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Muhammad Heru Muryawan
Staf pengajar Bagian Ilmu Kesehatan Anak FK Undip

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Stent angioplasti pada anak hipertensi akibat stenosis arteri renalis di RSUP dr. Kariadi Muryawan, Muhammad Heru; Santoso, Antonius Gunawan; Mellyana, Omega
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 2 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (262.73 KB) | DOI: 10.36408/mhjcm.v6i2.396

Abstract

Background : Renal artery stenosis (RAS) causes 5-10% of all secondary hypertension (HT) in children. Percutaneous transluminal angioplasty (PTA) has proven beneficial for adult patients, but for a children there are varying result. This paper is to report the management of PTA in HT children due to RAS in Dr. Kariadi Hospital. Case report: Nine years 8 months boy with stage II HT since 4 years old, in a good nutritional status, complaints headaches, no family history of hypertension. Treatment with of nifedipine, captopril, valsartan and furosemide has not improved. Four months ago, the patient was treated by the Children's Nephrology and Radiology Division in Dr. Kariadi Hospital for 4 days. initial blood pressure 150/100 mmHg (stage II HT), normal eye examination, heart and kidney function, the angiographic results obtained severe right middle renal artery stenosis.teh stenosis reduced by PTA with dilated balloons up to 30%. One day after the procedure, blood pressure decreased to stage I HT, no complication involved, and the patient was discharged on day 4, with nifedipine, valsartan to control HT and aspilet as anti platelet aggregation. Evaluation 4 months after PTA obtained normal blood pressure. Discussion: HT renovascular children e.c. unilateral RAS performed by PTA has a good prognosis. Unilateral RASre-stenosis rates are less than 30%. Anti-hypertensive therapy is needed after ballooning or angioplasty stents. PTA in Dr. Kariadi Hospital can managed patient to make blood pressure normal. Conclusion: PTA management is an option in children with HT renovasculere.c SAR. Dr. Kariadi Hospital can be a referral to manage the case. Keywords: pediatric hypertension, RAS, PTA, Dr. Kariadi Hospital Latar belakang : Stenosis arteri renalis (SAR) menyebabkan 5-10% dari seluruh hipertensi (HT) sekunder pada anak. Percutaneous transluminal angioplasty (PTA) terbukti bermanfaat untuk pasien dewasa, namun pada anak hasilnya bervariasi. Tujuan makalah ini melaporkan tatalaksana PTA pada anak HT akibat SAR di RSUP dr Kariadi. Laporan kasus : Anak laki laki 9 tahun 8 bulan dengan HTderajatII sejak usia 4 tahun, status gizi baik, keluhan kadang-2 sakit kepala, tidak ada riwayat keluarga hipertensi. Pengobatan nifedipin, kaptopril, valsartan dan furosemid belum membaik. Empat bulan yang lalu pasien di rawat oleh Divisi Nefrologi Anak dan Radiologi di RSUP dr Kariadi selama 4 hari. Tekanan darah saat masuk 150/100 mmHg, pemeriksaan mata, fungsi ginjal dan jantung normal, Hasil angiografi didapatkan stenosis berat arteri renalis kanan pertengahan, dilanjutkan PTA dengan stent post dilatasi dengan balon, stenosis mejadi 30%. Satu hari paska tindakan, tekanan darah menurun menjadi HT derajat I, tidak ada kelainan dan dipulangkan pada hari ke 4, mendapat nifedipin, valsartan dan aspilet sebagai anti agregasi trombosit. Evaluasi 4 bulan paska PTA didapatkan tekanan darah normal. Pembahasan : HT renovaskuler anak e.c.SAR unilateral yang dilakukan PTA mempunyai prognosis baik. Angka re-stenosis SAR unilateral kurang dari 30%. Terapi anti-hipertensi diperlukan setelah pemasangan balon atau stent angioplasti. PTA di RSUP dr Kariadi berhasil membuat tekanan darah menjadi normal. Kesimpulan :Manajemen PTA merupakan pilihan pada anak dengan HT renovaskuler e.c SAR. RSUP dr Kariadi dapat menjadi rujukan dalam tatalaksana kasus tersebut. Kata kunci : hipertensi anak, SAR, PTA, RSUP dr Kariadi
Hubungan Anemia Defisiensi Besi dengan Pneumonia pada Anak Usia 6 Bulan – 5 Tahun Saputra, Novel Widya; Kusumawardani, Tri; Muryawan, Muhammad Heru
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (275.318 KB) | DOI: 10.36408/mhjcm.v9i1.691

Abstract

Background Iron deficiency anemia is a health problem in developing countries that causes an increase in the incidence of infection. One of the consequences of infection is pneumonia which is the cause of high morbidity and mortality in children under five around the world. Purpose To determine the relationship between iron deficiency anemia and the incidence of pneumonia infection in children 6 months – 5 years. Methods The study was conducted with a cross sectional design, 27 subjects aged 6 months – 5 years at Bendan Hospital Pekalongan. The characteristics of the subjects studied were age, gender, nutritional status, breast milk, ferritin, hemoglobin and pneumonia. The data obtained were analyzed by contingency test C and logistic regression with a significance level was set at p<0.05.Result Iron deficiency anemia is associated with the incidence of pneumonia, p value < 0.001, with a weak correlation value (0.437). From the results of logistic regression (multivariate) analysis, Hb and ferritin levels had no effect on iron deficiency anemia PR 1.281 (95% CI <0.05), p=1,000 and PR 2.364 (95% CI <0.05), p=0.995. Conclusion There is a weak relationship between iron deficiency anemia and the incidence of pneumonia infection in children under five.. Hemoglobin and ferritin levels are not the dominant variables that affect iron deficiency anemia.