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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) ISM (Intisari Sains Medis) : Jurnal Kedokteran
Ida Bagus Subanada
Department Of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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THE OUTCOME OF ANTIBIOTIC THERAPY AMONG CHILDREN WITH SEVERE COMMUNITY ACQUIRED PNEUMONIA Usman, M. R.; Wati, D. K.; Subanada, I. B.
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: The effect of human immunodeficiency virus (HIV) status on the evolution of community acquired pneumonia (CAP) is still controversial. There are controversies regarding antibiotic treatment outcome of CAP in HIV infected children. Objective: The aim of this study was to investigate possible differences in hospital outcomes, with compared the outcome of the treatment in severe CAP among HIV infected and HIV uninfected children which had an empiric antibiotic therapy. Methods: A case control study of 80 patients with severe CAP in Department of Child Health, Sanglah General Hospital, Bali-Indonesia. We evaluated clinical features for seeing the effectiveness of the antibiotic therapy according to Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia between HIV infected and HIV uninfected patients. Results: 58% patients in failure treatment and 45% patients in favorable treatment were HIV infected. There were similar characteristics from both groups, except malnutrition condition was statistically significant contribute the outcome (OR 2.87 (95% CI 1.098 to 7.500, p= 0.031). There was no significantly statistic difference of the outcome in HIV infected as compared to HIV uninfected patients with severe CAP (OR 1.65 (95% CI 0.683 to 4.002, p= 0.263). Conclusion: HIV infection was not gave an effect on the outcome of severe CAP patients which had an antibiotic therapy based on Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia.
HUBUNGAN JUMLAH LEUKOSIT SERTA KADAR C-REACTIVE PROTEIN DENGAN DERAJAT KEPARAHAN PNEUMONIA PADA ANAK Pramana, Kissinger Puguh; Subanada, Ida Bagus
Medicina Vol 46 No 2 (2015): Mei 2015
Publisher : Medicina

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Abstract

Pneumonia merupakan salah satu penyebab kematian terbesar pada bayi dan balita. Sitokin-sitokinproinflamasi akan dilepaskan pada saat infeksi sehingga menyebabkan perubahan sistemik. Penandainflamasi sistemik seperti jumlah leukosit dan kadar C-reactive protein (CRP) dapat membantumenentukan derajat keparahan pada pneumonia. Penelitian ini bertujuan untuk mengetahui hubunganjumlah leukosit serta kadar CRP dengan derajat keparahan pneumonia pada anak. Penelitian analitik,dengan desain potong lintang, melibatkan 28 anak dengan pneumonia berat dan sangat berat.Pemeriksaan laboratorium seperti jumlah leukosit dan kadar CRP dilakukan pada subjek penelitian.Pneumonia sangat berat mempunyai rerata kadar CRP lebih tinggi [42,69 (SB 41,70)] dibandingkandengan pneumonia berat [2,95 (SB 3,03)]. Kadar CRP berbeda bermakna pada pneumonia berat dansangat berat [beda rerata 39,74 (IK95% 16,76 sampai 62,71) mg/L, P=0,003], namun jumlah leukosittidak berbeda bermakna [beda rerata 1,75 (IK95% -8,62 sampai 5,12) x 103 u/L, P=0,605]. Analisismultivariat menunjukkan derajat keparahan pneumonia dipengaruhi oleh kadar CRP [RO 1,46 (IK95%1,02 sampai 2,10), P=0,040], sedangkan jumlah leukosit tidak berhubungan dengan derajat keparahanpneumonia pada anak. Disimpulkan, kadar CRP berhubungan dengan derajat keparahan pneumoniapada anak. [MEDICINA 2015;46:77-81].Pneumonia is the biggest causes of death in infants and children under five years old. At the time ofinfection, proinflammatory cytokines would be released and caused systemic changes. Markers ofsystemic inflammation like leukocyte count and C-reactive protein (CRP) level can help to determinethe degree of severity of pneumonia. The aim of this study was to evaluate the association betweenleukocyte count and CRP level with the degree of severity of pneumonia in children. An analytic crosssectional study was done on 28 children with severe and very severe pneumonia at Sanglah HospitalDenpasar, who fulfilled the inclusion and exclusion criteria. Subjects were conducted laboratoricexamination includes testing the leukocyte count and CRP level. Very severe pneumonia had a highermean CRP level [42.69 (SD 41.70)] compared with severe pneumonia [2.95 (SD 3.03)]. There was asignificant difference between CRP level in severe and very severe pneumonia cases [mean difference39.74 (95%CI 16.76 to 62.71) mg/L, P=0.003], but there was not any significant difference in theleukocyte count [mean difference 1.75 (95%CI -8.62 to 5.12) x 103 u/L, P=0.605]. Multivariate analysisshowed that severity of pneumonia was influenced by CRP level [OR 1.46 (95%CI 1.02 to 2.10), P=0.040],but leukocyte count is not associated with the degree of severity of pneumonia. In conclusion, CRP levelis associated with the degree of severity of pneumonia. [MEDICINA 2015;46:77-81].
EVENTRATION OF DIAPHRAGM Eka Pratiwi, I G A P; Purniti, P Siadi; Subanada, IB; Putu Yasa, Ketut
Medicina Vol 39 No 1 (2008): Januari 2008
Publisher : Medicina

