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All Journal Medicina Jurnal Sains dan Teknologi Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran
Gusti Ayu Putu Nilawati
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar
Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Medicine & Pharmacology

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OBESITY IS ASSOCIATED WITH HYPERTENSION IN ADOLESCENTS Hendy, Hendy; Lanang Sidiartha, I Gusti; Putu Nilawati, Gusti Ayu
Medicina Vol 44 No 3 (2013): September 2013
Publisher : Medicina

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Abstract

Obesity has become a global issue. Previous studies in Bali reveal an increase in the proportionof obesity in adolescents. Obesity causes hypertension; hence there should also be an increase inthe prevalence of hypertension as well in Bali. Hypertension in obese adolescents could be causedby various factors, hence identification of the risks factors is crucial as a preventive approach.The aim of this study was to prove an association between obesity and hypertension in adolescents,and to look for the risk factors. We used an analitical cross sectional design conducted to 12-14years old samples. We took body weight, height, waist circumference, hip circumference, andblood pressure measurements with appropriate devices and asked for information regarding lifestyle and familial history by a questionnare filled in by the samples. The association of obeseadolescents with hypertension and their risk factors was analyzed by Chi-square and multivariatetests. A total of 225 subjects from Santo Yoseph junior high school students, west Denpasar,Bali, met the inclusion criteria. The proportion of obese subjects in this study was 25.7%. Wefound that proportion in familial history of obesity was greater in obese than non-obese subjects(70.7 % vs 41.3%). Logistic regression test revealed that obese subjects with hypertension had abody mass index (BMI) > 30 with odds ratio of 7.3 (CI 95% = 1.8 to 28.8) and P = 0.005. Weconcluded that there was an association between obesity and adolescents with hypertension,and BMI > 30 could be a risk factor for obese adolescents with hypertension.
HENOCH SCHONLEIN PURPURA ASSOCIATED WITH ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS: A CASE REPORT Melati, Deborah; Kumara Wati, Ketut Dewi; Putu Nilawati, Gusti Ayu
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

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Abstract

Acute post-streptococcal glomerulonephritis (APSGN) is one of the most common renal disease resulting from a prior infection with group A â-hemolytic streptococcus (GAS). Henoch Schonlein Purpura (HSP) is a systemic disease with frequent renal involvement, its etiology is still unknown but several infections have been described as trigger includingGAS infection. A 4 year 10 month old Balinese boy presented with full blown acute nephritic syndrome, an elevation in serum creatinine and four fold increase of anti streptolysin-O, also low serum levels of complement C3 with normal C4 confirmed the diagnosis of APSGN. During hospitalization he developed palpable purpura, gastrointestinal symptoms as well as leucytoclastic vasculitis in skin biopsy conclude HSP diagnosis.He was treated with anti-hypertensions and metylprednisolone intravenous. The prognosis of the patient was excellent, he showed normal physical examination with normal complete blood count and urinalysis after 3 months follow up. We conclude that both APSGN and HSP could appear concurrently after GAS infection. [MEDICINA 2014;45:102-7]  
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.
RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN CHILDREN Eva, Floria; Nilawati, Gusti Ayu Putu
Medicina Vol 46 No 1 (2015): Januari 2015
Publisher : Medicina

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Abstract

Rapidly progressive glomerulonephritis (RPGN) is a rare syndrome in children and one of the nephrologyemergency which needs special attention. Rapidly progressive glomerulonephritis  is determined bysymptoms and signs of glomerulonephritis (GN); edema, hypertension, gross hematuria, and rapid lossof renal function. Early diagnosis and appropriate treatment play a critical role in saving renal functionand preventing permanent glomerular damage. Diagnosis was made based on clinical and laboratoryfindings. We reported two cases of RPGN in an eleven year old boy and an eight year old boy. The patientcame  to  the pediatric outpatient clinic at sanglah hospital with chief complaint dark  ?cola colored?urine. Laboratory work up showed proteinuria, erythrocyturia, decrease of C3 and normal C4 complementlevel, increased serum urea and creatinine level and loss of renal function in a few days with glomerularfiltration  rate  decreased. Based  on  clinical  and  laboratory  findings,  the  patient was  diagnosed  asrapidly progressive glomerulonephritis. The patient was given methylprednisolone pulses for 3 days,followed  by  high  dose  oral methylprednisolone. Prognosis  of  the  patient was  good.  [MEDICINA2015;46:46-51].
SERAT SABUT KELAPA SEBAGAI BAHAN KAJIAN PEMBUATAN BIOETANOL DENGAN PROSES HIDROLISIS ASAM Ayuni, Ni Putu Sri; Hastini, Putu Nilawati
JST (Jurnal Sains dan Teknologi) Vol 9, No 2 (2020)
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.257 KB) | DOI: 10.23887/jst-undiksha.v9i2.29035

