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<![CDATA[PRESCRIPTION AND ADEQUACY OF HEMODIALYSIS ]]>
<![CDATA[Widiana, I Gde Raka]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
Publisher : <![CDATA[Medicina ]]>
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<![CDATA[Physiologically, uremic syndrome is a pollutional phenomenone of body fluid caused by uremic substance retention due to failing kidney. Hemodialysis (HD) is a substitution therapy to replace native kidney to filter out the toxic substances. The clearance capacity can be measured using urea kinetic modeling, where urea is used as a marker. Prescription of HD will produced prescribed KT/V, namely the amount of HD doses given. On the other hand delivered KT/V is real clearance effect occurred in the body. Each component of dialysis machine can be adjusted to produce adequate delivered KT/V. This KT/V has also to be adjusted with weekly frequency of HD and residual function of the native kidney. Value of KT/V in each HD session according the consensus has to be attained in order the patient live a better life longer]]>
<![CDATA[SECKEL SYNDROME IN A - 2 YEAR OLD GIRL ]]>
<![CDATA[Yulius Malino, Imanuel]]>;
<![CDATA[Arimbawa, Made]]>;
<![CDATA[Suryawan, Bikin]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
Publisher : <![CDATA[Medicina ]]>
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<![CDATA[Seckel syndrome is a frequent autosomal recessive that cause microcephalic osteodysplastic dwarfisms. It characterized with proportionate dwarfism of prenatal onset, dysmorphic features including severe microcephaly and “bird-headed” like appearance, mental retardation and autosomal recessive inheritance, becausedefect on chromosome 3q22.1-q24 (SCKL1), chromosome 18p11.31-q11.2 (SCKL2) and chromosome 14q23 (SCKL3). We reported, 2 years, 8 months female with intrauterine growth restriction, severe proportionately short stature, a “bird-headed” profile with receding forehead, large eyes, breaks like protrusion of the nose, narrow face, receding lower jaw and micrognathia and from bone survey we found a retarded bone age on which was appropriate for 6 months of age.There was no other systems dissorder have been found and no specific medication has been given. Patient was hospitalized to establish diagnosis and was dischargedafter ten days of hospitalization]]>
<![CDATA[BREAKFAST HABIT AND ACADEMIC PERFORMANCE AMONG SUBURBAN ELEMENTARY SCHOOL CHILDREN ]]>
<![CDATA[Widyanti, Putu Ayu]]>;
<![CDATA[Sidiartha, I Gst Lanang]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
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<![CDATA[Academic performance is affected by a numbers of factors. Age, gender, nutritional status, and breakfast habits are some factors that have relation with academic performance. Nutritional statues among school children still to be concerned. Breakfast habit is important thing to do before school to maintain enough calories to study and work well. The aim of this study was to determine the association of breakfast habits and academic performance especially in suburban elementary school children. An analytic cross sectional study conducted in children aged 6-12 years who studied at SD 1 Taro, Gianyar regency, Bali. There were 178 students participated in this study. We found 3 factors associated with academic performance i.e. breakfast, gender, and age with OR=2.56 (95% CI 1.16 to 5.66), P=0.02; OR=0.32 (95% CI 0.15 to 0.70), P=0.04; OR=6.52 (95% CI 2.73 to 15.53), P<0.0001, respectively. We conclude there was an association between breakfast habits and academic performance.]]>
<![CDATA[PHARMACOTHERAPY IN ELDERLY NEUROPATHIC PAIN ]]>
<![CDATA[Eko P, Thomas]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
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<![CDATA[The incidence of pain increases with age. Neuropathic pain are common in elderly patients and pose challenges in both their diagnosis and treatment. The most common neuropathic pain in elderly are radiculopathy due to foraminal or spinal stenosis, diabetic neuropathy, and postherpetic neuralgia. Pain in the elderly is often unrecognized and undertreated. The main problem with pain in older adults relates to impaired quality of life secondary to pain which may be expressed by depression (including increased suicide risk), anxiety, sleep disruption, appetite disturbance, and weight loss, cognitive impairment, and limitations in the performance of daily activities. Pain management in elderly patients requires a different perspective from that of younger patients. Causes, comorbidities, and responses to both pain and its treatment differ between young healthy and older patients. Effective pain management in elderly patients should include both pharmacologic and nonpharmacologic strategies. Pharmacological approaches are the first line of pain management in older person for neuropathic pain. Pharmacologic strategies call for administration of nonopioid analgesics, opioid analgesics, and adjuvant medication. Polypharmacy, drug-drug and drug-disease interactions, age-associated changes in drug metabolism, and the high frequency of adverse drug reactions need to be carefully considered in using medications in this population]]>
