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All Journal Jurnal Kedokteran Syiah Kuala Jurnal Kesehatan Hesti Wira Sakti Indonesian Journal of Urology Folia Medica Indonesiana Jurnal NERS Indonesian Journal of Tropical and Infectious Disease Indonesian Journal of Cancer The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Health Notions Jurnal Respirasi (JR) Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Green Medical Journal Indian Journal of Forensic Medicine & Toxicology Asian Journal of Health Research

I Dewa Gede Ugrasena

Department Of Child Health, Faculty Of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, East Java, Indonesia

Author-ID : 2762736

Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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PENURUNAN KECEMASAN DAN KOPING ORANG TUA DALAM MERAWAT ANAK YANG MENGALAMI HOSPITALISASI MELALUI PENERAPAN CARING SWANSON DI RS MARDI WALUYO BLITAR Rahmawati Maulidia; I Dewa Gede Ugrasena; Yuni Sufyanti
Jurnal Kesehatan Hesti Wira Sakti Vol. 4 No. 1 (2016)
Publisher : Institut Teknologi, Sains, dan Kesehatan RS dr. Soepraoen Malang

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

ABSTRAK Pendahuluan: Hospitalisasi pada anak dapat menimbulkan stress baik pada anak maupun orang tua. Kecemasan pada orang tua menimbulkan suatu mekanisme koping yang nantinya diperlukan dalam mengatasi suatu stress. Salah satu upaya untuk meminimalkan kecemasan dan koping orang tua tersebut dengan mengoptimalkan peran perawat dalam memberikan informasi dan dukungan kepada orang tua melalui penerapan caring. Metode: Penelitian ini menggunakan metode Pre-experimental One Group Pret-Post test Design yang bertujuan untuk mengetahui adanya penurunan kecemasan dan peningkatan koping orang tua pasien anak dengan adanya perilaku caring Swanson. Sampel yang digunakan 14 orang perawat dengan teknik total sampling dan 47 orang tua pasien dengan teknik purposive sampling. Variabel independent penelitian ini adalah perilaku caring perawat sedangkan variable dependentnya kecemasan dan koping orang tua pasien. Responden perawat mendapat perlakuan intervensi berupa sosialisasi dan bimbingan perilaku caring Swanson sedangkan responden orang tua mendapatkan intervensi perilaku caring Swanson oleh perawat ruangan di IRNA Nusa Indah Mardi Waluyo Blitar. Data penelitian ini di olah menggunakan uji Paired t test. Hasil dan analisa: Hasil menunjukkan bahwa nilai p adalah 0,000 (

Determinant Factors of Depression in Beta Major Thalassemia Children Ahmad Suryawan; Hapsari Widya Ningtiar; Irwanto Irwanto; I Dewa Gede Ugrasena
Folia Medica Indonesiana Vol. 57 No. 1 (2021): March
Publisher : Universitas Airlangga

Thalassemia is a chronic disease with long-term treatment that increases the potential for impact on physical, cognitive, and psychological conditions. About 80% of patients with major thalassemia have at least one psychiatric disorder, depression is one of the most frequently reported, especially in prepubertal and puberty periods. The aim of this study is to evaluate determinant factors of depression in beta mayor thalassemia children. This was a cross-sectional study on patients aged 9 to 17 years at hematology outpatient clinic in Dr. Soetomo General Hospital from September to Desember 2018. Level of depression determinded by Children Depression Inventory (CDI) questionnaire. The data were collected and analyzed using using the IBM SPSS Statistics version 21. It is statistically significant with p<0.05. Forty-five participants were included in this study, 15 participants with mild depression and 30 participants without depression. Gender (p=0.462), age of diagnosis (p=0.385), frequency of tranfussion (p=0.065), family history of depression (p=0,350), physical change (p=0.711), duration of illness (p=0.674) have no significant value as a determinant factor while complication (p=0.049) and serum cortisol level (p=0.037) had significant value as determinant factors of depression in Beta Major Thalassemia children. Mild depression is more common in thalassemia patients who experience complications and had high serum cortisol levels

