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Diagnostic value of clinical manifestations of Group A and Group B compared with rubella serology results in congenital rubella syndrome Sulasmi, Sulasmi; Dimiati, Herlina; Andid, Rusdi; Darussalam, Dora; Thaib, Teuku Muhammad; Anidar, Anidar
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.139-44

Background Congenital rubella syndrome (CRS) is the triad of defects/abnormalities in the heart, eyes, and ears, resulting from rubella virus infection, especially in the first trimester of pregnancy. Manifestations of CRS are divided into Group A including: hearing loss, congenital heart disease, cataracts or glaucoma, and pigmentary; Group consisted of purpura, splenomegaly, microcephaly, mental retardation, retinopathy and icteric radiolucent bone disoreder that appears within 24 hours after birth. CRS diagnosis is based on serologic rubella test results. Comprehensive management of CRS is needed to achieve optimal child development. However, not all referral center hospitals in Indonesia have serological rubella examination modalities. Objective To evaluate the diagnostic value of group A and group B clinical manifestations compared to rubella serology results in the diagnosis of CRS. Methods This cross-sectional study used secondary data from medical records of pediatric patients with suspected CRS who meet the criteria for groups A and B aged less than 12 months who had been hospitalized at Dr. Zainoel Abidin Regional General Hospital, Banda Aceh, during the three-year study period (2019-2021) which have complete data were included in the study. The IgM serology results were used as diagnostic comparison that performed at the age of less than 12 months. Results A total of 126 patients met the inclusion criteria. Sixty-five (51.6%) subjects were male, 80 (63.5%) subjects had normal birth weight, and 89 (70.6%) subjects were aged <6 months. The diagnostic sensitivity for groups A, B, as well as A and B clinical manifestations were 100%, 75%, and 100%, respectively. This excellent sensitivity value suggests that the clinical manifestations of groups A and B would be suitable as screening tools because they could “catch” many patients with suspected CRS. Conclusion The clinical manifestations of group A and group B have excellent diagnostic value as a screening tool for CRS.

Treatment duration and dosage of valproic acid and subclinical hypothyroidism incidence in pediatric epilepsy patients Carolina, Infra Yunita; Anidar, Anidar; Andid, Rusdi; Yusuf, Sulaiman; Darussalam, Dora; Sovira, Nora
Paediatrica Indonesiana Vol. 64 No. 6 (2024): November 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.6.2024.469-72

Background Epilepsy is a central nervous system disorder characterized by abnormal electrical activity in the brain.1 Prolonged administration of valproic acid at therapeutic doses can disrupt thyroid function, leading to subclinical hypothyroidism. This condition is marked by elevated thyroid stimulating hormone (TSH) levels, with normal serum free T4 (FT4) levels.2 Objective To investigate for possible associations between valproic acid therapy duration and dosage with the incidence of subclinical hypothyroidism in pediatric epilepsy patients. Methods This analytical, cross-sectional study included children aged 4 months to 18 years treated at the Pediatric Clinic of RSUD Dr. Zainoel Abidin, Banda Aceh, from September to November 2023. Subjects diagnosed with epilepsy and treated with valproic acid for at least 3 months were included in this study and underwent FT4 and TSH examinations. Results Forty-four children met the study criteria. Subclinical hypothyroidism occurred in 5 (11.4%) subjects during valproic acid therapy. Chi-square analysis revealed no significant association between therapy duration ?1 year (OR 1.286; 95%CI 0.193 to 8.568; P=1.00) or therapy dose ?20-40 mg/kg/day (OR 3.429; 95%CI 0.351 to 33.518; P=0.37) with subclinical hypothyroidism incidence. Conclusion Neither the duration nor the dosage of valproic acid therapy were significantly associated with the incidence of subclinical hypothyroidism in children with epilepsy.

