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All Journal Sari Pediatri Paediatrica Indonesiana Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research

Ria Nova

Bagian Kesehatan Anak Fakultas Kedokteran Universitas Sriwijaya/RS Moh. Hoesin, Palembang

Author-ID : 3211683

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Akurasi Pemeriksaan Auskultasi Jantung dan Elektrokardiografi untuk Deteksi Kelainan Jantung pada Anak Ria Nova; Deny Salverra Yosy; Bermansyah Bermansyah
Sari Pediatri Vol 22, No 3 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.3.2020.164-8

Latar belakang. Tidak semua kelainan jantung menimbulkan gejala klinis. Pemeriksaan ekokardiografi tidak semuanya tersedia di fasilitas kesehatan terbatas.Tujuan. Untuk mendeteksi kelainan jantung pada siswa-siswi sekolah dasar di Palembang melalui pemeriksaan auskultasi jantung dan elektrokardiografiMetode. Desain penelitian uji diagnostik dengan pendekatan cross sectional pada siswa-siswa sekolah dasar di kota Palembang. Penelitian dilakukan dari bulan Agustus sampai dengan November 2019. Subyek penelitian sebanyak 280 anak sekolah dasar. Semuanya dilakukan pemeriksaan auskultasi jantung, elektrokardiografi, dan ekokardiografiHasil. Subyek 280 anak sekolah dasar, terdiri dari 130 laki-laki dan 150 perempuan. Rerata umur 9,6 tahun (rentang 5-14) tahun. Median berat badan 27 kg. Pada pemeriksaan auskultasi ditemukan 79,2% normal, 9,2 % bising sistolik, 2,1 % bising diatolik, dan 7,1 % bising inosen. Hasil elektrokardiografi, normal 97,1%, sinus takikardi 1,4%, sinus bradikardi 0,4%, hipertrofi ventrikel kiri 0,7 %, right bundle branch block 0,4%. Hasil ekokardiografi, penyakit jantung rematik subklinis 20 anak, persisten foramen ovale 1 anak, pulmonal stenosis 2 anak dan hipertensi pulmonal primer 10 anak. Sensitivitas dan spesifisitas auskultasi jantung 90% dan 91%. Nilai prediksi positif dan negatif auskultasi jantung 57,69% dan 98,6%. Sensitivitas dan spesifisitas elektrokardiografi 6,06% dan 97,57%. Nilai prediksi positif dan negatif elektrokardiografi 25% dan 88,6%.Kesimpulan. Auskultasi jantung cukup akurat untuk deteksi awal kelainan jantung pada anak dibandingkan elektrokardiografi.Â

Perbandingan Efektifitas dan Keamanan Parasetamol Intravena dan Ibuprofen Oral pada Penutupan Duktus Arteriosus Persisten pada Bayi Kurang Bulan Oktaviliana Sari; Ria Nova; Herman Bermawi; Erial Bahar
Sari Pediatri Vol 17, No 4 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Duktus arteriosus persisten (DAP) pada bayi kurang bulan (BKB) dapat menimbulkan gangguan hemodinamika sehingga perlu segera ditutup. Salah satu cara penutupan adalah dengan obat penghambat siklooksigenase (COX), khususnya ibuprofen. Mengingat efek samping yang ditimbulkan ibuprofen, parasetamol yang bekerja menghambat peroksidase mulai diperkenalkan sebagai alternatif dengan efektifitas setara dan efek samping yang minimal.Tujuan. Membandingkan efektifitas dan keamanan antara parasetamol intravena dan ibuprofen oral untuk penutupan DAP pada BKB.Metode. Uji klinis terbuka, acak terkontrol pada bayi dengan usia gestasi â‰¤37 minggu yang dikonfirmasi DAP dengan menggunakan ekokardiografi. Dilakukan randomisasi blok untuk menerima parasetamol intravena atau ibuprofen oral. Hasil utama yang dinilai adalah respon terapi penutupan duktus arteriosus (DA), efek samping yang timbul, dan kejadian reopening.Hasil. Penutupan DAP terjadi pada 33 dari 36 (91,6%) BKB yang mendapat parasetamol intravena dan 29 dari 40 (72,5%) yang mendapat ibuprofen oral (p=0,03). Pada kelompok ibuprofen, efek samping yang timbul berupa trombositopenia (28,5%) dan perdarahan saluran cerna (25,7%), sedangkan pada kelompok parasetamol intravena tidak dijumpai efek samping. Reopening terjadi hanya pada satu bayi di kelompok ibuprofen oral.Kesimpulan. Parasetamol intravena lebih efektif dan lebih aman dibandingkan ibuprofen oral untuk penutupan DAP pada BKB.

