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Ascorbic acid and calcitriol as alternative preventive strategies for myocardial damage in type 2 diabetes mellitus: an in vivo study using diabetic and atherosclerotic rat models Saputra, Jefri Dwi; Heriansyah, Teuku; Sofyan, Hamny; Dimiati, Herlina; Mudatsir, Mudatsir
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.14

BACKGROUND: Type 2 diabetes mellitus can increase the production of reactive oxygen species (ROS) and genetic transcription factors, such as nuclear factor kappa beta (NF-κB). These phenomena may enhance the progression of atherosclerosis. Additionally, NF-κB can induce apoptosis of pancreatic beta cells and accelerate disease progression. OBJECTIVE: To investigate the role of calcitriol and ascorbic acid on NF-κβ expression in vivo in aortic and myocardial tissues of Wistar rats. METHODS: This randomized experimental study involved 24 male Wistar rats of the Rattus norvegicus strain, divided into four groups: NC (negative control), PC (positive control), AG (ascorbic acid group), and CG (calcitriol group). The study spanned 90 days, including a 30-day intervention period. Aortic and myocardial samples were processed into histological preparations and stained using immunohistochemical techniques. NF-κB expression was assessed using an intensity scoring method. RESULTS: The CG group demonstrated the lowest NF-κB immunoexpression in myocardial tissue (0.27 ± 0.08), followed by the AG (0.37 ± 0.05), NC (0.68 ± 0.08), and PC (1.13 ± 0.34) groups, with statistically significant 3sbetween the groups (p < 0.05). In aortic tissue, the CG group also exhibited the lowest NF-κB expression (0.30 ± 0.18), followed by the AG (0.50 ± 0.09), NC (0.97 ± 0.05), and PC (1.23 ± 0.38) groups, with statistically significant differences between the groups (p < 0.05). Similar trends were observed in the immunohistochemical staining of the NF-κB antigen in myocardial and aortic tissue samples. Calcitriol administration was more effective than ascorbic acid in reducing NF-κB expression in both myocardial (p < 0.05) and aortic tissues (p < 0.05). CONCLUSION: Both ascorbic acid and calcitriol reduce NF-κB expression in the aorta and myocardium, with calcitriol showing greater effectiveness than ascorbic acid.

Delayed growth rate based on bone age in children with idiopathic nephrotic syndrome at a general hospital in Banda Aceh, Indonesia Haris, Syafruddin; Dimiati, Herlina; Hasballah, Kartini; Pardede, Sudung O.
Trends in Infection and Global Health Vol 4, No 2 (2024): December 2024
Publisher : School of Medicine, Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/tigh.v4i2.42807

Paediatric nephrotic syndrome is the most common kidney disease in children, with corticosteroids as the primary treatment. While effective, corticosteroid therapy may decrease bone mineral density. Concurrent vitamin D and calcium supplementation can mitigate bone loss but does not entirely prevent it and may introduce side effects. This study assessed growth delay based on bone age in children with idiopathic nephrotic syndrome receiving long-term steroid therapy at Dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. This observational analytic study used a retrospective cohort design, with data collected from the hospitals Paediatric Polyclinic over one month. Paediatric patients diagnosed with INS who met inclusion criteria were included, and data were extracted from electronic medical records. Statistical analysis was conducted using the Mann-Whitney test. Among the 50 children included, 32 (64%) were male and 18 (36%) were female. The median corticosteroid therapy duration was 24 months (range: 284 months). No significant association was found between corticosteroid therapy duration and growth delay, as measured by BA (p=0.363). INS was more common in boys, particularly in the six to 10-year age group. Most participants had normal nutritional status and stature, with steroid-resistant nephrotic syndrome being the most prevalent type. The findings suggest no relationship between corticosteroid therapy duration and growth delay based on bone age, providing reassurance about the treatments impact on growth outcomes.

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

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.

