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All Journal Medicina Sari Pediatri Paediatrica Indonesiana Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan Indonesian Journal for Health Sciences (IJHS) ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Kesehatan Tambusai

I Wayan Gustawan

Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Author-ID : 485920

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

Published : 24 Documents Claim Missing Document

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Validity of parentsâ€™ evaluation of developmental status (PEDS) in detecting developmental disorders in 3-12 month old infants I Wayan Gustawan; Soetjiningsih Soetjiningsih; Soeroyo Machfudz
Paediatrica Indonesiana Vol 50 No 1 (2010): January 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background Early detection of development disorder is an effort to recognize disorders in every developmental stage. Parentsâ€™ concern can be helpful in identifying children in need of assessment and can be used as a prescreening test to reduce the number of children who require formal screening.Objective To examine diagnostic value of parentsâ€™ evaluation of developmental status (PEDS) instrument in order to determine developmental disorders in infant.Methods One hundred and seventy infants, 3-12 months old who visited Pediatric Outpatient Clinic were recruited. The parents filled in the PEDS questionnaire and the results were compared with those of Bayley Scales of Infant Development Second Edition (BSID-II) as a gold standard. The diagnostic properties of PEDS were then calculated.Results PEDS showed a sensitivity of 83.9% (95% CI 67.8 to 93.8), a specificity of 81.3% (95% CI 74.2 to 87.1), a positive predictive value of 50.0% (95% CI 40.6 to 59.4), a negative predictive value of 95.8% (95% CI 91.2 to 98.0), a likelihood ratio positive of 4.5 (95% CI 3.1 to 6.6), a likelihood ratio negative of 0.2 (95% CI 0.1 to 0.4), a pre-test probability of 18.2% and a post-test probability of 49.9% (95% CI 40.6 to 59.3).Conclusion PEDS can be used as an initial screening test to detect developmental disorders in 3-12 month infants.

Systemic juvenile rheumatoid arthritis in an 11 year old boy: a case report I Wayan Gustawan; Ketut Dewi Kumara Wati; Hendra Santosa
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Juvenile rheumatoid arthritis (JRA) is the mostcommon rheumatic condition in childrenand a major cause of chronic disability. 1 JRAis defined as persistent arthritis in one oro e joints for at least six weeks, when certainexclusionary conditions have been eliminated.2Â·3The three major subtypes of JRA are based onthe symptoms at disease onset and are designatedas systemic onset, pauciarticular onset, andpolyarticular onset.2 Systemic onset juvenilerheumatoid arthritis (SoJRA) represents about10-20% of all forms of JRA.4The incidence of ]RA is approximately 13.9/100,000 per year among children 15 years old oryounger.1 In Finland, the incidence was 19.5/100,000of the population under 16 years of age. The incidencewas significantly higher than in earlier years (1980,1985, and 1990) in the same district.5 Different racialand ethnic groups appear to have varying frequenciesof the subtype of JRA.1The treatment of JRA is achieved usingcombinations of anti-inflammatory and immunomodulatorymedications in combination withphysical and occupational therapy, occasionalsurgery, nutritional support, and psychosocial andeducational partnerships with patients and parents.3,6It is widely thought that a comprehensive teamapproach is associated with a superior outcome. 7This paper reports a case of systemic JRA in an 11-year old boy.

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.

Implementation of Dengue Recurrent Shock Prediction Score in pediatric dengue shock syndrome Armand Setiady Liwan; I Wayan Gustawan; Eka Gunawijaya; Soetjiningsih Soetjiningsih; Ketut Ariawati; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.178-85

Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.

LINGKUNGAN TEMPAT TINGGAL SEBAGAI FAKTOR RESIKO INFEKSI VIRUS DENGUE PADA ANAK-ANAK Jefry Gilberth Koibur; Agung Bagus Sista Satyarsa; I Wayan Gustawan; I Gusti Ngurah Sanjaya Putra; I Made Dwi Lingga Utama
Indonesian Journal for Health Sciences Vol 5, No 1 (2021): March
Publisher : Universitas Muhammadiyah Ponorogo