Cardiac Septal Defects in Children: Hemodynamics, Clinical Manifestations and Detection Ria Nova; Sukman Tulus Putra; Siti Nurmaini; Radiyati Umi Partan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 6 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i6.393

Cardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis.

Accuracy of Heart Auscultation Examination by General Practitioners From Various Levels of Competency in Detection of Heart Abnormality in Basic School Children Annisa Permatasari; Deny Salverra Yosy; Achirul Bakri; Ria Nova
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.460

Background. Most of heart defects in children do not show typical clinical symptoms. Ten percent of the cases are late detected. Echocardiography is an examination with high sensitivity and specificity in detecting heart defects in children, but it cannot be performed by all health workers, expensive and not always available in hospitals. Auscultation is an important part of a physical examination that inexpensive, easy examination, and becomes a competency of all doctors. The aim of this study to determine the accuracy of the screening method by listening to murmurs on heart auscultation by various levels of physician competence. Methods. This is a diagnostic test of 250 elementary school children held in the pediatric ward of dr. Mohammad Hoesin Palembang from September to November 2019. The auscultation examination was performed by three pediatrics resident from three stages (i.e. junior, middle and senior), followed by echocardiography examinations by a pediatric cardiologist. Results. The highest sensitivity of auscultation was found in senior resident, 42.4%, while the lowest was found in junior resident, 12.1%. The results of the kappa analysis of the cardiac auscultation examination on the three examiners showed a poor level of agreement on junior stage compared to senior resident (k = 0.189; CI = 0.033-0.346) and the level of agreement was sufficient in junior stage compared to middle stage resident (k = 0.297; CI = 0.134 -0.461) and middle stage compared to senior resident (k = 0.301; CI = 0.147-0.456). Conclusion. Experience and length of learning will affect the accuracy of the auscultation examination in detecting heart defects in children.

Relationship between small for gestational age and aortic intima-media thickness in newborns Ahmad Bayu Alfarizi; Ria Nova; Julniar Mawardi Tasli; Theodorus Theodorus
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Background Small for gestational age (SGA) has been associatedwith adult cardiovascular disease. Small for gestational agenewborns may undergo early aortic wall intima-media thickening(aIMT) in utero.Objective To determine the relationship between SGA as a riskfactor for increased aIMT, as a sign of atherosclerosis onset.Methods We conducted a case-control study in the Neonatal Wardand Rooming-in Nursery at Dr. Mohammad Hoesin Hospital,Palembang, between April to June 2012. Subjects were allocatedto either the case group (aIMT 2: 0.9 mm) or to the controlgroup (aIMT <0.9 mm). Newborns were classified as SGA iftheir birthweight (BW) was < l O'h percentile, and appropriatefor gestational age (AGA) if their BW was between lQth - 90'hpercentile, according to the Lubchenco curve. Abdominal aorticintima-media thickness was measured by echocardiographyexamination.Results The case and control groups consisted of 30 n ewbornseach. The proportion of SGA newborns was higher in the casegroup than the control group. The likelihood of infants in the casegroup being SGA was significantly higher compared to the controlgroup, with odds ratio of 10.8 (95%CI 3,26 to 35, 72) . The meanaIMT was significantly higher in SGA than in AGA infants, 0.9(SD 0.16) mm vs. 0.8 (SD 0.13) mm, respectively, with a meandifference of 0, 13 (9 5% CI 0, 050 to 0,209 mm; P"" 0,02).Conclusion Increased aIMT is more likely found in SGA newborns.

