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Sudigdo Sastroasmoro
Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Diagnostic Accuracy of Electrocardiographic Criteria for Left Ventricular Hypertrophy in Thalassemia Syndrome Sudigdo Sastroasmoro; Deddy Ria Saputra; Bambang Madiyono; Ismet N. Oesman; Sukman Tulus Putra
Paediatrica Indonesiana Vol 35 No 5-6 (1995): May - June 1995
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi35.5-6.1995.132-40

Abstract

We compared the diagnostic accuracy of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in 119 randomly selected from 400 patients with thalassemia major treated at the Department of Child Health, Medical School, University of Indonesia, Jakarta. Echocardiographically derived left ventricular hypertrophy (EchoLVH), both for body surface area (BSA)-indexed and height-indexed, served as the gold standard. There were 57 girls and 62 boys available, ranging in age from 5 to 27 years. ECG criteria for LVH was detected in 23 outof119 patients, while echo-LVH was detected in 47 patients if BSA-indexed LVH was used, or 22 patients if height-indexed LVH was used. The sensitivity and specificity of ECG-LVH were 25.5 and 84.7% respectively if BSA indexed LVH was used as gold standard, or 36.4% and 84.5%, respectively, when height indexed echo-LVH was used. It is concluded that ECG criteria for LVH has a low sensitivity and hjgh specificity in detecting increased left ventricular mass in children with thalassemia major.
Physical Growth of Children with Ventricular Septal Defect Bambang Madiyono; Eva Jeumpa Soelaeman; Ismet N. Oesman; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 34 No 1-2 (1994): January - February 1994
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1007.195 KB) | DOI: 10.14238/pi34.1-2.1994.16-25

Abstract

We conducted a prospective study on children with ventricular septal defect (VSD) for assessing the physical growth status, establishing the determinants of growth, and determining the effect of natural history on growth. There were 46 VSD patients and 30 controls aged 1-5 years. We divided the subjects into two groups; group A consisted of 32 VSD patients and 16 controls aged 12-35 months, group 8 comprised 14 VSD patients and 14 controls aged of 36-60 months. A simple hemodynamic scoring system was created to determine the correlation between physical growth and severity of hemodynamic alteration, using 10 findings based on history, physical, and non-invasive examinations. Body weight and height, and arm circumference were measured every 3 months up to 12 months. The growth status correlated well with the hemodynamic scores. Body weight and arm circumference were more affected than body height Physical growth disturbance was observed in high score patients at the beginning, and became more evident at the end, of the study. In low score patients and circumference was slightly affected at the beginning of the study, while body weight was slightly disturbed after 9 months of observation.
Diagnosis of Rheumatic Fever: Which Modification? Bambang Madiyono; Sudigdo Sastroasmoro; Ismet N. Oesman; Sukman Tulus Putra; Najib Advani
Paediatrica Indonesiana Vol 34 No 5-6 (1994): May - June 1994
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (984.836 KB) | DOI: 10.14238/pi34.5-6.1994.141-8

Abstract

We evaluated the implementation of diagnostic criteria on 547 ambulatory patients with rheumatic fever (RF) and rheumatic heart disease (RHD) between January 1, 1983 and December 31, 1992. The diagnosis of RF and reactive RHD was established by either revised Jones criteria, modified Jones criteria, or clinical judgment The patient's age ranged from 4-18 years, 255 (46.6%) of them were boys. The clinical manifestations found were fever (58.1 %), arthritis (41.9%), chorea (8.6%), subcutaneous nodule (1.3%), erythema marginatum (1.1%), holosystolic murmur (56.9%), mid-diastolic murmur (25.4%), and early diastolic murmur (29.5%). The laboratory changes were hemoglobin <10 g/dl (16.5%), BSR > 20 mm/h (56.30/o), ASTO >200 U (29.6%), PR interval> 0.16 sec (13.3%), and erR> 0.55 (27.6%). Revised Jones criteria were met in 162 cases (29%), modified criteria in 474 cases (86,6%), and clinical judgment in 521 cases (95.2%).
Association between low-grade chronic inflammation with adipocytokines and body fat mass in superobese male children Aryono Hendarto; Sudigdo Sastroasmoro; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (259.751 KB) | DOI: 10.14238/pi59.1.2019.13-7

Abstract

Background Obesity causes adipocytokines dysregulation and enhances the pro-inflammatory response. Low-grade chronic inflammation is related to cardiometabolic diseases. Objective To evaluate the status of low-grade chronic inflammation in pre-pubertal, obese boys and its potential correlation to adipocytokines and body fat mass. Methods This cross-sectional study included pre-pubertal, male, superobese children as the subjects. We determined obesity status using the CDC 2000 BMI-for-age chart. Body fat percentage was measured using bioelectric impedance analysis (BIA). Fasting blood specimens were collected to evaluate hsCRP, leptin, adiponectin, and TNF-α levels. Results Eighty subjects were recruited into this study, with a mean age of 6.9 years. Ten subjects (12.5%) had low-grade chronic inflammation (hsCRP level ≥ 1 mg/L). The levels of hsCRP was not correlated with leptin, adiponectin, and TNF-α levels. A weak, but significant correlation was observed between hsCRP level and body fat mass (r= +0.383; P<0.0001). The hsCRP level increased with increasing body fat mass, until it reached its peak at body fat mass of 28 kg. Beyond that point, hsCRP level was stable. Conclusion Low-grade chronic inflammation begins at a young age in obese children. The hsCRP level has a weak correlation with body fat mass, but no correlation with adipocytokine levels. Prevention and treatment of childhood obesity should be prioritized to prevent further cardiovascular and metabolic diseases.
Right Isomerism Ismet N. Oesman; Hindra Irawan S.; Bambang Mardiono; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 32 No 7-8 (1992): July - August 1992
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (549.742 KB) | DOI: 10.14238/pi32.7-8.1992.226-34

