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All Journal Sari Pediatri Paediatrica Indonesiana AcTion: Aceh Nutrition Journal Narra J Journal of International Surgery and Clinical Medicine
Ismy, Jufitriani
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children Kowita, Nurul Huda; Sovira, Nora; Safri, Mulya; Ismy, Jufitriani; Haris, Syafruddin; Herdata, Heru Noviat; Bakhtiar, Bakhtiar
Paediatrica Indonesiana Vol 63 No 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.492-8

Abstract

Background Acute kidney injury (AKI) in sepsis is associated with an inflammatory process in kidney microcirculation and may increase morbidity and mortality in children. The neutrophil lymphocyte ratio (NLR) is an inflammatory biomarker of the inflammatory process in sepsis. Objective To determine the role of NLR in predicting the severity of AKI and to describe the demographic and laboratory characteristics, as they relate to outcomes of pediatric patients with AKI and sepsis. Methods This cross-sectional study was conducted in the PICU at Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, Aceh. Medical record data were obtained from critically ill children with sepsis and AKI. Chi-square test was used to compare the proportions of each variable. We also calculated odds ratios to evaluate the AKI severity, PELOD-2 score, and patient outcomes. Spearman's analysis was used to look for a possible correlation between NLR and AKI severity in septic children. Results Seventy-one subjects with sepsis and AKI were included. Subject characteristics were as follows: 63.4% males, 63.4% < 1 year of age, 56.3% with respiratory problems as a primary disease, 38% with AKI injury stage, and 54.9% subjects with PELOD-2 score ?10. There was no significant correlation between AKI severity and mortality (OR 3.04; 95%CI 0.990 to 9.378; P=0.052). Subjects with a PELOD-2 score ?10 had a 47.6 times higher chance of mortality in septic children with AKI compared to those with PELOD-2 scores <10. There was no correlation between NLR and AKI severity (r=0.019; P=0.878). Conclusion There is no correlation between NLR and AKI severity. Sepsis accompanied by AKI may increase the risk of mortality in children. Septic children with more severe AKI tends to be less survive.
Multiple brain abscess in systemic lupus erythematosus patients Ismy, Jufitriani; Anidar; Sari, Desi Purnama
Journal of International Surgery and Clinical Medicine Vol. 4 No. 1 (2024): (Available online: 1 June 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i1.51

Abstract

Introduction: Because SLE patients receive immunosuppressive and glucocorticoid medication, they are more susceptible to opportunistic infections. Multiple brain abscesses are an extremely uncommon side effect of systemic lupus erythematosus (SLE). Case description: The purpose of this case study is to raise awareness of the 14-year-old girl who reported experiencing weakness in her limbs. A year ago, she received a diagnosis of systemic lupus erythematosus. Upon physical examination, nervus VII central paresis was discovered; the lower extremities' muscular strength was 3333/2222 and the upper extremities' 3333/2222. A head CT scan revealed findings that were consistent with lupus cerebritis. Multiple ring lesions with extensive edoema were detected by magnetic resonance imaging, raising the possibility of multiple brain abscesses. For six weeks, the patient had intravenous metronidazole and ceftriaxone. The patient was allowed to go home with instructions to keep taking corticosteroids and mycophenolic acid as well as to schedule routine outpatient appointments. This case study aims to raise awareness about the 14-year-old girl who reported experiencing weakness in her limbs. Her condition was identified by specialists as systemic lupus erythematosus a year ago. Upon physical examination, nervus VII central paresis was discovered; the lower extremities' muscular strength was 3333/2222 and the upper extremities' 3333/2222. A head CT scan revealed findings that were consistent with lupus cerebritis. Multiple ring lesions with extensive edoema were detected by magnetic resonance imaging, raising the possibility of multiple brain abscesses. For six weeks, the patient received metronidazole and ceftriaxone intravenously. We sent the patient home with instructions to keep taking mycophenolic acid and corticosteroids and to make routine outpatient appointments. This case study aims to raise awareness about the 14-year-old girl who reported experiencing weakness in her limbs. Her condition was identified by specialists as systemic lupus erythematosus a year ago. Upon physical examination, nervus VII central paresis was discovered; the lower extremities' muscular strength was 3333/2222 and the upper extremities' 3333/2222. A head CT scan revealed findings that were consistent with lupus cerebritis. Multiple ring lesions with extensive edoema were detected by magnetic resonance imaging, raising the possibility of multiple brain abscesses. For six weeks, the patient received metronidazole and ceftriaxone intravenously. We sent the patient home with instructions to keep taking mycophenolic acid and corticosteroids and to make routine outpatient visits. Conclusion: It is critical to being aware that individuals with impaired immune systems should always be suspected of having an opportunistic central nervous system infection when they experience new neurologic symptoms. A brain abscess is a chronic infection of the central nervous system that can arise from a number of risk factors and infection sources. A brain abscess is one of the uncommon side effects of SLE.
Role of antioxidants in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients Ismy, Jufitriani; Soebadi, Amanda; Mangunatmadja, Irawan; Monica, Merci; Sari, Teny T.; Yuliarti, Klara
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.790

