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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

Author-ID : 3474835

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Risk factors of bronchiolitis I Gde Doddy Kurnia Indrawan; IB Subanada; Rina Triasih
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Bronchiolitis peak incidence is in children aged 2 -6months. History of atopy in parents, non-exclusive breastfeeding,exposure to cigarette smoke, and infants living in crowded areasmay be risk factors for bronchiolitis. Gestational of age at birth isalso influences the mortality oflower respiratory tract infection.Objective To evaluate the following conditions as possiblerisk factors for bronchiolitis: history of atopy, non-exclusivebreastfeeding, preterm infants, exposure to cigarette smoke, and2:: 6 persons residing in the home.Methods A sex-matched case-control study was conductedby collecting data from medical records at Sanglah Hospital,Denpasar. The case group subjects met the diagnostic criteriafor bronchiolitis and were aged 1-24 months. The control groupincluded patients with diagnoses unrelated to the respiratorysystem. Data was analyzed using bivariate (Mc.N emar) andmultivariate methods (logistic regression) with 95% confidenceintervals and statistical significance value of P <0 .05.Results There were 96 subjects in our study, consisted of 48subjects in the case group and 48 in the control group. Thecase and control groups were similar in baseline characteristics.The presence of history of atopy (OR 34.7; 95%CI 3 to 367,P=0.003), non-exclusive breastfeeding (OR 4.3; 95%CI 1.4 to13, P=0.010), exposure to cigarette smoke (OR 3; 95%CI 1 to9.2, P=0.047), and 2:: 6 persons living in the home (OR 7.9;95%CI 2.6 to 24, P<0.0001) were found to be significant riskfactors for bronchiolitis, while the preterm infants seem notsignificant as a risk factor of bronchiolitis (OR3; 95%CI 0.31 to78.99, P=0.625).Conclusion History of atopy, non-exclusive breastfeeding,exposure to cigarette smoke, and 2:: 6 persons living in the homeare found to be risk factors, while preterm infants seem not a riskfactor for bronchiolitis.

Correlation between C--reactive protein and serum iron levels in children with pneumonia I Gd. Oki Novi Purnawan; Ida Bagus Subanada; Sri Mulatsih
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Pneumonia is an infectious disease often occuringin children under five years of age. At the time of infection,pro-inflammatory cytokines are released. It is thought that thesepro-inflammatory cytokines cause changes to iron homeostasisin the body.Objective To determine a correlation between CRP and serumiron levels in children with pneumonia.Methods An analytical, cross-sectional study was performedin children aged 6 months-5 years with severe pneumonia atSanglah Hospital, Denpasar, Bali from April-November 2010.Laboratory examinations included CRP and serum iron levels.The correlation between CRP and serum iron levels was analyzedby Pearson's correlation.Results From 69 children with severe pneumonia, 23 childrenfulfilled the inclusion criteria. Subjects' median CRP level was9.22 mg/Land median serum iron level was 25.55 ug/dL. Thecoefficient correlation between CRP and serum iron levels was-0.580 (P=0.004). The determination coefficient value was0.316.Conclusion In children with severe pneumonia, CRP levelcorrelates negatively with serum iron levels. [Paediatr lndones.2012;52:38-42).

