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All Journal Sari Pediatri Paediatrica Indonesiana Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Ilmu Kedokteran dan Kesehatan journal of Basic Medical Veterinary
Amna, Eka Yunita
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Risk factors for acute kidney injury in children with critical illness Chalisah, Lilis; Sovira, Nora; Amna, Eka Yunita; Anidar, Anidar; Haris, Syafruddin; Bakhtiar, Bakhtiar
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.398-404

Abstract

Background Acute kidney injury (AKI) is an acute functional kidney disorder that increases morbidity and mortality in children. The mortality rate for critically ill patients accompanied by AKI is quite high and is influenced by the degree of AKI, the severity of the disease, and organ function disorders. Understanding the risk factors of developing AKI in children with critical illness can help prevent AKI. Objective To determine the risk factors for AKI in children with critical illness. Methods This retrospective cohort study included 255 children aged 1 month to 18 years admitted at the pediatric intensive care unit (PICU) of dr. Zainoel Abidin Regional Public Hospital, Banda Aceh, Aceh, from January to December 2022 using medical record data. Bivariate and multivariate analyses were performed. Results Acute kidney injury occurred in 68 (26.7%) patients. Based on pRIFLE criteria, 34 (50%) patients had AKI in the failure stage. Risk factors for AKI in children with critical illness were in descending order of RR: sepsis (RR 14.3; 95%CI 11.68 to 18.66; P=0.000), mechanical ventilation (RR 12.13; 95%CI 8.75 to 15.98; P=0.000), respiratory disorders (RR 2.51; 95%CI 2.06 to 4.02; P=0.003), congenital heart disease (RR 2.08; 95%CI 2.00 to 3.05; P=0.004), CNS disorders (RR 1.24; 95%CI 1.02 to 2.49; P=0.048), nephrotoxic drug use (RR 1.41; 95%CI 1.24 to 3.08; P=0.000), and age 1 month to 5 years (RR 0.072; 95%CI 0.16 to 0.32; P=0.010). Conclusion Sepsis is a risk factor for AKI in children with critical illness, followed by mechanical ventilation use, respiratory disorders, nephrotoxic drug use. Age <5 years is a protective factor.
Role of Vitamin D and E as Antioxidants Against Cerebral Endothelial Dysfunction: An In Vivo Study in White Rats (Rattus norvegicus) Sepsis Model Fajri, Fauzan; Fajar, Sukmawan; Hasan, Denny Irmawati; Dimiati, Herlina; Amna, Eka Yunita; Sovira, Nora; Anidar, Anidar; Safri, Mulya; Gunawan, Aris
Journal of Basic Medical Veterinary Vol. 13 No. 2 (2024): Journal of Basic Medical Veterinary, December 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbmv.v13i2.61610

Abstract

Sepsis is a life-threatening condition caused by the body's response to an infection, leading to organ dysfunction. A antioxidants can help neutralize harmful free radicals that cause cellular and tissue damage through oxidative stress. Vitamin D and E are two antioxidants that have been extensively studied for their potential effectiveness. This study aims to evaluate the effectiveness of vitamins D and E in reducing oxidative stress in the cerebral vascular endothelial cells of Wistar mice in a sepsis model. The study follows an experimental design and uses a posttest with a control group. The levels of NO and SOD in 24 sepsis model mice were measured using ELISA, and the cerebral endothelial tissues were examined histopathologically. An ANOVA test was performed, followed by the Post Hoc LSD test. NO and SOD levels decreased in sepsis rats from 66.88 ± 16.59 to 88.77 ± 12.83µmol/L. Sepsis mice given vitamin D and E showed significant results on changes in NO and SOD levels (p<0.05). Based on the histopathological results of necrosis, inflammation, and hemorrhagic cell damage in sepsis rats reached over 50% of the field of view, significantly different from sepsis mice that had been given vitamin D and E. Sepsis mice were given vitamin D and E influenced 96.2% and 98.7% on changes in NO, SOD, and cerebral endothelial dysfunction (p<0.05). These findings imply that vitamins D and E may be beneficial in managing sepsis-induced cerebral endothelial dysfunction, potentially impacting the treatment and outcomes of sepsis patients.
Urinary neutrophil gelatinase-associated lipocalin to predict acute kidney injury in children with critical illness Fajri, Rizky; Sovira, Nora; Haris, Syafruddin; Dimiati, Herlina; Bakhtiar, Bakhtiar; Amna, Eka Yunita
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.47-53

