Background: Hearing loss is one of the congenital abnormalities frequently found in children, which is followed by delayed speech and language development. The majority of cases have unknown causes of hearing loss resulting in late diagnosis. Newborn Hearing Screening Program (NHSP) recommended Otoacoustic Emissions (OAE) and Brainstem Evoked Response Audiometry (BERA) as detection of hearing loss in infants and children. Objective: To obtain the prevalence and description of sensorineural hearing loss in infants and children. Method: A retrospective descriptive study of infants underwent OAE and BERA between 2011-2013 at Dr Soetomo Hospital. The degree of hearing loss was according to the International Standard Organization (ISO). Result: A total number of 552 infant and children were examined, and 377 (68%) were detected with sensorineural hearing loss (SNHL). This group of SNHL consisted of 199 males (52.79%) and 178 females (47.21%). The largest age group was 12 to 36 months, revealed 237 patients (62.86%) with SNHL. The majority degree of hearing loss was profound hearing loss in 329 patients (87.27%). The risk factors of SNHL mostly were not found, in 310 patients (82.23%). The majority number of SNHL was bilateral, in 357 patients (94.69%). Conclusion: SNHL was found in majority of infant and children in the Audiology Clinic of Dr.Soetomo Hospital. The hearing loss found were mostly profound and bilateral, with unknown risk factors, which might contribute to speech and language developmental delay. This is relevance with the Universal NHSP recommendation that early detection should be implemented to all newborn. ABSTRAK Latar belakang: Gangguan pendengaran adalah salah satu kelainan kongenital yang sering ditemukan, dan berpengaruh pada perkembangan bicara dan bahasa anak. Sebagian besar gangguan pendengaran tidak jelas ada faktor risikonya, sehingga tidak segera terdeteksi. Bila tidak dilakukan deteksi dini, akan menyebabkan keterlambatan diagnosis dan intervensi. Telah direkomendasikan oleh Newborn Hearing Screening Program (NHSP) pemeriksaan Otoacoustic Emissions (OAE) dan Brainstem Evoked Rresponse Audiometry (BERA) sebagai alat deteksi dini gangguan pendengaran pada bayi dan anak. Tujuan: Mendapatkan prevalensi dan deskripsi gangguan pendengaran sensorineural pada bayi dan anak. Metode: Penelitian deskriptif retrospektif dengan mengumpulkan data subjek periode 2011- 2013 di Rumah Sakit Dr.Soetomo. Pemeriksaan OAE menggunakan Distortion Product Otoacoustic Emissions. Pemeriksaan BERA berdasarkan International Standard Organization (ISO). Hasil: Terdapat sebanyak 377 pasien (68%) dengan gangguan pendengaran sensorineural dari total 552 bayi dan anak. Pada kelompok umur 12 sampai 36 bulan didapati gangguan pendengaran sensorineural tertinggi sebanyak 237 (62,86%) pasien. Sebagian besar pasien laki-laki sebanyak 199 (52,79%). Mayoritas pasien mengalami gangguan pendengaraan derajat sangat berat sebanyak 329 (87,287%) dari total 377 penderita. Mayoritas faktor risiko dari gangguan pendengaran yang tidak diketahui sebanyak 310 kasus (82,23%), dan mayoritas penderita mengalami gangguan pendengaran sensorineural bilateral sebanyak 357 (94,69%). Kesimpulan: gangguan pendengaran sensorineural ditemukan terbanyak pada bayi dan anak di Klinik Audiologi RSUD Dr. Soetomo. Derajat keparahan terbanyak adalah profound, dan ditemukan terbanyak bilateral. Faktor risiko yang tidak diketahui terbanyak ditemukan, dan bisa merupakan faktor yang berpengaruh pada kejadian lambat bicara dan berbahasa. Temuan ini sesuai dengan rekomendasi program skrining pendengaran yang seharusnya diterapkan pada semua bayi baru lahir.

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