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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana E-Jurnal Agroekoteknologi Tropika (Journal of Tropical Agroecotechnology) Sari Pediatri JURNAL HAMA DAN PENYAKIT TUMBUHAN TROPIKA Paediatrica Indonesiana CHEESA: Chemical Engineering Research Articles ISM (Intisari Sains Medis) : Jurnal Kedokteran Distilat: Jurnal Teknologi Separasi Jurnal Rekayasa Proses

I Made Arimbawa

Department Of Child Health, Medical Faculty, Udayana University, Indonesia

Author-ID : 3739797

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Health Professions Medicine & Pharmacology

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Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care Hendy Halim; Ida Bagus Gede Suparyatha; I Made Arimbawa; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in children requiring intensive care.Objective To determine the association between multiple organ dysfunction syndrome (MODS) in children requiring intensive care and hyperglycemia with blood sugar level higher than 140 mg/dl.Methods This case control study without matching was conducted on children aged 1 month-12 years from pediatric ward at Sanglah hospital during June-August 2012. We used consecutive sampling to recruit subjects, which then were screened by Pediatric Risk of Hospital Admission (PRISA) 2 score. All subjects were enrolled for blood sugar test, then divided into 2 groups; hyperglycemia with blood sugar level > 140 mg/dl as case and normoglycemia as control. We used organ dysfunction criteria to determine multiple organ dysfunction. The association between MODS and hyperglycemia was assessed by Chi-square test with 95% confidence interval and a statistical significance value of P < 0.05.Results Fifty two subjects were enrolled in this study. We excluded two subjects, hence each group consisted of 25 subjects. We found 18 subjects under and 7 subjects above five years old in hyperglycemia group. The association between multiple organ dysfunction and hyperglycemia was significant with an odds ratio of 10 (95% CI 3 to 38), P < 0.0001.Conclusion Multiple organ dysfunction syndrome had a significant association with hyperglycemia. Multiple organ dysfunction syndrome with hyperglycemia occurs ten times greater than with normoglycemia.

Adverse effects of hyperbilirubinemia on the development of healthy term infants I Made Arimbawa; Soetjiningsih Soetjiningsih; I K Kari
Paediatrica Indonesiana Vol 46 No 2 (2006): March 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.2.2006.51-6

Background Indirect hyperbilirubinemia is a common problem dur-ing the neonatal period and may cause long-term abnormality ordevelopmental delay.Objective To evaluate the adverse effects of hyperbilirubinemiaon the development of healthy term infants.Methods This was a prospective cohort study on healthy terminfants born in Sanglah Hospital, Denpasar. Mullen Scale Testswere performed at the ages of 3 and 6 months to assess subjectsâ€™development. Bivariate and multivariate analyses were conductedto examine the relationship between several dependent variablesand developmental outcomes.Results One hundred and twelve infants were enrolled in this study[56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%)male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months,below average category according to Mullen Scale Test was higherin infants with history of hyperbilirubinemia compared to those with-out hyperbilirubinemia, which was statistically significant for finemotor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95%CI 1.15;2.39). At 6 months of age, it was higher in infants withhistory of hyperbilirubinemia compared to those without hyperbi-lirubinemia and this was statistically significant for gross motor scale(19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008)and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI1.15; 2.39; P=0.039). Multivariate logistic regression test showedthat only hyperbilirubinemia was correlated with gross motor scaledelay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22;29.12).Conclusion Healthy term infants with history of hiperbilirubinemiawere associated with increased gross motor scale delay at theage of 6 months

HUBUNGAN FAKTOR PERILAKU DAN FAKTOR LINGKUNGAN TERHADAP KEJADIAN DIARE PADA BALITA DI DESA SUKAWATI, KABUPATEN GIANYAR BALI TAHUN 2014 I Wayan Arimbawa; Komang Ayu Trisna Dewi; Zakwan bin Ahmad
Intisari Sains Medis Vol. 6 No. 1 (2016): (Available online: 1 August 2016)
Publisher : DiscoverSys Inc.

