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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

Published : 60 Documents Claim Missing Document

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Investigating Minimum Acceptable Diet and Infant and Child Feeding Index as indicators of stunting in children aged 6-23 months Suryadi Limardi; Dini Mutia Hasanah; Ni Made Dwiyathi Utami; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.259-68

Background The complementary feeding period of 6-24 months of age is one of the most crucial moments in child growth, in which most of the decline in length-for-age Z-score (LAZ) occurs. The Minimum Acceptable Diet (MAD) and Infant and Child Feeding Index (ICFI) are indicators to assess complementary feeding practices in the children with potential for stunting. Objective To assess and compare the usefulness of MAD and ICFI scores as indicators of inadequate feeding practice on stunting in children aged 6-23 months. Methods This case-control study was conducted in South and West Wewewa subdisctricts of Southwest Sumba, East Nusa Tenggara, Indonesia, from February to August 2019. Participants were children aged 6-23 months who had received complementary feeding for a minimum duration of one month. Children with LAZ <-2 were allocated into the case group (stunted) and those with LAZ>-2 into the control group. Both MAD and ICFI scores were assessed in both groups. ICFI was categorized as low, average, and high. The association between complementary feeding practice which depicted by the MAD and ICFI scores and stunting was measured using logistic regression. Results Of 322 participants, 161 children were allocated into each group. Multivariate analysis revealed that those in low and average ICFI tertile had higher odds of stunting [(OR 2.85; 95%CI 1.35 to 6.00; P<0.01) and (OR 1.95; 95%CI 1.09 to 3.46; P<0.05), respectively]. No association was found between MAD and stunting. Conclusion Inadequate complementary feeding practice is found to increase the risk of stunting among children aged 6-23 months. Compared to MAD, ICFI is a better indicator in demonstrating an association between complementary feeding practice and stunting.

The Effect of Carnitine Supplementation on Blood Ammonia Level in Epilepsy Children Treated with Valproic Acid: A Randomized Controlled Trial I Gusti Lanang Sidiartha; I Gusti Ngurah Made Suwarba; Dyah Kanya Wati; Ida Bagus Subanada
Molecular and Cellular Biomedical Sciences Vol 5, No 1 (2021)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v5i1.177

Background: Long-term use of valproic acid is associated with a high level of blood ammonia related to carnitine deficiency. This study investigates the effect of carnitine supplementation on blood ammonia levels in children with epilepsy who have been treated with valproic acid for more than six months.Materials and Methods: This was a randomized, double-blind, placebo-controlled trial study where children with epilepsy who were treated with valproic acid were randomly allocated to the carnitine supplementation and control group. All children were followed for month, and then measured for blood ammonia level. Blood ammonia levels of both groups were compared using an Independent t-test with a significant of p<0.05.Results: Total of 32 children with epilepsy were enrolled as subjects in this study, with 16 children in carnitine group, and 16 children in control group. Among the subjects, 50% were male and 50% were female, with a mean age of 6.5 years old. The average duration of epilepsy in the carnitine and control group were 41.7 months and 36.9 months, respectively (p=0.419). The duration of valproic acid therapy in the carnitine and control group were 33.1 months and 27.6 months, respectively (p=0.483). The level of blood ammonia in carnitine and control group were 44.6 mg/dL and 81.4 mg/dL, respectively (p=0.007).Conclusion: The level of blood ammonia in a carnitine group was significantly lower than in a control group. It is recommended to give carnitine supplementation in epileptic children treating with long-term valproic acid.Keywords: ammonia, carnitine, epilepsy, seizure, valproic acid

Correlation Between Pyridoxal 5’-Phospate Level And Valproic Acid In Epilepsy Children I Gusti Ngurah Made Suwarba; Ni Putu Yunik Novayanti; I Gusti Lanang Sidiartha; Dewi Sutriani Mahalini
Molecular and Cellular Biomedical Sciences Vol 3, No 1 (2019)
Publisher : Cell and BioPharmaceutical Institute

Background: It is important to maintain the adequate level of vitamin B6 to ensure stable metabolism. Vitamin B6 serum level might decreased by absorption disturbance or increasing demand. Valproic acid increase the synthesis of serum GABAergic in the other hand vitamin B6 is required as cofactor for gamma-amino butyric acid (GABA) formation. The dosage and duration of valproic acid therapy might be correlated with vitamin B6 serum level. The aim of this study is to know the correlation between vitamin B6 serum level against dosage and duration of valproic acid therapy in children with epilepsy.Materials and Methods: This is a cross sectional study to investigate the correlation between vitamin B6 serum level against dosage and duration of valproic acid therapy. The level of vitamin B6 serum was determined by checking vitamin B6 active form in serum, pyridoxal 5’-phospate (PLP).Results: In this study, 37 epilepsy children with valproic acid duration therapy more than 3 months was enrolled. Fifty six percent epilepsy children were male, commonly on children age 1-5 years old. Spearman correlation coefficient test showed a significant weak negative correlation between vitamin B6 serum level and dosage of valproic acid (r=–0.35; p=0.03), and very weak negative correlation with valproic acid duration therapy (r=-0.08; p=0.59), however it was not significant. Conclusion: There was a significant weak negative correlation between vitamin B6 serum level and very weak negative correlation with valproic acid duration therapy, but not significant in children with epilepsy.Keywords: correlation, valproic acid, vitamin B6

