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A. Samik Wahab A. Samik Wahab
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Blokade Jantung Total pada Anak A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 21, No 01 (1989)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The diagnosis of complete heart block is based on electrocardiogram. There would be few or even no cases missed if electrocardiograms were made of all slow heart rate infants and children. The history, physical signs, and X•ray would lead to the recognition of congenital and acquired complete heart block as an isolated, uncomplicated, anomaly. Incomplete history in healthy asymptomatic older children may cause difficulty in differentiating congenital or acquired origin.The conduction defect is usually discovered accidentally in healthy, asymptomatic children. Adams-Stokes syncopes rarely happen, even in the young. An obstetrician may detect a slow fetal heart rate, in which fetal electrocardiography and echocardiography have diagnostic value. A history of maternal lupus (SLE) or collagen disease or connective tissue disease (CTD) is another-major important diagnostic. The arterial pulse is very slow, the pulse amplitude wide and rhythm regular, The jugular venous pulse is intermittent cannon waves due to independent A waves which are asynchronous with and more rapid than the carotid pulse.The diagnosis is confirmed by electrocardiogram, the P waves and QRS complexes have no constant relation. The QRS duration is normal if the heart beat is initiated high in the His bundle and prolonged if the pacemaker is located below it.The treatment is directed especially to Adams-Stokes syncope. Digitalisation and other anticongestive measures may be indicated if cardiac failure occurs. In patients with recurrent Adams•Stokes attacks, resting ventricular rate of 40 beats per minute or less probably should be paced.The prognosis for congenital and acquired heart block is usually favourable.Key Words: heart block -- a-v block -- congenital heart disease -- acquired heart disease --rheumatic heart disease
Streptococcal Infection A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 6, No 03 (1974)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Pharingitis karena Streptococcus punya hubungan erat dengan terjadinya glomerulonephritis dan demam rheumatik. Incidensnya bevariasi antara 0,3 - 3%. Di Indonesia incidens demam rheumatik masih tinggi, sehingga dengan demikian kita dapat mengambil kesimpulan bahwa inciderns infeksi streptococcus juga tinggi.dengan demikian kita dapat mengambil kesimpulan bahwa incidens infeksi streptococcus juga tinggi.Gejala klinis dari pharingitis karena steptococcus tidak khas, sehingga sukar untuk didifferensiasi dengan pharingitis karena virus. Ada tiga tingkatan gejala klinis, yalah berat, medium dan ringan, dan semuanya ini dapat merupakan pendahuluan dari demam rheumatik.Infeksi streptococcus yang berulang-ulang akan memberatkan kerusakan valvula pada kelainan jantung rheumatik, sehingga pada kelainan ini perlu dilakukan profilaksi. Tapi profilaksi ini tak perlu dikerjakan pada penderita glomerulonephritis, karena padanya infeksi ulang tak memberatkan.Bakteri streptococcus dapat diklasifikasikan sebagai berikut:a). Didasarkan pada sifat-sifat haemolisisnya pada agar darah kambing, maka bakteri ini diberi nama: alpha-, beta-, dan gamma-haernolisis.b). Didasarkan pada test serologis maka diberi nama grup A — Q (tanpa I dan J), sedang grup A sendiri dibagi jadi paling sedikit 45 tipe (subgrup).Strain group A dapat melepaskan sejumlah antigen extracellular.Pengobatan: Bila kita melakukan pengobatan awal dan cukup berarti kita mencegah terjadinya demam rheumatik dan kelainan jantung rheumatik. Obat-obat yang paling baik untuk infeksi ini yalah: penicilin, erythromycin dan Lincomycin. Sulfa tidak dapat digunakan sebagai pengobatan, karena resikonya lebih besar daripada kegunaanya. Tapi sulfa dapat digunakan sebagai profilaksi.
Atrial fibrillation in children: Case study A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 22, No 02 (1990)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Atrial fibrillation is very rare in children. Two children are described, although both were initially in congestive heart failure due to active carditis and were difficult to manage, but all have completely recovered. In addition to digitalis therapy all cases had quinidine, with therapeutic goal of controlling the heart rate rather than abolishing the fibrillation. One case died at home, 12 days after discharge from hospital and one recovered from fibrillation until now.Mitral and tricuspidal an nuloplasty have been performed to the second case, and the result is very satisfactory.Key Wards: atrial fibrillation — rheumatic hear t diseases — rheumatic fever— congestive heart failure — quinidine therapy
Uji Diagnostik Kriteria Baru Demam Reumatik A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 21, No 02 (1989)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

