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All Journal Folia Medica Indonesiana Journal of Agromedicine and Medical Sciences Global Medical and Health Communication Jurnal Media Gizi Indonesia (MGI) The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Health Notions Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Oto Rhino Laryngologica Indonesiana JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) Indian Journal of Forensic Medicine & Toxicology Jurnal Pengabdian Kesehatan Masyarakat

Mahrus A. Rahman

Departement Of Child Health, Dr. Soetomo General Hospital, Faculty Of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Surabaya

Author-ID : 3035987

Humanities Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Pulmonary Artery Hypertension in Acyanotic Congenital Heart Disease Underwent Transcatheter Closure at Dr. Soetomo Hospital I Ketut Alit Utamayasa1 , Mahrus A Rahman1 , Taufiq Hidayat1 , Teddy Ontoseno1
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (2021): 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.v15i1.13572

Background: Pulmonary artery hypertension (PAH) is common complication of congenital heart disease.Echocardiography before and after transcatheter closure procedure is needed for further evaluation.Objective: To evaluate the PAH before and after transcatheter closure procedure by echocardiography atDr. Soetomo Hospital.Methods: Medical record patients with acyanotic congenital heart disease with PAH and already donetranscatheter closure procedure in 2010 – 2014 were reviewed. Data taken were demographic, clinical,and echocardiography. Tricuspid regurgitation pressure gradient (TRPG) was evaluated. Statistical analysisusing t test comparative study; P<0.05 was considered significant.Results: There were 46 patients underwent transcatheter closure, ASD closure 22/46, VSD closure 16/46,PDA closure 8/46 patients. Ten patients with PAH (10/46), 4/10 ASD, 4/10 PDA and 2/10 VSD. Boys were6/10, median age was 60 (range 4-144 months). Median TRPG before procedure was 32.4 (range 25-43mmHg). Median TRPG after procedure was 21.5 (range 15-26.9 mmHg). There was significant decreased inPAH after transcatheter closure procedure (P=0.01).Conclusion: Transcatheter closure procedure in acyanotic congenital heart disease was important fordecreasing the pressure gradient of PAH.

Caracteristics, Diagnosis, Management and Output of Persistent Pulmonary Hypertension of the Newborn at Dr. Soetomo Hospital Mardiyan Aprianto1 , Mahrus A Rahman1 , Martono Tri Utomo1
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (2021): 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.v15i1.13587

Background Persistent pulmonary hypertension of the new-born (PPHN) is a failure of lung circulation innew-born. However the data related the characteristics of clinical profile, diagnostic, management and theoutcome was still limited.Objective To investigated the characteristics, diagnostics, management and outcome from PPHN.MethodsRetrospective observational study. Neonates with PPHN from January 2015 to December 2019 wereidentified from medical record. After the data was excluded, the characteristics, diagnostic, management andthe outcome was collected. The statistical analysis to known the frequency and the chi-square test used toanalyse the association between the treatment and the outcomes (P < 0.05).Results 37 medical records enrolled the study, with the characteristics; 62.2% babies was boy, 70.3% withterm infant, 70.3% with normal birth weight, 24.3% with maternal history of eclampsia. 62.2% babiesborn by C-section, 21.9% with history of asphyxia and MAS. 78.4% with differences between pre- andpost-ductal saturation. From echocardiography result, 13.5% diagnosed as mild PPHN, 54.1% as moderatePPHN and 32.4% severe PPHN. From the management consisted of 5.4% with O2 nasal, 32.4% O2 CPAPand 62.2% O2 ventilator, 24.3% with sildenafil, 5.4% with combination sildenafil and illoprost, 5.4% withcombination sildenafil, illoprost, and surfactant, 2.7% with combination sildenafil, illoprost, surfactant,and inotropic, 24.3% with combination sildenafil, illoprost, and inotropic, and 37.8% with combinationsildenafil and inotropic. The outcomes was obtained 35.1% babies was died and 64.9% babies was cured,with oxygenation supplementation had significantly affecting the outcomes (P=0.02)Conclusion The characteristics of PPHN was dominated by baby boy, term infant and good birth weight,history of asphyxia and MAS, maternal history of eclampsia, C-section delivery and the differences betweenpre- and post-ductal saturation. The diagnosis commonly with moderate PPHN. The management with O2ventilator and combination sildenafil-inotropic. The outcome mostly the babies was cured.

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

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.

