Sunny Mariana Samosir
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Echocardiographic Study in Preterm Infant with Hemodynamic Significant Patent Ductus Arteriosus Sunny Mariana Samosir; Martono Tri Utomo; Mahrus A. Rahman; Risa Etika; Dina Angelika; Kartika Darma Handayani; Agus Harianto
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17650

Abstract

Background: Potential complications of hemodynamic significant patent ductus arteriosus (hsPDA) after birth include heart failure, need for respiratory support, renal disfunction, intraventricular hemorrhage, as well as long term altered growth and development. Nevertheless, clinical signs of patent ductus arteriosus (PDA) are not sensitive and specific enough. Therefore, echocardiography still remains the preferred method to evaluate the ductal patency in preterm infant. The present study aimed to evaluate the echocardiography characteristic in preterm infant with hsPDA.Methods: A cross-sectional study was conducted on preterm infants aged 3-7 days with 24-336/7 weeks of gestation. Data taken were demographic, clinical and echocardiography. Diagnosis of hsPDA was carried out by echocardiography; defined as >1.5mm diameter of ductus and >1.4 left pulmonal artery and aorta (La/Ao) ratio. The statistical analysis was undertaken using SPSS 21.0.Results: There were 11 out of 52 preterm infants diagnosed hsPDA. Mean birth weight was 1213±293 gram; Mean gestational age was 30.72±2.01 weeks. In hsPDA group, mean ductus diameter was 2.84±0.93 mm, mean La/Ao ratio was 1.56±0.26, and mean ejection fraction (EF) was 71.55±5.72%.Conclusion: Echocardiographic evaluation is important for addressing hsPDA in preterm infants.
Binocular Diplopia in Miller Fisher Syndrome Pediatric Patient: A Rare Case Report: Poster Presentation - Case Report - Resident Dinda Zhafira; Reni Prastyani; Prastiya Indra Gunawan; Riza Noviandi; Sunny Mariana Samosir
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/36zz6w74

Abstract

Introduction : Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré syndrome that usually presents with ataxia, areflexia and ophthalmoplegia. It is more common among patients in their 40s and number of cases in pediatric patients is significantly smaller. Our objective is to report a rare case of diplopia in Miller Fisher. Case Illustration : An 11 years old boy came with complaint of double vision and history of gaze restriction. Patient had history of inpatient admission due to acute progressive generalized limb weakness and walking difficulty followed by respiratory failure. Patient also had history of chewing and swallowing difficulty. Inpatient treatment included intravenous immunoglobulin (IVIG) for 5 days which resultedin clinical improvement. Electromyography examination done while hospitalization showed normal results. Orthoptic examination revealed 15 degrees exotropia of left eye with 30 prism dioptres (PD) at near and far distance. Worth four dot test resulted in cross diplopia with no abnormality in head CT scan. After 2 months follow-up with push-up pencil exercise, patient showed improvement of symptoms. Discussion : MFS is a clinical diagnosis that can be assessed by clinical triad of ataxia, areflexia and ophthalmoplegia. Diagnosis can be supported by ancillary test such as cerebrospinal fluid analysis, electrophysiologic studies or antibody anti-GQ1b . Treatment of MFS are mainly for supportive care with respiratory support and immunotherapy if needed in severe cases. Conclusion : The outcome of MFS is usually good with a complete recovery. The improvements generally begin within two to four weeks after the onset of neurological symptoms and complete within six months.