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All Journal Kesmas: Jurnal Kesehatan Masyarakat Nasional Sari Pediatri Paediatrica Indonesiana Jurnal Plastik Rekonstruksi Medica Hospitalia ASEAN Journal of Community Engagement Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation JKKI : Jurnal Kedokteran dan Kesehatan Indonesia

Luh Karunia Wahyuni, Luh Karunia

Departemen Ilmu Kesehatan Fakultas Kedokteran Universitas Indonesia Anak/Rumah Sakit Cipto Mangunkusumo, Jakarta

Author-ID : 3459016

Civil Engineering, Building, Construction & Architecture Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Health Professions Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Other

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Speech Outcome Evaluation After Two-Flap Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital: A Retrospective study Bangun, Kristaninta; Handayani, Siti; Djoenaedi, Intania; Wahyuni, Luh Karunia
Jurnal Plastik Rekonstruksi Vol. 1 No. 2 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

One of the primary goal of cleft palate repair is to provide an intact mechanism for normal speech production. The purpose of this study is to evaluate the two-flap mucoperiosteal palatoplasty procedure on speech outcomes in patients undergoing surgical repair before the age of 2 years. A retrospective analysis study was done on 22 children with complete unilateral cleft palate (with or without cleft lip) who underwent two-flap palatoplasty between year 2002 to 2006 at Cipto Mangunkusumo Hospital. Evaluation was performed by a speech pathologist for pattern of articulation, hypernasality, intelligibility, and velopharyngeal competence. Palatoplasty were performed after 2 year-old in 11 patients and before 2 year-old in 11 patients. Speech of the 22 children postpalatoplasty was evaluated perceptually from standardised tape recordings. Velopharyngeal competence in patients who underwent palatoplasty before 2 year-old compared to after 2 year-old were 72.7% good, 18.2% fair and 9.1% poor versus 54,5% good, 9,1% fair and 36,4% poor respectively. Two-flaps mucoperiosteal palatoplasty performed before the age of 2 years old shows better spepolech outcome in all parameters, although the numbers are not statistically significant. Further prospective study with larger sample is needed.

HEALTH CARE SERVICE FOR LEPROSY PATIENTS IN SITANALA TANGERANG (A PROPOSED APPROACH OF COMPREHENSIVE HEALTH CARE FOR LEPROSY PATIENT) Irawati, Yunia; Lestari, Yeni Dwi; Bani, Anna Puspitasari; Menaldi, Sri Linuwih; Wahyuni, Luh Karunia; Kurniawardhani, Dewinta Retno
ASEAN Journal of Community Engagement Vol. 2 No. 2 (2018)
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Based on WHO data, Indonesia has the third largest leprosy burden in the world, afterIndia and Brazil. Although leprosy was declared to be eliminated in severalprovinces, there are still several leprosy settlements spread in Indonesia. Oneof these settlements is Neglasari village in Tangerang City, West Java, whereleprosy patients have been living since 1981. There is a scarcity ofinformation regarding the features of leprosy in Indonesia, especially aboutthe description of the patientsâ€™ posttreatment condition in terms of bothclinical sequelae and health services provided. A collaboration betweenmultiple departments of Ophthalmology, Dermatovenereology, and MedicalRehabilitation from the Cipto Mangunkusumo Hospital/Universitas Indonesia,Jakarta, was established in the form of a health service program to determinethe number and features of disabilities of ex-leprosy patients. We providehealth services, including physical examinations, extend free medication andeye glasses, and impart knowledge about the chronic complications to patientsand local cadres. A nonroutine health service program for leprosy patients wasconducted in Neglasari village, which performed four primary activities ofpromotive, preventive, curative, and rehabilitative. The program included atotal of 260 patients, with a mean age of 50.45 Â± 10.15 years and most of thembeing males (60.4%). A duration of >5 years of leprosy was found in 47% ofsubjects, and 96% of them have been released from treatment. Disabilitiescomprised 52.5% in the eye, 87.7% in the hand, and 92% in the foot. In total,65% of the patients had an uncorrected visual acuity of normal to mildimpairment, whereas 5.8% were blind. Eye abnormalities included madarosis(43.9%), entropion (41%), cataract (26%), corneal hypoesthesia (20.6%),trichiasis (17.8%), and lagophthalmos (15.1%), and examination of theextremities revealed that 16% of the subjects had an amputated foot. Spectacleswere successfully distributed to 100% of patients who were visually correctable.This proposed model for leprosy health care program involving multidisciplinaryexpertise is effective for screening numerous disabilities in leprosy patientsat one time. This enables caretakers to determine a holistic management that atthe end is intended to improve the quality of life of patients.

