Ni Nyoman Metriani Nesa
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Udayana/RS Universitas Udayana

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Journal : ISM (Intisari Sains Medis) : Jurnal Kedokteran

Karakteristik diare pada anak di RSUP Sanglah Denpasar tahun 2017 I Dewa Made Satrianjaya; Ni Nyoman Metriani Nesa; Dewi Sutriani Mahalini
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (779.152 KB) | DOI: 10.15562/ism.v10i2.194

Abstract

Background: Diarrhea is one of the most common diseases affecting children around the world. In Indonesia, the national rate of diarrhea prevalence is 9% where 16.7% of cases occur at 1-4 years old and 16.5% of cases at under one year old. In addition, dehydration causes most mortalities. Aim: This study aims to determine the characteristics of diarrhea in children in Sanglah General Hospital, Denpasar. Method: Thisstudyis a cross-sectional study design using secondary data from the register data in the Pediatric Division of Sanglah General Hospital Denpasar from January to November 2017. Of the 170 data, there were 165 survival samples. Characteristics of diarrhea in children are described using tables, pie charts, and graphs.Result: Most of the sample were males (56.5%), infants (40%), patients from Denpasar (55.3%) and those with good nutritional status (60%). The mean age of the patient was 26.6 months, the mean body weight was 10.6 kg, and the mean height was 79.8 cm. Most of them were diagnosed with acute diarrhea (98%), where the most common cause is a viral infection (75%). The most common comorbid diseases are congenital heart disease and neurological disease (10.6%). Most patients have only mild dehydration (57%). Long term treatment of diarrhea patient in child wards mostly for 2-3 days.Conclusion: Diarrheain children in Sanglah Denpasar Hospital period January-November 2017 most suffered by men and babies, mostly from Denpasar. Most of them have acute diarrhea that is mainly caused by a viral infection.
Hubungan ASI eksklusif terhadap terjadinya diare akut di Puskesmas III Denpasar Utara periode 2018 I Putu Gede Danika Adikarya; Ni Nyoman Metriani Nesa; Made Sukmawati
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 (238.532 KB) | DOI: 10.15562/ism.v10i3.434

Abstract

Introduction: Diarrhea is still a public health problem in developing countries, including Indonesia, because of its high morbidity and mortality. Breast milk is one of the important factors to reduce mortality and morbidity due to diarrhea. The aim of this study was to determine the relationship of exclusive breastfeeding to the occurrence of acute diarrhea. This research is analytic research with cross sectional method.Method: The study was carried out in Community Health Centre III Subdistrict of North Denpasar from October to November 2018. The research subjects were taken by consecutive sampling. Data analysis used the prevalence ratio calculation and chi square test to determine the relationship between exclusive breastfeeding and the incidence of diarrhea.Result: In this study the results of acute diarrhea patients in the exclusive breastfeeding group were 17 children and non-exclusive breastfeeding as many as 31 children. Subjects who did not experience acute diarrhea in the excluded breastfeeding group were 28 children and in the non-exclusive breastfeeding group as many as 14 children. The results of statistical analysis showed the value of p=0.003 (p<0.05)  PR=0.514 CI 95% (0.115-0.656).Conclusion: Exclusive breastfeeding has a significant relationship with the incidence of acute diarrhea and is a protective factor for the incidence of diarrhea.
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.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1120.126 KB) | DOI: 10.15562/ism.v10i3.447

Abstract

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 — 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.
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.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1032.244 KB) | DOI: 10.15562/ism.v11i1.508

Abstract

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.
Tingkat pengetahuan, sikap, dan perilaku orangtua tentang penyakit diare dan penanganannya pada anak balita di Pandu D’Care Made Refika Widya Apsari Tangkas; Ni Nyoman Metriani Nesa; Ayu Setyorini Mestika Mayangsari; Nyoman Budi Hartawan
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (267.646 KB) | DOI: 10.15562/ism.v11i3.678

Abstract

Background: Diarrhea is an increased frequency of defecation, 3 times or more a day, with changes in the consistency of the stool which become loose to watery. World Health Organization (WHO) states that there are 1.7 billion cases of diarrhea annually and responsible for 525,000 deaths in children each year.Aim: This study aimed to determine the level of knowledge, attitudes, and behavior of parents regarding early treatment of diarrhea of toddlers in D’Care Pandu Child Care Center in January 2019.Method: This study was a cross-sectional observational study. Research subjects consisted of 47 parents who entrust their children to be taken care at the D'Care Pandu Child Care Center. Subjects were asked to fill out a questionnaire to determine the level of knowledge, attitudes and behavior of parents regarding diarrheal disease and its management.Results: Most parents had good knowledge about diarrhea (66%). Most respondent had good attitude level (66%) and moderate level of parental behavior (52%).Conclusion: There were adequate knowledge, attitudes and behaviors of parents related to diarrhea problems in children. Diare adalah meningkatnya frekuensi defekasi yaitu 3 kali atau lebih dalam sehari, dengan perubahan konsistensi tinja menjadi lebih lembek hingga cair. World Health Organization (WHO) menyatakan bahwa terdapat 1,7 milyar kasus diare pertahun secara global dengan angka kematian pada anak sebesar 525.000 tiap tahunnya.Tujuan: Penelitian ini bertujuan untuk mengetahui tingkat pengetahuan, sikap, serta perilaku orangtua dalam penanganan awal diare pada balita di Tempat Penitipan Anak Pandu D’Care.Metode: Penelitian ini menggunakan merupakan penelitian observasional dengan pendekatan potong-lintang. Subyek penelitian terdiri dari 47 orangtua yang menitipkan anaknya di TPA Pandu D’Care pada Januari 2019. Subyek diminta mengisi kuisioner untuk mendapatkan gambaran tingkat pengetahuan, sikap serta perilaku orangtua tentang penyakit diare dan penanganannya.Hasil: tingkat pengetahuan orangtua mengenai diare sebagian besar adalah baik (66%). Sebagian besar responden memiliki tingkat sikap yang baik (66%) dan didapatkan dominansi perilaku orangtua dalam tingkatan sedang yaitu sebesar 52%.Simpulan: Studi ini menunjukkan cukup adekuatnya pengetahuan serta sikap dan perilaku orang tua terkait permasalahan diare pada anak. 
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.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (881.86 KB) | DOI: 10.15562/ism.v11i3.684

Abstract

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.