Claim Missing Document
Check
Articles

Found 30 Documents
Search

Potential of Soursop Leaf Extract as an Antioxidant in MCF-7 Cells Mustofa, Muhammad Samsul; Hadi, Restu Syamsul; Rahmah, Nunung Ainur; Pendrianto, Pendrianto
Biology, Medicine, & Natural Product Chemistry Vol 13, No 1 (2024)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2024.131.265-269

Abstract

The frequency of breast cancer tends to increase. Malondialdehyde (MDA) is a marker of oxidative stress as an end product from the chain reaction of lipid peroxidation. The use of traditional medicine soursopleaf (Annona muricata L.) has been reported for a long time because of its bioactivity as an antioxidant. This study analyzes the relationship between MDA levels and glutathione enzymes in MCF-7 cells given the methanol extract of soursop leaves. The methanol extract of soursop leaves was carried out by infusion method. The methanol extract of soursop leaves was given to cancer cells at several doses with an incubation of 24 hours. The cytotoxic test was carried out using the MTT method. Measurement of MDA levels was carried out using the thiobarbituric acid reactive substance (TBARS/TBA) reactivity test method. GSH measurements used the colorimetric method. The results showed that the ethanol extracts of soursop leaves have cytotoxic activity in the MCF-7 breast cancer cell line with IC50 values of 23.96 ppm. Ethanol extract of soursop leaves increased levels of MDA inhibition and GSH level. Soursop leaf extract could increase MDA inhibition GSH level in human breast cancer cells MCF-7.
The Effect of Course Schedule Density and Assignment Frequency on Burnout Syndrome in Students of The Faculty of Medicine YARSI University in 2019 And 2020 and Their Review According to Islam Rostiana, Ajeng Nita; Rahmah, Nunung Ainur; Royhan, Aan; Arifandi, Firman
Junior Medical Journal Vol. 2 No. 2 (2023): Oktober 2023
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v2i2.3009

Abstract

Background: Burnout syndrome is a measure of physical exhaustion and mental stress that is driven primarily by pressure and job requirements. The academic demands experienced by medical students, such as busy class schedules, practicum materials, group discussions, clinical skills, final exams, to organizational activities are some of the factors that make the duties and obligations as students pile up, triggering to the Burnout syndrome. According to the Islamic view, patience and trustworthiness are a way to deal with fatigue in studying. Method: This type of research is quantitative which is done in an analytical observational manner with a cross sectional design. Questionnaires were distributed via Google form to YARSI University Medical Faculty students in 2019 and 2020. The sample in this study was 224 respondents. The statistical test uses the Chi-Square test. Results: In the study it was found that there were 125 (55%) students who had moderate burnout syndrome. Based on the results of statistical tests, there is no effect between schedule density and the frequency of assignments on burnout syndrome. Conclusion: There is no effect of the density of schedules and the frequency of assignments on burnout syndrome
Cytotoxicity of Combination Doxorubicin and Garcinia picrorrhiza Fruit Extract on Fibroblast Cell Utami, Sri; Endrini, Susi; Batubara, Lilian; Rahmah, Nunung Ainur; Syarif, Irfan; Nafik, Said; Arrahmani, Betharie Cendera; Novianto, Agung; Kusuma, Hanna Sari Widya; Widowati, Wahyu
Global Medical & Health Communication (GMHC) Vol 11, No 3 (2023)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v11i3.10985

