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All Journal Medicina Folia Medica Indonesiana Sari Pediatri Paediatrica Indonesiana Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan ISM (Intisari Sains Medis) : Jurnal Kedokteran
I Wayan Dharma Artana
Department Of Pediatrics, Faculty Of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health Other

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.515 KB)

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.
CHARACTERISTICS OF NECROTIZING ENTEROCOLITIS IN NEONATES TREATED AT SANGLAH HOSPITAL Hartini, Kadek; Artana, Dharma; Putra, Junara
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

Necrotizing enterocolitis (NEC) is a very serious and severe neonatal gastrointestinal tract disease. Treatment are complex and the course of the disease is hardly predictable. Necrotizing enterocolitis is one of the main causes of morbidity and mortality in neonates. The objective of this study was to know the prevalence and characteristics of neonates with NEC. This was a retrospective descriptive study utilizing medical records of neonates who were admitted in perinatology care unit at Sanglah Hospital, Denpasar during the period of July 2011 to June 2012.There were 55 (5%) neonates with NEC out of 972 neonates admitted to the neonatology care unit at Sanglah Hospital, Denpasar. Mean gestational age was 33.9 weeks. Mean birth weight was 2.096 kg,and the mean time of nutrition initiation was 3.1 days. Stage II was found as the most prevalent stage of NEC (49%). Necrotizing enterocolitis patients were generally associated with clinical manifestations such as sepsis 96%, respiratory distress 87%, prematurity 63%, low birth weight 65%, and asphyxia 61%. There was 36 subjects dead. This outcome tended to increase in premature babies, babies with low birth weight, asphyxia, and sepsis. Death still occurred in all management of NEC. Neonates receiving breast milk as the initial nutrition constituted the highest proportion of recovered patients compared to the fasting, formula milk, and mixed milk (breast milk combined with formula milk) groups.We concluded, the prevalence of NEC was 5%. Death more common than recoveries. Recovery rate more common in breast-fed babies than other nutrients
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
Luaran Bayi Kurang Bulan Late Preterm I Wayan Dharma Artana
Sari Pediatri Vol 14, No 1 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (195.857 KB) | DOI: 10.14238/sp14.1.2012.62-6

Abstract

Latar belakang. Bayi kurang bulan (BKB) mempunyai risiko tinggi terhadap penyakit-penyakit yang berhubungan dengan prematuritas. Kejadian BKB late pretermadalah 75% dari kelahiran BKB.Tujuan. Mengetahui dan membandingkan luaran lama rawat, kesakitan dan kematian BKB late pretermdengan bayi cukup bulan (BCB).Metode. Penelitian kohort prospektif, subyek faktor risiko adalah BKB late pretermdan BCB sebagai kontrol, yang lahir di RSUP Sanglah Denpasar mulai Januari 2010 sampai Desember 2010. Perhitungan analisis untuk mencari hubungan antara faktor risiko BKB late preterm dengan lama rawat, kejadian kesakitan dan kematian, dilakukan analisis multivariat dengan regresi logistik dan chi square.Hasil. Didapatkan perbedaan bermakna di antara kedua kelompok mengenai lama rawat <3 hari (p=0,027; RR=2,76; IK 95%,12-6,15), kesakitan (p=0,016; RR= 3,84; IK 95% 2,06-8,49) kematian (p=0,001; RR=6,6; IK 95% 1,46-9,37).Kesimpulan.Bayi kurang bulan late preterm memiliki risiko lebih tinggi menjalani waktu perawatan di rumah sakit, kejadian kesakitan, dan kematian dibandingkan BCB.
Faktor Risiko dan Luaran Fungsi Hati pada Asfiksia Neonatus di Unit Perawatan Intensif Neonatus (UPIN) RSUP Sanglah Denpasar I Wayan Dharma Artana
Sari Pediatri Vol 14, No 4 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.4.2012.260-4

