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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
I Made Kardana
Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah, Denpasar
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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PRIMARY PERITONITIS WITH POCKETED ABSCESS INTRAPERITONEAL CAUSED BY UMBILICAL CATHETER INFECTION IN 22 DAYS OLD BABY -, Ariputra; Kardana, I Made; Darmajaya, Made
Medicina Vol 45 No 3 (2014): September 2014
Publisher : Medicina

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Abstract

Primary peritonitis defined  as  a microbial  infection  of  the peritoneum  and peritoneal  fluid  in  theabsence of a gastrointestinal or visceral perforation. The source of infection is extra abdominal andmay arise  from  lymphatics  or blood  stream. One  of  the  infection  source  can be  extension  from anomphalitis  or  infected  umbilicus. Omphalitis  can  occur  due  to  complication  of Umbilical VeinCatheterization  (UVC). UVC  are used  to  provide  access  for  resuscitation,  frequent monitoring  ofblood, administration of fluids, blood and parenteral nutrition. We report a case of primary peritonitiswith  pocketed  intraperitoneal  abscess  caused  by umbilical  infection  in  22  days  old  baby. Patientpresent a clinical sign of peritonitis and severe omphalitis with history of using umbilical catheter. X-ray found a free fluid impression in the abdominal cavity. Patient undergo a laparotomy and pocketedintraperitoneal  abscess was  found  around  ligamentum  teres hepatis  area,  suspected  of  infectiouscomplications arising out from the use of umbilical catheter.  [MEDICINA 2014;45:193-198].
CHARACTERISTICS AND THE OUTCOME OF VERY LOW BIRTH WEIGHT INFANT BORN IN SANGLAH HOSPITAL DENPASAR Putra, Yoga; Kardana, Made; Artana, Dharma; Putra, Junara
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

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Abstract

Very low birth weight (VLBW) infants is one of the most important medical problem especially in developing countries. This issue is due to its high morbidity and mortality rate. On the other hand, the long term impact of VLBW infants are poor growth and development including physical, emotional, intelectual (IQ), and disabilities, therefore it could decrease the quality of human resources and become a burden to their family. The objective of this study was to describe the characteristics and outcome among VLBW infants born in the Sanglah Hospital. This was a retrospective study. Data were collected from medical record of all infants with VLBW delivered in Sanglah Hospital from January to Desember 2009. Uncompleted infants and mother medical records were excluded from this study. Of 64 VLBW infants enrolled into the study of which 54.7%  of this subjects was male, median of weight was 1300 g, mean gestational of age was 30.9 (SD 2.28) weeks, and mean lenght of stay was 30.9 (SD 19.7) days. The survival of VLBW infants in this study was 62.5%,  mortality in the early neonatal period was 70,8%. The percentage of VLBW infants who survive was still low and the major causes mortality were HMD (50%) and sepsis (41.6%). The mortality of VLBW happened mostly in early neonatal periode.
SPONTANEOUS PNEUMOPERITONEUM IN A SEVEN DAY OLD INFANT Luhulima, Franky; Kardana, Made; Artana, IW Dharma; Junara, Putu; Dharmajaya, IM
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

The term pneumoperitoneum is used to describe the presence of free gas  or air within the peritoneal cavity. Spontaneous pneumoperitoneum or “non-surgical” pneumoperitoneum is a pneumoperitoneum. not associated with a perforated viscus. This pneumoperitoneum   is rare at any pediatric age. In the pediatric population, nonsurgical pneumoperitoneum occurs in 1% to 3% of mechanically ventilated infants, depend on the mode of the ventilation. Pneumoperitoneum without gastrointestinal perforation on the other hand is very rare, and this is usually seen in neonates with respiratory distress and on mechanically ventilator or CPAP. We reported a case of spontaneous pneumoperitoneum in a seven day old infant . The infant presented with a sudden abdominal distention and dyspnea. Plain abdominal x-ray showed a radiolucency image in the superior abdomen. In this patient is done the act of a needle aspirations for drainage air in the peritonium. This patient recovered well a[er done such action by pediatric surgical
PERINATAL TUBERCULOSIS WITH MILLIARY PATTERN IN INFANT AGED 28 DAYS Savitri, Dian; Purniti, Putu Siadi; Kardana, Made
Medicina Vol 45 No 3 (2014): September 2014
Publisher : Medicina