Gambaran Anemia Defisiensi Besi Pada Kejang Demam Di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh Anidar, Anidar; Haris, Syafruddin; Dimiati, Herlina
Journal of Medical Science Vol 1 No 2 (2020): Journal of Medical Science
Publisher : LITBANG RSUDZA

Kejang demam adalah bangkitan kejang yang terjadi pada kenaikan suhu tubuh di atas 380C yang disebabkan oleh suatu proses ekstrakranium. Kejang demam merupakan salah satu kejadian bangkitan kejang yang sering dijumpai pada anak balita dan merupakan peristiwa yang mengkhawatirkan bagi orang tua, dan tingginya angka kejadian dimasyarakat. Salah satu faktor yang dapat menyebabkan kejang demam adalah anemia defisiensi besi karena besi memiliki peran penting dalam fungsi penghantaran serabut saraf. Penelitian ini bertujuan untuk mengetahui hubungan anemia defisiensi besi dengan kejang demam. Penelitian ini dilakukan secara potong lintang. Populasi penelitian adalah semua pasien anak umur 1–5 tahun yang didiagnosis kejang demam yang dirawat di RSUD dr. Zainoel Abidin tahun 2019 yang tercatat pada rekam medis. Jumlah sampel dalam penelitian ini ada 40 orang terdiri dari 23 subyek dengan kejang demam sederhana dan 17 subyek dengan kejang demam kompleks. Variabel yang diteliti adalah usia, jenis kelamin, suhu tubuh, faktor genetik dan anemia defisiensi besi. Hasil penelitian didapatkan kejang demam sederhana 23(57.5%) dan kejang demam kompleks 17(42.5%). Jenis kelamin laki-laki didapatkan paling banyak yaitu 25(62.5%) ,suhu tubuh ≥390C 21(52.5%) subyek, faktor genetik yang mempengaruhi terjadinya kejang demam yaitu 17(42.5%). Anemia defisiensi besi didapatkan pada sebagian besar kejang demam yaitu 30(75%). Pada kejang demam kompleks didapatkan persentase anemia defisiensi besi lebih tinggi yaitu 15/17(88.2%). Fokus infeksi penyebab kejang demam adalah sebagian besar infeksi saluran pernafasan atas yaitu 37/40(92.5%). Terdapat gambaran anemia defisiensi besi pada sebagian besar pada subyek kejang demam pada anak balita di RSUD dr. Zainoel Abidin Banda Aceh pada tahun 2019.

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

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.

Role of vitamin C in reducing cardiovascular oxidative stress: An in vivo study using sepsis rat models Raihani, Rifa; Sovira, Nora; Andid, Rusdi; Yusuf, Sulaiman; Safri, Mulya; Dimiati, Herlina; Fajri, Fauzan; Sentosa, Sukmawan F.; Hasan, Denny I.
Narra X Vol. 3 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i1.179

The aim of this study was to evaluate the effect of vitamin C on reducing cardiovascular oxidative stress in sepsis rat models. An experimental animal study with a post-test control group design was conducted at the Laboratory of Animal Research, Faculty of Veterinary Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia, from September to December 2023, using 18 male Wistar strain rats (Rattus norvegicus). Rats were divided into three groups: control (Group K), lipopolysaccharide 5 mg/kg body weight (BW) (Group L), and lipopolysaccharide 5 mg/kg BW with oral vitamin C (18 mg/day) (Group LC). Rats were euthanized after two weeks with ketamine (15–20 mg/kg intraperitoneally) and cervical dislocation. Blood samples (3 mL) and heart organs were collected. Nitric oxide (NO) levels were measured through enzyme-linked immunosorbent assay (ELISA), and cardiac muscle cells were observed using an Olympus CX21 microscope. The LC group exhibited a significantly lower mean endothelial dysfunction score than the L group (p<0.001), although no significant difference in NO levels was observed between L and LC groups (p=0.262), indicating that vitamin C did not significantly affect NO levels. This suggests that the improvement in endothelial function observed in the LC group may be mediated through mechanisms other than NO modulation. The MANOVA test revealed that vitamin C administration accounted for 84.8% of changes in endothelial function in the sepsis rat model (p<0.001). In conclusion, vitamin C confers a protective effect against severe cardiac and endothelial damage, as evidenced by the amelioration of necrosis, inflammatory cell infiltration, congestion, and vacuolization caused by lipopolysaccharide.

