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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana Indonesian Journal for Health Sciences (IJHS) ISM (Intisari Sains Medis) : Jurnal Kedokteran JBMR: Journal of Business and Management Review
Made Gede Dwi Lingga Utama
Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, Bali
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences

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Profil Sepsis Anak di Pediatric Intensive Care Unit Rumah Sakit Umum Pusat Sanglah Denpasar - Bali Dyah Kanya Wati; I Nyoman Budi Hartawan; Ida Bagus Gede Suparyatha; Dewi Sutriani Mahalini; I Gusti Ayu Putu Eka Pratiwi; I Made Gede Dwi Lingga Utama
Sari Pediatri Vol 21, No 3 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp21.3.2019.152-8

Abstract

Latar belakang. Sepsis dan klasifikasinya merupakan kondisi yang mengancam nyawa dengan angka kematian mendekati 10% dari seluruh pasien dengan sepsis dan syok septik Angka kematian ini akan meningkat pada anak dengan minimal satu penyakit komorbid yang menyertai dan mendekati angka 76% berdasarkan jumlah organ yang mengalami disfungsi. Sampai saat ini belum ada data pasti yang menunjukan prevalensi dan karakteristik pasien dengan sepsis di Unit Perawatan Intensif (UPIA) Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar.Tujuan. Mengetahu prevalensi serta karakteristik pasien dengan sepsis pada pasien anak berusia 0-18 tahun di Unit Perawatan Intensif (UPIA) Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar tahun 2018.Metode. Penelitian ini merupakan penelitian deskriptif retrospektif dengan menggunakan data rekam medis RSUP Sanglah yang dikumpulkan meggunakan metode purposive sampling dengan kriteria inklusi dan eksklusi.Hasil. Penelitian ini sudah berjalan selama 1 tahun dari bulan Januari 2018 sampai dengan Desember 2018. Sampel yang dikumpulkan sebanyak 28 sampel. Kategori usia bayi tertinggi merupakan sampel yang digunakan, yaitu sebesar 57,1%. Diagnosis terbanyak adalah syok sepsis sebesar 60,7%. Skor pediatric sequential failure assesment (pSOFA) didapatkan dengan rerata sebesar 5,94.Kesimpulan. Prevalensi sepsis di UPIA Rumah Sakit Umum Pusat Sanglah Denpasar pada tahun 2018 didominasi oleh pasien dengan kategori usia bayi (<2 tahun).
Rasio Neutrofil dan Limfosit (NLCR) Sebagai Faktor Risiko Terjadinya Infeksi Bakteri di Ruang Rawat Anak RSUP Sanglah Denpasar I Made Yullyantara Saputra; W Gustawan; MG Dwilingga Utama; BNP Arhana
Sari Pediatri Vol 20, No 6 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp20.6.2019.354-9

