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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

Abstract

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.
PENERAPAN MODEL PEMBELAJARAN PjBL (PROJECT BASIC LEARNING) DI KELAS X SMAN 1 SAKTI PADA MATERI TEKS EKSPOSISI UNTUK MENINGKATKAN MOTIVASI BELAJAR SISWA Anidar, Anidar
Jurnal Real Riset Vol 5, No 3 (2023): Oktober 2023
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat (LPPM) Universitas Jabal Ghafur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47647/jrr.v5i3.2000

Abstract

 Penelitian ini bertujuan untuk mengetahui peningkatan hasil belajar siswa kelas X materi Teks eksposisi melalui model pembelajaran PjBL (Project Basic Learning) pada SMAN 1 Sakti.  Metode penelitian yang digunakan adalah penelitian tindakan kelas (PTK) yang terdiri atas 1 siklus. Subyek penelitian adalah siswa kelas X tahun ajaran 2023/2024 sebanyak 30 orang. Analisis data menggunakan teknik analisis diskriptif komparatif dengan membandingkan kondisi awal dengan hasil-hasil yang dicapai pada siklus, dan analisis deskriptif kualitatif hasil observasi dengan membandingkan hasil observasi dan refleksi sebelum menggunakan model PjBL dan setelah menggunakan model PjBL. Hasil dari penerapan model pembelajaran PjBL pada pembelajaran Bahsa Indonesia dapat dilihat dari tabel pertama sebelum diterapkan pendekatan ini masih 25% yang meningkatkan kemampuannnya dalam pembelajaran dalam pembelajaran. Akan tetapi setelah diterapkan pendekatan ini didapati hasil lebih 50% siswa sudah aktif pembelajaran sehingga pembelajaran meningkat.Kata Kunci: Project Basic Learning, Teks Eksposisi, Motivasi belajar  
Risk factors for acute kidney injury in children with critical illness Chalisah, Lilis; Sovira, Nora; Amna, Eka Yunita; Anidar, Anidar; Haris, Syafruddin; Bakhtiar, Bakhtiar
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/pi64.5.2024.398-404

Abstract

Background Acute kidney injury (AKI) is an acute functional kidney disorder that increases morbidity and mortality in children. The mortality rate for critically ill patients accompanied by AKI is quite high and is influenced by the degree of AKI, the severity of the disease, and organ function disorders. Understanding the risk factors of developing AKI in children with critical illness can help prevent AKI. Objective To determine the risk factors for AKI in children with critical illness. Methods This retrospective cohort study included 255 children aged 1 month to 18 years admitted at the pediatric intensive care unit (PICU) of dr. Zainoel Abidin Regional Public Hospital, Banda Aceh, Aceh, from January to December 2022 using medical record data. Bivariate and multivariate analyses were performed. Results Acute kidney injury occurred in 68 (26.7%) patients. Based on pRIFLE criteria, 34 (50%) patients had AKI in the failure stage. Risk factors for AKI in children with critical illness were in descending order of RR: sepsis (RR 14.3; 95%CI 11.68 to 18.66; P=0.000), mechanical ventilation (RR 12.13; 95%CI 8.75 to 15.98; P=0.000), respiratory disorders (RR 2.51; 95%CI 2.06 to 4.02; P=0.003), congenital heart disease (RR 2.08; 95%CI 2.00 to 3.05; P=0.004), CNS disorders (RR 1.24; 95%CI 1.02 to 2.49; P=0.048), nephrotoxic drug use (RR 1.41; 95%CI 1.24 to 3.08; P=0.000), and age 1 month to 5 years (RR 0.072; 95%CI 0.16 to 0.32; P=0.010). Conclusion Sepsis is a risk factor for AKI in children with critical illness, followed by mechanical ventilation use, respiratory disorders, nephrotoxic drug use. Age <5 years is a protective factor.
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

Abstract

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.
Role of Vitamin D and E as Antioxidants Against Cerebral Endothelial Dysfunction: An In Vivo Study in White Rats (Rattus norvegicus) Sepsis Model Fajri, Fauzan; Fajar, Sukmawan; Hasan, Denny Irmawati; Dimiati, Herlina; Amna, Eka Yunita; Sovira, Nora; Anidar, Anidar; Safri, Mulya; Gunawan, Aris
Journal of Basic Medical Veterinary Vol. 13 No. 2 (2024): Journal of Basic Medical Veterinary, December 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbmv.v13i2.61610

Abstract

Sepsis is a life-threatening condition caused by the body's response to an infection, leading to organ dysfunction. A antioxidants can help neutralize harmful free radicals that cause cellular and tissue damage through oxidative stress. Vitamin D and E are two antioxidants that have been extensively studied for their potential effectiveness. This study aims to evaluate the effectiveness of vitamins D and E in reducing oxidative stress in the cerebral vascular endothelial cells of Wistar mice in a sepsis model. The study follows an experimental design and uses a posttest with a control group. The levels of NO and SOD in 24 sepsis model mice were measured using ELISA, and the cerebral endothelial tissues were examined histopathologically. An ANOVA test was performed, followed by the Post Hoc LSD test. NO and SOD levels decreased in sepsis rats from 66.88 ± 16.59 to 88.77 ± 12.83µmol/L. Sepsis mice given vitamin D and E showed significant results on changes in NO and SOD levels (p<0.05). Based on the histopathological results of necrosis, inflammation, and hemorrhagic cell damage in sepsis rats reached over 50% of the field of view, significantly different from sepsis mice that had been given vitamin D and E. Sepsis mice were given vitamin D and E influenced 96.2% and 98.7% on changes in NO, SOD, and cerebral endothelial dysfunction (p<0.05). These findings imply that vitamins D and E may be beneficial in managing sepsis-induced cerebral endothelial dysfunction, potentially impacting the treatment and outcomes of sepsis patients.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (284.861 KB) | DOI: 10.55572/jms.v1i2.26