Demam Berdarah Dengue adalah penyakit disebabkan oleh virus dengue yang berkembang pesat di negara dengan iklim tropis seperti Indonesia. Penelitian ini bertujuan untuk mengidentifikasi faktor risiko infeksi virus dengue pada anak-anak di wilayah kerja Puskesmas Denpasar Selatan. Penelitian merupakan penelitian observasional analitikal dengan pendekatan cross-sectional. Data diperoleh dari jawaban reponden terhadap kuesioner yang telah tervalidasi sebelumnya dan selanjutnya data dianalisis secara univariat dan bivariat menggunakan aplikasi statistik yakni SPSS. Terdapat 75 responden yang mengikuti penelitian ini dengan rerata usia yakni 12±3,094 tahun. Karakteristik responden didominasi oleh anak laki-laki (73,3%) dan domisili di perkotaan (68%). Anak-anak lebih banyak tinggal di daerah yang padat penduduk (66,6%) dengan sanitasi lingkungan memadai hanya 45,3% dari total responden. Ditambah lagi, anak-anak memiliki risiko terinfeksi virus dengue dan mengalami demam berdarah pada lingkungan tempat tinggal di perkotaan dengan mobilitas penduduk yang padat (PR: 2,716; IK95%: 2,047-18,067; p: 0,011). Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa lingkungan tempat tinggal menjadi faktor risiko terhadap infeksi virus dengue pada anak-anak, sehingga diperlukan upaya preventif yang terfokus untuk mencegah infeksi virus dengue

Study of knowledge in diarrhea and personal hygiene among students below 10 years old in SD Santo Yoseph 2, Denpasar in 2016-2017 Karthigeyan Manogaran; I Made Gede Dwi Lingga Utama; I Wayan Gustawan
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: The lack of basic knowledge of diarrhea and also poor self-hygiene might be the risk factors of diarrhea.Aim: The study aims to identify the knowledge of diarrhea and personal hygiene among student below 10 years old in SD Santo Yoseph 2, Denpasar, Bali. Method: This cross sectional study was conducted on students below 10 years old in SD Santo Yoseph 2, Denpasar. Fifty students participated in this study, and they were divided into two groups. Of total study participants, 25 were from 8 years old, and 25 were from 9 years old. They were asked to fill up a self-administered questionnaire. The variables assessed were their knowledge of diarrhea (definition, etiology, risk factors, sign and symptoms, complications, treatment and management, and prevention) and application of personal hygiene.Result: About 34% of 50 students below 10 years old in SD Santo Yoseph respectively had good knowledge of diarrhea. However, 66% of students had very less knowledge about diarrhea where they get below. For the application of personal hygiene, 24% of students managed to get a good score while 74% of them failed to get a good score. The vast majority had adequate knowledge of the definition of diarrhea. At the same time, the majority of the students was unable to know that dehydration is the complication of diarrhea due to the loss of a large amount of water and salt in the body.Conclusion: Though the overall knowledge in diarrhea and application of hygienic lifestyle among the students were poor, few minorities of the students had a good understanding of both these variables. There is a strong need for early childhood education about knowledge in diarrhea and personal hygiene in school level itself as a method of prevention.