Abstract

Combining chemotherapeutic agents such as doxorubicin with herbal products or other compounds that can enhance cytotoxicity without side effects is required. Thus, we aimed to observe the cytotoxicity of doxorubicin and sesoot (Garcinia picrorrhiza) fruit ethanolic extract (GpKar) on human fibroblast cells, BJ. This study used a post-test-only control randomized group design with n=3 and a number group of 5. The method used in this research is cell number, and viability was measured with (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assay. Treatments consisted of a combination of doxorubicin (0.02 μg/ml) and GpKar of 66.47 µg/ml (DES1), 132.94 µg/ml (DES2) and 265.89 μg/ml (DES3). The data were analyzed using a one-way ANOVA and Duncan post hoc tests. DES3 showed the lowest viability among treatments (89.32%). DES1 and DES2 showed high viability (>90%), 97.93%, and 95.08%, respectively. Thus, the combination of doxorubicin (0.02 μg/ml) and GpKar (66.47 µg/ml) was considered safe for further use in the following assay. In summary, the combination of doxorubicin and GpKar showed high viability in normal fibroblast cells.
ANALISIS GAMBARAN GASTROSKOPI DAN HISTOPATOLOGI GASTRITIS PADA PENDERITA SINDROMA DISPEPSIA DI RS YARSI JAKARTA Syafruddin A. R. Lelosutan; Nunung Ainur Rahmah; Ari Fahrial Syam
Medika Alkhairaat: Jurnal Penelitian Kedokteran dan Kesehatan Vol 6 No 3 (2024): Desember
Publisher : Fakultas Kedokteran Universitas Alkhairaat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31970/ma.v6i3.237

Abstract

ABSTRAK Prevalensi Helicobacter pylori (HP) di Indonesia bervariasi sesuai lokasi daerah dan etnis. Di RS YARSI Jakarta kasus Sindroma Dispepsia (SD) cukup banyak mendapat prosedur tindakan Esofagogastroduodenoskopi (EGD) dan biopsi mukosa lambung (BML) dengan hasil histopatologi berupa sejumlah gambaran positif adanya HP. Mendapatkan angka prevalensi infeksi HP serta hasil analisis hubungan infeksi bakteri HP dengan gambaran diagnosis makroskopis EGD dan histopatologi hasil BML di RS YARSI, Jakarta. Studi retrospektif kasus SD yang mengalami prosedur tindakan EGD dan sekaligus pengambilan spesimen BML selama 1 tahun (2023‒2024) Data dipilih sesuai kriteria inklusi dan eksklusi. Pengolahan statistik memakai SPSS versi 26 dan uji analisis data menggunakan uji Chi-Square dalam batas kemaknaan 0,05 dan interval kepercayaan 95%. Sebanyak 72 subyek memenuhi kriteria. Prevalensi bakteri HP di RS YARSI Jakarta sebesar 18.0%. Ada hubungan antara infeksi bakteri HP dengan gambaran makroskopis (EGD) jaringan mukosa lambung (Gastritis hiperemikum-eritematousa, Gastritis erosif, dan Gastritis ulseratif) dan dengan kerusakan histologis mukosa lambung (Gastritis kronik aktif/GKA dan Gastritis kronik inaktif/GKI) yang signifikan masing-masing dengan p = 0,003 (p < 0,05) dan p = 0,004 (p < 0,05). Frekuensi kerusakan jaringan mukosa lambung akibat infeksi bakteri HP berupa GKA (Gastritis kronik aktif) dan GKI (Gastritis kronik inaktif) masing-masing sebesar 8,3% dan 9,7% dari keseluruhan Subyek. Ada hubungan infeksi bakteri HP dengan gambaran diagnosis makroskopis EGD dan histopatologi hasil BML di RS YARSI, Jakarta.
Hubungan antara Usia dan Jenis Kelamin dengan Kanker Kolorektal di Rumah Sakit Islam Cempaka Putih Jakarta Tahun 2015−2020 dan Tinjauannya Menurut Pandangan Islam Adilah Ulinnuha; Ainur Rahmah, Nunung; Arsyad, Muhammad
Junior Medical Journal Vol. 2 No. 9 (2024): Mei 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v2i9.4219