High Blood Ammonia Levels Associated with Long-term Valproic Acids Therapy in Epileptic Children I Gusti Lanang Sidiartha; I Gusti Ngurah Made Suwarba; Dyah Kanya Wati; Ida Bagus Subanada
Molecular and Cellular Biomedical Sciences Vol 4, No 2 (2020)
Publisher : Cell and BioPharmaceutical Institute

Background: Valproic acid is an effective drug for controlling seizure in children with epilepsy and it is usually used for treatment as long as two years or more. Blood ammonia level often increased in epileptic children who were treated with long-term valproic acid. The study was conducted to determine the relationship between blood ammonia level with valproic acid therapy in epileptic children.Materials and Methods: This is an observational study with cross-sectional approach. The subjects were 64 children with epilepsy, average age of 6.2 years old. Subjects were 33 boys and 31 girls. Blood ammonia level was examined using enzymatic glutamate dehydrogenase. Subjects were divided into 2 therapeutic groups based on the duration, doses and combination therapy of valproic acid. Subjects were recruited from Pediatric Neurology Clinic, Sanglah General Hospital, Bali, Indonesia, from May to December 2017. Comparison of blood ammonia level between groups were analyzed using an Independent t-test with significances if the p<0.05.Results: A significant difference of blood ammonia level was found between subjects who were treated with valproic acid less than 2 years and more than 2 years (45.7±16.4 mmol/L vs. 70.9±43.6 mmol/L; p=0.032). However, significant difference was not found between the groups according to the doses and combination therapy (p=0.450 and p=0.647, respectively).Conclusion: Blood ammonia level was significantly higher in epileptic children who used long-term valproic acid, hence it was recommended to check the blood ammonia level routinely.Keywords: ammonia, epilepsy, valproic, children

Low Total Lymphocyte Count as the Risk of Hospital Acquired Malnutrition in Children Dian Sulistya Ekaputri; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi
Molecular and Cellular Biomedical Sciences Vol 5, No 2 (2021)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v5i2.191

Background: Hospital Acquired Malnutrition (HAM) is characterized by inadequate nutritional therapy and the risk of developing malnutrition during the hospital stay. In clinical practice, there are many measurements to determine nutritional status. Total lymphocyte count (TLC) is associated with impaired function of immune system in malnutrition. The purpose of this study was to evaluate the prognostic value of TLC to the occurrence of HAM in pediatric patients.Materials and Methods: This an observational study with a prospective cohort design. Subjects were assessed for weight at the first day of hospitalization, then the subjects were followed until they were discharged. Body weight was re-measured on discharge to determine the presence or absence of HAM. This research was conducted at Sanglah Hospital from May-December 2019. Subjects who met the inclusion and exclusion criteria were enrolled in the study.Results: Among 120 subjects, 55 subjects or 45.8% were malnourished on admission. Subjects with a low TLC compared to a normal TLC had a 3.9-fold risk of experiencing hospital acquired malnutrition (95% Confidence Interval: 1.59 to 7.19, p=0.001). Subjects who had a low TLC had HAM of 61.8%, while subjects who had a normal TLC had HAM of 32.3%. In multivariate analysis, low TLC was the only risk factor for HAM in this research.Conclusion: This study proved that low TLC is the risk of HAM. Total lymphocyte count could be used as predictor of the risk of HAM in hospitalization children.Keywords: hospital malnutrition, total lymphocyte, children