Abstract

Background Acute kidney injury (AKI) can increase mortality in children with critical illness. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker for early prediction of AKI in children. Objective To determine the diagnostic value of uNGAL as a predictor of AKI in children with critical illness. Methods This observational cross-sectional study was conducted in the Emergency Room, Pediatric Intensive Care Unit, and Pediatric Ward of Zainoel Abidin Public Hospital, Banda Aceh, Indonesia, between August and December 2023. Subjects were 40 children aged 1 month to 18 years with critical illness. uNGAL levels were measured on the first day of admission. Blood urea and creatinine levels were measured on the first and third days of admission. We calculated the diagnostic sensitivity and specificity of uNGAL to predict AKI. The optimal uNGAL cut-off point for this purpose was determined using receiver operating characteristic (ROC) curve analysis. Result In the majority of patients (29/40; 72.5%) critical illness occurred at the ages of 5 to 18 years. The most common primary diseases were central nervous system disorders in 14/40 (35%) patients, gastrointestinal infection in 6/40 (15%) patients, and malignancy in 5/40 (12.5) patients. Median uNGAL levels were significantly elevated in subjects with renal impairment [17.37 (range 6.13-29.70) ng/mL] compared to those with normal renal function [4.87 (range 0.32-29.49) ng/mL] (P=0.0001). The optimal uNGAL cut-off point was >9.99 ng/mL, with an AUC of 0.842, 81% sensitivity, and 78.9% specificity to predict AKI. The OR of AKI in children with uNGAL levels >9.99 ng/mL was 10.66 (95%CI 2.30 to 49.30; P=0.003). Conclusion Urinary neutrophil gelatinase-associated lipocalin (uNGAL) can be used as a predictor of acute kidney injury in children with critical illness.
Pemantauan Perkembangan Anak Umur 0 - 12 Bulan Di Wilayah Kerja Puskesmas Ulee Kareng Kota Banda Aceh Zakia, Fitri; Amna, Eka Yunita; Lubis, Silvia Yasmin
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 3 (2025): Volume 12 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i3.17672

Abstract

Pemantauan perkembangan anak sangat penting dilakukan untuk memastikan anak berkembang sesuai dengan tahap yang diharapkan dan mengidentifikasi gangguan perkembangan anak lebih awal, dikarenakan perkembangan pada masa balita sangat menentukan perkembangan masa selanjutnya. Tujuan penelitian ini adalah mengetahui pemantauan perkembangan anak umur 0 – 12 Bulan di wilayah kerja Puskesmas Ulee Kareng Kota Banda Aceh. Penelitian ini menggunakan desain deskriptif dengan pendekatan cross sectional. Hasil penelitian ini menunjukkan pemantauan perkembangan anak pada semua Posyandu telah rutin dilakukan setiap bulan, mayoritas menggunakan KKA yaitu sebanyak 8 desa (88.9 %), dan tidak di dapatkan penyimpangan. Karakteristik demografi terbanyak yang datang adalah usia anak 7-12 bulan sebanyak 57 orang (63.3 %), jenis kelamin anak laki – laki sebanyak 55 orang (61.1 %), usia ibu 26 – 35 tahun sebanyak 61 orang (67.8 %), tingkat pendidikan ibu yaitu pendidikan tinggi sebanyak 49 orang (54.4%), pekerjaan ibu kategori IRT sebanyak 75 orang (83.3 %), dan pengetahuan ibu terhadap buku KIA dan KKA baik sebanyak 57 orang (63.3 %).
Hubungan Riwayat Pemberian Asi Eksklusif Dengan Angka Kejadian Infeksi Saluran Pernapasan Atas Pada Balita Di Rumah Sakit Pertamedika Ummi Rosnati Mahara, Cut; Julinar, Julinar; Amna, Eka Yunita
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 3 (2025): Volume 12 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i3.17555

