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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Sari Pediatri Paediatrica Indonesiana Medicinus : Jurnal Kedokteran ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Jurnal Prima Medika Sains Bioscientia Medicina : Journal of Biomedicine and Translational Research Indonesian Journal of Multidisciplinary Science Jurnal Kedokteran Meditek Cermin Dunia Kedokteran
I Wayan Bikin Suryawan
Bagian/SMF Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RSUP Sanglah, Denpasar
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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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

Abstract

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

Abstract

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

Abstract

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

Abstract

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.
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

Abstract

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

Abstract

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.
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

Abstract

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.
Korelasi Neutrofil-Limfosit Rasio dengan Kadar C-Reaktif Protein sebagai Biomarker Sepsis Neonatus pada Bayi Prematur di Rumah Sakit Wangaya Denpasar Sriwaningsi, Lina; Bikin Suryawan, I Wayan; Suarca, I Kadek
Sari Pediatri Vol 27, No 2 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.2.2025.89-95

Abstract

Latar belakang. Sepsis neonatus merupakan kondisi yang mengancam jiwa dengan angka kematian yang tinggi pada bayi prematur. Bayi prematur memiliki sistem kekebalan tubuh yang belum matang. Sampai saat ini, kultur darah masih menjadi pemeriksaan standar emas untuk mendiagnosis sepsis neonatus. Neutrofil-limfosit Rasio (NLR) diusulkan sebagai penanda inflamasi, mendeteksi, dan menentukan tingkat keparahan sepsis, sedangkan C-Reaktif Protein (CRP) paling banyak digunakan pada fase akut, tetapi parameter ini dibatasi oleh sensitivitas, spesifisitas, ketersediaan, dan biaya. Kami mencoba menganalisis NLR sebagai alternatif pada sepsis neonatus.Tujuan. Mengetahui nilai cut-off point Neutrofil-limfosit Rasio yang optimal sebagai prediktor sepsis neonatus pada bayi prematur di Rumah Sakit Umum Daerah Wangaya.Metode. Penelitian ini merupakan penelitian analitik observasional cross-sectional menggunakan data sekunder dari rekam medis bayi yang dirawat di perinatologi dan NICU/neonatal intensive care unit Rumah Sakit Umum Daerah Wangaya. Total 94 bayi yang memenuhi kriteria inklusi dan ekslusi. Data yang terkumpul disajikan secara deskriptif, dengan analisis bivariat dan analisis cut-off point menggunakan kurva ROC.Hasil. Berdasarkan sosiodemografi, bayi sepsis dengan berat badan lahir rendah sebanyak 81%, sebagian besar mengalami sepsis neonatorum awitan dini (SNAD) 73 bayi (77%). Nilai cut-off point NLR 3,52 dengan nilai AUC 85%, sensitivitas 81%, dan spesifisitas 81%. Sedangkan nilai cut-off point CRP dengan nilai AUC 71%, sensitivitas 68%, dan spesifisitas 67%. Terdapat hubungan nilai NLR dengan CRP pada sepsis neonatus bayi prematur p-value 0,00 (p=<0,05).Kesimpulan. Nilai cut-off point NLR dapat digunakan sebagai prediktor deteksi dini sepsis neonatus. Deteksi sepsis neonatus menjadi lebih baik bila dikombinasikan dengan CRP.
Analisis Faktor-Faktor yang Memengaruhi Kematian Neonatus: Studi Retrospektif di Rumah Sakit Wangaya Denpasar Predani, Ni Luh Putu Diaswari; Bikin Suryawan, I Wayan; Suryaningsih, Putu Siska
Sari Pediatri Vol 25, No 5 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.5.2024.322-7

Abstract

Latar belakang. Kematian pada masa neonatal masih menjadi penyebab kematian tertinggi pada bayi dan balita di Indonesia pada tahun 2021 dengan angka kematian bayi di Indonesia 12 dari 1000 bayi lahir hidup. Upaya untuk menurunkan angka kematian neonatus di Indonesia terus dilakukan dengan target 9 per 1000 kelahiran pada tahun 2025. Berat badan lahir rendah, asfiksia, prematuritas, kelainan kongenital serta sepsis menjadi faktor risiko tertinggi kejadian kematian neonatus. Tujuan. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kematian neonatus di Rumah Sakit Umum Daerah Wangaya, Denpasar.Metode. Penelitian ini menggunakan metode analitik observasional cross-sectional dengan data sekunder menggunakan rekam medis. Teknik pengambilan sampel adalah dengan consecutive sampling dengan total sampel 114 neonatus yang memenuhi kriteria inklusi dan eksklusi. Variabel yang diteliti adalah berat badan lahir rendah, asfiksia, prematuritas, kelainan kongenital dan infeksi. Data dianalisis dengan SPSS versi 23 mengunakan uji Chi-square. Hubungan antar variabel dikatakan signifikan apabila nilai p<0,05 dengan interval kepercayaan 95%.Hasil. Faktor yang berhubungan dengan kematian neonatus adalah berat badan lahir rendah (p=0,001 dan RP 2,02 dengan IK 95%: 1,18-3,07), asfiksia (p=0,000 dan RP 2,56 dengan IK 95%: 1,7-3,85) dan usia kehamilan kurang bulan (p=0,000 dan RP 2,52 dengan IK 95%: 1,68-3,89). Sedangkan kelainan kongenital dan infeksi tidak berhubungan secara bermakna dengan kejadian kematian neonatus (p=0,1 RP 1,6; 95%; IK 95%: 1,09-2,44 dan p=0,5 RP 1,14; IK 95%: 0,7-1,68)Kesimpulan. Disimpulkan bahwa ada hubungan yang bermakna antara berat badan lahir rendah, asfiksia dan usia kehamilan kurang bulan dengan kematian neonatus di Rumah Sakit Umum Daerah Wangaya, Denpasar.
Pengaruh Status Gizi terhadap Nilai CD4 pada Anak dengan Sindrom Imunodefisiensi Akuisita di Rumah Sakit Wangaya Kota Denpasar Paramerta, Ni Putu Gladys Arys; Suryawan, I Wayan Bikin; Dewi, Made Ratna
Sari Pediatri Vol 26, No 2 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.2.2024.80-4

