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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran

NP Veny Kartika Yantie

Department Of Child Health, Faculty Of Medicine, Universitas Udayana, Integrated Cardiac Service, Sanglah Hospital, Denpasar

Author-ID : 3452194

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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Outcomes of Tetralogy of Fallot repair performed after three years of age Ni Putu Veny Kartika Yantie; Mulyadi M. Djer; Najib Advan; Jusuf Rachmat
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

subject of debate, however, in general repair before 3 years of age has resulted in good myocardial performance. Late repair has led to prolonged QRS duration, ventricular dysfunction in terms of myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE), as well as longer intensive care unit (ICU) stays.Objective To evaluate QRS duration, right ventricular function as measured by TAPSE, and ICU length of stay (LoS) after repair of TOF performed after three years of age.Methods This retrospective cohort study was performed in children and adults who underwent ToF repair, with a minimum follow-up of 6 months. The TAPSE and QRS duration were evaluated during follow-up and compared between children who had the operation before vs. 3 years of age or older using Mann Whitney U and Chi-square tests.Results We enrolled 52 subjects who underwent ToF repair from January 2007 to June 2013 (18 in the â‰¤3 years-old group and 34 in the >3 years-old group). Subjectsâ€™ age at the time of repair ranged from 7 months to 25 years, with follow-up data at 24-30 months after discharge. Abnormalities of the right ventricle and left ventricle MPI were not significantly different between the two groups. However, we observed significant differences between the â‰¤3 years and >3 years groups in median ICU LoS [2 (range 1-9) days vs. 1.5 (range 1-46) days, respectively; (P=0.016)] and median QRS durations [118 (range 78-140) ms vs. 136 (range 80-190) ms, respectively; (P=0.039)]. The age at the time of repair did not increase the risk of having abnormal TAPSE (RR 0.85; 95%CI 0.26 to 2.79; P=0.798).Conclusion Tetralogy of Fallot repair after 3 years of age appears to not increase ICU LoS or is associated with lower TAPSE, but it is associated with longer QRS duration. [Paediatr Indones. 2016;56:176-83.].

Fever and laboratory profiles as predictors of serious bacterial infection in children Ni Putu Veny Kartika Yantie; BNP Arhana; Purnomo Suryantoro
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3ô€‰15% of children with fever of 2: 39Â°C.Various laboratory parameters including increased Cô€‰reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39Â°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 monthô€‰ 18 years.Methods A caseô€‰controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (nonô€‰SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P ô€€ 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P ô€€ 0.012, respectively].Conclusion Fever 2: 39Â°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection Ni Made Ayu Agustini; Eka Gunawijaya; Ni Putu Venny Kartika Yantie; Ketut Dewi Kumara Wati; Komang Ayu Witarini; Hendra Santoso
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearmanâ€™s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.

Cystatin C level and amikacin use in neonatal sepsis Putu Diah Pratiwi; I Wayan Dharma Artana; Ni Putu Veny Kartika Yantie; Hendra Santoso; I Gusti Ngurah Sanjaya Putra; Gusti Ayu Putu Nilawati; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Background Amikacin is the antibiotic of choice for eradicating bacteria in neonatal sepsis because of its effectiveness against Gram-negative bacteria. However, this drug has nephrotoxic effects. Monitoring kidney function in neonates is very important because amikacin can interfere with development of the kidney. Several studies have shown that serum cystatin C levels were closer to glomerular filtration rate (GFR) values â€‹â€‹compared to serum creatinine levels. Objective To evaluate cystatin C levels before and after administration of amikacin in neonates with sepsis. Methods This prospective cohort study was conducted in one group with a pretest and posttest design. Thirty neonatal sepsis patients who received amikacin therapy at Sanglah General Hospital, Denpasar, Bali, were included by consecutive sampling. Their cystatin C levels were measured before and after receiving amikacin therapy. Data were normally distributed and analyzed by paired T-test, with a value of P<0.05 considered to be significant. Results The mean difference was 0.23 [1.57 (SD 0.29) vs. 1.80 (SD 0.28)] mg/L with P value < 0.001. There was different value of cystatin c level before and after amikacin therapy with deviation standard 0.25 with P<0.001 (alfa 5%). Conclusion Cystatin C levels are significantly higher in neonates with sepsis after administration of amikacin.