Abstract

Latar belakang. Asfiksia neonatus menyebabkan disfungsi organ, termasuk hati sebagai salah satu organyang dikorbankan akan mengalami cedera karena proses asfiksia.Tujuan. Mengetahui dan membandingkan luaran fungsi hati pada asfiksia neonatus dan mengetahui faktorrisiko kejadian asfiksia.Metode. Penelitian dengan rancangan potong lintang, subyek dipilih dengan cara non random sampling,yaitu consecutive sampling, sejak bulan Juni sampai Desember 2010. Subyek penelitian 46 neonatus asfiksiadan 60 kontrol. Hubungan antara derajat asfiksia dengan parameter fungsi hati dilakukan dengan analisisof varian (ANOVA).Hasil. Dari 46 neonatus asfiksia, derajat ringan 21 (19,8%), derajat sedang 11 (10,4%), derajat berat 14(13,2%). Terdapat perbedaan yang signifikan antara kelompok asfiksia dengan kontrol terhadap enzim serumglutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), Prothrombin time(PT) dan International normalised ratio (INR)(p<0,001). Faktor risiko terhadap kejadian asfiksia adalahumur kehamilan (p<0,013) dan berat badan lahir (p<0,001).Kesimpulan.Asfiksia neonatus menyebabkan luaran SGOT, SGPT lebih tinggi dibandingkan kontrol. NilaiINR dan PT juga dipengaruhi oleh asfiksia neonatus.
Peran Suplementasi Mineral Mikro Seng Terhadap Kesembuhan Diare W Dharma Artana; Sudaryat Suraatmaja; K Nomor Aryasa; IKG Suandi
Sari Pediatri Vol 7, No 1 (2005)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (148.354 KB) | DOI: 10.14238/sp7.1.2005.15-8

Abstract

Seng termasuk golongan mineral mikro yang sangat esensial bagi tubuh, diabsorpsi diusus halus, terutama pada bagian proksimal jejunum. Defisiensi seng dapat menimbulkanbeberapa keadaan seperti akrodermatitis, alopesia, rabun senja, gangguan tumbuhkembang, gangguan sistem reproduksi, atrofi serta kerusakan mukosa usus halus denganmanifestasi diare, dan menurunnya respons imun. Mineral mikro seng berperan sebagaianti oksidan mempengaruhi absorpsi air dan natrium, meningkatkan metabolismevitamin A, mencegah defisiensi enzim disakaridase, memperbaiki sistem imun, sertasebagai ko-faktor enzim. Maka WHO menganjurkan pemberian suplementasi mineralmikro seng pada pasien diare untuk mempercepat kesembuhan, mencegah terjadinyakomplikasi seperti diare berkepanjangan maupun gizi buruk dan bersifat relatif tidaktoksis.
Risiko Asfiksia pada Ketuban Pecah Dini di RSUP Sanglah Wiradharma Wiradharma; Kardana I Md; Dharma Artana I Wyn
Sari Pediatri Vol 14, No 5 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (184.049 KB) | DOI: 10.14238/sp14.5.2013.316-9

Abstract

Latar belakang.Ketuban pecah dini (KPD) merupakan salah satu faktor risiko terjadinya komplikasi persalinan. Semakin lama KPD, semakin besar kemungkinan terjadi komplikasi persalinan, sehingga meningkatkan risiko terjadi asfiksia.Tujuan.Mengetahui besar risiko lama KPD terhadap kejadian asfiksia pada kehamilan cukup bulan.Metode.Rancangan penelitian analitik kategorikal tidak berpasangan, dengan pendekatan kasus kontrol. Tujuhpuluh enam bayi yang dirawat di RSUP Sanglah, Denpasar periode bulan Mei-November 2010 dipilih secara consecutive. Bayi asfiksia 38 kasus dan sebagai kelompok kontrol 38 bayi tidak asfiksia. Lama KPD dikelompokkan menjadi <12 jam dan ≥12 jam. Data lama KPD diambil dari catatan medik. Analisis data menggunakan uji Kai-kuadrat dan analisis multivariat (regresi logistik).Hasil.Terdapat perbedaan bermakna antara lama KPD (<12 dengan ≥12) jam terhadap kejadian asfiksia (p=0,002; RO=8,0; IK 95% 2,0-30,4).Kesimpulan.Ketuban pecah dini merupakan faktor risiko terjadinya asfiksia.
Risk factors for hearing loss in neonates Ni Luh Putu Maharani; Ekawaty Lutfia Haksari; I Wayan Dharma Artana
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.366 KB) | DOI: 10.14238/pi55.6.2015.328-32

Abstract

Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects) and without hearing loss (control group of 50 subjects). The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040). There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.
Cystatin C level and amikacin use in neonatal sepsis Putu Diah Pratiwi; I Wayan Dharma Artana; Ni Putu Veny Kartika Yantie; Hendra Santoso; I Gusti Ngurah Sanjaya Putra; Gusti Ayu Putu Nilawati; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (234.997 KB) | DOI: 10.14238/pi60.1.2020.1-5