Abstract

Drug-resistant epilepsy presents significant challenges in treating epileptic patients, leading to recurrent seizures and necessitating the use of polypharmacy with anti-epileptic drugs. Both of these conditions contribute to increased oxidative stress, which is detrimental to the brain. The aim of this study was to determine the role of vitamins C and E in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients. This was a double-blinded, randomized clinical trial with a placebo, parallel design, and block randomization. The subjects were drug-resistant epileptic patients aged 1–18 years who received routine treatment. Randomization was performed on 100 patients who were divided into the treatment or placebo groups. The patients received a combination of vitamin C (100 mg/day) and vitamin E (200 IU/day for those <5 years or 400 IU/day for those ≥5 years) or a placebo for eight weeks. Malondialdehyde (MDA) levels and seizure frequency were measured prior to and after the intervention. A total of 42 and 46 patients were followed till the end of the study in the intervention and placebo groups, respectively. Our data indicated that the MDA levels prior to treatment were not significantly different between the treatment and placebo groups (0.901 vs 0.890 mmol/mL, p=0.920) and were significantly reduced after the treatment in both the treatment group (p<0.001) and placebo group (p=0.028). The changes in MDA levels (between post- and pre-treatment) were also not significantly different between the two groups (p=0.181). Our per-protocol analysis indicated that the reduction in seizure frequency was significantly higher in the treatment group compared to the placebo group (95% vs 35%, p<0.001), with 92% and 60% relative and absolute risk reduction, respectively. The intention-to-treat analysis also indicated that the reduction in seizure frequency was significantly higher in the intervention group than in the control group (80% vs 32%, p<0.001), with relative and absolute risk reduction of 70% and 48%, respectively. There was no significant relationship between changes in MDA levels and seizure frequency in either group. In conclusion, vitamins C and E could reduce seizure frequency and, therefore, could be considered as adjuvant therapy in drug-resistant epileptic patients.
Risk factors of mortality in children with acquired prothrombin complex deficiency at Dr. Zainoel Abidin General Hospital,Banda Aceh Munawarah, Syifa; Sovira, Nora; Anidar, Anidar; Herdata, Heru Noviat; Edward, Eka Destianti; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.253-9

