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All Journal Medicina E-Jurnal Medika Udayana Folia Medica Indonesiana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia World Nutrition Journal Pediatric Sciences Journal Public Health and Preventive Medicine Archive

Ketut Dewi Kumara Wati

Department Of Pediatrics Faculty Of Medicine Udayana University

Author-ID : 588725

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health Other

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Exposure to cowâ€™s milk as a prognostic factor for atopic dermatitis during the first three months of life Putu Ayu Widyanti; Ketut Dewi Kumara Wati; Endy P. Prawirohartono
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Background The incidence of atopic dermatitis has increased inthe early life of children. Cow's milk, the first foreign protein towhich infants are exposed, is predicted to be a prognostic factorof atopic dermatitis.Objective To determine if exposure to cow's milk is a prognosticfactor for atopic dermatitis during the first three months oflife.Methods We performed a cohort study involving 136 newbornsfrom families with and without histories of atopy in SanglahHospital, Denpasar, between April to August 20 12. Subjects wereallocated into 2 groups, those who were exposed to cow's milk(n=68) and not exposed to cow's milk (n=68). We analyzedthe impact of several possible prognostic variables on atopicdermatitis at 3 months of age including exposure to cow's milk,birth weight, sex, gestational age, exposure to cigarette smoke,early solid feeding, and history of atopy in the mother, the father,or both, as well as maternal consumption of chicken eggs whennursing. Data were analyzed with Cox's proportional hazardfunction. The cumulative incidence and incidence rate in eachgroup were calculated.Results Exposure to cow's milk in the first 3 months of liferesulted in a cumulative incidence of atopic dermatitis of 17 .6%,with an incidence rate of atopic dermatitis of 54.5%. However,multivariate analysis showed that cow's milk exposure was nota significant prognostic factor for atopic dermatitis (HR 1.3 7;95%CI 0.22 to 8.43).Conclusion Cow's milk exposure is not a prognostic factor ofatopic dermatitis during the first three months of life

Caesarean delivery and risk of developing atopic diseases in children Anak Agung Tri Yuliantini; Mohammad Juffrie; Ketut Dewi Kumara Wati
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Background Caesarean delivery has been suggested to alterneonatal immune respon ses and increase the risk of atopicdiseases. Howevei; previous studies have reported inconsistentfindings.Objective To investigate a possible association between caesareandelivery and the development of atopic diseases in children.Methods This case-control study involved 100 children aged 3months-12 years, in Sanglah Hospital, Denpasai; Indonesia. Fiftyinfants and children with a confirmed diagnosis of atopic diseasesand 50 sex-paired controls (non-atopic infants and children)were enrolled. Demographic data was obtained, including modeof delivery and relevant history connected to atopic diseases.Skin prick test to four common aeroallergens was performed inall subjects. Possible confounding factors were considered in amultivariable logis tic regression model.Results Caesarean section was not significant as a risk factor foratopic diseases in a multivariate analysis [OR 2.4 (95%CI 0.7 to8.4; P=0.164)]. Howevei; multiple logistic regression analysisshowed that atopic diseases was significantly associated with apositive family history of atopy. Furthermore, caesarean sectionwas associated with a higher risk of atopic diseases in a subgroupanalysis for family history of atopy [OR= 4 (95%CI 1 to 16.2;P= 0.04)].Conclusion Children delivered by caesarean section and have afamily history of atopy have a 4-fo ld higher risk of atopic diseases.

