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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (846.409 KB) | DOI: 10.21705/mcbs.v3i1.38

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1094.965 KB) | DOI: 10.21705/mcbs.v4i2.105

Abstract

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
Fungsi Kognitif Anak Dengan Epilepsi Umum I Gusti Ngurah Made Suwarba; Ni Wayan Kurnia Wati
Buletin Penelitian Sistem Kesehatan Vol 25 No 1 (2022): Buletin Penelitian Sistem Kesehatan
Publisher : Pusat Penelitian dan Pengembangan Humaniora dan Manajemen Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsr.v25i1.4491

Abstract

Children with epilepsy may experience cognitive impairment due to the effects of structural lesions or seizure activity. This study aims to determine the cognitive function of children with general epilepsy. This study was a cross-sectional design that included children aged 6 to 68 months with general epilepsy in the polyclinic and pediatric ward of Sanglah Hospital Denpasar from September 2013 to January 2015. All children who participated in this study were subjected to a Mullen scale examination. Statistical analysis was performed using Chi-square test and multivariate analysis with logistic regression. In 93 children with general epilepsy, there was a significant correlation between the level of cognitive function and seizure frequency >10 times with an odds ratio 6.067 (95% CI 2.002-18.388, p value 0.001) and seizure duration ≥15 minutes with an odds ratio 6.006 (95% CI 1,817-20,246, p value 0.003). In this study, it can be concluded that seizure frequency >10 times and seizure duration ≥15 minutes in children with general epilepsy have a positive relationship of 6 times with the abnormal cognitive function. Further studies are needed to determine cognitive development of children with general epilepsy. Abstrak Anak dengan epilepsi dapat mengalami gangguan kognitif berkaitan dengan efek dari lesi struktural maupun aktivitas kejang. Penelitian ini ditujukan untuk mengetahui fungsi kognitif anak dengan epilepsi umum. Penelitian ini merupakan penelitian dengan desain potong lintang yang mengikutsertakan anak usia 6 sampai 68 bulan dengan epilepsi umum di poliklinik dan ruang perawatan anak RSUP Sanglah Denpasar pada bulan September 2013 hingga Januari 2015. Semua anak yang ikut serta dalam penelitian dilakukan pemeriksaan skala Mullen. Analisis statistik dilakukan dengan uji kai kuadrat dan analisis multivariat dengan regresi logistik. Pada 93 anak dengan epilepsi umum, didapatkan hubungan yang signifikan antara fungsi kognitif dengan frekuensi kejang >10 kali dengan rasio odds 6,067 (nilai p=0,001, 95% CI 2,002-18,388) dan lama kejang ≥15 menit dengan rasio odds 6,006 (nilai p=0,003, 95% CI 1,817-20,246). Pada penelitian ini dapat disimpulkan bahwa frekuensi kejang >10 kali dan lama kejang ≥15 menit pada anak dengan epilepsi umum memiliki hubungan yang positif sebesar 6 kali terhadap fungsi kognitif abnormal. Penelitian lanjutan perlu dilakukan untuk mengetahui perkembangan fungsi kognitif anak dengan epilepsi umum.
Perbedaan pemberian cairan isotonis dan hipotonis terhadap osmolalitas plasma pada penderita gangguan intrakranial akut di RSUP Sanglah, Denpasar, Bali Wayan Sulaksmana Sandhi Parwata; I Nyoman Budi Hartawan; I Gusti Ngurah Suwarba; Ida Bagus Suparyatha; Dyah Kanya Wati
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (237.617 KB) | DOI: 10.15562/ism.v10i1.313

Abstract

Background: Acute intracranial disturbance can lead to increased occurrence of cardiovascular activity that will lead to a decrease of sodium reabsorption in the kidney. The proper selection of liquid on acute intracranial disorders can help reduce damage to brain tissue. This study aims to determine differences in plasma osmolality levels in patients with acute intracranial disorders who get isotonic or hypotonic fluid.Methods: A cross-sectional observational study was carried out among 60 patients aged 1 month-12 years who experienced acute intracranial disturbance in Sanglah General Hospital during 2017. The difference in plasma osmolality in each group was tested using Mann-Whitney due to the data were not normally distributed. There was a significant difference in osmolality levels in the group receiving isotonic fluid compared with hypotonic (p <0.001)Results: Males were predominant in the isotonic group (66.7%) and hypotonic (70%). Good nutritional status was found in both groups (90%; 83.33%). Encephalitis is the most common cause of acute intracranial disturbance, namely 14 (46.67%) cases of istononic groups and 12 (40%) cases of hypotonic groups. The median value (IQR) of plasma and sodium osmolality levels that obtained isotonic fluid showed a difference in values of 139(6) mEq/L and 287(20) mOsm/kg H2O in isotonic and 132 (7) mEq/ L and 273(16) mOsm/kg H2O in hypotonic. There was a significant difference in osmolality levels in the group receiving isotonic fluid compared to hypotonic (p<0.001)Conclusion: There are differences in levels of osmolality in patients with acute intracranial disorders who get isotonic fluid compared to groups that get hypotonic fluid.
Profil anak dengan ketergantungan internet di SMPN 2 Denpasar I Gusti Ngurah Agung Jayadhi Widyakusuma; I Made Darma Yuda; I Gusti Ngurah Made Suwarba
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.266 KB) | DOI: 10.15562/ism.v10i3.472