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Abstract

Eventration of diaphragm (ED) refers to an abnormally high position of part or all of the diaphragm, but intact diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area with only the peripheral thoracic attachments showing normal muscle. Etiologically ED is congenital or acquired. Congenital diaphragmatic abnormalities occur in 1 per 2000 to 4000 birth, which 7% is diaphragmatic eventration. Most children with ED are asymptomatic when incidentally first seen, will not need theraphy. Those with symptoms develop acute respiratory distress, feeding difficulties, and recurrent pneumonitis. If the patient need assissted ventilation or cannot be weaned off the ventilator, she or he should be plicated. Failure to achieve extubation within a week of plication is an ominous prognostic sign. We reported a case of one month and four days old girl who was dispnea, feeding difficulty and bronchopneumonia caused by right ED with acquired etiology. Plication was done to repaired the symptom. But unfortunately this was not succeded because there was complication of postoperative treatment.
HUBUNGAN ANTARA PERSALINAN SEKSIO SESAREA DAN KEJADIAN BRONKIOLITIS PADA ANAK Yuliana, Yuliana; Subanada, Ida Bagus
Medicina Vol 45 No 1 (2014): Januari 2014
Publisher : Medicina

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Abstract

Bronkiolitis sering mengenai anak usia kurang dari 2 tahun yang menyebabkan morbiditas dan mortalitas yang tinggi tiap tahunnya. Beberapa penelitian menunjukkan adanya faktor-faktor yangmeningkatkan risiko terjadinya bronkiolitis, salah satunya persalinan seksio sesarea. Tujuan penelitian ini adalah untuk mengetahui hubungan antara persalinan seksio sesarea dan kejadian bronkiolitispada anak. Penelitian ini menggunakan metode kasus kontrol yang dilakukan terhadap 60 pasien bronkiolitis sebagai kasus dan 60 pasien bukan bronkiolitis sebagai kontrol. Data diperoleh darirekam medis dan anamnesis langsung dari keluarga pasien anak usia lebih dari 1 bulan dan kurang dari 3 tahun yang dirawat inap di Bagian/SMF Ilmu Kesehatan Anak FK Universitas Udayana/RSUPSanglah pada periode Januari 2013 sampai Maret 2013. Data dianalisis dengan uji Kai-kuadrat dan analisis multivariat (regresi logistik) dengan tingkat kemaknaan á = 0,05 (IK 95%). Dari data dasarsubjek penelitian didapatkan median usia 8 (1-36) bulan, laki-laki 63,3%, berat lahir rendah 15,8%, kehamilan kurang bulan 10,8%, malnutrisi 39,2%, pemberian ASI eksklusif 34,2%, vaksinasi BCG93,3%, riwayat atopi pada keluarga 16,7%, dan paparan asap rokok 27,5%. Tidak didapatkan hubungan yang bermakna secara statistik antara persalinan seksio sesarea dengan kejadian bronkiolitis {RO2,36 (IK 95% 0,89 sampai 6,25), P=0,76}. Paparan asap rokok mempunyai risiko lebih besar untuk terjadinya bronkiolitis {RO 2,87 (IK 95% 1,19 sampai 6,96), P=0,015}. Disimpulkan bahwa persalinanseksio sesarea tidak bermakna meningkatkan kejadian bronkiolitis. Paparan asap rokok merupakan salah satu faktor risiko terjadinya bronkiolitis. [MEDICINA. 2014;45:19-24].
PREVALENCE AND HEMATOLOGY PROFILES OF ANEMIA IN PATIENTS WITH ACUTE LOWER RESPIRATORY INFECTION Adi Wirawan, I Ketut; Ariawati, Ketut; Subanada, Ida Bagus
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

