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All Journal E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran INDONESIAN JOURNAL OF URBAN AND ENVIRONMENTAL TECHNOLOGY

Komang Ayu Witarini

Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Airlangga, RSU Dr Soetomo Surabaya

Author-ID : 3472463

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Civil Engineering, Building, Construction & Architecture Energy Environmental Science Health Professions Medicine & Pharmacology

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Assessment of the quality of general movements in newborn infants: a tool to predict developmental disorders at an early age Ahmad Suryawan; Bambang Permono; Komang Ayu Witarini; Risa Etika; Fatimah lndarso; Moersintowarti B. Narendra
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Background Nowadays, quality assessment of general movements(GMs) in infants can be used as a tool to predict developmentaloutcome. Until now, there is no published study in this field inIndonesia.Objectives The aim of this study was to evaluate the quality ofGMs of newborn infants.Methods A prospective study was done at neonatal ward, Dr.Soetomo Hospital in Surabaya, between December 2006 andJanuary 2007. A single supine position video recording of newbornsat GMs preterm and writhing age was made using Precthl's method.Infants were chosen consecutively among singletons above 28week gestational age. The quality of GMs was assessed by meansof Gestalt perception by one of the authors, who had been trainedand certified in GMs. GMs were classified into: normal-optimal,normal-suboptimal, mildly-abnormal, and definitely-abnormal.Correlation tests were used to assess the relationship betweenperinatal conditions and the quality of GMs.Results 106 videos were recorded, and 100 were assessedcompletely. Abnormal GMs were found in both 35 pretermage (normal-optimal 2.9%; normal-suboptimal 28.6%; mildly-abnormal45. 7o/o; definitely-abnormal22.9o/o) and 65 writhing age(3.1 o/o; 41.5%; 41.5%; 13.8%, respectively) (P=0.285). There wasa weak negative correlation between birth weight and the qualityofGMs (r=-0.20, P=0.044).Conclusions The quality ofGMs in Indonesian newborn infants inour study was predominantly abnormal, which puts these infantsat high risk for later developmental disorders. The lower theinfants'birth weight, the more likely for abnormal GMs.

Liver function in children with human immunodeficiency virus infection before and after 6 months of highly active antiretroviral therapy Eva Jacomina Jemima Sapulete; I Gusti Ngurah Sanjaya Putra; Ketut Dewi Kumara Wati; Hendra Santoso; I Putu Gede Karyana; Komang Ayu Witarini; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Background Highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and improved survival rate in human immunodeficiency virus (HIV)-infected patients. Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity. Hepatotoxicity is often reflected in biochemical abnormalities of liver function, such as elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and aspartate aminotransferase-to-platelet ratio index (APRI). Objective To compare liver function spectrum (AST, ALT, and APRI) in HIV-infected children before and after at least 6 months of HAART. Methods This observational study (before and after) was conducted in pediatric patients with HIV infection who received HAART for at least 6 months at Sanglah Hospital, Denpasar. Data were collected from medical records. Results Forty-nine patients were observed in this study. The mean AST, ALT, and APRI levels before HAART were higher than after at least 6 months of HAART. Anti-tuberculosis treatment and fluconazole therapy were not confounding factors for AST, ALT, and APRI. Conclusion Liver function spectrum enzyme levels of AST, ALT, and APRI are improved after at least 6 months of HAART.

Age and HIV stage at initiation of highly active antiretroviral therapy determine non-reversal of stunting at 3 years of treatment Putu Diah Vedaswari; Ketut Dewi Kumara Wati; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi; Hendra Santoso; Komang Ayu Witarini
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ â‰¤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.

Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection Ni Made Ayu Agustini; Eka Gunawijaya; Ni Putu Venny Kartika Yantie; Ketut Dewi Kumara Wati; Komang Ayu Witarini; Hendra Santoso
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearmanâ€™s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.

