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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Majalah Kedokteran Nusantara The Journal Of Medical School Sumatera Medical Journal Cermin Dunia Kedokteran Cermin Dunia Kedokteran

Munar Lubis

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Sumatera Utara

Author-ID : 565435

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Metabolisme Protein Pada Anak Sakit Kritis Syarif, Erlita Wienanda; Lubis, Munar; Yanni, Gema Nazri
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

Show Abstract | Download Original | Original Source | Check in Google Scholar

Hospital malnutrition is known as a risk factor for mortality and morbidity in children, adolescents, and adults. Critically ill child more prone to suffer from malnutrition during treatment. This is because protein metabolism in critically ill children in different to the healthy children. Protein metabolism in critically ill children influenced by catabolic hormones triggered by stressful state resulting in increased protein breakdown. Therefore the protein requirement for critically ill children is different from healthy children. There are several methods of evaluation that can be used to evaluate the protein metabolism status, among others anthropometry, nitrogen balance, and tracer isotope. The importance of maintaining the balance of formation and protein breakdown must be one of the targets of nutritional therapy in the pediatric intensive care unit, thus improving treatment outcomes.Keyword : critically ill, protein metabolism, children

The effects of colloids or crystalloids on acute respiratory distress syndrome in swine (Sus scrofa) models with severe sepsis: analysis on extravascular lung water, IL-8, and VCAM-1 Dewi, Rismala; Supriyatno, Bambang; Madjid, Amir S.; Gunanti, Gunanti; Lubis, Munar
Medical Journal of Indonesia Vol 25, No 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Background: Acute respiratory distress syndrome (ARDS) is a fatal complication of severe sepsis. Due to its higher molecular weight, the use of colloids in fluid resuscitation may be associated with fewer cases of ARDS compared to crystalloids. Extravascular lung water (EVLW) elevation and levels of interleukin-8 (IL-8) and vascular cell adhesion molecule-1 (VCAM-1) have been studied as indicators playing a role in the pathogenesis of ARDS. The aim of the study was to determine the effects of colloid or crystalloid on the incidence of ARDS, elevation of EVLW, and levels of IL-8 and VCAM-1, in swine models with severe sepsis.Methods: This was a randomized trial conducted at the Laboratory of Experimental Surgery, School of Veterinary Medicine, IPB, using 22 healthy swine models with a body weight of 8 to 12 kg. Subjects were randomly allocated to receive either colloid or crystalloid fluid resuscitation. After administration of endotoxin, clinical signs of ARDS, EVLW, IL-8, and VCAM-1 were monitored during sepsis, severe sepsis, and one- and three hours after fluid resuscitation. Analysis of data using the Wilcoxon test , Kolmogorov-Smirnov test, Mann-Whitney test, unpaired t test.Results: Mild ARDS was more prevalent in the colloid group, while moderate ARDS was more frequent in the crystalloid group. EVLW elevation was lower in the colloid compared to the crystalloid group. There was no significant difference in IL-8 and VCAM-1 levels between the two groups.Conclusion: The use of colloids in fluid resuscitation does not decrease the probability of ARDS events compared to crystalloids. Compared to crystalloids, colloids are associated with a lower increase in EVLWI, but not with IL-8 or VCAM-1 levels.

Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis Saragih, Rina A.C.; Pudjiadi, Antonius H.; Tambunan, Taralan; Satari, Hindra I.; Aulia, Diana; Bardosono, Saptawati; Munasir, Zakiudin; Lubis, Munar
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Background: Increased capillary permeability in sepsis is associated with several complications and worse outcomes. Glycocalyx degradation, marked by increased serum syndecan-1 levels, alters vascular permeability, which can manifest as albuminuria in the glomerulus. Therefore, elevated urinary albumin to creatinine ratio (ACR) potentially provides an index of systemic glycocalyx degradation. The aim of this study was to analyze the correlation between urinary ACR and serum syndecan-1 levels.Methods: A longitudinal prospective study with repeated cross-sectional design was conducted on children with sepsis in pediatric intensive care unit, we evaluated serum syndecan-1 levels and urinary ACR on days 1, 2, 3, and 7. A descriptive study on healthy children was also conducted to determine the reference value of syndecan-1 in children.Results: 49 subjects with sepsis were recruited. Based on the data of the healthy children group (n=30), syndecan-1 level of >90th percentile (41.42 ng/mL) was defined as systemic glycocalyx degradation. The correlation coefficients (r) between urinary ACR and syndecan-1 levels were 0.32 (p<0.001) from all examination days (162 specimens), 0.298 (p=0.038) on day 1, and 0.469 (p=0.002) on day 3. The area under the curve of urinary ACR and systemic glycocalyx degradation was 65.7% (95% CI 54.5%–77%; p=0.012). Urinary ACR ≥157.5 mg/g was determined as the cut-off point for glycocalyx degradation, with a sensitivity of 77.4% and a specificity of 48%.Conclusion: Urinary ACR showed a weak correlation with systemic glycocalyx degradation, indicating that the pathophysiology of elevated urinary ACR in sepsis is not merely related to glycocalyx degradation.

