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All Journal Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran

Bagus Ngurah Putu Arhana

Bagian Ilmu Kesehatan Anak FK Universitas Udayana /RSUP Sanglah Denpasar

Author-ID : 3213814

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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Diagnostic Accuracy of CRP (C-Reactive Protein) Examination in Neonatal Infections M. Sholeh Kosim; Bagus Ngurah Putu Arhana; Harry Mangunsong
Paediatrica Indonesiana Vol 33 No 7-8 (1993): July - August 1993
Publisher : Indonesian Pediatric Society

The incidence of neonatal infections has been still high in Indonesia. The main factors influencing success of treatment are early clinical diagnosis and rapid determination of the etiologic microorganisms. C-reactive protein (CRP) could be measured in the serum of baby suffering from bacterial infections. The aim of this study was to compare the capability of CRP examination in determining the diagnosis of neonatal infections, using blood culture examination as the gold standard. For comparison, white blood cell (WBC) and platelet counts, which have been used as indicators of neonatal infections, were also evaluated. This study was done prospectively on 30 cases with suspected neonatal infections admitted to the High Risk Baby Ward, Division of Perinatology, and 30 normal babies as control, during the period of April to December 1990. CRP examination was done by latex agglutination method. The results of this study revealed that CRP examination has good sensitivity, specificity. and predictive values. CRP was also proved to be superior to WBC and platelet counts. CRP examination was also easy to perform, cheaper, and faster than blood culture examination. It is concluded that CRP examination could be used as the confirmatory tool in the diagnosis of neonatal bacterial infections.

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.

Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia Ni Putu Wirantari; I Wayan Gustawan; Made Gede Dwilingga Utama; Bagus Ngurah Putu Arhana; Ni Nengah Dwi Fatmawati; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquiredÂ infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%â€“30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).Conclusion: The MPV â‰¥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).

Hubungan Rasio Neutrofil Limfosit (RNL) terhadap kejadian relaps pada anak dengan sindrom nefrotik di RSUP Sanglah, Bali, Indonesia Wega Upendra Sindhughosa; Gusti Ayu Putu Nilawati; Ni Putu Siadi Purniti; Bagus Ngurah Putu Arhana; Ketut Ariawati; Putu Junara Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Nephrotic Syndrome is a disease whose cause is not fully known and has a high relapse rate. The lymphocyte neutrophil ratio is a marker of inflammation in patients with malignancy, infection, and coronary heart disease. This study aims to determine the relationship between Neutrophil Lymphocyte Ratio (NLR) and the occurrence of relapse nephrotic syndrome.Methods: This study was a retrospective analytic observational study with a cross-sectional approach to finding the relationship between increased NLR and the incidence of relapse in patients with nephrotic syndrome at SMF Children's Health Sciences Faculty of Medicine Universitas Udayana/Sanglah General Hospital. Data were taken from medical records of 45 respondents with episodes of relapse or remission from January 2018-January 2019. Data were analyzed using SPSS version 20 for Windows.Results: The results showed that most of the subjects were male (71.1%), aged 1-5 years (51.2%), and aged 4.00 Â± 8.50 years in both the relapse and remission groups. However, the infection rate (66.7%) and medication adherence (75.0%) tended to be higher in the relapse group. The analysis of the ROC curve shows the cut-off point of NLR was 2.36 (AUC: 0.521), with a sensitivity of 71.1% and a specificity of 73.3%. There was a significant relationship between the NLR value and the incidence of relapsed nephrotic syndrome in multivariate analysis (adjusted OR: 4.53; 95% CI: 1.68 - 12.22; p = 0.003).Conclusion: This study shows that there is a relationship between an increase in RNL and the incidence of relapse in pediatric nephrotic syndrome patients at Sanglah General Hospital, Bali, Indonesia.Â Latar belakang: Sindrom Nefrotik merupakan salah satu penyakit yang penyebabnya belum sepenuhnya diketahui dan memiliki angka relaps yang tinggi. rasio neutrofil limfosit merupakan suatu pertanda inflamasi pada pasien yang mengalami keganasan, infeksi dan penyakit jantung koroner. Penelitian ini bertujuan untuk mengetahui hubungan Rasio Neutrofil Limfosit (RNL) dengan terjadinya sindrom nefrotik relaps.Metode: Penelitian ini merupakan penelitian retrospektig observasional analitik dengan pendekatan potong lintang untuk mencari hubungan peningkatan RNL terhadap kejadian relaps pada pasien sindrom nefrotik di SMF Ilmu Kesehatan Anak FK UNUD/Rumah Sakit Umum Pusat Sanglah. Data diambil dari rekam medik terhadap 45 responden dengan episode relaps maupun remisi dari Januari 2018-Januari 2019. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian menunjukkan bahwa sebagian besar subyek adalah laki-laki (71,1%), berusia 1-5 tahun (51,2%), maupun berusia 4,00Â±8,50 tahun baik pada kelompok relaps maupun remisi. Akan tetapi angka infeksi (66,7%) maupun ketidak patuhan pengobatan (75,0%) cenderung lebih tinggi pada kelompok relaps. Analisa kurva ROC menunjukkan titik potong RNL sebesar 2,36 (AUC: 0,521) dengan sensitivitas 71,1% dan spesifisitas 73,3%. Terdapat hubungan bermakna antara nilai RNL dengan kejadian sindrom nefrotik relaps pada analisis multivariat (adjusted OR: 4,53; 95%IK: 1,68 â€“ 12,22; p=0,003).Simpulan: Penelitian ini menunjukkan bahwa terdapat hubungan antara peningkatan RNL terhadap kejadian relaps pada penderita sindrom nefrotik anak di RSUP Sanglah, Bali, Indonesia

