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All Journal Medicina E-Jurnal Medika Udayana Media Penelitian dan Pengembangan Kesehatan BULETIN PENELITIAN SISTEM KESEHATAN Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) ISM (Intisari Sains Medis) : Jurnal Kedokteran
I Gusti Ngurah Made Suwarba
Bagian/SMF Ilmu Kesehatan Anak RSUP Sanglah, Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Environmental Science Health Professions Immunology & microbiology Mechanical Engineering Medicine & Pharmacology Neuroscience Public Health

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Journal : Paediatrica Indonesiana

 1 
Electroencephalogram abnormalities in full term infants with history of severe asphyxia Susanti Halim; I Gusti Nyoman Made Suwarba; I Made Kardana
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.104 KB) | DOI: 10.14238/pi55.6.2015.297-301

Abstract

Background An electroencephalogram (EEG) is an electroimaging tool used to determine developmental and electrical problems in the brain. A history of severe asphyxia is a risk factor for these brain problems in infants. Objective To evaluate the prevalence of abnormal EEGs in full term neonates and to assess for an association with severe asphyxia, hypoxic ischemic encephalopathy (HIE), and spontaneous delivery. Methods This cross-sectional study was conducted at the Pediatric Outpatient Department of Sanglah Hospital, Denpasar, from November 2013 to January 2014. Subjects were fullterm infants aged 1 month who were delivered and/or hospitalized at Sanglah Hospital. All subjects underwent EEG. The EEGs were interpreted by a pediatric neurology consultant, twice, with a week interval between readings. Clinical data were obtained from medical records. Association between abnormal ECG and severe asphyxia were analyzed by Chi-square and multivariable logistic analyses. Results Of 55 subjects, 27 had a history of severe asphyxia and 28 were vigorous babies. Forty percent (22/55) of subjects had abnormal EEG findings, 19/22 of these subjects having history of severe asphyxia, 15/22 had history of hypoxic-ischemic encephalopathy (HIE), and 20/22 were delievered vaginally. There were strong correlations between the prevalence of abnormal EEG and history of severe asphyxia, HIE, and spontaneous delivery. Conclusion Prevalence of abnormal EEG among full-term neonates referred to neurology/growth development clinic is around 40%, with most of them having a history of severe asphyxia. Abnormal EEG is significantly associated to severe asphyxia, HIE, and spontaneous delivery.
Outcome of synthetic adrenocorticotropin hormone treatment in children with infantile spasm I Gusti Ngurah Made Suwarba
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.94-100

Abstract

Background Infantile spasms (IS) is an age-spedfic epilepsy syndrome characterized by flexor, extensor, and mixed flexor-extensor spasms which often occur in clusters during the first 2 years of life. IS is often difficult to manage 'With the usual anti-epilepsy drugs (AEDs). Therapy with adrenocorticotropin honnone (ACTH) has been used since 1958. In Indonesia, ACTH usage is still rare.Objective This study aims to examine the effectiveness of ACTH as an anti-epileptic drug in managing IS.Methods This was descriptive retrospective cohort study. Subjects were IS patients who visited the neurology outpatient clinic in Sanglah Hospital, Bali, from January 2007 until June 2010. Each subject received AED(s) plus either ACTH or methylprednisolone for 4􀁆6 weeks.Results There were 19 IS patients over the four year duration of this study. They were mostly boys (11), aged 2 weeks to 17 months, with a mean age at treatment of 9 months. Eighteen patients received poly therapy, while one patient received only phenobarbital as monotherapy. Most patients who received ACTH (13/16) had a seizure-free period, while the 3 that did not receive ACTH continued having seizures. Patients who received ACTHshowed a good response (seizure-free) after 5-13 days therapy and their EEG pattern showed disappearance of burst suppression Mthin 1-2 weeks. ACTH side effects included weight gain and cushingoid appearance. One patient died from pneumonia.Conclusions Diagnosis of IS should be considered in patients pre-senting Mth spasms at less than 6 months old. IS treatment should begin as soon as possible. IS patients responded well to a short course of ACTH therapy. 
The role of bovine colostrum on recovery time and length of hospital stay of acute diarrhea in infants and children: a double-blind randomized controlled trial IGN Suwarba; Sudaryat S; Hendra S; IKG Suandi; Raka Widiana
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.127-33

