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All Journal Sari Pediatri Biomedical Journal of Indonesia Paediatrica Indonesiana Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal 'Aisyiyah Medika Journal of Industrial Engineering
Afifa Ramadanti
Department Of Child Health, Universitas Sriwijaya Medical School/Dr. Moh. Hoesin General Hospital, Palembang, South Sumatra, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Industrial & Manufacturing Engineering Medicine & Pharmacology Public Health

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Journal : Paediatrica Indonesiana

 1 
Procalcitonin vs. the combination of micro-erythrocyte sedimentation rate and C-reactive protein for diagnosing neonatal bacterial sepsis Afifa Ramadanti; Renya Hiasinta; Herman Bermawi; Erial Bahar
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.643 KB) | DOI: 10.14238/pi57.4.2017.205-10

Abstract

Background Given the high rates of mortality and morbidity in neonatal sepsis, rapid, easy-to-use, and inexpensive biomarkers with high sensitivity and specificity are needed to diagnose neonatal sepsis. Procalcitonin is often used as a predictor in identifying neonatal sepsis, but C-reactive protein (CRP) and micro-erythrocte sedimentation rate (m-ESR) may also be valid biomarkers of neonatal sepsis.Objective To compare the accuracy of procalcitonin to the combination of CRP and m-ESR, as well as to find cut-off points for the three tests, in diagnosing bacterial neonatal sepsis.Methods Subjects were neonates hospitalized from July to October 2016 in Mohammad Hoesin Hospital, Palembang with sepsis at clinical presentation and healthy neonates with sepsis risk factors. All subjects underwent complete blood counts, CRP, m-ESR, blood cultures, and  procalcitonin examinations.Results Ninety-four infants were included, of whom 26 had proven sepsis. The combined values of m-ESR and CRP had 85% sensitivity, 59% specificity, and 66% accuracy. A procalcitonin (PCT) cut-off point of 9.7ng/mL showed 100% sensitivity, 96% specificity, and 97% accuracy level, which were significantly higher than the combined values of m-ESR and CRP.Conclusion The combined values of m-ESR (13 mm/hour) - CRP (17 mg/dL) and procalcitonin alone (2ng/mL) are both valid for the diagnosis of bacterial neonatal sepsis, but the accuracy of procalcitonin at 9.7ng/mL is significantly greater. 
Achievement of full enteral feeding using volume advancement in infants with birth weight 1,000 to Teti Hendrayanti; Afifa Ramadanti; Indrayady Indrayady; Raden Muhammad Indra
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.173-7

Abstract

Background Early enteral feeding is one of the efforts to improve gastrointestinal adaptability in preterm infants. Volume advancement (VA) enteral feeding has been associated with less time to reach full feeding, which can improve outcomes. Objective To evaluate the duration of VA needed to achieve full enteral feeding (FEF) in low birth weight (LBW) and very low birth weight (VLBW) infants and related factors. Methods This prospective study was done in infants with birth weight 1,000 to <2,000 grams in the Neonatal Ward and NICU of Dr. Moh. Hoesin General Hospital, Palembang, South Sumatera. All infants underwent VA feeding. The time needed to achieve FEF (150 ml/kg/day) was recorded. Several clinical factors were analyzed for possible associations with the success rate of achieving FEF within 10 days of feeding. Results Thirty-five infants were included in this study with a mean gestational age of 31.83 (SD 2.67) weeks. Their median body weight at the start of protocol was 1,400 (range 1,000 – 1,950) grams and 80% had hyaline membrane disease. Median time to achieve FEF was 11 (range 8–21) days, with 48.6% subjects achieving FEF in <=10 days. Gestational age <32 weeks (OR 5.404, 95%CI 0.963 to 30.341), birth weight <1,500 grams (OR 5.248, 95%CI 0.983 to 28.003), and male (OR 4.751, 95%CI 0.854 to 26.437) gender were associated with the failure of achieving FEF within 10 days of feeding, however, no factors remained statistically significant after multivariate analysis. Conclusion Full enteral feedings in infants with birth weight 1,000 to <2,000 grams with VA feeding are achieved within a median of 11 days. Gestational age, birth weight, and gender are not associated with time needed to achieve FEF.
Diagnostic value of platelet indices for neonatal bacterial sepsis Ading Rohadi; Afifa Ramadanti; Indrayady Indrayady; Achirul Bakri
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/pi60.5.2020.253-8