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Abstract

Perinatal  tuberculosis  (TB) was a very  rare  case.  Its  clinical manifestations  could mimic bacterialinfection. The clinical course was often fulminant and characterized by dissemination and meningitis.Its mortality was very high, could achieve 100% in untreated patient. We reported a case of infant aged28  days  admitted with  breathlessness,  fever,  and  poor  feeding.  Physical  examination  showedbreathlessness, pale, lethargy, and hepatomegaly. Chest radiograph showed a feature of milliary patternwith fine tubercles in both lung, supported with positive result on gastric aspirates for acid fast bacilli3 days respectively. Gastric aspirate culture for Mycobacterium tuberculosis showed positive result.Patient then diagnosed with perinatal TB with milliary pattern. This condition was accompanied withsevere sepsis and meningitis. Four TB regimens (isoniazid, rifampisin, pirazinamide, and ethambutol),corticosteroid, antibiotics were given. The patient was eventually died after receiving TB therapy for 13days. [MEDICINA 2014;45:208-212].
MALE TERM NEONATE WITH BLADDER EXSTROPHY–EPISPADIAS COMPLEX Utami Budha, Made Indah Nastiti; Retayasa, I Wayan; Kardana, I Made; *, Bowolaksono; Kawiyana, Ketut Siki
Medicina Vol 40 No 1 (2009): Januari 2009
Publisher : Medicina

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Abstract

Bladder exstrophy is a malformation of the bladder, in which the bladder and related structures are turned inside out. Bladder exstrophy affects one in approximately 50,000 livebirths. Male to female ratio is 2.3 : 1. Epispadias is commonly seen with exstrophy of the bladder. The cause and nature of the faulty development is not yet clear. The diagnosis is generally immediately apparent. Bladder exstrophy is a surgical correctable birth defect. In this case, bladder exstrophy–epispadias complex founded in male term neonate. On inspection was founded bladder everted through a midline lower abdominal wall defect, widening of the pubic symphisis and epispadias. Urology ultrasound revealed absent of the right kidney at right fossa renalis or in pelvic cavity, slight hydronephrosis of left kidney, no appearance of bladder in pelvic cavity. Patient underwent surgery during hospitalized in Sanglah Hospital - Denpasar. This patient was referred to the Congenital Anomaly Team in Dr. Soetomo Hospital - Surabaya because there was wound dehiscence during post operation care.[MEDICINA 2009;40:60-4].
Risk factors of neonatal mortality in sanglah hospital denpasar Lufyan, Reddy; Kardana, Made; Subanada, Ida Bagus
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

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Abstract

The neonatal mortality continues to be one of the global burden for both developed and developing countries. Information on neonatal mortality at international level is in great demand because it emerges as an increasingly prominent component of overall under-five mortality. Since causes of neonatal death vary by country and with the availability and quality of health care, understanding neonatal mortality in relation to these factors is crucial. This study aimed to acknowledge the characteristics and identify the related risk factors of neonatal mortality in Sanglah Hospital Denpasar. This study was a case control study performed in Sanglah Hospital Denpasar. Data was obtained from medical record and registry, analyzed as bivariate using chi-square test and multivariate by using logistic regression analysis model. This study involved 96 subjects for each case and control group. Bivariate analysis showed that asphyxia, low birthweight, major congenital anomaly, prematurity, respiratory distress syndrome, and sepsis were risk factors of neonatal mortality. Multivariate analysis showed that major congenital anomaly (OR 15.67; 95%CI 3.43 to 71.57), prematurity (OR 4.99; 95%CI 1.23 to 20.17), and respiratory distress syndrome (OR 34.90; 95%CI 12.79 to 95.26) were the most significant risk factors of neonatal mortality. In conclusion, neonatal mortality is still an important issue to be concerned seriously. Respiratory distress syndrome, major congenital anomaly, and prematurity were the most significant risk factors associated to neonatal mortality. Better understanding of the risk factors would increase the clinical awareness, develop, and improve better service for neonatal care to reduce neonatal mortality rate. Keywords: risk factor, neonatal, mortality
KARAKTERISIK LUARAN BAYI YANG LAHIR DENGAN SECTIO CAESAREA DI RSUP SANGLAH DENPASAR Hendry Raymen Satria; I Made Kardana; I GAN Sugitha Adnyana
E-Jurnal Medika Udayana Vol 9 No 10 (2020): Vol 9 No 10(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i10.P13

