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"Latar Belakang : Pasien anak merupakan pasien yang memiliki resiko tinggi mengalami penurunan kondisi klinis secara tiba-tiba yang disebabkan oleh gangguan pernapasan atau gangguan jantung (cardiac arrest) dan bisa menyebabkan kematian, tanggung jawab yang besar dimulai dari penerimaan, triase, penilaian awal, stabilisasi, kondisi akut, cedera, perawatan dan rujukan dan keperawatan berkelanjutan, Kematian anak di rumah sakit sering terjadi 24 jam pertama dalam penerimaan. Kematian dapat dicegah dengan identifikasi yang benar Salah satu strategi untuk mendeteksi kegawatan pasien seperti cardiac arrest pada anak saat masuk ke rumah sakit adalah dengan adanya instrumen yang baik dan akurat.Penelitian dilakukan untuk mengatehui perbandingan penggunaan Emergency Severity Index dan Emergency Department Paediatric Early Warning Score dalam mengidentifikasi kegawatan pasien anak Rumah Sakit.Metode : Penelitian menggunkaan desain cross sectional study rumus besar sampel komparatik kesesuain kategorik yang akan di uji dengan uji kappa ini melibatkan 174 anak yang dirawat dirumah sakit berusia 1 bulan hingga 18 tahun.Hasil : hasil uji menunjukan bahwa uji nilai p value < 0,05 (0,000) yang artinya terdapat kesepakatan antara penggunaan ESI dengan kegawatan anak di UGD Rumah Sakit Primaya Tangerang dan hasil yang di dapatkan nilai 1,000 yang artinya excellent agreement, dengan kesemuanya tidak ada yang menilai berbeda.Kesimpulan :Penggunaan Paediatric Early Warning Score masih perlu dikembangkan dan diperbaiki kembali untuk penyempurnaan. Penelitian memberikan implikasi supaya hasil penelitian dapat dijadikan evidence base dalampengelolaan asuhan keperawatan anak di Instalasi Gawat Darurat.

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Background : Pediatric patients are patients who have a risk of experiencing a sudden decline in clinical conditions caused by respiratory disorders or heart problems (cardiac arrest) and can cause death. The big responsibility starts from admission, triage, initial assessment, stabilization, acute conditions, injuries, care and referrals and ongoing nursing, Child mortality in hospital often occurs in the first 24 hours of admission. Death can be prevented by correct identification. One strategy to detect patient emergencies such as cardiac arrest in children upon admission to the hospital is to have good and accurate instruments. The study was conducted to determine the use of Emergency Severity Index and emergency department Paediatric Early Warning Score in identifying emergency pediatric hospital patients.

The research method used a cross-sectional study design. The formula for the comparative sample size of the categorical suitability to be tested with the kappa test involved 174 children who were hospitalized from 1 month to 18 years of age.

Results : the test results show that the test value of p value <0.05 (0.000) which means that there is an agreement between the use of ESI with pediatric emergencies in the Emergency Room of Primaya Hospital Tangerang and the results obtained are a value of 1,000 which means excellent agreement, with none of them rate differently.

Conclusion : The use of ED PEWS still needs to be developed and improved again to refinement. The research has implications so that research results can be used as an evidence base in managing child nursing care in the Emergency Room

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"Doxorubicin (DOX) dilemahkan oleh toksisitas jantung dan ginjal meskipun efektif melawan kanker. Walaupun dexrazoxane tersedia untuk mengatasi toksisitas DOX, efektivitasnya terbatas, begitu pula obat konvensional seperti beta-blocker dan statin. Penelitian ini menyelidiki efek perlindungan ekstrak etanol daun Andrographis panikulata (EEAP) terhadap toksisitas jantung dan ginjal yang diinduksi oleh DOX pada tikus sehat dengan fokus pada mekanisme anti-inflamasi dan mitokondria. Sebanyak 30 ekor (5 kelompok) tikus Sprague Dawley diaklimatisasi selama 2 minggu. Kelompok normal mendapat saline (ip) selama 4 minggu. Kelompok DOX menerima doxorubicin (4mg/kg/minggu). Kelompok perlakuan (DOX+EEAP) menerima doksorubisin dan ekstrak daun Andrographis Paniculata dengan dosis bervariasi (125, 250, 500 mg/kg/hari) secara oral selama 4 minggu. Setelah darah dan organ (jantung, ginjal) dikumpulkan, darah dianalisis untuk elektrolit (kalsium dan natrium). Jaringan dianalisis sebagai penanda inflamasi (NF-κB, IL-1β, NLRP-3), fungsi mitokondria (PGC1-α, TFAM), dan gambaran histopatologis yang menggunakan pewarnaan hematoxylin dan eosin (H&E) serta pewarnaan trikrom Masson. Kadar kalsium jantung juga diukur. Pengobatan bersama EEAP menurunkan natrium dan kalsium plasma dan kadar penanda inflamasi IL-1β dan NLRP-3 di jaringan jantung dan ginjal tetapi tidak menunjukkan efek signifikan pada ekspresi PGC1-α dan TFAM dibandingkan dengan kelompok DOX. Selain itu, kadar kalsium jantung berkurang. Lebih lanjut, konsentrasi NF-кB berkurang sedikit oleh EEAP dibandingkan dengan kelompok DOX saja. EEAP kemungkinan besar terlindungi dari peradangan yang disebabkan oleh DOX yang mengarah pada pemulihan histologi jantung dan ginjal menjadi normal. Efek perlindungan EEAP dalam penelitian ini dimediasi, setidaknya sebagian, oleh modulasi jalur NF-ĸB/NLRP3/IL-1β.

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Doxorubicin (DOX), despite its effectiveness against cancer, is compromised by cardiac and renal toxicity. While dexrazoxane exists for DOX toxicity, its effectiveness is limited, as are conventional drugs like beta-blockers and statins. This study investigates the protective effects of an ethanolic extract of Andrographis paniculata leaves (EEAP) against DOX-induced cardiac and renal toxicity in healthy rats, focusing on anti-inflammatory and mitochondrial mechanisms. 30 Sprague Dawley rats (5 groups) were acclimatized for 2 weeks. The normal group received saline (ip) for 4 weeks. The DOX group received only doxorubicin (4mg/kg/week). Treatment groups (DOX+EEAP) received doxorubicin and varying doses (125, 250, 500 mg/kg/day) of Andrographis paniculata leaf extract orally for 4 weeks. After sacrifice, blood and organs (heart, kidneys) were collected. Blood was analysed for electrolytes (calcium and sodium). Tissues were analysed for inflammatory markers (NF-κB, IL-1β, NLRP-3), mitochondrial function (PGC1-α, TFAM), and histopathological features using hematoxylin and eosin (H&E) or Masson’s trichrome stain. Cardiac calcium levels were also measured. EEAP co-treatment lowered plasma sodium and calcium, decreased levels of inflammatory markers (IL-1β and NLRP-3) in heart and kidney tissues, but showed no significant effect on PGC1-α and TFAM expression compared to the DOX group. Additionally, cardiac calcium levels were reduced. Further, NF-кB concentration was slightly reduced by EEAP compared to the DOX only group. EEAP likely protected against DOX-induced inflammation, leading to a restoration of normal heart and kidney histology. EEAP's protective effects in this study were mediated, at least in part, by modulation of the NF-ĸB/NLRP3/IL-1β pathway."