The Development of Model Family-Centered Empowerment on Caring for Children with Leukemia Yuni Sufyanti Arief; Nursalam Nursalam; I Dewa Gede Ugrasena; Shrimarti Rukmini Devy; Eileen Savage
Jurnal Ners Vol. 13 No. 1 (2018): April 2018
Publisher : Universitas Airlangga

Introduction: Children with leukemia desperately need serious attention, commitment and it is a hard struggle for family members. Powerlessness experienced by the family will affect the ability of the families to provide care for their children. Many factors can affect the empowerment of families in providing care to their families.Methods: The purpose of this study was to develop a family-centered empowerment model related to the family's ability to care for their child suffering from leukemia. The research design used was an explanation survey. The sample consisted of 140 families with children suffering from leukemia in the pediatric ward of Dr. Soetomo Hospital.Results: The family-centered empowerment model was formed from the family factor, patient factor and nurse factor. The greatest effect was on the nurse factor, with the T statistic value = 6.590.Conclusion: Family factors and nurse factors need to be taken into account in family-centered empowerment. The patient factor has little influence on family empowerment in relation to caring for children. More research is needed on family-centered empowerment models in relation to their ability to care for children with leukemia. For example, a nurse providing a nursing intervention, especially a pediatric nurse, in relation to empowering a parent at the time of caring for their child with leukemia.

Reliability of Different RBC Indices and Formulas in the Discrimination of ?-Thalassemia Minor and Iron Deficiency Anemia in Surabaya, Indonesia Yulia Nadar Indrasari1 , Yetti Hernaningsih1 , Munawaroh Fitriah1 , Arifoel Hajat1 , I Dewa Gede Ugr
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i1.13543

In this study, we evaluated the RBC indices in differentiating ?-thalassemia minor and iron deficiencyanemia in a healthcare center. This was an observational analytic study with a cross-sectional design usingblood specimens of children aged 3 years to 17 years with microcytic hypochromic anemia based onthe results of complete blood counts and evaluation of peripheral blood smears. Calculation of the RBCindices was performed as an initial screening to differentiate ?-thalassemia minor and iron deficiencyanemia. Iron profile examination and hemoglobin electrophoresis were performed to confirm the diagnosisof ?-thalassemia minor and iron deficiency anemia. The results of the independent samples t-test showedsignificant differences in Hb, MCV, MCH, and MCHC between ?-thalassemia minor and iron deficiencyanemia (p <0.05). The results of the Mann Whitney test showed a significant difference in the MentzerIndex to distinguish between ?-thalassemia minor and iron deficiency anemia (p <0.05). Also, the resultsof the independent samples t-test showed significant differences in the Green & King formula, Sirdah etal. formula, and the Maltos and Carvalho Index (p <0.05). The Green and King formula has a diagnosticsensitivity of 78.6% and a specificity of 76.6% and an accuracy of 78.03%. Various formulas based on theresults of complete blood count parameters have been developed to detect ?-thalassemia minor in areas witha high prevalence of ?-thalassemia with different sensitivity and specificity. In this study, it showed that theGreen and King formula has a diagnostic sensitivity of 78.6% and a specificity of 76.6%, and an accuracyof 78.03%. Green and King’s formula can be applied as an initial screening to differentiate ?-thalassemiaminor and iron deficiency anemia

Epidemiological Study of Clinical and Laboratory Profiles of Patients with Acute Lymphoblastic Leukemia at Dr. Soetomo Hospital Surabaya Kezia Warokka Putri; I Dewa Gede Ugrasena; Yetti Hernaningsih
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Introduction: Considering the high number of acute lymphoblastic leukemia (ALL) and it being the type of cancer with the highest fatality rate among the children, this study seeks to determine the epidemiological description of the clinical and laboratory profiles of patients with ALL.Methods: This research used a descriptive study by using medical data record of patients with ALL. The research variables were gender, age, leukemia history of the patient’s family, nutritional status, symptoms and signs, laboratory examination, ALL subtypes, risk factors, and result outcomes. All data presented descriptively.Results: From a total of 50 patients, 54 % of them were male aged 1,5 – 10 years old. 84% of the patients’ family had no medical record related to leukemia. 42% of the patient malnutrition. Pale (78%), fever (64%), pain (32%), hepatomegaly (38%), lymphadenopathy (28%), splenomegaly (26%), patients with anemia (82%), leukocytosis (38%), thrombocytopenia (54%). The highest types were ALL–LI (68%), SR-ALL (54%), and remission outcome reached 82%.Conclusion: Insidence higher in male, aged 1,5 – 10 years old, malnourished at the start of the diagnosis. Most of the patients’ family had no medical history of leukemia. Symptoms and medical signs mostly appeared were pale, fever, and bone/joint pain. The physical examination showed hepatomegaly, lymphadenopathy, and splenomegaly and laboratory first test showed the patients had anemia, leukocytosis, and thrombocytopenia.

