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All Journal MEDIA MEDIKA INDONESIANA Indonesian Journal of Cancer Sari Pediatri Paediatrica Indonesiana ACI (Acta Cardiologia Indonesiana) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Indonesian Journal of Cancer
Indah Kartika Murni
Department Of Pediatrics, Dr. Sardjito Hospital, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Perbedaan Gambaran Elektrokardiografi pada Remaja Obes dengan Hipertensi dan Tanpa Hipertensi Bibit Murdiyanti; Indah Kartika Murni; Dian C Sulistyoningrum; Rina Susilowati; Madarina Julia
Sari Pediatri Vol 24, No 1 (2022)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp24.1.2022.16-22

Abstract

Latar belakang. Prevalensi obesitas remaja semakin meningkat. Obesitas berhubungan dengan hipertensi yang dapat menyebabkan perubahan struktur mekanik dan listrik jantung. Elektrokardiografi (EKG) merupakan alat pemeriksaan aktivitas listrik jantung yang mudah dan tersedia luas. Tujuan. Mengetahui gambaran EKG pada anak obes dengan hipertensi dibandingkan dengan tanpa hipertensi.Metode. Penelitian cross-sectional dilakukan pada siswa SMA obes usia 15-18 tahun di Yogyakarta. Subjek dengan data tidak lengkap, menderita penyakit diabetes melitus, ginjal, jantung, infeksi akut, serta riwayat penyakit sistemik atau menggunakan steroid dieksklusi. Analisis bivariat menggunakan uji t test dan chi square.Hasil. Subjek penelitian adalah 177 remaja obes terdiri dari 100(56,5%) laki-laki dan 77(43,5%) perempuan. Didapatkan subjek hipertensi sebesar 30%. Pada analisis bivariat tidak didapatkan perbedaan signifikan rerata frekuensi jantung, durasi gelombang P, interval PR, interval QTc, durasi QRS, amplitudo gelombang R, dan gelombang S serta prevalens left ventricular hyperthrophy (LVH); strain pattern; pemanjangan durasi gelombang P, kompleks QRS, interval QTc; dan pergeseran axis P, QRS, dan T ke kiri (p>0,05).Kesimpulan. Penelitian ini belum bisa membuktikan adanya perbedaan bermakna gambaran EKG pada remaja obes dengan hipertensi dibandingkan tanpa hipertensi.
Profil Jantung Pasien Akut Limfoblastik Leukemia Anak yang Mendapatkan Terapi Anthracycline DAVID VICTORY WA’U; SRI MULATSIH; INDAH KARTIKA MURNI
Indonesian Journal of Cancer Vol 11, No 1 (2017): Jan-Mar
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (227.452 KB) | DOI: 10.33371/ijoc.v11i1.496

Abstract

ABSTRACTAcute lymphoblastic leukemia (ALL) is the most common malignancy in children under fifteen years of age. Advanced cancer therapy with anthracycline has increased survival rate but also chronic health problem and the most iscardiovascular. This study aims to describe cardiac events of ALL patients who received anthracyline during chemotherapy. We conducted a cross sectional study of childhood ALL who were hospitalized at DR Sardjito hospital between April and June 2016. Electrocardiography (ECG) and echocardiography were performed. Results of this study shows childhood ALL who received anthracycline may suffer from cardiotoxicity. Cardiac events can be found in all stage of chemotherapy.ABSTRAKLeukemia limfoblastik akut (LLA) adalah keganasan yang paling banyak dialami anak di bawah usia 15 tahun. Kemajuan pengobatan kanker dengan anthracycline telah meningkatkan angka kesintasan penderita LLA dan masalah kesehatan kronik, terutama penyakit kardiovaskuler. Penelitian ini bertujuan untuk mengetahui kelainan jantung pada pasien LLA yang mendapatkan kemoterapi anthracyline. Penelitian dilakukan secara potong lintang dengan subjek anak penderita LLA yang dirawat di rumah sakit Dr. Sardjito antara April–Juni 2016. Pasien menjalani pemeriksaan elektrokardiografi (EKG) dan echocardiography. Penelitian ini menyimpulkan bahwa anak penderita ALL yang mendapatkan anthracycline dapat mengalami kardiotoksisitas. Kelainan jantung dapat ditemukan pada semua tahap kemoterapi.
Tricuspid regurgitation pressure gradient to diagnose pulmonary hypertension: a diagnostic accuracy study Indah Kartika Murni; Emmanuel Mareffcita Siagian; Nurnaningsih Nurnaningsih; Nadya Arafuri
Paediatrica Indonesiana Vol 62 No 6 (2022): November 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.6.2022.367-72

