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Arumndari, Runi
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Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Mathematics Public Health Social Sciences

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Necrotizing enterocolitis, sepsis, and diarrhea due to cow's milk allergy in a full-term infant with Hypothyroidism: a case report Arumndari, Runi; Putri, Asterisa Retno; Liman, Claudia Natasha; Suryaningsih, Putu Siska
Pediatric Sciences Journal Vol. 4 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v4i2.58

Abstract

Introduction: Necrotizing enterocolitis (NEC) remains one of neonates' most common gastrointestinal diseases. NEC is allegedly to be a multifactorial disease. Some of the predisposing factors are cow’s milk formula (CMF) feeding or not being breast-fed from birth, sepsis, and Hypothyroidism. Case: An 8-day-old full-term baby girl was admitted with an initial diagnosis of sepsis and acute diarrhea due to cow's milk allergy. She had never been breast-fed from birth. She also had a fever, signs of mild-to-moderate dehydration, a C-Reactive Protein (CRP) level at 114, leukocyte 6.280/ul, platelet counts 477.000/ul, and fat on the stool test. She was given Cefotaxime, probiotics, zinc, and a hypoallergenic milk formula. Her condition worsened on the 4th day of hospitalization. She showed abdominal distention, bradypnea, and vomiting. She was then fasting, required a nasal cannula oxygen, and undergone several laboratory examinations showing leukocyte 4.980/ul, platelet count 54.300/ul, and a positive fecal occult blood test. An abdominal x-ray showed an increased bowel gas. She was then diagnosed with grade I NEC, and the antibiotic was changed to Meropenem, added with Metronidazole. She also undergone a thyroid hormone screening, had a TSH level of 6.36 and FT4 1.23, and thus was given Levothyroxine. Her condition improved gradually. After being given Meropenem for 7 days, she was discharged on the 12th day of hospitalization in good condition. Two days later, during the clinic’s follow-up, she was in good health, and it was planned that she would do a follow-up examination for thyroid hormones a month later. Conclusion: Cow’s milk allergy can be severe enough to develop sepsis. Meanwhile, both are predisposing factors for NEC. Hypothyroidism can also be a predisposing factor by causing a decrease in intestinal motility, which plays a role in bacterial overgrowth. A study in animals showed that bacteria play an important role in the development of NEC because NEC will not occur in a germ-free environment but can only develop after exposure to microbes. Conservative treatment for NEC includes broad-spectrum antibiotics, bowel rest, and abdominal decompression.
Neonatal hypoglycemia and associated factors at Wangaya General Hospital Putri, Asterisa Retno; Arumndari, Runi; Liman, Claudia Natasha; Suarca, Kadek; Suryawan, I Wayan Bikin
Indonesian Journal of Multidisciplinary Science Vol. 3 No. 1 (2023): Indonesian Journal of Multidisciplinary Science
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/ijoms.v3i1.709

Abstract

In the early hours to early days of life, managing low blood glucose levels and screening infants at risk are common problems in the care of newborns. Still missing, though, is a precise definition of newborn hypoglycemia. The purpose of this study is knowing that pregnancy hypertension/preeclampsia/eclampsia, prematurity, small-gestational-weight (SGA), large-gestational-weight (LGA), asphyxia, and sepsis are risk factors associated with neonatal hypoglycemia. The type of research conducted was a cross-sectional retrospective analytic study on infants in the perinatology room at Wangaya Hospital in 2022. The sample in this study consisted of 18 hypoglycemia babies and 18 normoglycemia babies taken by purposive sampling with matching hypertension/preeclampsia/eclampsia pregnancy, prematurity, SGA, LGA, asphyxia and sepsis. Data collection used medical record data and perinatology register data. Statistical tests used were Chi-Square and logistic regression with a 95% confidence interval. The results showed that prematurity was an associated risk factor (OR=2.78; 95% CI=1.437-5.379), asphyxia and sepsis also showed statistical significance (OR=2.07; 95% CI=1.221-3.513) (OR=2.27; 95% CI=1.257-4.109). In multivariate analysis, there was no statistical significance among other factors (p-value 0.019). Prematurity, asphyxia, and sepsis were risk factors associated with the incidence of neonatal hypoglycemia with odds of 2.78 times, 2.07 times and 2.27 times respectively compared to the control population. However, in the multivariate analysis, there was no relationship between one factor to another factor that influenced each other in being a risk factor associated with hypoglycemia at Wangaya Hospital.
Necrotizing Enterocolitis, Sepsis, dan Diare Akibat Alergi Susu Sapi pada Bayi Cukup Bulan dengan Hipotiroidisme Arumndari, Runi; Retno Putri, Asterisa; Liman, Claudia Natasha; Suryaningsih, Putu Siska
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.981

Abstract

Necrotizing enterocolitis (NEC) remains one of the most common gastrointestinal diseases in neonates, with high morbidity and mortality. An 8-day-old full-term baby girl was admitted with an initial diagnosis of sepsis and acute diarrhea due to a cow’s milk allergy. Her condition worsened on the 4th day of hospitalization with abdominal distention, bradypnea, and vomiting. An abdominal x-ray showed increased bowel gas. She had a slightly lowered FT4. The findings met Bell’s criteria for the diagnosis of NEC. After being given meropenem and levothyroxine for 7 days, she was discharged on the 12th day of hospitalization in good condition. NEC is allegedly to be a multifactorial disease, with predisposing factors of cow’s milk formula (CMF) feeding or not breast-fed since birth, sepsis, and hypothyroidism. The combination of clinical symptoms, radiologic findings, and risk factor tracing is important in the diagnosis and management of NEC.
Hipoglikemia Persisten pada Neonatus Prematur, Kecil Masa Kehamilan (KMK), dan Berat Badan Lahir Rendah (BBLR) dari Ibu dengan Riwayat Preeklampsia Berat: Laporan Kasus Putri, Asterisa Retno; Arumndari, Runi; Liman , Claudia Natasha; Suryaningsih , Putu Siska
Cermin Dunia Kedokteran Vol 51 No 11 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i11.1019