Pendahuluan: Penyakit diare masih merupakan masalah kesehatan di negara-negara berkembang, termasuk Indonesia. Survei morbiditas oleh Depkes Indonesia terlihat kecenderungan insiden diare meningkat dari tahun 2000 sebesar 301/1000 penduduk dan tahun 2010 menjadi 411/1000 penduduk. Dilihat dari kelompok umur, prevalensi tertinggi terjadi pada kelompok balita sebesar 16.7%. Di Bali, angka insidens diare tercatat sebesar 5.0%. Penyakit diare masih menjadi salah satu dari sepuluh penyakit terbanyak di puskesmas di Bali. Dari laporan tahunan Puskesmas Sukawati I, Gianyar tercatat pada tahun 2012 sebanyak 48,62% kasus diare terjadi di Desa Sukawati Gianyar dan tahun 2013 tercatat sebanyak 54.64% kasus diare terjadi di sana. Faktor lingkungan, perilaku, pengetahuan, dan sosioekonomi berkaitan erat dengan peningkatan transmisi diare. Tujuan penelitian ini adalah untuk mengetahui hubungan faktor perilaku dan lingkungan terhadap kejadian diare pada balita.Metode penelitian: Penelitian menggunakan rancangan analisis multivariat cross-sectional dengan populasi terjangkau adalah seluruh kepala keluarga yang memiliki balita dan berdomisili di Desa Sukawati, Gianyar. Sampel penelitian dipilih menggunakan metode stratifiedrandom sampling dan besar sampel adalah 70 orang. Ibu balita dari setiap kepala keluarga yang terpilih ditetapkan sebagai responden. Penelitian menggunakan kuesioner terstruktur dan pengamatan langsung lingkungan rumah. Analisis data dilakukan secara univariat, bivariat dengan uji chi-square, dan multivariat dengan uji regresi logistik.Hasil: Hasil penelitian menunjukkan bahwa faktor yang berhubungan dan berpengaruh secara signifikan terhadap kejadian diare balita adalah perilaku kebiasaan memasak air minum (p=0.018). Faktor yang tidak berhubungan dengan kejadian diare balita antara lain: kebiasaan mencuci tangan (p=0.606), makpakang (p=1.00), penggunaan filtrasi air tradisional (0.223), kepemilikan jamban keluarga (0.149), akses sumber air (0.236), dan tempat pembuangan sampah (0.303).Simpulan: Perilaku kebiasaan memasak air minum berhubungan dengan kejadian diare pada balita di Desa Sukawati, Gianyar. Kebiasaan memasak air minum merupakan faktor paling berpengaruh secara signifikan.

HUBUNGAN JENIS KELAMIN, STATUS GIZI DAN BERAT BADAN LAHIR DENGAN ANGKA KEJADIAN ISPA PADA BALITA DI PUSKESMAS BANJARANGKAN II TAHUN 2016 Putu Meitri Nirmala Utami; Putu Siadi Purniti; I Made Arimbawa
Intisari Sains Medis Vol. 9 No. 3 (2018): (Available online: 1 December 2018)
Publisher : DiscoverSys Inc.