Hubungan Hiperbilirubinemia dengan Infeksi Saluran Kemih pada Neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh Utami, Maharani Risiska; Darnifayanti, Darnifayanti; Haris, Syafruddin; Darussalam, Dora; Safri, Mulya; Andid, Rusdi
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.272-6

Latar belakang. Hiperbilirubinemia sering dijumpai pada neonatus. Beberapa penelitian menunjukkan terdapat hubungan hiperbilirubinemia dengan infeksi bakteri salah satunya infeksi saluran kemih (ISK). Pemeriksaan urinalisis perlu dilakukan untuk mendiagnosis ISK. Komponen urinalisis yang memiliki sensitivitas tinggi untuk diagnosis ISK adalah leukosituria.Tujuan. Mengetahui hubungan hiperbilirubinemia dengan leukosituria pada neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh.Metode. Studi analitik observasional dengan desain penelitian potong lintang. Sampel adalah neonatus dengan hiperbilirubinemia di ruang Neonatal Intensive Care Unit/NICU Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Analisis penelitian dengan uji korelasi Spearman.Hasil. Dari 31 neonatus dengan hiperbilirubinemia terdiri dari laki-laki 19(61,3%) dan perempuan 12(38,7%). Leukosituria didapatkan pada 6 laki-laki dan 4 perempuan. Analisis data menunjukkan tidak terdapat hubungan hiperbilirubinemia dengan leukosituria pada neonatus (nilai p=0,071), koefisien korelasi -0,328.Kesimpulan. Tidak terdapat hubungan hiperbilirubinemia dengan infeksi saluran kemih pada neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh.

Faktor Risiko Mortalitas Anak dengan Sepsis dan Disseminated Intravascular Coagulation: Peran Penanda Inflamasi dan Koagulasi di Rumah Sakit Zainoel Abidin Banda Aceh Nuriyanto, Alivia Rizky; Edward, Eka Destianti; Andid, Rusdi; Sovira, Nora; Herdata, Heru Noviat; Thaib, Teuku Muhammad
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/sp27.1.2025.9-17

Latar belakang. Sepsis yang tidak tertangani dapat berlanjut menjadi Disseminated Intravascular Coagulation (DIC). Apabila DIC tidak segera ditangani dapat menimbulkan kegagalan organ dan meningkatkan mortalitas. Memahami pemeriksaan penanda inflamasi dan faktor koagulasi memegang peranan penting dalam prognosis dan upaya mencegah mortalitas pada anak dengan sepsis dan DIC. Tujuan. Untuk mengetahui faktor risiko mortalitas berdasarkan penanda inflamasi dan faktor koagulasi pada anak dengan sepsis disertai DIC di RSUD dr. Zainoel Abidin Banda Aceh.Metode. Penelitian ini merupakan studi observasional analitik dengan pendekatan cross-sectional pada anak usia 1 bulan sampai 18 tahun di ruang rawat inap dan Pediatric Intensive Care Unit (PICU) RSUD dr. Zainoel Abidin Banda Aceh sejak Januari sampai Desember 2023 dengan menggunakan data rekam medis 104 anak yang memenuhi kriteria penelitian. Analisa data Bivariat menggunakan uji chi-square dan uji fisher serta uji regresi logistik untuk data multivariat.Hasil. Insiden sepsis dan DIC pada anak sebanyak 104 subjek dengan kelompok meninggal paling banyak dijumpai pada kelompok usia <5 tahun, jenis kelamin perempuan, gangguan respirasi, ? 2 komorbid, lama rawatan yang lebih lama, skor PELOD-2 yang lebih dari 13, skor ISTH yang lebih dari 5, gizi baik dan penggunaan ventilasi mekanik. Faktor risiko mortalitas berdasarkan penanda inflamasi dan faktor koagulasi pada anak dengan sepsis dan DIC adalah Neutrofil to Lymphocyte Ratio (NLR) (p < 0,001) dengan OR 16,16 (IK95%: 4,43-154,42), leukosit (p=0,006) dengan OR 9,05 (IK95%: 1,83-43,79), D-dimer (p=0,006) dengan OR 6,25 (IK95%: 1,67-23,39) dan trombosit (p=0,026) OR 0,22 (IK95%: 0,06-0,835).Kesimpulan. Nilai NLR merupakan faktor risiko mortalitas pada anak dengan sepsis dan DIC.

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.

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

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.