The determinant factors for Quality of Life (QOL) among children with Acute Lymphoblastic Leukemia (ALL) after induction phase at Sanglah General Hospital, Bali, Indonesia Made Suadnyani Pasek; Ketut Ariawati; Bagus Ngurah Putu Arhana; I Gusti Lanang Sidiartha; I Gusti Ngurah Sanjaya Putra; I Gusti Ngurah Made Suwarba
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: The Quality of Life (QOL) of patients with acute lymphoblastic leukemia (ALL) is important to be examined. Some determinant factors of the QOL for ALL patients are age, gender, ethnicity, nutritional status, level of income of parents, educational level of parents, and risk groups. This study aims to determine the quality of life score among children with ALL after the induction phase of chemotherapy and to determine determinant factors that are associated with the quality of life of children with ALL.Methods: An observational analytic study using a cross-sectional approach has been conducted among 38 ALL patients to assess the QOL after the induction phase chemotherapy at Sanglah General Hospital. The independent sample T test evaluated comparative values between independent factors. Multivariate analysis was assessed by the General Linear Model ANCOVA. Data were analyzed using SPSS version 20 for Windows.Results: Most of the respondents were age > 5 years old (55.3%), followed by the male (55.3%), well-nourished of nutritional status (55.3%), low parentsâ€™ educational status (55.3%), a high income of parents (52.6%), standard risk of stratification (52.6%), and non-Balinese ethnicity (55.3%). The mean score of QOL was 79.37Â±21.64. The results showed that male gender (95% CI: 2.35-16.04; p=0.010), high income of parents (95% CI: 3.17-22.05; p=0.010), standard risk factors (95% CI: 1.48-16.36; p = 0.020) were significantly related to the QOL of children with ALL.Conclusion: High-income parents, standard risk stratification, and male gender are determinant factors for higher QOL scores of children with ALL after the chemotherapy induction phase.

Co-Authors Anak Agung Ngurah Ketut Putra Widnyana Djoko, Sri Wahyuni Dyah Kanya Wati Eka Gunawijaya Gusti Ayu Putu Nilawati Harry Mangunsong Hendra Santoso I Gde Raka Widiana I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Komang Kari I Made Yullyantara Saputra I Nyoman Budi Hartawan I Putu Gede Karyana I Wayan Gustawan Ida Bagus Subanada Ida Safitri Ida Sri Iswari Ketut Ariawati Ketut Dewi Kumara Wati Ketut Tuti Parwati Merati M. Sholeh Kosim Made Gede Dwi Lingga Utama Made Suadnyani Pasek Ni Made Adi Tarini Ni Nengah Dwi Fatmawati Ni Putu Siadi Purniti Ni Putu Wirantari NP Veny Kartika Yantie P Suwendra Purnomo Suryantoro Putu Junara Putra Soetjiningsih Soetjiningsih Sudaryat S Susilawati Susilawati Wega Upendra Sindhughosa Yoga Putra

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