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Background: The internet is technology that developed is very fast in recent years. Development of internet may occur positive and negative effect. Survey that conducted in 2017 in Indonesia, according to gender showed that males (51,43%) are more than females in using the internet. The purpose of this research was to know internet addiction profiles and relationship between internet addiction and gender in SMPN 2 Denpasar students.Methods: The study design was a cross sectional study with total sampling. The data were taken from students by using questionnaire at SMPN 2 Denpasar. The result was analyzed by univariate and bivariate method using chi-square test.Results: There are 366 subjects included in this study. 198 samples were males, and 168 samples were females. Based on the analyzed result, it confirmed that the internet addiction relates significantly with gender (p-value = 0.048) (p < 0.05). Univariate analysis showed that 21,8% were suffer mild internet addiction and 4,3% were suffer moderate internet addiction. Males were suffering internet addiction more than females. Internet was mainly used to play game online and chatting were smartphone are the most device-used to access the internet. Basic needs were the most activities that can stop internet access. The most duration of internet usage are 2-4 hours/day and <40 hours/week.Conclusions: From the result of this study, can be concluded that there is a significant relationship between internet addiction and gender in SMPN 2 Denpasar students.Latar Belakang: Internet merupakan teknologi yang berkembang pesat dalam beberapa tahun terakhir. Perkembangan internet dapat menimbulkan berbagai dampak positif dan negatif. Survei tahun 2017 di Indonesia, komposisi pengguna internet di Indonesia berdasarkan jenis kelamin menunjukkan bahwa laki-laki (51,43%) lebih banyak dibandingkan perempuan (48,57%). Tujuan penelitian ini adalah mengetahui profil kejadian ketergantungan internet dan hubungan ketergantungan internet terhadap jenis kelamin pada siswa SMPN 2 Denpasar.Metode: Desain penelitian adalah cross-sectional study dengan total sampling. Data bersumber dari kuisoner yang diisi oleh siswa SMPN 2 Denpasar. Analisa data dilakukan secara bertahap yaitu analisa univariat dan analisa bivariat menggunakan chi-square test.Hasil: Terdapat 366 subjek yang diteliti. Didapatkan 198 sampel laki-laki, dan 168 sampel perempuan. Hasil penelitian menunjukkan ketergantungan internet berhubungan secara bermakna dengan jenis kelamin p=0.048 (p<0.05). Sebanyak 21,8% responden mengalami ketergantungan internet ringan dan 4,3% mengalami ketergantungan internet sedang. Berdasarkan jenis kelamin, laki-laki lebih banyak mengalami ketergantungan internet. Penggunaan internet terbanyak adalah untuk bermain game online dan chatting. Smartphone merupakan gawai terbanyak yang digunakan untuk mengakses internet. Kebutuhan dasar merupakan kegiatan yang paling dominan menghentikan kegiatan berinternet. Durasi menggunakan internet terbanyak adalah 2-4 jam dalam sehari dan <40 jam dalam seminggu.Simpulan: Berdasarkan hasil penelitian ini dapat disimpulkan bahwa terdapat hubungan yang bermakna antara kecanduan internet dengan jenis kelamin pada siswa SMPN 2 Denpasar.
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.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.044 KB) | DOI: 10.15562/ism.v11i2.668

Abstract

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 parents’ 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 79.37±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.
Pengaruh pemberian edukasi kepada pengasuh terhadap tingkat kepatuhan pemberian obat anti epilepsi pada anak dengan epilepsi I Gusti Ngurah Made Suwarba; Ni Made Dani Febriansiswanti; Anita Purnamayanti
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (979.993 KB) | DOI: 10.15562/ism.v12i1.892