Prevalens dan Faktor Prediktor dari Kemampuan Berjalan Pasien Palsi Serebral pada Masa Anak di Rumah Sakit Cipto Mangunkusumo dan Yayasan Pembinaan Anak Cacat Primo Parmato; Luh Karunia Wahyuni; Aryono Hendarto
Sari Pediatri Vol 16, No 1 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Permasalahan palsi serebral (PS) yang menjadi perhatian bagi orangtua adalah kemampuan berjalan.Tujuan. Mengetahui prevalens kemampuan berjalan pasien PS dan faktor prediktor yang berhubungan terhadap kemampuan berjalan pasien PS pada masa anak.Metode. Dilakukan penelitian terhadap 102 pasien PS berusia 6 tahun ke atas dengan pengisian kuesioner melalui wawancara orang tua dan melihat rekam medis di RSCM dan YPAC.Hasil. Duapuluh tujuh (26,5%) pasien berjalan tanpa alat bantu, 13 (12,7%) pasien berjalan dengan alat bantu, dan 62 (60,8%) pasien tidak berjalan walau dengan alat bantu. Faktor prediktor yang bermakna secara statistik adalah mampu duduk tanpa topangan sebelum usia 2 tahun (p<0,001; OR=6,89; IK 95%=2,42-19,71) dan tipe PS spastik unilateral (OR=7,36; IK 95%=1,86-29,18).Kesimpulan. Prevalens kemampuan berjalan pasien PS di RSCM dan YPAC adalah 26,5% berjalan tanpa alat bantu, 12,7% berjalan dengan alat bantu, dan 60,8% tidak berjalan walaupun dengan alat bantu. Faktor prediktor yang berhubungan dengan kemampuan berjalan pada masa anak adalah mampu duduk tanpa topangan sebelum usia 2 tahun dan tipe spastik unilateral.

Feeding difficulties in children with cerebral palsy Hikari Ambara Sjakti; Damayanti Rusli Syarif; Luh Karunia Wahyuni; lmral Chair
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.224-9

Background Children with cerebral palsy (CP) often have feedingdifficulties due to their disability. This results in inadequate calorieintake which finally leads to malnutrition. Several studies foundthat 30-90% of children with CP have feeding difficulties associ-ated with malnutrition. There has been no sufficient publisheddata about this problem in Indonesia.Objective To determine the prevalence of feeding difficulties andmalnutrition in children with CP.Methods A cross-sectional study was done from January toSeptember 2005 in the pediatric outpatient clinic of Dr. CiptoMangunkusumo Hospital (CMH). Children with CP underwentnutritional and feeding difficulties assessment. Nutritional sta-tus was determined by the ratio of body weight to body heightstandardized to CDC-NCHS 2000 growth curve and wereclassified based on Waterlow. Calorie intake was evaluated bydietary analysis and defined as adequate if it reached 13.9 kcal/em BH Â± 10%. Feeding difficulties assessment included historytaking, physical examination and observation of feeding skill inthe outpatient clinic.Results Fifty-five children with CP were included in this study,most of them were spastic type, mainly spastic diplegic and spasticquadriplegic cerebral palsy (SQCP). Malnutrition was found in76% subjects, most were SQCP. Feeding difficulties were found in76% subjects, half of them were SQCP, 38% with spastic diplegic.Thirty- eight percents of the parents whose children had feedingdifficulties was not aware of these problems in their children.Parallel with data above, 78% subjects received inadequatecalorie intake.Conclusions The prevalence of undernourished and severemalnutrition in children with CP is 66% and 11% respectively.Malnutrition in CP patients tends to be related with inad-equate calorie intake due to feeding difficulties that is found in78% subjects especially those with SQCP

