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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) ISM (Intisari Sains Medis) : Jurnal Kedokteran World Nutrition Journal Public Health and Preventive Medicine Archive

I Gusti Lanang Sidiartha

Department Of Child Health, Medical Faculty, Udayana University

Author-ID : 379682

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Low serum zinc and short stature in children Kadek Wini Mardewi; I Gusti Lanang Sidiartha; Eka Gunawijaya
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Short stature/stunting is common in developing countries, and has been used as an indicator of a nationâ€™s general health condition. Short stature increases the risk of metabolic disease, disturbances in cognitive development, infection prevalence, physical as well as functional deficits, and even death. Nutritional factors that frequently cause stunting are low intake of energy, protein, or micronutrients such as iron, vitamin A, and zinc. The role of zinc supplementation in children with short stature has not been well defined. In addition, zinc supplementation should be evaluated in the setting of specific conditions and regions.Objective To assess the association between low serum zinc level and short stature in children.Methods This cross-sectional study was done in a primary health care center at Klungkung I, Klungkung District, from August to September 2013. Children with short and normal stature (as reference group) were enrolled and their serum zinc level was measured, Other risk factors were inquired by questionnaire. Association between low serum zinc level (<65 Âµg/dL) and short stature was analyzed by stepwise multivariable regression analysis; degree of association was presented as odds ratio (OR) and its corresponding confidence interval.Results The prevalence of low serum zinc level in our subjects was 71%. Low serum zinc level was significantly associated with short stature [adjusted OR 16.1; 95%CI 3.1 to 84.0; (P=0.001)]. In addition, the occurrence of low serum zinc was higher in the short stature group (88.5%) compared to the normal stature group (53.8%). We also found that low calorie intake was associated with short stature [adjusted OR 29.4; 95%CI 2.76 to 314.7; (P=0.001)].Conclusion Low serum zinc level appears to be associated with short stature. [Paediatr Indones. 2016;56:171-5.].

Waist circumference and insulin levels in obese children Vina Paramitha Cempaka; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Background Childhood obesity is one of the most serious public health challenges of the 21st century. Its prevalence has increased at an alarming rate. Overweight and obese children are prone to obesity in adulthood and to developing non-communicable diseases (NCDs) like diabetes and cardiovascular diseases at a younger age. Increased waist circumference has been shown to contribute to the risk of metabolic syndrome in obese adults.Objective To assess for a correlation between waist circumference and insulin level in obese children.Methods In this cross-sectional study, obese children aged 6-10 years were included by consecutive sampling. We excluded children with infectious disease, malignancy, dyslipidemia, type 2 diabetes mellitus, or those who had not fasted before the blood draw. Subjects underwent waist circumference and fasting blood glucose measurements. Serum insulin levels were examined by enzyme-labeled chemiluminescent immunometric assay,after subjects had fasted for 10-14 hours. Data were analyzed by correlation analysis.Results Subjects had a mean waist circumference of 80.2 cm (SD 7.2) and mean insulin level of 10.70 (SD 7.5). ÂµIU/mL Pearsonâ€™s correlation test revealed a significant, moderately positive correlation between waist circumference and elevated insulin level (r=0.45; P=0.006).Conclusion Waist circumference and insulin level have a significant, moderate, positive correlation in obese children. As such, waist circumference may be a simple method for early detection of hyperinsulinemia, as a risk factor for metabolic syndrome.

Prevalence of underweight, stunting and wasting in under five years old children based in the WHO-2006 and CDC-2000 growth standard on Kintamani, Bangli I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Healthy children will have normal growth according totheir age and gender. To assess and monitor the growth of children, agrowth standard is needed. The WHO and CDC released a newgrowth standard to replace the 1977 NCHS growth standard in April2006 and May 2000 respectively.Objective To obtain the prevalence of underweight, stunting andwasting in less than five years old children based on the WHO-2006and CDC-2000 growth standard and compared the results.Methods A cross-sectional study was conducted in Songan Village,District of Kintamani, Bangli on December 2006. Healthy childrenaged 0-59 months who visited the study site were enrolled.Anthropometric data including weight and length/height were obtainedusing standard anthropometrics procedures by trained doctor assistants.Nutritional status was determined by calculating Z-score values (cut-off point -2SD) weight-for-age (underweight), length/height-for-age(stunting) and weight-for-length/height (wasting) using WHO-2006and CDC-2000 growth standard. McNemar test was done to compareboth results and P<0.05 was considered as a statistically significant.Results There were 264 children, consisted of 139 (52.7%) male and125 (47.3%) female. The prevalence of underweight, stunting andwasting based on WHO 2006 was 20.5%, 20.1% and 45.1%respectively and based on CDC 2000 was 26.5%, 12.1% and 52.3%.The difference was statistically significant (P<0.0001).Conclusion The prevalence of underweight and wasting in childrenless than five years old based on the WHO-2006 was lower comparedto that based on CDC-2000, while the prevalence of stunting washigher.