Clinical Profile of Pediatric Patients with Acyanotic Congenital Heart Disease in Dr. Soetomo General Hospital Surabaya Kartika Hardiyani; Taufiq Hidayat; Alit Utamayasa; Mahrus Abdur Rahman; Teddy Ontoseno
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): 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.v15i2.14306

Congenital Heart Diseases (CHD) are classified as Acyanotic or Cyanotic CHD. Prevalence of CHDaccording to various studies is 8-10 per 1000 live births worldwide, 10% of cases became infant mortalityin developing countries. This research aims to study the characteristics and clinical presentations in childrenwith acyanotic CHD in Dr. Soetomo General Hospital. A retrospective observational study from children withacyanotic type of CHD from medical record outpatient clinic in the Division of Neonatology and PediatricWard at Dr. Soetomo General Hospital from June to December 2016. Age, sex, heart defect, comorbid andnutritional status were taken from the medical record. The most dominant clinical profile was female witha mean age of 4 years. Atrial Septal Defect was the most common type of left-to-right shunt, followed byVentricular Septal Defect, and Patent Ductus Arteriosus. Pulmonary Stenosis was the most common typeof obstructive lesion, followed by Aortic Stenosis. Complications of acyanotic CHD were dominated byrecurrent respiratory tract infections followed by growth and developmental disorder, and heart failure. Themost common nutritional status was moderate malnutrition.

Profile of Age and Sex of Congenital Rubella Syndrome Patients with Congenital Heart Disease Chaq El Chaq Zamzam Multazam; Mahrus A. Rahman; Wiwin Retnowati
Health Notions Vol 5, No 3 (2021): March
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn50306

Background: Rubella is an acute viral disease that often attacks vulnerable children and young adults throughout the world. Even though it only causes mild clinical illness, concern in the health world arises from its teratogenic potential resulting in congenital rubella syndrome (CRS). The most common abnormalities of CRS are hearing loss or deafness, eye defects and congenital heart defects. Purpose: To determine the profiles of age and sex in congenital rubella syndrome patients with congenital heart disease in Dr Soetomo Regional Public Hospital for the period of 2016-2018. Methods: This type of research was a descriptive study by collecting data on the age and sex in congenital rubella syndrome patients with congenital heart disease in Dr Soetomo Regional Public Hospital retrospectively through medical records of patients for the period of 2016-2018. Results: The most age group of congenital rubella syndrome patients with congenital heart disease in Dr Soetomo Regional Public Hospital for the period of 2016-2018 was the toddler (0-

Oxygen saturation among newborns in the first 10 hours of life to detect Critical Congenital Heart Disease - Ductus Dependent Fatchul Wahab; Mahrus Abdul Rahman; Teddy Ontoseno; Risa Etika; Alit Utamayasa; Taufiq Hidayat; Sarmanu Sarmanu
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.4258

ABSTRACT Delay diagnosis of Critical Congenital Heart Disease (CHD) can be associated with sudden clinical deterioration and dangerous cardiovascular conditions. The oxygen saturation screening among newborns in the first 10 hours of life is essential for early detection of critical CHD. This study aims to prove that measuring oxygen saturation among newborns in the first 10 hours of life can detect critical CHD. This study is a diagnostic experimental with consecutive sampling subjects in the infant care unit of Dr. Soetomo Hospital, including all newborns with birth weight ≥ 1500 grams and oxygen saturation at ≥ 1 hour of age below 90%. The measurement of oxygen saturation uses fingertip pulse oximetry in the right hand and foot at the age of 10 hours. A "positive oxygen saturation" is defined as oxygen saturation ≤ 85% or different oxygen saturation ≥ 3%, while a "negative oxygen saturation" is when the oxygen saturation is 85% to 90% or different oxygen saturation is 3%. Echocardiography is performed for the gold standard. From November 2019 to January 2020, 11 newborns underwent an oxygen saturation examination. Five subjects (45.46%) in the category of positive oxygen saturation, echocardiographic showed all Critical CHD (100%). Six subjects (54.54%) with negative oxygen saturation category, echocardiographic results showed two critical CHD (33.34%) and four non-critical CHD (66.66%). Fisher's exact test p < 0.005 (α). The diagnostic oxygen saturation test among newborns at 10 hours of life shows ≤85%, all subject’s echocardiography (100%) shows detection of critical CHD, while saturation 85% to 90% has of 33.3% for detection of critical CHD. The sensitivity and specificity of oxygen saturation for early diagnosis of critical CHD are 100% and 67%, respectively. Keywords: critical congenital heart disease, oxygen saturation, fingertip pulse oximetry, diagnostic tests*Corresponding Author: wfatchul045@gmail.com

ANTHROPOMETRIC PROFILE OF CHILDREN WITH CYANOTIC AND NONCYANOTIC CONGENITAL HEART DISEASE Mahrus Rahman; I Ketut Alit Utamayasa; Taufiq Hidayat; Roedi Irawan; Rina Elizabeth
Media Gizi Indonesia Vol. 15 No. 1 (2020): JURNAL MEDIA GIZI INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mgi.v15i1.1-6