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Background: Adherence was the main problem in anti-epilepsy drug therapy because it has to be consumed up to 2 years free of seizures to require education intervention. This research aimed to analyze the effect of oral and written (leaflet) education on patient carer's adherence level in administering epilepsy medicines to the pediatric patient (?18 years old).Methods: The design of This study was one group pre - post-test research. Subjects were collected using consecutive sampling.Results: This study's subject was 24 patient carers with low and moderate levels of medication adherence. Oral and written education material was provided every week for eight weeks, and the adherence level was analyzed through the pills count and self-report checklist every week during the study. The Wilcoxon signed-rank test results were significantly different between pre and post-pill counts, and the result of repeated measure test showed that there was an increasing level of medication adherence significantly in third obtained by pill count method week ( p=0,000 ) and remained high until the end of this study.Conclusion: Oral and written education could improve the caregivers administering medication adherence level to their epilepsy children.  Latar belakang: Kepatuhan merupakan masalah utama dalam terapi obat anti epilepsi karena obat anti epilepsi harus dikonsumsi sampai 2 tahun bebas kejang, sehingga diperlukan edukasi. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian edukasi berupa lisan dan tertulis (leaflet) terhadap tingkat kepatuhan pemberian obat oleh pengasuh kepada pasien epilepsi anak usia ?18 tahun.Metode: Rancangan penelitian ini adalah one group pre – post test design. Pengumpulan subjek dengan consecutive sampling.Hasil: Subjek penelitian sebanyak 24 orang dengan kriteria tingkat kepatuhan rendah dan sedang. Edukasi lisan dan tertulis diberikan setiap minggu selama 8 minggu, penilaian tingkat kepatuhan melalui pill count dan self report checklist setiap minggu selama 8 minggu. Hasil uji wilcoxon signed rank terdapat perbedaan pre pill count dan post pill count, dan hasil uji repeated measure terdapat pengaruh pemberian edukasi, yang dapat dilihat dari peningkatan nilai pill count secara signifikan pada minggu ke-3 (p=0,000) dan tetap tinggi sampai akhir penelitian.Simpulan: Pemberian edukasi berupa lisan dan tertulis memberikan pengaruh peningkatan kepatuhan pemberian obat oleh pengasuh kepada pasien epilepsi anak.
Gambaran Gejala Klinis Pasien Anak COVID-19 di RSUP Sanglah Denpasar Semanggiasih, Ni Nyoman Ayu; Suwarba, I Gusti Ngurah Made; Ariawati, I Ketut; Utama, I Made gede Dwi Lingga
E-Jurnal Medika Udayana Vol 11 No 6 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i06.P17

Abstract

Coronavirus disease 2019 (COVID-19) adalah suatu penyakit akibat terinfeksi coronavirus baru dengan nama SARS-CoV-2 serta bisa menular antar manusia. Penularan COVID-19 terjadi lewat droplet yang dihasilkan oleh orang yang terinfeksi. Mudahnya penularan COVID-19 menyebabkan kasus COVID-19 semakin meningkat. Terhitung tahun 2020 jumlah kasus anak positif COVID-19 di Indonesia mencapai 37.706 kasus. Bali merupakan salah satu provinsi terdampak dengan kasus anak positif COVID-19 mencapai 1.524 kasus. Tujuan dari penelitian ini yakni untuk mengetahui gambaran gejala klinis pasien anak positif COVID-19 di RSUP Sanglah Denpasar berdasarkan usia, jenis kelamin, dan komorbid. Penelitian ini mengunakan metode deskriptif dengan rancangan penelitian cross sectional. Pengambilan sampel penelitian menggunakan non-probability sampling dengan teknik Consecutive sampling. Data yang diambil berupa data sekunder pasien yang tercatat pada rekam medis pada Instalasi Rekam Medis RSUP Sanglah periode Maret 2020 – Maret 2021. Sampel yang diambil sebanyak 75 sampel. Hasil penelitian ini menunjukkan gejala klinis yang ditemukan adalah demam, pilek, batuk, sesak napas, sakit tenggorokan, napas cepat, mual/muntah, diare, nyeri perut, sakit kepala, dan kelelahan, dimana demam merupakan gejala terbanyak (74,7%). Pasien anak positif COVID-19 di RSUP Sanglah paling banyak laki-laki, kelompok usia terbanyak yaitu 11-18 tahun, dan paling banyak tidak memiliki komorbid. Komorbid yang paling banyak ditemukan adalah keganasan.Kata kunci : COVID-19, Gejala klinis, Anak, RSUP Sanglah.
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

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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.