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All Journal Sari Pediatri Paediatrica Indonesiana Cermin Dunia Kedokteran
Tina Christina Tobing
Bagian Ilmu Kesehatan Anak FK-USU / RS H. Adam Malik
Health Professions Medicine & Pharmacology Public Health

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Dampak Kardiotoksik Obat Kemoterapi Golongan Antrasiklin Irwan Harpen Siahaan; Tina Christina Tobing; Nelly Rosdiana; Bidasari Lubis
Sari Pediatri Vol 9, No 2 (2007)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp9.2.2007.151-6

Abstract

Pengobatan kanker semakin pesat beberapa tahun terakhir dengan pilihan kombinasi obat kemoterapi,radioterapi dan pembedahan. Salah satu obat kemoterapi yaitu golongan antrasiklin, tetapi obat inimempunyai efek samping terhadap jantung yang tergantung dosis kumulatif pemakaian obat. Efek terhadapjantung dibagi menjadi efek cepat dan lambat. Efek cepat terjadi pada <1% kasus kanker. Sering ditemukanadalah efek lambat, dan seringkali subklinis. Mekanisme kerja obat diduga melalui proses ikatan denganDNA. Setelah pemberian obat intravena kadar obat dalam plasma akan menurun cepat dan bertahan lamadi jaringan, sehingga diperlukan pemantauan seumur hidup. Prosedur diagnostik untuk mendeteksi efekini adalah EKG, ekokardiografi, angiografi dan biopsi endomiokardium. Pencegahan yang dapat dilakukanyaitu penggunaan analog obat, membatasi jumlah obat yang masuk, mencari alternatif cara pemberianobat, dan pemberian obat yang disertai dengan obat yang melindungi jantung. Tantangan pemberian obatgolongan antrasiklin adalah bagaimana mengurangi efek toksik terhadap jantung sementara efek obatterhadap kanker tidak berkurang.
Obesity and left ventricular mass in children Mauliza Mauliza; Muhammad Ali; Melda Deliana; Tina Christina L Tobing
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.786 KB) | DOI: 10.14238/pi55.4.2015.224-29

Abstract

Background Obesity has negative effects on cardiac function during growth leading to increased heart size and mass, as a result of higher stroke volume and cardiac output.Objective To assess for a relationship between obesity and left ventricular mass (LVM) in children, as well as to assess for a correlation between the duration of obesity and LVM.Methods This cross-sectional study was conducted from October 2011 until February 2012 in Medan and included 30 obese and 30 normal weight children, aged 6 to 13 years. All subjects underwent complete echocardiography examinations to assess LVM and other left ventricular parameters. The Devereux formula was used to measure LVM.Results During the study, 65 children underwent echocardiography, but 5 were subsequently excluded. The left ventricular dimensions in the obese group were significantly higher compared to normal weight group with regards to interventricular septum at end diastole (IVSd), interventricular septum at end systole (IVSS), left ventricular internal diameter at end diastole (LVIDd), left ventricular internal diameter at end systole (LVIDs), left ventricular posterior wall thickness at end diastole (LVPWd), left ventricular mass (LVM), and left ventricular mass index (LVMI) (P=0.0001). Duration of obesity and LVM had a moderate, positive correlation (r=0.407).Conclusion There is significantly higher LVM in the obese group than in the normal weight group. The duration of obesity had a moderate, positive correlation to LVM.
Hemoglobin level and cardiothoracic ratio in children with chronic severe anemia Fera Wahyuni; Muhammad Ali; Bidasari Lubis; Netty D. Lubuis; Tina Christina Tobing
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.5.2011.262-5