ABSTRAKInfeksi saluran pernapasan akut (ISPA) adalah penyakit infeksi akut yang menyerang salah satu bagian dan atau lebih dari saluran napas. ISPA sering dijumpai di negara-negara berkembang. Sebagai negara berkembang, Indonesia menduduki posisi keempat bersama dengan Bangladesh dan Nigeria. Sedangkan Bali memiliki angka periode prevalensi sebesar 22,6% dimana angka tersebut tidak jauh dari angka periode prevalensi ISPA di Indonesia yaitu 25,0%. Tujuan penelitian ini untuk melihat faktor-faktor yang berhubungan dengan ISPA terutama jenis kelamin, status gizi dan berat badan lahir terhadap balita penderita ISPA. Penelitian ini menggunakan studi analitik cross-sectional. Sampel yang digunakan berjumlah 223 orang yang diambil secara konsekutif di Puskesmas Banjarangkan II Klungkung pada rentang waktu 1 Januari 2016 s.d. 31 Desember 2016. Data penelitian adalah data sekunder dari rekam medis pasien. Hasil penelitian menunjukan bahwa balita dengan ISPA cenderung lebih banyak pada usia 1-3 tahun (57,9%), jenis kelamin laki-laki (62,6%), status gizi baik (89,9%), dan berat badan lahir normal (88,5%). Hasil analisis menggunakan uji chi-square menyatakan terdapat hubungan yang bermakna antara jenis kelamin (p=0,003), status gizi (p<0,0001), dan berat badan lahir (p<0,0001) dengan angka kejadian ISPA pada balita.Terdapat hubungan bermakna antara variabel jenis kelamin, status gizi dan berat badan lahir dengan angka kejadian ISPA pada balita.Kata Kunci: balita, ISPA, jenis kelamin, status gizi, berat badan lahirâ€ƒABSTRACTTHE RELATION BETWEEN GENDER, NUTRITIONAL STATUS, AND BIRTH WEIGHT WITH THE INCIDENCE OF URTI IN CHILDREN BELOW 5 YEARS OLD AT PUSKESMAS BANJARANGKAN II IN 2016Upper respiratory tract infection (URTI) is an acute infection disease affecting one or more upper respiratory tracts. This infection is often found in developing countries. As a developing country, Indonesia holds the fourth position together with Bangladesh and Nigeria. Meanwhile, Bali has the prevalence number of 22.6% in which this number is not much different with Indonesiaâ€™s of 25.0%. The objective of this study was to find out the factors which were related to upper respiratory tract infection such as gender, nutritional status, and birth weight of children below 5 years old infected with URTI in particular. This research was a cross sectional analytic study involving 223 samples who were gathered consecutively at Puskesmas Banjarangkan II Klungkung from 1 january 2016 till 31 December 2016. The data obtained were secondary data in form of medical records. The result showed that children with URTI tended to be 1-3 years old (57.9%), male (62.6%), and have good nutritional status (89.9%) and normal birth weight (88.5%). The data were analyzed using Chi-square test which showed that there was significant relation between gender (p=0.003), nutritional status (p<0.0001), and birth weight (p<0.0001) with the URTI incidence in children below 5 years old.There was significant relation between gender, nutritional status, and birth weight with the URTI incidence in children below 5 years old.Keywords: children below 5 years old, upper respiratory tract infection, gender, nutritional status, birth weight

Prevalensi dan karakteristik obesitas pada anak di Sekolah Dasar Saraswati V Kota Denpasar tahun 2016 Kadek Adi Suryamulyawan; I Made Arimbawa
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Introduction: One of the problems of excess nutrients that occur in children and received special attention in the world of health is obesity. Obesity itself can be defined as the accumulation of excess fat raises the risk of health problems. The prevalence of obesity in children in the world between 1980 and 2013 increased by 47.1%. Childhood obesity has both immediate effects and long-term health. This study aims to determine the prevalence and characteristics of obesity in children at elementary school.Method: This research is a descriptive cross sectional study, conducted in Saraswati V Denpasar elementary school, November - December 2016, by taking samples of obese children in Saraswati V elementary school Denpasar 2016.Result: From the results, 17.2% children with obese, 18.2% children with overweight, 54.6% children with normal BMI, and 10.0% children with underweight from total students many as 1003 children. While the characteristics of obese children obtained: 62.2% of obese children aged <9 years, 73.4% of obese children of boy, 86.7% of obese children have birth weight â‰¥2500 gram, 62.9% do breakfast, 98,6% escorted to school, 67.8% had obese father and 34.3% had obese mothers, 99.3% had educated father and 97.2% had educated mother.Conclusion: The high prevalence of obesity, which is 17.2%, is a focus that should be of a better concern than parents, and the government.

