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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran

I Putu Gede Karyana

Department Of Child Health, Medical School Of Udayana University, Denpasar, Indonesia

Author-ID : 505249

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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Efficacy of reduced osmolarity oral rehydration solution, rice ... based oral rehydration solution, and standard WHO oral rehydration solution in children with acute diarrhea - a randomized open trial Thermiany Anggri Sundari; Soetjiningsih Soetjiningsih; Sri Supar Yati Soenarto; I P. G. Karyana
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The composition of the WHO's standard oral rehydration solution (ORS) is similar to that of choleric stool. Currently, there are questions about whether the composition is acceptable for treating dehydration caused by diarrhea. Efforts are being made to try and improve the WHO ORS, e.g., to decrease the solution osmolarity to avoid hypertonic side effects.lt is acknowledged that if glucose is used in ORS, the sodium will go through enterocytes and glucose will tum into an absolute substance for the formula. Glucose is less affordable and not widely produced in developing countries, hence researchers are currently exploring substitutes such as rice flour.Objective To compare the efficacy of reduced osmolarity ORS,rice-based ORS and the WHO standard ORS among childrenwith acute diarrhea.Methods A randomized open trial was conducted in children aged6-59 months old admitted for acute diarrhea. One-way AN OVAwas used to compare the three different types of ORS given.Results The mean duration of diarrhea was significantly lower inthe group treated with reduced osmolarity ORS (52.66 h, 95%CI 4 7.13 to 58.18) and rice-based ORS (54.66 h, 95% CI 4 7.97to 61.34) compared to the group treated with the WHO standardORS (67.34 h, 95% CI 61.50 to 73.18). Multivariate analysisshows that intervention had a significant effect on reducing theduration of diarrhea.Conclusions Reduced osmolarity ORS and rice-based ORSsignificantly lower the mean duration of children with acutediarrhea compared with the group treated with the WHO standardORS.

Fava beanâ€“induced hemolytic crisis in glucose-6-phosphate dehydrogenase deficiency IPG Karyana; IB Mudita
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

This paper reports a case of hemolytic crisis dueto fava beans in a child with G6PD deficiency.

The value of IgG to IgM ratio in predicting secondary dengue infection I Putu Gede Karyana; Hendra Santoso; Bagus Ngurah Putu Arhana
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/pi46.3.2006.113-7

Background The determination of primary or secondary dengueinfection using hemagglutination inhibition (HI) test is time-con-suming. The IgG to IgM ratio which can be obtained earlier wasused by several studies to differentiate secondary from primaryinfection, but they still reported various cut-off points.Objective To find the diagnostic value and best cut off point ofIgG to IgM ratio for predicting secondary dengue infection.Methods This was a prospective study carried out between July2003 and June 2004. Children with suspected dengue hemor-rhagic fever (DHF) were tested for HI during acute and convales-cent phase. The IgG and IgM titer were examined during the acutephase using ELISA method.Results Sixty-two children were recruited, 48 with secondary in-fection and 14 with primary infection. The prevalence of second-ary infection was 77%. The best cut off point of the IgG to IgM ratioto predict secondary infection was >1.1 with sensitivity of 87.5%,specificity 92.9%, likelihood ratio 12.3, and post test probability97.7%.Conclusion The IgG to IgM ratio of >1.1 is a good predictor forsecondary infection

Liver function in children with human immunodeficiency virus infection before and after 6 months of highly active antiretroviral therapy Eva Jacomina Jemima Sapulete; I Gusti Ngurah Sanjaya Putra; Ketut Dewi Kumara Wati; Hendra Santoso; I Putu Gede Karyana; Komang Ayu Witarini; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Background Highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and improved survival rate in human immunodeficiency virus (HIV)-infected patients. Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity. Hepatotoxicity is often reflected in biochemical abnormalities of liver function, such as elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and aspartate aminotransferase-to-platelet ratio index (APRI). Objective To compare liver function spectrum (AST, ALT, and APRI) in HIV-infected children before and after at least 6 months of HAART. Methods This observational study (before and after) was conducted in pediatric patients with HIV infection who received HAART for at least 6 months at Sanglah Hospital, Denpasar. Data were collected from medical records. Results Forty-nine patients were observed in this study. The mean AST, ALT, and APRI levels before HAART were higher than after at least 6 months of HAART. Anti-tuberculosis treatment and fluconazole therapy were not confounding factors for AST, ALT, and APRI. Conclusion Liver function spectrum enzyme levels of AST, ALT, and APRI are improved after at least 6 months of HAART.