Correlation between Breastfeeding Duration and Motor Development in Children Siregar, Gurnal Rai Gandra; Lubis, Munar; Fujiati, Isti Ilmiati
Sumatera Medical Journal Vol. 1 No. 1 (2018): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

World Health Organization (WHO) recommends to continue breastfeeding until two years of age. There are few studies assessing the correlation between breastfeeding duration and motor development. A cross-sectional study was conducted in April 2016 in Muara Batang Gadis District. The sample were children 3-6 years of age. Breastfeeding duration was obtained by interview, and motor development was assessed using Denver Developmental Screening Test II. Chi-square test was used to evaluate the correlation between breastfeeding duration and motor development, with P-value <0.05 and 95% Confidence Interval (CI). Among 204 children, 5.4% had the fine motor delay, and 1% had the gross motor delay. Children with breastfeeding duration for at least for two years had better fine motor development compared to breastfeeding duration for less than two years (P<0.001, PR=1.139, 95% CI=1.055-1.231) and there is no difference in gross motor development (P=0.193, PR=1.023, 95% CI=0.991-1.055). There is a correlation between breastfeeding duration and fine motor development.

Effectiveness of Vitamin A in Albendazole Against Reinfection of Ascaris Lumbricoides Wijaya, Richo; Lubis, Munar; Nafianti, Selfi; Lubis, Inke Nadia
Sumatera Medical Journal Vol. 2 No. 1 (2019): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

WHO recommends the supplementation of 200,000 IU vitamin A into 400 mg albendazole to cut down its reinfection. A Randomized Controlled Trial was conducted in SD N 384 Sikapas, North Sumatera from April - June 2016. Inclusion criteria were children with ascariasis. Sample divided into intervention and control group. Kato-Katz was used to identify egg worms and faecal egg count intensity (FECs). P value < 0.05 was consider significant. After three months follow up, there were 51 and 56 samples in intervention and control group with average age 9.6 years (SD 1.99) and 9.7 years (SD 2.20). Prevalence of ascariasis was 75.5%. There was no significant difference in Ascaris lumbricoides reinfection but instead of in FECs intensity. The NNT was 22.31. The addition of vitamin A in albendazole was not suggested according to this study.

Luka Tembak Tembus Kepala pada Remaja Laki-laki Lestari, Indah Nur; Yoel, Chairul; Lubis, Munar; Saragih, Rina Amalia; Yanni, Gema Nazri
Cermin Dunia Kedokteran Vol 47, No 2 (2020): Penyakit Infeksi
Publisher : PT. Kalbe Farma Tbk.

Luka tembak tembus kepala adalah luka otak disebabkan trauma fisik berupa penetrasi massa tajam yang menembus tengkorak dan jaringan otak. Luka tembak tembus memiliki luka masuk dan luka keluar. Dilaporkan kasus luka tembak tembus kepala.Â Penetrating gunshot wound was caused by projectiles. Peneterating gunshot have an entrance wounds and exit wounds. This is a case report of cranial penetrating gunshot wounds.

Hubungan Disomnia dan Tekanan Darah pada Remaja Sembiring, Krisnarta; Ramayani, Oke Rina; Lubis, Munar; Siregar, Rosmayanti; Siregar, Beatrix
Cermin Dunia Kedokteran Vol 44, No 12 (2017): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Disomnia merupakan gangguan tidur yang sering dijumpai pada remaja, disebabkan oleh faktor internal dan eksternal, serta faktor medis dan nonmedis. Disomnia dapat berdampak buruk pada kesehatan remaja. Disomnia dapat didiagnosis secara objektif maupun subjektif. Salah satu komplikasi disomnia adalah peningkatan tekanan darah. Peningkatan tekanan darah pada remaja akan menyebabkan hipertensi saat dewasa serta berbagai masalah kardiovaskuler lainnya.Dyssomnia is a common sleep disturbance in adolescents; it is caused by internal and external factors along with medical and nonmedical factors. Dyssomnia may have negative impact on adolescentâ€™s health. One of itâ€™s complications is increased blood pressure. Increased blood pressure in adolescent will lead to hypertension in adult together with other cardiovascular problems.

