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All Journal Paediatrica Indonesiana Journal of Indonesia Vascular Access
Ria Nova, Ria
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology

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A case series of paediatric atrial myxoma: Clinical challenges and surgical management: Atrial Myxoma Septyandra, Ezi; Bermansyah; Nugraha, Aswin; Nova, Ria
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.55

Abstract

Introduction : Cardiac myxomas are rare, benign tumors of the heart, most commonly found in the left atrium, though they can occur in any heart chamber. These tumors can embolize, causing organ infarction, and may present with symptoms such as dyspnea, orthopnea, cough, peripheral edema, palpitations, and fatigue. The clinical presentation varies widely and may mimic other diseases, making early detection and diagnosis critical. The reported incidence of cardiac myxoma at RS Mohammad Hoesin is 5 cases over 2023-2024, consisting of 3 pediatric cases and 2 adult cases. This report emphasizes the significance of thorough history taking, detailed physical examination, echocardiography, and surgical resection in managing atrial myxoma in two paediatric patients. Case Presentation : We reported three cases: a 16-year-old male, an 11-year-old female, and 12-year-old male, They were presenting with shortness of breath as the chief complaint. The male patient was diagnosed with decompensated heart failure due to a large left atrial myxoma, accompanied by tricuspid and pulmonary regurgitation, and underwent successful surgical removal of the myxoma. The female patient, with a history of contact with tuberculosis, was found to have a mass in the right atrium with a differential diagnosis of myxoma or tuberculoma. She was treated for clinical pulmonary tuberculosis and is currently under medical management. The last patient, male was diagnosed with a large left atrial myxoma, tricuspid regurgitation, and severe mitral regurgitation. The myxoma had removed from the left atrium in this patient. Conclusion : Paediatric atrial myxoma is a rare condition with a wide range of clinical manifestations, from asymptomatic cases to intracardiac obstruction, embolization, and constitutional symptoms. This often results in misdiagnosis as other more common heart diseases. Transthoracic echocardiography is useful as an initial diagnostic tool, as it effectively determines the tumor's location, size, shape, and connections, aiding in the selection of the optimal management strategy. Surgical excision is the primary treatment, with regular echocardiographic follow-up essential for the early detection of recurrence and long-term patient health.
Nerve conduction parameters in children with severe acute malnutrition treated with standard nutritional therapy Khalid, Naman; Dewi, Msy Rita; Indra, RM; Anzar, Julius; Nova, Ria; Indrayadi, Indrayadi; Hasanah, Yulisnawati; Fauzi, Moretta Damayanti
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.54-60

Abstract

Background Nerve damage has been found in malnourished patients due to deficiencies in micronutrients and macronutrients. Studies on nerve conduction in malnourished children are scarce, specifically those comparing nerve conduction parameters before and after nutritional intervention, are few. Objective To identify nerve conduction changes in children with severe acute malnutrition (SAM) treated with standard nutritional therapy. Methods This was a one-group pretest-posttest quasi-experimental study on children with SAM aged 1 month to 18 years who received standard nutritional therapy for 3 months. We recorded anthropometric data and measured motor and sensory nerve conduction velocity (NCV) of the upper and lower limb nerves before and after the nutritional intervention. Results Thirty participants were included in the study; only 27 underwent post-treatment follow-up nerve conduction testing. All anthropometric indices increased after the intervention, except for body length/height. Moderate correlations were observed between pre-intervention weight and NCVs of the right sural sensory (r=0.496; P=0.005) and left median motor (r=-0.502; P=0.024) nerves. After intervention, conduction velocities of the left median sensory nerve (r=0.750; P=<0.001), right median motor nerves (r=0.521; P=0.015), left ulnar motor nerves (r=0.628; P=0.005), and left tibial motor nerves (r=0.419; P=0.047), had moderate to strong correlations with weight. There were moderate post-treatment correlations between BMI and NCV in the right ulnar (r=0.534; P=0.013) and right fibular (r=0.441; P=0.031) motor NCVs. Conclusion There are significant correlations between weight and some motor and sensory NCVs, as well as between BMI and motor NCVs, after 3 months of receiving nutritional therapy.
Hemodynamically significant patent ductus arteriosus and tissue oxygenation in preterm infants Amaliah, Lissaberti; Indrayady, Indrayady; Ramadanti, Afifa; Nova, Ria; Akbari, Atika
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/pi65.5.2025.364-72

Abstract

Background  One of the most common side effects of preterm birth is hemodynamically significant patent ductus arteriosus (hsPDA), with a prevalence of approximately 70% among preterm infants. The clinical consequences of hsPDA are impaired tissue perfusion and oxygenation to organs. Near-infrared spectroscopy (NIRS), a validated non-invasive method for determining regional oxygen saturation (rSO2), can identify early changes in organ perfusion and oxygenation.  Cerebral and renal tissues as these vital organs are highly susceptible to systemic hypoperfusion caused by hsPDA, which can lead to serious complications such as brain injury and renal insufficiency.  We used (NIRS to clarify the impact of hsPDA on regional oxygenation in the brains and kidneys of preterm infants. Objective To compare oxygenation of cerebral and renal regional tissues in preterm infants with and without hsPDA Methods A cross-sectional study was conducted at Mohammad Hoesin Hospital. Forty preterm infants (gestational age <37 weeks), born between November 2023 and September 2024, who were diagnosed with PDA and had a chronological age >24 hours and <7 days, were enrolled. Infants with multiple congenital anomalies, ductal-dependent cyanotic congenital heart disease, early-onset sepsis, or without parental consent were excluded. Cerebral and renal oxygenation were assessed using NIRS monitoring. Statistical analysis was performed with unpaired T-test. Results Based on echocardiographic criteria, 22 of the 40 infants had hsPDA, while 18 had non-hsPDA. The mean cerebral rSO2 values in the hsPDA and non-hsPDA groups were 79.5 (SD 12.1)% and 80.9 (SD 4.3)%, respectively. The mean renal rSO2 values were 70.4 (SD 17.8)% and 77.8 (SD 6.4)%, respectively. The mean cerebral fractional tissue oxygen extraction (FTOE) values of the hspda and non-hsPDA groups were 0.2 (0.1 to 0.21). The mean renal FTOE values were 0.3 (SD 0.19) and 0.2 (SD 0.07), respectively. There were no significant differences between the two groups in renal and cerebral rSO2 and FTOE. Conclusion Preterm infants’ cerebral and renal tissue oxygenation is  were not significantly different in those with and without hsPDA.  
Co-Authors Afifa Ramadanti Akbari, Atika AMALIAH, LISSABERTI Bermansyah Fauzi, Moretta Damayanti Indrayadi, Indrayadi Indrayady, Indrayady Julius Anzar, Julius Khalid, Naman Msy Rita Dewi, Msy Rita Nugraha, Aswin RM Indra, RM Septyandra, Ezi Yulisnawati Hasanah