The discrepancy between manual and computerized leukocyte and thrombocyte counts Bambang Permono; Retno Asih; I Dewa Gede Ugrasena
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background Discrepancy between results of leukocyte and throm-bocyte count by computerized and manual examination may existObjective To determine the discrepancy between computerizedand manual leukocyte and thrombocyte count.Methods The design was a randomized sampling cross sectionalstudy. The blood sample was examined with computerized CellDyn 1400 instrument for the leukocyte and thrombocyte count. Formanual examination, blood smear was performed to measurethrombocyte while leukocyte was measured in Improved Neubauerhemocytometer. The results of computerized examination wereused as gold standard. Sensitivity, specificity, predictive values ofmanual count were calculated. The agreement of Kappa and McNemar test were determinedResults Blood specimens drawn from 100 patients with differentkinds of diagnoses were examined using computerized and manualmethods. In computerized group, 66% had normal leukocyte and55% had normal thrombocyte count. In the manual group, 78% ofsubjects had normal leukocyte and 82% had normal thrombocytecount. From leukocyte examination, the sensitivity of manual countwas 87.9%, specificity was 41.2%, and positive predictive valuewas 74.36 with the agreement of Kappa of 0.32 and Mc Nemarvalue of 0.036. From thrombocyte examination, the sensitivity was96.4%, specificity was 35.6%, and positive predictive value was64.6 with the agreement of Kappa of 0.41 and Mc Nemar value of0.41.Conclusion The result of manual thrombocyte count was in ac-cordance with computerized with the agreement of Kappa of 0.41.On the other hand, there was a discrepancy between manual infavor of computerized leukocyte count with the agreement of Kappaof 0.32

Pedigree analysis of glucose-6 phosphate dehydrogenase (G6PD) deficiency of a Javanese Chinese family in Indonesia IDG Ugrasena; Taku Shirakawa; Kaoru Nishiyama; Masafumi Matsuo
Paediatrica Indonesiana Vol 41 No 1-2 (2001): January 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.1.2001.56-9

The molecular and pedigree analyses in a Javanese Chinese family were carried oul on glucose-6-phosphate dehydrogenase deficiencies. By method of Â MPTP scanning without the sequencing steps, those variants could be confirmed. Two out of three sons were clinically jaundiced at birth due to G6PD deficiency and identified to have a G to T nucleotide change al 1376th nucleotide 01 the G6PD gene (GI376T), corresponding to G6PD Canton. Another son was also identified to have a C to T nucleotide change at 1311st nucleotide 01 the G6PD gene (CI311T), corresponding to a Silent mutation. Their father was normal, but their mother obsorved to have the heleromutation 01 G1376T (G6PD Canton and C1311T (a Silent mutation).