Association between parentsâ€™ body height with stunting in children ages 1-5 years old in Nagi Primary Health Care Working Area Larantuka City, East Flores, Indonesia Wega Upendra Sindhughosa; I Made Arimbawa
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background:Â Parents' body height is one factor associated with stunting incidence in the child. In under-five years old children, the body height is influenced by genetic factors and the environment during development periods. Short mothers are one of the factor that related to the incidence of stunting. This study aims to determineÂ the associations of parents' body height with stunting in children age 1-5 years old in Nagi Primary Health Care working area, Larantuka City.Â Â Methods:Â A cross-sectional study was conducted among 123 children age 1-5 years old who met the inclusion criteria were included in this study at Nagi Primary Health Care, Larantuka City. Data was taken from primary data and questionnaire distributed that consist of 3 main parts contains research sample characteristics, father's body height, and mother's body height. Chi-square is used to analyze the relationship between the father's body height and mother's body height with stunting. All of the data were analyzed using SPSS version 17 for Windows.Results: Most of the respondents were female (53.7%), followed by having a normal body height (67.5%), normal body weight (97.6%),Â >155 cm of mother's body height (65.0%), andÂ >165 cm of father's body height (62.6%). In bivariate analysis, there is no relationship between father's body height with stunting (p>0.01), but statistically significant between mother's body height with stunting (p<0.01). In addition, a moderate positive correlation was found between Mid-Parental Height (MPH) with the children body weight (r=0.41; p=0.01).Conclusion: Mother's body height had a significant association with stunting incidence. In addition, the MPH also had a moderate positive correlation to the children body height.

Gambaran profil lipid dan dislipidemia pada remaja dengan obesitas di kota Denpasar, Bali, Indonesia Luh Gede Yuliadewi NS; I Made Arimbawa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Obesity results in an increase fat accumulation in the body, related to blood lipid levels, and causes dyslipidemia. Dyslipidemia is one of the main risk factors for cardiovascular events. This study aims to determine the overview of lipid profiles and dyslipidemia in adolescents with obesity in the city of Denpasar, Bali, Indonesia.Method: A descriptive observational analytic study with a cross-sectional design was conducted on 51 obese adolescents in Denpasar using a two-stage random sampling technique. The variables assessed included examining lipid profiles such as total cholesterol, High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), and triglycerides. Data were analyzed with SPSS version 23 for Windows.Results: The results showed that there were 25 male subjects (49.01%) and 26 female subjects (50.99%) with an average age of 15.00Â±3.41 years. The mean body weight was 89.39Â±9.81 kg, the mean height was 158.62Â±7.31 cm, and the Body Mass Index (BMI) was 33.56Â±3.36 kg/m2. The mean total cholesterol 170.57 Â± 25.92 mg/dl, HDL 47.59 Â± 10.24 mg/dl, LDL 113.61 Â± 26.64 mg/dl, and triglycerides 126.14 (75.00) mg/dl. Dyslipidemia status based on criteria for total cholesterol levels was found in 27 subjects (52.9%), followed by HDL (23.59%), LDL (52.90%), and based on triglyceride levels of 15.70% subjects. Dyslipidemia based on the overall lipid profile was found in 36 subjects (70.60%).Conclusions: Most subjects had total cholesterol levels above normal, HDL levels below normal, LDL levels above normal, and most subjects experienced dyslipidemia.Â Latar belakang: Obesitas mengakibatkan peningkatan akumulasi lemak berlebihan dalam tubuh, berkaitan dengan kadar lipid darah dan menyebabkan terjadinya dislipidemia. Dislipidemia merupakan salah satu faktor resiko utama untuk terjadinya kardiovaskular. Penelitian ini bertujuan untuk mengetahui gambaran gambaran profil lipid dan dislipidemia pada remaja dengan obesitas di kota Denpasar, Bali, Indonesia.Metode: Penelitian observasioanal deskriptif dengan desain potong lintang dilakukan terhadap 51 remaja dengan obesitas di kota Denpasar menggunakan teknik two-stages random sampling. Variabel yang dinilai meliputi pemeriksan profil lipid seperti kolesterol total, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), dan trigliserida. Data dianalisis dengan SPSS versi 23 untuk Windows.Hasil: Hasil penelitian menunjukkan bahwa terdapat 25 subyek berjenis kelamin laki-laki (49,01%) dan 26 subyek perempuan (50,99%) dengan rerata usia 15,00Â±3,41 tahun. Rerata berat badan 89,39Â±9,81 kg, rerata tinggi badan 158,62Â±7,31 cm dan Indeks Massa Tubuh (IMT) 33,56Â±3,36 kg/m2. Rerata kolesterol total 170,57Â±25,92 mg/dl, HDL 47,59Â±10,24 mg/dl, LDL 113,61Â±26,64 mg/dl, dan trigliserida 126,14 (75,00) mg/dl. Status dislipidemia berdasarkan kriteria kadar kolesterol total didapatkan pada 27 subyek (52,9%), diikuti dengan HDL (23,59%), LDL (52,9%), dan berdasarkan kadar trigliserida sebesar 15,70% subyek. Dislipidemia berdasarkan keseluruhan profil lipid didapatkan pada 36 subyek (70,6%).Simpulan: Sebagian besar subyek memiliki kadar kolesterol total diatas normal, kadar HDL di bawah normal, kadar LDL di atas normal, dan sebagian besar subyek mengalami dislipidemia.

