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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana Indonesian Journal for Health Sciences (IJHS) ISM (Intisari Sains Medis) : Jurnal Kedokteran Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Eduvest - Journal of Universal Studies

I Gusti Ngurah Sanjaya Putra

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RS Sanglah, Denpasar

Author-ID : 505250

Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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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 Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity.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.

Cystatin C level and amikacin use in neonatal sepsis Putu Diah Pratiwi; I Wayan Dharma Artana; Ni Putu Veny Kartika Yantie; Hendra Santoso; I Gusti Ngurah Sanjaya Putra; Gusti Ayu Putu Nilawati; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Background Amikacin is the antibiotic of choice for eradicating bacteria in neonatal sepsis because of its effectiveness against Gram-negative bacteria. However, this drug has nephrotoxic effects. Monitoring kidney function in neonates is very important because amikacin can interfere with development of the kidney. Several studies have shown that serum cystatin C levels were closer to glomerular filtration rate (GFR) values â€‹â€‹compared to serum creatinine levels. Objective To evaluate cystatin C levels before and after administration of amikacin in neonates with sepsis. Methods This prospective cohort study was conducted in one group with a pretest and posttest design. Thirty neonatal sepsis patients who received amikacin therapy at Sanglah General Hospital, Denpasar, Bali, were included by consecutive sampling. Their cystatin C levels were measured before and after receiving amikacin therapy. Data were normally distributed and analyzed by paired T-test, with a value of P<0.05 considered to be significant. Results The mean difference was 0.23 [1.57 (SD 0.29) vs. 1.80 (SD 0.28)] mg/L with P value < 0.001. There was different value of cystatin c level before and after amikacin therapy with deviation standard 0.25 with P<0.001 (alfa 5%). Conclusion Cystatin C levels are significantly higher in neonates with sepsis after administration of amikacin.

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

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.

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.

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.

Penanganan terkini diare pada anak: tinjauan pustaka Desa Putu Rendang Indriyani; I Gusti Ngurah Sanjaya Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Diarrhea still ranks third as the leading cause of death for children under five years. It is estimated that as many as 800,000 deaths under five years were caused by diarrhea in 2010; 11% of the total deaths were under five yearsâ€”about 80% of these deaths occurring in Africa and Southeast Asia.Methods: This manuscript's writing used the literature review method in which a detailed search was carried out on the document in national and international databases.Results and Discussion: The leading cause of diarrhea in children is a virus. The most commonly known virus is Rotavirus (40â€“60%). Viruses that enter through food and drink to enterocytes will cause infection and damage to the small intestine villi. According to WHO, there are five lines of diarrhea management, namely: adequate rehydration, zinc, nutrition, appropriate antibiotics, and education.Conclusion: With good diarrhea management, diarrhea has a good prognosis. Death in sufferers of diarrhea is caused by severe dehydration and secondary malnutrition.Â Â PendahuluanÂ : Diare masih menempati urutan ketiga sebagai penyebab kematian terbanyak untuk anak-anak dibawah lima tahun. Diperkirakan sebanyak 800.000 kematian dibawah lima tahun disebabkan oleh diare pada tahun 2010, yang merupakan 11% dari total kematian dibawah lima tahun. Dengan sekitar 80% kematian ini terjadi di Afrika dan Asia tenggara.Metode: Penulisan naskah ini menggunakan metode tinjauan pustaka dimana dilakukan penelusuran terdahap naskah pada database nasional dan internasional.Hasil dan Diskusi: Penyebab utama diare pada anak oleh virus, virus terbanyak yang diketahui adalah jenis Rotavirus (40â€“60%). Virus dapat masuk kedalam tubuh melaui makanan dan minuman yang dikonsumsi. Setelah sampai sampai ke enterosit, virus akan menimbulkan infeksii dan kerusakan pada villii usus, terutama usus halus. Menurut badan kesehatan dunia (WHO) dipublikaskan lima lintas penatalaksanaan diare, diantaranyai: pemberian carian yang adekuat, pemberian suplement zinc, lanjutkan nutrisi sesuai, pemberian antibiotik bila diperlukan, dan edukasi orang tua.Kesimpulan: Dengan penatalaksanaan diare yang baik, diare memiliki prognosis yang baik. Dominan, angka kematian anak yang mengalami diare disebabkan oleh karena dehidrasi berat serta malnutrisi sekunder yang tidak tertangani dengan baik.