Impaired nutritional status is a frequent complication of congenital heart disease (CHD). Non cyanotic congenital heart disease (NC-CHD) have problem with lung overfl ow and heart failure. Consequences of Cyanotic congenital heart disease (C-CHD) are decrease pulmonary blood fl ow and prolong hypoxia. These conditions can have eff ect on nutritional status and outcome of surgery. This study aimed to compare anthropometric profi les of children with C-CHD and NC-CHD. Cross-sectional study conducted in 66 children, age 3 months until 5 years old who met inclusion criteria in Pediatric Cardiology Outpatient Unit Dr. Soetomo Hospital Surabaya in November 2012. A total of 66 children, consisted of 26 children with C-CHD and 40 children NC-CHD included in study. We measure weight, length/height, head circumference, upper arm circumference, and skin fold thickness. We used Chi Square test for statistical analysis with Confi dence Interval 95%. Mean age of both groups was 27.82 ± 16.63 months. Majority of NC-CHD was Ventricular Septal Defect (28.6%) and C-CHD was Tetralogy of Fallot (21.4%). There were no signifi cant diff erence from weight for age, length for age weight for length, head circumference for age, mid upper arm circumference for age, mid upper arm circumference for age, and skin fold thickness for age between children with C-CHD and NC-CHD (p= 0.80; 0.98;0.54 0.29; 0.80; 0.53 respectively). There were no diff erence in anthropometric profi les among children with cyanotic congenital heart disease and non-cyanotic congenital heart disease in this study.

Comparison of Angiotensin-Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB) for Heart Failure Treatment in Congenital Heart Diseases with Left-to-Right Shunt Alit Utamayasa; Mahrus Ahmad Rahman; Teddy Ontoseno; Budiono budiono
The Indonesian Biomedical Journal Vol 12, No 1 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i1.997

BACKGROUND: The angiotensin-converting enzyme inhibitors (ACEIs) have become the forefront of heart failure treatment for more than a decade. Currently, angiotensin receptor blockers (ARBs) are thought to have similar effectiveness. This study aimed to compare the impact of captopril, one of ACEI, and valsartan, one of ARB, on clinical presentation and echocardiographic, electrocardiographic, and chest x-ray improvement in patients with left-to-right shunt congenitalheart diseases.METHODS: This study used a double-blind randomized controlled trial of captopril and valsatran to children with left-to-right shunt congenital heart diseases who suffer from heart failure in the Dr. Soetomo General Hospital, Surabaya, Indonesia. Pediatric heart failure scores, echocardiography, electrocardiography (ECG), and chest photographs were examined at the beginning of the study and after 30 days of treatment.RESULTS: A decrease in pediatric heart failure scores were showed after the administration of ACEI (7.06±2.04 vs. 4.75±2.43; p<0.0001; 95% CI: −2.98 - 1.65); ARB (6.81±2.25 vs. 3.94±1.98; p<0.0001; 95% CI: −3.76 to 1.98). The echocardiography examination, an increase in left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), % fractional shortening (FS), and left ventricular (LV) dimension occurred after the administration of ACEI and ARB. The values also didn’t significantly differrent between the two groups. The ECG evaluation showed a decrease in heart rate frequency after the administration of ACEI (117.75±14.67 vs. 109.63±17.59; p=0.039; 95% CI: −15.78 to −0.46) and ARB (117.10±21.86 vs.108.6±20.66; p=0.006; 95% CI: −14.17 to −2.83).CONCLUSION: ARB showed better outcome in clinical condition, echocardiography, ECG, and chest radiographs.KEYWORDS: captopril, valsartan, heart failure, congenital heart disease, left to right shunt