Abstract

Perubahan pola penyakit dapat disebabkan oleh perubahan pola hidup masyarakat. Masalah utama masyarakat di bidang kesehatan salah satunya adalah keganasan. Peristiwa penyakit keganasan, khususnya kejadian kanker kolorektal selalu meningkat tiap tahunnya. Kanker kolorektal adalah penyakit keganasan di bagian usus besar. Usia dan jenis kelamin dapat berhubungan peningkatan resiko terjadinya kanker kolorektal. Umur adalah lamanya hidup manusia dari lahir sampai tutup usia. Rata-rata usia manusia saat ini mengikuti zaman Nabi. Semakin bertambahnya usia maka manusia semakin rentan untuk terkena penyakit. Tujuan penelitian ini adalah untuk mengetahui hubungan antara usia dan jenis kelamin dengan kanker kolorektal di Rumah Sakit Islam Cempaka Putih Jakarta Tahun 2015−2020 dan tinjauannya menurut pandangan Islam. Rancangan penelitian menggunakan metode retrospektif cross sectional dengan cara melihat rekam medik pada populasi seluruh pasien yang didiagnosis klinis sebagai kanker kolorektal yang dirawat inap di Rumah Sakit Islam Cempaka Putih Jakarta pada tahun 2015−2020. Sampel dipilih dari populasi yang sesuai kriteria. Umur, jenis kelamin, diagnosis kanker kolorektal dimasukan ke komputer dan dianalisis menggunakan Program Statistical package for social science (SPSS). Selanjutnya dilakukan uji Chi-Square. Pada penelitian ini menunjukan hasil tidak terdapat hubungan yang bermakna secara statistic antara umur dan jenis kelamin dengan karsinoma kolon. Pasien yang berusia >50 tahun memiliki risiko 1,90 kali lebih besar mengalami karsinoma dan pasien dengan usia 40−50 tahun memiliki risiko 1,429 kali lebih besar mengalami karsinoma dibandingkan dengan pasien yang berusia <40 tahun. Kesimpulan pada penelitian ini yaitu Tidak ada hubungan antara usia dan jenis kelamin dengan kanker kolorektal di Rumah Sakit Islam Cempaka Putih Jakarta Tahun 2015−2020. Menurut pandangan Islam rata-rata usia manusia saat ini mengikuti zaman Nabi. Semakin bertambahnya usia maka manusia semakin rentan untuk terkena penyakit.
Hubungan Usia dan Kejadian Tumor Ovarium: Study Cross-Sectional Retrospektif dan Tinjauannya Menurut Pandangan Islam Ulisyafitri, Atikah; Ainur Rahmah, Nunung; Al Ichsan
Junior Medical Journal Vol. 2 No. 11 (2024): July 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v2i11.4294

Abstract

Latar Belakang: Tumor ovarium ganas merupakan penyebab paling umum kedua kematian akibat kanker ginekologi pada wanita di seluruh dunia. Risiko terkena tumor ovarium menjadi lebih tinggi seiring bertambahnya usia. Pola makan dan obesitas merupakan salah satu faktor risiko tumor ovarium yang dapat diubah, sedangkan usia merupakan faktor risiko yang tidak dapat diubah. Ajaran Islam sangat memperhatikan penerapan untuk seorang muslim menjaga pola makan yang baik. Penelitian ini merupakan penelitian deskriptif kuantitatif menggunakan form patologi anatomi Rumah Sakit Islam Jakarta Cempaka Putih tahun 2013—2022. Uji Chi square digunakan untuk analisis statistik. Kriteria signifikansinya adalah nilai p jika p≤0,05 berarti signifikan secara statistik. Hasil: Sebanyak 161 kasus tumor ovarium dengan komposisi pada usia <40 tahun dengan kasus tumor ovarium mayoritas jenis tumor non-epitelial jenis epithelial (45,7%), sedangkan usia ≥40 tahun kasus mayoritas jenis tumor epitelial (55,6%). Tidak ada hubungan antara usia dengan kejadian tumor ovarium (p=1,000). Kesimpulan: Tidak ada hubungan antara usia dengan kejadian tumor ovarium di Rumah Sakit Islam Jakarta Cempaka Putih tahun 2013—2023. Background: Malignant ovarian tumors are the second most common cause of gynecologic cancer death in women worldwide. The risk of developing ovarian tumors becomes higher with age. Diet and obesity are among the risk factors for ovarian tumors that can be changed, while age is a risk factor that cannot be changed. Islamic teachings are very concerned about the application of a Muslim to maintain a good diet. This study is a quantitative descriptive study using the anatomical pathology form of Jakarta Islamic Hospital Cempaka Putih in 2013-2022. The Pearson Chi-square test is used for statistical analysis. The significance criterion is a p-value if p≤0.05 means statistically significant. Results: A total of 161 cases of ovarian tumors with composition at the age of <40 years with ovarian tumor cases the majority of non-epithelial tumor types (45.7%), while the age of ≥40 years cases were the majority of epithelial tumor types (55.6%). There was no association between age and ovarian tumor incidence (p = 1,000). Conclusion: There is no relationship between age and ovarian tumor incidence at Jakarta Islamic Hospital Cempaka Putih in 2013-2023.
Hubungan Usia dan Kejadian Kanker Servik: Study Cross-Sectional Retrospektif dan Tinjauannya Menurut Pandangan Islam Alfia, Nurul; Ainur Rahmah, Nunung; Al Ichsan; Riani, Siti Nur
Junior Medical Journal Vol. 2 No. 11 (2024): July 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v2i11.4295