Abstract

Background  Acquired prothrombin complex deficiency (APCD) is a rare but life-threatening bleeding disorder in children. Intracranial hemorrhage (ICH) is the leading cause of death, with an estimated risk affecting 50–80% of cases. Key risk factors associated with mortality in APCD include onset of disease, presence of ICH, and the initial Glasgow Coma Scale (GCS) score. Routine intramuscular administration of vitamin K at birth has been shown to effectively prevent early and late-onset vitamin K deficiency bleeding. However, in settings where vitamin K prophylaxis is not administered or is delayed, the risk of APCD increases significantly. Despite these concerns, other potentially relevant clinical factors contributing to APCD outcomes remain under-investigated. Objective To identify risk factors associated with APCD mortality in children treated at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods This cross sectional study analyzing children diagnosed with APCD at Dr. Zainoel Abidin General Hospital from October 2022 to October 2024. Data were collected from the medical records of 30 children and analyzed using Chi-square and logistic regression tests. Results This study included 30 subjects, the majority of whom were male and aged 8 days to 6 months. Most of subject were born full term, delivered vaginally, and had birth weight ≥ 2.500 grams. Notably, 25/30 children did not receive vitamin K prophylaxis, 14/18 children were exclusively breastfed without vitamin K prophylaxis, and 25/30 children had good nutritional status. Late-onset APCD was observed in 14 out of 30 cases.  Intracranial vs extracranial hemorrhage was occurred in 21 vs 9 children. Initial GCS scores ≤ 8 at initiation of treatment were noted in 11/30 children. The mortality rate was occurred in 12/30 subjects (40%). Chi-square analysis revealed significant associations between increased mortality and late onset APCD (P=0.030), ICH (P=0.049), and initial GCS score ≤ 8 (P=0.009). Logistic regression analysis revealed initial GCS score was associated with the highest risk of mortality in APCD, with a 16-fold increase in risk (P=0.022; OR 15.9; 95%CI 1.5 to 168.9). Conclusion Intracranial hemorrhage, late-onset APCD, and initial GCS scores ≤ 8 are significantly associated with increased APCD mortality, with initial GCS emerging as the most influential risk factor.
Pengaruh Pola Asuh dan Pemberian Makan terhadap Status Gizi Balita di Puskesmas Kuta Alam Banda Aceh Hasibuan, Reina Rizqia Muharrami; Ismy, Jufitriani; Husnah, Husnah; Syahrizal, Syahrizal; Dimiati, Herlina
Sari Pediatri Vol 27, No 1 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.1.2025.38-43

Abstract

Latar belakang. Hasil survei status gizi Indonesia tahun 2022 menunjukkan prevalensi status gizi di Provinsi Aceh untuk kategori gizi buruk 95.504 balita, 584.232 balita gizi kurang. World Health Organization (WHO) memperkirakan bahwa 54% kematian anak di dunia disebabkan oleh keadaan gizi yang buruk. Sementara di Indonesia masalah gizi mengakibatkan lebih dari 80% kematian anak. Aceh diklasifikasikan sebagai salah satu provinsi dengan empat permasalahan gizi pada balita yakni stunting, wasting, underweight, dan overweight.Tujuan. Penelitian ini bertujuan untuk menganalisis hubungan antara pola asuh dan pola pemberian makan dengan status gizi balita 12-59 bulan di wilayah Puskesmas Kuta Alam.Metode. Penelitian dilakukan pada bulan Juli sampai dengan September 2024 menggunakan desain observasional analitik dengan pendekatan cross-sectional, data dikumpulkan melalui pengisian kuesioner oleh 96 responden dengan teknik purposive sampling yang ditentukan berdasarkan kriteria inklusi dan eksklusi.Hasil. Hasil menunjukkan mayoritas ibu balita berusia 26–30 tahun, lulusan SMA, IRT, dan berpenghasilan < Rp1.000.000. Balita didominasi perempuan usia 12–24 bulan, berat <11 kg, dan tinggi 71–90 cm. Pola asuh sebagian besar kurang baik (58,33%) dan pola makan umumnya tepat (95,83%). Status gizi balita sebagian besar baik (66,67%). Terdapat hubungan signifikan antara pola asuh dan pola makan dengan status gizi (r=0,283 dan 0,272; p=0,005 dan 0,007). Kesimpulan. Pola asuh dan pola makan berpengaruh terhadap perbaikan status gizi balita. Oleh karena itu, intervensi yang menitikberatkan pada peningkatan kualitas pengasuhan dan pemberian makan yang tepat sangat penting untuk mendukung perbaikan status gizi anak di wilayah Puskesmas Kuta Alam.
Vitamin D and calcium status in children with thalassemia beta major: A cross sectional study in Banda Aceh Fiska, RR. Rima Aulia; Edward, Eka Destianti; Amna, Eka Yunita; Herdata, Heru Noviat; Sovira, Nora; Ismy, Jufitriani
AcTion: Aceh Nutrition Journal Vol 10, No 3 (2025): September
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i3.2486