More than 40 years ago T. Duckett Jones published a set of guidelines for the diagnosis of acute rheumatic fever that became known as the Jones criteria. The criteria became widely used throughout the world and provided a uniform diagnostic reference for national and international epidemiologic, prevention and treatment studies.Although the basic concepts proposed by Jones have been retained, modifications of the original criteria should be done to simplify the criteria in order to be used as a diagnostic tool at the primary health care, type D and C hospitals and for surveillance. These new simple diagnostic instruments should have good sensitivity, specificity, positive and negative predictive values using Jones criteria as gold standard.Eight criteria have been considered as a new simple diagnostic instrument, with various sensitivity, specificity, positive predictive and negative predictive values. The optimum result of this diagnostic test is in the eight criteria, i. e. the criteria of specific murmur.Key Words: rheumatic fever -- cardiomegaly -- heart failure -- Jones criteria -- specific murmur
Left bundle branch block in diphtheritic myocarditis A case study A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 25, No 02 (1993)
Publisher : Universitas Gadjah Mada

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Abstract

Left bundle branch block is very rare in children. A boy, 5 years old with diphtheritic myocarditis had left bundle branch block in ECG pattern during the first days in hospital. He had received basic DPT vaccination 4 1/2 years ago, when his age was three months.The prognosis of left bundle branch block in diphtheritic myocarditis is usually poor. However, as he received DPT vaccination in the last 5 years the prognosis was tending to good. After 11 days hospitalisation, the ECG pattern suddenly reversed to normal. The follow up- through outpatient department has no further complications, despite he discharged with still high LDH serum leveLThe purpose of this study is to report a very rare case, and this case hopefully to be the last diphtheritic disease in Yogyakarta, due to a very good coverage of vaccination.Key Words: diphtheria diphtheritic myocarditis left bundle branch block DPT vaccination LDH enzyme
Pericarditis With Effusion in Children A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 6, No 01 (1974)
Publisher : Universitas Gadjah Mada

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Abstract

Two cases of pericarditis with effusion admitted to the Department of Child Health, Gadjah Mada University Hospital were presented. The suspicion was based on the presence of pericardial friction rub for the first case, and the presence of cardiac enlargement and liquid line (on X-ray) for the second case. Pericardiocentesis was performed to confirm the diagnosis and for treatment.An accurate etiological diagnosis could not be made due to lack of laboratory facilities. The treatment was based on clinical and pathological findings
Hubungan Antara Tekanan Darah Dan Ukuran-Ukuran Anthropometrik Sekelompok Anak sekolah Dasar di Daerah Istimewa Yogyakarta A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 17, No 03 (1985)
Publisher : Universitas Gadjah Mada

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Abstract

The relationship between blood pressure and body weight, body height and upper arm circumference was studied in 506 school children, consisting of 227 boys and 279 girls, aged 6-14 years. Blood pressure was measured by using mercury sphygmomanometer. measurements were conducted once in the sitting position, and the subjects were selected at random from 7 000 school children in the district of Sewon, Bantul, Yogyakarta. The results found showed that there are correlations between either systolic or diastolic blood pressure with body weight, body height and upper arm cir cumference, especially in the ages of 15 co 14 years. Key Words: blood pressure - anthropometric measurements - school children - nutrition —body mass
Insidensi streptococcus beta-haemolyt cus pada anak dengan pharyngitis A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 9, No 03 (1977)
Publisher : Universitas Gadjah Mada

