan pembatasan screen time untuk menurunkan peluang terjadinya GPPH pada anak.

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High level of screen time among children has raised public awareness about its negative impact. Some studies associate attention deficit and hyperactivity disorder (ADHD) with excessive amount of screen time. The objective of this research is to analyze the association between screen time and ADHD symptoms in children. A cross sectional study was used for this research along with SPPAHI questionnaire, which was filled by parents with a minimum educational background of junior high school. The questionnaire was distributed to all students of SD Negeri Beji 1 Depok and a total of 227 data were collected, 95 data were selected randomly and used as sample for data analysis.

These data were analyzed using Chi-square test and showed a significant relationship between screen time and ADHD symptoms in children (p = 0.035). Children with excessive amount of screen time are 3.1 times more likely to develop ADHD than children who do not have excessive amount of screen time (95% CI = 1.051-9.174). Therefore, screen time limitation is needed to reduce the odds of developing ADHD in children."