<![CDATA[CHARACTERISTICS OF NECROTIZING ENTEROCOLITIS IN NEONATES TREATED AT SANGLAH HOSPITAL ]]>
<![CDATA[Hartini, Kadek]]>;
<![CDATA[Artana, Dharma]]>;
<![CDATA[Putra, Junara]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
Publisher : <![CDATA[Medicina ]]>
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<![CDATA[Necrotizing enterocolitis (NEC) is a very serious and severe neonatal gastrointestinal tract disease. Treatment are complex and the course of the disease is hardly predictable. Necrotizing enterocolitis is one of the main causes of morbidity and mortality in neonates. The objective of this study was to know the prevalence and characteristics of neonates with NEC. This was a retrospective descriptive study utilizing medical records of neonates who were admitted in perinatology care unit at Sanglah Hospital, Denpasar during the period of July 2011 to June 2012.There were 55 (5%) neonates with NEC out of 972 neonates admitted to the neonatology care unit at Sanglah Hospital, Denpasar. Mean gestational age was 33.9 weeks. Mean birth weight was 2.096 kg,and the mean time of nutrition initiation was 3.1 days. Stage II was found as the most prevalent stage of NEC (49%). Necrotizing enterocolitis patients were generally associated with clinical manifestations such as sepsis 96%, respiratory distress 87%, prematurity 63%, low birth weight 65%, and asphyxia 61%. There was 36 subjects dead. This outcome tended to increase in premature babies, babies with low birth weight, asphyxia, and sepsis. Death still occurred in all management of NEC. Neonates receiving breast milk as the initial nutrition constituted the highest proportion of recovered patients compared to the fasting, formula milk, and mixed milk (breast milk combined with formula milk) groups.We concluded, the prevalence of NEC was 5%. Death more common than recoveries. Recovery rate more common in breast-fed babies than other nutrients]]>
<![CDATA[A 7 YEAR-7-MONTH OLD BOY WITH LEUKEMIC RETINOPATHY ]]>
<![CDATA[Rini Suari, Ni Made]]>;
<![CDATA[**, Widnyana]]>;
<![CDATA[Budhiastra, Putu]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
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<![CDATA[Ocular problems in patient with leukemia which are called leukemic retinopathy and subhyaloid hemorrhage is one of its feature. Subhyaloid hemorrhage in children with acute lymphoblastic leukemia (ALL) is rarely happened. We reported a boy 7 year 7 month old, complained sudden blurred vision on his both eyes and diagnosed with acute lymphoblastic leukemia. When patient had complained his vision, result of routine hematology showed anemia, thrombocytopenia, and leukocytosis. Treatment of leukemic retinopathy in this patient was supportive and causal therapy with transfusion of thrombocyte concentrate, hydration for leukocytosis, giving chemotherapy intrathecal methotrexate and systemic (vincristine, daunorubicin, L-asparginase). We found gradually undergone resolution of subhyaloid hemorrhages, visible flame shaped thin, and his vision recovered nearly completely to 6/6 OD and 6/20 OS]]>
<![CDATA[PREVALENCE AND RISK FACTORS OF OBESITY IN PRIMARY SCHOOL IN URBAN AND RURAL AREAS ]]>
<![CDATA[Ratna Dewi, Made]]>;
<![CDATA[Sidiartha, I Gusti Lanang]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
Publisher : <![CDATA[Medicina ]]>
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<![CDATA[Obesity has become a continous increasing global health problem. Obesity can happen in adult population and also on children as well as teenagers. There are several factors that influence the occurrence of obesity. The aim of this study is to determine the prevalence and risk factors for obesity in primary school children in urban and rural areas. A cross sectional study was conducted with a total sample of 241 pupils in several elementary schools. Anthropometric status determine using body mass index for age and obesity stated if measurement exceed ?95th percentile based on CDC 2000. Analysis data perform with the Pearson Chi-square, Fisher's Exact Test, and logistic regression. A P value of <0.05 was considered significant. This study