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Faktor-Faktor yang Mempengaruhi Keberhasilan ASI Eksklusif pada Anak di RSUD Wangaya Bella Kurnia; I Wayan Bikin Suryawan
Majalah Kedokteran Indonesia Vol 69 No 10 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.10-2020-178

Background: Breastmilk is the best natural food for babies. Human milk consists of nutrients, such as proteins, lipid, carbohydrate, minerals, vitamins, and trace elements that are important for babies to ensure optimum growth and development. There is still low percentage of breastfeeding coverage in Indonesia. This study was designed to determine the factors that associated with the success of exclusive breastfeeding of children at Wangaya General Hospital. Methods: This study uses case-control method. Data was collected from medical record and interviews in Wangaya Regional General Hospital between April to May 2019. This study uses consecutive sampling. Data analysis uses chi square for bivariate and logistic regression for multivariate. Results: Factors associated with the success of exclusive breastfeeding were multipara (p=1,000; OR=1.214), labor method (p=1,000; OR=1.214), information availability (p less than 0,001; OR=46.000), occupation (p=0,148; OR=2.778), and educational level (p=0,240; OR=2.364). From multivariate analysis, information availability (p=0,001) was significant. Conclusion: Factor associated with successful breastfeeding in children at Wangaya General Hospital was information availability about breastfeeding to the mother.

Exclusive breastfeeding for 6 months is associated with reduced risk of febrile seizure Gosal, Jessica; Suryawan, I Wayan Bikin; Indrawan, I Gde Doddy Kurnia
Paediatrica Indonesiana Vol 64 No 6 (2024): November 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.6.2024.463-8

Background Febrile seizure (FS) is the most common convulsion disorder without an intracranial abnormality in children aged 6 months to 5 years. Risk factors for FS vary from maternal illness during pregnancy to pediatric nutritional factors, such as micronutrient deficiency or history of exclusive breastfeeding (EBF). The WHO recommends breastfeeding for up to 6 months because breastmilk contains numerous protective factors that may influence immune system development. Objective To analyze the relationship between FS and EBF and other potential risk factors in children aged 6-60 months. Methods This paired case-control study used patient medical record data from Wangaya Hospital, Denpasar from 2019-2020. Subjects were included by a purposive sampling technique, matched by age group. Children aged 6 to 60 months with fever >38oC and seizures were allocated to the case group; those with fever but without seizures were allocated to the control group. Patients with intracranial disorders, born prematurely, or with incomplete medical record data were excluded. Data were analyzed using McNemar test, with P values <0.05 deemed to be statistically significant. Results Of 92 participants, 46 children were allocated into each group. There were no significant differences of gender, delivery method, or birth weight between the case and control groups. Febrile seizure was significantly greater in subjects with a family history of all seizures, overweight nutritional status, and who were non-EBF. McNemar analysis showed that EBF children had significantly lower risk of FS compared to non-EBF children (OR 0.74; 95%CI 0.15 to 3.55; P=0.017). Additionally, positive family history of FS was also a significant factor (OR 4.33; 95% CI 0.25 to 76.04; P=0.021), but not with the overweight nutritional status. Conclusion Exclusive breastfeeding are associated with reduced risk of FS in children aged 6 months to 5 years.

Clinical Characteristics and Progression of Osteogenesis Imperfecta Type III: A Case Series Edbert Wielim; Chyntia; Regina Suriadi; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1268