Abstract

Background Chronic severe anemia is known to increase cardiac output when the hemoglobin levels are < 7 g/dL for more than three months. Chronic severe anemia is also associated with a high incidence of cardiac enlargement and congestive heart failure.Objective To determine the relationship between hemoglobin level and cardiothoracic ratio in children with chronic severe anemia.Methods We conducted a cross-sectional study in Haji Adam Malik Hospital, Medan, Indonesia from October to December 2009. Subjects had chronic severe anemia and were aged 1 to 15 years. Hematological data was collected at the beginning of the study. The heart was considered enlarged if the cardiothoracic ratio (CTR) was greater than 50% (0.50) by chest roentgenogram. We used simple linear regression to analyze the relationship between hemoglobin and CTR values.Results Thirty subjects enrolled in our study. Their mean age was 115.7 months (SD 56.95). Hemoglobin levels ranged from 2.1 to 6.9 g/dL. The mean hemoglobin level and duration of anemia were 4.71 g/dL (SD 1.48) and 3.9 months (SD 0.70), respectively. Heart enlargement was observed in 23 patients (76.6%). The CTR ranged from 0.52 to 0.69, with a mean of 0.54 (SD 0.06). We found a significant correlation between CTR and hemoglobin levels with Pearson’s correlation coefficient, (r) = - 0.612 and P = 0.001.Conclusion Low hemoglobin levels significantly correlated with high CTR values in children with chronic severe anemia. [Paediatr Indones. 2011;51:262-5].
Correlation between hemoglobin level and left ventricular systolic functions and dimensions in children with chronic severe anemia Erlina Masniari Napitupulu; Fera Wahyuni; Tina Christina L. Tobing; Muhammad Ali; Bidasari Lubis
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.79-83

Abstract

Background Chronic severe anemia is a connnon disease. Cardiac output may increase when the hemoglobin (Hb) level decreases to < 7 g/dL for 3 months or more. Alteration of left ventricular (LV) function occurs frequently in children 'With chronic severe anemia, in the {onn of concentric LV hypertrophy, LV dilatation with or v.ithout LV hypertrophy, or systolic dysfunction. Objective To examine the correlation between Hb level and alteration of LV systolic function in children with chronic severe anemia. Methods We conducted a cross-sectional study in Adam Malik Hospital from October to December 2009. Subjects were chronic severely anemic children. Left ventricular systolic function (ejection fraction/EF, fractional shortening/FS) and dimensions (left ventricular end diastolic diameter/LVEDD and left ventricular end systolic diameter/LVESD) were measured using Hitachi EUB 5500 echocardiography unit. Univariate analysis  and Pearson correlation were performed.Results Thirty children were enrolled in the study. The mean of age was 113.5 months (SD 53.24). Hb values ranged from 2.1 to 6.9 g/dL with mean value of 4.6 g/dL (SD 1.44). Mean duration of anemia was 3.9 months (SD 0.70). Chronic severe anemia was not associated \\lith decreased LV systolic function [EF 62.2% (SD 9.16), r =0.296, P=0.112; FS 33.8% (SD 7.26), r =0.115, P=0.545], nor LV dimension changes [LVEDD 40.2 mm (SD 6.85), r = -0.192, P=0.308; LVESD 26.2 mm (SD 4.98), r=-0.266, P=0.156]. Conclusion There was no correlation between Hb level in chronically anemic children and changes in LV systolic function or dimension.
Consanguinity and congenital heart disease in offspring Aris Fazeriandy; Muhammad Ali; Johannes H. Saing; Tina Christina L. Tobing; Rizky Adriansyah
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.785 KB) | DOI: 10.14238/pi58.2.2018.75-9

Abstract

Background Congenital heart disease (CHD) is a common congenital abnormality in children. Consanguineous marriage has been identified as a risk factor of CHD. There was an autosomal recessive pattern of inheritance seen in children with some forms of congenital heart disease. Objective To assess the possible association between consanguineous marriage and congenital heart disease incidence in the offspring. Methods A case-control study was conducted from March to May 2016 on pediatric patients at H. Adam Malik General Hospital, Medan. Subjects were allocated into two groups, 100 children with CHD in the case group, and the rest in the control group. Data were analyzed using Chi-square and logistic regression tests. In the present study, P value less than 0.05 was considered statistically significant. Results In the case group, 14 patients (14%) were born of consanguineous marriages. In the control group, only 5 patients (5%) were born of consanguineous marriages. There was a significant association between consanguineous marriage and CHD (OR 1.551; 95%CI 1.138 to 2.113). Based on the result of multivariate analysis, consanguineous marriage was a risk factor for CHD in offspring (Wald=4.525; P=0.033). Conclusion Consanguineous marriage is a risk factor for CHD in offspring.
Quality of life in children with congenital heart disease after cardiac surgery Sindy Atmadja; Tina Christina Tobing; Rita Evalina; Sri Sofyani; Muhammad Ali
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (63.227 KB) | DOI: 10.14238/pi57.6.2017.285-90