Abstract

Latar belakang. Human immunodeficiency virus / Acquired Immune Deficiency Syndrome pada anak merupakan masalah kesehatan global yang serius. Penurunan sistem imun yang diukur melalui nilai CD4 seringkali diperparah oleh status gizi yang buruk, yang dapat memengaruhi perkembangan penyakit dan kualitas hidup pasien. Studi tentang hubungan antara status gizi dan nilai CD4 pada anak dengan HIV/AIDS masih terbatas.Tujuan. Tujuan penelitian ini untuk mengetahui hubungan antara status gizi dengan nilai CD4 pada pasien anak dengan Sindrom Imunodefisiensi Akuisita.Metode. Penelitian ini menggunakan rancangan penelitian analitik observasional dengan penegakan potong lintang. Penelitian ini dilakukan pada bulan Maret 2023 – Juni 2023.Hasil. Sebanyak 36 pasien anak dengan Sindrom Imunodefisiensi Akuisita dilibatkan dalam penelitian ini. Berdasarkan analisis deskriptif, rerata usia pasien sebesar 9,25±2,99 tahun. Selain itu, sebagian besar pasien merupakan perempuan, yakni sebanyak 19 pasien (52,8%) sedangkan untuk pasien laki-laki sebanyak17 pasien (47,2%). Sebagian besar pasien memiliki nilai CD4 normal, yakni sebesar 27 pasien (75,0%), sedangkan pasien yang memiliki nilai CD4 rendah, yakni sebesar 9 pasien (25,0%). Hasil analisis Chi-square menunjukkan bahwa tidak terdapat hubungan yang signifikan antara status gizi dengan nilai CD4 pada pasien anak dengan Sindrom Imunodefisiensi Akuisita (p=0,079; two-tailed).Kesimpulan. Tidak terdapat hubungan yang signifikan antara status gizi dengan nilai CD4 pada pasien anak dengan Sindrom Imunodefisiensi Akuisita
Co-Authors A.A Made Sucipta A.A Made Widiasa A.A. Made Sucipta A.A. Made Widiasa Adi Wirawan Alberto Afrian Alice Indradjaja, Alice Aman B Pulungan Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta, Anak Agung Made Anak Agung Made Widiasa Anak Agung Made Widiasa Anak Agung Made Widiasa Andreas Eric Andrew Permana Suliarta Arimbawa * Arumndari, Runi Ayu Setyorini Mestika Mayangsari Bambang Tridjaja AAP, Bambang Tridjaja Bella Kurnia Bella Kurnia Cahaiantari, Ni Putu Elis Callista Beatrice Christina, Jessica Chyntia Conchita Christal Yasadipura Cynthia Cynthia Cynthia Cynthia Cynthia Cynthia Cynthia Jodjana Dewi, Made Ratna Doddy Kurnia Indrawan Edbert Wielim Elien Yuwono Erica Lidya Yanti Gosal, Jessica H Salim I Dewa Gede Ugrasena I Gde Doddy Kurnia Indrawan, I Gde Doddy Kurnia I Gusti Amanda Jaya I Gusti Lanang Sidiartha I Kadek Serisana Wasita I Kadek Suarca I Kadek Suarca I Made Arimbawa IB Mahendra Ida Bagus Ramajaya Sutawan, Ida Bagus Ramajaya Ida Bagus Wiadnyana IKG Suandi IM Widiaskara Imanuel Yulius Malino Jeven Reggie Santoso Jose RL Batubara Kadek Suarca Kadek Suarca Kadek Suarca, Kadek Kanthi Soraca Widiatmika Ketut Ariawati Komang Tria Anggareni Kurnia, Bella Liman, Claudia Natasha Lukman, Leni Made Cynthia Mahardika Putri Made Dwi Purnami Made Ratna Dewi Made Ratna Dewi Made Ratna Dewi Made Widiasa Mayland Margaretha Sunata Melisa Anggraeni Mustika, Putu Pradnyanita Paramerta, Ni Putu Gladys Arys Predani, Ni Luh Putu Diaswari PT Pramitha Putri Prashanti, Nyoman Ananda Putri Widyastiti, Ni Nyoman Putri, Asterisa Retno Putu Andrie Setiawan Putu Pramitha Rahayu Putu Siska Suryaningsih Putu Wahyu Dyatmika Tanaya Regina Suriadi Retno Putri, Asterisa Ruby Kurniawan Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sriwaningsi, Lina Stanley Haryono Suarca, I Kadek Sukarno, Theodora Sunartini Sunartini Suriadi, Regina Suryaningsih, Putu Siska Susan Natalia Budihardjo sutanti sutanti Valerie Michaela Wilhelmina Widiasa - Wielim, Edbert William Grandinata Soeseno