Abstract

Latar belakang. Rasio neutrofil dan limfosit (NLCR) memiliki potensi sebagai prediktor bakteremia pada pasien dengan infeksi yang didapat di masyarakat. Insidensi bakteremia, atau adanya bakteri hidup dalam darah, mencapai sekitar 1% kasus pada populasi. Angka kematian mencapai 25%-30% dan meningkat hingga 50% pada sepsis berat.Tujuan. Untuk mengetahui hubungan rasio neutrofil dan limfosit (NLCR) dengan kejadian infeksi bakteri.Metode. Sebuah studi kasus-kontrol dilakukan dengan meninjau rekam medis di RSUP Sanglah, Denpasar, pada periode Januari 2016 hingga Maret 2018. Data yang diambil adalah usia, jenis kelamin, kadar WBC, Neutrofil, limfosit, monosit, platelet, dan kultur darah. Kemudian dilakukan analisis hubungan antara rasio neutrofil dan limfosit terhadap infeksi aliran darah.Hasil. Selama periode studi didapatkan 98 pasien dengan hasil kultur positif dan 100 pasien dengan hasil kultur negatif. Dari total subjek yang dianalisis, didapatkan 116 (58,5%) subjek laki-laki dan 82 (40,9%) subjek perempuan. Median usia pada kelompok kasus adalah 12 bulan, sedangkan median usia pada kelompok kontrol adalah 24 bulan. Analisis kurva ROC menunjukkan nilai cut-off optimal untuk NLCR adalah 4,67. Rasio odd untuk hubungan antara NLCR dengan kejadian infeksi bakteri adalah 3,24 (95% IK 1,74 – 5,92) dan adjusted odds ratio sebesar 3,49 (95% IK 1,83-6,64).Kesimpulan. Nilai NLCR ≥4,67 merupakan faktor risiko untuk infeksi aliran darah yang berkembang. Hasil ini dapat digunakan sebagai titik potong untuk antibiotik yang awalnya diberikan untuk mencegah prognosis yang buruk (sepsis, kegagalan organ multipel, dan kematian).
Quantitative NS1 antigen and the severity of dengue virus infections Ni Made Adi Purnami; Mohammad Juffrie; Made Gde Dwi Lingga Utama
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (106.325 KB) | DOI: 10.14238/pi55.2.2015.87-90

Abstract

Background Dengue infection is one of the main cause ofmorbidity and mortality in children in Indonesia. Since it is knownthat earlier treatment and supportive therapies can decreased casefatality rate from dengue hemorrhagic fever (DHF), identificationof children who have risks to develop to DHF must be quicklyidentified, mainly in areas of endemic.Objective To find a correlation between increased quantitativesecreted nonstructural protein-1 (sNS1) with clinical course ofsevere dengue infections.Methods This was a cross-sectional study conducted on childrenwith dengue infections in Tropical Infections Division of ChildHealth Department, Sanglah Hospital, Denpasar. Detection ofthe dengue antigen was made by examining sNS1 quantitativeimmuno-assay. Analysis correlation of Spearman test was used tolook the relationship between increased quantitative sNS1 withclinical course of severe dengue infections.Results There was a positive relationship between quantitativesNS1 and clinical course of severe dengue infections with a valueof r = 0.903, P=0.001. Increased sNS1 level had a positivecorrelation with more severe dengue infections.Conclusions Quantitative sNS1 titer has a strong positivecorrelation with clinical course of severe dengue infections.
McIsaac criteria for diagnosis of acute group-A β-hemolytic streptococcal pharyngitis Imanuel Y. Malino; Dwi Lingga Utama; Yati Soenarto
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.966 KB) | DOI: 10.14238/pi53.5.2013.258-63

Abstract

Background The early use of antibiotics for acute upper respiratory infections is controversial because most of these infections are caused by viruses. A strategy is needed to correctly identify the causitive agents of acute pharyngitis, so that antibiotics can be prescribed appropriately.Objective To assess McIsaac criteria for diagnosing acute group-A β-hemolytic streptococcal (GABHS) pharyngitis in children.Methods This diagnostic study was conducted from August 2011 to February 2012, to compare clinical criteria of McIsaac to throat swab culture results as the gold standard for diagnosis. Subjects were children aged 3-14 years who visited the pediatric outpatient clinic or emergency ward at Sanglah Hospital and the pediatric outpatient clinic at Wangaya Hospital.Results There were 550 cases of acute pharyngitis during the study period, with 313 patients aged 3-14 years and 199 patients excluded due to a history of taking antibiotics in the two weeks prior to the hospital visit. Hence, 114 subjects were eligible for the study. GABHS prevalence in this study was 7.9%. McIsaac’s area under the curve (AUC) from receiver operating characteristic (ROC) curve was 78.1%(95%CI 60.3 to 96%, P= 0.005). A McIsaac score ≥4 had a 66.7% (95%CI 49 to 97%) sensitivity, 87.6% (95% CI 81 to 94%) specificity, 31.6% (95 %CI 11 to 52%) positive predictive value (PPV), 96.8% (95%CI 93 to 100%) negative predictive value (NPV), 86.0% accuracy, 5.4 (95% CI 2.7 to 10.7) positive likelihood ratio (LR+) and 0.4 (95% CI 0.2 to 0.9) negative likelihood ratio (LR-).Conclusion A McIsaac criteria total score of <4 is favorable for excluding a diagnosis of GABHS pharyngitis. A McIsaac total criteria score of ≥4 requires further examination to confirm a diagnosis of GABHS pharyngitis.
Plasma NT-proBNP and pulmonary to systemic blood flow ratio in congenital heart defects with left-to-right shunts Eko Kristanto Kunta Adjie; Ni Putu Veny Kartika Yantie; Made Gede Dwi Lingga Utama; Eka Gunawijaya; Ketut Ariawati; Ida Bagus Subanada; Anak Agung Ngurah Ketut Putra Widnyana
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.310-5