Comparison of serum aminotranferases in overweight and obese children Ayu Shintia Shanti; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Background Obesity has become a global issue. Non-alcoholic fatty liver disease is a metabolic complication of obesity, and indicated by elevated serum aminotransferases.Objective To compare serum aminotransferase levels in overweight and obese children.Methods This cross-sectional study was conducted from August to October 2015. A total of 82 subjects aged 6-10 years met the study criteria. Blood specimens and data concerning lifestyle and family history using questionnaires were collected. Subjects were divided into three groups based on BMI: overweight, obese, and severely obese. Comparisons of serum aminotransferase levels were analyzed by Kruskal-Wallis and post hoc tests, with P values < 0.05.Results The median serum alanine aminotransferase (ALT) levels in overweight, obese, and severely obese subjects were 14 (IQR 6-42) U/L, 15 (IQR 11-44) U/L, and 23 (IQR 9-59) U/L, respectively (P=0.031). The median serum aspartate aminotransferase (AST) levels in overweight, obese, and severely obese subjects were 22 (IQR 17-36) U/L, 22 (IQR 16-32) U/L, and 24 (IQR 15-41) U/L, respectively (P=0.049). Post hoc analysis revealed that median serum ALT levels were significantly higher in the severely obese group than in the overweight group [-8.982 (95% CI -14.77 to -3.20; P=0.003)], as well as in the obese group [-5.297 (95% CI -10.58 to -0.02; P=0.049)]. In addition, the median serum AST level was significantly higher in the severely obese group than in the obese group [-2.667(95% CI -5.27 to -0.07; P= 0.044)].Conclusion Median serum ALT and AST levels are significantly higher in severely obese children than in obese and overweight children.Â

Accuracy of modified simple pediatric nutritional risk score to detect in-hospital malnutrition Ni Nyoman Metriani Nesal; Gusti Lanang Sidiartha; Endy Paryanto Prawirohartono; Kompiang Gede Suandi
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background In-hospital malnutrition is malnutrition that occurs during hospitalization. Approximately 70% patients with in-hospital malnutrition are not identified. Only few nutritional screening tools are widely used among children , one of those is the modified risk score.Objective To determine cutoff point and accuracy of risk scores using the modified simple nutritional risk score to detect in-hospital malnutrition.Methods A diagnostic study on 1 month-12 year old children hospitalized at Sanglah Hospital Denpasar was conducted between September-December 2008. The subjects were collected using consecutive sampling method and were assessed using the modified simple pediatric nutritional risk score. Inô€€¿hospital malnutrition was defined days), 5% (length of stay 8-30 days), or 10% (length of stay >30 days). The statistical analyses done were sensitivity, specificity, positive/negative predictive value (PPV /NPV), positive/negative likelihood ratio (PLR/NLR), and post-test probability.Results This study recruited 310 children. Based on ROC curve, the cutoff point \\lith combination of the highest sensitivity and spesificity the sensitivity was 79%, spesificity was 92%, positive likelihood ratios was 2.71, negative likelihood ratio was 0.29 , and post test probality was 47%.Conclusion The modified simple pediatric nutritional risk score can be used as a screening tool to detect inô€€¿hospital malnutrition.

Quality of life among obese and non-obese early adolescents Putu Vivi Paryati; I. G. Lanang Sidiartha; I. G. Ayu Trisna Windiani; I. G. A. N. Sugitha Adnyana
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Background Obesity in adolescents adversely affects both their psychological as well as their physical health.Objective To compare the quality of life between obese and non-obese early adolescents, using the PedsQL inventory.Methods A cross-sectional study was carried out on early adolescents aged 10-12 years among several elementary schools in Denpasar, Bali. Body mass index (BMI) percentiles for age and sex were categorized as obese (BMI â‰¥95th percentile) and non-obese (BMI <95th percentile). Data on quality of life were collected using PedsQL Generic Core Scales version 4.0 inventory, filled by the children and their parents separately.Results Total PedsQL score in obese and non-obese group were significantly difference in both reports [child report: mean difference of 9.59 (95%CI 7.14 to 12.05; P<0.05) and parent-proxy report: mean difference at 8.95(95%CI6.64 to 11.26; P<0.05)]. After classifying subjects into impaired and not impaired quality of life based on a total score cut-off <78 as well as other cut-off points for each domain, the individual domains of physical, social, and school function were also significantly associated with obesity (child report: P=0.02, P< 0.001, P=0.018, respectively, and parent-proxy report:P=0.007, P<0.001, P<0.001, respectively). However, emotional function was not significantly associated with obesity (P>0.05). After adjusting for age, gender, and parental education, obesity was significantly associated with PedsQL scores in the child report (OR 7.25; 95%CI 2.94 to 17.89; P<0.05) and the parent-proxy report (OR 10.87; 95%CI 3.83 to 30.84; P<0.05).Conclusion Obese early adolescents reported significantly poorer quality of life with regards to the physical, social, school function domains and total quality of life than those who were classified into non-obese.