Abstract

Background Neonatal bacterial sepsis is a major cause of neonatal morbidity and mortality worldwide. Blood culture as a gold standard, as well as C reactive protein (CRP), micro erythrocyte sedimentation rate (micro ESR), white blood count (WBC), and immature-to-total (I/T) ratio as a sepsis screens are currently used methods, but their utility may be limited due to delayed reporting. Platelet indices are one of the parameters which can be helpful in the diagnosis of neonatal bacterial sepsis. Objective To evaluate the use of platelet indices, either alone or in combination, with other laboratory screening parameters to diagnose neonatal bacterial sepsis. Methods Neonates admitted to the Neonatal Unit of RSUP Dr. Muhammad Hoesin Hospital, Palembang, South Sumatera, and showing symptoms of sepsis were included in this study. Subjects underwent testing for blood culture, sepsis screen (CRP, micro ESR, WBC, I/T ratio), and platelet indices [platelet count, mean platelet volume (MPV), and platelet distribution width (PDW)]. Results The 107 neonates who fulfilled the inclusion criteria consisted of 42 neonates with proven bacterial sepsis (positive blood culture), 10 neonates with probable bacterial sepsis (positive sepsis screen and negative blood culture), and 55 with clinical bacterial sepsis (negative in both blood culture and sepsis screen). There were no significant differences in platelet count among the proven bacterial sepsis, probable bacterial sepsis, and clinical bacterial sepsis groups. Platelet count < 150,000/ml, PDW ³ 16.8 fL, MPV ³ 10.8 fL and combinations of the three, were highly specific markers for proven sepsis, with specificities of 92.3%, 97%, 75.4%, and 80%, respectively. However, all of these parameters were poor predictive markers for positive cultures in neonatal clinical bacterial sepsis, with sensitivities of 19%, 7.1%, 35.7%, and 23.8%, respectively. Conclusion Platelet indices have high specificity but low sensitivity for the prediction of proven neonatal bacterial sepsis.
Music for pain in healthy neonates Nessie Amelia Ramli; Afifa Ramadanti; Indrayady Indrayady; Yuli Doris Memy
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.69-73

Abstract

Background The neonatal pain threshold is 30-50% lower than in adults and older children because of immature pain inhibition function in nervous centers. Acute pain in neonates results in behavioral, physiological, and cerebral blood flow changes that may lead to intraventricular bleeding and periventricular leukomalacia. Music is believed to reduce pain perception as it distracts, influencing the parasympathetic and sympathetic nervous system by decreasing pulse rate, blood pressure, and breathing, hence, promoting a relaxed state. Objective To evaluate effects of music intervention on physiological parameters and pain perception in healthy newborns undergoing a painful medical procedure (immunization injection). Methods This was a double-blind, randomized control trial study. A recorded instrumental lullaby “Nina Bobo” was given for 5 minutes to the music group and no music for control, prior injection of Hepatitis B 0. The evaluation of heart rate and SpO2 were performed at baseline, 30 seconds, and 5 minutes after injection. Pain perception were measured by Neonatal Infant Pain Scale (NIPS) at 30 seconds and 5 minutes after injection. Results Total of 51 subjects were enrolled. There were no difference of SpO2 and NIPS between both music and control groups. Music improved heart rate after 30 seconds and 5 minutes after injection, median 126 (range 55-149) bpm from median 136 (range 78-154) bpm, and even lower than baseline [mean 128.9 (SD 12.5) bpm; P=0.019]. The control showed no improvement of heart rate mean 124,34 (SD 18,45) from 124,73 (SD 18,39); P=0.875There were no significant differences between the 2 groups. Conclusion Music is not effective in improving oxygen saturation, heart rate, and is not effective in reducing the degree of pain.
Ceftazidime as an empiric therapy for neonatal sepsis Indrayady Indrayady; Afifa Ramadanti; Yulia Iriani; Herka Pratama Putra
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.198-204

Abstract

Background Sepsis is still the leading cause of death in neonates in developing countries. Proper administration of antibiotics is important for managing neonatal sepsis. The microorganisms that cause neonatal sepsis, as well as their sensitivity patterns, change over time and differ from one place to another. Since 2001, ceftazidime has been used as an empirical antibiotic for managing neonatal sepsis at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, but its effectiveness is questionable. Objective To evaluate the effectiveness of ceftazidime as an empiric therapy for neonatal sepsis. Methods This study was pre-experimental, for one group, pre- and post-test, was conducted in 49 neonates with neonatal sepsis in the Neonatal Ward at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, from April to September 2019. The effectiveness of ceftazidime was determined based on clinical and laboratory improvements 72 hours after ceftazidime administration. Results Of 49 neonates, 28 experienced clinical and laboratory improvement, while 21 experienced improvement in only one parameter, either clinical or laboratory. Gram positive bacteria were found in 22/49 subjects. Conclusion There is a significant difference on white blood cell count and CRP level between before and after ceftazidime administration but overall ceftazidime is no longer effective as empiric antibiotic therapy in neonatal sepsis.
Medical and non-medical factors associated with stunting in infants and toddlers aged 3-59 months in Palembang Elsi, Yuanita Rimadini; Fauzi, Moretta Damayanti; Anzar, Julius; Indra, Raden Muhammad; Yosy, Deny Salverra; Saputra, Indra; Ramadanti, Afifa
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/pi65.1.2025.16-24