Abstract

Background Cardiac left-to-right shunts changes to the pulmonary-to-systemic blood flow ratio (Qp/Qs ratio). This ratio can be used to monitor the hemodynamics of the heart. Left-to right-shunts cause the release of amino terminal proB-ty natriuretic peptide (NT-proBNP) that can be utilized as a specific marker for the presence of heart failure in children with congenital heart defects (CHDs). Early intervention such as defect closure in CHD is important to prevent heart failure. Objective To assess for a correlation between the level of NT pro-BNP and Qp/Qs ratio in CHD patients with left-to-right shunts. Methods This cross-sectional, analytical study was conducted in 32 children who underwent cardiac catheterization at Sanglah General Hospital, Denpasar, Bali, and were recruited by consecutive sampling. NT-proBNP levels were measured by ELISA with a two-step sandwich assay system; Qp/Qs ratio using Fick rules. Statistical analyses included Shapiro-Wilk test, descriptive analysis for subject characteristics, and Pearson’s correlation analysis. A P value of <0.05 was considered to be statistically significant. Age and defect size were analyzed as confounding factors by partial correlation test. Results The correlation value between NT-proBNP and Qp/Qs ratio was r=0.384 (P<0.05), after controlling for age and defect size as cofounding factors. Conclusion There is a weak positive correlation between NT-proBNP levels and pulmonary-to-systemic blood flow ratio in patients with left-to-right shunt, after controlling for age and defect size as confounding factors.
The Impact of Flexible Working Hours, Remote Working, and Work Life Balance to Employee Satisfaction in Banking Industry during Covid-19 Pandemic Period Kresna Chandra Putra; Tedo Aris Pratama; Rionaldo Aureri Linggautama; Sekar Wulan Prasetyaningtyas
Journal of Business and Management Review Vol. 1 No. 5 (2020): (Issue-November)
Publisher : Profesional Muda Cendekia Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47153/jbmr15.592020

Abstract

During the situation like Coronavirus COVID -19 pandemic that happened in 2020, forcing various banking companies to make adjustments and changes to their work system. The flexible working system is one of the most widely used, which has an impact on workers especially during this pandemic conditions. The impact of the change in work system in banking sector is interesting to study, especially since the banking industry in Indonesia still mostly uses conventional work systems. . This study aims to measure the impact of flexible working hours (FWH), remote working (RW), and work life balance (WLB) on employee job satisfaction in the banking industry during the pandemic. In this study, data were collected using quantitative, non-probability, purposive sampling methods via online questionnaires, which were distributed to employees in the banking sector during the pandemic period in Jabodetabek area. With total of 160 respondents who were used to perform analysis using the PLS-SEM method which was carried out with the SMART-PLS software. This study found that in pandemic conditions, achieving WLB conditions will have a positive impact on job satisfaction. The implementation of the RW system itself has a positive impact in helping to achieve the WLB conditions that are felt by banking workers in the Jabodetabek area, in contrast to the FWH system which does not have a similar effect on WLB. In addition, this study also provides an academic basis for the use of flexible working hour and remote working systems to increase job satisfaction, especially in the banking industry.
LINGKUNGAN TEMPAT TINGGAL SEBAGAI FAKTOR RESIKO INFEKSI VIRUS DENGUE PADA ANAK-ANAK Jefry Gilberth Koibur; Agung Bagus Sista Satyarsa; I Wayan Gustawan; I Gusti Ngurah Sanjaya Putra; I Made Dwi Lingga Utama
Indonesian Journal for Health Sciences Vol 5, No 1 (2021): March
Publisher : Universitas Muhammadiyah Ponorogo