Mean Platelet Volume sebagai Faktor Prognostik Sepsis pada Anak Puspitasari, Ria; C. Saragih, Rina; Lubis, Munar
Cermin Dunia Kedokteran Vol 46, No 5 (2019): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Abstrak. Sepsis adalah kondisi klinis disfungsi organ yang berpotensi mengancam nyawa. Skor Pediatric Logistic Organ Dysfunction 2 (PELOD-2) sering digunakan untuk memprediksi kematian pasien sepsis. Sebagian besar penelitian menemukan peningkatan nilai MPV pada pasien sepsis, baik neonatus maupun dewasa. Nilai MPV dapat dijadikan salah satu parameter untuk menilai prognosis pasien sepsis.Abstract. Sepsis is a clinical condition of organ dysfunction that potentially life-threatening. Pediatric Logistic Organ Dysfunction 2 (PELOD-2) is used to predict mortality in patients with sepsis. Many studies found increased MPV value in sepsis (neonates and adults). MPV can become a prognostic parameter in sepsis.Â

Hubungan ASI Eksklusif dan Enuresis Primer pada Anak Hasibuan, Syahreza; Ramayani, Oke Rina; Lubis, Munar; Siregar, Rosmayanti; Siregar, Beatrix
Cermin Dunia Kedokteran Vol 47, No 8 (2020): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Enuresis adalah keluarnya air kemih yang tidak disadari dan berulang pada anak berusia 5 tahun atau lebih yang diharapkan sudah dapat mengendalikan proses berkemihnya. Istilah enuresis primer dipakai untuk anak yang belum pernah berhenti mengompol sejak bayi. Salah satu penyebab enuresis primer adalah keterlambatan maturasi sistem saraf pusat. ASI merupakan nutrisi yang ideal untuk bagi perkembangan sistem saraf. Pemberian ASI eksklusif menunjukkan manfaat besar dalam perkembangan visual, kognitif, dan neurologis anak sehingga berperan dalam mencegah enuresis pada anak. Hal ini didukung oleh beberapa penelitian yang melaporkan hubungan antara pemberian ASI eksklusif dengan enuresis pada anak.Enuresis is repeated involuntary discharge of urine in children 5 years of age or older expected to be able to control the micturition. Primary enuresis is when children 5 years of age or older still bed-wetting. One of the causes of primary enuresis is delayed maturation of the central nervous system. Exclusive breastfeeding has beneficial effect in visual, cognitive, and neurological development in children; it may have a role in preventing enuresis. Several studies report the correlation between exclusive breastfeeding and enuresis prevention in children.Â

Vasoactive-inotropic Score for Early Detection and Mortality Prediction of Sepsis in Children Aileen Clarissa Dauhan; Aridamuriany Dwiputri Lubis; Munar Lubis
The Indonesian Biomedical Journal Vol 13, No 1 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i1.1323

BACKGROUND: Early detection and treatment of sepsis can prevent septic shock and reduce mortality rate. Troponin can become a prognostic factor in sepsis. However, not all health facilities are equipped to assess troponin levels. Vasoactive-inotropic score (VIS) is a simpler and more accessible method to describe hemodynamic status. The aim of this study was to assess the suitability of VIS score as early prognosis and mortality predictor of sepsisMETHODS: A retrospective study was conducted to determine the correlation between VIS and troponin levels for sepsis cases in Pediatric Intensive Care Unity (PICU) Haji Adam Malik Hospital, Medan from January 2018 to December 2019. VIS score at 48 hours, maximum VIS score, pediatric logistic organ dysfunction-2 (PELOD-2) score, cardiac troponin levels at 48 hours were taken from medical records.RESULTS: There were 54 samples analyzed. VIS scores were positively correlated (p<0.001) to troponin T and troponin I levels at 48 hours (r=0.670 and r=0.606, respectively). VIS at 48 hours and maximum VIS were related to mortality (p=0.001 and p<0.001, respectively). VIS score at 48 hours could be used as a predictive factor for mortality (area under the curve (AUC): 79.7%, p<0.001) with a cut-off point at 11 (74.4% sensitivity and 80% specificity). High VIS at 48 hours indicated poor outcomes of sepsis in children with odd ratio (OR) value: 1.99 (95% confidence interval (CI): 1.25-3.19).CONCLUSION: Vasoactive-inotropic score was suitable as an alternative to cardiac troponin T and troponin I levels at 48 hours to early detect myocardial dysfunctions and mortality in children.KEYWORDS: troponin, vasoactive-inotropic score, sepsis, children, mortality