Karakteristik infeksi Acinetobacter baumannii pada anak yang dirawat di RSUP Sanglah, Bali, Indonesia periode Januari 2017-Desember 2018 Gusti Ayu Putu Sri Satya Mahayani; I Wayan Gustawan; I Made Gede Dwi Lingga Utama; Ida Bagus Gede Suparyatha; I Made Arimbawa; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Acinetobacter baumannii is a gram-negative bacterium that can cause nosocomial infections in humans. An increased incidence of A. baumannii infection is accompanied by increased antibiotic resistance and mortality from this bacterial infection. This study aims to determine the characteristic Acinetobacter baumannii infection and the pattern of germ sensitivity of antibiotics in children treated at Sanglah Hospital.Methods: A cross sectional study was conducted in the Pediatric Ward Sanglah Hospital. We performed a retrospective review of medical records from pediatric patients who were proven to have Acinetobacter baumannii infection through microbiological examination from blood culture samples while undergoing treatment in Pediatric Ward Sanglah Hospital from January 2017 to December 2018. Data were analyzed using SPSS version 20 for Windows.Results: A total of 33 pediatric patients were proven to have Acinetobacter baumannii bloodstream infection through microbiological examination. Most of them are males (72.7%) and 57.57% are neonates. Laboratory results obtained mean leukocyte levels 16.2±8.6 x 103/?L, median platelets 113.8 (3.7-464) x 103/?L, and mean procalcitonin 20.0±3.11 ng/ml. The average length of stay before Acinetobacter baumannii infection was 7 days, with the average total length of stay was 29.7 days. Patients who died during treatment were relatively high (45.5%) and 84.8% of them were treated in the intensive care unit, with 30 out of 33 patients infected with A. baumannii multidrug-resistant (MDR). Most patients use medical devices with an average usage time of more than 7 days.Conclusion: Most patients infected by Acinetobacter baumannii are treated in the intensive care unit with a high mortality rate. The A.baumannii bacteria identified were mostly MDR with a history of long-term use of antibiotics and medical devices. Latar Belakang: Acinetobacter baumannii adalah bakteri gram negatif yang dapat menyebabkan infeksi nosokomial pada manusia. Terdapat peningkatan insiden infeksi A. baumannii yang disertai peningkatan kejadian resistensi terhadap antibiotik, serta mortalitas akibat infeksi bakteri ini. Penelitian ini bertujuan untuk mengetahui bagaimana gambaran infeksi Acinetobacter baumannii serta pola sensitifitas kuman terhadap antibiotik pada anak yang dirawat di RSUP Sanglah yang merupakan rumah sakit rujukan di wilayah Indonesia bagian timur.Metode: Studi ini merupakan studi deskriptif dengan pendekatan potong lintang. Studi ini menggunakan data sekunder dari rekam medis pasien anak yang terbukti terinfeksi Acinetobacter baumannii melalui pemeriksaan kultur darah selama dirawat di RSUP Sanglah periode Januari 2017-Desember 2018. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat 33 pasien dengan kultur darah positif Acinetobacter baumannii. Sebagian besar berjenis kelamin lelaki (72,7%) dan 57,57% merupakan neonatus kurang bulan. Hasil laboratorium didapatkan rerata kadar leukosit 16,2±8,6 x 103/?L, median trombosit 113,8 (3,7- 464) x 103/?L, dan rerata procalcitonin 20,0±3,11 ng/ml. Median lama perawatan sebelum terjadinya infeksi adalah 7 hari dengan rerata lama perawatan 29,7 hari. Pasien yang meninggal selama perawatan cukup tinggi (45,5%) dan 84,8% dari pasien dirawat di ruang intensif dengan 30 dari 33 pasien terinfeksi multidrug resistant (MDR) A. baumannii. Sebagian besar pasien menggunakan alat medis dengan rerata lama pemakaian lebih dari 7 hari.Simpulan: Sebagian besar pasien yang terinfeksi Acinetobacter baumannii dirawat di ruang intensif dengan angka kematian yang cukup tinggi. Kuman A.baumannii yang teridentifikasi sebagian besar bersifat MDR dengan riwayat penggunaan antibiotika serta alat medis dalam jangka waktu lama.