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Abstract

Anemia remains a major health problem worldwide, both in developed or developing countries. Approximately, 30% of world population suffered from anemia, and half of it is due to iron deficiency anemia (IDA). Clinical aspect of iron deficiency is lack of immunity. Objectives of this study were to measure prevalence and anemia profile on hospitalized children with acute lower respiratory tract infection (ALRI). This study was a crossectional descriptive study, using children with diagnosed of ALRI in Sanglah Hospital Denpasar, on January-December 2009. Children aged 6-59 months with diagnosed of ALRI and admitted for this study was 74 children. Most of them were male (69%), aged 6-11 months (57%), and 61% suffered from pneumonia. Most children with ALRI (64%) suffered from anemia, and 80% of them suffered from IDA. At ALRI group who were diagnosed with IDA, the average concentrations of hemoglobin, MCHC, SI, TIBC and transferin saturation were 9.72 g/dl, 32.76 g/dl, SI 21.03 µg/dl, 364.19 µg/dl and 6.05% respectively. It was concluded that prevalence of anemia in patients with ALRI was 64%, and 80% of them were IDA. Most ALRI patients with anemia (76%) have less iron status.
EFICACY OF ZINC SUPLEMENTATION AS ADJUVANT THERAPY IN CHILDREN 6- 60 MONTHS OLD WITH PNEUMONIA Sidiartha, I Gusti Lanang; Gede Suandi, I Kompiang; Subanada, Ida Bagus; Siadi Purniti, Ni Putu; Karsana, AA Raka
Medicina Vol 43 No 1 (2012): Januari 2012
Publisher : Medicina

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Abstract

Morbidity and mortality rates of childhood pneumonia is still high, especially in developing countries. Many efforts are done to decrease the morbidity and mortality rate and one of them is zinc supplementation as adjuvant therapy. The aim of the study is to find the effectiveness of zinc supplementation as adjuvant therapy in childhood pneumonia. The randomized controlled trial study was done on 33 patients with pneumonia at Sanglah Hospital Denpasar. Intervention group received 20 mg zinc elemental each day. Time for recovery and length of hospital stay were compared between zinc and placebo groups. The different was significant if the P value < 0.05. Time for recovery in zinc group and placebo group was 4 days and 3.4 days, respectivelly. Length of hospital stay was 5.9 days in zinc group and 5.6 days in placebo group. The different was not significant. Conclusion is zinc supplementation as adjuvant therapy in childhood pneumonia is not effective to decreased the time for recovery and length of hospital stay. (MEDICINA 2012;43:9-14).
ACCURACY OF RAPID TEST OF STORED ACUTE PHASE SERUM FOR DIAGNOSE JAPANESE ENCEPHALITIS Subanada, Ida Bagus; Kari, I Komang
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

Japanese encephalitis (JE) is common viral encephalitis with high sequele and mortality. With some limitations, there are several diagnostic tool to diagnose of JE. The objecive of this study was to know the accuracy of rapid test of stored acute phase serum for diagnose of JE. We conducted diagnostic test of stored acute phase serum of encephalitis patients with MAC ELISA of cerebrospinal fluid as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and post-test probability were calculated. This study found the prevalence of JE was 42.1%, sensitivity 15.7 % (95% CI 9.2 to 22.2%), specificity 95.7% (95% CI 92.1 to 99.3%), PPV 72.7% (95% CI 64.8 to 80.6%), NPV 60.9% (95% CI 52.2 to 69.6%), PLR 3.7, NLR 0.9, and post-test probability was 0.73. We concluded that rapid test of acute phase stored serum was insensitive but specific to diagnose of JE.
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
HUBUNGAN PEMBERIAN ASI EKSKLUSIF DENGAN KEJADIAN DIARE PADA BAYI Kadek Agus Rendy Surya Sentana; I Gusti Agung Ngurah Sugitha Adnyana; Ida Bagus Subanada
E-Jurnal Medika Udayana Vol 7 No 10 (2018): Vol 7 No 10 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Diare pada anak didefinisikan sebagai pengeluaran feses dengan konsistensi cair, lembek, atau bahkan air saja dan frekuensi pengeluaran feses 3x atau lebih dalam satu hari. Penyebab paling sering dari diare pada bayi adalah virus, sehingga pada bayi faktor imunitas saluran cerna merupakan faktor penting untuk mencegah terjadinya diare. ASI ekslusif ialah pemberian ASI saja, tanpa makanan tambahan lain hingga usia bayi 6 bulan. ASI merupakan nutrisi yang tepat untuk membangun imun bayi pada awal kehidupannya. ASI juga dikatakan sebagai faktor protektif terhadap kejadian diare pada bayi. Tujuan penelitian ini adalah untuk membuktikan kembali adanya hubungan antara pemberian ASI eksklusif dengan kejadian diare pada bayi pada populasi di Bali. Penelitian ini merupakan penelitian analitik kasus-kontrol yang dilakukan di wilayah kerja Puskesmas Banjarangkan II, Klungkung. Teknik pengambilan sampel yang digunakan pada penelitian ini adalah consecutive sampling. Data yang diperoleh berupa data sekunder dari pencatatan puksesmas dan data primer yang dicatat melalui kuesioner. Selanjutnya dilakukan pengolahan data dan analisis menggunakan aplikasi statistik komputer. Hasil penelitian menunjukan bahwa ASI eksklusif berhubungan secara signifikan terhadap kejadian diare, dimana status non-ASI eksklusif meningkatkan risiko kejadian diare pada bayi dengan nilai RO = 4,129 (IK 95% 1,542 sampai 11,05) nilai p = 0,005. Disimpulkan bahwa ASI non-eksklusif meningkatkan risiko diare pada bayi. Kata kunci: diare, ASI eksklusif
PREVALENSI DAN KARAKTERISTIK OBESITAS PADA ANAK DI POLIKLINIK ANAK RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR PERIODE JANUARI-DESEMBER 2016 Anak Agung Wira Ryantama; Ida Bagus Subanada
E-Jurnal Medika Udayana Vol 10 No 1 (2021): Vol 10 No 01(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i1.P17