Karakteristik infeksi virus dengue pada pasien anak di poliklinik anak Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar tahun 2016 I Made Bagus Wilaksmana Putra; I Nyoman Budi Hartawan; I Wayan Gustawan
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Dengue infection is a mosquito induced viral infection with the highest virility level in the world. This disease is an international emergency problem and creates economic and social burdens around the world. Therefore, this study aims to determine the characteristics of dengue virus infection in pediatric patients in 2016 based on several parameters. Methods: A cross-sectional study was conducted among 96 pediatric patients with dengue virus infection who were treated at Sanglah General Hospital, Bali in 2016 period. A secondary data obtained from the collection of medical records of patients were used in this study. Data were analyzed using Microsoft Excel 2010 for Windows software.Results: Most of patients were female (54.17%), aged 5-18 years (67.71%), and with normal BMI status (42.71%). Most subject comes with bleeding signs and have positive tourniquets tests (64.58%), followed by abdominal clinical symptoms with nausea (50.00%), and neurological status with headache (41.67%). The length of stay of patients were mostly 3-5 days (73.96%) and the results of the axial temperature examination at the time of hospital admission were dominant <37ÂºC (65.63%). Based on laboratory examination, most subject has hemoglobin examination of 11-13 g/dl (57.29%), platelet examination results 50,000-100,000 (65.63%), hematocrit examination results <41% (44.79%), and leukocyte examination results <5,000/Âµl (59.38%). Most subjects are patient with Grade I DHF (56.25%%).Conclusion: The most predominant characteristics of pediatric patients with dengue virus infection was female, bleeding signs, nausea, headache, 3-5 days length of stay, atypical hematological parameters such as on hematocrit, platelet, and leucocyte examination.Â Latar Belakang: Penyakit infeksi dengue merupakan penyakit infeksi virus vektor nyamuk dengan tingkat penyebaran tertinggi di dunia. Penyakit ini seringkali menjadi masalah darurat antarnegara serta menimbulkan beban ekonomi dan sosial di dunia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui karakteristik infeksi virus dengue pada pasien anak tahun 2016 berdasarkan beberapa parameter.Metode: Sebuah studi potong lintang dilakukan pada 96 pasien anak-anak dengan infeksi virus dengue yang dirawat di Rumah Sakit Umum Pusat Sanglah, Bali pada periode tahun 2016. Data sekunder yang diperoleh dari rekam medis pasien digunakan dalam penelitian ini. Data dianalisis menggunakan piranti lunak Microsoft Excel 2010 untuk Windows.Hasil: Sebagian besar pasien adalah perempuan (54,17%), berusia 5-18 tahun (67,71%), dan dengan status BMI normal (42,71%). Sebagian besar subjek datang dengan tanda-tanda perdarahan dan memiliki tes tourniquets positif (64,58%), diikuti oleh gejala klinis perut mual (50,00%), dan status neurologis dengan sakit kepala (41,67%). Lama tinggal pasien sebagian besar 3-5 hari (73,96%) dan hasil pemeriksaan suhu aksial saat masuk rumah sakit didominasi <37ÂºC (65,63%). Berdasarkan pemeriksaan laboratorium, sebagian besar subjek memiliki pemeriksaan hemoglobin 11-13 g/dl (57,29%), hasil pemeriksaan trombosit 50.000-100.000 (65,63%), hasil pemeriksaan hematokrit <41% (44,79%), dan hasil pemeriksaan leukosit <5.000 / Î¼l (59,38%). Sebagian besar subyek adalah pasien dengan DBD kelas I (56,25%%).Kesimpulan: Karakteristik yang paling dominan dari pasien anak dengan infeksi virus dengue adalah wanita, tanda-tanda perdarahan, mual, sakit kepala, 3-5 hari tinggal, parameter hematologis khusus seperti pada hematokrit, trombosit, dan pemeriksaan leukosit.

Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia Ni Putu Wirantari; I Wayan Gustawan; Made Gede Dwilingga Utama; Bagus Ngurah Putu Arhana; Ni Nengah Dwi Fatmawati; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquiredÂ infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%â€“30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).Conclusion: The MPV â‰¥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).

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.