Abstract

Latar Belakang: Kanker serviks merupakan salah satu jenis kanker yang paling sering ditemui pada wanita dan merupakan penyebab kematian ke-4 pada wanita diseluruh dunia. Mayoritas Wanita yang didiagnosis terkena kanker serviks berusia antara 35-44 tahun. Kanker serviks disebabkan oleh berbagai faktor yaitu, usia, pasangan seksual dan penggunaan pil kontrasepsi oral. Dalam pandangan agama Islam, berganti-ganti pasangan seksual termasuk dalam perbuatan zina. Islam melarang seseorang untuk mendekati perbuatan zina karena hal ini dapat mendatangkan penyakit. Penelitian ini bertujuan mengetahui hubung antara usia dengan kejadian kanker serviks. Metode: Penelitian ini merupakan penelitian deskriptif kuantitatif menggunakan form patologi anatomi Rumah Sakit Islam Jakarta Cempaka Putih tahun 2013—2022. Uji Pearson Chi square digunakan untuk analisis statistik. Kriteria signifikansinya adalah nilai p jika p≤0,05 berarti signifikan secara statistik. Hasil: Sebanyak 48 kasus kanker serviks dengan komposisi mayoritas pada usia ≥40 tahun dengan kasus mayoritas adalah karsinoma sel skuamosa pada semua kategori usia, tetapi tidak bermakna secara statistik (p=0,656), yaitu <40 tahun sebesar 85,7% dan ≥40 tahun sebesar 70,7%. Kesimpulan: Tidak ada hubungan antara usia dan kejadian kanker serviks di Rumah Sakit Islam Jakarta Cempaka Putih tahun 2013—2023. Dalam pandangan Islam, berganti-ganti pasangan seksual dalam Islam merupakan perilaku yang dilarang. Background: Cervical cancer is one of the most common types of cancer in women and is the 4th cause of death in women throughout the world. The majority of women diagnosed with cervical cancer are aged between 35-44 years. Cervical cancer is caused by various factors, namely, age, sexual partners, and use of oral contraceptive pills. In the view of Islam, changing sexual partners is considered an act of adultery. Islam prohibits someone from approaching adultery because this can cause disease. This study aims to determine the relationship between age and the incidence of cervical cancer. Method: This research is a quantitative descriptive study using the anatomical pathology form at the Jakarta Cempaka Putih Islamic Hospital for 2013-2022. Pearson Chi square test was used for statistical analysis. The significance criterion is the p value if p≤0.05 means statistically significant. Results: A total of 48 cases of cervical cancer with the majority composition aged ≥40 years with the majority of cases being squamous cell carcinoma in all age categories, but this was not statistically significant (p=0.656), namely <40 years at 85.7% and ≥40 year by 70.7%. Conclusion: There is no relationship between age and the incidence of cervical cancer at the Jakarta Cempaka Putih Islamic Hospital in 2013-2023. In the Islamic view, changing sexual partners in Islam is prohibited behavior.
The Comparative Effects of Almond and Peanut on Adipose Tissue Profile and Blood Sugar Levels in Rats: A Review from an Islamic Perspective prastina sari, Putri Agnia; Mukhtar, Diniwati; Ainur Rahmah, Nunung; Astiwara, Endy Muhammad
Junior Medical Journal Vol. 3 No. 1 (2024): September 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v3i1.4690