Abstract

Researches about the health effect of caesarean section (CS) on maternal and perinatal morbidity, pediatric outcomes, psychologic or social well-being are still unclear and limited. This research aims to study the characteristics outcome and indications of CS baby in Sanglah General Hospital. The descriptive cross-sectional research was conducted on 36 eligible babies out of 72 cesarean cases by medical record throughout 2017. As a result, 22 (61.1%) were male, 18 (50%) were preterm, 19 (52.8%) were normal weight baby. Four most common indications found were antepartum bleeding placenta previa, fetal distress, breech presentation and locus minoris resitentiae (LMR) with 3 (8.3%) cases each. In conclusion, CS delivery rate were higher in male gender. Proportion of baby between aterm and preterm, also normal and low birth weight were similar. Placenta previa, fetal distress, breech presentation and LMR as the most common indication for cesarean babies in Sanglah General Hospital. Keywords: Cesarean Section, Characteristics, Indication, Neonatal, Pediatrics Outcome
Efektivitas Fototerapi Terhadap Penurunan Kadar Bilirubin Total pada Hiperbilirubinemia Neonatal di RSUP Sanglah Ayu Ketut Surya Dewi; I Made Kardana; Ketut Suarta
Sari Pediatri Vol 18, No 2 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.259 KB) | DOI: 10.14238/sp18.2.2016.81-6

Abstract

Latar belakang. Enampuluh persen bayi lahir normal berkembang menjadi kuning dalam satu minggu pertama kehidupan. Fototerapi merupakan salah satu tatalaksana mengurangi hiperbilirubinemia melalui proses fotoisomerisasi dan isomerisasi struktural.Tujuan. Mengetahui jumlah penurunan kadar serum bilirubin total pada bayi hiperbilirubinemia usia gestasi ≥35 minggu setelah dilakukan fototerapi selama 24 jam, agar dapat memprediksi lama perawatan fototerapi di rumah sakit. Metode. Penelitian cohort dengan melibatkan 44 bayi hiperbilirubinemia usia kehamilan ≥35 minggu, melihat kadar bilirubin sebelum dan setelah dilakukan fototerapi. Analisis data dan statistik digunakan SPSS 22 dan uji t berpasangan dengan nilai p≤0,05 dan koefisien interval 95% dianggap signifikan. Hasil. Rerata usia kuning 4,2±0,88 hari dengan rerata berat badan 2784±643 gram. Rerata kadar bilirubin sebelum dilakukan fototerapi 15,3±1,94 mg/dL, dan setelah dilakukan fototerapi 24 jam 12,8±1,88 mg/dL dengan p=0,001. Penurunan kadar bilirubin 2,5±0,8mg/dL dalam 24 jam (turun 16,3% dalam 24 jam). Komplikasi fototerapi yaitu hipertermi (2,3%) dan eritema (27,3%). Kesimpulan. Penurunan kadar bilirubin setelah dilakukan fototerapi selama 24 jam 2,5±0,8mg/dL (turun 16,3%).
Penyakit Kawasaki Made Kardana; Ida Bagus Agung Winaya
Sari Pediatri Vol 3, No 1 (2001)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (492.009 KB) | DOI: 10.14238/sp3.1.2001.19-23

Abstract

Penyakit Kawasaki adalah penyakit akibat vaskulitis akut menyeluruh. Sampai saat ini penyebabnya secara pasti belum diketahui, diduga karena infeksi, toksin atau kelainan imunoregulator. Penyakit ini tersebar luas di seluruh dunia, 80% menyerang anak di bawah usia 5 tahun. Diagnosis ditegakkan apabila terdapat panas lebih dari 5 hari, ditambah 4 dari 5 gejala berikut yaitu injeksi konjungtiva bilateral, mukosa mulut dan faring kemerahan atau pecah-pecah, edema dan atau eritema pada ekstremitas, ruam kulit, limfadenopati servikal yang tidak dapat dijelaskan oleh penyakit lain yang penyebabnya diketahui. Dua puluh sampai 25% dapat berkembang menjadi aneurisma arteri koronaria. Pengobatan aspirin dosis tinggi dan gamma globulin bertujuan untuk mengurangi proses inflamasi pada miokardium dan dinding arteri koronaria dan aspirin dosis rendah untuk menghambat agregasi trombosit. Pembedahan dilakukan apabila gejalanya berkembang menjadi angina dan terdapat bukti obstruksi satu atau  lebih arteri koronaria mayor. Prognosis tergantung dari ada tidaknya kelainan arteri koronaria dan kematian sebagian besar akibat infark miokardium.
Pola Kuman dan Sensitifitas Antibiotik di Ruang Perinatologi I Made Kardana
Sari Pediatri Vol 12, No 6 (2011)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.6.2011.381-5

