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Najib Advani
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Ventricular function and high-sensitivity cardiac troponin T in preterm infants with neonatal sepsis Nusarintowati Ramadhina; Rubiana Sukardi; Najib Advani; Rinawati Rohsiswatmo; Sukman T. Putra; Mulyadi M. Djer
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 (126.089 KB) | DOI: 10.14238/pi55.4.2015.203-8

Abstract

Background Hemodynamic instability in sepsis, especially in the neonatal population, is one of the leading causes of death in hospitalized infants. The major contribution for heart dysfunction in neonatal sepsis is the myocardial dysfunction that leads to decreasing of ventricular function. The combination of echocardiography and laboratory findings help us to understand the ventricular condition in preterm infants with sepsis.Objective To assess for a correlation between ventricular function and serum high-sensitivity cardiac troponin T (hs-cTnT) level in preterm infants with neonatal sepsis.Methods We prospectively studied 30 preterm infants with neonatal sepsis who were admitted to the neonatal intensive care unit (NICU) of Cipto Mangunkusumo Hospital from June 1 – August 31, 2013. The ventricular functions were measured using 2-dimensional echocardiography. The parameters of right ventricular (RV) function assessment were tricuspid annular plane systolic excursion (TAPSE) and RV myocardial performance index (MPI). For left ventricular (LV) performance, we assessed ejection fraction (EF), fractional shortening (FS), and LV-MPI. Serum hs-cTnT was measured and considered to be a marker of myocardial injury.Results Subjects had a mean gestational age of 31.5 (SD 2.18) weeks and mean birth weight of 1,525 (SD 437.5) g. The mean LV function measured by MPI was 0.281 (SD 0.075); mean EF was 72.5 (SD 5.09)%; and mean FS was 38.3 (SD 4.29)%. The RV function measured by TAPSE was mean 6.85 (SD 0.94) and that measured by MPI was median 0.255 (range 0.17-0.59). Serum hs-cTnT level was significantly higher in non-survivors than in survivors [282.08 (SD 77.81) pg/mL vs. 97.75 (24.2-142.2) pg/mL, respectively P =0.023]. There were moderate correlations between LV-MPI and hs-cTnT concentration (r=0.577; P=0.001), as well as between RV-MPI and hs-cTnT concentration (r=0.502; P=0.005). The positive correlation between LV and RV-MPI in neonatal sepsis was strong (r=0.77; P <0.001).Conclusion Left and right ventricular MPI show positive correlations with hs-cTnT levels. Serum hs-cTnT is significantly higher in non survivors. As such, this marker may have prognostic value for neonatal sepsis patients.
Risk factors and outcomes, a case series of ischemic stroke in children Shirley L. Anggriawan; lrawan Mangunatmadja; Djajadiman Gatot; Sofyan lsmael; Najib Advani
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (155.353 KB) | DOI: 10.14238/pi49.1.2009.59-64

Abstract

Ischemic strokes in children, although generallyrare events, are more prevalent  than  commonlybelieved. Ischemic stroke in children have  beenassociated with coagulation disorders, cardiacanomalies, infections  and  trauma.
Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma Alit Utamayasa; Najib Advani; Imam Boediman; Sudigdo Sastroasmoro; Bambang Madiyono
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (142.917 KB) | DOI: 10.14238/pi49.3.2009.131-4