CD4+ T-cell, CD8+ T-cell, CD4+ /CD8+ ratio, and apoptosis as a response to induction phase chemotherapy in pediatric acute lymphoblastic leukemia May Fanny Tanzilia; Andi Cahyadi; Yetti Hermaningsih; Endang Retnowati; I Dewa Gede Ugrasena
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Background Acute lymphoblastic leukemia (ALL) is a neoplastic disease resulting from somatic mutation in the lymphoid progenitor cells, often occuring in children aged 2-5 years, predominantly in males. Results from the induction phase of chemtherapy are used to measure success, but the failure remission rate is still high. Increased apoptosis of cancer cells, as induced by CD4+ and CD8+T-cells, is an indicator of prognosis and response to chemotherapy.Objective To assess for correlations between CD4+, CD8+, or CD4+/CD8+ ratio to the chemotherapy induction phase response (i.e., apoptosis) in pediatric ALL patients.Methods This observational analytical cohort study was done in 25 pediatric ALL patients. Whole blood (3 mL) with EDTA anticoagulant were used to measure absolute counts of CD4+, CD8+, and CD4+/CD8+ ratio. Peripheral blood mononuclear cells (PBMC) were examined for apoptosis. The principle of CD4+, CD8+ examination was bond between antigens on the surface of the leukocyte in the blood with fluorochrome labeled antibodies in the reagents, while the principle of apoptosis examination was FITC Annexin V will bonds with phosphatidylserine that moves out of the cell when the cell undergoes apoptosis, then intercalation with propidium iodide (PI). All examination were detected by flow cytometry BD FACSCalibur.Results Subjects were 25 newly-diagnosed, pediatric ALL patients (64% males and 36% females). Most subjects were 3 years of age (20%). Numbers of CD4+ and CD8+ cells, as well as CD4+/CD8+ were significantly decreased after chemotherapy. However, apoptosis was not significantly different before and after chemotherapy (P=0.689), There were significant negative correlations between apoptosis and CD4+ (P=0.002; rs=-0.584), and CD8+ (rs=-0.556; P=0.004), before chemotherapy. In addition, CD4+-delta and apoptosis-delta also had a significant positive correlation (rs=0.478; P=0.016). However, no correlation was found between the CD4+/CD8+ ratio and apoptosis, before or after chemotherapy.Conclusion There are significantly lower mean CD4+, CD8+, and CD4+/CD8+ ratio after chemotherapy than before. Also, there are significant correlations between CD4+-delta and apoptosis-delta, as well as between apoptosis and CD4+, CD8+, and CD4+/CD8+, before chemotherapy. CD4+, CD8+, and CD4+/CD8+ can be used to predict apoptosis before chemotherapy. In addition, CD4+-delta can be used to predict apoptosis-delta as a response to induction phase chemotherapy in pediatric ALL.

Vitamin D, insulin-like growth factor-1, and stunting in children with transfusion-dependent thalassemia I Gusti Ayu Putu Eka Pratiwi; Roedi Irawan; I Dewa Gede Ugrasena; Muhammad Faizi
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.98-103

Background Transfusion-dependent thalassemia (TDT) has a major impact on a child's growth and is associated with stunting, risk of vitamin D deficiency, and decreased insulin-like growth factor-1 (IGF-1). To date, the relationship between vitamin D levels and stunting in TDT remains unclear. Futhermore, the role of vitamin D and IGF-1 in mediating stunting in TDT patients is still unknown. Objective To investigate the relationship between stunting and vitamin D as well as IGF-1 levels in children with TDT. Methods This cross-sectional study involved 50 TDT children aged 5 to 18 years, included consecutively from the Pediatric Hemato-oncology Outpatient Clinic, Dr. Soetomo Hospital, Surabaya, East Java. Subjects were divided into two groups: stunted (S) and not stunted (NS). Vitamin D and IGF-1 were evaluated by antibody competitive immunoassay and sandwich-enzyme-linked immunosorbent assay (ELISA), respectively. Age, sex, and duration of repeated transfusion were analyzed as confounding factors. Results Median IGF-1 levels were 91.43 (13.67-192.86) ng/mL and 161.53 (17.99-363.01) ng/mL in the S and NS groups, respectively (P=0.011). Mean vitamin D levels were 20 (+ 5.71) ng/mL and 20.46 (5.25) ng/mL in the S and NS groups, respectively (P=0.765). The correlation coefficient (r) of vitamin D and IGF-I levels was not significant. Multivariate analysis showed that low IGF-1 levels, male, and longer duration of repeated transfusions were associated with stunting in children with TDT. Conclusion Low IGF-1 level is associated with stunting in children with TDT. Vitamin D is not significantly associated with either stunting or IGF-1 in children with TDT.