Background: Osteogenesis imperfecta (OI) is a rare genetic disorder primarily affecting bone formation, leading to increased bone fragility and fractures. OI Type III is characterized by severe clinical manifestations, including multiple fractures, skeletal deformities, and short stature. This case series describes the clinical characteristics and progression of three patients diagnosed with OI Type III, highlighting the impact of early intervention with zoledronic acid on their outcomes. Case presentation: This study presents three cases of OI Type III in female patients. Two patients (Patient A and Patient R) were diagnosed at birth with multiple fractures and received zoledronic acid treatment starting at three months of age. The third patient (Patient D) presented with fractures later in infancy and began treatment at one year of age. All patients demonstrated hallmark features of OI Type III, including blue sclerae, short stature, and progressive skeletal deformities. However, the two patients who received earlier treatment with zoledronic acid showed better mobility and fewer fractures compared to the patients who started treatment later. Conclusion: This case series emphasizes the importance of early diagnosis and intervention in OI Type III. Zoledronic acid appears to be effective in reducing fracture rates and improving mobility in these patients. Further studies with larger sample sizes are needed to confirm these findings and optimize treatment strategies for OI Type III.

A case of pediatric Ramsay Hunt syndrome: diagnostic vigilance and prompt management Christina, Jessica; Sucipta, Anak Agung Made; Suryawan, I Wayan Bikin
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.78-84

Ramsay Hunt syndrome (RHS) is a neurological disorder due to geniculate ganglion infection caused by reactivated latent varicella zoster virus (VZV). RHS is rare condition in children, with an incidence estimated at 2.7/100,000 children per year. Studies on pediatric RHS have been very limited and opinions differ on the best option for treatment.

Analisis Faktor Faktor Risiko Anemia pada Anak di Rumah Sakit Umum Daerah Wangaya Bali Suriadi, Regina; Mustika, Putu Pradnyanita; Wielim, Edbert; Cynthia, Cynthia; Suryawan, I Wayan Bikin
Sari Pediatri Vol 27, No 1 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.1.2025.32-7

Latar belakang. Anemia merupakan kondisi yang sering ditemukan pada anak. Anemia memiliki dampak yang besar bagi pertumbuhan, perkembangan, morbiditas dan mortalitas anak, sehingga penting untuk mencegah dan menangani anemia pada anak sejak dini. Tujuan. Penelitian ini bertujuan mengetahui hubungan kejadian anemia dan faktor-faktor determinannya pada pasien anak.Metode. Penelitian ini adalah penelitian cross-sectional analitik melibatkan pada pasien anak dengan anemia yang datang ke Rumah Sakit Umum Daerah Wangaya, Bali selama periode Januari 2023 hingga jumlah sampel terpenuhi. Berdasarkan jumlah sampel minimal untuk penelitian cross-sectional dibutuhkan minimal 76 sampel. Kriteria inklusi adalah pasien anak berusia 1 bulan -18 tahun yang terdiagnosis anemia. Pasien dengan catatan medis yang tidak lengkap dikeluarkan dari penelitianHasil. Sebanyak 76 pasien anak dengan anemia diikutsertakan dalam penelitian ini. Rata-rata kadar Hb 12-20% lebih rendah pada kelompok dengan berat badan lahir rendah, usia ibu, lama pemberian ASI, stunted, gizi kurang, dan riwayat gastroenteritis, hasil ini juga bermakna secara statistik. Analisis multivariat menunjukkan faktor yang memiliki hubungan paling kuat terhadap kadar Hb anak adalah gizi kurang (koefisien ?: 0,283).Kesimpulan. Terdapat hubungan antara faktor anak (BBLR, stunted, gizi kurang, riwayat gastroenteritis) dan faktor ibu (usia ibu, lama pemberian ASI) terhadap kejadian anemia pada anak.