Gambaran umum berbagai faktor keterlambatan pemberian nutrisi enteral pada pasien anak di Ruang Rawat Intensif Anak, RSUP Sanglah, Denpasar, Bali Ni Luh Sri Apsari; I Gusti Lanang Sidiartha; I Nyoman Budi Hartawan; Dyah Kanya Wati; Ida Bagus Gede Suparyatha
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Enteral nutrition is the primary choice in pediatric patients who do not experience gastrointestinal disorders. Many factors inhibit the achievement of enteral nutrition in pediatric patients treated in intensive care. This study aims to determine the overview of various factors that may result in delays enteral nutrition administration in critically ill pediatric patientsMethods: An observational cross-sectional analytic study was carried out on secondary data of medical records among children who were treated in pediatric intensive care unit at Sanglah Hospital throughout 2016. Delay in enteral nutrition was assessed if there was enteral nutrition administration more than 2x24 hours since first admission. Factors assessed include gender, age, PELOD, diagnosis, invasive breathing aids, impaired motility, gastrointestinal bleeding, and hemodynamic instability. Data were analyzed using the SPSS version 20 software program whereas P value <0.05 was considered statistically significant.Results: From the 115 samples, there were 69 (60%) males and 46 (40%) females. About 50 samples (43,5%) experienced delayed enteral nutrition. Significant variables related to the delay in enteral nutrition after multivariate analysis were gastrointestinal motility disorders (p = 0,004, OR 9,082, 95% IK 2,827 â€“ 29,171), and gastrointestinal bleeding (p = 0,0001; OR 14,317; IK 95 % 4,087 â€“ 50,155).Conclusion Intestinal motility disorders and gastrointestinal bleeding are known as a contributing factor in the delay of enteral nutrition administration in PICU Sanglah Hospital, Denpasar, Bali.

Anemia and metabolic acidosis are a predictor for mortality in children with severe acute malnutrition at Sanglah General Hospital, Bali Ni Putu Andina Kluniari; I Gusti Lanang Sidiartha
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in children in developing countries.Â Nutritional disorders are frequent in hospitalized patients, of which malnutrition is the most prevalent Anemia and PH disturbance was commonly found in this condition. This study aims to determine the association between anemia and metabolic acidosis with the mortality among children with severe acute malnutrition.Methods: A retrospective cohort study was conducted among 135 severe acute malnutrition children in the pediatric care unit of Sanglah General Hospital from the 2017-2018 period. The inclusion criteria were children aged 1 month to 18 years diagnosed with SAM. Exclusion criteria were a patient diagnosed with a hematological disorder or renal disorder. Data were analyzed using SPSS version 20 for Windows.Results: Anemia was diagnosed in 89 (65.9%) subjects in this study. Anemia increases the risk of death significantly by 3.98 times (95% CI 2.167-10.389; p<0.001). Metabolic acidosis was found in 35 (25.9%) subjects; this condition was also shown to significantly increase the risk of death by 1.5 times (95% CI 1.005-2.145; p=0.018).Conclusion: Anemia and metabolic acidosis can be used as predictors for mortality in severe acute malnutrition patient significantly.

The association between Body Surface Area (BSA) and vitamin D level among obese adolescent patients in Denpasar, Bali, Indonesia Luh Gede Yuliadewi NS; I Gusti Lanang Sidiartha
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background:Â Prevalence of obesity in adolescent in Indonesia is still high. An obese adolescent is likely to stay obese into adulthood and tends to develop into cardiovascular and metabolic diseases. Obese subjects have larger body surface area and should be able to produce more vitamin D from cutaneous synthesis. This study aims to determine the prevalence of obesity in adolescent in Denpasar, determine vitamin D status among obese adolescents and obtained an association between body surface area and vitamin D levels.Methods:Â A descriptive observational study using a cross-sectional approach has been conducted among 51 obese adolescents in Denpasar during May to December 2018. Several variables assessed in this study were age, sex, weight, height, Body Mass Index (BMI), Body Surface Area (BSA), and vitamin D levels. Factors associated with vitamin D levels in obese adolescence were analyzed with appropriate statistical analysis. Data were analyzed using SPSS version 17 for Windows.Â Results:Â From 51 subjects, 32 (62.74%) male and 19 (37.26%) female subjects were enrolled in this study. The mean weight and height of respondents were 89.4Â±9.8 kg and 158.6Â±7.3 cm. In addition, the average Body Mass Index (BMI) and Body Surface Area (BSA) were 33.6Â±3.4 kg/m2 and 2.1Â±0.2 m2. The mean Vitamin D levels was 18.9Â±4.9 ng/mL with 40 subjects (78,4%) were known in a vitamin D deficiency state. There was a significant weak positive association between BSA and vitamin D levels (r=0.32; p=0,002).Conclusion:Â Most obese adolescents were in vitamin D deficiency with a significant weak positive association between BSA and vitamin D levels.Â