Ibuprofen vs. indomethacin for persistent ductus arteriosus closure in preterm infants Deny Salverra Yosy; Ria Nova; Julniar M. Tasli; Theodorus Theodorus
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Background Indomethacin and ibuprofen are anti-prostaglandinE2 agents administered for persistent ductus arteriosus (PDA)closure. Ibuprofen has weaker cyclooxygenase-1 inhibitor affinitythan that of indomethacin, causes decreased gastrointestinalcirculation, as well as brain and kidney side effects.Objective To compare the efficacy of oral ibuprofen andindomethacin for PDA closure in preterm infants.Methods A randomized double-blind controlled trial on preterminfants with PDA was performed in Moehammad HoesinHospital, Palembang, from October to December 2011. Persistentductus arteriosus was diagnosed by echocardiography. Subjectswere divided into two groups, and received either ibuprofen orindomethacin. Ibuprofen was given at a dose of 10 mg/kgBW /don day 1 and 5 mg/kgBW /d on days 2 and 3. Indomethacin wasgiven in three doses over 24 hour-intervals; the first dose was 0.2mg/kg, and the second and third doses were 0.1 mg/kg each.Results Sixty infants were enrolled in this study, 36 boys (60%)and 24 girls ( 40%). Fifty-two subjects completed the study protocol.Ductus arteriosus (DA) closure after treatment was observed in 22out of 26 subjects in the ibuprofen group and 19 out of 26 subjectsin the indomethacin group (P= 0.04). The mean DA diameterreductions after administration of ibuprofen or indomethacin were0.40 (SD 0.16) mm and 0.30 (SD 0.21) mm, respectively (95%CIof differences0.05 to0.17; P= 0.04). Serum creatinine was elevatedin the indomethacin group following treatment compared to theibuprofen group [P = 0.002, 95% CI of differences 0.06 to 0.27].Ductus arteriosus reopening occurred in 4 out of 19 subjects in theindomethacin group, while n one in the ibuprofen group .Conclusions Ibuprofen is better than indomethacin, in terms ofhigher PDA closure rate and mean DA diameter reduction aftertreatment. In additional, indomethacin has significantly greaterincrease in mean serum creatinine level after treatment thanibuprofen.

Risk factors for patent ductus arteriosus in preterm neonates Novia Bernati; Ria Nova; Julniar M. Tasli; Theodorus Theodorus
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background The reported prevalences of patent ductus arteriosus(PDA) in preterm neonates vaty, and are currently unknown inPalembang. Birth weight, ges tational age, asphyxia, histoty ofantenatal steroid use, hyaline membrane disease (HMD), raceand ethnicity, are potential risk factors for PDA.Objective To determine the prevalence of PDA and its riskfactors in preterm neonates at Mohammad Hoesin Hospital,Palembang.Methods This cross-sectional study was conducted from October2011 to April 2012. Echocardiographic examinations wereperformed on 242 preterm neonates aged 15 hours to 7 days. Datawas taken from medical records and interviews, and analyzed byChi square and logistic regression analyses.Results Patent ductus arteriosus was found in 142 (58.7%)preterm neonates with a prevalence ratio of 1.43. Neonates withbirthweight ::;;2,000 grams tended to have 1.9 (95% CI 1.17 to3.32) rimes higher risk for PDA (P=0.01). Neonates ::;;JO weeksgestation were also at 1.9 rimes higher risk for PDA (P=0.16).Probabilities for PDA occurrence in neonates with asphyxia,without antenatal corticosteroids and HMD were 1.6 (95%CI 1.13 to 3.36) rimes, 1.3 (95%CI 0.73 to 2.50) times and 2.2(95%CI 1.29 to 3.72) rimes higher risk for PDA, respectively(P=0.22, 0.41, and 0.005, respectively).Conclusion Birth weight and HMD are statistically significantrisk factors of PDA, but the more significant one is HMD.

Correlation of heart failure severity and N-terminal pro-brain natriuretic peptide level in children Yasmien Mahrani; Ria Nova; Masagus Irsan Saleh; Kemas Yakub Rahadianto
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Background Â Heart failure affects morbidity and mortality in children with heart disease. There is no single, specific test to diagnose heart failure. The modified Ross Reithmann scoring system has been used to classify heart failure severity, but it is limited due to its subjectivity. The N-terminal pro-brain natriuretic peptide (NT-proBNP) is secreted by the ventricles during heart failure. It has been suggested as a possible marker for diagnosing heart failure.Objective To investigate the correlation between heart failure severity and plasma NT-proBNP concentration in children aged one month to 14 years.Methods A cross-sectional study was performed in the Pediatrics Department of Mohammad Hoesin Hospital from July to September 2015 on children with congestive heart failure, aged one month to 14 years. Heart failure severity was assesed using the modified Ross Reithmann scoring system. Plasma NT-proBNP measurements were done in all subjects. Statistical analysis was done by Spearmanâ€™s test.Results Â Subjectsâ€™ median plasma NT-proBNP concentration was 1,703 pg/mL (range 310-9,000 pg/mL). The NT-proBNP level and severity of heart failure had a significant, positive correlation (r=0.87; P<0.001). The NT-proBNP minimum levels in subjects with mild, moderate and severe heart failure were 310 pg/mL, 1,251 pg/mL, and 2,610 pg/mL, respectively.Conclusion Plasma NT-proBNP level has a significant, positive correlation with the severity of heart failure in children. As such, NT-proBNP level may be useful as a biochemical marker for the diagnosis and grading of the severity of heart failure in children.