Risk factors for cefotaxime resistance in children with pneumonia Anak Agung Made Sucipta; Ida Bagus Subanada; Samik Wahab
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Pneumonia is a health problem in developingcountries, often caused by bacterial agents. The 'Widespreaduse of cefotaxime, a thirdô€’generation of cephalosporin, may leadto increased incidence of resistance to this antibiotic. Severalstudies have reported on risk factors associated v.ith resistanceto cefotaxime.Objective To identify risk factors for cefotaxime resistance inchildren 'With pneumonia.Methods We performed a caseô€’control study at Sanglah Hospitalbetween January 2006ô€’December 2010. The case group includedchildren with blood cultureô€’positive pneumonia and resistanceto cefotaxime by sensitivity test. The control group was selectedfrom the same population as the case group, but the bacteriaisolated from these subjects were sensitive to cefotaxime. Wetested the folloMng risk factors for resistance to cefotaxime:age :53 years, microorganism species, history of antimicrobialuse, and history of hospitalization within the prior 3 months.Chi square test and logistic regression analysis were performedto determine any associations between the four potential riskfactors and resistance to cefotaxime. A P<0.05 was consideredto be statistically significant.Results Univariate analysis showed that the risk factors forresistance to cefotaxime were history of antimicrobial use in theprior 3 months (OR 2.79; 95%CI 1.40 to 5.55; Pô€“O.OOI) andhistory of hospitalization Mthin the prior 3 months (OR 5.57;95%CI 1.95 to 15.87; P=<O.OOOl). By multivariate analysis,risk factors associated Mth resistance to cefotaxime were historyof antimicrobial use in the prior 3 months (OR 2.4; 95%CI 1.18to 4.86; P=0.015), history of hospitalization within the prior 3months (OR 4.7; 95%CI 1.62 to 13.85; Pô€“0.004), and historyof breast feeding for less than 2 months (OR 2.3; 95%CI 1.0 to5.4; Pô€“0.042).Conclusion History of antimicrobial use and history ofhospitalization within the prior 3 monthsweresignificantriskÂ factors for resistance to cefotaxime in children Mth pneumonia.[Paediatr Indanes. 2012;52:255-9].

Neurological impairment of children with history of prematurity and neonatal hyperbilirubinemia Ida Bagus Subanada; I Komang Kari; Abdul Hamid
Paediatrica Indonesiana Vol 43 No 2 (2003): March 2003
Publisher : Indonesian Pediatric Society

Background In premature infants, the incidence of hyperbiliru-binemia is still high. Bilirubin encephalopathy can develop withoutmarked hyperbilirubinemia.Objective To know the incidence of neurological impairment inpremature with hyperbilirubinemia and the association betweenneurological impairment and serum unconjugated billirubin con-centration.Methods A retrospective study was conducted on 54 prematureswith history of hyperbilirubinemia and 54 without history of hyper-bilirubinemia born between 1997 and 1998 and discharged fromSanglah Hospital. Consecutive sampling was done. After univariateanalysis, multivariate analysis was used to identify the associationbetween serum unconjugated bilirubin concentration and neuro-logical impairment at the adjusted age of 318 months.Results There were statistically significant differences in mean ofage and neurological impairment between subjects with and with-out hyperbilirubinemia (p<0.0001 and 0.026). In subjects with hy-perbilirubinemia, univariate analysis showed significant differencesin means of serum unconjugated bilirubin concentration, gesta-tional age, birth weight, and serum albumin concentration betweensubject who had neurological impairment and who had no neuro-logical impairment with p = 0.005; 0.001; 0.002; <0.0001, respec-tively. Multivariate analysis found there were association betweenneurological impairment and serum unconjugated bilirubin concen-tration, gestational age, and serum albumin concentration withp<0.0001; 0.004; and <0.0001, respectively.Conclusion Neurological impairment in subject with hyperbiliru-binemia was greater than subject without hyperbilirubinemia. Se-rum unconjugated bilirubin concentration is one of three factorsthat associated with neurological impairment

Clinical predictors of hypoxemia in 1-5 year old children with pneumonia Made Supartha; Putu Siadi Purniti; Roni Naning; Ida Bagus Subanada
Paediatrica Indonesiana Vol 50 No 6 (2010): November 2010
Publisher : Indonesian Pediatric Society