Abstract

Infeksi Saluran Pernapasan Atas ialah suatu penyakit menular yang disebabkan oleh invasi virus dan bakteri yang menimbulkan reaksi inflamasi pada jalur pernapasan, seperti nasofaringitis, faringitis, sinusitis, laringitis, rinitis dan tonsilitis. Salah satu faktor yang mempengaruhi timbulnya ISPA ialah balita yang tidak diberikan ASI eksklusif berisiko lebih besar mengidap ISPA karena efek proteksi ASI mampu mencegah timbulnya gangguan kesehatan di awal kehidupan. Tujuan penelitian ini untuk menganalisis hasil pemberian ASI eksklusif dengan frekuensi ISPA pada anak di bawah lima tahun. Desain cross-sectional dipakai dalam studi observasional analitik. Sampel penelitian terdiri dari 74 anak berumur 6-59 bulan dengan menggunkan metode total sampling. Analisis data univariat dan bivariat didapatkan umur balita < 35 bulan sebanyak 58,1%, jenis kelamin  balita laki- laki yaitu sebanyak 51,4%, balita yang tidak diberikan ASI eksklusif yaitu sebanyak 52,7%, balita yang mengalami ISPA sebanyak 59,5%. Klasifikasi penyakit ISPA paling banyak yaitu kategori faringitis sebanyak 25,7%. Menurut hasil uji Chi-square (p-value 0,785 > α = 0,05), tidak ada hubungan antara usia balita dengan kejadian ISPA dan Berdasarkan hasil uji Chi-square (p-value = 0,006 < α = 0,05), terdapat korelasi antara riwayat pemberian ASI dengan insiden ISPA.
Risk factors for poor initial response to valproic acid therapy in children with epilepsy Sari, Eva Devita; Anidar, Anidar; Amna, Eka Yunita; Andid, Rusdi; Yusuf, Sulaiman; Sovira, Nora
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.286-90

Abstract

Background The initial response in the first three months of valproic acid therapy is a prognostic factor for predicting treatment success, and it is considered to be poor if seizures persist during the three months of valproic acid treatment. Several factors might influence the initial response to valproic acid therapy, including gender, age, family history of epilepsy, electroencephalogram (EEG), head circumference, type of seizure, cerebral palsy, and pre-therapy seizure frequency. Objective To determine the risk factors for poor early response to valproic acid therapy in children with epilepsy. Methods This retrospective cohort study was conducted in children newly diagnosed with epilepsy. Data were collected from medical records of patients who had been treated at the Pediatric Polyclinic of dr. Zainoel Abidin Hospital for one year. Results Of 90 subjects, most were male (58; 64.4%) and aged three years or older (79; 87.8%). Forty-five (50%) patients had a family history of epilepsy. More than a quarter of the subjects (35; 38.9%) showed initial poor responses to valproic acid therapy. Bivariate analysis revealed risk factors for poor initial response to valproic acid therapy were age ≥ 3 years, family history of epilepsy, normal EEG, normal head circumference, generalized seizure type, cerebral palsy, and pre-therapy seizure frequency. However, multivariate analysis revealed that risk factors for poor initial response to valproic acid therapy in children with epilepsy that retained significance were family history of epilepsy (RR 6.58; 95%CI 1.67 to 25.95; P=0,001), abnormal EEG (RR 5.27; 95%CI 1.16 to 23.87; P=0,000), focal seizures (RR 7.10; 95%CI 1.15 to 43.80; P=0,000), and cerebral palsy (RR 62.62; 95%CI 3.93 to 996.45; P=0,001). Conclusion The risk factors for poor initial response to valproic acid therapy in children with epilepsy are family history of epilepsy, abnormal EEG, focal seizures, and cerebral palsy.
Neutrophil Gelatinase-Associated Lipocalin Plasma sebagai Prediktor Gangguan Fungsi Ginjal pada Anak dengan Penyakit Jantung Bawaan Asianotik di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh Safrizal, Safrizal; Dimiati, Herlina; Amna, Eka Yunita; Sovira, Nora; Haris, Syafruddin; Darussalam, Dora
Sari Pediatri Vol 26, No 4 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.4.2024.218-23