Ascites permagna caused by large mesenteric cyst in 2 years old male: A case report I Made Yullyantara Saputra; Putu Gde Karyana; Sanjaya Putra; Metriani Nesa; Made Dharmajaya; Kadek Deddy Arianta
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Mesenteric cysts are documented as a rare entity in the pediatric population. They are considered as benign intraabdominal tumors with an unknown etiology and may occur anywhere in the mesentery of the gastrointestinal tract from the duodenum to the rectum. They are most commonly located in the mesentery of the ileum followed by localization in the sigmoid mesocolon. Approximately one-third of mesenteric cysts occur in children younger than 15 years of age and are slightly more common in males. The surgery is the common methods to remove the cyst.Case presentation: A 2-year-old boy was hospitalized with a history of the bloated abdomen and dull achy pain on the left side of the abdomen since I year before admitted. Physical examination revealed distended of abdomen and ascites. Laboratory investigation showed normal limit; ultrasonography investigation showed cystic lesion and fluid collection in the cavum abdomen. It was confirmed with a CT scan. We diagnosed the patient with ascites permagna et causa suspected mesenteric cyst. After the diagnosis, a laparoscopic exploration and drainage ascites and total resection of the cyst were performed. Seven days after surgery, the patient was in good condition and discharged from the hospital â€” no distention in the abdomen.Conclusion: The mesenteric cyst can be the cause of ascites and can be well treated with laparoscopic modalities; the outcome is excellent with no malignancy founded.

Implementasi lintas diare dan penggunaan obat antidiare pada anak dengan diare Vidya Lakshmi Anbhuselvam; I Putu Gede Karyana; Ni Putu Siadi Purniti
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Introduction: Diarrhea is still a major problem that causes illness and death for children in Indonesia. Inappropriate care, both at home and in health agencies, is a major cause of deaths of children with diarrhea.Method: The design of this study was descriptive with a cross sectional study design. The design of this study aims to be able to describe the implementation of cross diarrhea and the use of antidiarrheal drugs for pediatric patients with diarrhea at RSUP Sanglah Denpasar. The data used in the form of secondary data obtained from the medical records of Sanglah Hospital RSUP patients Denpasar January 2017-April 2017. The technique of determining the sample used is total sampling where all target populations that meet the criteria are included as samples.Result: The most widely used cross group of diarrheas was ORS (Oral Rehydration solution) (17.9%). The most commonly used antidiarrhea drug is adsorbent (11.6%).Conclusion: The most widely used cross-diarrhea group was ORS (Oral Rehydration solution) followed by the antibiotic group and so on the zinc group. There are minority cases that have given negative results on antibiotics. The most widely used group of antidiarrheal drugs was the adsorbent followed by the class of antimotility drugs and so on other classes of drugs such as probiotics and herbal medicinesLatar Belakang: Diare masih menjadi masalah utama yang menyebabkan sakit dan kematian bagi anak-anak di Indonesia. Perawatan yang tidak tepat, baik dirumah maupun di instansi kesehatan, merupakan penyebab utama kematian anak-anak dengan diare.Metode: Rancangan penelitian ini bersifat deskriptif dengan rancangan penelitian cross sectional. Rancangan penelitian ini bertujuan untuk dapat menggambarkan implementasi lintas diare dan penggunaan obat antidiare terhadap pasien anak dengan diare di RSUP Sanglah Denpasar. Data yang digunakan berupa data sekunder yang didapat dari rekam medis pasien Anak RSUP Sanglah Denpasar bulan Januari 2017-April 2017. Teknik penentuan sampel yang digunakan adalah total sampling dimana seluruh populasi target yang memenuhi kriteria dimasukan sebagai sampel.Hasil: Golongan lintas diare paling banyak digunakan adalah cairan rehidrasi yaitu oralit sebanyak 34 (17,9%). Penggunaan obat antidiare paling sering digunakan adalah adsorben sebanyak 22 (11,6%).Simpulan: Golongan lintas diare paling banyak digunakan adalah cairan rehidrasi yaitu oralit diikuti oleh golongan antibiotik dan seterusnya golongan zink. Terdapat kasus minoritas yang telah memberi hasil negatif pada pemberian antibiotik. Golongan penggunaan obat antidiare paling banyak digunakan adalah adsorben diikuti oleh golongan obat antimotilitas dan seterusnya golongan obat lain-lain seperti probiotik dan obat herbal