Abstract

Penelitian ini bertujuan untuk mengetahui konsentrasi optimum asam klorida (HCl) dan waktu optimum hidrolisis serat sabut kelapa untuk memperoleh kadar glukosa yang maksimal. Subjek dalam penelitian ini adalah serat sabut kelapa yang diperoleh dari Desa Temukus, sedangkan objek dalam penelitian ini adalah konsentrasi HCl dan waktu optimum. Penelitian dilakukan pada bulan Oktober 2013 – Maret 2014 di Laboratorium Analis Kimia Universitas Pendidikan Ganesha. Kadar glukosa dianalisis menggunakan metode Dubois dan diukur menggunakan spektrofotometer UV-Vis. Dari hasil penelitian diperoleh glukosa sebesar 1,44% dengan konsentrasi optimum katalis HCl pada hidrolisis serat sabut kelapa adalah 4 M dan waktu optimum hidrolisis 90 menit.
Kejadian Acute Kidney Injury dengan Kriteria pRIFLE pada Unit Perawatan Intensif Anak Rumah Sakit Sanglah Denpasar GAP Nilawati
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/sp14.3.2012.158-61

Abstract

Latar belakang.Acute kidney injury(AKI) merupakan merupakan suatu keadaan yang dapat meningkatkan angka morbiditas dan mortalitas pada anak yang dirawat di rumah sakit terutama dengan perawatan intensif.Tujuan.Mengetahui kejadian AKI pada anak yang mendapat perawatan di Unit Perawatan Intensif Anak.Metode.Penelitian deskriptif retrospektif dengan mengambil data dari rekam medis dan register perawatan ruang intensif selama tahun 2010Hasil.Dari 411 pasien yang dirawat di Unit Perawatan Intensif Anak, 149 (36,25%) dilakukan pemeriksaan blood urea nitrogen(BUN) dan serum kreatinin (SC). Terdapat 25 kasus (6,1%) merupakan kasus AKI. Sebagian besar subyek berusia di bawah 1 tahun (10/25) dan berjenis kelamin laki-laki 15/25. Berdasarkan kriteria pRIFLE, 3 termasuk dalam kriteria risk (R),12 injury (I),dan 10 dimasukkan failure (F).8 orang meninggal.Kesimpulan.Acute kidney injuryterbanyak dijumpai pada laki-laki dengan kasus terbanyak termasuk kriteria injury(I).
Profil Sindrom Nefrotik pada Ruang Perawatan Anak RSUP Sanglah Denpasar GAP Nilawati
Sari Pediatri Vol 14, No 4 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.4.2012.269-72

Abstract

Latar belakang. Sindrom nefrotik merupakan salah satu penyakit ginjal yang sering dijumpai pada anak,ditandai dengan proteinuria, hipoalbuminemia, edema, dan hyperkolesterolemia.Tujuan. Untuk mengetahui karakteristik, gambaran klinis, dan laboratorium anak dengan sindromnefrotik.Metode. Penelitian deskriptif retrospektif, dengan mengambil data dari rekam medis pasien sindrom nefrotikselama periode 2001-2007, di Bagian Ilmu Kesehatan Anak RSUP Sanglah, Denpasar.Hasil. Selama periode 6 tahun (2001-2007), terdapat 68 anak dengan sindrom nefrotik. Usia berkisar dari 6bulan sampai dengan 11 tahun (rerata 5,1),laki-laki 50 (73,5%), perempuan 18 (26,5%) dengan rasio 2,7:1.Sebagian besar pasien datang dengan keluhan utama bengkak 62 (91%), demam 2 (3%), kejang 2 (3%), dan syok2 (3%). Kadar albumin rata-rata 1,02 ± 0,67, kolesterol 485,3±162,39, 14,7% dengan hematuria. Peningkatankreatinin 16 (23,5%), respons terhadap terapi 58 (85,2%) sensitif steroid, 10 (14,8%) resisten steroid.Kesimpulan. Sindrom nefrotik lebih banyak mengenai laki-laki dibandingkan perempuan. Sebagianbesar pasien datang ke rumah sakit dengan keluhan bengkak dan proteinuria masif. Respons pengobatanmenunjukkan sebagian besar sensitif terhadap steroid.
Cystatin C level and amikacin use in neonatal sepsis Putu Diah Pratiwi; I Wayan Dharma Artana; Ni Putu Veny Kartika Yantie; Hendra Santoso; I Gusti Ngurah Sanjaya Putra; Gusti Ayu Putu Nilawati; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (234.997 KB) | DOI: 10.14238/pi60.1.2020.1-5