Efficacy of high-dose methylprednisolone and cyclophosphamide in childhood-onset systemic lupus erythematosus Putu Ayunda Trisnia; Ketut Dewi KUmara Wati; Komang Ayu Witarini; Ida Bagus Ramajaya Sutawan; Hendra Santoso
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Background Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease. Untreated SLE often become progressive and lead to increased risk of mortality. Corticosteroid and cyclophosphamide remain the treatment of choice for severe SLE. Disease activity assessed with SLE Daily Activity Index (SLEDAI). Objective To compare the disease activity of childhood-onset severe SLE at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide by using SLEDAI. Methods This study was conducted in the Division of Pediatric Allergy and Immunology, Department of Child Health, Udayana University/Sanglah Hospital, Denpasar, Bali. Subjects were SLE patient aged 0-18 years who had severe clinical manifestations. Subject received therapy combination of high dose methylprednisolone and cyclophosphamide every 2 weeks for six doses. SLEDAI score was assessed at the time of diagnosis, after completion of high dose methylprednisolone, and after three month of cyclophosphamide. Results During the study period, 51 children were diagnosed as SLE. Twenty-one subjects were included for analysis. Median SLEDAI score at the time of diagnosis was 23 (range 13-39). SLEDAI score after three months of cyclophosphamide was decreased to 2 (range 0-14). Post hoc analysis with Wilcoxon signed-rank test showed the improvement of SLEDAI score at the time of diagnosis and after three months of cyclophosphamide was statistically significant (Z=-4.016, P<0.0001). Conclusion SLEDAI score reduced after completion of high-dose methylprednisolone and three month of cyclophosphamide therapy.

Co-Authors Adiputra, I Komang Hotra Ahmad Suryawan Apsari, Ni Luh Sri Ayu Setyorini Mestika Mayangsari Bambang Permono Biantara, I Wayan Arya Cempaka, Putu Mas Vina Paramitha Cokorda Agung Wahyu Purnamasidhi Darren Junior Defranky Theodorus Dewa Ayu Fony Prema Shanti Dewi Sutriani Mahalini Dewi, Ida Ayu Made Ratna Dyah Kanya Wati Eka Gunawijaya Eka Pratiwi, I Gusti Ayu Putu Eva Jacomina Jemima Sapulete Fatimah Indarso Fatimah lndarso Haning, Joy Aprianis Hendra Santoso Hendra Santoso Hendra Santoso I Dewa Ayu Agung Warmadewanthi I Dewa Made Sukrama I Gde Raka Widiana I Gede Purna Weisnawa I Gusti Ayu Putu Eka Pratiwi I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Komang Hotra Adiputra I Made Arimbawa I Made Kardana I Nyoman Budi Hartawan I Nyoman Supadma I Putu Gede Karyana I Wayan Arya Biantara I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma I Wayan Gustawan I.D.A.A Warmadewanthi Ida Bagus Krisna Jaya Sutawan Ida Bagus Subanada Irwanto, Irwanto Jerry Jerry Junior, Darren Kadek Diana Harmayani Ketut Dewi Kumara Wati Ketut Suarta Luh Gede Yuliadewi NS Luh Putu Putri Sanjiwani Made Ardinata Moersintowarti B. Narendra Moersintowati B. Narendra Ni Made Ayu Agustini Ni Made Susilawathi Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti NP Veny Kartika Yantie Nurliandari, Nia Purwoko, Agus Putu Ayunda Trisnia Putu Diah Vedaswari Putu Junara Putra, Putu Junara Putu Kintan Wulandari Risa Etika, Risa Sampe, Dhea Gracia Eliani Saputra, I Made Yullyantara Setiyawan, I Made Karma Shanti, Dewa Ayu Fony Prema Sindhughosa, Wega Upendra Siska Permanasari Sinardja Sri Widiani, Ni Komang Ayu Sukarta, Ni Kadek Yusthiani Susilawathi, Ni Made Sylviati M. Damanik Wardani, Ni Made Elsa Weisnawa, I Gede Purna Wulandari, Putu Kintan

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