A large-liver abscess with severe anaemia in 6 years-old patient: a case report I Gusti Istri Agung Widnyani; I Putu Gede Karyana; I Gusti Ngurah Sanjaya Putra; Nyoman Metriani Nesa
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Liver abscess are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a potentially lethal condition. This study aims to describe the signs, symptoms, and prognosis of pyogenic liver abscess in children with severe anaemia.Case Description: Six years old boy complained about abdominal pain for 4 months before admitted to the hospital. The abdomen began to stiff 23 days before. Since 4 weeks, there was several episodes of fevers, more than 4 times but not more than 3 days, relieved by antipyretic. Every fever followed by a stomachache. His parents said he looked paler than before and his activities decreased, was sleepy and irritable. In physical examination, we found the patient looked anaemic, with a distended abdomen with hepatomegaly. Routine CBC revealed: WBC was 16.99, Hemoglobin was 5.45g/dL platelet was 796.20, iron parameters was: iron serum: 11.27 ug/dL (normal: 50-120 ug/dL) TIBC: 180 ug/dL(normal 225-450 ug/dL). A liver abscess 4.5 cm x 5.1 cm with liquefaction was obtained by ultrasound and confirmed by abdomen MSCT with contrast 4,4 x 4,3 x 6,1 cm. The patient family refused abscess draining surgery, so only conservative therapy by antibiotics was given and further followed up in polyclinic. Nine-month after therapy, follow up by ultrasound was normal.Conclusion: The sign and symptom of pyogenic LA were non-specific; abdomen MSCT confirmed the diagnosis with contrast. The prognosis was good.

Cholelithiasis and chronic cholecystitis in a ten-year-old-boy: a case report Carissa Lidia; I Gusti Ngurah Sanjaya Putra; I Putu Gede Karyana; Ni Nyoman Metriani Nesa; I Made Darmajaya; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Cholelithiasis in children is uncommon and challenging to diagnose because the patient is often asymptomatic and the clinical feature doesn't clearly depict cholelithiasis or cholecystitis. This case study aims to describe a rare case of cholelithiasis with chronic cholecystitis in a ten-year-old boy.Case Presentation: A ten-year-old boy presented with umbilical pain, nausea, and emesis. Physical examination showed there is no tenderness in all abdominal quadrants with a negative Murphy sign. Laboratory results revealed elevated white blood cell count 20.42x103/?L, elevated erythrocyte sedimentation rate 47.2 mm/hour, normal liver function tests, urine, and stool analysis. He underwent transabdominal ultrasound twice. The latest transabdominal ultrasound showed cholelithiasis, free fluid around the pelvic region due to suspected visceral organ perforation. Laparoscopic cholecystectomy was performed without complication. The result of pathology anatomy examination was chronic cholecystitis. The patient was discharged 3 days after surgery in good condition. The long-term prognosis of the patient was good.Conclusion: Even though the patient is male with good nutritional status (not obese), the patient was in the mean age that was identified as a key contributor to this disease. Ultrasonography examination is a screening modality that is still an excellent diagnostic tool with 95% accuracy even though it is highly operator dependent. Laparoscopic cholecystectomy is a gold standard for management even in children with decreased pain and shorter lengths of stay in the hospital.

Hubungan Vaksinasi Rotavirus dengan Kejadian Diare pada Anak Usia 6-24 Bulan di Kota Denpasar Widiantari, Ni Made; Cempaka, Putu Mas Vina Paramitha; Nesa, Ni Nyoman Metriani; Karyana, I Putu Gede; Wati, Ketut Dewi Kumara
E-Jurnal Medika Udayana Vol 11 No 2 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i02.P18

Diarrhea constantly becomes an issue of health because of its high mortality and morbidity. Rotavirus infection is known as the predominant cause of acute diarrhea with severe dehydration and hospitalized diarrhea among children less than five years of age. Therefore, rotavirus vaccination is supposed to provide protective effect against the diarrhea cases. The study was implemented to prove the association between rotavirus vaccination and the diarrhea cases among children 6-24 months of age in Denpasar City. The study used an observation cross-sectional analytic design located at private pediatric clinic in Denpasar City and Puskesmas III Denpasar Utara from January to June 2020. The subjects selected by consecutive sampling technique were 104 children 24-36 months of age who divided into vaccinated and unvaccinated groups. The diarrhea cases were measured retrospectively from 6-24 months of age. The study data were derived through questionnaires, processed and analyzed through chi-square and logistic regression test on SPSS. In this study, the percentage of diarrhea cases in the vaccinated group (15,4%) was smaller than the unvaccinated group (36,5%). The statistical test showed PR = 0,42, 95% CI = 0,271-0,654, and p value = 0,001 (p<0,05) which means that rotavirus vaccination was significantly associated with the diarrhea cases and acts as a protective factor. Keywords : Children, Diarrhea, Rotavirus, Vaccination