Co-Authors Adillida Adillida Aileen Clarissa Dauhan Amir S. Madjid, Amir S. Antonius H. Pudjiadi Aridamuriany D Lubis Aridamuriany D Lubis Aridamuriany D. Lubis Aridamuriany Dwiputri Lubis Aridamuriany Dwiputri Lubis Armila Armila Arto, Karina Sugih Austin Simon Tjowanta Ayodhia P. Pasaribu Ayodhia Pitaloka Pasaribu Bambang Supriyatno Beatrix Siregar Beatrix Siregar, Beatrix Bidasari Lubis Bugis Mardina Lubis C. Saragih, Rina Chaerul Yael Chairoel Yoel Chairuddin P. Lubis Chairuddin P. Lubis Chairuddin P. Lubis Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel, Chairul Charles Siregar Charles Siregar Cynthea Prima Destariani Danny Dasraf Dewi Shandi Laila, Dewi Shandi Diana Aulia Dini Lailani Ditho Athos P. Daulay Effa Triani Effa Triani Efori Gea Elmeida Effendy Ema Mutiara Emil Azlin Emil Salim Endang D. Hamid Erika S. Panjaitan Erna Mutiara Erna Mutiara Erna Mutiara Erniwaty P Panggabean Fauzi Rizal Fujiati, Isti Ilmiati Gabriel P. Gema N. Yanni Gema Nazri Yani Gema Nazri Yanni Gema Nazri Yanni Gema Nazri Yanni Gunanti . Hakimi Hakimi Hasibuan, Syahreza Helmi M. Lubis Hendy Zulkarnain Hindra I. Satari, Hindra I. Ichwan HH Batubara Indah Nur Lestari Iskandar Z Lubis Iskandar Z. Lubis Isra Firmansyah Isra Firmansyah Isti Ilmiati Jenny Ginting Johannes H. Saing Johnny Arsyad Jose Rizal Latief Batubara Jose RL Batubara Jufitriani Ismy Jufitriany Ismi Kristina Ambarita Kristina Ambarita Lestari, Indah Nur Lily Irsa Lily Rahmawati Lubis, Inke Nadia Mahadi Mahadi Manihar D. Marbun Melda Deliana Melda Deliana Melda Deliana Monalisa Elizabeth Muhammad Adib Mahara Muhammad Ali Muhammad Ali Muhammad Ali Nafianti, Selfi Nasution, Badai Buana Nelly Rosdiana Nora Sovira Oke Rina Ramayani Oke Rina Ramayani Oke Rina Ramayani, Oke Rina Purnama Fitri Putri Amelia Putri Amelia Putri Amelia Putri Hasria Sri Murni Rafita Ramayanti Rafita Ramayati Rafita Ramayati Ria Puspitasari Ria Puspitasari Ridwan M. D. Rina A.C. Saragih Rina A.C. Saragih, Rina A.C. Rina Amalia C Saragih Rina Amalia C. Saragih Rina Amalia C. Saragih Rina Amalia Karomina Saragih Rina C. Saragih Rismala Dewi Rizki Aryo Wicaksono Rizki Aryo Wicaksono ROSIHAN ANWAR Rosmayanti Siregar Rosmayanti Siregar, Rosmayanti Rusdidjas dr Rusdidjas Rusdidjas Rusdidjas Rusdidjas Saptawati Bardosono Saragih, Rina Amalia Sembiring, Krisnarta Siregar, Gurnal Rai Gandra Siska Mayasari Siti Helmyati Sri Alemina Ginting Sri Sofyani Srie Yanda Sulaiman Yusuf Suryani Ginting Syafruddin Haris Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syamsidah Lubis Syarif, Erlita Wienanda Syilvia Jiero T. Murad El Fuad Taralan Tambunan Tiangsa Sembiring Tjut Dharmawati Tri Faranita Tri Faranita Trina Devina Wahyudi Wahyudi Wijaya, Richo Wisman Dalimunte Wisman Dalimunthe Yanni, Gema Nazri Yanni, Gema Nazri Yoyoh Yusroh Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Zakiudin Munasir

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