Abstract

Background Pulmonary hypertension carries significant morbidity and mortality in children. Early diagnosis and management may improve outcomes in children with pulmonary hypertension. Heart catheterization, a gold standard for diagnosing pulmonary hypertension, is an invasive procedure and not widely available. Echocardiography can be used as an alternative diagnostic tool for pulmonary hypertension. Objective To determine the diagnostic value of tricuspid regurgitation pressure gradient on echocardiography compared to heart catheterization to diagnose pulmonary hypertension in children. Methods This diagnostic test study was done with medical record data of children with acyanotic congenital heart disease who underwent cardiac catheterization and echocardiography procedures from January 2018 to December 2020 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Data were analyzed to obtain sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios. Results A total of 98 children with acyanotic congenital heart disease were included. The sensitivity and specificity of the tricuspid regurgitation pressure gradient to determine pulmonary artery pressure compared to heart catheterization were 64.4% and 54.5%, respectively. The positive likelihood ratio was 1.42. The pre-test and post-test probability of this study were 88.7% and 91.7%, respectively. Conclusion Tricuspid regurgitation pressure gradient measured using echocardiography has poor sensitivity and specificity to diagnose pulmonary hypertension.
Predictors of heart failure in children with congenital heart disease Meily Elven Nora; Indah Kartika Murni; Sasmito Nugroho; Noormanto Noormanto
Paediatrica Indonesiana Vol 62 No 6 (2022): November 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.6.2022.390-5

Abstract

Background Heart failure continues to be a significant contributor to morbidity and mortality in children with congenital heart disease (CHD). Little is known about heart failure in children. Identifying predictors of heart failure in children with CHD can serve to guide preventive strategies to heart failure. Objective To understand the predictors of heart failure of children with congenital heart disease. Methods A nested, case-control study was performed using secondary data based on a prospective study previously conducted in Dr Sardjito Tertiary Hospital in Yogyakarta in years 2011-2013. We included children aged 1 month-18 years who had been diagnosed with CHD by echocardiography. Age, sex, type of CHD, CHD complexity, as well as presence of syndrome, no pulmonary obstruction, pneumonia, and malnutrition were analyzed as potential predictors of heart failure. Results are presented as odds ratios (OR) with 95% confidence intervals (95%CI). Results A total of 2,646 children were hospitalized in Dr Sardjito Tertiary Hospital during the study period. Congenital heart disease was noted in 216 children (8.16%), 200 (7.5%) of whom met the inclusion criteria. The 100 children with heart failure had median age of 1.5 years and 15% died during hospitalization. Multivariate analysis revealed that acyanotic CHD (OR 2.69; 95%CI 1.45 to 5.00), no pulmonary obstruction (OR 3.05; 95%CI 1.33 to 6.99) and the presence of pneumonia (OR 2.04; 95%CI 1.03 to 4.06) were statistically significant as independent predictors of heart failure in children with CHD. However, sex, age, CHD complexity, as well as presence of a syndrome, and malnutrition were not significantly associated with heart failure in children with CHD. Conclusion The predictors of heart failure in children with CHD were acyanotic CHD, no pulmonary obstruction, and presence of pneumonia.
Infective endocarditis due to Achromobacter xylosoxidans: A case report and a literature review Oktania Candrawati; Indah Kartika Murni; Osman Sianipar
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art13

Abstract

Congenital heart disease (CHD) and invasive cardiac procedures are risk factors for infective endocarditis (IE) in children. IE with Achromobacter xylosoxidans is a rare case and has a high mortality rate. This case report and literature review aim to understand the risk factors, diagnosis, therapy, and outcome of IE wirh Achromobacter xylosoxidans. We observed a 14-months-old boy with ventricular septal defect (VSD), a history of cardiac catheterization, 9 days fever and febrile convulsion; and tachycardia and pansystolic murmur on the tricuspid valve were found. Transthoracic echocardiography revealed vegetation on the tricuspid valve. Monomicrobial clinical isolates of Achromobacter xylosoxidans were consistently found in three samples of aerobic blood culture bottles. The patient was treated with definitive antibiotic therapy with 200 mg/8 hours of ceftazidime for 21 days. Bacterial growth was not found in the blood culture evaluation which was performed after 48 hours of the therapy. Also, it was found that in the follow up period the patient had no fever on the sixth day, and the vegetation size was reduced. A patient with CHD, especially with VSD as an underlying condition who had a history of cardiac catheterization and accompanied by fever and heart murmur, should be suspected of having IE. Then the definitive antibiotic therapy with ceftazidime contributed to a better clinical outcome.
Tuberculous pericarditis in adolescents: A case series Paramitha, Winda; Murni, Indah Kartika; Arguni, Eggi; Setyowireni, Dwikisworo
Paediatrica Indonesiana Vol. 60 No. 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (817.568 KB) | DOI: 10.14238/pi60.2.2020.111-6

