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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran
Putu Junara Putra
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RSUP Sanglah,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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CHARACTERISTICS AND THE OUTCOME OF VERY LOW BIRTH WEIGHT INFANT BORN IN SANGLAH HOSPITAL DENPASAR Putra, Yoga; Kardana, Made; Artana, Dharma; Putra, Junara
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.515 KB)

Abstract

Very low birth weight (VLBW) infants is one of the most important medical problem especially in developing countries. This issue is due to its high morbidity and mortality rate. On the other hand, the long term impact of VLBW infants are poor growth and development including physical, emotional, intelectual (IQ), and disabilities, therefore it could decrease the quality of human resources and become a burden to their family. The objective of this study was to describe the characteristics and outcome among VLBW infants born in the Sanglah Hospital. This was a retrospective study. Data were collected from medical record of all infants with VLBW delivered in Sanglah Hospital from January to Desember 2009. Uncompleted infants and mother medical records were excluded from this study. Of 64 VLBW infants enrolled into the study of which 54.7%  of this subjects was male, median of weight was 1300 g, mean gestational of age was 30.9 (SD 2.28) weeks, and mean lenght of stay was 30.9 (SD 19.7) days. The survival of VLBW infants in this study was 62.5%,  mortality in the early neonatal period was 70,8%. The percentage of VLBW infants who survive was still low and the major causes mortality were HMD (50%) and sepsis (41.6%). The mortality of VLBW happened mostly in early neonatal periode.
CHARACTERISTICS OF NECROTIZING ENTEROCOLITIS IN NEONATES TREATED AT SANGLAH HOSPITAL Hartini, Kadek; Artana, Dharma; Putra, Junara
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

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
NUTRISI ENTERAL PADA DIARE PERSISTEN P, Junara; S, Sudaryat; Suandi, IK.
Medicina Vol 38 No 1 (2007): Januari 2007
Publisher : Medicina

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SPONTANEOUS PNEUMOPERITONEUM IN A SEVEN DAY OLD INFANT Luhulima, Franky; Kardana, Made; Artana, IW Dharma; Junara, Putu; Dharmajaya, IM
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

The term pneumoperitoneum is used to describe the presence of free gas  or air within the peritoneal cavity. Spontaneous pneumoperitoneum or “non-surgical” pneumoperitoneum is a pneumoperitoneum. not associated with a perforated viscus. This pneumoperitoneum   is rare at any pediatric age. In the pediatric population, nonsurgical pneumoperitoneum occurs in 1% to 3% of mechanically ventilated infants, depend on the mode of the ventilation. Pneumoperitoneum without gastrointestinal perforation on the other hand is very rare, and this is usually seen in neonates with respiratory distress and on mechanically ventilator or CPAP. We reported a case of spontaneous pneumoperitoneum in a seven day old infant . The infant presented with a sudden abdominal distention and dyspnea. Plain abdominal x-ray showed a radiolucency image in the superior abdomen. In this patient is done the act of a needle aspirations for drainage air in the peritonium. This patient recovered well a[er done such action by pediatric surgical
Pengaruh Pemberian ASI Eksklusif Terhadap Kejadian Diare pada Anak Usia 1-3 Tahun Ni Made Elsa Wardani; Komang Ayu Witarini; Putu Junara Putra; I Wayan Dharma Artana
E-Jurnal Medika Udayana Vol 11 No 1 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.v11.i01.p03

Abstract

Abstrak Diare adalah suatu penyakit yang ditandai dengan adanya perubahan bentuk dan konsistensi tinja yang lembek sampai mencair dan bertambahnya frekuensi buang air besar yaitu 3 kali atau lebih dalam sehari yang dapat disertai dengan muntah atau tinja yang berdarah. Kejadian diare pada anak dapat terjadi akibat pemberian susu formula sebagai pengganti ASI. Penelitian ini bertujuan untuk dapat mengetahui pengaruh pemberian ASI Eksklusif terhadap kejadian diare pada anak usia 1-3 tahun. Penelitian ini dilakukan dengan metode analitik menggunakan studi kasus kontrol dengan sampel yang sesuai dari populasi berdasarkan kriteria inklusi dan eksklusi. Data dianalisis menggunakan software SPSS versi 26 untuk mendapatkan pengaruh pemberian ASI Eksklusif terhadap kejadian diare pada anak usia 1-3 tahun dan dengan memperhatikan faktor lain seperti keberadaan toilet, berat bayi saat lahir, tingkat pendidikan ibu, sumber air minum, kebersihan diri, kebersihan lingkungan dan status gizi. Hasil menunjukkan tidak terdapat hubungan yang signifikan antara pemberian ASI Eksklusif terhadap kejadian diare pada anak usia 1-3 tahun. Saran yang diberikan yaitu melakukan penelitian kembali dalam rentang waktu yang singkat sehingga memudahkan dalam mengingat kembali hal-hal yang telah dialami saat wawancara. Selain itu juga perlu memperhatikan berbagai faktor lain seperti kebersihan lingkungan, kebersihan diri, dan juga kebersihan peralatan makan dan botol susu sebelum digunakan. Kata Kunci: Diare, ASI Eksklusif, pengaruh
Perbandingan Keamanan dan Konversi Tuberkulin dari Vaksin BCG Strain Moskow dan Vaksin BCG Strain Pasteur pada Bayi Ni Putu Siadi Purniti; Novilia Sjafri Bachtiar; Ida Bagus Subanda; Ayu Setyorini; Putu Junara Putra; Wayan Gustawan; IGA Trisna Windiani; Julitasari S; Rini Mulia Sari
Sari Pediatri Vol 17, No 3 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (91.504 KB) | DOI: 10.14238/sp17.3.2015.169-74