Abstract

Objectives To study changes in parameters of right ventricular(RV) diastolic function after procaterol and budesonide inhalationin children with asthma.Methods This was a one-group pretest-posttest design to determinechanges in right ventricular diastolic function followingfour weeks of inhaled procaterol and budesonide administration.Subjects were children aged 8 to 18 years with frequent episodicasthma recruited consecutively at the Department of ChildHealth, Cipto Mangunkusumo Hospital. M-mode and 2-Dechocardiography examinations were performed to determine RVisovolumetric relaxation time (IVRT), acceleration time (AT),deceleration time (DT), E wave, A wave, E/ A ratio, and tricuspidannular plane systolic excursion (TAPSE). Means of the RVfunction parameters before and after treatment were comparedusing the paired t-test or Wilcoxon test.Results There were 29 patients comprising 16 boys and 13 girls. Themeans or medians of theE wave, A wave, E/A ratio, accelerationtime (AT), deceleration time (DT), and isovolumetric relaxationtime (IVRT) before and after treatment were 0.55 and 0.55 em/sec(P=0.709), 0.45 and 0.35 em/sec (P<O.OOOl), 1.17 and 1.58 em/sec(P<0.0001), 52.73 and 55.03 m/sec (P=0.04), 55.39 and 58.10 m/sec (P=0.03), and 46.50 and 70.0 m/sec (P<0.0001), respectively.The median pre- and post-inhalation TAPSE were 1.63 and 1.84em, respectively (P<0.001).Conclusions In children with frequent episodic asthma, thereare changes in RV diastolic functions IVRT, AT, DT, E/A ratioand A wave following procaterol and budesonide inhalation.There was no increase in E wave following inhalation. TAPSEwas increased following procaterol and budesonide inhalation.
Incidence and characteristics of antituberculosis drug-induced hepatotoxicity in children: a preliminary study Bina Akura; Hanifah Oswari; Bambang Supriyatno; Najib Advani
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.74 KB) | DOI: 10.14238/pi49.6.2009.342-8

Abstract

Background Antituberculosis drugs show good efficacy but have adverse effects including hepatotoxicity.Objective To find the incidence and characteristics of antituberculosis hepatotoxicity in children during the first 2 weeks of therapy.Methods A cohort study was performed in Cipto Mangunkusumo, Persahabatan, and Tangerang Hospitals from August 2008 toMarch 2009. The diagnosis of tuberculosis (TB) based on TB scoring system. Laboratory tests were performed including transaminase enzymes, bilirubin, y-GT, albumin, ureum, and creatinine before and after 2 weeks of treatment. Patients were monitored during the first 2 weeks of therapy. Informed consent obtained from the parents.Results Six of 81 subjects had hepatotoxicity reaction. Most of the patients were 1 to 5 years old (65%) and well nourished (50%). Extrapulmonary tuberculosis found in 67% of cases. Thirty-three percents of patients received four agents. Thirty-three percents of cases received 4 agents combined with other hepatotoxic drugs. Six subjects had hepatotoxicity (1 hepatitis, 2 mixed case, and 3 asymptomatic). Two of 50 children (4%) with pulmonary TB and 4 out of 31 ( 13%) children with extrapulmonary TB had hepatotoxicity reaction. Antituberculosis drug doses were similar between the hepatotoxicity group and control.Conclusions Incidence of antituberculosis hepatotoxicity in thefirst 2 weeks of therapy was 7%, consisted of hepatitis (1 cases), mixed (2 cases), and asymptomatic (3 cases). There was no difference in sex as well as in nutritional state distribution found in cases with hepatotoxicity.
The correlation between ferritin level and cardiac dysfunction in patients with thalassemia Fajar Subroto; Bulan Ginting Munthe; Najib Advani; Agus Firmansyah
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.98 KB) | DOI: 10.14238/pi43.1.2003.24-7

