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ABSTRAK

Background: The most common complication in acyanotic congenital heart disease (CHD) is heart failure which definitive diagnosis and therapy remain unsatisfactory. Heart failure’s progression is often associated with oxidative stress process. Superoxide dismutase (SOD) is the first line antioxidant of defense against superoxide anion. While Catalase (CAT) breaks down hydrogen peroxide into water and oxygen molecules which complements previous detoxification carried out by SOD. Objective: This study aimed to compare the differences of SOD and CAT levels in acyanotic CHD patients between those with and without heart failure. Methods: A case-control study was conducted on three to ten years old children with a left-to-right shunt acyanotic CHD with and without heart failure in the Pediatric Cardiology outpatient clinic, ward, and emergency room of Dr. Soetomo Hospital Surabaya from April-July 2020. Echocardiography was used to establish the diagnosis of CHD, while Pediatric Heart Failure Score (PHFS) criteria was used to indicate heart failure. T-test was undertaken for analysing the difference between both groups. Results: The total samples were 41 children, consisted of 29 subjects in the case group (CHD with heart failure) and 12 subjects in the control group (without heart failure). The level of SOD in CHD with heart failure was lower (74.670+15.705) than those without it (109.163+3.111) (p<0.05). In contrast, level of CAT in CHD with heart failure was higher (25.895) than those without it (13.976) (p<0.05). Conclusion: There was a significant difference of SOD and CAT levels in acyanotic CHD between those with and without heart failure.

Penyakit jantung bawaan (PJB) mempengaruhi sekitar 0,8% sampai 1,2% dengan angka kejadian kematian adalah 81 kasus per 100.000 kelahiran hidup. Umumnya, PJK adalah kelainan struktural jantung dan (atau) pembuluh darah besar yang muncul saat lahir. Keterbatasan pengetahuan petugas kesehatan tentang etiologi, faktor risiko, dan tingginya heterogenitas PJK merupakan hambatan utama untuk pencegahan dan skrining dini. Metode:Pelatihan dilaksanakan melalui webinar dengan peserta tenaga kesehatan di Lumajang. Materi yang diberikan meliputi cara deteksi dini, diagnosis dan terapi, serta simulasi kasus PJK. Pre dan Post-test digunakan untuk mengevaluasi tingkat pengetahuan. Kunjungan pemeriksaan ekokardiografi dan oksimetri nadi oleh dokter spesialis jantung anak dilaksanakan dua minggu kemudian di Lumajang.Hasil: Ada 140 peserta yang mengikuti pelatihan webinar. Nilai rata-rata pre-test adalah 11,13/15 dengan hanya 5 peserta yang mendapat nilai sempurna. Di akhir webinar, nilai rata-rata post-test adalah 14,34/15 dengan 115 peserta yang akhirnya mendapat nilai sempurna. Sebanyak 28 anak diperiksa dengan pemeriksaan ekokardiografi. Didapatkan 20 anak terdiagnosis PJK sianotik, 6 anak terdiagnosis PJK sianotik, dan 2 anak normal. Pada pemeriksaan oksimetri nadi, semua bayi memiliki saturasi oksigen 95% atau lebih dan tidak ada perbedaan lebih dari 3% antara situs pra dan pasca duktus.Kesimpulan:Pelatihan webinar dapat meningkatkan pengetahuan petugas kesehatan tentang deteksi dini PJK dan ada 93% anak yang didiagnosis PJK di antara peserta skrining di Lumajang.Kata kunci  : Penyakit Jantung Bawaan; Penyaringan; Ekokardiografi; Anak-anak; webinar; Oksimetri nadi.Abstract Congenital heart disease (CHD) affects approximately 0.8% to 1.2% with incidence rate of mortality was 81 cases per 100,000 live births. Generally, CHD is a structural abnormality of the heart and (or) great vessels that is present at birth.  Limited knowledge among health workers for the etiologist, risk factors, and the high heterogeneity in CHD constitutes the major obstacles for prevention and early screening.  Method:The training was implemented through webinar with health workers participants in Lumajang. The topics contained how to early detect, diagnosis and therapy, and cases simulation of CHD. Pre and Post-test were used to evaluate knowledge level. The visitation of echocardiographic and pulse oximetry screening by Pediatric cardiologist was held two weeks later in Lumajang.Results:There were 140 participants during the webinar training. The mean score of pre-test was 11.13/15 with only 5 participants who got the perfect score. At the end of the webinar, the mean score of post-test was 14.34/15 with 115 participants who finally got the perfect score. Total 28 children were screened by echocardiography examination. There were 20 children diagnosed with acyanotic CHD, 6 children with cyanotic CHD, and 2 children were normal. At the pulse oximetry screening, all baby had an oxygen saturation at 95% or above and there was no difference more than 3% between a pre and post-ductal site.Conclusion:Webinar training can improve the knowledge among health workers about early detection of CHD and there were 93% children diagnosed with CHD among screening participants in Lumajang.Keywords: Congenital Heart Disease; Screening; Echocardiography; Children; Webinar; Pulse Oximetry.

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