Six-minute Walk Test in Children with Cerebral Palsy: Comparing the Walking Distance between Different Level of Communication Function Budiati Laksmitasari; Luh Karunia Wahyuni; Tirza Z Tamin
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 02 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Introduction: Children with cerebral palsy (CP), six-minute walk test (6MWT) is more difficult to perform because some children have communication impairment. The objective to study the distance of 6MWT among different level of communication in children with CP.Methods: This study was cross-sectional study , in a Rehabilitation Clinic, on Juli to December 2018. The subjects were children aged 7-18 years old with cerebral palsy with Gross Motor Function Classification System (GMFCS) I-III, Communication Function Classification System (CFCS) I-III, able to walkindependently with or without aid, and understand the instruction of 6MWT. All the subjects performed 6MWT. Level of communication function was evaluated by CFCS. The 6MWD between CFCS groups were compared.Results: There were 23 subjects mean aged 9 years old, consisted of 17(73.9%) male and 6(26.1%) female, with GMFCS level I-III in sequence were 3(13%), 11(47.8%), and 9(39.1%), also with CFCS level I-III in sequence were 5(21.7%), 7(30.4%), and 11(47.8%). Subjects with verbal communicationwere 14(60.9%) and nonverbal communication were 9(39.1%). The median of 6MWD in group with CFCS level I, II, and III respectively were 115 (60-282), 161 (17.5-281), and 135 (23-280) m. There was no significant difference in 6MWD between different groups of CFCS (p=0.960).Conclusion: There were no difference in walking distance on 6MWT among different level of communication function in children with CP.Keywords: Cerebral palsy, Six-minute walk-test, Six-minute walking-distance, Communication Function Classification System (CFCS)

Associations among the Degree of Hip Adductor Spasticity, the Level of Gross Motor Function Classification System (GMFCS) and the Migration Percentage in Children with Cerebral Palsy Lindrawati Tjuatja; Luh Karunia Wahyuni; Aryadi Kurniawan; Damayanti Sekarsari; Hamzah Shatri
Indonesian Journal of Physical Medicine & Rehabilitation Vol 5 No 01 (2016): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives : This study was aimed at detecting the occurrence of hip dislocation in children with cerebral palsy (CP) by seeking the association among the degree of hip adductor spasticity, level of Gross MotorFunction Classification System (GMFCS) and Migration Percentage (MP).Methods : It was a cross sectional study with inclusion criterias were children with cerebral palsy, both male and female aged 2-10 years old, and parent’s approval by signing informed consent. Exclusion criterias werecomorbidities of other neuromotor impairments, such as spina bifida; other neuromuscular or musculoskeletal diseases, etc; uncooperative; and presenting severe diseases at the day of assessment. Measurement methodsincluded the Modified Tardieu Scale (MTS) R2, R1 and R2-R1 components to measure hip adductor spasticity; Gross Motor Function Classification System (GMFCS) protocol to assess gross motor ability; andAnterior-Posterior (AP) pelvic plain radiograph to calculate the Migration Percentage (MP) value.Results : At the initial phase, 31 children were included, however only 57 legs were analyzed for hip adductor spasticity and MP. There were no correlation between the degree of hip adductor spasticity and MPboth the R2 with MP (r = -0.060; p = 0.658), and R1 with MP (r = -0.136; p = 0.314). Moreover, there was insignificant difference between level of GMFCS and MP (p = 0.831).Conclusion : This study indicates nill correlation between the degree of hip adductor spasticity and the MP, and insignificant difference between the level of GMFCS and MP to detect the occurence of hip dislocationin children with cerebral palsy.Keywords : Modified Tardieu Scale, R2, R1, level of GMFCS, AP pelvic plain radiograph, MP value.

