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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Journal Pharmaceutical Science and Application (JPSA) Jurnal Kimia (Journal of Chemistry) Jurnal Farmasi Udayana E-Jurnal Medika Udayana Media Penelitian dan Pengembangan Kesehatan Sari Pediatri Paediatrica Indonesiana Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of Health Sciences and Medicine
Ketut Ariawati
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/Rumah Sakit Sanglah Denpasar, Bali
Biochemistry, Genetics & Molecular Biology Chemistry Decision Sciences, Operations Research & Management Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health

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Journal : Medicina

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ACUTE PROMYELOCYTIC LEUKEMIA Wati, Ni Wayan Kurnia; Ariawati, Ketut
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML). The disease isvery uncommon in children less than 10 years of age. Every sign and symptom  that present on patientwith APL are caused by the infiltration of the bone marrow with leukemic cells and resulting failure ofnormal hematopoiesis. Without the normal hematopoietic elements, the patient is at risk for developinglife-threatening complications of anemia, infection due to neutropenia, and hemorrhage due tothrombocytopenia, disseminated intravascular coagulation, fibrinolysis, and proteolysis of maturecells. We reported one case of a nine-year-old girl with pale, limp, recurred fever, hematome, andpetechiae. Physical examination revealed pale in conjunctiva, ginggival hypertrophy, and hepatomegaly.Complete blood count showed normochromic normocytic anemia, thrombocytopenia, and leukopenia,with neutropenia. Bone marrow aspiration revealed a bundle of auer rod, promyelocyte 60 %, myeloblast2 %, concluded AML(M3). We provided chemoterapy with vitamine A, daunorubicine, and cytarabine,but the condition was decreased and finally died after the first cycle of chemotherapy. [MEDICINA2015;46:178-83].Leukemia promielositik akut (LPA) merupakan salah satu subtipe dari leukemia mielositik akut(LMA). Penyakit ini sangat jarang pada anak-anak kurang dari 10 tahun. Semua tanda dan gejalaklinis pada pasien dengan LPA disebabkan karena infiltrasi sumsum tulang oleh sel-sel leukemiadan mengakibatkan kegagalan hematopoiesis normal. Komplikasi LPA yang mengancam jiwa antaralain anemia, infeksi akibat netropenia, dan perdarahan akibat trombositopenia, disseminatedintravascular coagulation, fibrinolisis, dan proteolisis. Kami melaporkan satu kasus anak sembilantahun dengan keluhan pucat, lemas, demam berulang, hematoma, dan petekie. Pada pemeriksaanfisis didapatkan konjungtiva pucat, hipertrofi gingiva, dan hepatomegali. Pemeriksaan darah lengkapmenunjukkan anemia normokronik normositik, trombositopenia, dan leukopenia, dengan neutropenia.Aspirasi sumsum tulang menunjukkan adanya bundle of auer rod, promyelocyte 60%, myeloblast 2%,disimpulkan sebagai AML (M3). Kami kemoterapi dengan vitamin A, daunorubisin, dan sitarabin,tapi kondisi anak kemudian menurun dan akhirnya meninggal setelah periode pertama kemoterapi.[MEDICINA 2015;46:178-83].
RETINOBLASTOMA FAMILIAL IN A 3-YEAR-OLD GIRL Wini Mardewi, Kadek; Ariawati, Ketut
Medicina Vol 44 No 2 (2013): Mei 2013
Publisher : Medicina

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Abstract

Retinoblastoma is the commonest intraocular tumor in childhood. About one thirds  of all cases are bilateral. It is recognized that bilateral and familial retinoblastoma are cause by germline mutation and are thus a heritable tumor. We reported a case, 3-year-old girl showing proptosis of the right eye since six months before admission. She had family history (his father) of retinoblastoma. Physical examination showed mass of the righ eye and leucorea of the left eye. Computed tomography scan showed  retinoblastoma extraoccular of the right eye and retinoblastoma intraoccular of the left eye without spread to the pinealis gland or Parsellar. Bone marrow aspration showed non hemopoitic cell (metastatic tumor). Patient was diagnosed with bilateral retinoblastoma familial grade V. Despite the management of this patient is chemotherapy and still on treatment chemotherapy continuous phase, the prognosis still worse. [MEDICINA 2013;44:128-134]
Estimasi laju filtrasi glomerulus penderita leukemia limfoblastik akut yang mendapatkan kemoterapi metotreksat dosis tinggi Suradhipa, I Wayan; Ariawati, Ketut; Nilawati, Gusti Ayu Putu
Medicina Vol 47 No 2 (2016): Mei 2016
Publisher : Medicina