Abstract

Type 2 diabetes and cardiovascular disease are associated with high blood sugar and poor lipid profiles. Almonds and peanuts have the potential to reduce these risks. This study aims to evaluate the effects of these two nuts on blood sugar levels and lipid profiles, within the Islamic perspective of halal and thayyib foods. An experimental study was conducted with 4 groups: standard feed (K1), high-fat feed (K2), almond feed (K3), and peanut feed (K4) over 4 weeks. Blood sugar measurements were taken using the GOD-PAP method, and histopathological analysis of adipose tissue was performed using Hematoxylin-Eosin (HE) staining. The results showed that both almonds and peanuts significantly (P<0.05) increased blood sugar levels. When compared to the high-fat feed group, the nut groups were more effective in inhibiting this increase. However, changes in blood sugar levels and lipid profiles were not statistically significant (P>0.05). From the study results, it can be concluded that there are differences in blood sugar and lipid profiles after the consumption of almonds and peanuts, although not significant. The consumption of halal and thayyib foods is recommended in Islam.
Optimizing Image Preprocessing for AI-Driven Cervical Cancer Diagnosis Chandra Prasetyo Utomo; Neng Suhaeni; Nashuha Insani; Elan Suherlan; Nunung Ainur Rahmah; Ahmad Rusdan Utomo; Indra Kusuma; Muhamad Fathurachman; Dewa Nyoman Murti Adyaksa
Advance Sustainable Science Engineering and Technology Vol. 7 No. 1 (2025): November-January
Publisher : Science and Technology Research Centre Universitas PGRI Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26877/asset.v7i1.1128

Abstract

Cervical cancer ranks among the top causes of cancer-related deaths in women globally. Early detection is vital for improving patient survival rates. The multiclass classification of cervical cell images presents challenges primarily due to the notable variations in cell sizes across different classes. Conventional AI methods for diagnosing cervical cancer often rely on image-resizing techniques that overlook crucial features like relative cell dimensions, which impairs the models' ability to distinguish between classes effectively. This paper presents a novel AI-driven approach that employs constant padding to maintain the natural size differences among cells. Our method utilizes deep learning for both feature extraction and multiclass classification. We assessed the method using the publicly accessible SIPaKMeD dataset. Experimental findings indicate that our approach surpasses traditional image-resizing methods, especially in classes that are more challenging to predict. This strategy highlights AI's potential to improve cervical cancer diagnosis, offering a more precise and dependable tool for early detection. A reliable and precise AI model for diagnosing cervical cancer is crucial for promoting widespread screening and ensuring timely and effective treatment, which can ultimately lower mortality rates. By aiding early and accurate diagnosis, this approach aligns with global health efforts to alleviate the burden of cancer and other diseases, especially in areas with limited access to advanced healthcare services facilities.
Dietary almonds and peanuts improve metabolic health and reduce oxidative stress in wistar rats Mukhtar, Diniwati; Rahmah, Nunung Ainur; Royhan, Aan; Yusnidar, Amirah
Science Midwifery Vol 13 No 1 (2025): April: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v13i1.1856