HUBUNGAN OVERWEIGHT-OBESITAS DENGAN NILAI AKADEMIS SISWA SEKOLAH MENENGAH ATAS (SMA) NEGERI 1 TABANAN, BALI Dewi, Ni Nyoman Gita Kharisma; Arimbawa, I Made; Putra, I Gusti Ngurah Sanjaya; Windiani, I Gusti Ayu Trisna
E-Jurnal Medika Udayana Vol 11 No 8 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i8.P05

Overweight-obesity is a condition that results from the accumulation of excess body fat and can affect cognitive function in adolescents, thus having an impact on academic achievement. The aim of this study was to see the relationship between overweight-obesity and academic achievement of student at SMA N 1 Tabanan. The research design of this study was analytic observational cross-sectional. The data were taken by consecutive sampling method through distributing questionnaires in the form of google form. The subject of this study were students of class XI of SMA N 1 Tabanan. Bivariate and multivariate tests were used to analyze the data in this study. The results of the bivariate analysis, the relationship between academic achievement with nutritional status (p = 0.018), gender (p = < 0.001), socioeconomic status (p = 0.005), screen time (p = 0.001), breakfast habits (p = 0.133), and physical activity (p = 0.516). The results of the multivariate analysis, the relationship between academic achievement with nutritional status (OR 4.343; CI 95% 1.050-17.964), socioeconomic status (OR 4.614; CI95% 1.775-11.993), breakfast habits (OR 2.605; CI95% 1.003-6.767), screen time (OR 0.245; CI95% 0.092-0.651), and gender (OR 2.567; CI95% 0.979–6.733).The conclusion is that the overweight-obesity nutritional status has a significant relationship with academic achievement that is less than the average. The habit of not frequent/never having breakfast and less socioeconomic status were also shown to have a significant relationship with academic achievement that is less than the average. Key word : overweight-obesity, academic achievement, school age students.

Validation of PIM 3, Prism III, and Pelod 2 Scores As Predictors of Mortality in Acute Respiratory Distress Syndrome in Pediatric Intensive Care Unit Sihombing, Rina Margareth; Suparyatha, Ida Bagus Gede; Putra, I Gusti Ngurah Sanjaya
Eduvest - Journal of Universal Studies Vol. 5 No. 4 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i4.49949

Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition in pediatric patients characterized by alveolar fluid accumulation that disrupts gas exchange. Various scoring systems—Pediatric Index of Mortality 3 (PIM 3), Pediatric Risk of Mortality III (PRISM III), and Pediatric Logistic Organ Dysfunction 2 (PELOD 2)—are utilized to estimate mortality, disease severity, and organ dysfunction. However, their validation specifically in pediatric ARDS remains limited. This prospective cohort study aims to evaluate the predictive validity of PIM 3, PRISM III, and PELOD 2 in children aged 1 month to 18 years diagnosed with ARDS and admitted to the Pediatric Intensive Care Unit (PICU). A total of 60 patients were enrolled, with 16 observed for a full 28-day period and 44 reaching clinical outcomes earlier (19 deaths, 25 survivals). Each scoring system was assessed using Receiver Operating Characteristic (ROC) analysis to determine optimal cut-off values for mortality prediction. The PIM 3 score with a cut-off of ≥6.8 yielded a sensitivity of 90.0% and specificity of 95.0%. PRISM III with a cut-off of ≥26 showed 85.0% sensitivity and 100% specificity, while PELOD 2 with a cut-off of ≥9 demonstrated similar performance (85.0% sensitivity, 100% specificity). Among the three, PIM 3 exhibited superior sensitivity for mortality prediction. These findings support the clinical utility of PIM 3 as a more responsive tool for early risk stratification in pediatric ARDS, aiding in timely and targeted interventions.

