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

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Journal : Medicina

 1 
OBESITY IS ASSOCIATED WITH HYPERTENSION IN ADOLESCENTS Hendy, Hendy; Lanang Sidiartha, I Gusti; Putu Nilawati, Gusti Ayu
Medicina Vol 44 No 3 (2013): September 2013
Publisher : Medicina

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Abstract

Obesity has become a global issue. Previous studies in Bali reveal an increase in the proportionof obesity in adolescents. Obesity causes hypertension; hence there should also be an increase inthe prevalence of hypertension as well in Bali. Hypertension in obese adolescents could be causedby various factors, hence identification of the risks factors is crucial as a preventive approach.The aim of this study was to prove an association between obesity and hypertension in adolescents,and to look for the risk factors. We used an analitical cross sectional design conducted to 12-14years old samples. We took body weight, height, waist circumference, hip circumference, andblood pressure measurements with appropriate devices and asked for information regarding lifestyle and familial history by a questionnare filled in by the samples. The association of obeseadolescents with hypertension and their risk factors was analyzed by Chi-square and multivariatetests. A total of 225 subjects from Santo Yoseph junior high school students, west Denpasar,Bali, met the inclusion criteria. The proportion of obese subjects in this study was 25.7%. Wefound that proportion in familial history of obesity was greater in obese than non-obese subjects(70.7 % vs 41.3%). Logistic regression test revealed that obese subjects with hypertension had abody mass index (BMI) > 30 with odds ratio of 7.3 (CI 95% = 1.8 to 28.8) and P = 0.005. Weconcluded that there was an association between obesity and adolescents with hypertension,and BMI > 30 could be a risk factor for obese adolescents with hypertension.
HENOCH SCHONLEIN PURPURA ASSOCIATED WITH ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS: A CASE REPORT Melati, Deborah; Kumara Wati, Ketut Dewi; Putu Nilawati, Gusti Ayu
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

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Acute post-streptococcal glomerulonephritis (APSGN) is one of the most common renal disease resulting from a prior infection with group A â-hemolytic streptococcus (GAS). Henoch Schonlein Purpura (HSP) is a systemic disease with frequent renal involvement, its etiology is still unknown but several infections have been described as trigger includingGAS infection. A 4 year 10 month old Balinese boy presented with full blown acute nephritic syndrome, an elevation in serum creatinine and four fold increase of anti streptolysin-O, also low serum levels of complement C3 with normal C4 confirmed the diagnosis of APSGN. During hospitalization he developed palpable purpura, gastrointestinal symptoms as well as leucytoclastic vasculitis in skin biopsy conclude HSP diagnosis.He was treated with anti-hypertensions and metylprednisolone intravenous. The prognosis of the patient was excellent, he showed normal physical examination with normal complete blood count and urinalysis after 3 months follow up. We conclude that both APSGN and HSP could appear concurrently after GAS infection. [MEDICINA 2014;45:102-7]  
Estimasi laju filtrasi glomerulus penderita leukemia limfoblastik akut yang mendapatkan kemoterapi metotreksat dosis tinggi Suradhipa, I Wayan; Ariawati, Ketut; Nilawati, Gusti Ayu Putu
Medicina Vol 47 No 2 (2016): Mei 2016
Publisher : Medicina

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Metotreksat dosis tinggi banyak digunakan dalam pengobatan leukemia limfoblastik akut (LLA) di Sub-Bagian Onkologi Pediatri. Pemberian metotreksat dosis tinggi menimbulkan efek toksik berupa disfungsi ginjal. Indikator disfungsi ginjal dapat dilihat dari nilai estimasi laju filtrasi glomerulus (eLFG). Penelitian ini bertujuan untuk mengetahui efek pemberian MTX dosis tinggi pada pasien LLA terhadap kejadian disfungsi ginjal yang dinilai dari eLFG. Penelitian retrospektif, melibatkan 19 anak LLA yang mendapatkan kemoterapi sesuai protokol LLA di Sub-Bagian Hemato-Onkologi Bagian/SMF Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RSUP Sanglah Denpasar pada bulan Januari 2011 sampai Desember 2013. Data mengenai nama, jenis kelamin, umur atau tanggal lahir, berat badan, tinggi, serum kreatinin, dan berapa kali sudah mendapatkan MTX dosis tinggi diperoleh dari rekam medis pasien. Nilai rerata eLFG sebelum dan sesudah pemberian MTX dosis tinggi didapatkan perbedaan yang bermakna. Nilai rerata eLFG setelah pemberian MTX dosis tinggi I, II, dan III menurun secara signifikan berturut-turut sebesar 277,10 ml/mnt/1,73m2 (SB 97,32), 248,05 ml/mnt/1,73m2 (SB 85,06), dan 212,65 ml/mnt/1,73m2 (SB 71,95) dengan P < 0,001. Disimpulkan, nilai rerata eLFG pasien LLA setelah pemberian MTX dosis tinggi I, II dan III didapatkan penurunan secara signifikan tetapi penurunan ini masih dalam rentang normal. High-dose methotrexate is widely used in the treatment of acute lymphoblastic leukemia (ALL) in pediatric oncology department. Administration of high-dose methotrexate cause toxic effects such as kidney dysfunction. Indicators of renal dysfunction can be seen from the value estimated glomerular filtration rate (eLFG). This study aims to describe estimation GFR (eGFR) in ALL patient after methotraxate high dose in pediatric. A retrospective study, in 19 children who receive chemotherapy according ALL protocol in Sanglah Hospital from January 2011 to December 2013. Data regarding name, sex, age or date of birth, weight, height, serum creatinine, and how many times have received high-dose MTX obtained from medical records of patients. ). There were differences between eGFR of patients before and after treatment with high dose methotrexate. The mean of eGFR after the first, the second and the third methotrexate high dose were decrease significant 277.10 ml/mnt/1.73 m2 (SD 97.32), 248.05 ml/mnt/1.73 m2 (SD 85.06), 212.65 ml/mnt/1.73 m2 (SD 71.95) with P < 0.001. It was concluded that eGFR patients with ALL decrease significant after treatment with high dose methotrexate but still in normal range of eGFR.
RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN CHILDREN Eva, Floria; Nilawati, Gusti Ayu Putu
Medicina Vol 46 No 1 (2015): Januari 2015
Publisher : Medicina

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Abstract

Rapidly progressive glomerulonephritis (RPGN) is a rare syndrome in children and one of the nephrologyemergency which needs special attention. Rapidly progressive glomerulonephritis  is determined bysymptoms and signs of glomerulonephritis (GN); edema, hypertension, gross hematuria, and rapid lossof renal function. Early diagnosis and appropriate treatment play a critical role in saving renal functionand preventing permanent glomerular damage. Diagnosis was made based on clinical and laboratoryfindings. We reported two cases of RPGN in an eleven year old boy and an eight year old boy. The patientcame  to  the pediatric outpatient clinic at sanglah hospital with chief complaint dark  ?cola colored?urine. Laboratory work up showed proteinuria, erythrocyturia, decrease of C3 and normal C4 complementlevel, increased serum urea and creatinine level and loss of renal function in a few days with glomerularfiltration  rate  decreased. Based  on  clinical  and  laboratory  findings,  the  patient was  diagnosed  asrapidly progressive glomerulonephritis. The patient was given methylprednisolone pulses for 3 days,followed  by  high  dose  oral methylprednisolone. Prognosis  of  the  patient was  good.  [MEDICINA2015;46:46-51].
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