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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) Bali Journal of Anesthesiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Jurnal ARSI : Administrasi Rumah Sakit Indonesia

I Nyoman Budi Hartawan

Departemen Ilmu Kesehatan Anak, Universitas Udayana, Bali, Indonesia

Author-ID : 276885

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care Hendy Halim; Ida Bagus Gede Suparyatha; I Made Arimbawa; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in children requiring intensive care.Objective To determine the association between multiple organ dysfunction syndrome (MODS) in children requiring intensive care and hyperglycemia with blood sugar level higher than 140 mg/dl.Methods This case control study without matching was conducted on children aged 1 month-12 years from pediatric ward at Sanglah hospital during June-August 2012. We used consecutive sampling to recruit subjects, which then were screened by Pediatric Risk of Hospital Admission (PRISA) 2 score. All subjects were enrolled for blood sugar test, then divided into 2 groups; hyperglycemia with blood sugar level > 140 mg/dl as case and normoglycemia as control. We used organ dysfunction criteria to determine multiple organ dysfunction. The association between MODS and hyperglycemia was assessed by Chi-square test with 95% confidence interval and a statistical significance value of P < 0.05.Results Fifty two subjects were enrolled in this study. We excluded two subjects, hence each group consisted of 25 subjects. We found 18 subjects under and 7 subjects above five years old in hyperglycemia group. The association between multiple organ dysfunction and hyperglycemia was significant with an odds ratio of 10 (95% CI 3 to 38), P < 0.0001.Conclusion Multiple organ dysfunction syndrome had a significant association with hyperglycemia. Multiple organ dysfunction syndrome with hyperglycemia occurs ten times greater than with normoglycemia.

Level of knowledge on HIV I AIDS among senior high school students I Nyoman Budi Hartawan; Ketut Dewi Kumara Wati
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/pi48.4.2008.235-9

Background Young people are now the epicenter and bear adisproportionate burden ofHIV/AIDS pandemic. Until now,one of the strategies which are implemented by the govern-ment is by increasing the level of HIV/AIDS knowledge inorder to avoid its spreading.Objective This study was to explore the level of HIV/AIDSknowledge of senior high school's students towards HIV I AIDSat subdistrict ofPetang. The secondary outcome is to comparethe levels of knowledge toward HIV I AIDS between Petang andPelaga Senior high school, between class and gender.Methods This was a descriptive study, conducted between1st to 28th February 2007 in Petang and Pelaga Senior HighSchool. The study subjects are 529 students (all of senior highschool students in subdistrict of Petang, Badung Regency).Data was taken using UNICEF questionnaire 2000 for youngpeople, which had been passed the reliability test with thekappa value of 0.85.Results Most subjects (90.5%) have excellent and goodknowledge and only 9,5% have sufficient knowledge. Level ofknowledge in girls is better than boys with significant differ-ence between them (P=O.OOO), while school and grade didn'tshow any differences (P=0.760) and (P=0.489).Conclusion The level of knowledge of senior High School inSubdistrict ofPetang, Badung Regency toward HIV /AIDS is atexcellent or good level

Effectiveness of lactose-free formula in management of acute rotavirus diarrhea I. Nyoman Budi Hartawan; S. Yati Soenarto; I. K. G. Suandi
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Acute rota virus diarrhea causes mucosal destruction, blunted villi, villus shortening, and death of cells. The process also decreases lactose secretion which responsible in lactose absorption. Non-absorbed lactose then causes the progression of osmotic and secretory diarrhea causing delayed recovery. Lactose-free formula may decrease lactose, thus shortened the duration of diarrhea episode.Objective To compare the cure rate and duration of acute rota virus diarrhea in children treated with lactose-free formula and lactose containing formula.Methods A randomized, double-blind controlled trial was performed to infants and children aged 2: 6 to 59 months old with acute rotavirus diarrhea accompanied with mild or moderate dehydration that were admitted to pediatric gastroenterology division. Latex agglutination test was used to detect rota virus. After an appropriate rehydration therapy had been done, they were fed with either lactose-free formula (n = 29) or lactose-containing formula (n = 31). Comparisons between duration of diarrhea, weight gain, and defecation frequency were made. Statistical analysis for comparing the two groups were independent t-test and multivariate analysis (Cox regression). Statistical significant was defined ifF< 0.05 with 95% confidence interval.Results The mean duration of diarrhea in lactose-free formulagroup was 57.59 hours (SD 9.40) and lactose-containing formulawas 85.97 hours (SD 13.94), mean difference was 28.38 hours(SE 3.09) [P = 0.001; (95% CI 22.19 to 34.56)]. Decrease instool frequency was found significantly in the lactose-free formula group. Multivariate analysis (Cox regression) revealed that the intervention was affected significantly.Conclusion Lactose-free formula may shorten the duration of acute rotavirus diarrhea.