Electrocardiogram abnormalities in obese adolescents Elizabeth Joan Salim; Eka Gunawijaya; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Background Obesity in adolescents is a known risk factor for cardiovascular disease mortality and sudden cardiac death. Obesity is associated with a wide variety of electrocardiogram (ECG) abnormalities. Objective To assess prevalence and describe the ECG abnormalities in obese adolescents. Methods This cross-sectional study was conducted at Children’s Cardiology Clinic – Integrated Heart Center of Sanglah General Hospital, Denpasar, Bali, by recording ECGs of obese adolescents aged 11-15 years from several junior high schools from December 2016 to April 2017. The inclusion criteria were obese adolescents aged 11 to 15 years, who were willing to participate in the study and provided informed consent. Results A total of 78 ECGs of obese adolescents (60% male) were selected. Subjects’ mean weight and age were 82.6 (SD 15.2) kg and 13.2 (SD 1) years, respectively. Pre-hypertension was found in 25 (32%) subjects, while hypertension was found in 18 (23%) subjects. There were 29 (37%) subjects with abnormal ECGs. Sinus tachycardia was present in 13 (17%) subjects, and sinus arrhythmia was identified in 11 (14%) subjects. Eight (10%) patients experienced prolongation of QTc interval and 5 (6%) patients presented with prolongation of PR interval. There were no shifts of the P wave, QRS wave and T wave axes, changes of P wave morphology, low QRS voltage, T wave flattening, ventricular enlargement, or ST segment changes found in this study. Conclusion The prevalence of cardiac abnormalities based on ECG examination in obese adolescents is 37%, consisting of heart rhythm abnormalities, prolonged PR interval, and prolonged QTc interval.

Serum zinc level and prognosis of neonatal sepsis Chaliza Adnan; I Wayan Dharma Artana; Ketut Suarta; I Gusti Lanang Sidiartha; I Wayan Gustawan; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Background The prognosis of neonatal sepsis can be influenced by various risk factors, one of which is a deficiency of zinc micronutrient substances. Objective To assess for a potential association between serum zinc level and prognosis of infants with early-onset neonatal sepsis (EONS). Methods This prospective cohort study was done in neonates with clinical EONS from September 2017 until December 2018. Serum zinc level was measured on the first day of diagnosis and prognosis was assessed on the fourth day. The association between serum zinc levels and prognosis of EONS was analyzed by Chi-square test and logistic regression with adjustment for confounding variables. Results A total of 70 subjects were divided into two groups based on their serum zinc levels. A cut-off point of 75 ug/dL was used based on area under the curve (sensitivity 91.2% and specificity 93.7%), with accuracy 97.8% (95%CI 0.943 to 1.000; P=0.0001). Subjects with lowzinc level had a 16.8 times greater risk compared to subjects with high serum zinc (RR=16.81; 95% CI 4.35 to 65.02; P <0.0001). Multivariate analysis revealed that subjects with low serum zinc levels had 203.7 times greater risk of worsening than subjects who had a higher serum zinc level (RR 203.72; 95% CI 26.79 to 1549.17; P <0.0001). Covariates such as male sex, low gestational age (<37 weeks), low birth weight (<2,500 grams), asphyxia, Caesarean section delivery, and the presence of comorbidities did not have significant associations with outcomes of EONS (P >0.05). Conclusion Serum zinc level is associated with prognosis of early onset neonatal sepsis, with a cut-off of 75 Î¼g/dL. The high level of serum zinc associates with a better prognosis.

Cost analysis of congenital heart disease patients who underwent diagnostic catheterization Ni Putu Wirantari; Eka Gunawijaya; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.244-52

Background Cardiac catheterization has developed into an important technique for diagnosis and management of congenital heart disease (CHD) patients. Catheterization is expensive and almost all patients who undergo the procedure at Sanglah General Hospital are participants of the Social Insurance Administration Organization (Badan Penyelenggara Jaminan Sosial/BPJS) that uses the Indonesian Case-Based Groups (INA-CBGs) payment system. Objective To determine the characteristics and analyze costs of CHD patients who underwent diagnostic catheterization. Methods This retrospective study used patient medical record data from March 2009 - July 2018 in Sanglah Hospital, Bali. Data collected included CHD type, age, sex, weight, height, nutritional status, length of procedure, complications, hospital rates, and INA-CBG rates. Data analysis was done with SPSS software. Results Of 219 CHD patients who underwent non-intervention catheterization, most had cyanotic CHD. Catheterization intervention in 2018 showed a discrepancy between the INA-CBG rate and hospital rate. The biggest difference was 107%, in patients who underwent mild heart intervention with class 3 of treatment. Conclusion Most subjects are diagnosed with cyanotic CHD especially tetralogy of Fallot and most has already received intervention. There are negative differences between the INA-CBG rates and the hospital real rates for catheterization.