Clinical Characteristics and Progression of Osteogenesis Imperfecta Type III: A Case Series Edbert Wielim; Chyntia; Regina Suriadi; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1268

Background: Osteogenesis imperfecta (OI) is a rare genetic disorder primarily affecting bone formation, leading to increased bone fragility and fractures. OI Type III is characterized by severe clinical manifestations, including multiple fractures, skeletal deformities, and short stature. This case series describes the clinical characteristics and progression of three patients diagnosed with OI Type III, highlighting the impact of early intervention with zoledronic acid on their outcomes. Case presentation: This study presents three cases of OI Type III in female patients. Two patients (Patient A and Patient R) were diagnosed at birth with multiple fractures and received zoledronic acid treatment starting at three months of age. The third patient (Patient D) presented with fractures later in infancy and began treatment at one year of age. All patients demonstrated hallmark features of OI Type III, including blue sclerae, short stature, and progressive skeletal deformities. However, the two patients who received earlier treatment with zoledronic acid showed better mobility and fewer fractures compared to the patients who started treatment later. Conclusion: This case series emphasizes the importance of early diagnosis and intervention in OI Type III. Zoledronic acid appears to be effective in reducing fracture rates and improving mobility in these patients. Further studies with larger sample sizes are needed to confirm these findings and optimize treatment strategies for OI Type III.

The combined effect of neonatal hypothyroidism and low family income on intellectual disability: A review of mechanisms and interventions Sutanti, Sutanti; Suryawan, I Wayan Bikin
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6651

This review investigates the combined effect of neonatal hypothyroidism and low family income on the prevalence of intellectual disability, drawing insights from existing literature, including specific findings from studies involving neonatal cases such as 15 cases at Wangaya Regional Hospital Denpasar. Neonatal hypothyroidism significantly impacts cognitive development due to the critical role of thyroid hormones in brain maturation. Concurrently, low family income acts as a risk factor for intellectual disability by limiting access to essential healthcare, education, and developmental resources. The review explores the epidemiology of neonatal hypothyroidism, highlighting global and regional variations influenced by genetic, environmental, and socioeconomic factors. It delves into the mechanisms by which neonatal hypothyroidism affects brain and cognitive function, leading to deficits in intelligence, memory, attention, and executive function. Furthermore, the review examines the relationship between socioeconomic status and intellectual disability, emphasizing the role of resource scarcity and environmental factors associated with poverty. Findings from the reviewed literature suggest a compounding effect of neonatal hypothyroidism and low family income on a child's cognitive development and intellectual disability risk. Addressing this complex interplay necessitates a multifaceted approach, including early detection, prompt treatment, and integrated interventions spanning healthcare, education, and social support services. The review underscores the importance of equitable access to newborn screening, comprehensive early intervention programs, and family-centered support for children from low-income households.

Re-evaluating WHO Warning Signs in Pediatric Dengue: Abdominal Pain, Not Vomiting, is Associated with Plasma Leakage Cynthia Cynthia; Andreas Eric; I Kadek Suarca; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1382

Background: Dengue virus infection represents a significant cause of morbidity and mortality in pediatric populations across endemic regions. The progression to severe disease is characterized by a critical phase of plasma leakage. The World Health Organization (WHO) has established warning signs to aid in clinical triage, yet the independent clinical significance of these signs, particularly abdominal pain and vomiting, requires more precise clarification to optimize patient management. Methods: This study was a retrospective, cross-sectional analysis conducted at Wangaya General Hospital in Denpasar, Indonesia. Electronic medical records of 172 pediatric patients hospitalized with a diagnosis of dengue between January and May 2024 were reviewed. The primary outcome was significant plasma leakage, defined as a hematocrit increase of 20% or more from the admission baseline. Bivariate and multivariate logistic regression analyses were performed to determine the association of abdominal pain and vomiting with plasma leakage, controlling for the confounding effects of age, gender, and the day of fever at assessment. Results: In the multivariate logistic regression model, the presence of abdominal pain was independently and significantly associated with an increased likelihood of plasma leakage (Adjusted Odds Ratio [aOR]: 2.15, 95% Confidence Interval [CI]: 1.05–4.41; p=0.036). Conversely, the association for vomiting was not statistically significant after adjustment for confounders (aOR: 1.25, 95% CI: 0.65–2.42; p=0.508). The co-occurrence of both symptoms was also identified as a significant indicator of plasma leakage in the adjusted model (aOR: 2.09, 95% CI: 1.01–4.34; p=0.047). Conclusion: In this retrospective analysis of a hospitalized pediatric study, abdominal pain emerged as a robust independent correlate of significant plasma leakage, whereas vomiting did not. This differential association suggests that abdominal pain should be weighted more heavily in the clinical assessment of children with dengue as a key indicator of ongoing or impending hemoconcentration. These findings, while limited by their retrospective nature, can help refine clinical risk assessment in resource-constrained settings.