Serum C - Reactive Protein Level and Peripheral Blood Picture in Children with Pneumonia IGL Sidiartha; BNP Arhana; P Suwendra; Sudaryat S
Paediatrica Indonesiana Vol 38 No 3-4 (1998): March - April 1998
Publisher : Indonesian Pediatric Society

This cross sectional study aimed to determine the relation between serum C-reactive protein (CRP) levels and peripheral blood picture in children with bronchopneumonia, conducted at the Division of Pulmonology, Sanglah Hospital, Denpasar during 3 months (December 1996 to February 1997). Serum CRP levels, hemoglobin, leukocyte count, neutrophil count and ESR values in 30 cases between 1 month and 4.5 years (20 male and 10 female) were measured. Bronchopneumonia was mostly found in < 1 year old (67%) and with male to female ratio of 2:1. High CRP serum level (>12 microgram/ml) was found in 33% of 30 cases. Anemia was found in 37%, leukocytosis in 50%, increase segment neutrophil ratio in 30%, increase of ESR in 40% and increase of body temperature more than 38Â°C in 4 7% of the cases. Neutrophilia, increase of ESR and increase of body temperature were found statistically significant difference between the positive CRP and negative CRP group. Most bronchopneumonia patients in this study were probably caused by non bacteria. Neutrophilia, higher ESR and higher body temperature could be used as an indicator of bacterial infection besides the increase of serum CRP levels.

Comparison of inflammation and oxidative stress levels by the severity of obesity in prepubertal children Ni Luh Putu Surya Candra Eka Pertiwi; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Children with severe obesity are more likely to develop diabetes and cardiovascular diseases at a younger age. Inflammation and oxidative stress associated with childhood obesity may be important in the development of insulin resistance and atherosclerosis. Objective To compare levels of high-sensitivity C-reactive protein (hsCRP) and malondialdehyde (MDA) by the severity of obesity in prepubertal children aged 6 to 10 years. Methods We conducted a cross-sectional study at the Pediatric Nutrition and Metabolic Syndrome Clinic, Sanglah Hospital, Bali, from August to December 2015. Subjects were categorized into three body mass index (BMI) groups, according to the 2000 Centers for Disease Control and Prevention growth chart: overweight (85th-94.9th percentile), obese (95th-98.9th percentile), or severely obese (â‰¥ 99th percentile). Plasma MDA and serum hsCRP were analyzed in blood specimens obtained at enrollment. Data were analyzed by Kruskal-Wallis test, followed by Mann-Whitney U test for post-hoc comparison between groups. Results Subjects were 20 overweight children, 29 obese children, and 28 severely obese children. Levels of MDA were significantly higher in the severely obese [median 0.25 (IQR 0.1) Î¼mol/L] than in obese subjects [median 0.19 (IQR 0.1) Î¼mol/L; P=0.001], and than in overweight subjects [median 0.16 (IQR 0.1) Î¼mol/L; P<0.0001]. Also, the severely obese children had significantly higher hsCRP levels compared to obese [median 3.2 (IQR 2.0) mg/L vs. 1.3 (1.6) mg/L, respectively; P<0.0001] and compared to overweight children [median 0.7 (IQR 0.6) mg/L; P<0.0001]. Â Â Â Conclusion Prepubertal children at the â‰¥ 99th percentile for BMI (severely obese) are more likely to have significantly higher hsCRP and MDA compared to those in the obese and overweight groups. Â

Age and HIV stage at initiation of highly active antiretroviral therapy determine non-reversal of stunting at 3 years of treatment Putu Diah Vedaswari; Ketut Dewi Kumara Wati; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi; Hendra Santoso; Komang Ayu Witarini
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ â‰¤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.