Abstract

Frequent blood transfusions in children with beta-thalassemia major result in iron overload, leading to hemosiderosis in various body tissues, and impair the function of these organs, disrupting vitamin D metabolism, which contributes to osteoporosis and other morbidities, which are believed to be associated with hypocalcemia, which significantly affects growth. This study aimed to investigate the relationship between vitamin D and calcium status in children with β-thalassemia major at dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. Methods: An analytical observational study employed a cross-sectional design involving 40 children aged 2–18 years with a beta-thalassemia major attending the Children's Thalassemia Clinic at dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. from July to November, 2024. Categorical data were analyzed using the Spearman test, with a p-value of <0,05. Results, of the 40 subjects, 55% subjects were male, in 45% of subjects, there was Vitamin D deficiency, 25% was vitamin D insufficiency, hypocalcemia in 77,5% subjects. Among subjects with vitamin D deficiency, 94,4% also had hypocalcemia (r = 0,037, p = 0,017). In conclusion, there was a significant association between vitamin D and calcium status in children with beta-thalassemia major.
Nutritional status, age and gender factors associated on pneumonia in congenital heart disease: A hospital-based cross-sectional study in Banda Aceh, Indonesia Sovira, Nora; Dimiati, Herlina; Yusuf, Sulaiman; Bakhtiar, Bakhtiar; Ismy, Jufitriani
AcTion: Aceh Nutrition Journal Vol 10, No 3 (2025): September
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i3.2442

Abstract

Pneumonia is a leading cause of morbidity and mortality in children with congenital heart disease (CHD). Risk factors for pneumonia in these children include anemia, hypoxemia, nutritional status, congestive heart failure, and neuromuscular disorders. This study aimed to determine the risk factors for pneumonia in children with CHD at the Dr. Zainoel Abidin Public Hospital, Banda Aceh, Indonesia. This analytical, observational study employed a cross-sectional approach. This study included children aged 1 month to 18 years who were treated at the Dr. Zainoel Abidin Public Hospital from January 2022 to December 2023. Data were collected from medical records of 121 children who met the inclusion and exclusion criteria. Data were analyzed using bivariate analysis with the chi-square test and multivariate analysis with logistic regression. Pneumonia was observed in 66 (54,5%) patients. The majority of children with critical illnesses who developed pneumonia were between 1 month and 5 years of age (60%), female (61,7%), had poor nutritional status (53,2%), and had a birth weight ≥ 2500 g (54,5%). The type of CHD was found to be a significant risk factor for pneumonia (p = 0,024), with an odds ratio of 3,16 (95% CI: 1,162–8,617). In conclusion, the CHD type is a risk factor for pneumonia in children with CHD.
Co-Authors Amna, Eka Yunita Anidar Anidar Anidar, Anidar Bakhtiar Bakhtiar DESI PURNAMA SARI Edward, Eka Destianti Fiska, RR. Rima Aulia Hasibuan, Reina Rizqia Muharrami Herlina Dimiati, Herlina Heru Noviat Herdata, Heru Noviat Husnah Husnah Irawan Mangunatmadja Kowita, Nurul Huda Merci Monica br Pasaribu Mulya Safri, Mulya Munawarah, Syifa Nora Sovira, Nora Sari, Teny T. Soebadi, Amanda Sulaiman Yusuf Syafruddin Haris, Syafruddin Syahrizal Syahrizal Yuliarti, Klara