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU Sri Wahyuni Djoko; Nyoman Budi Hartawan; Bagus Ngurah Putu Arhana; Eka Gunawijaya; Anak Agung Ngurah Ketut Putra Widnyana; Dyah Kanya Wati
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Background Thyroid hormone stimulates the regulation of Î²-adrenergic receptors in order to increase the inotropic effect of the heart myocardium. Euthyroid sick syndrome is a disorder of non-metabolic thyroid function, which is characterized by a decrease in triiodothyronine (T3) levels in patients with non-thyroid systemic disease, such as sepsis. Low serum T3 hormone level is a potentially high-risk factor for mortality from sepsis. Objective To assess for a relationship between decreased serum T3 levels and mortality in pediatric sepsis patients admitted in the PICU. Methods This study used a nested case-control design. The subjects were children aged 1 month-18 years who were diagnosed with sepsis in the pediatric intensive care unit at Sanglah Hospital, Denpasar, Bali, from September 2017 to January 2019. Results A total of 90 children were included, of whom 44 died and 46 survived. Median age was 10.5 (IQR 44) months in subjects who died and 9 (IQR 50) months in those who survived. The majority of subjects in both groups had well-nourished nutritional status. Bivariate analysis revealed that significantly more subjects who died had low serum T3 (â‰¤1 ng/dL), PELOD-2 score â‰¥5, than subjects who survived. Multivariate analysis revealed that serum T3 Â£1 ng/dL (OR 55.1; 95%CI 9 to 334.8; P<0.001) and PELOD-2 score Â³5 (OR 6.5; 95%CI 1.6 to 26.7; P=0.01) were significant risk factors for sepsis mortality. Conclusion Low serum T3 level and high PELOD-2 score are risk factors for death in sepsis.

Implementation of Dengue Recurrent Shock Prediction Score in pediatric dengue shock syndrome Armand Setiady Liwan; I Wayan Gustawan; Eka Gunawijaya; Soetjiningsih Soetjiningsih; Ketut Ariawati; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.178-85

Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.

Prevalence and factors associated with extrauterine growth restriction in premature infants Anggareni, Komang Tria; Sidiartha, I Gusti Lanang; Artana, I Wayan Dharma; Suwarba, I Gusti Ngurah Made; Hartawan, I Nyoman Budi; Gustawan, I Wayan
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.405-11

Background Extrauterine growth restriction (EUGR) is common in preterm infants and has been shown to affect their neurodevelopment. Significant variability exists in the criteria used to define EUGR and a standard definition has not yet been established. Several factors associated with EUGR have been identified, yet EUGR remains a problem in preterm infants. There is still much to be explored regarding risk factors associated with EUGR. Objective To determine the prevalence and factors associated with EUGR in preterm infants. Methods This cross-sectional study included randomly selected premature infants (<37 weeks gestational age) who were admitted to levels II and III Neonatal Ward at Prof. Dr. I.G.N.G. Ngoerah Hospital from May 2022 to August 2023. Results Of 185 subjects, the prevalence of EUGR in preterm infants was 47% and there were significant associations between EUGR and birth weight <1500 g (PR 8.814; 95%CI: 3.943 to 19.7; P=0.000), small for gestational age/SGA (PR 28.95; 95%CI: 3.79 to 220.1; P=0.000), neonatal sepsis (PR 4.29; 95%CI: 2.21 to 8.31; P=0.000), hyaline membrane disease/HMD (PR 2.12; 95%CI: 1.16 to 3.88; P=0.021), use of respiratory support (PR 2.57; 95%CI: 1.35 to 4.92; P=0.005), initiation of enteral nutrition at >48 hours (PR 2.23; 95%CI: 1.21 to 4.09; P=0.014) and length of stay/LOS >14 days (PR 8.11; 95%CI: 4.13 to 15.9; P=0.000). Multivariate analysis revealed birth weight <1500 g (aPR 5.14; 95%CI: 1.55 to 17.06; P=0.007), SGA (aPR 24.26; 95%CI: 2.64 to 222.6; P=0.005), presence of sepsis (aPR 2.35; 95%CI: 1.00 to 5.5; P=0.049), and length of hospital stay >14 days (aPR 4.93; 95%CI: 2.15 to 11.31; P=0.000) maintained positive significant associations with EUGR. Conclusion The prevalence of EUGR in preterm infants is 47%. Birth weight <1500 g, small for gestational age, sepsis, and length of stay >14 days are associated with EUGR in preterm infants.

