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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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Disease-related malnutrition in children and role of oral nutrition supplement: - Sidiartha, I Gusti Lanang; Pratiwi, I Gusti Ayu Putu Eka; Subanada, Ida Bagus
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.450-5

Abstract

Background Disease-related malnutrition (DRM) is a common complication in chronic diseases. An oral nutrition supplement (ONS) is a formula with high energy density which is commonly used to treat malnutrition. Objective To identify the prevalence of DRM in children with chronic disease and evaluate the benefits of ONS. Methods A retrospective study was conducted at Prof. IGNG Ngoerah Hospital, Denpasar, Bali. Data were collected from medical records of patients who were admitted from January to December 2021. Inclusion criteria were patients aged 1-18 years with chronic diseases. Patients with organomegaly, edema, and incomplete medical record data were excluded. Disease-related malnutrition was defined as weight-for-height (for < 5 years of age) or BMI-for-age < -2SD (for > 5 years of age), according to the WHO growth charts. Subjects who received ONS for more than 80% of total energy during hospitalization were classified as part of the ONS group and the rest as standard group. Several variables between ONS and standard group were analyzed and considered significant if P value < 0.05. Results Of 313 subjects with chronic disease, 139 (44.4%) were diagnosed with DRM. Among of 139 subjects with DRM, a total of 64 subjects were analyzed in the ONS and standard feeding groups. No significant difference was found between groups with regards to age, gender, weight, height, white blood cell count, and lymphocyte cell count. Subjects with severe malnutrition significantly more classified as an ONS group than subjects with moderate malnutrition (P=0.001). Mean length of hospital stay was significantly shorter in the ONS group [11.8 (SD 6.7) days] than in the standard group [16.1 (SD 6.6) days]; (P=0.012). Conclusion Malnutrition related to chronic disease in children is prevalent. Use of ONS is associated with a shorter length of hospital stay. Thus, routine nutritional status assessment to identify malnutrition in children with chronic disease is needed to treat with ONS in order to improve prognoses.
Slow 0.9% NaCl Bolus Administration Reduces ANP, MMP-2, and Syndecan-1 Shedding in Septic Shock Rabbit Models Hartawan, I Nyoman Budi; Wiryana, Made; Jawi, I Made; Astawa, I Nyoman Mantik; Bakta, I Made; Subanada, Ida Bagus; Suparyatha, Ida Bagus; Wati, Dyah Kanya
Molecular and Cellular Biomedical Sciences Vol 9, No 2 (2025)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v9i2.590

Abstract

Background: The optimal rate for fluid bolus administration in septic shock remains a critical and unresolved question. Rapid bolus administration is commonly practiced but has been linked to elevated levels of atrial natriuretic peptide (ANP), matrix metalloproteinase-2 (MMP-2), and syndecan-1 shedding, potentially exacerbating endothelial glycocalyx damage and increasing vascular permeability. However, the physiological and clinical implications of slower bolus rates have not been thoroughly investigated. This study was conducted to identify safer fluid management practices and improve patient outcomes in septic shock.Materials and methods: A randomized post-test-only control group design was employed, involving 36 male New Zealand rabbits with lipopolysaccharide-induced septic shock. The treatment group received 0.9% NaCl boluses (20 mL/kg body weight) over 20 minutes per bolus (slow bolus), while the control group received the same volume over 5 minutes per bolus (rapid bolus). ANP, MMP-2, and syndecan-1 levels were measured using ELISA 10-15 minutes post-intervention.Results: The median ANP levels in the treatment group (92.86 ng/mL) were significantly lower (p<0.05) than those in the control group (367.32 ng/mL). The mean MMP-2 levels in the treatment group (10.26 ng/dL) were lower than those in the control group (11.43 ng/dL). The median levels of syndecan-1 were also lower in the treatment group (4.31 ng/mL) compared to the control group (5.94 ng/mL).Conclusion: Slow fluid boluses appear to mitigate endothelial damage by reducing ANP, MMP-2, and syndecan-1 shedding. These findings suggest that slower infusion rates may offer a protective advantage in fluid resuscitation, paving the way for updated clinical guidelines.Keywords: fluid bolus, ANP, MMP-2, syndecan-1
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