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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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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.

The Effect of Carnitine Supplementation on Blood Ammonia Level in Epilepsy Children Treated with Valproic Acid: A Randomized Controlled Trial I Gusti Lanang Sidiartha; I Gusti Ngurah Made Suwarba; Dyah Kanya Wati; Ida Bagus Subanada
Molecular and Cellular Biomedical Sciences Vol 5, No 1 (2021)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v5i1.177

Background: Long-term use of valproic acid is associated with a high level of blood ammonia related to carnitine deficiency. This study investigates the effect of carnitine supplementation on blood ammonia levels in children with epilepsy who have been treated with valproic acid for more than six months.Materials and Methods: This was a randomized, double-blind, placebo-controlled trial study where children with epilepsy who were treated with valproic acid were randomly allocated to the carnitine supplementation and control group. All children were followed for month, and then measured for blood ammonia level. Blood ammonia levels of both groups were compared using an Independent t-test with a significant of p<0.05.Results: Total of 32 children with epilepsy were enrolled as subjects in this study, with 16 children in carnitine group, and 16 children in control group. Among the subjects, 50% were male and 50% were female, with a mean age of 6.5 years old. The average duration of epilepsy in the carnitine and control group were 41.7 months and 36.9 months, respectively (p=0.419). The duration of valproic acid therapy in the carnitine and control group were 33.1 months and 27.6 months, respectively (p=0.483). The level of blood ammonia in carnitine and control group were 44.6 mg/dL and 81.4 mg/dL, respectively (p=0.007).Conclusion: The level of blood ammonia in a carnitine group was significantly lower than in a control group. It is recommended to give carnitine supplementation in epileptic children treating with long-term valproic acid.Keywords: ammonia, carnitine, epilepsy, seizure, valproic acid

High Blood Ammonia Levels Associated with Long-term Valproic Acids Therapy in Epileptic Children I Gusti Lanang Sidiartha; I Gusti Ngurah Made Suwarba; Dyah Kanya Wati; Ida Bagus Subanada
Molecular and Cellular Biomedical Sciences Vol 4, No 2 (2020)
Publisher : Cell and BioPharmaceutical Institute

Background: Valproic acid is an effective drug for controlling seizure in children with epilepsy and it is usually used for treatment as long as two years or more. Blood ammonia level often increased in epileptic children who were treated with long-term valproic acid. The study was conducted to determine the relationship between blood ammonia level with valproic acid therapy in epileptic children.Materials and Methods: This is an observational study with cross-sectional approach. The subjects were 64 children with epilepsy, average age of 6.2 years old. Subjects were 33 boys and 31 girls. Blood ammonia level was examined using enzymatic glutamate dehydrogenase. Subjects were divided into 2 therapeutic groups based on the duration, doses and combination therapy of valproic acid. Subjects were recruited from Pediatric Neurology Clinic, Sanglah General Hospital, Bali, Indonesia, from May to December 2017. Comparison of blood ammonia level between groups were analyzed using an Independent t-test with significances if the p<0.05.Results: A significant difference of blood ammonia level was found between subjects who were treated with valproic acid less than 2 years and more than 2 years (45.7±16.4 mmol/L vs. 70.9±43.6 mmol/L; p=0.032). However, significant difference was not found between the groups according to the doses and combination therapy (p=0.450 and p=0.647, respectively).Conclusion: Blood ammonia level was significantly higher in epileptic children who used long-term valproic acid, hence it was recommended to check the blood ammonia level routinely.Keywords: ammonia, epilepsy, valproic, children

The suitability of sputum and blood culture in children with pneumonia at Sanglah General Hospital, Bali, Indonesia Ayu Setyorini Mestika Mayangsari; Ida Bagus Subanada; Putu Siadi Purniti; Wayan Agustini Selumbung
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Pneumonia is one of the diseases in children with high morbidity, especially in children under 5 years old. In developing countries, the most common cause of pneumonia is bacteria. There is a newer method that gives a better reflection of the aetiology, which is the sputum examination. This study aims to determine the suitability of sputum and blood culture in children with pneumonia at Sanglah General Hospital, Bali.Methods: A cross-sectional study was conducted at Respirology Subdivision in Department of Child Health Sanglah Hospital from November 2016 until February 2017. A categorical comparative matching was carried out between 2 formula groups. The sputum culture and blood culture were obtained through Microbiology Laboratory at Sanglah General Hospital. Data were analysed using SPSS version 16 for Windows.Results: There were 50 children with pneumonia enrolled in this study. The children aged less than 1 years old were predominant (62%). There were a statistically systematic difference and only a fair agreement between blood and sputum culture (Ä¸=0.257; p= 0.004). In a subject with positive sputum culture, 90.9% had a better outcome than the positive blood culture even though no statistically significant (RR=0.23; 95%CI: 0.15-22.53)Conclusion: There is suitability between the culture of sputum and blood cultures in children with pneumonia. Sputum culture has a higher probability to reveal the microorganism compared to blood cultures.

HUBUNGAN POLA KONSUMSI ANAK DI KANTIN SEKOLAH DENGAN OBESITAS DI SD NEGERI 17 DANGIN PURIi Jumantini, Ni Komang Pasek Nurhyang; Wati, Dyah Kanya; Subanada, Ida Bagus; Suparyatha, Ida Bagus Gede
E-Jurnal Medika Udayana Vol 11 No 4 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i04.P06

ABSTRAK Obesitas kini telah menjadi tantangan kesehatan. Kasus obesitas pada anak menjadi salah satu permasalahan yang perlu diperhatikan. Pada tahun 2016, obesitas terjadi pada lebih dari 650 juta orang dengan melampaui angka 340 juta anak dan remaja usia 5-19 tahun mengalami obesitas. Obesitas terjadi akibat ketidakseimbangan antara intake energi dan energi yang digunakan tubuh. Obesitas merupakan penyakit multifakatorial. Pada anak usia sekolah dasar, pola konsumsi di kantin sekolah berkontribusi besar terhadap kasus obesitas. Anak usia sekolah dasar cenderung memiliki kebiasaan jajan di kantin sekolah. Makanan tinggi karbohidrat dan lemak mendominasi jajanan di kantin sekolah, seperti gorengan, makanan ringan (snack), sosis, aneka kue, cokelat, dan makanan cepat saji lainnya serta berbagai jenis minuman. Penelitian ini bertujuan untuk mengetahui apakah terdapat hubungan pola konsumsi anak di kantin sekolah dengan kejadian obesitas anak. Penelitian ini merupakan penelitian observasional dengan metode pengambilan data cross-sectional dan pengumpulan data dilakukan dengan wawancara dan pengukuran antropometri. Penelitian ini dilakukan di SD Negeri 17 Dangin Puri, dengan besar sampel sebanyak 66 responden. Berdasarkan hasil penelitian, ditemukan adanya hubungan bermakna antara pola konsumsi tidak seimbang di kantin sekolah anak dengan status gizi obesitas (OR=5,400; IK 95% 1,185-24,597; p=0,029), dan adanya hubungan bermakna antara aktifitas fisis dengan status gizi anak (OR=0,165; IK 95% 0,036-0,749; p=0,020). Kesimpulan dari penelitian ini bahwa terdapat hubungan pola konsumsi anak di kantin sekolah dengan kejadian obesitas. Kata kunci : obesitas, anak sekolah dasar, pola konsumsi di kantin sekolah

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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