Exclusive Breastfeeding And Acute Diarrhea In Children: A Cross-Sectional Study Lukman, Leni; Suryawan, I Wayan Bikin
Medicinus Vol. 8 No. 2 (2019): February : 2019
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i4.2383

Introduction : Breastmilk is known to contain molecules such as oligosaccharides, sIgA and lactoferrin which hold vital importance in immune system. These molecules specifically functioned to protect the body from pathogens including those causing diarrhea. The objective of this study is to define the relationship between exclusive breastfeeding and acute diarrhea incidence frequency in children as primary outcome and age of first acute diarrhea occurrence in children as secondary outcome.Methods: This is an analytic observational cross-sectional study which included 35 children aged 6-24 months who were admitted to Kaswari Ward Wangaya General Hospital Denpasar between 01 June 2018 to 16 August 2018. Samples were obtained through consecutive sampling method and analyzed data were presented in both tables and narrative.Results: From 35 samples included in this study, 13 were exclusively breastfed (37,1%) and 22 were non-exclusively breastfed (62,9%). Sample characteristics including gender, number of siblings, nutritional status, residence, source of water, age of mother, parent’s occupation and education were comparable between two groups. Total samples who were exclusively breastfed and experience less diarrhea is 13 (p = 0,031; PR = 1,47 CI 95% 1,10-1,95). Total samples who were exclusively breastfed and first age of experiencing diarrhea over 12 months old is 11 (p = 0,002 ; PR = 3,10 CI 95% 1,47-6,27). Conclusion: There is statistically significant relationship between exclusive breastfeeding and acute diarrhea incidence frequency and age of first acute diarrhea occurrence in children aged 6-24 months in Kaswari Ward Wangaya General Hospital.

Association between Anemia and Severe Pneumonia among Children 6-59 Months Old in RSUD Wangaya, Denpasar: A Cross Sectional Study Sukarno, Theodora; Suryawan, I Wayan Bikin; Sucipta, Anak Agung Made
Medicinus Vol. 12 No. 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7361

Background: Severe pneumonia dan anemia happened to many children under five years old. Anemia leads to hypercapnia and slowing down red blood cell maturation and facilitate ischaemic syndrome. In the other side, pneumonia may increase hepcidin that suppressed erythropoiesis, hence anemia could worsen pneumonia. The aim of this research is to find association of hemoglobin level and severe pneumonia under five years old.Methods: Cross sectional study was done in medical record RSUD Wangaya Denpasar starting from May-August 2022. Data was taken from subject with severe and mild and moderate pneumonia age 6-59 months old that admitted to PICU and Kaswari ward from January 2020-June 2022. Variables processed in this study are gender, pneumonia severity, hemoglobin level, and length of stayResult: This study admits 56 subjects that fulfilled inclusion and exclusion criteria. Boy and girls subjects are found equally (28 subjects equally in both groups). Severe pneumonia found in 18 (32.1%) subjects and 25 subjects (44.6%) has anemia. Length of stay for severe pneumonia is 4.83 ± 1.54 days. Hemoglobin level in severe pneumonia is 10.93±1,96 mg/dL and subjects with mild and moderate pneumonia is 11.69 ±1.41 mg/dL. The result of chi-square test between haemoglobin level and severe pneumonia is p= 0.26Conclusions: This study shows that there is no correlation between hemoglobin level and severe pneumonia. Further study is needed since the correlation between them is still controversial.

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