Korelasi nilai Homeostasis Model Assesment for Insulin Resistance (HOMA-IR) dan kadar vitamin D pada remaja dengan obesitas di Kota Denpasar, Bali, Indonesia Luh Gede Yuliadewi NS; I Made Arimbawa; Ketut Suarta; I Gde Raka Widiana; Made Kardana; Ni Putu Veny Kartika Yantie; Komang Ayu Witarini
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Obesity during adolescence can developed into obesity in adulthood and will increase the risk of metabolic dissease sush as insulin resistance. Recent years the role of vitamin D begin to be connection with insulin resistance. Vitamin D plays a role in regulation of synthesis dan insulin secretions from pancreatic beta cells, increase peripheral and hepatic glucose uptake. In obesity there is decrease in vitamin D bioavailability that causes low levels of vitamin D. This study aimed to proves a correlation between insulin resistance and vitamin D levels in adolescents with obesity.Methods: A observational analytic research with crossestional design has been done in junior and senior high school in Denpasar. Adolescennts performed anthropometric screening covers weight, height, body mass index (BMI), obesity if BMI > 95th percentile of CDC 2000 curve. Examined vitamin D levels and insulin resistance through calculation of HOMA-IR levels. Sample size calculation with ? 0,05, correlation coefficient (r) set to 0,5 with minimum sampel size 50. Data were analyzed using SPSS versin 17 for Windows.Results: Anthropometric screening performed obtained 135 students (3,3%) with obesity. Mean of vitamin D levels was 18,9 ng/mL, 10 (20 %) classified as vitamin D insufficiency and 39 (78 %) vitamin D deficiencies. The average of HOMA-IR levels 3,84, 24 (48 %) with insulin resistance based on HOMA-IR levels. Correlation coefficient between HOMA-IR levels and vitamin D was obtained – 0,37 (p=0,007). There was significant difference of prevalence of insulin resistance between obese adolescent with vitamin D deficiency compared with insuficiency and suficiency group (OR=5.8; 95%CI=1.1-30.6; p=0.025).Conclusion: This study concluded that There is a moderate negative correlation between HOMA-IR levels and vitamin D in obese adolescents. Latar Belakang: Obesitas pada masa remaja berisiko menjadi obesitas pada masa dewasa dan meningkatkan risiko penyakit metabolik seperti resistensi insulin. Beberapa tahun terakhir peran vitamin D mulai dihubungkan dengan resistensi insulin. Vitamin D berperan dalam regulasi sintesis dan sekresi insulin oleh sel beta pankreas, meningkatkan uptake glukosa perifer dan hepatik. Pada obesitas terjadi penurunan bioavaibilitas vitamin D yang menyebabkan rendahnya kadar vitamin D. Penelitian ini bertujuan untuk membuktikan adanya korelasi antara kadar vitamin D dengan resistensi insulin pada remaja dengan obesitas.Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang pada remaja SMP dan SMA di kota Denpasar. Remaja dilakukan skrining antropometri meliputi berat badan, tinggi badan, Indeks Masa Tubuh (IMT). Diagnosis obesitas jika IMT > persentil 95 kurva CDC 2000. Dilakukan pemeriksaan kadar vitamin D darah dan resistensi insulin melalui perhitungan kadar HOMA-IR. Perhitungan besar sampel dengan ? 0,05 ( tingkat kemaknaan 0,95), koefesien korelasi (r) ditetapkan 0,5 dengan jumlah sampel minimal 50. Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Skrining antropometri dilakukan pada 135 subyek (3,3%) dengan obesitas. Rerata kadar vitamin D 18,9 ng/mL, dimana 10 ( 20 %) tergolong insufiseiensi vitamin D dan 39 (79%) defisiensi vitamin D. Rerata kadar HOMA-IR 3,84, 24 (48 %) mengalami resistensi insulin berdasarkan kadar HOMA-IR. Besar koefesien korelasi antara kadar HOMA-IR dan kadar vitamin D didapatkan – 0,37 (nilai p 0,007). Terdapat perbedaan bermakna kejadian resistensi insulin antara kelompok remaja obesitas dengan status defisiensi vitamin D dan kelompok dengan status vitamin D pada kelompok sufisien dan insufisien (OR=5,8; 95%IK=1,1-30,6; p=0,025).Kesimpulan: Penelitian ini menyimpulkan terdapat korelasi negatif sedang antara kadar HOMA-IR dan kadar vitamin D pada remaja dengan obesitas.

