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All Journal Paediatrica Indonesiana Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Deny Salverra Yosy
Department Of Child Health, Sriwijaya University Medical School
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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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

Abstract

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.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.475 KB) | DOI: 10.14238/pi53.3.2013.138-43

Abstract

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.
Epidemiologic profiles of subclinical rheumatic heart disease in children Dewi Rahmawati Syam; Deny Salverra Yosy; Achirul Bakri; Ria Nova
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.334-40

Abstract

Background Rheumatic heart disease (RHD) causes premature deaths every year worldwide. Low socioeconomic level is considered to be a risk factor facilitating the transmission of airway infections due to Streptococcus pyogenes. Subclinical RHD is a stage of RHD in which heart valve abnormalities have occurred according to the WHO or WHF classification but without any complaints to the subject. Echocardiography is used to screen subclinical RHD in several countries. Objective To estimate the prevalence, risk factors, and echocardiographic features of subclinical RHD in children. Methods This cross-sectional study was conducted on 250 elementary school children in Palembang, South Sumatera. We interviewed subject's parents about family characteristics, environment, and history of recurrent sore throat. Subjects underwent anthropometric examination, auscultation, and echocardiography. Diagnosis of RHD was based on World Health Organization (WHO) and World Heart Federation (WHF) criteria. Results Of 250 subjects, 132 (53.8%) were girls. Subjects’ age range was 5-14 years. The prevalence of subclinical RHD was 8% (95%CI 4.8 to 11.6). Of the 20 subclinical RHD subjects, 15 (75%) met the possible RHD criteria, 5 (25%) met the probable RHD criteria, and none met the definite RHD criteria. Multivariate analysis showed that household crowding (OR 8.135; 95%CI 1.048 TO 63.143; P=0.045), history of recurrent sore throat within the previous 6 months (OR 6,476; 95%CI 1.79 to 23.427; P=0.004) and age > 10 years (OR 3.167, 95%CI 1.184 to 8.471; P=0.022) significantly increased the risk of subclinical RHD. Conclusion The prevalence of subclinical RHD in elementary school children in Palembang was 8%. For echocardiographic features, most cases met the WHO/WHF possible RHD criteria. Factors significantly associated with the incidence of subclinical RHD are age > 10 years, household crowding, and history of recurrent sore throat in the previous 6 months.
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

Abstract

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.
Co-Authors Achirul Bakri Achirul Bakri Annisa Permatasari Dewi Rahmawati Syam Julniar M. Tasli Ria Nova Theodorus Theodorus