Cowâ€™s milk exposure and atopic dermatitis after six months of age Surya Jayanti Kadek; Dewi Kumara Wati Ketut; Karyana Putu Gede
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cowâ€™s milk (CM) exposure is considered to be a risk factor for AD.Objective To evaluate for an association between cowâ€™s milk exposure and atopic dermatitis in infants > 6 months of age.Â Â Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cowâ€™s milk/formulaÂ and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis.Â Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cowâ€™s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04).Conclusion Cowâ€™s milk exposure is significantly associated with atopic dermatitis in infantsÂ > six months of age.Â

Systemic juvenile rheumatoid arthritis in an 11 year old boy: a case report I Wayan Gustawan; Ketut Dewi Kumara Wati; Hendra Santosa
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Juvenile rheumatoid arthritis (JRA) is the mostcommon rheumatic condition in childrenand a major cause of chronic disability. 1 JRAis defined as persistent arthritis in one oro e joints for at least six weeks, when certainexclusionary conditions have been eliminated.2Â·3The three major subtypes of JRA are based onthe symptoms at disease onset and are designatedas systemic onset, pauciarticular onset, andpolyarticular onset.2 Systemic onset juvenilerheumatoid arthritis (SoJRA) represents about10-20% of all forms of JRA.4The incidence of ]RA is approximately 13.9/100,000 per year among children 15 years old oryounger.1 In Finland, the incidence was 19.5/100,000of the population under 16 years of age. The incidencewas significantly higher than in earlier years (1980,1985, and 1990) in the same district.5 Different racialand ethnic groups appear to have varying frequenciesof the subtype of JRA.1The treatment of JRA is achieved usingcombinations of anti-inflammatory and immunomodulatorymedications in combination withphysical and occupational therapy, occasionalsurgery, nutritional support, and psychosocial andeducational partnerships with patients and parents.3,6It is widely thought that a comprehensive teamapproach is associated with a superior outcome. 7This paper reports a case of systemic JRA in an 11-year old boy.

Level of knowledge on HIV I AIDS among senior high school students I Nyoman Budi Hartawan; Ketut Dewi Kumara Wati
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.235-9

Background Young people are now the epicenter and bear adisproportionate burden ofHIV/AIDS pandemic. Until now,one of the strategies which are implemented by the govern-ment is by increasing the level of HIV/AIDS knowledge inorder to avoid its spreading.Objective This study was to explore the level of HIV/AIDSknowledge of senior high school's students towards HIV I AIDSat subdistrict ofPetang. The secondary outcome is to comparethe levels of knowledge toward HIV I AIDS between Petang andPelaga Senior high school, between class and gender.Methods This was a descriptive study, conducted between1st to 28th February 2007 in Petang and Pelaga Senior HighSchool. The study subjects are 529 students (all of senior highschool students in subdistrict of Petang, Badung Regency).Data was taken using UNICEF questionnaire 2000 for youngpeople, which had been passed the reliability test with thekappa value of 0.85.Results Most subjects (90.5%) have excellent and goodknowledge and only 9,5% have sufficient knowledge. Level ofknowledge in girls is better than boys with significant differ-ence between them (P=O.OOO), while school and grade didn'tshow any differences (P=0.760) and (P=0.489).Conclusion The level of knowledge of senior High School inSubdistrict ofPetang, Badung Regency toward HIV /AIDS is atexcellent or good level

The relationship between contact to cat and the development of asthma in children Made lndah Nastiti Utami Budha; Roni Naning; Ketut Dewi Kumara Wati
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Data suggesting history of direct or indirect contactto cats are either protective, has no effect or increase risk ofsensitization and asthma development.Objective To determine the relationship between childhoodcontact to cat and the development of asthma in children.Methods A case control study was conducted in Denpasar sinceDecember 2006 until Juli 2008. In this study, subjects withasthma (cases group) were selected for comparisons to a series of healthy subjects without asthma (controls group). Forty-sevensubjects (3-12 years) with asthma were recruited and matched(age and sex) with 4 7 healthy and non asthma controls. Data were collected using two kinds of questionnaires, i.e: ISAAC, ATS 78, and Robertson modification questionnaire from Medical School, University of Indonesia, which had been validated to determine asthma and asthma risk factors questionnaire. Data were analyzed as univariate by using chi-square or Fisher's exact test, and multivariate analysis by stepwise logistic regression model.Results Result of univariate analysis showed that there were seven significant risk factors of asthma. Using multivariate analysis, contact to cat was significant risk factor for asthma [OR: 4.5 (95% CI 1.3 to 16.0), P= 0.020]. Other significant risk factors were; contact to cockroach [OR: 11.7 (95% CI 2.6 to 51.6), P= 0.001], use of kapok mattress [OR: 6.4 (95% CI 1.4 to 29.0), P= 0.015], passive smoker [OR: 4.7 (95% CI 1.3 to 17.0), P= 0.018], and atopic history [OR: 9.2 (95% CI 2.3 to 36.7), P= 0.002].Conclusions There was a relationship between childhood contactto cat and the development of asthma in children. Risk factors that statistically significant were; contact to cockroach, use of kapok mattress, passive smoker, and history of allergy in study subject.