Abstract

Latar belakang. Penggunaan antibiotik pada sepsis neonatorum seharusnya didasarkan pada kuman penyebab infeksi yang diperoleh dari biakan darah dan hasil uji sensitifitas. Pola kuman dan hasil uji sensitifitas dapat dipakai sebagai dasar pemberian antibiotik secara empiris.Tujuan. Mengetahui profil mikroorganisme penyebab sepsis neonatorum di Bagian Ilmu Kesehatan Anak RSUP Sanglah Denpasar serta sensitifitasnya terhadap antibiotik.Metode. Penelitian retrospektif dilakukan dari Januari 2008-Desember 2009. Kriteria inklusi adalah neonatus tersangka sepsis dan didiagnosis akhir sebagai sepsis neonatorum berdasarkan biakan darah positif. Kriteria eksklusi apabila data tidak lengkap. Hasil. Terdapat 458 kasus tersangka sepsis. Biakan darah positif 220 (48%). Bakteri penyebab terbanyak adalahSerratia marcescens.Bakteri penyebab sepsis mempunyai sensitifitas rendah terhadap antibiotik lini pertama (ampisilin dan gentamisin), kecuali Acinetobacter baumanniimempunyai sensitifitas tinggi terhadap antibiotik tersebut. Sensitifitas bakteri penyebab sepsis umumnya masih tinggi terhadap meropenem, cefoperason-sulbactam, dan piperasilin-tazobactam.Kesimpulan. Penyebab sepsis neonatorum terbanyak adalah Serratia marsescens.Sebagian besar bakteri penyebab sepsis mempunyai sensitifitas rendah terhadap ampisilin dan gentamisin, kecuali Acinetobacter baumannii.Terhadap meropenem, cefoperazon-sulbactam dan piperasilin-tazobactam sensitifitas masih tinggi.
Co-Authors Anak Agung Ngurah Subawa Ariputra -, Ariputra Artana, Wayan Dharma Ayu Ketut Surya Dewi Ayu Setyorini Mestika Mayangsari Bowolaksono * Carissa Lidia Desak Laksmi DIAN SAVITRI Dyah Kanya Wati Ekaputri, Dian Sulistya Franky Luhulima Gusti Ayu Putu Nilawati Hendra Santoso Hendry Raymen Satria Hendy Hendy I Gde Raka Widiana I Gede Deden Susma Sugara I Gede Ketut Aryana, I Gede Ketut I Gusti Agung Ngurah Sugitha Adnyana I Gusti Ayu Putu Eka Pratiwi I Gusti Ngurah Made Suwarba I Made Arimbawa I Nyoman Adipura I Nyoman Budi Hartawan I Nyoman Sartika I Nyoman Wande I Putu Sidhi Rastu Karyana I Wayan Darma Artana I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma I Wayan Retayasa IB. Mahendra Ida Bagus Agung Winaya Ida Bagus Mudita Ida Bagus Subanada IM Dharmajaya Kadek Deddy Ariyanta Kadek Deddy Ariyanta Kadek Deddy Ariyanta Ketut Dewi Kumara Wati Ketut Siki Kawiyana Ketut Suarta Ketut Suarta Ketut Suarta Komang Ayu Witarini Komang Kari Kristopher May Pamudji Lim, Heriyanto Lufyan, Reddy Luh Gede Yuliadewi NS Made Bandem Kenny Wijaya Nugraha Made Darmajaya Made Darmajaya Made Indah Nastiti Utami Budha Made lndah Nastiti Utami Budha Made Sukmawati Made Widia Markus Gunawan Ni Kadek Mulyantari Ni Luh Gede Wahyuni Suismaya Ni Made Sukewanti Ni Made Sumiartini Ni Nyoman Mahartini Ni Nyoman Mahartini Ni Putu Siadi Purniti Novita Purnamasari Assa Novita Purnamasari Assa NP Veny Kartika Yantie Nyoman Gina Henny Kristianti Putu Junara Putra Putu Junara Putra, Putu Junara Rathasari, Ni Made Dea Adilla Setya Wandita Sianny Herawati Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sukmawati, Made Susanti Halim Wayan Retayasa Wayan Retayasa Wayan Sulaksmana Sandhi Parwata Wijaya, I Made Samitha Yoga Putra