Risk factors for progression of chronic kidney disease in children with nephrotic syndrome Adrian, Riki; Sovira, Nora; Haris, Syafruddin; Andid, Rusdi; Darnifayanti, Darnifayanti; Yusuf, Sulaiman
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/pi65.4.2025.291-6

Background Nephrotic Syndrome (NS) is a progressive kidney disease in children that can lead to chronic kidney disease (CKD). Understanding the interactions between various risk factors is critical in developing new strategies to prevent the progression of CKD in pediatric patients with NS. Objective To determine the risk factors for the progression of CKD in children with nephrotic syndrome at Dr. Zainoel Abidin Public Hospital, Banda Aceh. Methods This analytical observational study with a cross-sectional approach was conducted from September 2021 to September 2023. Data were obtained from medical records of 52 children aged 2 to 18 years in the inpatient and outpatient wards of Dr. Zainoel Abidin Public Hospital, Banda Aceh who met the inclusion criteria. Bivariate analysis using the Chi-square and Fisher's tests and multivariate analysis using logistic regression test were performed. Results Of 52 subjects, most were male and over ten years of age; 53.8% of subjects had Stage 1 CKD. The majority of stage 3-5 of CKD cases had immunosuppressive toxicity and anemia, while the majority of all subjects had hyperfiltration and proteinuria. Risk factors for CKD progression in children with NS are Hypertension (OR 2.54; 95%CI 0.32 to 20.1; P=0.003), immunosuppressant toxicity with (OR 33.67; 95%CI 2.59 to 437.5; P=0.007) and anemia (OR 33.92; 95%CI 2.77 to 414.5; P=0.006). Conclusion Hypertension, immunosuppressant toxicity and anemia for CKD progression in children with NS.

Penjepitan Tali Pusat Tertunda Terhadap Kadar Hemoglobin dan Hematokrit pada Bayi Baru Lahir Fariyasni, Fariyasni; Darnifayanti, Darnifayanti; Anidar, Anidar; Andid, Rusdi; Sovira, Nora; Herdata, Heru Noviat
Sari Pediatri Vol 27, No 3 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.3.2025.153-8

Latar belakang. Anemia pada anak dengan penyebab utama kekurangan zat besi. Salah satu faktor yang memengaruhi jumlah total besi dalam sirkulasi sebagai hemoglobin saat lahir adalah waktu penjepitan tali pusat. Delayed cord clamping (DCC) meningkatkan simpanan zat besi. Penjepitan dan pemotongan tali pusat saat lahir merupakan intervensi paling lama, tetapi tidak ada definisi pasti mengenai waktu optimal untuk penjepitan tali pusat.Tujuan. Mengetahui pengaruh waktu DCC terhadap kadar hemoglobin (Hb) dan hematokrit (Ht) pada bayi baru lahir.Metode. Penelitian kuasi eksperimen ini dengan rancangan nonequivalent control group posttest-only pada kelahiran pervaginam di Rumah Sakit dr. Zainoel Abidin Banda Aceh sejak Juli 2023 hingga September 2023 yang memenuhi kriteria penelitian. Sampel kelompok I DCC ?30- – 60 detik dan kelompok II DCC >1-3 menit. Nilai Hb dan Ht bayi diukur maksimal 2 jam setelah lahir. Analisis data menggunakan independent t-test.Hasil. Empat puluh bayi baru lahir dilibatkan dalam penelitian ini, 20 kelompok I dan 20 kelompok II. Karakteristik dasar kedua kelompok sebanding. Rerata kadar Hb pada kelompok I 16,41±1,16 g/dL dan kelompok II 19,79±1,51 g/dL (p=0,001; IK95%: 2,5-4,2). Rerata kadar Ht pada kelompok I 50,07±4,57% dan kelompok II 61,06±4,53% (p=0,001; IK95%: 8,06-13,9). Menunjukkan perbedaan yang signifikan secara statistik antara kedua kelompok.Kesimpulan. Penundaan penjepitan tali pusat >1-3 menit memiliki rerata kadar Hb dan Ht yang lebih tinggi

Lama Pemberian Kortikosteroid dan Perawakan Pendek pada Anak dengan Sindrom Nefrotik Idiopatik di Rumah Sakit Umum Daerah Dr. Zainoel Abidin Rahmi, Nurul Maulina; Haris, Syafruddin; Andid, Rusdi; Sovira, Sovira; Bakhtiar, Bakhtiar; Herdata, Heru Noviat
Sari Pediatri Vol 26, No 6 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.6.2025.370-4