Using N-terminal pro-B-type natriuretic peptide to diagnose cardiac abnormalities in children with dyspneaen with dyspnea Zakaria Mukalla; Ria Nova; Legiran Legiran; Yangtjik Yangtjik
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Background. Dyspnea could be caused by various reason, one of which is the presence of cardiac abnormality. Physical examination sometimes difficult to distinguish breath caused by heart abnormalities, especially small children, so we need another way to find out.Objective. To evaluate whether the examination of NT-proBNP levels can be used as a screening tool to diagnose cardiac abnormality in children presenting with dyspnea.Methods. A Cross sectional study was conducted from August to October 2015 on pediatric patients aged 1 month to 18 years presenting with dyspnea in pediatric ward Mohammad Hoesin Hospital Palembang. All subjects performed blood sampling for NT-proBNP examination and echocardiography to assess the presence of cardiac abnormalities. The diagnostic value analyzed by ROC curve, and determined the optimal cut-off point, sensitivity and specificity.Â Result. We obtained 58 subjects with median age 9.5 (1-180) months, consisted of 39 subjects with cardiac abnormalities and 19 subjects without cardiac abnormality. There is a significant difference (p = 0.002) of NT-proBNP levels in both groups with a medianÂ 1,775 (189-9,000) pg/ml vs 759 (245-9,000) pg/ml. In ROC curve analysis, AUC value was 0.75, and at the optimal cut-off point 1,235 pg/ml, sensitivity was 74.4% and specificity was 73.7%.Conclusion. The level of NT-proBNP can be used to diagnose cardiac abnormalities in children presenting with dyspnea.

NT-proBNP level and left ventricle diameters before and after transcatheter closure of PDA and VSD Devy Kusmira; Ria Nova; Achirul Bakri
Paediatrica Indonesiana Vol 58 No 5 (2018): September 2018
Publisher : Indonesian Pediatric Society

Background Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels before and after transcatheter closure may correlate with changes in left ventricular internal diameter end diastole (LVIDd) and end systole (LVIDs). Patent ductus arteriosus (PDA) and ventricular septal defect (VSD) are structural abnormalities which effects cardiac hypertrophy. Cardiac muscle stretching decreases after closure, followed by reduced left ventricle diameters and decreased NT-proBNP levels. Objective To analyze for possible correlations between NT-proBNP levels and left ventricle diameters before and after transcatheter closure. Methods Subjects were PDA and VSD patients who underwent transcatheter closure in the Pediatrics Department of dr. Moh Hoesin Hospital, Palembang, South Sumatera, from May 2016 to March 2017. Measurement of NT-proBNP levels and echocardiography were performed before closure, as well as one and three months after closure. Results There were 34 subjects (15 girls) with median age of 91.5 months. Median NT-proBNP levels were significantly reduced after closure: before closure 111.7pg/mL, one month after closure 62pg/mL, and three months after closure 39 pg/mL (P<0.05). Median LVIDd and LVIDs were also significantly reduced after closure [LVIDd: 39.5mm before, 34.5mm one mo after, and 32.5mm 3 mo after (P<0.05); LVIDs: 23.9mm before, 20.5mm 1 mo after, and 20.0mm 3 mo after (P<0.05)]. At one month after closure, there was a moderate positive correlation between NT-proBNP levels and LVIDd (r=0.432; P=0.011), but no correlation with LVIDs (r=0.287; P=0.100). At three months after closure, there was a significant moderate positive correlation between changes of NT-proBNP levels and changes of LVIDd (r=0.459; P=0.006), as well as LVIDs (r=0.563; P=0.001). Conclusion In pediatric PDA and VSD patients, NT-proBNP levels have a significant positive correlation with diastolic and systolic left ventricle diameters at three months after closure. Decreased NT-proBNP levels may be considered as a marker of closure effectiveness.

Co-Authors Achirul Bakri Achirul Bakri Achirul Bakri Ahmad Bayu Alfarizi Annisa Permatasari Bermansyah Bermansyah Deny Salverra Yosy Deny Salverra Yosy Devy Kusmira Dewi Rahmawati Syam Erial Bahar Herman Bermawi Julniar M. Tasli Julniar Mawardi Tasli Legiran Legiran Masagus Irsan Saleh Novia Bernati Oktaviliana Sari Radiyati Umi Partan Siti Nurmaini Sukman Tulus Putra Theodorus Theodorus Yakub, Kemas M Yangtjik Yangtjik Yasmien Mahrani Zakaria Mukalla

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