Plasma NT-proBNP and pulmonary to systemic blood flow ratio in congenital heart defects with left-to-right shunts Eko Kristanto Kunta Adjie; Ni Putu Veny Kartika Yantie; Made Gede Dwi Lingga Utama; Eka Gunawijaya; Ketut Ariawati; Ida Bagus Subanada; Anak Agung Ngurah Ketut Putra Widnyana
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/pi60.6.2020.310-5

Background Cardiac left-to-right shunts changes to the pulmonary-to-systemic blood flow ratio (Qp/Qs ratio). This ratio can be used to monitor the hemodynamics of the heart. Left-to right-shunts cause the release of amino terminal proB-ty natriuretic peptide (NT-proBNP) that can be utilized as a specific marker for the presence of heart failure in children with congenital heart defects (CHDs). Early intervention such as defect closure in CHD is important to prevent heart failure. Objective To assess for a correlation between the level of NT pro-BNP and Qp/Qs ratio in CHD patients with left-to-right shunts. Methods This cross-sectional, analytical study was conducted in 32 children who underwent cardiac catheterization at Sanglah General Hospital, Denpasar, Bali, and were recruited by consecutive sampling. NT-proBNP levels were measured by ELISA with a two-step sandwich assay system; Qp/Qs ratio using Fick rules. Statistical analyses included Shapiro-Wilk test, descriptive analysis for subject characteristics, and Pearsonâ€™s correlation analysis. A P value of <0.05 was considered to be statistically significant. Age and defect size were analyzed as confounding factors by partial correlation test. Results The correlation value between NT-proBNP and Qp/Qs ratio was r=0.384 (P<0.05), after controlling for age and defect size as cofounding factors. Conclusion There is a weak positive correlation between NT-proBNP levels and pulmonary-to-systemic blood flow ratio in patients with left-to-right shunt, after controlling for age and defect size as confounding factors.

Factors contributing to successful patent ductus arteriosus closure with first pharmacological course I Gusti Ayu Made Dwisri Okadharma; Ni Putu Veny Kartika Yantie; Eka Gunawijaya
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.86-90

Background Successful closure of patent ductus arteriosus (PDA) with ibuprofen or paracetamol as the first-line treatment has been reported, but little is known about factors affecting the closure rate. Objective To identify the closure success rate and contributing factors affecting a first course of pharmacological treatment in neonates with PDA. Methods A retrospective study was conducted in infants with isolated PDA treated with either ibuprofen or paracetamol and admitted to our neonatal care unit from January 2017 until June 2020. Included infants had PDA on echocardiography and received ibuprofen or paracetamol therapy as the closure treatment. Oral ibuprofen was given at 10 mg/kg on first day, then 5 mg/kg on the 2nd and 3rd days; while paracetamol was given intravenously 15 mg/kg every 6 hours for 3 days. Echocardiographic evaluation was performed 3 days after first course of treatment. Results In total, 20 of 33 (60.6%) infants achieved PDA closure with the first course of treatment. Earlier age at the start of the first course of treatment (PR 7.7; 95%CI 1.2 to 47.7; P=0.035) and normal birth weight (PR 13.3; 95%CI 2.4 to 72.4; P=0.001) were significant factors contributing to PDA closure. However, PDA size did not affect closure rate (PR 2.0; 95%CI 0.4 to 8.5; P=0.46). Conclusion Pharmacological treatment seems to have a good success rate for PDA closure, with significant positive associations with earlier age at start of treatment and normal birth weight.

Co-Authors Anak Agung Ngurah Ketut Putra Widnyana Bagus Ngurah Putu Arhana Chaliza Adnan Dewi, Luh G.A.P. Eka Gunawijaya Eko Kristanto Kunta Adjie Elizabeth Joan Salim Gusti Ayu Putu Nilawati Hendra Santoso Hendra Santoso I Gde Raka Widiana I Gusti Ayu Made Dwisri Okadharma I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Made Arimbawa I Made Kardana I Nyoman Budi Hartawan I Wayan Dharma Artana I Wayan Gustawan Ida Bagus Subanada IGN Sanjaya Jusuf Rachmat Karmelia Kumala Ketut Ariawati Ketut Dewi Kumara Wati Ketut Suarta Ketut Suarta Komang Ayu Witarini Luh Gede Yuliadewi NS Made Gede Dwi Lingga Utama Mulyadi M. Djer Najib Advan Ni Made Ayu Agustini Ni Nyoman Metriani Nesa Ni Putu Wirantari Purnomo Suryantoro Putu Diah Pratiwi

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