Hyperglycemic hyperosmolar state in children: a case series Leni Lukman; I Made Darma Yuda; I Made Arimbawa
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Hyperglycemic hyperosmolar state (HHS) is a life-threatening rare acute complication of diabetes mellitus (DM). The condition should be distinguished from diabetic ketoacidosis (DKA) as the management differs significantly. HHS is classically associated with type 2 DM, but it has been increasingly reported in type I DM as well. The literature regarding HHS in children is still sparse. The management of HHS in children is extrapolated from the adult study. Cases: The first case was male 5 years old, and the second case was female 15 years old. Both cases were typed 1 DM patient. The first case was newly diagnosed. Both of the patients came with general weakness, mild dehydration, overly high blood sugar, normal blood pH, hypocalcemia, glucosuria and only mild ketonuria. In the second case develop, both patients were rehydrated, given insulin and discharged in 7-10 days without any sequelae. Conclusion: These case series emphasize the importance of recognizing HHS and differ it from DKA. These two cases prove that HHS is increasingly reported in children with clinical symptoms resembling DKA. It is also proven that with early diagnosis and correct management, children with HHS can be discharged home without any sequelae.

Co-Authors Alice Indradjaja, Alice Aman B Pulungan Anak Agung Ngurah Ketut Putra Widnyana Ayu Diah Perdana Paramita Bambang Tridjaya AAP Boy Arief Fachri Damastra, Garda Bagus Dewi, Ni Nyoman Gita Kharisma Fadilah, Siska Nuri Felix Arie Setiawan Gusti Ayu Putu Sri Satya Mahayani Gusti Ngurah Alit Susanta Wirya H Salim Hendy Halim Herman Saputra Herman Saputra I Gde Ardika Nuaba I Gde Ardika Nuaba I Gde Raka Widiana I Gusti Agung Trisna Windiani I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I K Kari I Made Darma Yuda I Made Kardana I MADE SUDANA I MADE WINANTARA I Nyoman Budi Hartawan I Putu Sudiarta I Wayan Bikin Suryawan I Wayan Gustawan Ida Bagus Gede Suparyatha Ida Bagus Ramajaya Sutawan, Ida Bagus Ramajaya Imanuel Yulius Malino Jose RL Batubara Kadek Adi Suryamulyawan Kartika Yantie, Ni Putu Veny Ketut Ariawati Ketut Suarta Khamil, Achri Isnan Komang Ayu Trisna Dewi Komang Ayu Witarini Leni Lukman Lestari, Afrila Tutut Dwijati Luh Gede Yuliadewi NS Luh Gede Yuliadewi NS Made Ayu Krishna Levina, Made Ayu Made Dwi Purnami Made Gede Dwi Lingga Utama Melisa Anggraeni Muharja, Maktum Ni Made Adi Tarini Ni Putu Siadi Purniti NP Veny Kartika Yantie Paramita, Ayu Diah Perdana Prastika, Andika Putri, Navisa Ayudia Putu Gede Karyana, Putu Gede Putu Meitri Nirmala Utami Rizki Fitria Darmayanti SANJAYA, I GUSTI NGURAH PRABU WIRA Selangga, Dewa Gede Wiryangga Setiyawan, I Made Karma Sholeha, Irdatus Soetjiningsih Soetjiningsih Wardhani, Maharani Tri Wega Upendra Sindhughosa Wibowo, Jihan Nafila Zakwan bin Ahmad

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