Abstract

Background Major achievements in congenital heart disease (CHD) treatment over the past 20 years have altered the course and prognosis of CHD. Improvement of quality of life (QoL) is now a major goal of CHD treatment. Objective To assess the QoL in children after cardiac surgery for CHD. Methods A cross-sectional study was performed in children aged 2 to 18 years. The case group had 20 children with a history of corrective heart surgery in the 12 months prior to the study. The control group had 20 healthy children, age-matched to the case group. The QoL of both groups was assessed by Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales. The same post-operative children were also assessed with the PedsQL Cardiac Module. Data were analyzed using T-test with P < 0.05 as the level of significance. Results This study recruited 40 subjects: 20 post-operative and 20 healthy children. PedsQL Generic Core Scales assessment showed significant differences between groups in the physical function parameter of QoL (P<0.05) in children aged 13-18 years, but there were no significant differences in the social, emotional, and school function parameters. In children aged 2-12 years, there were no significant differences in physical, social, emotional, or school parameters. The PedsQL Cardiac Module assessment revealed that 35% of post-operative children was at risk for physical appearance problems, 80% was at risk for anxiety problems, 40% was at risk for cognitive problems, and 80% was at risk for communication problems. Conclusion Thirteen to 18-year-old children with non complex CHD have poorer physical function than healthy children. Post operative children are at risk for physical appearance, anxiety, cognitive, and communication problems.
Oral contraceptive use and conotruncal congenital heart disease Mars Nashrah Abdullah; Muhammad Ali; Melda Deliana; Tina Christina L. Tobing
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.309-13

Abstract

Background Congenital heart disease (CHD) represents some of the more prevalent malformations among live births and remains the leading cause of death from congenital malformations. Conotruncal anomalies comprise a diverse group of CHD involving the outflow tracts of the heart and the great vessels. Oral contraceptive exposure before pregnancy may be one of the risk factors for conotruncal CHD. Objective To evaluate the effect of oral contraceptive use before pregnancy on the risk of conotruncal CHD in children. Methods A case-control study was conducted from July 2010 until July 2011 in Haji Adam Malik Hospital, Medan. Subjects with CHD were divided into two groups: conotruncal CHD as the case group and non-conotruncal CHD as the control group. Both groups had mothers with and without histories of oral contraceptive use before pregnancy. Parents were interviewed using questionnaires. Statistical analyses were performed using Chi-square test, student’s T-test, and Mann Whitney test. Results A total of 80 subjects were eligible, with 40 subjects in each group. The percentages of subjects whose mothers used oral contraceptives were 62% of the conotruncal CHD group and 60% of the non-conotruncal CHD group (OR 0.82; 95%CI 0.33 to 1.98). The mean duration of maternal oral contraceptive use before pregnancy was 19.1 months for the case group and 18.8months for the control group (P=0.87). Conclusion In children with CHD, maternal oral contraceptive use before pregnancy does not appear to increase the risk of conotruncal CHD.
Nutritional Status in Children with Congenital Heart Disease: Prevalence and Its Associated Factors Rafner lndra; Tina Christina L Tobing; Ahmad Dian Siregar; Abdullah Afif Siregar; Endang D Hamid; Iskandar Z Lubis
Paediatrica Indonesiana Vol 38 No 1-2 (1998): January - February 1998
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (655.535 KB) | DOI: 10.14238/pi38.1-2.1998.38-46

Abstract

A cross sectional study was undertaken on 58 children (age range 4 months-15 years) With congenital heart disease (CHD) and in controls of 58 subjects without CHD. The study was performed by anthropometric examination, history of acute respiratory tract infection, dietary intake, simple laboratory examination and type and severity of CHD were recorded. There were significant differences in: 1. Nutritional status between patients With CHD and without CHD (p<0.001). 2. Frequency of acute respiratory tract infection between patients with CHD and without CHD (p<0.001). 3. Duration of each episode of acute respiratory tract infection between patients with CHD and without CHD (p<0.05). 4. Calorie and protein intakes between patients with CHD and without CHD (p<0.005). Type of CHD (cyanotic and non-cyanotic) was significantly associated with nutritional status based on height for age among patients with CHD (p<0.01). However, there was no siignificant association between the presence or absence of heart failure with nutritional status among patients with CHD. In conclusion, there were Significantly differences of nutritional status, frequency/duration of acute respiratory tract infection, calories and protein intake between patients with CHD and without CHD. Type of CHD (cyanotic and non-cyanotic) was significantly associated with nutritional status based on height for age.
Time period after transcatheter PDA closure with changes in left ventricular function and nutritional status Muhammad Irfan; Muhammad Ali; Tina Christina Lumban Tobing; Wisman Dalimunthe; Rizky Adriansyah
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.100-6