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Abstract

Pharynx-swabs using filter paper strip method were done on children with pharyngitis, and 3,8% positive Streptococcus beta-haemolyticus group A and 4,8% positive non-group A werefound.Clinical manifestations were: fever (100%), hyperaemic pharynx with exudate 54%, without exudate 46% and with cough 27%. Blood examinations were done on 40 positive cases of which 60% showed leucocytosis.Months with a high incidence were: January — February 27%, May — June 36% and September — October 27%.
Studies of Blood Pressure in Primary School Children in a Rural Area in Indonesia A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 16, No 04 (1984)
Publisher : Universitas Gadjah Mada

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Abstract

Telah diukur tekanan darah pada 506 anak sekolah yang berumur antara 6-14 tahun dan terdiri atas 227 anak laki-laki dan 279 anak wanita. Sampel ini diambil secara duster dan acak dari suatu populasi anak sekolah di pedesaan. Tekanan darah ini diukur pada anak sekolah clari 17 sekolah dasar kecamatan Sewon, Bantu!, Daerah lstimewa Yogyakarta. 17 sekolah ini merupakan sampel dari seluruh sekolah dasar yang ada di kecamatan Sewon.Alat yang dipakai untuk mengukur adalah sphygmomanometer bahan air raksa, dan pengukuran dilakukan oleh hanya sacs orang. Semua anak mula•mula diukur tekanan darahnya pada posisi duduk, kemudian pada posisi telentang.Hasilnya pada posisi duduk tekanan darah sistolik berbeda secara bermakna antara anak lakilaki dan wanita, kecuali pada anak umur 6 tahun. Demikian juga tekanan darah diastolik, kecuali pada anak umur 14 tahun.Tekanan darah pada posisi duduk dan tidur berbeda bermakna balk pada laki-laki maupun pada wanita.Key Words: blood pressure - rural primary school children - systolic pressure - diastolic pressure
Supravengricular tachycardia in children: The role of infectious diseases and its relationship to serum enzyme A. Samik Wahab, A. Samik Wahab
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 18, No 03 (1986)
Publisher : Universitas Gadjah Mada

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Abstract

In twenty four children an episode of supraventricular tachycardia occurred before 15 years (median age 12 months). Fourteen male and 10 female children were reviewed, of which one had a congenital heart disease. Lown-Ganong-Levine syndrome was present on surface ECG in 1/24 (4 per cent). Forty six per cent of children were undernourished as determined by the weight to height ratio according to the WHO criteria (1983), and 58 per cent of them were anemic, according to the WHO criteria (1972). All children have had fever, mostly above 38.5° C. In ten children with an SVT episode the serum enzyme level, was also studied, i. e. the serum glutamine oxalo-transaminase (SCOT), lactate dehydrogenase (LDH) and creatinine phosphokinase (CPK). Five out of 11 children had a high serum enzyme level, ranging 25-68 U/dI (mean: 40.88 ± 16.30) for GOT, 315 889 U/dI (mean: 482 ± 232.53) for LDH, and 57-581 U/d1 (mean: 251.33 ± 287.02) for CPK, instead of a normal level range of 1-19 U/c11, 80-240 U/dl and 0-50 U/dl respectively. It is concluded that the episode of SVT often occurs in children with infection, especially gastrointestinal intention, meningitis, encephalitis. bronchopneumonia and septicemia. Fever, undernutrition and anemic status are considered as precipitating factors. Preexitation syndromes, such as WPW and LGL syndromes, were infrequently found. Digitalis treatment has to be changed with other preparations which are often used such as calcium antagonist or ATP, especially for patients who do not respond to digitalis. Physicians who work in the surgery department, should be aware of an SVT episode, especially if the children have fever, undernutrition and anemia. Key Words: supraventricular tachycardia - anemia - undernutrition - WPW syndrome - LGL syndrome
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