Abstract

Background: Neonatal hypoglycemia is a metabolic problem that is often found in the NICU and is one of the causes of permanent brain damage in infants. The diagnosis of persistent hypoglycemia and its causes are still controversial. Case: A male baby was born to a mother with severe preeclampsia at 36 weeks of gestation, with a birth weight of 1600 grams. At 1 hour of age, he experienced hypoglycemia that lasted more than 72 hours with the lowest blood sugar of 18 mg/dL, and experienced hyperkalemia (potassium level 6.1 mmol/L). The baby is diagnosed as persistent hypoglycemia. The clinical condition improved after being given dextrose and dexamethasone, and was discharged in stable condition. Conclusion: Management of persistent hypoglycemia depends on the cause. Diagnosis refers to risk factors before or after birth.
Efusi Pleura dan Asites pada Anak dengan Demam Berdarah Dengue dan Penatalaksanaannya: Laporan Kasus Putri, Asterisa Retno; Arumndari, Runi; Liman, Claudia Natasha; Sucipta, Anak Agung Made
Cermin Dunia Kedokteran Vol 52 No 2 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i2.1068

Abstract

Background: Dengue haemorrhagic fever (DHF) is caused by dengue virus type 1-4; it is still endemic in Indonesia. Case: A 1 year and 11 months--old baby-girl with fever, lethargic, nausea and vomiting, and thrombocytopenia. She was diagnosed with dengue hemorrhagic fever. Pleural effusion and ascites were diagnosed after fluid resuscitation. Clinical improvement was observed after furosemide therapy and could be discharged after seven days of treatment. Conclusion: Diuretic administration can be considered in case of dengue haemorrhagic fever with severe plasma leakage. Further research is needed.
Hubungan Antara Status Nutrisi dan Respons Imunologis pada Anak dengan HIV/AIDS di RSUD Wangaya Kota Denpasar: Hasil Penelitian Arumndari, Runi; Retno Putri, Asterisa; Liman, Claudia Natasha; Made Ratna Dewi; Suryawan, I Wayan Bikin
Cermin Dunia Kedokteran Vol 51 No 10 (2024): Infeksi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i10.1097

Abstract

Introduction: HIV infection and malnutrition are strongly linked and correlated. Although the exact mechanism is unknown, malnutrition is suspected to disrupt antiretroviral (ART) drug absorption. This research is aimed at determining the relationship between nutritional status and immunological response in children with HIV/AIDS taking ART. Methods: A cross-sectional retrospective analytic study was conducted on 30 children with HIV/AIDS in the pediatric clinic at Wangaya Hospital, using medical record data. The sample was taken with purposive sampling. Nutritional status was defined as poor (weight per height [WHZ] < -2 for children <5 years old and BMI for age [BAZ] <-2 for children ≥5 years old) and good nutrition (WHZ ≥-2 and <+1 for <5 years old children and BAZ ≥-2 and <+1 for ≥5 years old). Immunological response was seen by the increase in CD4 level through a certain time span and categorized into poor (did not increase or increase below the average) and good response (increase above the average). The data was analyzed using Chi-Square. Results: There is no significant relationship between nutritional status and immunological response in children with HIV/AIDS (p = 0.660). There was an almost equal amount of each immunological response category for both good and poor nutritional status. Conclusion: This study showed no difference in immunological response among children with either good or poor nutritional status. Further research on other confounding factors that may affect immunological responses is needed.
Stunting pada Anak dengan Tuberkulosis Paru dan Anemia Defisiensi Besi: Laporan Kasus Putri, Asterisa Retno; Arumndari, Runi; Liman, Claudia Natasha; Dewi, Made Ratna
Cermin Dunia Kedokteran Vol 52 No 3 (2025): Oftalmologi dan Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i3.1111

Abstract

Background: Stunting is defined as low height-for-age caused by chronic or recurrent undernutrition. Undernutrition is the leading risk factor for tuberculosis (TB) globally. It is usually associated with poverty, poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life. Stunting prevents children from reaching their physical and cognitive potential, so appropriate management is needed. Case: weight for age but severely stunted and suggestive TB. Blood study result showed anemia with Mentzer index >13. Bone age showed the age of A 4 year-old girl was referred with breathing difficulty since 2 weeks accompanied with decreased appetite and weight. She was in normal 3 years and below chronological age. Management was focused on TB, nutritional, and anemia treatment. Conclusion: Nutritional assessment should be integrated into standard TB care and also simultaneously treat iron deficiency anemia.
Co-Authors Anak Agung Made Sucipta, Anak Agung Made Dewi, Made Ratna I Wayan Bikin Suryawan Kadek Suarca, Kadek Liman , Claudia Natasha Liman, Claudia Natasha Made Ratna Dewi Putri, Asterisa Retno Retno Putri, Asterisa Suryaningsih , Putu Siska Suryaningsih, Putu Siska