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All Journal Paediatrica Indonesiana International Journal of Health and Pharmaceutical (IJHP)
Nadya Arafuri
Department Of Child Health, Gadjah Mada University Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java
Health Professions Medicine & Pharmacology Nursing Public Health

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Risk factors for the failure to achieve normal albumin serum levels after albumin transfusion in neonates Nadya Arafuri; Pudjo Hagung Widjajanto; Ekawaty L. Haksari
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.957 KB) | DOI: 10.14238/pi56.3.2016.129-33

Abstract

Background Albumin transfusion for the treatment of neonatal hypoalbuminemia may reduce morbidity. In conditions with disrupted endothelial integrity (e.g., sepsis and critical illness), the administered albumin may leak into the interstitial space, hence, serum albumin levels may fall below expected levels after transfusion. To date, few studies have been done to evaluate the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Objectives To determine the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Methods We performed a case-control study in the Neonatal Ward of Dr. Sardjito Hospital from 2007 to 2012. Normal albumin level was defined as above 3 g/dL. The case group included neonates with post-transfusion albumin levels <3 g/dL and the control group included those with post-transfusion albumin ≥3 g/dL. Subjects received intravenous transfusions of 25% or 20% albumin according to the clinical standard of the Neonatal Ward of Dr. Sardjito Hospital. Neonates with very low birth weight, severe birth trauma, burn injuries, severe bleeding, or incomplete medical records were excluded. The data were analyzed with logistic regression test.Results From January 2007 to December 2012, 124 neonates were enrolled in the study. Multivariate analysis showed that low albumin levels before transfusion (OR 12.27; 95%CI 2.17 to 69.30), presence of critical illness (OR 4.01; 95%CI 1.49 to 10.79), diagnosis of sepsis (OR 3.56; 95%CI 1.36 to 9.32), and the >24-hour interval between albumin examination and transfusion (OR 0.06; 95%CI 0.01 to 0.37) were significant risk factors affecting the failure to achieve normal albumin levels.Conclusions Failure to achieve normal albumin levels after transfusion in neonates was significantly associated with low albumin level prior to transfusion, critical illness, sepsis, and >24-hour interval between transfusion and post-transfusion albumin examination.[Paediatr Indones. 2016;56:129-33.].
Methylprednisolone as an alternative therapy for Kawasaki disease: case series Yudha Fadhol Arafah; Sasmito Nugroho; Noormanto Noormanto; Nadya Arafuri; Indah Kartika Murni
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.283-6

Abstract

Kawasaki disease (KD), or mucocutaneous syndrome, is an acute, systemic vasculitis of small- and medium-sized arteries that predominantly affects patients younger than five years.1 KD is the leading cause of childhood acquired heart disease in the developed world.2 The incidence in those aged under 5 years varies widely throughout the world, accounting for 8.4 per 100,000 in the UK, 17.5 to 20.8 per 100,000 in the USA, and 239.6 per 100,000 in Japan.2 The diagnosis of classic KD is based on the simultaneous presence of high fever for 5 or more days with at least four of five other symptoms (bilateral conjunctival hyperemia, ulcerations of the lips and inflammation of the oral cavity, polymorphous rash, edema and desquamation of the extremities, and cervical lymphadenopathy), or fever associated with less than 4 of the diagnostic criteria and echocardiographic abnormalities of the coronary arteries.3
Tricuspid regurgitation pressure gradient to diagnose pulmonary hypertension: a diagnostic accuracy study Indah Kartika Murni; Emmanuel Mareffcita Siagian; Nurnaningsih Nurnaningsih; Nadya Arafuri
Paediatrica Indonesiana Vol 62 No 6 (2022): November 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.6.2022.367-72

Abstract

Background Pulmonary hypertension carries significant morbidity and mortality in children. Early diagnosis and management may improve outcomes in children with pulmonary hypertension. Heart catheterization, a gold standard for diagnosing pulmonary hypertension, is an invasive procedure and not widely available. Echocardiography can be used as an alternative diagnostic tool for pulmonary hypertension. Objective To determine the diagnostic value of tricuspid regurgitation pressure gradient on echocardiography compared to heart catheterization to diagnose pulmonary hypertension in children. Methods This diagnostic test study was done with medical record data of children with acyanotic congenital heart disease who underwent cardiac catheterization and echocardiography procedures from January 2018 to December 2020 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Data were analyzed to obtain sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios. Results A total of 98 children with acyanotic congenital heart disease were included. The sensitivity and specificity of the tricuspid regurgitation pressure gradient to determine pulmonary artery pressure compared to heart catheterization were 64.4% and 54.5%, respectively. The positive likelihood ratio was 1.42. The pre-test and post-test probability of this study were 88.7% and 91.7%, respectively. Conclusion Tricuspid regurgitation pressure gradient measured using echocardiography has poor sensitivity and specificity to diagnose pulmonary hypertension.
Undetected Takayasu arteritis presenting as severe hypertension in children: a report of two cases Wirawan, Muhammad Taufik; Murni, Indah Kartika; Patria, Suryono Yudha; Arafuri, Nadya; Noormanto, Noormanto; Nugroho, Sasmito
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/pi64.5.2024.454-8

Abstract

Takayasu arteritis (TA) is a rare chronic granulomatous vasculitis mainly affecting the aorta and its main branches. Clinical presentations of TA are non-specific, especially in the initial phase, which likely contributes to delayed diagnosis besides the rarity of the disorder. Childhood-onset of TA is associated with significant morbidity and mortality. This case report aimed to present two rare cases of acute symptomatic severe hypertension in children due to TA.
Early Detection of Critical Congenital Heart Disease Through Pulse Oximetry Screening In Resource-Limited Settings Edi Susyanto, M Bambang; Arafuri, Nadya; Ayu Shinta Lesmanawati, Dyah
International Journal of Health and Pharmaceutical (IJHP) Vol. 5 No. 4 (2025): November 2025
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v5i4.464

Abstract

Critical congenital heart disease (CCHD) is a major cause of neonatal mortality. Early detection using pulse oximetry (SpO₂) within 24–48 hours of life improves survival by identifying hypoxemia before clinical deterioration. A feasibility study in Yogyakarta, Indonesia, screened 1,452 newborns and detected eight CCHD cases (~6 per 1,000 live births), confirming its value in limited-resource settings. A full-term female neonate delivered by elective cesarean section had an initial SpO₂ of 96% but developed cyanosis within 24 hours, with saturation dropping to 90%. Abnormal SpO₂ results led to referral, and echocardiography confirmed critical pulmonary stenosis with PDA and PFO. Balloon valvuloplasty was performed successfully, normalizing oxygen levels. Pulse oximetry screening shows moderate sensitivity (76–83%) and high specificity (~99.9%) for detecting CCHD. Despite logistical and training challenges, it remains feasible and cost-effective in low- and middle-income settings. Integrating SpO₂ screening into routine newborn assessment, supported by national policy and staff training, can enhance early diagnosis and reduce neonatal deaths related to undetected CCHD.
Co-Authors Ayu Shinta Lesmanawati, Dyah Edi Susyanto, M Bambang Ekawaty L. Haksari Emmanuel Mareffcita Siagian Indah Kartika Murni Noormanto Noormanto Noormanto Noormanto, Noormanto Nurnaningsih Nurnaningsih Pudjo Hagung Widjajanto Sasmito Nugroho Sasmito Nugroho, Sasmito Suryono Yudha Patria Wirawan, Muhammad Taufik Yudha Fadhol Arafah