Manifestasi klinis dan penanganan demam berdarah dengue grade 1: sebuah tinjauan pustaka Desak Putu Rendang Indriyani; I Wayan Gustawan
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Introduction: Dengue Hemorrhagic Fever (DHF) is a disease caused by the Dengue virus from the Flavivirus genus, Flaviviridae family, with four serotypes (DEN-1. DEN-2, DEN-3, and DEN-4). Primary dengue fever Grade 1 should receive serious attention by monitoring the patient's clinical manifestations so that patients get the right therapy immediately. If it is not treated quickly and adequately, the patient can experience an emergency with signs of shock and cause death.Method: The writing methodology used is a literature review. The literature source consists of relevant journals and books from the search engines PubMed, Google Scholar, and Proquest.Results: Dengue virus infection can be asymptomatic and symptomatic. Symptomatic dengue virus infection generally has a clinical spectrum grouped into 3, namely undifferentiated fever, dengue fever, and dengue hemorrhagic fever. Dengue fever (DD) patients who have no comorbidities and social indications can be treated as outpatients. Patients are given symptomatic treatment in the form of antipyretics such as paracetamol at a dose of 10-15 mg/kg/body weight, repeated 4-6 hours if fever. The management of dengue hemorrhagic fever (DHF) is symptomatic and supportive. Supportive therapy in the form of fluid replacement, which is the main point in managing DHF.Conclusion: In patients with dengue hemorrhagic fever grade I, close monitoring is needed regarding their clinical condition. This is because grade 1 dengue has the potential to be a more critical clinical condition. Early treatment will determine a better outcome.Â Â Pendahuluan: Demam Berdarah (DB) disebabkan oleh vÃrus Dengue (genus Flavivirus), dengan empat serotipe utama, yaitu DEN1. DEN2, DEN3 dan DEN4. Penyakit DB utamannya Demam berdarah dengue (DBD) Grade 1 harus mendapat perhatian serius, salah satunya dengan melakukan monitoring manifestasi klinis pasien agar pasien mendapatkan terapi yang tepat dengan segera. Apabila tidak diatasi dengan tepat dan cepat pasien dapat mengalami kegawatan dengan tanda-tanda syok dan dapat menyebabkan kematian. Tinjauan Pustaka ini bertujuan untuk memberikan informasi terbaru mengenai tanda-tanda klinis DBD grade 1 agar praktisi dapat memberikan penanganan terbaik sebelum jatuh pada kondisi kritisMetode: Dalam penulisan ini digunakan metode tinjauan pustaka. Sumber bacaan berasal jurnal-jurnal dan buku-buku yang relevan dan sesuai dari PubMed dan Google Scholar.Hasil: Manifestai klinis DB dapat tidak bergejala (asimtomatik) dan bergejala simtomatik. Pasien dengan gejala dengue secara umum memiliki tiga jenis spektrum klinis yaitu demam yang tidak terdiferensiasi, demam dengue, dan demam berdarah dengue.. Pasien demam dengue (DD) yang tidak memiliki komorbiditas dan indikasi sosial dapat diperlakukan sebagai pasien rawat jalan. Pasien diberikan pengobatan simptomatik berupa anitpiretik seperti parasetamol dengan dosis 10-15 mg/kg/BB/dosis, diulang 4-6 jam bila demam. Tatalaksana demam berdarah dengue (DBD) diberikan secara simtomatis (sesuai gejala) dan suportif. Penanganan suportif dapat diberikan berupa cairan tambahan yang merupakan poin utama dalam penatatalaksanaan DBD.Kesimpulan: Pada pasien demam berdarah dengue derajat I diperlukan pemantauan yang ketat terkait kondisi klinis pasien. Hal ini dikarenakan DBD grade 1 berpontensi menjadi kondisi klinis yang lebih kritis. Penanganan dini akan menentukan outcome yang lebih baik.

Co-Authors Ade Tarini, Ade Agung Bagus S. Satyarsa Anggareni, Komang Tria Armand Setiady Liwan Artawan Artawan Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana BNP Arhana Chaliza Adnan Dalima AW Astrawinata Defranky Theodorus Desak Putu Rendang Indriyani Dewi, Ni Komang Ayu Renita Dyah Kanya Wati Eka Gunawijaya Gusti Ayu Putu Sri Satya Mahayani Hindra Irawan Satari Hindra Irawan Satari I Gusti Agung Trisna Windiani I Gusti Ayu Putu Eka Pratiwi I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Ketut Suarta I Made Arimbawa I Made Bagus Wilaksmana Putra I Made Yullyantara Saputra I Nyoman Budi Hartawan I Wayan Dharma Artana I Wayan Dharma Artana, I Wayan Dharma Ida Bagus Gede Suparyatha Ida Bagus Subanada Ida Bagus Subanda Idham Amir IKG Suandi Jefry Gilberth Koibur Julitasari S Karthigeyan Manogaran Ketut Ariawati Ketut Dewi Kumara Wati Ketut Suarta Komang Ayu Witarini Leni Lukman Luh Putu Ratna Sundari M Kardana Made Gede Dwi Lingga Utama Mulya Rahma Karyanti, Mulya Rahma Ni Made Adi Tarini Ni Nengah Dwi Fatmawati Ni Putu Siadi Purniti Ni Putu Wirantari Niluh Putu Wida Pangestika Novilia Sjafri Bachtiar NP Veny Kartika Yantie Putu Junara Putra Rini Mulia Sari Siska Permanasari Sinardja Soeroyo Machfudz Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sri Rezeki S Hadinegoro W Retayasa

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