Hubungan antara Pengetahuan Ibu dengan Sikap dan Tindakan Penanganan Diare dalam Mencegah Dehidrasi pada Anak Balita di RSUD Sanjiwani, Gianyar, Bali Dewi, Ni Luh Putu Mulia Laksmi; Kumara Wati, Ketut Dewi; Metriani Nesa, Ni Nyoman; Cempaka, Putu Mas Vina Paramitha; Karyana, I Putu Gede
E-Jurnal Medika Udayana Vol 12 No 9 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i09.P08

Diare adalah salah satu permasalahan sekaligus penyebab kematian utama pada anak, khususnya di negara berkembang. Diare pada balita dapat menyebabkan dehidrasi hingga kematian. Ibu memiliki peranan penting terhadap jumlah kasus diare pada balita. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan ibu dengan sikap dan tindakan penanganan diare dalam mencegah terjadinya dehidrasi pada balita. Penelitian ini merupakan penelitian merupakan jenis penelitian dengan metode analitik observasional yang menggunakan dengan pendekatan studi potong lintang dengan teknik consecutive sampling. Jumlah responden minimal dalam penelitrian ini adalah sebanyak 94 orang. Pengambilan data dilakukan dengan instrument kuisioner, kemudian dilakukan analisis data univariate dan bivariate. Analisis bivariate dilakukan dengan uji Chi Square menggunakan aplikasi SPSS dengan tujuan untuk mengetahui hubungan variabel yang diuji. Dari 96 orang responden bahwa nilai median dari usia ibu adalah 30 tahun dengan nilai median dari usia balita adalah 24 bulan. Karakteristik subjek didapatkan bahwa sebanyak 61 orang (63.5%) ibu dengan pendidikan terakhir D1/D2/D3/D4/S1, sebanyak 26 orang (37.5%) ibu bekerja sebagai pegawai swasta, sebanyak 67 orang (69.8%) ibu dengan kategori pengetahuan cukup, sebanyak 73 orang (76%) ibu dengan kategori sikap positif, sebanyak 61 orang (63.5%) ibu dengan kategori tindakan tepat terhadap penanganan diare. Dari hasil uji chi square mengenai hubungan pengetahuan dengan sikap ibu didapatkan hasil OR 3.594, P-Value=0.009, 95% CI 1.346-9.592. Hubungan bersifat searah antara pengetahuan dengan sikap ibu karena OR bernilai positif. Pengetahuan ibu meningkatkan sikap penanganan diare sebesar 3.594 kali. Hubungan pengetahuan dengan tindakan ibu didapatkan hasil OR 4.813, P-Value= 0.001, 95% CI 1.898-12.202. Hubungan bersifat searah antara pengetahuan dengan tindakan ibu karena OR bernilai positif. Pengetahuan ibu meningkatkan tindakan penanganan diare sebesar 4.813 kali. Kata Kunci : Pengetahuan, Sikap, Tindakan

Co-Authors A. A. Made Widiasa Bagus Ngurah Putu Arhana Carissa Lidia Cempaka, Putu Mas Vina Paramitha Dewi, Ni Luh Putu Mulia Laksmi Eva Jacomina Jemima Sapulete Franky Luhulima Hendra Santoso Hendra Santoso I Gede Ketut Aryana, I Gede Ketut I Gusti Istri Agung Widnyani I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Gusti Ngurah Sanjaya Putra I Ketut Adi Wirawan I Made Darmajaya I Made Pramana Dharmatika I Made Suwananta I Made Yullyantara Saputra I Nyoman Budi Hartawan IB Mudita IGN Sanjaya Kadek Deddy Arianta Kadek Deddy Ariyanta Kadek Surya Jayanti, Kadek Surya Ketut Dewi Kumara Wati Komang Ayu Witarini Made Darmajaya Made Dharmajaya Made Ratna Dewi Metriani Nesa, Ni Nyoman Muhammad Reza Nesa, Ni Nyoman Metriani Ni Nyoman Metriani Nesa Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Ni Putu Veny Kartika Yanti Sanjaya Putra Soetjiningsih Soetjiningsih Sumadiono Sumadiono Suwananta, I Made Thermiany Anggri Sundari Vidya Lakshmi Anbhuselvam Widiantari, Ni Made Yati Soenarto

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