The determinant factors for Quality of Life (QOL) among children with Acute Lymphoblastic Leukemia (ALL) after induction phase at Sanglah General Hospital, Bali, Indonesia Made Suadnyani Pasek; Ketut Ariawati; Bagus Ngurah Putu Arhana; I Gusti Lanang Sidiartha; I Gusti Ngurah Sanjaya Putra; I Gusti Ngurah Made Suwarba
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: The Quality of Life (QOL) of patients with acute lymphoblastic leukemia (ALL) is important to be examined. Some determinant factors of the QOL for ALL patients are age, gender, ethnicity, nutritional status, level of income of parents, educational level of parents, and risk groups. This study aims to determine the quality of life score among children with ALL after the induction phase of chemotherapy and to determine determinant factors that are associated with the quality of life of children with ALL.Methods: An observational analytic study using a cross-sectional approach has been conducted among 38 ALL patients to assess the QOL after the induction phase chemotherapy at Sanglah General Hospital. The independent sample T test evaluated comparative values between independent factors. Multivariate analysis was assessed by the General Linear Model ANCOVA. Data were analyzed using SPSS version 20 for Windows.Results: Most of the respondents were age > 5 years old (55.3%), followed by the male (55.3%), well-nourished of nutritional status (55.3%), low parentsâ€™ educational status (55.3%), a high income of parents (52.6%), standard risk of stratification (52.6%), and non-Balinese ethnicity (55.3%). The mean score of QOL was 79.37Â±21.64. The results showed that male gender (95% CI: 2.35-16.04; p=0.010), high income of parents (95% CI: 3.17-22.05; p=0.010), standard risk factors (95% CI: 1.48-16.36; p = 0.020) were significantly related to the QOL of children with ALL.Conclusion: High-income parents, standard risk stratification, and male gender are determinant factors for higher QOL scores of children with ALL after the chemotherapy induction phase.

Karakteristik malnutrisi rumah sakit pada pasien anak di RSUP Sanglah, Bali, Indonesia Hanzelina Hanzelina; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Hospital Malnutrition (HM) is malnutrition diagnosed while being treated at the hospital either when admitted to the hospital, during treatment or even when discharged from the hospital, which is closely related to hospital care. The incidence of HM is still quite high and can increase morbidity and mortality among inpatient children. This study aims to determine the characteristics of in-hospital malnutrition cases in children undergoing treatment at Sanglah Hospital.Methods: This study used a prospective cohort design using primary data obtained from interviews and anthropometry of 120 children hospitalized at Sanglah Hospital in the 2019-2020 period. HM was defined as a decrease in a Z-score of Weight/Height (W/H) > 0.5 Standard Deviation (SD) at the time of hospital discharge. Data were analyzed using SPSS version 20 for Windows.Results: The incidence of HM was 47.1%, of which 54.0% of patients were female. The incidence of in-hospital malnutrition was primarily found in patients aged 1-3 years (50.0%) and >5 years (42.0%). Approximately 64.0% of children with HM were malnourished before being admitted to the hospital and 14.0% got parenteral nutrition. It was found that 72% of children with HM had a hospital stay length of > 7 days. More than half of children with HM (56.0%) have parents with low levels of education (less than secondary education) and 58.0% have more than 3 siblings.Conclusion: The incidence of hospital malnutrition is more often found in girls, age >5 years old, malnutrition before admitted, get parenteral nutrition, had parents with low education levels, number of siblings > 3, had a single diagnosis and length of stay > 7 days. Latar Belakang: Malnutrisi rumah sakit (MRS) adalah malnutrisi yang didiagnosis saat dirawat di Rumah Sakit (RS) baik saat masuk RS, selama perawatan atau bahkan saat pasien keluar dari rumah sakit yang erat kaitannya dengan perawatan di RS. Kejadian MRS masih cukup tinggi dan dapat meningkatkan morbiditas dan mortalitas pada anak yang dirawat. Penelitian ini bertujuan untuk mengetahui karakteristik dari kasus MRS pada anak yang menjalani perawatan di RSUP Sanglah.Metode: Studi ini menggunakan desain kohort prospektif dengan menggunakan data primer dari wawancara dan pemeriksaan antropometri terhadap 120 anak yang dirawat inap di RSUP Sanglah pada periode 2019-2020. MRS didefinisikan sebagai penurunan Z-score Berat Badan/Tinggi Badan (BB/TB) > 0,5 Standard Deviation (SD) pada saat keluar RS. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Kejadian MRS ditemukan sebanyak 47,1% dengan 54,0% sampel berjenis kelamin perempuan. Insidens MRS paling banyak ditemukan pada pasien kelompok usia 1-3 tahun (50,0%) dan >5 tahun (42,0%). Sebanyak 64,0% anak dengan MRS sudah mengalami malnutrisi sebelum masuk RS dan 14,0% mendapatkan nutrisi parenteral. Ditemukan bahwa 72,0% anak dengan MRS memiliki lama rawat di RS >7 hari. Lebih dari separuh anak dengan MRS (56,0%) memiliki orang tua dengan tingkat pendidikan rendah (<SMP) dan 58,0% memiliki jumlah saudara lebih dari > 3.Kesimpulan: Insiden MRS lebih sering ditemukan pada anak perempuan, kelompok usia >5 tahun, malnutrisi sebelum masuk RS, mendapatkan nutrisi parenteral, memiliki orang tua dengan tingkat pendidikan rendah, jumlah saudara kandung > 3, serta memiliki diagnosis tunggal serta lama rawat > 7 hari.

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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