Abstract

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.
Risk factors of mortality in children with acquired prothrombin complex deficiency at Dr. Zainoel Abidin General Hospital,Banda Aceh Munawarah, Syifa; Sovira, Nora; Anidar, Anidar; Herdata, Heru Noviat; Edward, Eka Destianti; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.253-9

Abstract

Background  Acquired prothrombin complex deficiency (APCD) is a rare but life-threatening bleeding disorder in children. Intracranial hemorrhage (ICH) is the leading cause of death, with an estimated risk affecting 50–80% of cases. Key risk factors associated with mortality in APCD include onset of disease, presence of ICH, and the initial Glasgow Coma Scale (GCS) score. Routine intramuscular administration of vitamin K at birth has been shown to effectively prevent early and late-onset vitamin K deficiency bleeding. However, in settings where vitamin K prophylaxis is not administered or is delayed, the risk of APCD increases significantly. Despite these concerns, other potentially relevant clinical factors contributing to APCD outcomes remain under-investigated. Objective To identify risk factors associated with APCD mortality in children treated at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods This cross sectional study analyzing children diagnosed with APCD at Dr. Zainoel Abidin General Hospital from October 2022 to October 2024. Data were collected from the medical records of 30 children and analyzed using Chi-square and logistic regression tests. Results This study included 30 subjects, the majority of whom were male and aged 8 days to 6 months. Most of subject were born full term, delivered vaginally, and had birth weight ≥ 2.500 grams. Notably, 25/30 children did not receive vitamin K prophylaxis, 14/18 children were exclusively breastfed without vitamin K prophylaxis, and 25/30 children had good nutritional status. Late-onset APCD was observed in 14 out of 30 cases.  Intracranial vs extracranial hemorrhage was occurred in 21 vs 9 children. Initial GCS scores ≤ 8 at initiation of treatment were noted in 11/30 children. The mortality rate was occurred in 12/30 subjects (40%). Chi-square analysis revealed significant associations between increased mortality and late onset APCD (P=0.030), ICH (P=0.049), and initial GCS score ≤ 8 (P=0.009). Logistic regression analysis revealed initial GCS score was associated with the highest risk of mortality in APCD, with a 16-fold increase in risk (P=0.022; OR 15.9; 95%CI 1.5 to 168.9). Conclusion Intracranial hemorrhage, late-onset APCD, and initial GCS scores ≤ 8 are significantly associated with increased APCD mortality, with initial GCS emerging as the most influential risk factor.
Nutritional status and laboratory characteristics of nephrotic syndrome in children undergoing steroid and non-steroid therapy at Dr. Zainoel Abidin Hospital, Banda Aceh Haris, Syafruddin; Riza, Fahrul; Thaib, T. M.; Anidar, Anidar; Thaib, Bakhtiar; Sovira, Nora
AcTion: Aceh Nutrition Journal Vol 10, No 2 (2025): June
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i2.2478

Abstract

Nephrotic syndrome (NS) is a clinical condition characterized by massive proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. Frequently relapsing NS, steroid-dependent NS, and steroid-resistant NS are categorized as problematic owing to treatment difficulties. These patients require prolonged high-dose steroid therapy or immunosuppressants, resulting in significant side effects. This study evaluated the nutritional status and laboratory characteristics of NS in children undergoing steroid and non-steroid therapies. This study is the first to assess the nutritional status and laboratory characteristics of children with difficult-to-treat NS who received steroid and non-steroid therapy at RSUDZA Banda Aceh. A cross-sectional study was conducted at the outpatient clinic and pediatric ward of Dr. Zainoel Abidin General Hospital, Banda Aceh, in 2019, which was a limitation because it was conducted during the Covid-19 pandemic so that the number of research subjects was limited, which could have caused bias in the study. Statistical analyses included the chi-square test or Fisher’s exact test for categorical variables and the independent sample t-test or Mann-Whitney test for numerical variables, with a 95% significance level (p < 0,05). A total of 60 children aged 2–18 years participated in this study, with 29 receiving steroid therapy and 31 receiving non-steroid therapy. Urine protein levels and relapse incidence differed significantly between the groups (p < 0,001). However, the serum albumin, urea, creatinine, calcium, and total cholesterol levels were not significantly different. No significant differences were observed in the laboratory characteristics between the steroid and non-steroid therapy groups. However, the non-steroid group exhibited a better urine protein status and fewer relapses, indicating potential therapeutic advantages.
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

Abstract

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.
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

Abstract

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