Rehabilitation management of pediatric post-Covid 19 syndrome: A case report Rizky Kusuma Wardhani; Luh Karunia Wahyuni; Budiati Laksmitasari; Clements Clements; Skolastika Mitzy Benedicta
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 1, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss1.art13

Indonesia is one of the countries with highest rate of COVID infection in pediatric population. Although the symptoms of acute COVID infection in children are mostly mild, several studies report frequent post-COVID persisting symptoms in pediatric population, causing limitations in daily activities. This case report discusses rehabilitation therapy in a 12 years old child diagnosed with post-COVID syndrome. Rehabilitation therapy in the form of breathing exercise, muscle strengthening, and aerobics exercise can improve subjective complaints, cardiopulmonary endurance, and quality of life at two weeks follow-up. Further research is needed to determine the correlation between rehabilitation therapy and the outcome of children with post-COVID 19 syndrome.

A comparison of objective and subjective measurements of non-nutritive sucking in preterm infants Luh Karunia Wahyuni; Irawan Mangunatmadja; Risma Kerina Kaban; Elvie Zulka Kautzia Rachmawati; Melinda Harini; Budiati Laksmitasari; Agatha Geraldyne; Inez Ayuwibowo Sangwidjojo; Dini Prima Utami; Victor Prasetyo Poernomo; Adrian Prasetya Sudjono
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.274-81

Background Of preterm infants born before 32 weeks of gestation, 40-70% have atypical and immature feeding skills, which could delay initiation of oral feeding. A formal objective measurement of non-nutritive sucking may increase the accuracy of determining the right time to initiate oral feeding, however, most hospital perinatology care units do not own a suction pressure measurement device to objectively measure non-nutritive sucking parameters. Objective To compare objective and subjective non-nutritive sucking (NNS) based on sucking pressure, number of suctions per burst, and time between bursts. Methods One hundred twenty preterm infants born at 28-34 weeks’ gestation were evaluated for objective and subjective NNS. Data were collected from August to November 2021 at five hospitals in Jakarta. Objective NNS was measured by a suction pressure measurement device, while subjective NNS was clinically examined. Number of suctions per burst, sucking pressure, and time between bursts were analysed by Spearman’s correlation test. Results A positive and significant correlation between objective and subjective NNS was found in all parameters (P<0.001). The highest correlation was found in time between bursts (r=0.74; P<0.001), followed by number of suctions per burst (r=0.60; P<0.001), and sucking pressure (r=0.58; P<0.001). Conclusion The correlation between objective and subjective NNS examination was moderate in preterm infants. Therefore, an objective NNS measurement is still required for optimizing the examination.

Non-nutritive sucking milestones of preterm infants in Indonesia: a descriptive study Luh Karunia Wahyuni; Irawan Mangunatmadja; Risma Kerina Kaban; Elvie Zulka Kautzia Rachmawati; Melinda Harini; Budiati Laksmitasari; Agatha Geraldyne; Inez Ayuwibowo Sangwidjojo; Dini Prima Utami; Victor Prasetyo Poernomo; Adrian Prasetya Sudjono
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.311-7

Background Non-nutritive sucking (NNS) maturity has been used as one of the markers of oral feeding readiness in infants. Prematurity may hinder the attainment of NNS milestones. Depending on gestational age (GA) at birth, preterm infants may display various degrees of immaturity, potentially affecting the strength, coordination, and efficiency of skills required for NNS. Objective To identify the progression of NNS patterns across gestational age groups of preterm infants in Indonesia by comparing NNS parameters between moderate-to-late preterm and very preterm infants. Methods NNS evaluation was conducted in 120 preterm infants born at 28-34 weeks gestational age in five tertiary hospitals in Jakarta, Indonesia. Three aspects of NNS (suction pressure, number of suctions per burst, and time between bursts) were documented and arranged to present a descriptive overview. A suction pressure measurement device was used to record, identify, and analyze NNS parameters. We hypothesize that maturity, as determined by GA, positively affected the attainment of NNS milestones. Results Moderate-to-late preterm infants (GA 32 to <37 weeks), compared to very preterm infants (GA 28 to <32 weeks), had higher mean NNS pressure (-79.8 vs. -72.7 mmHg, respectively, P=0.041) and shorter mean time between bursts (6.63 vs. 7.36 s, respectively, P=0.030). Mean number of suctions per burst were also significantly different between the two GA groups (8.90 vs. 8.99 sucks/burst, respectively, P=0.048). Conclusion Maturity, as reflected by GA, had a positive effect on the attainment of NNS milestones in preterm infants in Indonesia. Significant differences in the three NNS parameters: number of suctions per burst, time between bursts, and suction pressure were found between moderate-to-late preterm and very preterm infants.