Abstract

Background WHO standard treatment for acute diarrhea remainsunsatisfying to the parents of acute diarrhea patients, particularlythe need of medical treatment. Bovine colostrum contains immuneand growth factors that is thought able to neutralize some agentscausing acute diarrhea in infants and children.Objective To evaluate the efficacy of bovine colostrum as adju-vant therapy on recovery time and length of hospital stay for acutediarrhea in infants and children.Methods A double-blind randomized controlled trial was conductedon infants and children with acute diarrhea admitted to SanglahHospital. Treatment group received standard therapy with bovinecolostrums and control group received standard therapy plus pla-cebo. The primary outcomes were achievement of recovery timeand length of hospital stay. Recovery time was determined by thenumber of days needed to achieve defecation frequency <3 times/day and needed to achieve normal stool consistency.Results Seventy infants and children were enrolled. The treatmentgroup significantly achieved recovery time earlier than the control groupin regard to the time of achieving defecation frequency to <3 times/day [2.31 (0.76) vs 3.34 (1.45); mean difference of -1.03; P= 0.001; CI95% -1.58;-0.48] and normal stool consistency [2.40 (0.77) vs 3.43(1.48); mean difference of -1.03; P = 0.001; CI 95% -1.59;-0.46]. Lengthof hospital stay was shorter in the treatment group than the controlgroup [2.89 (0.78) vs 3.94 (1.53); mean difference of -1.05; P= 0.001;CI 95% (-1.3;-0.7)]. No significant difference was found in mean ofbody weight recovery in two groups [0.47 (0.16) vs 0.49 (0.20); meandifference of -0.03; P=0.556; CI 95%: -0.11;0.06]. Age, nutritionalstatus, breastfeeding, and diarrhea before admission did not influ-ence the study outcome.Conclusion Bovine colostrums as an adjuvant in standard therapyfor acute diarrhea in infants and children is effective in regard toachieve earlier recovery time and shorter length of hospital stay
Occurence and risk factors of tuberculosis infection in orphanage children in Bali Clearesta, Kartika Eda; Mayangsari, Ayu Setyorini Mestika; Wati, Dyah Kanya; Purniti, Ni Putu Siadi; Suwarba, I Gusti Ngurah Made; Artana, I Wayan Dharma
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.152-9

Abstract

Background Tuberculosis (TB) is an infectious disease that is still a common threat worldwide, especially in pediatric populations. TB transmission occurs particularly when the transmitter has no obvious manifestation of the disease. There is a higher incidence of TB infection in children than in the general population, especially in high risk populations such as children in orphanages. However, the incidence of TB infection in orphaned children in Indonesia, including Bali, is unknown. Objective To describe the incidence and risk factors for TB infection in children in orphanages in Bali. Methods This case-control study was conducted in 12 orphanages in Bali. Subjects were divided into a case group comprised of children with TB infection, and a control group comprised of those without TB infection. TB infection was diagnosed by positive tuberculin test without clinically confirmed TB. Results A total of 175 children were recruited as subjects. There were 49 (28.0%) children with TB infection. Bivariate analysis revealed significant associations between density, humidity, ventilation/room area ratio, and area of ??origin with TB infection. Multivariate analysis showed that ventilation/room area ratio and room humidity of ?73% were independently positive correlated with TB infection. Natural lighting and BCG scar were not significantly different between groups. Conclusion The occurence of TB infection in children residing in orphanages in Bali is high (28%). The risk factors identified independently are lower ventilation and higher room humidity.
Prevalence and factors associated with extrauterine growth restriction in premature infants Anggareni, Komang Tria; Sidiartha, I Gusti Lanang; Artana, I Wayan Dharma; Suwarba, I Gusti Ngurah Made; Hartawan, I Nyoman Budi; Gustawan, I Wayan
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.405-11