Ascorbic acid and calcitriol as alternative preventive strategies for myocardial damage in type 2 diabetes mellitus: an in vivo study using diabetic and atherosclerotic rat models Saputra, Jefri Dwi; Heriansyah, Teuku; Sofyan, Hamny; Dimiati, Herlina; Mudatsir, Mudatsir
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.14

BACKGROUND: Type 2 diabetes mellitus can increase the production of reactive oxygen species (ROS) and genetic transcription factors, such as nuclear factor kappa beta (NF-κB). These phenomena may enhance the progression of atherosclerosis. Additionally, NF-κB can induce apoptosis of pancreatic beta cells and accelerate disease progression. OBJECTIVE: To investigate the role of calcitriol and ascorbic acid on NF-κβ expression in vivo in aortic and myocardial tissues of Wistar rats. METHODS: This randomized experimental study involved 24 male Wistar rats of the Rattus norvegicus strain, divided into four groups: NC (negative control), PC (positive control), AG (ascorbic acid group), and CG (calcitriol group). The study spanned 90 days, including a 30-day intervention period. Aortic and myocardial samples were processed into histological preparations and stained using immunohistochemical techniques. NF-κB expression was assessed using an intensity scoring method. RESULTS: The CG group demonstrated the lowest NF-κB immunoexpression in myocardial tissue (0.27 ± 0.08), followed by the AG (0.37 ± 0.05), NC (0.68 ± 0.08), and PC (1.13 ± 0.34) groups, with statistically significant 3sbetween the groups (p < 0.05). In aortic tissue, the CG group also exhibited the lowest NF-κB expression (0.30 ± 0.18), followed by the AG (0.50 ± 0.09), NC (0.97 ± 0.05), and PC (1.23 ± 0.38) groups, with statistically significant differences between the groups (p < 0.05). Similar trends were observed in the immunohistochemical staining of the NF-κB antigen in myocardial and aortic tissue samples. Calcitriol administration was more effective than ascorbic acid in reducing NF-κB expression in both myocardial (p < 0.05) and aortic tissues (p < 0.05). CONCLUSION: Both ascorbic acid and calcitriol reduce NF-κB expression in the aorta and myocardium, with calcitriol showing greater effectiveness than ascorbic acid.

Nilai Rasio Neutrofil Limfosit dan Red Cell Distribution Width pada Neonatus Sepsis Machya, Farish; Darussalam, Dora; Herdata, Heru Noviat; Haris, Syafruddin; Edward, Eka Destianti; Dimiati, Herlina
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.146-51

Latar belakang. Insiden sepsis pada negara berkembang sampai saat ini masih tinggi. Banyaknya faktor risiko yang memengaruhi, menjadikan sepsis sebagai penyumbang tingginya angka kematian pada bayi. Diagnosis yang seringkali terlambat ditegakkan karena pemeriksaan kultur darah sebagai Gold Standard baru bisa didapatkan hasilnya setelah beberapa hari. Deteksi dini sepsis neonatorum dapat diltegakkan salah satunya dengan pemeriksaan rasio neutrofil limfosit dan red cell distribution width.Tujuan. Menilai rasio neutrofil limfosit, red cell distribution width, dan faktor risiko pada neonatus dengan diagnosis sepsis di neonatal intensive care unit - NICU Rumah Sakit Zainoel Abidin Banda Aceh dengan luaran kematian.Metode. Penelitian desain kohort retrospektif dengan data rekam medis neonatus di NICU Rumah Sakit Umum Daerah Dr. Zainoel Abidin, Banda Aceh, dari Februari hingga Oktober 2023. Sebanyak 43 neonatus dengan diagnosis sepsis yang memenuhi kriteria inklusi dianalisis. Data yang dikumpulkan meliputi karakteristik demografis, hasil laboratorium, serta luaran klinis. Analisis dilakukan menggunakan uji Chi-square dan analisis multivariat dengan SPSS versi 20.0.Hasil. Diperoleh 88,3% neonatus menunjukkan peningkatan NLR, dan 86,05% mengalami peningkatan RDW. Terdapat hubungan signifikan antara metode persalinan sectio caesaria (p<0,03) dengan peningkatan risiko mortalitas. Neonatus dengan berat badan ?2500 gram dan usia gestasi preterm lebih sering mengalami peningkatan NLR dan RDW. Kesimpulan. Peningkatan nilai rasio neutrofil limfosit lebih banyak terjadi pada neonatus sepsis dibandingkan nilai red cell distribution width.