Abstract

Background Few studies perform follow ups on patent ductus arteriosus (PDA) patients who undergo transcatheter closure. In addition to side effects from the procedure, it is important to evaluate changes in left ventricular function (LVF) parameters and nutritional status. Objective To compare LVF and nutritional status before and during the one-year period post-transcatheter PDA closure, and evaluate potential associated factors in post-closure PDA transcatheter patients. Methods This retrospective cohort study was done in a single center in patients diagnosed with PDA who had undergone transcatheter closure. Data were obtained from subjects’ medical records. The relationship between the post-closure PDA time span and LVF parameters [ejection fraction (EF) and fractional shortening (FS)] was analyzed by Friedman and repeated ANOVA tests; the post-closure PDA time period and nutritional status was analyzed by Friedman test. The time periods analyzed were 1, 3, 6, and 12 months post-closure. Factors potentially associated with LVF 12 months post-closure were analyzed by linear regression. Results A total of 30 patients who had undergone transcatheter PDA closure were included. The body weight mean of at the time of transcatheter PDA closure was 13.1 kg. We found a significant relationship between time period after PDA closure and nutritional status, before and 1, 3, 6, and at 12 months post-closure. In a comparison of pre-closure to 12 months post-closure, subjects’ mean EF (66.6 vs. 70.9%, respectively; P<0.001) and FS (34.4 vs. 37.8%, respectively; P<0.001) were significantly higher. In addition, significantly more patients had normal nutritional status 12 months post-closure than before closure. Age was not related to LVF parameters (EF: r=0.212; P=0.260; FS: r=0.137; P=0.471). Conclusion Both LVF and nutritional status significantly improve gradually over the 12 months post-closure compared to pre-closure. PDA size is not significantly associated with improved LVF parameters and nutritional status.
Tatalaksana Penutupan Duktus Arteriosus Persisten Transkateter Muhammad Irfan; Muhammad Ali; Tina Christina Lumban Tobing; Rizky Adriansyah; Hafaz Zakky Abdillah; Putri Amelia
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i6.1432

Abstract

Penyakit jantung bawaan (PJB) merupakan salah satu kelainan bawaan terbanyak di dunia. Secara umum kelainan ini dibagi menjadi tipe sianotik dan asianotik. Duktus arteriosus persisten (DAP) merupakan salah satu tipe PJB asianotik dan menduduki peringkat ke 3 dari seluruh kelainan jantung bawaan. Penutupan DAP secara transkateter saat ini menjadi pilihan utama jika gagal dengan obat-obatan dan ukuran defek memungkinkan. Pengamatan pasca penutupan transkateter penting untuk menilai perubahan klinis dan kemungkinan komplikasi.Congenital heart disease (CHD) is one of the most frequent congenital anomalies in the world. These anomalies are usually divided into cyanotic and acyanotic type. Patent ductus arteriosus (PDA) is acyanotic type of CHD and ranked 3rd of all CHD. Transcatheter PDA closure now become first choice if drug treatment fails and the size of the defect is qualified for nonsurgery closure. Post-closure observation is important to assess clinical changes and possible complications.
Co-Authors Abdillah Abdullah Afif Siregar Ahmad Dian Siregar Aris Fazeriandy Bidasari Lubis Bidasari Lubis Bidasari Lubis Endang D Hamid Erlina Masniari Napitupulu Fera Wahyuni Fera Wahyuni Hafaz Zakky Hafaz Zakky Abdillah Irwan Harpen Siahaan Iskandar Z Lubis Johannes H. Saing Mars Nashrah Abdullah Mauliza Mauliza Melda Deliana Melda Deliana Muhammad Ali Muhammad Ali Muhammad Ali Muhammad Ali Muhammad Ali Muhammad Ali Muhammad Ali Muhammad Irfan Muhammad Irfan Nelly Rosdiana Netty D. Lubuis Putri Amelia Rafner lndra Rita Evalina Rizky Adriansyah Rizky Adriansyah Rizky Adriansyah Sindy Atmadja Sri Sofyani Wisman Dalimunthe Yofita Sandra, S.Pd., M.Pd., Zico Farlin, Dr. Budiwirman, M.Pd.,