Abstract

Latar belakang. Pemberian vaksin BCG pada bayi masih menjadi kebijakan pemerintah Indonesia dan WHO.Tujuan. Membandingkan keamanan dan konversi tuberkulin vaksin BCG strain Moskow dengan strain Pasteur.Metode. Tergabung dalam penelitian ini 220 bayi 0-1 bulan, kelompok A menerima vaksin BCG strain Pasteur, dan kelompokB menerima strain Moskow dengan randomisasi tersamar tunggal. Reaksi lokal dan sistemik yang timbul diamati hingga 30 haripasca imunisasi. Uji tuberkulin dilakukan pada hari ke-90 pasca imunisasi, dengan pembacaan 48-72 jam kemudian.Hasil. Terdapat 205 anak berhasil menyelesaikan studi. Pembesaran kelenjar getah bening ditemukan pada kedua kelompok,masing-masing 2 bayi, yang sembuh sendiri tanpa pengobatan. Tidak ditemukan kejadian ikutan pasca imunisasi serius karenavaksin BCG. Jumlah bayi yang mempunyai jaringan parut dan konversi tuberkulin tidak berbeda signifikan, p=0,578 dan p=0,205(p>0.05).Kesimpulan.Vaksin BCG strain Pasteur dan strain Moskow mempunyai profil keamanan dan konversi tuberkulin yang relatifsama.
Insiden dan Faktor-Faktor yang Berhubungan dengan Sepsis Neonatus di RSUP Sanglah Denpasar Putu Junara Putra
Sari Pediatri Vol 14, No 3 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.3.2012.205-10

Abstract

Latar belakang. Sepsis neonatus sampai saat ini masih merupakan masalah utama di bidang pelayanan dan perawatan neonatus. Insiden sepsis neonatus bervariasi dari 1 sampai 4 dari 1000 kelahiran hidup di negara maju dan 10 sampai 50 dalam 1000 kelahiran hidup di negara berkembang. Kematian pada sepsis neonatus masih tinggi, terutama di negara-negara berkembang.Tujuan.Menggambarkan insiden, angka kematian, dan faktor yang terkait dengan kematian pada sepsis neonatus di RSUP Sanglah, Denpasar.Metode.Penelitian retrospektif dilakukan di Ruang Rawat Neonatologi Bagian Ilmu Kesehatan Anak, RSUP Sanglah, Denpasar dari Januari hingga Desember 2010. Seratus dua puluh lima pasien dengan sepsis neonatus dilibatkan dalam penelitian. Analisis univariat dengan kai kuadrat, analisis multivariat dengan regresi logistik, dan nilai p<0,05 dianggap bermakna.Hasil. Terdapat 125 kasus sepsis neonatus yang diteliti dengan gambaran 56,8% dari subjek laki-laki, 72% lahir secara spontan, 64,0% lahir dengan asfiksia, 56% berat lahir rendah, 68,8% prematur, dan 86,4% dengan sepsis neonatus awitan dini (SNAD). Insiden sepsis neonatus 5%, dengan tingkat kematian 30,4%. Berat lahir rendah dan prematuritas secara bermakna berkaitan dengan kematian pada sepsis neonatus (RR 2,66, 95% IK 1,03-6,90), p=0,04 dan RR 5,45 (95% IK 4,47-20,25), p=0,01).Kesimpulan.Insiden sepsis neonatus di RSUP Sanglah, Denpasar 5% dengan tingkat kematian 30,4%. Berat lahir rendah dan prematuritas terkait dengan kematian pada sepsis neonatus.
Sindrom Sturge Weber Putu Junara Putra; I Komang Kari
Sari Pediatri Vol 8, No 1 (2006)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp8.1.2006.69-74