The efficacy of fortified human milk compared to human milk alone for the growth of low birth weight infants Dewi Kumara Wati Ketut; Soetjiningsih Soetjiningsih; Suandi IKG; Hamid H A
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

Objective To evaluate the growth of low birth weight infants fedby fortified human milk (FHM) compared to human milk (HM) alone.Methods Sixty premature infants enrolled in this study and ran-domly assigned to have FHM and HM delivered by infusofeedpump,in parallel, non-blinded controlled trial. All patients were followeduntil day 30 or until discharge, whichever came first. The weightgain was recorded daily, while length and head circumference in-crement were recorded weekly.Results The FHM group gained more weight than the HM group(335.0+55.5 g vs. 290.6+108.4 g, p=0.000, 95%CI -170.2;-81.2),larger length increment (1.9+1.1cm vs. 1.2+0.4cm, p=0.000, 95%CI-1.37;-0.55), and larger head increment (1.87+1.1cm vs.0.91+0.43cm, 95%CI -1.37;-0.55). A similar result was found whenthe group was divided into subgroup of 1000-1499 g and 1500-1999 g birth weight. The larger calorie intake in the FHM groupwas the reason for better growth. No adverse effect related to theintervention was found.Conclusion The study shows the benefit of FHM in growth of lowbirth weight infants, which is consistent when the group is dividedinto 1000-1499 g birth weight and 1500-1999 g birth weight subgroups. Better growth is achieved through higher calorie intake inthe FHM group. No adverse effect is found as a consequence ofintervention

AIDS in a three-year old girl Dyah Kanya Wati; Bagus Ngurah Putu Arhana; Dewi Kumara Wati; Tuti Parwati Merati
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

The acquired immunodeficiency syndromein children was first recognized in 1982, oneyear after the initial description in adults.WHO estimates that 2 million children hadbeen infected with human immunodeficiency virus(HIV) by the year 2000. Pediatric AIDS threatenschild survival in developing countries. At the endof 1999, 34.3 million individuals were estimated tobe infected globally, of which 1.3 million (3.8%)were children below 15 years old. Until September2005, no children with HIV AIDS in Indonesia wasfound.Approximately 80% of children acquired HIV-1infection from vertical maternal transmission; the restare infected from contaminated blood products,infected organs, breastfeeding, or sexual abuse.Two general patterns of congenital infection arerecognized. Twenty percent of infected infants developearly disease, while the rest progress slowly, developinginto AIDS in adolescents. The most successfulapproach in the management of children with HIVrequires a multidisciplinary team approach.