Latar belakang. Sindrom nefrotik idiopatik (SNI) merupakan penyakit ginjal terbanyak pada anak, dengan kortikosteroid sebagai terapi utama. Namun, pemberiannya dalam jangka panjang berpotensi menyebabkan gangguan pertumbuhan, termasuk perawakan pendek.Tujuan. penelitian ini bertujuan menganalisis hubungan lama pemberian kortikosteroid dengan kejadian perawakan pendek pada pasien SNI di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh.Metode. Penelitian ini adalah studi analitik observasional, dengan desain kohort retrospektif, menggunakan data rekam medis 50 pasien anak SNI dari 1-30 mei 2024. Analisis statistik menggunakan uji Mann-Whitney dan kurva ROC untuk menentukan titik potong lama pemberian kortikosteroid. Hasil. Hasil menunjukan 64% anak laki-laki dan 36% anak perempuan. Sebanyak 74% memiliki perawakan normal, sementara 26% perawakan pendek (14% pendek, 12% sangat pendek). Analisis menemukan hubungan signifikan antara lama pemberian kortikosteroid dan perawakan pendek (p=0,029). Pasien yang menerima kortikosteroid >21 bulan berisiko lebih tinggi mengalami perawakan pendek (AUC=0,704; p=0,03; IK95%: 0,537-0,871; sensitivitas 61%, spesifitas 59,5%).Kesimpulan. Pemberian kortikosteroid >21 bulan pada anak dengan SNI berhubungan dengan peningkatan risiko perawakan pendek. Temuan ini menekankan pentingnya pemantauan ketat durasi terapi kortikosteroid untuk meminimalkan dampak pada pertumbuhan linier anak.

Korelasi Neutrophil Gelatinase-Associated Lipocalin Urin dan Laju Filtrasi Glomerulus pada Anak dengan Penyakit Kritis di Rumah Sakit dr Zainoel Abidin Banda Aceh Agustin, Amelia Wijaya; Sovira, Nora; Edward, Eka Destianti; Haris, Syafruddin; Ismy, Jufitriani; Andid, Rusdi
Sari Pediatri Vol 27, No 6 (2026)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.6.2026.408-14

Latar belakang.Penyakit kritis merupakan kondisi akut yang mengancam jiwa dan membutuhkan perawatan intensif. Deteksi dini pemeriksaan fungsi ginjal terhadap kejadian Gagal Ginjal Akut (GGA) biasanya dilihat dari penurunan mendadak Laju Filtrasi Glomerulus (LFG). Kondisi GGA dapat menyebabkan peningkatan mortalitas pada pasien kritis. Banyak biomarker dapat digunakan untuk mendeteksi GGA, termasuk Neutrophil Gelatinase-Associated Lipocalin urin (NGALu) sebagai penanda yang lebih cepat untuk mendeteksi GGA. Penelitian ini ingin mengetahui korelasi NGALu dan LFG pada anak dengan penyakit kritis.Tujuan. Mengetahui korelasi NGALu dengan LFG pada anak dengan penyakit kritis.Metode. Penelitian ini merupakan studi observasional analitik dengan pendekatan cross sectional retrospektif. Penelitian dilakukan dengan pengambilan data dari rekam medis pada anak usia 1 bulan hingga 18 tahun yang dirawat di Pediatric Intensive Care Unit sejak Agustus 2023 hingga Desember 2023 dengan jumlah sampel 40 anak yang memenuhi kriteria penelitian. Data dianalisis dengan uji korelasi Spearman.Hasil. Penelitian mengikutsertakan 40 anak dengan penyakit kritis. Didominasi oleh anak laki-laki sebanyak 28 anak (70%), dengan rentang usia 6 tahun hingga 18 tahun yaitu 26 anak (65%). Berdasarkan status gizi, anak dengan status gizi baik dan kurang memiliki presentasi yang sama, yaitu masing-masing 18 anak (45%). Adapun penyakit kritis yang mendasari adalah infeksi SSP (35%) yang didapatkan paling banyak, dengan hasil LFG yang tidak normal yaitu hiperfiltrasi pada 19 anak (47,5%) dan AKI pada 2 anak (5%), dengan lama perawatan (?8 hari) sebanyak 52,5% dan banyak luaran yang meninggal yaitu 22 anak (55%). Hasil uji korelasi Spearman menunjukkan korelasi negatif yang bermakna antara kadar NGALu terhadap nilai LFG dengan nilai p = 0,001 dan r=-0,656 pada nilai LFG normal serta r=0,029 dengan nilai p=0,55 pada nilai LFG yang tidak normal.Kesimpulan.Kadar NGALu berkorelasi dengan nilai LFG yang tidak normal pada anak dengan penyakit kritis.

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