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (450.184 KB) | DOI: 10.24269/ijhs.v5i1.2984

Abstract

Demam Berdarah Dengue adalah penyakit disebabkan oleh virus dengue yang berkembang pesat di negara dengan iklim tropis seperti Indonesia. Penelitian ini bertujuan untuk mengidentifikasi faktor risiko infeksi virus dengue pada anak-anak di wilayah kerja Puskesmas Denpasar Selatan. Penelitian merupakan penelitian observasional analitikal dengan pendekatan cross-sectional. Data diperoleh dari jawaban reponden terhadap kuesioner yang telah tervalidasi sebelumnya dan selanjutnya data dianalisis secara univariat dan bivariat menggunakan aplikasi statistik yakni SPSS. Terdapat 75 responden yang mengikuti penelitian ini dengan rerata usia yakni 12±3,094 tahun. Karakteristik responden didominasi oleh anak laki-laki (73,3%) dan domisili di perkotaan (68%). Anak-anak lebih banyak tinggal di daerah yang padat penduduk (66,6%) dengan sanitasi lingkungan memadai hanya 45,3% dari total responden. Ditambah lagi, anak-anak memiliki risiko terinfeksi virus dengue dan mengalami demam berdarah pada lingkungan tempat tinggal di perkotaan dengan mobilitas penduduk yang padat (PR: 2,716; IK95%: 2,047-18,067; p: 0,011). Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa lingkungan tempat tinggal menjadi faktor risiko terhadap infeksi virus dengue pada anak-anak, sehingga diperlukan upaya preventif yang terfokus untuk mencegah infeksi virus dengue
Gambaran Gejala Klinis Pasien Anak COVID-19 di RSUP Sanglah Denpasar Ni Nyoman Ayu Semanggiasih; I Gusti Ngurah Made Suwarba; I Ketut Ariawati; I Made gede Dwi Lingga Utama
E-Jurnal Medika Udayana Vol 11 No 6 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Coronavirus disease 2019 (COVID-19) adalah suatu penyakit akibat terinfeksi coronavirus baru dengan nama SARS-CoV-2 serta bisa menular antar manusia. Penularan COVID-19 terjadi lewat droplet yang dihasilkan oleh orang yang terinfeksi. Mudahnya penularan COVID-19 menyebabkan kasus COVID-19 semakin meningkat. Terhitung tahun 2020 jumlah kasus anak positif COVID-19 di Indonesia mencapai 37.706 kasus. Bali merupakan salah satu provinsi terdampak dengan kasus anak positif COVID-19 mencapai 1.524 kasus. Tujuan dari penelitian ini yakni untuk mengetahui gambaran gejala klinis pasien anak positif COVID-19 di RSUP Sanglah Denpasar berdasarkan usia, jenis kelamin, dan komorbid. Penelitian ini mengunakan metode deskriptif dengan rancangan penelitian cross sectional. Pengambilan sampel penelitian menggunakan non-probability sampling dengan teknik Consecutive sampling. Data yang diambil berupa data sekunder pasien yang tercatat pada rekam medis pada Instalasi Rekam Medis RSUP Sanglah periode Maret 2020 – Maret 2021. Sampel yang diambil sebanyak 75 sampel. Hasil penelitian ini menunjukkan gejala klinis yang ditemukan adalah demam, pilek, batuk, sesak napas, sakit tenggorokan, napas cepat, mual/muntah, diare, nyeri perut, sakit kepala, dan kelelahan, dimana demam merupakan gejala terbanyak (74,7%). Pasien anak positif COVID-19 di RSUP Sanglah paling banyak laki-laki, kelompok usia terbanyak yaitu 11-18 tahun, dan paling banyak tidak memiliki komorbid. Komorbid yang paling banyak ditemukan adalah keganasan.Kata kunci : COVID-19, Gejala klinis, Anak, RSUP Sanglah.
Study of knowledge in diarrhea and personal hygiene among students below 10 years old in SD Santo Yoseph 2, Denpasar in 2016-2017 Karthigeyan Manogaran; I Made Gede Dwi Lingga Utama; I Wayan Gustawan
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 (351.448 KB) | DOI: 10.15562/ism.v10i2.411