Neurological manifestations in patients with multisystem inflammatory syndrome in children (MIS-C) in the post-COVID-19 era Wati, Dyah Kanya; Suparyatha, Ida Bagus Gede; Hartawan, I Nyoman Budi; Manggala, Arya Krisna; Artini, Ni Wayan Noni; Aurelya, Anira Rema
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.239-44

Background Multisystem inflammatory syndrome in children (MIS-C) is an emerging condition associated with the COVID-19 pandemic. It occurs in approximately 2-8% cases of COVID-19, sometimes leading to shock, multiorgan failure, and the need for intensive care. Neurological manifestations are uncommon and sometimes overlap with previous comorbidities. Objective To explore the neurological manifestations in critically ill children with MIS-C. Methods This cross-sectional study included children aged <18 years, diagnosed with MIS-C according to World Health Organization (WHO) criteria and admitted to the pediatric intensive care unit (PICU) at a tertiary hospital in Bali, Indonesia. Retrospective data were extracted from electronic medical records covering January 2022 to December 2023. Demographic characteristics, clinical manifestations, treatments, and outcomes were collected and analyzed using SPSS. Patient were grouped based on the presence or absence of neurological symptoms for comparison. Results There were 47 children diagnosed with MIS-C; 78.7% of them were critically ill and treated in our intensive care unit. Thirty-seven subjects were included in the study. The most common symptom was fever (83.8%). Neurological manifestations were found in 12 children (32.4%), most commonly decreased consciousness (58.3%), followed by seizures (25.0%), hemiparesis (8.3%), and behavioral changes (8.3%). When comparing subjects with vs. without neurological symptoms, those with neurological manifestations had higher proportions of invasive mechanical ventilation (58.3% vs. 36.0%, respectively), combined use of intravenous immunoglobulin and methylprednisolone (83.3% vs. 64.0%, respectively), and mortality (58.3% vs. 28.0%, respectively). Conclusion Neurological manifestations, particularly decreased consciousness, were common in critically ill MIS-C patients. These patients exhibited higher rates of invasive ventilation and mortality, emphasizing the need for early recognition and targeted management.

Co-Authors Abdul Latief Alice Indradjaja, Alice Anak Agung Ngurah Ketut Putra Widnyana Anggareni, Komang Tria Antonius H. Pudjiadi Armand Setiady Liwan Artini, Ni Wayan Noni Aurelya, Anira Rema Ayu Setyorini Mestika Mayangsari Ayu Widyanti Bagus Ngurah Putu Arhana Dewi Sutriani Mahalini Djoko, Sri Wahyuni Dyah Kanya Wati Eka Gunawijaya Estina, Vania Catleya Haning, Joy Aprianis Harsika Sari, Ni Wayan Diah Intan Hendra Salim Hendy Halim I Gusti Agung Trisna Windiani I Gusti Ayu Putu Eka Pratiwi I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Made Arimbawa I Made Bagus Wilaksmana Putra I Made Bakta I Made Jawi I Made Kardana I Made Karma Setiyawan I Made Pramana Dharmatika I NYOMAN MANTIK ASTAWA I Putu Gede Karyana I Wayan Dharma Artana, I Wayan Dharma I Wayan Gustawan I. K. G. Suandi Ida Bagus Gede Suparyatha Ida Bagus Subanada IGN Sanjaya Putra Irene Yuniar, Irene Karmelia Kumala Ketut Ariawati Ketut Dewi Kumara Wati Khema Metta Wijaya Komang Ayu Witarini Luh Wayan Puspa Ningsih Made Gede Dwi Lingga Utama Made Michel Kresnayasa Made Pande Lilik Lestari Made Refika Widya Apsari Tangkas Made Wiryana Manggala, Arya Krisna Ni Luh Sri Apsari Ni Nyoman Metriani Nesa Ni Putu Anggun Laksmi NP Veny Kartika Yantie Pande Putu Agung Willa Kesawa Putra Putu Diah Pratiwi Putu Diah Pratiwi Putu Dita Arsintha Widma Rathasari, Ni Made Dea Adilla Rismala Dewi Romy Windiyanto Sekarningrum, Putu A. Siska Permanasari Sinardja Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sukmapermata, Bunga Sukmawati, Made Suparyatha, Ida Bagus Gede Sutriani Mahalini, Dewi Wati, Dyah K. Wayan Sulaksmana Sandhi Parwata Yati Soenarto

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