Abstract

Background Although the prevalence of stunting in South Sumatera is estimated to be relatively high, there have been few studies to date on stunting and the factors associated with it in the region. Objective To determine the proportion of stunting in infants and toddlers aged 3-59 months at Mohammad Hoesin General Hospital (RSMH), Palembang, South Sumatera, and to identify medical and non-medical factors associated with stunting in these children. Methods A cross-sectional study was conducted at RSMH from April to September 2023. Stunting was defined according to the WHO standard and combined with a growth pattern that reflects chronic malnutrition. We recorded the proportion of stunting as well as data on several potential medical and non-medical risk factors of stunting. Results A total of 183 subjects met the inclusion criteria. The overall proportion of stunting was 65/183 (35.5%). The proportion of stunting was higher in boys (39.6%) and in children <2 years of age (38.2%). Medical risk factors significantly associated with stunting were infectious disease [OR 4.13 (95%CI 1.91 to 8.94); P=0.001] and chronic disease [OR 3.02 (95%CI 1.56 to 5.85); P=0.001]. The only non-medical factor significantly associated with stunting was low paternal education level [OR 2.45 (95%CI 1.17 to 5.15); P=0.016]. Conclusion During the study period, over a third of pediatric patients at RSMH experienced stunting. Infectious disease, chronic disease, and low paternal education level were significant risk factors that contributed to the occurrence of stunting.
Hemodynamically significant patent ductus arteriosus and tissue oxygenation in preterm infants Amaliah, Lissaberti; Indrayady, Indrayady; Ramadanti, Afifa; Nova, Ria; Akbari, Atika
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.364-72

Abstract

Background  One of the most common side effects of preterm birth is hemodynamically significant patent ductus arteriosus (hsPDA), with a prevalence of approximately 70% among preterm infants. The clinical consequences of hsPDA are impaired tissue perfusion and oxygenation to organs. Near-infrared spectroscopy (NIRS), a validated non-invasive method for determining regional oxygen saturation (rSO2), can identify early changes in organ perfusion and oxygenation.  Cerebral and renal tissues as these vital organs are highly susceptible to systemic hypoperfusion caused by hsPDA, which can lead to serious complications such as brain injury and renal insufficiency.  We used (NIRS to clarify the impact of hsPDA on regional oxygenation in the brains and kidneys of preterm infants. Objective To compare oxygenation of cerebral and renal regional tissues in preterm infants with and without hsPDA Methods A cross-sectional study was conducted at Mohammad Hoesin Hospital. Forty preterm infants (gestational age <37 weeks), born between November 2023 and September 2024, who were diagnosed with PDA and had a chronological age >24 hours and <7 days, were enrolled. Infants with multiple congenital anomalies, ductal-dependent cyanotic congenital heart disease, early-onset sepsis, or without parental consent were excluded. Cerebral and renal oxygenation were assessed using NIRS monitoring. Statistical analysis was performed with unpaired T-test. Results Based on echocardiographic criteria, 22 of the 40 infants had hsPDA, while 18 had non-hsPDA. The mean cerebral rSO2 values in the hsPDA and non-hsPDA groups were 79.5 (SD 12.1)% and 80.9 (SD 4.3)%, respectively. The mean renal rSO2 values were 70.4 (SD 17.8)% and 77.8 (SD 6.4)%, respectively. The mean cerebral fractional tissue oxygen extraction (FTOE) values of the hspda and non-hsPDA groups were 0.2 (0.1 to 0.21). The mean renal FTOE values were 0.3 (SD 0.19) and 0.2 (SD 0.07), respectively. There were no significant differences between the two groups in renal and cerebral rSO2 and FTOE. Conclusion Preterm infants’ cerebral and renal tissue oxygenation is  were not significantly different in those with and without hsPDA.  
Co-Authors Achirul Bakri Ading Rohadi Akbari, Atika AMALIAH, LISSABERTI Andrina, Hana Deny Salverra Yosy, Deny Salverra Diah Sukarni Elsi, Yuanita Rimadini Erial Bahar ERMA PUSPITA SARI Fauzi, Moretta Damayanti Henni Maulani Herka Pratama Putra Herman Bermawi Hertanti Indah Lestari Hertanti Indah Lestari, Hertanti Indah Iman Hendarman Indra Saputra Indra, Raden Muhammad Indrayady Indrayady Indrayady, Indrayady Julius Anzar, Julius Latifah, Murwani Emasrissa Lumbantoruan, Regina Paranggian Mariana Audini Maulani, Henni Nessie Amelia Ramli Novianesari, Putri H Nuswil Bernolian Peby Maulina Lestari, Peby Maulina Putri H Novianesari Raden Muhammad Indra Regina Paranggian Lumbantoruan Renya Hiasinta Ria Nova, Ria Santika Sari Stevanny, Bella Sutrisno, Muhammad Al Farisi Teti Hendrayanti Theodorus Theodorus Theodorus Theodorus Widia Wati Yuli Doris Memy Yulia Iriani, Yulia