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All Journal Journal of Health and Nutrition Research Frontiers on Healthcare Research
Kino Kino
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Health Professions Medicine & Pharmacology Nursing Public Health

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Coexistence of Infective Endocarditis and Recurrent Acute Rheumatic Fever: A Case Report Kino, Kino; Hariyanto, Didik; Fernando, Harben; Fahlevi, Indra
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p29-34.2025

Abstract

Background: Infective endocarditis (IE) and recurrent acute rheumatic fever (ARF) are two serious cardiovascular conditions frequently associated with rheumatic heart disease (RHD). Their coexistence complicates diagnosis and management due to overlapping clinical features such as fever, migratory arthritis, and valvular dysfunction. This case report aims to elucidate the clinical presentation, diagnostic challenges, and treatment strategies in a pediatric patient with coexisting IE and recurrent ARF.   Methods: A detailed clinical case study was conducted involving a 10-year-old boy with a history of RHD presenting with joint pain and intermittent fever. Diagnostic evaluations included physical examination, laboratory investigations (including blood cultures and antistreptolysin O titers), and serial transthoracic echocardiography. Therapeutic interventions combined targeted intravenous antibiotics, corticosteroids, and secondary prophylaxis with benzathine penicillin G. Multidisciplinary consultations were employed to optimize management. Results: The patient exhibited echocardiographic evidence of mitral valve vegetations along with severe mitral regurgitation. Blood cultures remained negative, likely due to prior antibiotic exposure. Elevated antistreptolysin O titers confirmed recent streptococcal infection supporting recurrent ARF diagnosis. Clinical improvement was observed with symptom resolution and reduction in vegetation size on follow-up echocardiography. Multimodal therapy was well-tolerated, preventing further complications. Conclusion: This case highlights the diagnostic complexity and therapeutic balancing act required in managing coexisting IE and recurrent ARF in children with RHD. Early recognition through comprehensive evaluation and integrated treatment combining antimicrobial and immunomodulatory approaches can improve outcomes. Continued vigilance and multidisciplinary care are essential for preventing morbidity in this high-risk population.
Activin A and Heart Function in Severe Preeclampsia: Insights From Global Longitudinal Strain Sriyanti, Roza; Permatasari, Ressy; Kino, Kino
Journal of Health and Nutrition Research Vol. 4 No. 3 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i3.605

Abstract

Preeclampsia, a serious pregnancy complication affecting 2–5% of women globally, is a leading cause of maternal and fetal mortality. Its prevalence in Indonesia ranges from 0.8–7% depending on parity. Associated with long-term cardiovascular risks, recent research suggests that elevated maternal activin A levels may play a causal role in linking severe preeclampsia to subsequent cardiovascular complications, particularly through mechanisms involving cellular damage, including to the heart. The aim of this study was to assess the correlation between Activin A circulating level and cardiac ventricular function as assessed by cardiac global longitudinal strain (GLS) in severe preeclampsia. A cross-sectional study was conducted at M. Djamil Hospital, Padang, West Sumatera, Indonesia with a total of 31 patients with severe preeclampsia. The Enzyme-Linked Immunosorbent Assay (ELISA) as used to determine the level of Activin A in the blood serum. Ventricular function was assessed from the global longitudinal strain using echocardiographic evaluation. The mean level of Activin A was 2.97 ± 1.91 ng/mL. From the echocardiographic evaluation, the mean cardiac GLS value was 18.01 ± 3.27%.  The correlation between activin A levels and cardiac ventricular function was analyzed using Pearson's correlation test, which showed a strong negative correlation (r = -0.718, p < 0.001). This indicates that higher activin A levels are significantly associated with lower GLS values, demonstrating worse ventricular function.
Co-Authors Didik Hariyanto Fahlevi, Indra Fernando, Harben Permatasari, Ressy Sriyanti, Roza