Abstract

Background Amikacin is the antibiotic of choice for eradicating bacteria in neonatal sepsis because of its effectiveness against Gram-negative bacteria. However, this drug has nephrotoxic effects. Monitoring kidney function in neonates is very important because amikacin can interfere with development of the kidney. Several studies have shown that serum cystatin C levels were closer to glomerular filtration rate (GFR) values ​​compared to serum creatinine levels. Objective To evaluate cystatin C levels before and after administration of amikacin in neonates with sepsis. Methods This prospective cohort study was conducted in one group with a pretest and posttest design. Thirty neonatal sepsis patients who received amikacin therapy at Sanglah General Hospital, Denpasar, Bali, were included by consecutive sampling. Their cystatin C levels were measured before and after receiving amikacin therapy. Data were normally distributed and analyzed by paired T-test, with a value of P<0.05 considered to be significant. Results The mean difference was 0.23 [1.57 (SD 0.29) vs. 1.80 (SD 0.28)] mg/L with P value < 0.001. There was different value of cystatin c level before and after amikacin therapy with deviation standard 0.25 with P<0.001 (alfa 5%). Conclusion Cystatin C levels are significantly higher in neonates with sepsis after administration of amikacin.
Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia Carissa Lidia; I Made Kardana; Gusti Ayu Putu Nilawati; Ida Bagus Subanada; I Gusti Agung Ngurah Sugitha Adnyana; Ayu Setyorini Mestika Mayangsari
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.8-11

Abstract

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.
Ginjal tapal kuda dengan hidronefrosis unilateral sekunder akibat atresia ureter: laporan kasus Putu Kurnia Darma Pratama; Gede Wirya Kusuma Duarsa; Gusti Ayu Putu Nilawati; Pande Putu Yuli Anandasari
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 (844.085 KB) | DOI: 10.15562/ism.v10i2.594

Abstract

Background: Total prevalence of multiple congenital anomalies (MCA) was 15.8 per 10,000 births. Genitourinary anomalies were associated with MCA cases about 43.8% of the cases. The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA and up to one third also had hydronephrosis thought to be secondary to ureteric atresia.Case: A 10-month-old boy presented with a 5-month history of abdominal distention. On physical examination, there was a large non-tender cystic mass in the right upper abdomen extending down to the right lower abdomen. The other congenital anomalies on this patient were hydrocephalus, hypospadias, and bilateral undescended testis. Abdominal CT showed a significant right hydronephrosis with megaureter and mesenteric cyst. The horseshoe kidney was unclear. The surgical approach to the kidney was via a transverse upper abdominal transperitoneal incision. Exploration revealed a horseshoe kidney with cystic mass situated retroperitoneally on the right side, massive dilatation of renal pelvis and proximal ureter 3 cm from UPJ. The distal ureter was markedly atresia. It was decided to perform nephroureterectomy on the right side considering its thin renal cortex. The postoperative average urine production is 25 ml/hour, no bleeding from surgical wound, BUN 10.7 mg/dL, and serum creatinine 0.37 mg/dL.Conclusion: The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA. Up to one third with horseshoe kidney had hydronephrosis secondary to ureteric atresia, which can be managed by reconstruction surgery or nephroureterectomy considering the function of the affected side of kidney. 
Co-Authors Ayu Setyorini Mestika Mayangsari Bagus Ngurah Putu Arhana Carissa Lidia Deborah Melati, Deborah Desak Made Widiastiti Arga Floria Eva, Floria Gede Wirya Kusuma Duarsa Hendra Santoso Hendy Hendy I Gusti Agung Ngurah Sugitha Adnyana I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Ketut Suarta I Made Kardana I Wayan Dharma Artana I Wayan Suradhipa, I Wayan Ida Bagus Subanada Ketut Ariawati Ketut Dewi Kumara Wati Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Ni Putu Sri Ayuni NP Veny Kartika Yantie Pande Putu Yuli Anandasari Putu Diah Pratiwi Putu Junara Putra Putu Kurnia Darma Pratama Wega Upendra Sindhughosa