Abstract

Background Amikacin is the antibiotic of choice for eradicating bacteria in neonatal sepsis because of its effectiveness against Gram-negative bacteria. However, this drug has nephrotoxic effects. Monitoring kidney function in neonates is very important because amikacin can interfere with development of the kidney. Several studies have shown that serum cystatin C levels were closer to glomerular filtration rate (GFR) values ​​compared to serum creatinine levels. Objective To evaluate cystatin C levels before and after administration of amikacin in neonates with sepsis. Methods This prospective cohort study was conducted in one group with a pretest and posttest design. Thirty neonatal sepsis patients who received amikacin therapy at Sanglah General Hospital, Denpasar, Bali, were included by consecutive sampling. Their cystatin C levels were measured before and after receiving amikacin therapy. Data were normally distributed and analyzed by paired T-test, with a value of P<0.05 considered to be significant. Results The mean difference was 0.23 [1.57 (SD 0.29) vs. 1.80 (SD 0.28)] mg/L with P value < 0.001. There was different value of cystatin c level before and after amikacin therapy with deviation standard 0.25 with P<0.001 (alfa 5%). Conclusion Cystatin C levels are significantly higher in neonates with sepsis after administration of amikacin.
Serum zinc level and prognosis of neonatal sepsis Chaliza Adnan; I Wayan Dharma Artana; Ketut Suarta; I Gusti Lanang Sidiartha; I Wayan Gustawan; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.253 KB) | DOI: 10.14238/pi60.2.2020.61-66

Abstract

Background The prognosis of neonatal sepsis can be influenced by various risk factors, one of which is a deficiency of zinc micronutrient substances. Objective To assess for a potential association between serum zinc level and prognosis of infants with early-onset neonatal sepsis (EONS). Methods This prospective cohort study was done in neonates with clinical EONS from September 2017 until December 2018. Serum zinc level was measured on the first day of diagnosis and prognosis was assessed on the fourth day. The association between serum zinc levels and prognosis of EONS was analyzed by Chi-square test and logistic regression with adjustment for confounding variables. Results A total of 70 subjects were divided into two groups based on their serum zinc levels. A cut-off point of 75 ug/dL was used based on area under the curve (sensitivity 91.2% and specificity 93.7%), with accuracy 97.8% (95%CI 0.943 to 1.000; P=0.0001). Subjects with lowzinc level had a 16.8 times greater risk compared to subjects with high serum zinc (RR=16.81; 95% CI 4.35 to 65.02; P <0.0001). Multivariate analysis revealed that subjects with low serum zinc levels had 203.7 times greater risk of worsening than subjects who had a higher serum zinc level (RR 203.72; 95% CI 26.79 to 1549.17; P <0.0001). Covariates such as male sex, low gestational age (<37 weeks), low birth weight (<2,500 grams), asphyxia, Caesarean section delivery, and the presence of comorbidities did not have significant associations with outcomes of EONS (P >0.05). Conclusion Serum zinc level is associated with prognosis of early onset neonatal sepsis, with a cut-off of 75 μg/dL. The high level of serum zinc associates with a better prognosis.
Co-Authors Chaliza Adnan Dyah Kanya Wati Ekawaty Lutfia Haksari Franky Luhulima Gusti Ayu Putu Nilawati Hendra Santoso I Gede Deden Susma Sugara I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Made Kardana I Nyoman Supadma I Wayan Gustawan IKG Suandi IM Dharmajaya Intan Astariani K Nomor Aryasa Kadek Deddy Ariyanta Kadek Hartini Kardana I Md Ketut Ariawati Ketut Dewi Kumara Wati Ketut Suarta Ketut Suarta Komang Ayu Witarini Leni Lukman Made Ardinata Made Sukmawati Ni Luh Gede Wahyuni Suismaya Ni Luh Putu Maharani Ni Made Rini Suari Ni Made Sukewanti Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Novita Purnamasari Assa NP Veny Kartika Yantie Purwoko, Agus Putu Diah Pratiwi Putu Indah Budi Apsari Putu Junara Putra Soetjiningsih Soetjiningsih Sudaryat Suraatmaja Wayan Sulaksmana Sandhi Parwata Wiradharma Wiradharma Yoga Putra