Fungsi Sistolik dan Diastolik Ventrikel Kiri pada Anak dengan Leukemia Limfoblastik Akut Pasca Terapi Daunorubisin Mahrus A Rahman
Sari Pediatri Vol 7, No 3 (2005)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Pengobatan utama limfomia limfoblastik akut (LLA) adalah kemoterapi.Sitostatik yang paling sering memberikan efek samping pada sistem kardiovaskuler adalahgolongan antrasiklin yaitu doksorubisin dan daunorubisin. Tanda awal kardiomiopatikarena antrasiklin adalah gangguan fungsi diastolik. Adanya gangguan fungsi ventrikeldapat dibuktikan dengan metode radionuklid dan ekokardiografi Doppler.Tujuan penelitian. Memperoleh data fungsi diastolik dan sistolik ventrikel kiri, dimensiventrikel kiri, dan status gizi pada anak dengan LLA pasca terapi daunorubisin.Metode. Penelitian cross sectional meneliti fungsi diastolik dan sistolik ventrikel kiripada 19 anak LLA pasca terapi daunorubisin. Sebagai kontrol penelitian 21 anak LLAtanpa terapi daunorubisin dan 18 anak sehat. Pemeriksaan fungsi dan dimensi ventrikelkiri dilakukan dengan pemeriksaan ekokardiografi 2D, M mode dan Doppler. Analisisstatistik hasil penelitian dilakukan dengan mempergunakan uji ANOVA dan Chi-square.Hasil. Terdapat 12 dari 19 anak pada kelompok studi dan 5 dari 21 anak pada kelompokkontrol LLA yang mengalami gangguan fungsi diastolik ventrikel kiri dengan pola penurunanrelaksasi. Pola penurunan relaksasi terdapat pada kardiomiopati hipertrofi maupunkardiomiopati dilatasi, hipertrofi ventrikel kiri karena berbagai sebab, penyakit jantungiskemik, preload yang menurun, dan afterload yang meningkat. Pada kelompok kontrolLLA juga sudah terdapat gangguan fungsi diastolik ventrikel kiri. Disamping daunorubisinterdapat faktor lain yang mempengaruhi fungsi diastolik ventrikel kiri, penyakitnya sendiridan obat-obat lain. Gangguan fungsi sistolik ventrikel kiri hanya didapatkan pada 1 anakkelompok studi. Hal ini disebabkan oleh dosis kumulatif daunorubisin yang masih relatifrendah dan follow up yang masih pendek. Tidak terdapat perubahan dimensi ventrikel kiripada kelompok studi dibandingkan kelompok kontrol; belum terjadi kardiomiopati yangberhubungan dengan dosis kumulatif yang tinggi dan penggunaan yang lama untuktimbulnya manifestasi klinis. Pada kelompok studi tidak didapatkan perbedaan yang bermaknaantara gizi dengan timbulnya gangguan fungsi diastolik.Kesimpulan. Pada anak dengan penyakit leukemia limfoblastik akut pasca terapidaunorubisin dosis kumulatif 120 mg/m2 telah mengalami gangguan fungsi diastolikventrikel kiri, sedangkan fungsi sistolik tidak terganggu. Dimensi ventrikel kiri tidakmengalami perubahan. Tidak terdapat perbedaan status gizi pada anak dengan fungsidiastolik ventrikel kiri terganggu.

Mortality Risk Factors in Tetralogy of Fallot Patients Undergoing Total Correction Juliana Juliana; Yan Efrata Sembiring; Mahrus Abdur Rahman; Heroe Soebroto
Folia Medica Indonesiana Vol. 57 No. 2 (2021): June
Publisher : Universitas Airlangga

A total correction is a preferred treatment for Tetralogy of Fallot patients in every part of the world. However, the mortality in developing countries was as high as 6.9% to 15.3%. This was a retrospective analytic study that analyzed pre and post-operative risk factors that affected mortality on TOF patients that were performed total correction in Indonesia. A total of 47 TOF patients that were performed total correction from January 2016 to September 2019 were enrolled in this study based on the inclusion criteria. Preoperative and post-operative data were obtained from medical records. In this research, the majority of mortality was found in male patients (39.3%), while the female’s rate was lower (36.8%). Overall mortality was 38.3% and one operative death was found. The average age of patients was 84.12 months (12-210 months), whereas the average height (85.56 ± 36.17cm vs. 112.93 ± 21.73) and weight (17.22kg vs. 28.21kg) were lower for mortality patients. Some significant preoperative variables were identified as mortality risk factors such as: age below 60 months (p=0.047), smaller weight and height (p=0.008; p=0.002), abnormal hematocrit (p=0.002), and oxygen saturation below 75% (p=0.018). Significant post-operative risk factors included: temperature above 38.5⁰C (p=0.000), and ventilator time of more than 48 hours (p=0.033). In conclusion, the mortality of TOF patients undergoing a total correction in developing countries was quite high. It was associated with some risk factors, such as younger age, lower weight and height, low oxygen saturation, post-operative fever, and prolonged ventilator time.

Co-Authors Achmad Lefi Agus Harianto Alit Utamayasa Budiono budiono Chaq El Chaq Zamzam Multazam Cintya Dipta Dina Angelika Evisina Hanafiati Frans Fatchul Wahab Henry Wicaksono Heroe Soebroto I Dewa Gede Ugrasena Juliana Juliana Kartika Darma Handayani Kartika Hardiyani Martono Tri Utomo Mia Puspitasari Nabila Izzati Ni Wayan Thirthaningsih Nyilo Purnami Ovin Nada Saputri R Fatchul Wahabe Rina Elizabeth Rio Herdyanto Risa Etika, Risa Roedi Irawan Saraswati Dewi Sarmanu Sarmanu Saskia Ratna Desita Sunny Mariana Samosir Taufiq Hidayat Teddy Ontoseno Teddy Ontoseno Teddy Ontoseno Teddy Ontoseno Teddy Ontoseno Vinny Yoanna Viskasari P. Kalanjati Wiwin Retnowati Yan Efrata Sembiring Yudi Her Oktaviono, Yudi Her

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