Abstract

Background Patients with b-thalassemia major, long-term trans-fusion, extravasal hemolytic, and increased intestinal absorptionof iron result in systemic iron overload, which may accumulate inmyocardium causing cardiac dysfunctions. Congestive heart fail-ure usually develops in adolescence or early adult years, and pa-tient usually dies within 1 year after the onset of symptoms. There-fore, it is important to detect early signs of cardiac dysfunction inpatient with thalassemia.Objective This study aimed to assess the correlation betweenferritin level and cardiac dysfunction in patients with thalassemia.Methods A cross sectional study was conducted on 62 b-thalas-semic patients (34 males and 28 females) with age ranging from3.5 to 23 years. They received 3,150 – 94,985 mL of blood; withthe serum ferritin level of 812.2 – 12,175 ng/mL. Each patient un-derwent laboratory examinations and clinical cardiac evaluationwith ECG and echocardiography.Results Cumulative blood transfusions correlated well with theserum ferritin values (p=0.001). The serum ferritin level did notshow correlation with deferoxamine (DFO) treatment. ECG exami-nation revealed 5 patients (8.1%) with dysrhythmia, LVH, and heartblock grade II and I. Echocardiography examination showed 18patients (29%) with systolic or diastolic dysfunction. There was nocorrelation between the serum ferritin level and cardiac dysfunc-tions (p=0.640). The serum ferritin prediction value against car-diac dysfunctions could not be established.Conclusion There was no correlation between serum ferritin lev-els with cardiac dysfunctions. In detecting cardiac dysfunctions inthalassemic patients, echocardiography was more sensitive thanECG
Stent implantation into ductus arteriosus: a new alternative of palliative treatment of duct-dependent pulmonary circulation Mulyadi M Djer; Bambang Madiyono; Sudigdo Sastroasmoro; Sukman T Putra; Ismet N Oesman; Najib Advani; Mazeni Alwi
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (544.032 KB) | DOI: 10.14238/pi44.1.2004.30-6

Abstract

Background The technical aspects of ductal stenting have beenreported, but little is known about the fate of the duct after stentimplantation.Objectives To determine the effects of PDA stenting on the degreeof cyanosis, blood oxygen saturation, long-term patency of PDA,and the growth of pulmonary artery and its branches, in patientswith duct-dependent pulmonary circulation.Methods This was a case series study conducted at the Depart-ment of Pediatric Cardiology, Institut Jantung Negara (National HeartInstitute), Kuala Lumpur, Malaysia from November 1996 to Septem-ber 2001 on patients with duct-dependent pulmonary circulation whounderwent stent implantation. All patients were followed-up until oc-clusion or block occurred or until the end of follow-up time. The evalu-ation consisted of clinical manifestations, electrocardiography, chestx-ray, echocardiography, and cardiac catheterization.Results Stent was successfully implanted in 60 patients (84%),failed in 7 patients (10%) and contra indicated in 4 patients (6%).There was significant improvement on the degree of cyanosis afterstent implantation (p<0.0001). The blood oxygen saturation signifi-cantly increased from 74% (ranged 42-93; SD 12) before proce-dure, to 90% (ranged 62-100; SD 8) afterward (p<0.0001). The meanduration of follow-up time was 14.2 months (ranged 2.5-50.8; SD13) and the minimal patency of PDA was 11.2 months (ranged 1.1-47.7; SD 10.7) after implantation. At the end of follow-up, the stentswere widely patent in 33 patients (55%), stenotic in 15 patients (25%)and spontaneously occluded in 12 patients (20%). There was in-creased growth of pulmonary artery as measured by McGoon ratiofrom 1.23 (ranged 0.4-2.3; SD 0.4) to 1.81 (ranged 0.7-0.9; SD 0.57),and no distortion of pulmonary artery and its branches found.Conclusion Stent implantation into ductus arteriosus decreasedthe degree of cyanosis, increased blood oxygen saturation, main-tained long-term patency of ductus arteriosus, and promoted theincreased growth of pulmonary artery without distortion of pulmo-nary artery and its branches
Co-Authors Agus Firmansyah Alit Utamayasa Bambang Madiyono Bambang Supriyatno Bina Akura Bulan Ginting Munthe Djajadiman Gatot Fajar Subroto Hanifah Oswari Imam Boediman Ismet N Oesman lrawan Mangunatmadja Mazeni Alwi Mulyadi M Djer Mulyadi M. Djer Nusarintowati Ramadhina Rinawati Rohsiswatmo Rubiana Sukardi Shirley L. Anggriawan Sofyan lsmael Sudigdo Sastroasmoro Sukman T Putra Sukman T. Putra