Abstract

A rare case of complex heart malformatrion with right isomerism in a full-term baby boy which was the first case published in Indonesia is reported. The patient was initially managed as a healthy baby, but on the 20th hours after delivery he repeatedly vomitted, and from the rontgenographic finding diagnosis at that time was duodenal atresia. During the duodenostomy operation the surgeon noticed that the spleen was absent. Cyanosis appeared after operation. Techocardiography and electrocardiography was done immediately, which showed complex cyanotic congenital heart disease. Diagnosis complex cyanotic congenital heart disease with right isomerism then was suspected. Unfortunately the baby died on the 12th day of admission. 1be cause of death was sepsis and anoxia because of complex cyanotic congenital heart disease. Autopsy findings confirmed the diagnosis of right isomerism (bilateral trilobes lung, bilateral right atrial appendages).
Sensitivity and Specificity of Electrocardiographic Criteria for Left Ventricular Hypertrophy in Children with Rheumatic Heart Disease Sudigdo Sastroasmoro; Bambang Madiyono; Ismet N. Oesman
Paediatrica Indonesiana Vol 31 No 9-10 (1991): September - October 1991
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (982.404 KB) | DOI: 10.14238/pi31.9-10.1991.233-44

Abstract

Electrocardiographic criteria for left ventricular hypertrophy (L VH) were examined in 84 unselected pediatric patients with rheumatic heart disease. There were 47 male and 3 7 female patients, ranging in age from 6 to 19 years. Electrocardiographic L VH was detected m 41 patients (48.8%), i.e. in 55.3% (26/47) of boys and in 36.6% (15/41) of girls. Echocardiographically determined L VH was present in 42 cases (50%) if left ventricular mass (L VM) was indexed for height, or 47 cases (56%) if L VM was indexed for body surface area (BSA). The overall sensitivity of height-indexed electrocardiographic diagnosis of LVH was 71.4% (95% confidence interval= 57.7% to 85.1%), while its sensitivity was 73.8% (95% confidence interval= 60.0% to 87.0%). For BSA indexed echocardiographic LVH, the sensitivity was 68.1% (95% confidence interval = 54.8 to 81.4%) and the specificity was 75.7% (95% confidence interval = 61.9% to 89.5%). When sex-adjustment was examined, there was no increase of sensitivity of electrocardiographic LVH. Sensitivity of the electrocardiogram for LVH increased when age-adjustment was examined with 13 years of age as a cut-off point, both for height indexed and BSA-indexed echocardiographic LVH. Reasons/or the difference between these findings and the findings in adult patients (remarkably low sensitivity and very high specificity of ECG L VH) were discussed. Electrocardiogram was a moderate diagnostic modality in the detection of L VH in our pediatric patients with rheumatic heart disease. Sex did not influence the sensitivity of ECG L VH, but older age group tended to increase its sensitivity.
Transumbilical Balloon Atrial Septostomy with Echocardiographic Monitoring Sudigdo Sastroasmoro; Bambang Madiyono; Ismet N. Oesman; Sukman Tulus Putra; Eva Jeumpa Soelaiman
Paediatrica Indonesiana Vol 28 No 7-8 (1988): July - August 1988
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (636.683 KB) | DOI: 10.14238/pi28.7-8.1988.160-6

Abstract

Balloon atrial sept ostomy is usually necessary for survival beyond infancy in patients with transposition of the great arteries and insufficient intracardiac mixing. Since the umbilical vein and ductus venosus are often patent in the newborn infants, this route can be considered as an alternative to a femoral venous route in a critically ill infant. A 7 day-old newborn with D-transposition with intact ventricular septum and small patent foramen ovate was successfully managed by creating atrial septal defect through transumbilical balloon arterial septostomy. The procedure was carried out in the neonatal intensive care unit, guided by 2D-echocardiography. The arterial oxygen saturation increased dramatically upon the completion of the procedure, and a large atrial septal defect could be demonstrated echocardiographically. Unfortunately the infant died before further definitive surgery was performed.
Co-Authors Aryono Hendarto Bambang Madiyono Bambang Mardiono Damayanti Rusli Sjarif Deddy Ria Saputra Eva Jeumpa Soelaeman Eva Jeumpa Soelaiman Hindra Irawan S. Ismet N. Oesman Najib Advani Sukman Tulus Putra