Abstract

Latar belakang. Penyakit jantung bawaan asianotik merupakan kelainan struktur dan fungsi jantung sejak lahir yang tidak ditandai dengan sianosis. Morbiditas PJB asianotik signifikan, dengan prevalensi 69,3-78,5%. Pada PJB dapat terjadi gangguan fungsi ginjal yang dapat meningkatkan mortalitas pada anak. Neutrophil Gelatinase-Associated Lipocalin (NGAL) plasma merupakan penanda prediktor gangguan fungsi ginjal pada anak. Tujuan. Mengetahui kadar NGAL plasma sebagai prediktor gangguan fungsi ginjal pada anak dengan penyakit jantung bawaan asianotik.Metode. Penelitian ini merupakan studi observasional analitik dengan pendekatan prospektif pada anak usia 1 tahun sampai 10 tahun dengan diagnosis PJB asianotik yang melakukan rawat jalan maupun rawat inap di Rumah Sakit Umum Daerah dr Zainoel Abidin Banda Aceh pada bulan Februari hingga Juni 2024 yang memenuhi kriteria penelitian.Hasil. Dari 35 anak dengan PJB asianotik, terbanyak berusia usia 1 tahun sampai dengan kurang dari 5 tahun (41,7%). Sebanyak 31,2% anak dengan diagnosis defek septum atrium terdapat gangguan fungsi ginjal. Kadar NGAL plasma sebesar 100,18 ng/ml menjadi cut-off point gangguan fungsi ginjal pada anak dengan PJB asianotik. Pada nilai AUC sebesar 0,95 didapat nilai sensitivitas, spesifisitas, PPV dan NPV masing-masing sebesar 100%; 94,73%; 94,1%; dan 100%. Kadar NGAL plasma pada anak dengan PJB asianotik memiliki hubungan signifikan (p=0,001) dengan gangguan fungsi ginjal.Kesimpulan. Neutrophil Gelatinase-Associated Lipocalin plasma dapat digunakan sebagai prediktor gangguan fungsi ginjal pada anak dengan PJB asianotik.
Hubungan Kadar Bilirubin Transkutan dengan Bilirubin Serum Total pada ikterus Neonatorum di Rumah Sakit Umum dr. Zainoel Abidin Banda Aceh Muliana, Cut; Firmansyah, Isra; Amna, Eka Yunita; Haris, Syafruddin; Yusuf, Sulaiman; Akbar, Zaki
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i11.52280

Abstract

Ikterus pada minggu pertama kehidupan ditemukan 60% pada neonatus cukup bulan dan 80% pada neonatus kurang bulan. Pemeriksaan kadar bilirubin penting dalam membedakan hiperbilirubinemia fisiologis dan patologis pada neonatus, juga untuk menentukan pengobatan pada ikterus neonatorum. Selama ini penentuan kadar bilirubin dilakukan dengan pemeriksaan serum darah vena, namun memiliki beberapa efek samping. Pengukuran bilirubin transkutan merupakan metode non-invasif untuk mengukur kadar bilirubin pada bayi baru lahir. Penelitian ini bertujuan untuk mengetahui korelasi kadar bilirubin transkutan dengan bilirubin serum total pada ikterus neonatorum di Rumah Sakit dr. Zainoel Abidin Banda Aceh. Penelitian ini menggunakan pendekatan analitik obervasional dengan desain cross sectional. Data dikumpulkan dari neonatus yang dirawat dalam periode Januari – Maret 2023. Subjek penelitian merupakan neonatus yang mengalami ikterus neonatorum dan menjalani pemeriksaan kadar bilirubin serum total dan kadar bilirubin transkutan dengan interval waktu maksimal 30 menit antara kedua pemeriksaan tersebut. Semua subjek penelitian belum pernah mendapatkan fototerapi. Total 30 sampel yang memenuhi kriteria inklusi dan eksklusi penelitian. Rerata kadar bilirubin serum total 14,46 ± 3,36 mg/dL dan rerata kadar bilirubin transkutan 12,50 ± 3,55 mg/dL pada dahi serta 13,10 ± 3,25 mg/dL pada sternum. Koefisien korelasi antara kadar bilirubin serum total dengan bilirubin transkutan adalah 0,85 pada dahi dan 0,88 pada sternum, p<0,000. Pada penelitian ini didapatkan kadar bilirubin transkutan memiliki korelasi yang baik dengan bilirubin serum total sehingga dapat digunakan sebagai alat skrining untuk memperkirakan kadar bilirubin serum total pada ikterus neonatorum. Pemeriksaan kadar bilirubin transkutan pada sternum memiliki akurasi yang lebih baik dibandingkan pada dahi.
Co-Authors Akbar, Zaki Anidar Anidar, Anidar Bakhtiar Bakhtiar Chalisah, Lilis Dora Darussalam, Dora Fajar, Sukmawan Fajri, Fauzan Fajri, Rizky Gunawan, Aris Hasan, Denny Irmawati Herlina Dimiati, Herlina Isra Firmansyah, Isra Julinar Julinar Mahara, Cut Muliana, Cut Mulya Safri, Mulya Nora Sovira, Nora Rusdi Andid, Rusdi Safrizal Safrizal Sari, Eva Devita Silvia Yasmin Lubis, Silvia Yasmin Sulaiman Yusuf Syafruddin Haris, Syafruddin Zakia, Fitri