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All Journal Medicina Jurnal Sains dan Teknologi Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran

Gusti Ayu Putu Nilawati

Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar

Author-ID : 352779

Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Medicine & Pharmacology

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Ginjal tapal kuda dengan hidronefrosis unilateral sekunder akibat atresia ureter: laporan kasus Putu Kurnia Darma Pratama; Gede Wirya Kusuma Duarsa; Gusti Ayu Putu Nilawati; Pande Putu Yuli Anandasari
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Total prevalence of multiple congenital anomalies (MCA) was 15.8 per 10,000 births. Genitourinary anomalies were associated with MCA cases about 43.8% of the cases. The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA and up to one third also had hydronephrosis thought to be secondary to ureteric atresia.Case: A 10-month-old boy presented with a 5-month history of abdominal distention. On physical examination, there was a large non-tender cystic mass in the right upper abdomen extending down to the right lower abdomen. The other congenital anomalies on this patient were hydrocephalus, hypospadias, and bilateral undescended testis. Abdominal CT showed a significant right hydronephrosis with megaureter and mesenteric cyst. The horseshoe kidney was unclear. The surgical approach to the kidney was via a transverse upper abdominal transperitoneal incision. Exploration revealed a horseshoe kidney with cystic mass situated retroperitoneally on the right side, massive dilatation of renal pelvis and proximal ureter 3 cm from UPJ. The distal ureter was markedly atresia. It was decided to perform nephroureterectomy on the right side considering its thin renal cortex. The postoperative average urine production is 25 ml/hour, no bleeding from surgical wound, BUN 10.7 mg/dL, and serum creatinine 0.37 mg/dL.Conclusion: The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA. Up to one third with horseshoe kidney had hydronephrosis secondary to ureteric atresia, which can be managed by reconstruction surgery or nephroureterectomy considering the function of the affected side of kidney.Â

Hubungan Rasio Neutrofil Limfosit (RNL) terhadap kejadian relaps pada anak dengan sindrom nefrotik di RSUP Sanglah, Bali, Indonesia Wega Upendra Sindhughosa; Gusti Ayu Putu Nilawati; Ni Putu Siadi Purniti; Bagus Ngurah Putu Arhana; Ketut Ariawati; Putu Junara Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Nephrotic Syndrome is a disease whose cause is not fully known and has a high relapse rate. The lymphocyte neutrophil ratio is a marker of inflammation in patients with malignancy, infection, and coronary heart disease. This study aims to determine the relationship between Neutrophil Lymphocyte Ratio (NLR) and the occurrence of relapse nephrotic syndrome.Methods: This study was a retrospective analytic observational study with a cross-sectional approach to finding the relationship between increased NLR and the incidence of relapse in patients with nephrotic syndrome at SMF Children's Health Sciences Faculty of Medicine Universitas Udayana/Sanglah General Hospital. Data were taken from medical records of 45 respondents with episodes of relapse or remission from January 2018-January 2019. Data were analyzed using SPSS version 20 for Windows.Results: The results showed that most of the subjects were male (71.1%), aged 1-5 years (51.2%), and aged 4.00 Â± 8.50 years in both the relapse and remission groups. However, the infection rate (66.7%) and medication adherence (75.0%) tended to be higher in the relapse group. The analysis of the ROC curve shows the cut-off point of NLR was 2.36 (AUC: 0.521), with a sensitivity of 71.1% and a specificity of 73.3%. There was a significant relationship between the NLR value and the incidence of relapsed nephrotic syndrome in multivariate analysis (adjusted OR: 4.53; 95% CI: 1.68 - 12.22; p = 0.003).Conclusion: This study shows that there is a relationship between an increase in RNL and the incidence of relapse in pediatric nephrotic syndrome patients at Sanglah General Hospital, Bali, Indonesia.Â Latar belakang: Sindrom Nefrotik merupakan salah satu penyakit yang penyebabnya belum sepenuhnya diketahui dan memiliki angka relaps yang tinggi. rasio neutrofil limfosit merupakan suatu pertanda inflamasi pada pasien yang mengalami keganasan, infeksi dan penyakit jantung koroner. Penelitian ini bertujuan untuk mengetahui hubungan Rasio Neutrofil Limfosit (RNL) dengan terjadinya sindrom nefrotik relaps.Metode: Penelitian ini merupakan penelitian retrospektig observasional analitik dengan pendekatan potong lintang untuk mencari hubungan peningkatan RNL terhadap kejadian relaps pada pasien sindrom nefrotik di SMF Ilmu Kesehatan Anak FK UNUD/Rumah Sakit Umum Pusat Sanglah. Data diambil dari rekam medik terhadap 45 responden dengan episode relaps maupun remisi dari Januari 2018-Januari 2019. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian menunjukkan bahwa sebagian besar subyek adalah laki-laki (71,1%), berusia 1-5 tahun (51,2%), maupun berusia 4,00Â±8,50 tahun baik pada kelompok relaps maupun remisi. Akan tetapi angka infeksi (66,7%) maupun ketidak patuhan pengobatan (75,0%) cenderung lebih tinggi pada kelompok relaps. Analisa kurva ROC menunjukkan titik potong RNL sebesar 2,36 (AUC: 0,521) dengan sensitivitas 71,1% dan spesifisitas 73,3%. Terdapat hubungan bermakna antara nilai RNL dengan kejadian sindrom nefrotik relaps pada analisis multivariat (adjusted OR: 4,53; 95%IK: 1,68 â€“ 12,22; p=0,003).Simpulan: Penelitian ini menunjukkan bahwa terdapat hubungan antara peningkatan RNL terhadap kejadian relaps pada penderita sindrom nefrotik anak di RSUP Sanglah, Bali, Indonesia