showed the prevalence of obesity was 15%. The prevalence of obesity in urban areas was 21% and rural areas was 5%. The result showed risk of obesity multiplied by 3.8 times in urban children as they had a habit of "snacking" had risk of suffering obesity by 3.4 times (95% CI 1.2 to 9.0). Children who had habit of having fast food more than 2 times per week had the more risk of obesity by 5 times (95% CI 1.9 to 13.5). Mothers education in urban areas as a protective factor. Conclusion of this study show that the prevalence of obesity in urban areas is 21% and 5% in rural areas. “Snacking” habit and eating fast food more than 2 times per week increase the risk of obesity in urban areas, while in rural areas no risk factors consider significant for obesity.]]>
<![CDATA[A 44-DAY OLD MALE INFANT WITH THORACOABDOMINAL ECTOPIA CORDIS OF PENTALOGY CANTRELL’S SYNDROME ]]>
<![CDATA[Yuliantini, Tri]]>;
<![CDATA[Gunawijaya, Eka]]>;
<![CDATA[Putu Yasa, Ketut]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
Publisher : <![CDATA[Medicina ]]>
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<![CDATA[Ectopia cordis is a rare and impressive congenital abnormality, occurring in 5.5 to 7.9 per 1 million live births. The defect is characterized by partial or complete displacement of the heart out of the thoracic cavity. This defect require a staged procedure to achieve a complete repair. We reported a 44-day-old male infant presented with symptoms of tachypnea and mild cyanosis since birth. On physical examination, the child looked lethargic with a weak cry. The midline defect extended from the lower margin of the neck to the umbilicus. The sternum was completely bifid, with an inter-ridge distance of 6 cm, through which the heart was protruded for 4-5 cm and the apex pointed anteriorly. The first and second heart sounds were normal with ejection holosystolic murmur. The diagnosis was ectopia cordis. A two dimensional echocardiography showed complete atrioventricular septal defect, which was known as a group of cyanotic congenital heart defect. The infant was referred subsequently to the neonatal intensive care unit with the ventilator support. Historically, the prognosis of this condition is poor. Our patient died before surgery being performed.]]>
<![CDATA[ACCURACY OF RAPID TEST OF STORED ACUTE PHASE SERUM FOR DIAGNOSE JAPANESE ENCEPHALITIS ]]>
<![CDATA[Subanada, Ida Bagus]]>;
<![CDATA[Kari, I Komang]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
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<![CDATA[Japanese encephalitis (JE) is common viral encephalitis with high sequele and mortality. With some limitations, there are several diagnostic tool to diagnose of JE. The objecive of this study was to know the accuracy of rapid test of stored acute phase serum for diagnose of JE. We conducted diagnostic test of stored acute phase serum of encephalitis patients with MAC ELISA of cerebrospinal fluid as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and post-test probability were calculated. This study found the prevalence of JE was 42.1%, sensitivity 15.7 % (95% CI 9.2 to 22.2%), specificity 95.7% (95% CI 92.1 to 99.3%), PPV 72.7% (95% CI 64.8 to 80.6%), NPV 60.9% (95% CI 52.2 to 69.6%), PLR 3.7, NLR 0.9, and post-test probability was 0.73. We concluded that rapid test of acute phase stored serum was insensitive but specific to diagnose of JE.]]>
<![CDATA[CASE REPORT KALLMANN SYNDROME IN A 14-YEAR-OLD BOY ]]>
<![CDATA[Anggraeni, Melisa]]>;
<![CDATA[Arimbawa, Made]]>;
<![CDATA[Suryawan, IW Bikin]]>
<![CDATA[ Medicina Vol 44 No 1 (2013): Januari 2013 ]]>
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<![CDATA[Kallmann syndrome is a combination of hypogonadotropic–hypogonadism due to gonadotropine releasing hormone (GnRH) deficiency with anosmia or hyposmia. Magnetic resonance imaging (MRI) reveals hypoplasia or aplasia of the olfactory bulbs. The incidence is estimated at 1 in 10.000 and 50.000 males and females respectively. The main clinical features consists of the absence of spontaneous puberty, partial or total loss of the sense of smell (anosmia). In this case report, we describe a 14 year old boy with Kallmann syndrome who was refferred with delayed puberty and lack of smell function. Physical examination revealed Tanner stage I and proven anosmia from olfactory test. Laboratory test showed low titer of testosteron. Testicular ultrasonography (USG) revealed small testicles. Treatment of this particular patient was with a 25 mg of intramuscular testosterone injection and were then increased by 25 mg every two weeks. Proper management of patients with Kallmann syndrome usually allows them to attain normal reproductive health.]]>