Evaluasi Pengetahuan dan Tindakan Ibu terhadap Diare pada Balita Puskesmas Banda Raya Salsabila, Nisa; Dimiati, Herlina; Maharani, Cut Rika; Saputra, Irwan; Aini, Zahratul
Sari Pediatri Vol 25, No 5 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.5.2024.310-15

Latar belakang. Diare masih menyebabkan tingginya angka kesakitan dan kematian pada balita. Diare dapat disebabkan oleh beberapa faktor salah satunya adalah pengetahuan dan perilaku ibu Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dan perilaku ibu dengan penanganan diare pada balita di Puskesmas Banda Raya Kota Banda Aceh.Metode. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross-sectional. Sampel pada penelitian ini adalah ibu dengan balita yaang berdomisili di Banda Raya berjumlah 96 orang. Pengambilan sampel dengan menggunakan simple random sampling. Penelitian menggunakan instrumen kuesioner yang telah dilakukan uji validitas dan reabilitas. Pengolahan data menggunakan analisis univariat dan bivariat dengan uji Chi-squre. Hasil. Mayoritas responden dengan usia 21-35 tahun (66,7%), pendidikan SMA (55,2%), mayoritas ibu di Kecamatan Banda Raya bekerja sebagai ibu rumah tangga (79,2%), dengan umur anak 1 hingga 2 tahun (55,2%). Analisis data menggunakan uji Chi-square menunjukkan adanya hubungan antara pengetahuan ibu dengan penanganan diare pada balita (p=<0,05). Serta terdapat hubungan antara perilaku ibu dengan penanganan diare pada balita (p=<0,05). Kesimpulan. Dapat disimpulkan bahwa pengetahuan dan perilaku ibu berhubungan dengan penanganan diare pada balita di Puskesmas Banda Raya Kota Banda Aceh.

Stres Ibu Menyusui dan Keberhasilan ASI Eksklusif di Banda Aceh: Studi Cross-Sectional Aminah, Siti; Dimiati, Herlina; Utami, Niken Asri
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.164-70

Latar belakang. Pemberian ASI eksklusif mulai sejak bayi berusia 0-6 bulan pertama kehidupan, memberikan dampak positif bagi bayi dan juga ibu. Beberapa faktor seperti nutrisi ibu, frekuensi menyusui, pengetahuan ibu, dukungan keluarga, pekerjaan, dan stres yang dialami ibu dapat memengaruhi keberhasilan pemberian ASI eksklusif.Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan tingkat stres pada ibu menyusui dengan keberhasilan pemberian ASI eksklusif di Puskesmas Banda Raya Banda Aceh.Metode. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Sampel pada penelitian ini adalah ibu yang memiliki bayi usia 6-12 bulan berjumlah 68 orang. Pengambilan sampel dengan menggunakan total sampling. Data tingkat stres ibu diperoleh dari hasil pengisian kuesioner Perceived Stress Scale (PSS-10).Hasil. Responden dengan tingkat stres ringan memberikan ASI eksklusif (84,9%). Responden dengan tingkat stres sedang mayoritas tidak memberikan ASI eksklusif (60,7%), dan responden dengan tingkat stres berat tidak memberikan ASI eksklusif (100%). Analisis data menggunakan uji korelasi Spearman Rank dengan p value sebesar 0,000 (p<0,05) dan nilai koefisien korelasi – 0,503 (hubungan sedang).Kesimpulan. Terdapat hubungan tingkat stres pada ibu menyusui terhadap keberhasilan pemberian ASI eksklusif, yaitu semakin ringan tingkat stres akan semakin tinggi keberhasilan pemberian ASI eksklusif.

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