Background Pneumonia remains a major killer of under five children. Hypoxemia is the most serious manifestation of pneumonia. The most reliable way to detect hypoxemia is an arterial blood analysis or SPar However, these tools are not widely available; therefore, a simple clinical manifestation should be used as an alternative.Objective To determine clinical predictors of hypoxemia in 1-5 year-old children with pneumonia in Indonesia.Methods This study was conducted between February 2007 to Â August 2008 at Sanglah Hospital, Denpasar, Bali. Sample was selected using a convenient sampling method. Subjects were divided into group of hypoxemia and nonnal saturation. We did clinical examination and SpOz measurement, as the gold standard, simultaneously.Results From 120 subjects" the prevalence of hypoxemia was 17.5%. The best single clinical predictors of hypoxemia was cyanosis (sensitivity 43%, specificity 99%, positive predictive value (PPV) 90%, negative predictive value (NPV) 89%). The best combination of clinical predictors of hypoxemia was cyanosis and head nodding (sensitivity 43%, specificity 99%, PPV 90%, NPV 89%.Conclusion Cyanosis or combination of cyanosis and head nodding is useful clinical predictors of hypoxemia in childhood pneumonia.

Effectiveness of PainAwayÂ® on hepatitis B intramuscular injection in term neonates: a randomized controlled trial Susilawati Susilawati; Soetjiningsih Soetjiningsih; Bagus Ngurah Putu Arhana; Ida Bagus Subanada
Paediatrica Indonesiana Vol 50 No 4 (2010): July 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.4.2010.214-9

Background Routine immunization injections are the mostcommon painful procedure in childhood and most of theseinjections are administered in early life. Immunizations can causenegative short- and long-term consequences for children. Childrenwho experience high levels of pain during an immunizationare more likely to have elevated distress level of subsequentinjections.Objective To evaluate the effectiveness of pain away in reducingpain associated with hepatitis B intramuscular injection in termneonates.Methods An open randomized controlled trial on healthy termneonates was conducted between November 2009 and December2009 at Sanglah Hospital in Denpasar, Bali. Subject were selectedrandomized using six-blocked randomization. The sampleswere divided into two groupsto either recieve intramuscularhepatitis B injection using PainAwayÂ® and or standard hepatitisB intramuscular injection. The pain response was assessed usingDouleur Aiquedu Noureanu-nÃ©(DAN) scale. Mann-Whitney testwas used to analyze the data. The confounding factor that mayhave influenced the pain response was analyzed using multivariateanalysis (ANCOVA).Results Out of 66 subject, DAN scale was significantly lower inintervention group (median 5.0) compared to control (median 7.0)with P < 0.0001. Multivariate analysis showed that the differencein the intervention given was the only variable that influencedthe pain response (P < 0.0001).Conclusion PainAwayÂ® can reduce the pain secondary tohepatitis B intramuscular injection on term neonates.

Lung function in athletes and non-athletes aged 13-15 years Ni Komang Diah Saputri; Ayu Setyorini Mestika Mayangsari; Ida Bagus Subanada
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Background Regular sports or physical training contributes in increasing the body's pulmonary function. The increase of pulmonary function is determined by the strength of respiratory muscle, thoracic compliance, upper respiratory system resistance, and pulmonary elasticity. Objective To compare pulmonary function between athletes and non-athletes aged 13-15 years. Methods This is a cross-sectional analytical study conducted onnior high school students aged 13-15 years throughout June to August 2017. Participants are classified as athletes from particular sports and non-athletes. Assessment of pulmonary function was done using a spirometry test, in which each subject was asked to inhale and exhale in a particular method. Parameters assessed include vital capacity (VC), forced vital capacity (FVC), expiratory volume in 1 second (FEV1), forced expiratory flow (FEF) and FEV1/FVC. Differences in lung function between athletes and non-athletes were analyzed using independent T-test. Results There were 60 athletes and 60 non-athletes included in this study. The mean age of athletes and non-athletes were 13.38 (SD 0.99) years old and 13.70 (SD 0.76) years old, respectively. The statistically significant differences in mean lung function parameters between athletes and non-athletes were as follows: VC: 85.03% vs. 79.41%, respectively (P=0.035); FVC: 95.66% vs. 88.43%, respectively (P=0.016); FEV1: 102.10% vs. 94.28%, respectively (P=0.016); and FEV1/FVC: 105.95% vs. 102.69%, respectively (P=0.011). However, there were no statistically significant differences in the means of FEF 25-75% between the two groups (P>0.05). Conclusions Parameters of lung function in athletes are in general significantly higher than in non-athletes.