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Abstract

Metotreksat dosis tinggi banyak digunakan dalam pengobatan leukemia limfoblastik akut (LLA) di Sub-Bagian Onkologi Pediatri. Pemberian metotreksat dosis tinggi menimbulkan efek toksik berupa disfungsi ginjal. Indikator disfungsi ginjal dapat dilihat dari nilai estimasi laju filtrasi glomerulus (eLFG). Penelitian ini bertujuan untuk mengetahui efek pemberian MTX dosis tinggi pada pasien LLA terhadap kejadian disfungsi ginjal yang dinilai dari eLFG. Penelitian retrospektif, melibatkan 19 anak LLA yang mendapatkan kemoterapi sesuai protokol LLA di Sub-Bagian Hemato-Onkologi Bagian/SMF Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RSUP Sanglah Denpasar pada bulan Januari 2011 sampai Desember 2013. Data mengenai nama, jenis kelamin, umur atau tanggal lahir, berat badan, tinggi, serum kreatinin, dan berapa kali sudah mendapatkan MTX dosis tinggi diperoleh dari rekam medis pasien. Nilai rerata eLFG sebelum dan sesudah pemberian MTX dosis tinggi didapatkan perbedaan yang bermakna. Nilai rerata eLFG setelah pemberian MTX dosis tinggi I, II, dan III menurun secara signifikan berturut-turut sebesar 277,10 ml/mnt/1,73m2 (SB 97,32), 248,05 ml/mnt/1,73m2 (SB 85,06), dan 212,65 ml/mnt/1,73m2 (SB 71,95) dengan P < 0,001. Disimpulkan, nilai rerata eLFG pasien LLA setelah pemberian MTX dosis tinggi I, II dan III didapatkan penurunan secara signifikan tetapi penurunan ini masih dalam rentang normal. High-dose methotrexate is widely used in the treatment of acute lymphoblastic leukemia (ALL) in pediatric oncology department. Administration of high-dose methotrexate cause toxic effects such as kidney dysfunction. Indicators of renal dysfunction can be seen from the value estimated glomerular filtration rate (eLFG). This study aims to describe estimation GFR (eGFR) in ALL patient after methotraxate high dose in pediatric. A retrospective study, in 19 children who receive chemotherapy according ALL protocol in Sanglah Hospital from January 2011 to December 2013. Data regarding name, sex, age or date of birth, weight, height, serum creatinine, and how many times have received high-dose MTX obtained from medical records of patients. ). There were differences between eGFR of patients before and after treatment with high dose methotrexate. The mean of eGFR after the first, the second and the third methotrexate high dose were decrease significant 277.10 ml/mnt/1.73 m2 (SD 97.32), 248.05 ml/mnt/1.73 m2 (SD 85.06), 212.65 ml/mnt/1.73 m2 (SD 71.95) with P < 0.001. It was concluded that eGFR patients with ALL decrease significant after treatment with high dose methotrexate but still in normal range of eGFR.
PREVALENCE AND HEMATOLOGY PROFILES OF ANEMIA IN PATIENTS WITH ACUTE LOWER RESPIRATORY INFECTION Adi Wirawan, I Ketut; Ariawati, Ketut; Subanada, Ida Bagus
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

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Abstract

Anemia remains a major health problem worldwide, both in developed or developing countries. Approximately, 30% of world population suffered from anemia, and half of it is due to iron deficiency anemia (IDA). Clinical aspect of iron deficiency is lack of immunity. Objectives of this study were to measure prevalence and anemia profile on hospitalized children with acute lower respiratory tract infection (ALRI). This study was a crossectional descriptive study, using children with diagnosed of ALRI in Sanglah Hospital Denpasar, on January-December 2009. Children aged 6-59 months with diagnosed of ALRI and admitted for this study was 74 children. Most of them were male (69%), aged 6-11 months (57%), and 61% suffered from pneumonia. Most children with ALRI (64%) suffered from anemia, and 80% of them suffered from IDA. At ALRI group who were diagnosed with IDA, the average concentrations of hemoglobin, MCHC, SI, TIBC and transferin saturation were 9.72 g/dl, 32.76 g/dl, SI 21.03 µg/dl, 364.19 µg/dl and 6.05% respectively. It was concluded that prevalence of anemia in patients with ALRI was 64%, and 80% of them were IDA. Most ALRI patients with anemia (76%) have less iron status.
INHIBITOR IN HEMOPHILIA K Yantie, Veny; K, Ariawati
Medicina Vol 43 No 1 (2012): Januari 2012
Publisher : Medicina

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Abstract

Hemophilia is an X-linked recessive disorder which is believed to affect approximately one in 5000-10.000 male birth. An inhibitor  is a type of antibody. In hemophilia patients type A, B, and C are directly destroy factor VII, IX, and XI. The incidence of antibody development in hemophilia A is between 20% and 40%, hemophilia B inhibitors only 1 to 6 %. The presence of an inhibitor is usually confirmed using a specific blood test called the Bethesda inhibitor assay. The treatment of hemophilic bleeding in a person with an inhibitor can be a challenging experience. Patients hemophilia with inhibitor have poor prognostic. (MEDICINA 2012;43:31-36).
Co-Authors A.A. Raka Karsana Anak Agung Made Wijaya Kusuma Anak Agung Ngurah Ketut Putra Widnyana Armand Setiady Liwan Bagus Ngurah Putu Arhana Dewi, N.L.P.R. Djajadiman Gatot Eka Gunawijaya Eko Kristanto Kunta Adjie Endang Windiastuti Gusti Ayu Putu Nilawati H Salim I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Made Ady Wirawan I Made Arimbawa I Nyoman Budi Hartawan I Nyoman G. Budiana I Putu Hendri Aryadi I Wayan Bikin Suryawan I Wayan Dharma Artana I Wayan Gustawan I Wayan Suradhipa, I Wayan I. K. Kari Ida Bagus Subanada IGN Sanjaya Inna Narayani Irene Irene Kadek Wini Mardewi Komalasari, K. T. Leni Lukman Luh Putu Rihayani Budi Made Gede Dwi Lingga Utama Made Suadnyani Pasek Mahardika Aprilia Iflahah Manik Trisna Arysanti Ni Kd Rintan Listiani Ekayanti Ni Made Intan Pertiwi Ni Made Rini Suari Ni Nyoman Ayu Semanggiasih Ni Putu Siadi Purniti Ni Wayan Kurnia Wati, Ni Wayan Kurnia Niruri, R Niruri, R. NP Veny Kartika Yantie Nyoman Adiputra Paulus Arief Budiman Pertiwi, N.M.I. Putu Dita Arsintha Widma Putu Junara Putra R. Niiruri Rasmaya Niruri Rini Noviyani S. Herawati Sagung Chandra Yowani Sianny Herawati Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Utami, A.A.I.A.Y.T Wega Upendra Sindhughosa Yohannes Adinatha