Abstract

ABSTRAK Obesitas dapat diartikan“sebagai suatu kelainan yang ditandai dengan penimbunan.”jaringan lemak tubuh secara berlebihan akibat ketidakseimbangan antara konsumsi kalori dan kebutuhan energi. Di Indonesia, prevalens “obesitas pada anak usia 6-15 tahun meningkat dari 5% tahun 1990 menjadi.”16% tahun 2001. Tujuan penelitian ini adalah untuk mengetahui karakteristik kasus obesitas pada anak yang terdapat“di RSUP Sanglah Denpasar periode Januari.”2016- Desember 2016. Penelitian ini merupakan studi deskriptif retrospektif dengan pendekatan potong lintang menggunakan data sekunder rekam medis dengan sampel anak obesitas yang datang ke Poliklinik Anak RSUP Sanglah Denpasar. Karakteristik yang diambil berupa umur, jenis kelamin, riwayat ASI ekslusif, pekerjaan orangtua dan pendidikan terakhir orangtua. Dari 34 anak dengan obesitas, ditemukan paling banyak berusia 7 tahun (23,5%) dan paling sedikit terjadi pada usia 12 tahun (5,9%). Anak lelaki lebih banyak menderita obesitas dibandingkan dengan anak perempuan (61,8% vs 38,2%). Lebih dari setengah sampel anak dengan obesitas tidak memiliki riwayat ASI ekslusif (55,9%). Orangtua anak dengan obesitas sebagian besar bekerja sebagai pegawai swasta (76,5%) dan memiliki riwayat pendidikan terakhir SMA (58,8%). Disimpulkan bahwa anak obesitas kebanyakan berusia 7 tahun, berjenis kelamin lelaki, tidak memiliki riwayat ASI ekslusif, memiliki orangtua dengan pekerjaan pegawai swasta dan pendidikan terakhir SMA. Kata kunci: Obesitas, Anak, Karakteristik, RSUP Sanglah
Co-Authors AA Raka Karsana ABDUL HAMID Anak Agung Made Sucipta Anak Agung Ngurah Ketut Putra Widnyana Anak Agung Wira Ryantama Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana Bambang Supriyatno BNP Arhana Budastra I Nyoman Carissa Lidia D. K. Wati, D. K. Darmawan B Setyanto Defranky Theodorus Dewi Aryawati Utami Dyah Kanya Wati Eka Gunawijaya Eko Kristanto Kunta Adjie Gusti Ayu Putu Nilawati I Gd. Oki Novi Purnawan I Gde Doddy Kurnia Indrawan I Gede Epi Paramarta I Gusti Agung Ngurah Sugitha Adnyana I Gusti Ayu Putu Eka Pratiwi I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Kadek Rai Suardita I Komang Kari I Komang Kari I Kompiang Gede Suandi I Made Ady Wirawan I Made Bakta I Made Jawi I Made Kardana I Nyoman Budi Hartawan I NYOMAN MANTIK ASTAWA I Nyoman Supadma I Wayan Gustawan Ida Ayu Okti Cahyani Putri Ida Bagus Gede Suparyatha Ida Sri Iswari Jumantini, Ni Komang Pasek Nurhyang Kadek Agus Rendy Surya Sentana Ketut Ariawati Ketut Dewi Kumara Wati Ketut Putu Yasa Kissinger Puguh Pramana, Kissinger Puguh Komang Ayu Witarini Lufyan, Reddy Luh Gde Ayu Pramitha Dewi M. R. Usman, M. R. Made Gede Dwi Lingga Utama Made Sukmawati Made Supartha Made Wiryana Manik Trisna Arysanti Ni Komang Diah Saputri Ni Made Adi Tarini Ni Putu Siadi Purniti Novita Purnamasari Assa NP Veny Kartika Yantie Putu Astawa Rina Triasih Roni Naning Samik Wahab Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sri Mulatsih Suparyatha, Ida Bagus Gede Susilawati Susilawati Wayan Agustini Selumbung Yuliana Yuliana