Full outline of unresponsiveness score as a predictor of outcomes in critically ill pediatric patients Novita Purnamasari Assa; Dyah Kanya Wati; Ida Bagus Subanada; Soetjiningsih Soetjiningsih; Made Kardana; Made Sukmawati
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Background Mortality predictions are very important for improving service quality in the pediatric intensive care unit (PICU). The full outline of unresponsiveness (FOUR) is a new coma scale and is considered capable of predicting mortality and outcome. Objective To assess the ability of FOUR scores to predict outcomes of critically ill patients in the PICU. Methods This prospective cohort study included children aged 1 months - 18 years who were admitted to the PICU. Subjects were assessed by FOUR, grouped into score < 9 or score >9, and followed until outcomes were obtained. Bivariate analysis to assess the risk of death was made by cross-tabulation and the strength of the association in the form of risk ratio by Chi-square test. Multivariate analysis was done by logistic regression test. Results Of 94 subjects, 47 had FOUR scores <=9 and 47 subjects had FOUR >9. Bivariate analysis revealed that PICU patients with FOUR score <=9 had a higher risk of death than those with FOUR score >9 (RR 12.5; 95%CI 3.1 to 49.8; P<0.0001). Multivariate analysis revealed that FOUR score, length of stay <=7 days, and non-surgical disease significantly increased the risk of mortality in PICU patients (by 42.8 times, 8.9 times, and 5.9 times, respectively). Conclusion The FOUR scores have good ability to predict the outcomes of critically ill pediatric patients. A FOUR score <=9 at the beginning of treatment is significantly associated with the outcome of mortality during treatment in the PICU.

Plasma NT-proBNP and pulmonary to systemic blood flow ratio in congenital heart defects with left-to-right shunts Eko Kristanto Kunta Adjie; Ni Putu Veny Kartika Yantie; Made Gede Dwi Lingga Utama; Eka Gunawijaya; Ketut Ariawati; Ida Bagus Subanada; Anak Agung Ngurah Ketut Putra Widnyana
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.310-5

Background Cardiac left-to-right shunts changes to the pulmonary-to-systemic blood flow ratio (Qp/Qs ratio). This ratio can be used to monitor the hemodynamics of the heart. Left-to right-shunts cause the release of amino terminal proB-ty natriuretic peptide (NT-proBNP) that can be utilized as a specific marker for the presence of heart failure in children with congenital heart defects (CHDs). Early intervention such as defect closure in CHD is important to prevent heart failure. Objective To assess for a correlation between the level of NT pro-BNP and Qp/Qs ratio in CHD patients with left-to-right shunts. Methods This cross-sectional, analytical study was conducted in 32 children who underwent cardiac catheterization at Sanglah General Hospital, Denpasar, Bali, and were recruited by consecutive sampling. NT-proBNP levels were measured by ELISA with a two-step sandwich assay system; Qp/Qs ratio using Fick rules. Statistical analyses included Shapiro-Wilk test, descriptive analysis for subject characteristics, and Pearsonâ€™s correlation analysis. A P value of <0.05 was considered to be statistically significant. Age and defect size were analyzed as confounding factors by partial correlation test. Results The correlation value between NT-proBNP and Qp/Qs ratio was r=0.384 (P<0.05), after controlling for age and defect size as cofounding factors. Conclusion There is a weak positive correlation between NT-proBNP levels and pulmonary-to-systemic blood flow ratio in patients with left-to-right shunt, after controlling for age and defect size as confounding factors.

Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia Carissa Lidia; I Made Kardana; Gusti Ayu Putu Nilawati; Ida Bagus Subanada; I Gusti Agung Ngurah Sugitha Adnyana; Ayu Setyorini Mestika Mayangsari
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.8-11

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.

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

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