Abstract

Sindrom Sturge Weber (SSW) atau disebut juga encephalofacialangiomatosis, merupakankelainan neurokutaneus yang ditandai dengan angioma leptomeningeal dan angiomakutaneus pada kulit wajah (Port Wine stain), terutama khas pada daerah perjalanannervus trigeminalis yaitu nervus oftalmikus (V1) dan nervus maksilaris (V2). PenyakitSSW disebabkan oleh anomali perkembangan bantalan vaskular pada stadium awalvaskularisasi otak yang mengakibatkan kelainan pada otak. Di Amerika, angka kejadianSSW diperkirakan sebesar 1 tiap 50.000. Kejadian SSW tidak dipengaruhi oleh ras danjenis kelamin. Kelainan neurologis dan perkembangan meliputi kejang, kelemahan, stroke,sakit kepala, hemianopsi, retardasi mental, dan kelainan perkembangan. Diagnosisditegakkan berdasarkan manifestasi klinis yang ditemukan pada tiga organ yaitu nervus,kulit dan mata, serta ditunjang oleh pemeriksaan pencitraan yaitu foto kepala, CT scan,MRI, single photon emission computed tomografi (SPECT), dan EEG.
Characteristics and outcomes of low birth weight infants in Bali Putu Junara Putra
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (104.602 KB) | DOI: 10.14238/pi52.5.2012.300-3

Abstract

Background The prevalence and the mortality of low birthweight infants are still high. Low birth weight (LBW) births areresponsible for newborn death. LBW infants are easier to sufferserious health problems and death. Lower infant body weightand younger gestational age are determinants of greater risk ofmortality.Objective To determine the characteristics of LBW infants andtheir outcomes in Sanglah Hospital, Denpasar.Methods This prospective study was conducted on all LBWinfants in the nursery from their time of admission until dischargefor the year of 20 11..Results There were 120 LBW infants admitted to SanglahHospital fromJanuary 2011 to December 2011. The prevalenceofLBW was 8.9%. The birth weight group of 1500􀁰2499 gramshad the highest number of infants (79.2%). The gestational agegroup of 33􀁰36 weeks had 53.3% of the infants, while 68.3% ofthe LBW infants were of the appropriate gestational age. Themost common method of delivery was normal spontaneousdelivery (70%). Moderate asphyxia was observed in 25% of thesubjects, while severe asphyxia was observed in 22.5% of subjects.The mortality rate was 24.2%.Conclusions The prevalence of LBW of all newborns in ourhospital was 8.9%. Severe asphyxia was observed in 22.5% ofsubjects. The mortality rate of the LBW infants was 24.2%. OurLBW infants were most cormnonly in the categories of birth weightof 1500􀁰2499 grams, gestational age was between 33􀁰36 weeks,appropriate for gestational age, as well as delivered spontaneously.[Paediatr lndanes. 2012,52:30003].
Oxidative stress in neonates with hyperbilirubinemia before and after phototherapy: malondialdehyde and catalase activity Putu Junara Putra; Rinawati Rohsiswatmo; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (214.323 KB) | DOI: 10.14238/pi58.6.2018.269-73

Abstract

Background Phototherapy is used to treat neonatal hyperbilirubinemia, but is currently thought to cause photodynamic stress and can induce lipid peroxidation. There is increasing evidence that many severe diseases of the neonates are caused by oxidative injury and lipid peroxidation. In the present communique, we review the oxidative succeptibility of the neonate and the evidence now available that phototherapy induces oxidative stress. Malondialdehyde (MDA) is a metabolic product of free radicals. Catalase is a antioxidant that binds free radicals. Objective To compare the levels of oxidants and antioxidants before and after phototherapy in neonates with hyperbilirubinemia. Methods This pretest-posttest control group study was conducted in Sanglah Hospital, Bali from November 2016 to April 2017. Thirty babies with gestational age ≥35 weeks and hyperbilirubinemia with total bilirubin levels requiring phototherapy were included in this study. The MDA levels and catalase activity were measured before and after 24 hours of phototherapy. Results Comparative analysis using paired T-test showed a significant increase of malondialdehyde level, with mean MDA 23.73 (SD 8.20) nmol/mL before and 53.05 (SD 10.18) nmol/mL after phototherapy (P<0.001). However, catalase activity significantly decreased from of 72.33 (SD 10.63) kU/L before phototherapy to 44.85 (SD 14.79) kU/L after phototherapy (P<0.001). The MDA level had a significant, negative association with catalase activity after phototherapy (r =-0.4; P=0.028). Conclusion Neonates with hyperbilirubinemia are found to have increased oxidative stress after phototherapy, as indicated by increased MDA levels and decreased CAT activity after 24 hours of phototherapy.
Co-Authors Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana Franky Luhulima Gusti Ayu Putu Nilawati I Gusti Agung Trisna Windiani I Komang Kari I Made Kardana I Wayan Darma Artana I Wayan Dharma Artana I Wayan Gustawan Ida Bagus Subanda IK. Suandi IM Dharmajaya Julitasari S Kadek Deddy Ariyanta Kadek Deddy Ariyanta Kadek Hartini Ketut Ariawati Komang Ayu Witarini Made Darmajaya Made Sukmawati Ni Made Elsa Wardani Ni Made Sukewanti Ni Putu Siadi Purniti Novilia Sjafri Bachtiar Novita Purnamasari Assa Nyoman Gina Henny Kristianti Pustika Amalia Wahidiyat Rinawati Rohsiswatmo Rini Mulia Sari Sudaryat S Wayan Sulaksmana Sandhi Parwata Wega Upendra Sindhughosa Yoga Putra