Abstract

Background: The lack of basic knowledge of diarrhea and also poor self-hygiene might be the risk factors of diarrhea.Aim: The study aims to identify the knowledge of diarrhea and personal hygiene among student below 10 years old in SD Santo Yoseph 2, Denpasar, Bali. Method: This cross sectional study was conducted on students below 10 years old in SD Santo Yoseph 2, Denpasar. Fifty students participated in this study, and they were divided into two groups. Of total study participants, 25 were from 8 years old, and 25 were from 9 years old. They were asked to fill up a self-administered questionnaire. The variables assessed were their knowledge of diarrhea (definition, etiology, risk factors, sign and symptoms, complications, treatment and management, and prevention) and application of personal hygiene.Result: About 34% of 50 students below 10 years old in SD Santo Yoseph respectively had good knowledge of diarrhea. However, 66% of students had very less knowledge about diarrhea where they get below. For the application of personal hygiene, 24% of students managed to get a good score while 74% of them failed to get a good score. The vast majority had adequate knowledge of the definition of diarrhea. At the same time, the majority of the students was unable to know that dehydration is the complication of diarrhea due to the loss of a large amount of water and salt in the body.Conclusion: Though the overall knowledge in diarrhea and application of hygienic lifestyle among the students were poor, few minorities of the students had a good understanding of both these variables. There is a strong need for early childhood education about knowledge in diarrhea and personal hygiene in school level itself as a method of prevention.
Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia Ni Putu Wirantari; I Wayan Gustawan; Made Gede Dwilingga Utama; Bagus Ngurah Putu Arhana; Ni Nengah Dwi Fatmawati; Ni Made Adi Tarini
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 (425.308 KB) | DOI: 10.15562/ism.v11i1.553

Abstract

Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquired  infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%–30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).Conclusion: The MPV ≥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).
Co-Authors Agung Bagus S. Satyarsa Anak Agung Ngurah Ketut Putra Widnyana Andi Nurul Khadijah Artawan Artawan Bagus Ngurah Putu Arhana Dewi Sutriani Mahalini Dyah Kanya Wati Eka Gunawijaya Eko Kristanto Kunta Adjie Gusti Ayu Putu Sri Satya Mahayani I Gusti Ayu Putu Eka Pratiwi I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Ketut Suarta I Made Arimbawa I Made Yullyantara Saputra I Nyoman Budi Hartawan I Wayan Gustawan Ida Bagus Gede Suparyatha Ida Bagus Subanada Imanuel Y. Malino Jayadhi Widyakusuma Jefry Gilberth Koibur Karthigeyan Manogaran Ketut Ariawati Kresna Chandra Putra Mohammad Juffrie Ni Made Adi Purnami Ni Made Adi Tarini Ni Made Anggi Dwi Jayanti Ni Nengah Dwi Fatmawati Ni Nyoman Ayu Semanggiasih Ni Putu Indah Kartika Putri Ni Putu Wirantari Ni Wayan Ari Utami Niluh Putu Wida Pangestika NP Veny Kartika Yantie Nyoman Dinar Astika Pande Putu Firsta Widyaning Sekar Wulan Prasetyaningtyas Siska Permanasari Sinardja Tedo Aris Pratama Yati Soenarto