Stigma and Prosthetic Rehabillitation Chalange for Leprosy Survivor in Pandemic Situation Melinda Harini; Steven Setiono; Luh Karunia Wahyuni; Sri Linuwih Menaldi; Satyanaya Widyaningrum; Edbert Wreksoatmojo
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 02 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i02.258

Indonesia ranks third in terms of countries with the highest number of leprosy in the world. This fact hasn't changed since 20 years ago. This shows the magnitude of leprosy management problems, both at the world level and national level. These problems range from the problem of finding new cases, continuity of the provision of various drug regimens, and control of the spread. In addition to problems related to the detection and handling of new cases, there are also problems in leprosy survivors. Survivors generally have disabilities due to the disease. The disability can continue to be aggravated over time, even though leprosy itself has healed long since. These disabilities vary from numbness, paralysis, shortened and claw-like fingers on the hands and feet, wounds resulting in amputations of the nose, ears, fingers and limbs. Such problems require a complete and continues management. Meanwhile, the management of leprosy, both in patients and survivors, has challenges both in terms of medical, policy, financing, and culture. Not to mention the challenges related to low socialistism, not many Indonesians know the problem of leprosy, especially knowing the magnitude of the problem. Pandemic conditions make things worse. This case report will explain the journey of leprosy survivor who has been amputated and has rehabilitation related to the maintenance and replacement of leg prosthetic in pandemic situation. It will describe the stigma, medical, and socioeconomic challenges that he has to go through. This case report is expected to be an inspiration in improving public, academics, policy makers, and stakeholder awareness, related to leprosy handling problems in Indonesia, both problems for patient and survivors. Thus, it is ultimately expected to reduce the level of disability, promote equal rights for people with disabilities, and support the realization of leprosy elimination nationally and internationally.

Co-Authors Adrian Prasetya Sudjono Agatha Geraldyne Aldri Frinaldi Aryono Hendarto Bangun, Kristaninta Bani, Anna Puspitasari Boya Nugraha Budiati Laksmitasari Clements Clements Damayanti Rusli Syarif Dini Prima Utami Djoenaedi, Intania Edbert Wreksoatmojo Elfrida Ratnawati Grace Wangge, Grace Hikari Ambara Sjakti, Hikari Ambara Ika Fitriana Indri Wijayanti Inez Ayuwibowo Sangwidjojo Irawan Mangunatmadja Irawan Mangunatmadja Irawati, Yunia Kreshanti, Prasetyanugraheni Kurniawardhani, Dewinta Retno Lindrawati Tjuatja lmral Chair Melinda Harini Melinda Harini Melinda Harini Melinda Harini Mellisya Ramadhany Octaviany Hidemi Peggy Sunarjo Primo Parmato Putra, Johanes Rachmawati, Elvie Zulka Kautzia Risma Kerina Kaban Risma Kerina Kaban Rizky Kusuma Wardhani Sari, Vania Aramita Satyanaya Widyaningrum Siti Handayani Skolastika Mitzy Benedicta Sri L. Menaldi Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Steven Setiono Tedjasukmana, Deddy Tirza Z Tamin Tirza Z Tamin Victor Prasetyo Poernomo Wardhani, Rizky Kusuma Yeni Dwi Lestari

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