Abstract

Tuberculosis (TB) is one of the major causes of childhood mortality, especially in endemic areas. In 2013, the World Health Organization (WHO) estimated 550,000 new cases and 80,000 deaths due to TB among children. Around 70-80% of the cases were pulmonary TB, while the rest were extra-pulmonary TB.1 Tuberculous pericarditis accounts for only 8% of all TB cases, however, tuberculosis is the main cause of pericarditis in high-TB-burden countries, including Indonesia.2 The mortality rate reached 17-40% and is affected by treatment adequacy.3 Without adequate therapy, the mean life expectancy is 3.7 months, with only 20% surviving to the sixth month.4 A 2004 study reported that successful treatment of TB in children depends on several factors, such as treatment compliance, timing and accuracy of diagnosis, concurrent human immunodeficency virus (HIV) infection and its clinical stage of disease, malnutrition, and drug resistance.5 Adolescents and young adults are at the highest risks of having TB.6 We report here on three cases of tuberculous pericarditis in adolescents and their outcomes following pericardiocentesis and medication.
Undetected Takayasu arteritis presenting as severe hypertension in children: a report of two cases Wirawan, Muhammad Taufik; Murni, Indah Kartika; Patria, Suryono Yudha; Arafuri, Nadya; Noormanto, Noormanto; Nugroho, Sasmito
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.454-8

Abstract

Takayasu arteritis (TA) is a rare chronic granulomatous vasculitis mainly affecting the aorta and its main branches. Clinical presentations of TA are non-specific, especially in the initial phase, which likely contributes to delayed diagnosis besides the rarity of the disorder. Childhood-onset of TA is associated with significant morbidity and mortality. This case report aimed to present two rare cases of acute symptomatic severe hypertension in children due to TA.
The frequency and distribution of healthcare-associated infections in children Murni, Indah Kartika; Wirawan, Muhammad Taufik; Patmasari, Linda; Laksanawati, Ida Safitri
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/pi65.5.2025.382-9

Abstract

Background Healthcare-associated infections (HAIs) are major contributors to increased morbidity, mortality, and healthcare costs. Ongoing epidemiological surveillance of nosocomial infection is needed to accurately assess their burden and inform prevention strategies. Objective To determine the frequency and distribution of HAIs. Methods A 26-month prospective cohort study (February 2016 to April 2018) was carried out at Dr Sardjito Hospital, a tertiary hospital in Indonesia, where pediatric patients hospitalized in the wards and pediatric ICU were monitored daily. HAIs were defined according to the criteria set by the Centers for Disease Control and Prevention. Results Out of 1,855 patients enrolled in the study period, 314 (16.9%) had HAI with an incidence density rate of 20.1 infections per 1,000 patient-days (416/20,672). The incidence of nosocomial urinary tract infection (UTI) was 4.3% (82/1,855) and the catheter-associated urinary tract infection (CAUTI) incidence density rate was 16.5 CAUTIs/1,000 patient-days (36/2,179). The incidence of nosocomial pneumonia, which includes both hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), was 3.2% (59/1,885), while the specific incidence rate of VAP was 5.1 per 1,000 patient-days (14/1,359). The incidence of nosocomial bloodstream infection was 1.9% (36/1,855) and the central line-associated bloodstream infection (CLABSI) incidence rate was 4.4 CLABSIs/1,000 patient-days (5/1,121). The incidences of surgical site infection, phlebitis, nosocomial upper respiratory infection, and nosocomial gastroenteritis were 0.2% (3/1,855), 0.9% (17/1,855), 2.9% (54/1,855), and 3.4% (63/1,855), respectively. Conclusion One-sixth of children in our hospital developed HAIs, with an incidence rate of 20.1 HAI/1,000 days. The most common HAI was CAUTI, followed by VAP and CLABSI.
Co-Authors Agung Triono Amalia Setyati Artha Christin Yulianti Bibit Murdiyanti Carolina Kurniawan DAVID VICTORY WA’U Desy Rusmawatiningtyas Dian C Sulistyoningrum Dwikisworo Setyowireni Eggi Arguni Emmanuel Mareffcita Siagian Ida Safitri Ida Safitri Laksanawati Madarina Julia Meily Elven Nora Muhammad Agus Muljanto Nadia Qoriah Firdausy Nadya Arafuri Noormanto Noormanto Noormanto Noormanto Noormanto Noormanto, Noormanto Nurnaningsih Nurnaningsih Oktania Candrawati Osman Sianipar Paramitha, Winda Patmasari, Linda Rina Susilowati Roni Naning Sasmito Nugroho Sasmito Nugroho Sasmito Nugroho, Sasmito Sri Mulatsih Suryono Yudha Patria WA’U, DAVID VICTORY Weny Inrianto Wirawan, Muhammad Taufik Yudha Fadhol Arafah Yusuf Yusuf