Serum zinc level and prognosis of neonatal sepsis Chaliza Adnan; I Wayan Dharma Artana; Ketut Suarta; I Gusti Lanang Sidiartha; I Wayan Gustawan; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Background The prognosis of neonatal sepsis can be influenced by various risk factors, one of which is a deficiency of zinc micronutrient substances. Objective To assess for a potential association between serum zinc level and prognosis of infants with early-onset neonatal sepsis (EONS). Methods This prospective cohort study was done in neonates with clinical EONS from September 2017 until December 2018. Serum zinc level was measured on the first day of diagnosis and prognosis was assessed on the fourth day. The association between serum zinc levels and prognosis of EONS was analyzed by Chi-square test and logistic regression with adjustment for confounding variables. Results A total of 70 subjects were divided into two groups based on their serum zinc levels. A cut-off point of 75 ug/dL was used based on area under the curve (sensitivity 91.2% and specificity 93.7%), with accuracy 97.8% (95%CI 0.943 to 1.000; P=0.0001). Subjects with lowzinc level had a 16.8 times greater risk compared to subjects with high serum zinc (RR=16.81; 95% CI 4.35 to 65.02; P <0.0001). Multivariate analysis revealed that subjects with low serum zinc levels had 203.7 times greater risk of worsening than subjects who had a higher serum zinc level (RR 203.72; 95% CI 26.79 to 1549.17; P <0.0001). Covariates such as male sex, low gestational age (<37 weeks), low birth weight (<2,500 grams), asphyxia, Caesarean section delivery, and the presence of comorbidities did not have significant associations with outcomes of EONS (P >0.05). Conclusion Serum zinc level is associated with prognosis of early onset neonatal sepsis, with a cut-off of 75 Î¼g/dL. The high level of serum zinc associates with a better prognosis.

Co-Authors AA Raka Karsana Adnyana, I Gusti Agung Ngurah Sugitha Ahmad Syafiq Anak Agung Ngurah Ketut Putra Widnyana Anak Agung Ratna Purnama Santhi Anggareni, Komang Tria Aria Kekalih Arimbawa * Artawan Artawan Ayu Putri Satyawati Ayu Setyorini Mestika Mayangsari Ayu Shintia Shanti Bagus Ngurah Putu Arhana Bambang Supriyatno BNP Arhana Chaliza Adnan Damayanti Rusli Sjarif Desak Ayu Sri Cinthya Uttari Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dewi Sutriani Mahalini Dian Sulistya Ekaputri Dini Mutia Hasanah Doddy Kurnia Indrawan Dyah Kanya Wati Dyah Kanya Wati Eka Gunawijaya Elmy S Endy Paryanto Prawirohartono Gusti Ayu Putu Nilawati Hanzelina Hanzelina Hartono Gunardi Hendra Santoso Hendy Hendy I Gusti Agung Ngurah Sugitha Adnyana I Gusti Agung Trisna Windiani I Gusti Ayu Putu Eka Pratiwi I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Ketut Adi Wirawan I Kompiang Gede Suandi I Made Arimbawa I Nyoman Ali Suandana I Nyoman Budi Hartawan I Putu Gede Karyana I Wayan Bikin Suryawan I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma I Wayan Gustawan ID Ayu Eka Cahyani Ida Bagus Gede Suparyatha Ida Bagus Subanada Ida Bagus Subanada IGN Sanjaya IKG Suandi IKG Suandi IKG Suandi Ina Susianti Timan Kadek Dedy Sudiawan Kadek Tresna Adhi Kadek Wini Mardewi Kartika Yantie, Ni Putu Veny Katharina Yosephin Lakonawa Ketut Ariawati Ketut Dewi Kumara Wati Ketut Suarta Komang Ayu Witarini Kompiang Gede Suandi Lakonawa, Katharina Yosephin Luh Gede Yuliadewi NS M Kardana Made Michel Kresnayasa Made Ratna Dewi Made Suadnyani Pasek Made Yos Darmayasa Ni Luh Putu Ariastuti Ni Luh Putu Maharani Ni Luh Putu Sudiasih Ni Luh Putu Surya Candra Eka Pertiwi Ni Luh Sri Apsari Ni Made Chandra Mayasari Ni Made Dwiyathi Utami Ni Nyoman Kanta Karmani Ni Nyoman Metriani Nesa Ni Putu Andina Kluniari Ni Putu Ayu Wulan Noviyanti Ni Putu Eka Suwitri Ni Putu Lia Juliantini Ni Putu Siadi Purniti Ni Putu Yunik Novayanti Novita Tjiang Noviyanti, Ni Putu Ayu Wulan NP Veny Kartika Yantie P Suwendra Putu Austin Widyasari Wijaya Putu Ayu Widyanti Putu Diah Vedaswari Putu Gede Karyana, Putu Gede Putu Mas Vina Paramitha Cempaka Putu Satya Pratiwi Putu Vivi Paryati Rini Andriani Romy Widianto, Romy Romy Windiyanto Sawitri, Anak Agung Sagung Setiyawan, I Made Karma Sidiartha, I Gusti Ayu Dian Noviyani Silvia Sudarmadji Sindhughosa, Wega Upendra Sudaryat S Sudiasih, Ni Luh Putu Suryadi Limardi Suwitri, Ni Putu Eka Tjiang, Novita W Retayasa Wanami Putri, Ni Made Wini Jayesthiwi Yuliana Yuliana

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