Comparison of 25-Hydroxyvitamin D Levels in Pediatric Hematologic Cancer with and without Suspected Sepsis Erfina Lim; IGAA Putri Sri Rejeki; I Dewa Gede Ugrasena
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1632

Vitamin D is known to play an important role in fighting infections through innate and adaptive immune systems. Children with cancer have a higher risk of suffering sepsis and vitamin D deficiency. Some studies on vitamin D levels in pediatric cancer with sepsis have shown varied results and remain controversial. This study aimed to analyze 25-hydroxyvitamin D levels in pediatric hematologic cancer with and without suspected sepsis. The study was an observational analytical study with a cross-sectional design. Samples were collected during April–September 2019 from the Pediatrics Outpatient Clinic of the Dr. Soetomo Hospital, Surabaya. The samples were a group of pediatric hematologic cancer consisted of 32 subjects with suspected sepsis and 30 without sepsis. Each group was measured the 25-hydroxyvitamin D levels, then differences in levels of 25-hydroxyvitamin D between groups were assessed. Vitamin D levels were measured using ADVIA Centaur. Both groups had low 25-hydroxyvitamin D levels with a deficiency state of 96.9% and 80% in the suspected sepsis group and group without sepsis. There were differences in levels of 25-hydroxyvitamin D in pediatric cancer with and without suspected sepsis (p=0.045). Lower vitamin D levels were found in the cancer group with suspected sepsis. Low vitamin D levels reduce T-helper 2 activity, decrease cellular immunity, and decrease phagocytic macrophages, leading to an easier entry of pathogens and bacteremia. There were significant differences in 25-hydroxyvitamin D levels in pediatric hematologic cancer with and without suspected sepsis.

Co-Authors Ahmad Suryawan Anang Endaryanto Andi Cahyadi Andi Cahyadi Andi Cahyadi Aras, Jusli Arief, Yuni Sufyanti Aryati Aryati Bambang Permono Budi Utomo Diah Kusuma Arumsari Dimarzsiana Dara Sjahruddin Djajadiman Gatot Djajadiman Gatot Dominicus Husada Dominicus Husada Eileen Savage Endang Retnowati Endang Retnowati Erawati Armayani Erfina Lim Esthy Poespitaningtyas Evisina Hanafiati Frans Fauzi, Intani Dewi Syahti Hapsari Widya Ningtiar Harianto Notopuro I Gusti Ayu Putu Eka Pratiwi I Wayan Bikin Suryawan I. G.A.A Putri Sri Rejeki IGAA Putri Sri Rejeki IM Widiaskara Intani Dewi Syahti Fauzi Irene Ratridewi Irwanto, Irwanto Ismoedijanto Kaoru Nishiyama Kardani, Astrid Kristina Kezia Warokka Putri Larasati, Maria C Shanty Mahrus A Rahman, Mahrus A Mangihut Rumiris Maria C Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Masafumi Matsuo Maulidia, Rahmawati Mia Ratwita Mia Ratwita Andarsini Mohammad Sjaifullah Noer Muchtaruddin Mansyur Muhammad Faizi Murti Andriastuti, Murti Mutiani, Faradillah Nathalya Dwi Kartikasari Ninik Asmaningsih Soemyarso Noer Saudah Noer Saudah, Noer Nunki, Nastasya Nursalam Nursalam Nursalam, Nursalam Parwati Setiono Basuki Ponpon Idjradinata Priscilla Putri Harmany PT Pramitha Puspa Wardhani R Fatchul Wahabe Retno Asih Retno Asih Setyoningrum Riadi Wirawan Rianto Setiabudy Risky Vitria Prasetyo Roedi Irawan S.Pd. M Kes I Ketut Sudiana . Savitri Laksmi Winaputri Shanty, Maria Christina Sherly Yuniarchan, Sherly Shrimarti Rukmini Devy Soedewo, Fery Hudowo Soeprapto Ma’at Sudarmo, Subijanto Marto Suprapto Ma'at Ma'at Susanto Nugroho Syntia TJ Taku Shirakawa Tanzilia, May Fanny Teddy Ontoseno Tigor Pandapotan Sianturi Widiaskara IM Yetti Hermaningsih Yetti Hernaningsih

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