Abstract

Metabolic syndrome characterized by insulin resistance, atherogenic dyslipidemia, and hypertension, is a significant health concern often associated with obesity and Diabetes Mellitus. Regular consumption of nuts has been suggested to mitigate some of these conditions. This study investigates the effects of almond and peanut consumption on oxidative stress, plasma lipids, body weight, glucose, and blood pressure in Wistar rats. Wistar rats were divided into four dietary groups: standard diet (ST), high-fat diet (HF), high-fat diet with almonds (HFA), and high-fat diet with peanuts (HFP). The treatment lasted for 8 weeks, during which body weight was monitored weekly. Blood pressure measurements and retro-orbital blood samples were collected before and after the treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured using ELISA and TBARS methods. Blood lipid profiles and glucose levels were analyzed using enzymatic methods. Statistical tests used the oAnova followed by Posthoc LSD. The HF group exhibited significant increases in body weight, blood glucose, cholesterol, triglycerides, MDA, and blood pressure, with reduced SOD levels. Conversely, the HFA and HFP groups showed moderated increases in these parameters compared to the HF group. Both nut-supplemented groups had significantly lower MDA levels and higher SOD activity, indicating reduced oxidative stress and enhanced antioxidative defenses. Almonds and peanuts can reduce body fat, improve lipid profiles, and stabilize blood glucose levels, suggesting their potential role in promoting metabolic health and reducing cardiovascular risk. Further research should explore the long-term benefits and the specific bioactive compounds responsible for these effects.
Co-Authors Aan Royhan Abdussalam, Moch Adilah Ulinnuha Agung Novianto, Agung Agustin, Rika Alivia Ahmad Randy Ahmad Rusdan Utomo Ahmad Rusdan Utomo Al Ichsan Alfia, Nurul Ari Fahrial Syam Arifandi, Firman Arrahmani, Betharie Cendera Batubara, Lilian Bethy Suryawati Hernowo Chandra Prasetyo Utomo Citra Fitri Agustina Damayanti, Ndaru Andri Darmawan Kartono David Handojo Muljono Dewa Nyoman Murti Adyaksa Dewa Nyoman Murti Adyaksa Diah Rini Handjari Diah Rini Handjari Dianti, Sry Vhina Dinda, Salsabila Chyllia Diniwati Mukhtar Dr. dr. Hj. Diniwati Mukhtar, M. Kes., AIFM Elan Suherlan Elan Suherlan Endang Purwaningsih Endy Muhammad Astiwara Ening Krisnuhoni Fachry Abda El Rahman Firman Arifandi Firman Arifandi Fitria Nur Ain Fransiscus D. Suyatna Hanna Sari Widya Kusuma, Hanna Sari Widya Harliansyah Harliansyah Harliansyah Harliansyah Harliansyah INDRA KUSUMA Indra Kusuma Indranita, Lusy Irfan Syarif, Irfan Irwandi, Nurmayani Janah, Lulu Ah Joedo Prihartono Juniarti Juniarti . Juniarti Juniarti Kiagus Raihan, Kiagus Raihan Kuslestari Kuslestari Ma'sum, Ali Mellyna Mellyna Mpu Kanoko Muhamad Fathurachman Muhamad Fathurachman Muhammad Achmad Yani Muhammad Arsyad Muhammad Kholik Sanaba Mustofa, Muhammad Samsul Nafik, Said Nashuha Insani Nashuha Insani Nenden Lilis Aisyah Neng Suhaeni Neng Suhaeni Patrisha, Milaviza Pendrianto Pendrianto Pendrianto Pendrianto, Pendrianto prastina sari, Putri Agnia Pratiwi, Nike Primariadewi Rustamadji Putra Pangraizan, Farel Raka Auriza Fathaya Ratu Salia Siskowati Restu Syamsul Hadi Riani, Siti Nur Rostiana, Ajeng Nita Saffa Hasanah Samuel Johny Haryono Sri Utami Susi Endrini Susmiarsih, Tripanjiasih Syafruddin A. R. Lelosutan Taslim, Siti Ghadira Inayah Thamrin, Nabila Pyrenina Toto Heriyanto, S.Pd.I., M.Ag Triana Intan Sari Ulisyafitri, Atikah Vera Yuwono WAHYU WIDOWATI Wiji Purnamasari, Yulia Wirasmi Marwoto Wirasmi Marwoto Yulia Suciati Yuniar, Fanni Yusnidar, Amirah