Karakteristik hipertensi pada anak di Instalasi Rawat Inap (IRNA) RSUP Sanglah, Bali, Indonesia Desak Made Widiastiti Arga; I Ketut Suarta; Gusti Ayu Putu Nilawati
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: The prevalence of hypertension in children and adolescents has increased in the last decade. Hypertension in children is associated with hypertension in adults that have not been treated well and one of the risk factors for cardiovascular disease, kidney disease, and other organ damage. Data on hypertension in children is still limited, especially in Indonesia. This study aims to determine the characteristics of children with hypertension in the inpatient installation of Sanglah Hospital Denpasar.Methods: This is a retrospective cross-sectional study with a descriptive design. Data were collected from pediatric patients' medical records age 1-18 years old diagnosed with hypertension in 2018-2019. Variables assessed in this study were gender, age, etiology of hypertension, symptoms, and number of antihypertensive therapies. Data were analyzed using SPSS version 22 for Windows.Results: A total of 56 children with hypertension were included in this study. Subjects were dominated by the female (53.6%), ages 6-13 years (46.4%) with a median age of 11 years, and well-nourished (46.4%). The etiology of hypertension for all subjects is secondary hypertension, mostly caused by kidney disease (75%). Hypertension symptoms are generally not specific; headache is the most common symptom of hypertensive crisis (35.7%). Stage 2 hypertension is most common in this study (57.1%); hypertensive crises mostly occur in children aged ?13 years and are treated in the intensive care unit. Children with stage 2 hypertension and hypertensive crisis tend to show uncontrolled hypertension upon hospital discharge (44.4%). The majority of children received single antihypertensive therapy (51.8%).Conclusion: The etiology of hypertension in children is mostly secondary hypertension caused by kidney disease. Second-degree hypertension is the most common hypertension in children who are treated with hypertension. The outcome is mainly controlled hypertension with single antihypertensive therapy. Latar belakang: Angka kejadian hipertensi pada anak dan remaja mengalami peningkatan dalam dekade terakhir. Hipertensi pada anak erat kaitannya dengan kejadian hipertensi pada dewasa yang tidak ditata laksana dengan baik, dan salah satu faktor risiko timbulnya penyakit kardiovaskuler, ginjal dan kerusakan organ lain. Data mengenai hipertensi pada anak masih terbatas terutama di Indonesia. Penelitian ini bertujuan untuk mengetahui karakteristik hipertensi pada anak di Instalasi Rawat Inap RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan penelitian potong lintang retrospektif menggunakan rancangan deskriptif. Data diambil dari rekam medis pasien anak berusia 1-18 tahun yang dirawat dengan hipertensi pada tahun 2018-2019. Variabel yang dinilai pada penelitian ini adalah Jenis kelamin, usia, etiologi hipertensi, gejala, dan jumlah obat anti hipertensi. Data dianalisis dengan SPSS versi 22 untuk Windows.Hasil: Sebanyak 56 anak dengan hipertensi diikutkan dalam penelitian ini. Subjek didominasi oleh jenis kelamin perempuan (53,6%), usia 6-13 tahun (46,4%) dengan median usia 11 tahun, dan gizi baik (46,4%). Etiologi hipertensi seluruh subjek adalah hipertensi sekunder yang paling banyak disebabkan oleh penyakit ginjal (75%). Gejala hipertensi secara umum tidak spesifik; sakit kapala merupakan gejala yang paling sering dikeluhkan pada krisis hipertensi (35,7%). Hipertensi derajat 2 paling banyak ditemukan pada subjek (57,1%); krisis hipertensi sebagian besar terjadi pada anak berusia ?13 tahun dan dirawat di ruang intensif. Anak dengan hipertensi derajat 2 dan krisis hipertensi cenderung menunjukkan hipertensi yang tidak terkontrol saat keluar rumah sakit (44,4%). Mayoritas anak mendapatkan terapi antihipertensi tunggal (51,8%).Kesimpulan: Hipertensi pada anak mayoritas adalah hipertensi sekunder yang disebabkan oleh penyakit ginjal. Hipertensi derajat 2 adalah hipertensi yang paling banyak ditemukan pada anak yang dirawat dengan hipertensi. Sebagian besar memiliki luaran hipertensi yang terkontrol dengan terapi antihipertensi tunggal.

Co-Authors Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana Carissa Lidia Deborah Melati, Deborah Desak Made Widiastiti Arga Floria Eva, Floria Gede Wirya Kusuma Duarsa Hendra Santoso Hendy Hendy I Gusti Agung Ngurah Sugitha Adnyana I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Ketut Suarta I Made Kardana I Wayan Dharma Artana I Wayan Suradhipa, I Wayan Ida Bagus Subanada Ketut Ariawati Ketut Dewi Kumara Wati Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Ni Putu Sri Ayuni NP Veny Kartika Yantie Pande Putu Yuli Anandasari Putu Diah Pratiwi Putu Junara Putra Putu Kurnia Darma Pratama Wega Upendra Sindhughosa

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