Using family atopy scores to identify the risk of atopic dermatitis in infants Melisa Anggraeni; Ketut Dewi Kumara Wati; Ketut Tangking
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.330-7

Background Atopic dermatitis is the first manifestation ofallergic disease in early life. Early interventions may prevent thedevelopment of allergy disease. Allergy trace cards have beenused to identify the level of allergic risk, based on family atopyscores. Because environmental factors may also influence thedevelopment of atopic dermatitis, the usefulness of the allergytrace card needs to be reevaluated.Objective To compare the incidence of atopic dermatitis ininfants aged 0-4 months with total family atopy scores of > 0 tothose with scores of 0.Methods We conducted this cohort study from June 1, 2012 toDecember 31, 2012 at Sanglah Hospital, Denpasar. Family atopyscore was tabulated from all pregnant woman in the ObstetricOutpatient Clinic and the Maternity Room. Subjects were dividedinto two groups based on their total family atopy score: those withscores > 0 and those with scores of 0. The appearance of atopicdermatitis symptoms in the infants were evaluated until theyreached 4 months of age. The incidence of atopic dermatitis intwo groups was compared using Chi-square test.Results The incidence of atopic dermatitis in this study was 10.9%.The group with total family atopy scores of 0 had a significantlyhigher incidence of atopic dermatitis than the group with scores> 0 (adjusted RR 22.5; 95%CI 8.8 to 57.0; P = 0.001).Conclusion The incidence of atopic dermatitis is higher ininfants with total family atopy score > 0 and this group has a 22.5times higher risk of atopic dermatitis compared to infants withtotal family atopy score of 0. Allergy trace cards are relevant indifferentiating the risk of atopy with regards to development ofatopic dermatitis. We suggest that family atopy scores be evaluatedduring antenatal care in order to limit the development of atopicdermatitis in infants.

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.

Co-Authors Ahmad Suryawan Anak Agung Tri Yuliantini Anang Endaryanto Arini Setiawati Ayu Setyorini Mestika Mayangsari Badriul Hegar Bagus Ngurah Putu Arhana BNP Arhana Budi Setiabudiawan Budi Setiabudiawan Cempaka, Putu Mas Vina Paramitha Deborah Melati, Deborah Dewi, Ni Luh Putu Mulia Laksmi Dina Muktiarti, Dina Dyah Kanya Wati Eka Gunawijaya Endy P. Prawirohartono Erfi Prafiantini Eva Jacomina Jemima Sapulete Gusti Ayu Putu Nilawati Hamid H A Haryadi Haryadi - Hendra Santoso Hendra Santoso Hendra Santoso I Gusti Agung Ngurah Sugitha Adnyana I Gusti Ayu Putu Eka Pratiwi I gusti Lanang Sidhiarta I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Ketut Suarta I Made Kardana I N Sartika I Nyoman Budi Hartawan I Nyoman Supadma I Nyoman Supadma I Putu Gede Karyana I Wayan Dharma Artana I Wayan Eka Satriawibawa I Wayan Gede Artawan Eka Putra I Wayan Gede Artawan Eka Putra, I Wayan Gede Artawan Eka I Wayan Gustawan Ida Bagus Krisna Jaya Sutawan Ida Bagus Subanada Irene Irene Johannes Hudyono Juergens, Stefanie Kadek Surya Jayanti, Kadek Surya Ketut Suarta Ketut Tangking Ketut Tuti Parwati Merati Komang Ayu Witarini Luh Putu Ratna Sundari Made Ardinata Made Bandem Kenny Wijaya Nugraha Made lndah Nastiti Utami Budha Maria Priskila Melisa Anggraeni Melva Louisa Merati, Tuti Parwati Metriani Nesa, Ni Nyoman Mohammad Juffrie Nesa, Ni Nyoman Metriani Ni Made Ayu Agustini Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Ni Putu Veny Kartika Yantie, Ni Putu Veny Kartika NP Veny Kartika Yantie Pande Putu Yuli Anandasari Purwoko, Agus Putu Ayu Widyanti Putu Ayunda Trisnia Putu Diah Vedaswari Putu Indah Budi Apsari Ronaldi, Melissa Roni Naning Sawitri, Anak Agung Sagung Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Stefanie Juergens Suandi IKG Sumadiono Sumadiono Widiantari, Ni Made Widiastari, A.A Ayu Yvan Vandenplas Zakiudin Munasir

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