Faktor Risiko Mortalitas pada Pasien Anak dengan Sepsis di Rumah Sakit Ngoerah Denpasar Tahun 2023 Berdasarkan Skor PELOD-2 dan Skor Vasoaktif Inotropik Haning, Joy Aprianis; Hartawan, I Nyoman Budi; Witarini, Komang Ayu; Suwarba, I Gusti Ngurah Made; Putra, I Gusti Ngurah Sanjaya; Wati, Dyah Kanya
Sari Pediatri Vol 27, No 3 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.3.2025.166-72

Latar belakang. Sepsis merupakan salah satu penyebab utama morbiditas dan mortalitas pada anak yang dirawat di ruang intensif. Identifikasi faktor risiko kematian pada pasien anak dengan sepsis penting untuk menunjang deteksi dini dan pengambilan keputusan klinis yang lebih tepat guna menurunkan angka kematian. Namun, penelitian mengenai faktor risiko mortalitas anak dengan sepsis di Indonesia, khususnya yang memanfaatkan skor prognostik seperti PELOD-2 dan Vasoactive-Inotropic Score (VIS), masih sangat terbatas sehingga diperlukan data lokal untuk memperkuat bukti klinis.Tujuan. Mengetahui faktor-faktor risiko yang berhubungan dengan mortalitas pada pasien anak dengan sepsis yang dirawat di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G Ngoerah Denpasar. Metode. Penelitian ini menggunakan desain case-control retrospektif dengan data diambil dari rekam medis pasien anak usia satu bulan hingga 18 tahun yang dirawat karena sepsis selama periode Januari hingga Desember 2023. Subjek dibagi menjadi kelompok kasus (meninggal) dan kontrol (hidup). Variabel yang diteliti meliputi usia, status gizi, penggunaan ventilator, skor PELOD-2, skor vasoaktif-inotropik, mikroorganisme penyebab, dan lama rawat. Analisis statistik dilakukan dengan uji chi-square dan regresi logistik multivariat. Hasil. Sebanyak 62 pasien sepsis memenuhi kriteria inklusi, terdiri dari 31 pasien meninggal dan 31 pasien hidup. Analisis bivariat menunjukkan bahwa penggunaan ventilator, skor PELOD-2 ?7, skor vasoaktif-inotropik ?20, dan lama rawat ?12 hari berhubungan signifikan dengan peningkatan risiko mortalitas. Kesimpulan. Penggunaan ventilator, skor PELOD-2 tinggi, skor vasoaktif-inotropik tinggi, dan lama rawat yang singkat merupakan faktor risiko utama mortalitas pada pasien anak dengan sepsis. Penilaian dini terhadap faktor-faktor ini dapat meningkatkan efektivitas intervensi dan perbaikan luaran klinis.

Co-Authors Abdul Hamid Agung Bagus S. Satyarsa Agus Firmansyah Aswitha D Boediarso Badriul Hegar Bagus Ngurah Putu Arhana Carissa Lidia Defranky Theodorus Della Sabrina Marta Desa Putu Rendang Indriyani Dewi, Ni Nyoman Gita Kharisma Dyah Kanya Wati Eka Gunawijaya Eva Jacomina Jemima Sapulete Fatima Safira Alatas, Fatima Safira Gusti Ayu Putu Nilawati Haning, Joy Aprianis Hendra Santoso Hendra Santoso I Gede Ketut Aryana, I Gede Ketut I Gusti Agung Trisna Windiani I Gusti Istri Agung Widnyani I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Ketut Nomor Aryasa I Made Arimbawa I Made Darmajaya I Made Pramana Dharmatika I Nyoman Budi Hartawan I Nyoman Semadi I Putu Gede Karyana I Wayan Dharma Artana I Wayan Gustawan Ida Bagus Gede Suparyatha Ida Bagus Subanada Jefry Gilberth Koibur Kadek Deddy Ariyanta Kadek Deddy Ariyanta Ketut Ariawati Ketut Dewi Kumara Wati Komang Ayu Witarini Luh Putu Diah Virayanti Made Darmajaya Made Gede Dwi Lingga Utama Made Suadnyani Pasek Muhammad Reza Muzal Kadim Nesa, Ni Nyoman Metriani Ni Nyoman Metriani Nesa Ni Putu Veny Kartika Yanti NP Veny Kartika Yantie Putu Diah Pratiwi Sihombing, Rina Margareth Sudaryat Suraatmaja Suparyatha, Ida Bagus Gede Suwananta, I Made

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