Abstract

Background Extrauterine growth restriction (EUGR) is common in preterm infants and has been shown to affect their neurodevelopment. Significant variability exists in the criteria used to define EUGR and a standard definition has not yet been established. Several factors associated with EUGR have been identified, yet EUGR remains a problem in preterm infants. There is still much to be explored regarding risk factors associated with EUGR. Objective To determine the prevalence and factors associated with EUGR in preterm infants. Methods This cross-sectional study included randomly selected premature infants (<37 weeks gestational age) who were admitted to levels II and III Neonatal Ward at Prof. Dr. I.G.N.G. Ngoerah Hospital from May 2022 to August 2023. Results Of 185 subjects, the prevalence of EUGR in preterm infants was 47% and there were significant associations between EUGR and birth weight <1500 g (PR 8.814; 95%CI: 3.943 to 19.7; P=0.000), small for gestational age/SGA (PR 28.95; 95%CI: 3.79 to 220.1; P=0.000), neonatal sepsis (PR 4.29; 95%CI: 2.21 to 8.31; P=0.000), hyaline membrane disease/HMD (PR 2.12; 95%CI: 1.16 to 3.88; P=0.021), use of respiratory support (PR 2.57; 95%CI: 1.35 to 4.92; P=0.005), initiation of enteral nutrition at >48 hours (PR 2.23; 95%CI: 1.21 to 4.09; P=0.014) and length of stay/LOS >14 days (PR 8.11; 95%CI: 4.13 to 15.9; P=0.000). Multivariate analysis revealed birth weight <1500 g (aPR 5.14; 95%CI: 1.55 to 17.06; P=0.007), SGA (aPR 24.26; 95%CI: 2.64 to 222.6; P=0.005), presence of sepsis (aPR 2.35; 95%CI: 1.00 to 5.5; P=0.049), and length of hospital stay >14 days (aPR 4.93; 95%CI: 2.15 to 11.31; P=0.000) maintained positive significant associations with EUGR. Conclusion The prevalence of EUGR in preterm infants is 47%. Birth weight <1500 g, small for gestational age, sepsis, and length of stay >14 days are associated with EUGR in preterm infants.
Co-Authors Anggareni, Komang Tria Anita Purnamayanti Ariawati, I Ketut Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana Clearesta, Kartika Eda Deborah Melati, Deborah Dewi Sutriani Mahalini Dwi Putro Widodo Dyah Kanya Wati Dyah Kanya Wati Haning, Joy Aprianis Hendra S I Gde Raka Widiana I Gusti Lanang Sidiartha I Gusti Ngurah Agung Jayadhi Widyakusuma I Gusti Ngurah Sanjaya Putra I Made Darma Yuda I Made Gede Dwi Lingga Utama, I Made Gede Dwi Lingga I Made Kardana I Nyoman Budi Hartawan I Putu Hendri Aryadi I Wayan Dharma Artana, I Wayan Dharma I Wayan Gustawan Ida Bagus Gede Suparyatha Ida Bagus Subanada Ida Bagus Subanada IKG Suandi Ketut Ariawati Komang Ayu Witarini Komang Kari Made Suadnyani Pasek Ni Made Dani Febriansiswanti Ni Putu Siadi Purniti Ni Putu Yunik Novayanti Ni Putu Yunik Novayanti Ni Wayan Kurnia Wati Novayanti, Ni Putu Yunik Sekarningrum, Putu A. Semanggiasih, Ni Nyoman Ayu Setyo Handryastuti Sudaryat S Susanti Halim Tri Yuliantini Wati, Dyah K. Wayan Sulaksmana Sandhi Parwata