registration &

Accommodation form committee RSMH

BIODATA (Please Complete All Fields)

Academic Title : □ Prof □ Dr □ dr □ Specialist □ Other

Full Name :

Organization/Institution :

Mailing Address : Patron

Chairman of Indonesian Medical Association of South Sumatera Region
Country : Rector of Universitas Sriwijaya
Zip Code : Advisory Board
Dean of Faculty of Medicine Universitas Sriwijaya
Mobile Phone : Director of Dr. Mohammad Hoesin Hospital Palembang
Prof. dr. Rusdi Ismail, SpA(K)
Email : Prof. dr. Zarkasih Anwar, SpA(K)
Sponsor : Name: Steering Committee
Chairman of Cardiology Working Group Indonesian Pediatric Society : dr. Noormanto,SpA(K)

7
Mobile Phone : Secretary of Cardiology Working Group Indonesian Pediatric Society : dr. Rahmat Budi K, SpA(K)
Chairman of Indonesian Pediatric Society of South Sumatera Branch : dr. Silvia Triratna, SpA(K)
Please Mark (√) on Symposium you choose Head of Department of Child Health Faculty of Medicine Universitas Sriwijaya : dr.Yusmala, SpA(K)
Registration Fee Organizing Committee

PEDIATRIC
No Symposium Chairman : dr. Ria Nova, SpA(K)
Before January 31st 2019 After January 31st 2019 General secretary : dr. Deny Salverra Yosy, SpA(K), M.Kes
Pediatrician / Other Specialist
Treasurer : dr. RA Myrna Alia, SpA(K), M.Kes
1.  IDR 2,000,000  IDR 2,500,000
Funding and partnership : dr. Achirul Bakri, SpA(K)

2. Resident / General Practitioner
TOTAL
Please Mark (√ ) on Workshop you choose
No
ECG (WS 1)
1  Day 1 (April 6th 2019)
 Day 2 (April 7th 2019)
CRITICAL CHD (WS 2)
2  Day 1 (April 6th 2019)
 Day 2 (April 7th 2019)
CARDIAC SOUNDS (WS 3)
3 th
 Day 1 (April 6 2019)
 Day 2 (April 7th 2019)
4
ECHOCARDIOGRAPHY (WS 4)
th
 Two Days (April 6 - 7 2019)
th
TOTAL
* Each participant may attend two single day workshops (1-3) on different day
HOTEL
Novotel Hotel
CHECK - IN DATE: CHECK - OUT DATE:
cardiology
 IDR 1,500,000  IDR 2,000,000 dr. Ziske Machmudi, SpA
dr. Syarif Darwin Anshori, SpA(K)
IDR dr. Meliza Zubir, SpA
dr. KH. Yantjik, SpA(K)
dr. Herman Bermawi, SpA(K)
dr. HM. Nazir, SpA(K) THE ROLE OF PEDIATRICIAN update
Workshop Registration Fee
Secretariat : dr. Eka Intan Fitriana, SpA(K), M.Kes
dr. Atika Akbari, SpA IN PEDIATRIC CARDIAC care
 IDR 2,500,000 dr. Virdayanty, SpA WITH LIMITED RESOURCEs
 IDR 2,500,000 Scientific and event : DR. dr. Yulia Iriani, SpA(K)
dr. RA Myrna Alia, SpA(K), M.Kes
dr. Yudianita Kesuma, SpA(K), M.Kes
 IDR 2,500,000 dr. Msy Rita Dewi, SpA(K), MARS
 IDR 2,500,000 dr. Rismarini, SpA(K)
dr. Dewi Rosariah Ayu, SpA
 IDR 2,500,000 dr. Indrayady, SpA(K)
dr. Afifa Ramadanty, SpA(K)
 IDR 2,500,000
dr. Fifi Sofiah, SpA(K)
 IDR 4,000,000
Food & beverages :
dr. Moretta Damayanty, SpA(K), M.Kes
dr. Elvietha Alamanda, SpA, M.Sc.
symposium&WORKSHOP
IDR
Information & technology :
dr. Julniar M. Tasli, SpA(K)
dr. R.M. Indra, SpA(K)
Pediatrician
dr. Azwar Aruf, SpA, M.Sc. Other specialist
Publication : dr. Hertanti Indah Lestari, SpA(K)
ROOM TYPE ACCOMMODATION FEE dr. Aditiawati, SpA(K) pediatrician resident
Transportation : dr. Hasri Salwan, SpA(K)
Superior  IDR 1,100,000
dr. Hadi Asyik, SpA general practitioner
Deluxe  IDR 1,250,000 Accomodation : dr. Prakanita, SpA lIVE CASE
dr. Dian Puspita Sari, SpA(K), M.Kes Transcatheter closure
(vsd, pda, asd)
Junior Suite  IDR 2,000,000 Equipment : dr. Julius Anzar, SpA(K)
Permit and security : dr. Syamsul Rizal, SpA
TOTAL NIGHT(S):

TOTAL IDR
RECERTIFICATION OF PEDIATRIC CARDIOLOGY CONSULTANT
CANCELLATION AND REFUND POLICY ELECTROPHYSIOLOGY AND FETAL ECHOCARDIOGRAPHY
Written cancellation notice is required. Cancellation must be received before March 1 st 2019 a 50% refund will be
returned after congress ended. No refund will be allowed thereafter
SIGNATURE
PAYMENT BY : :
Bank Name : BTPN Branch Menara BTPN Jakarta
:
Account Number : 0537.3.002323
:
Account Name : GPDI-PEDIATRIC CARDIOLOGY UPDATE 7
Bank Code : 213
Swift Code : BTPNIDJA

NOVOTEL HOTEL
Please quote the sender’s name on the bank transfer statement
When transmitting, please make sure who send the money possibly by fax.

PALEMBANG, APRIL 6 - 7 , 2019

th th

THIS FORM TOGETHER WITH THE REQUISITEMENT PAYMENT AND/OR DOCUMENTATION SHOULD BE
EMAILED/FAXED TO SECRETARIAT :
SKP
Phone: +62217254424, +62217229339, +628111332664 |
Fax: +6221 – 7396261 information & registration IDI & IDAI
Email : erlin@gpdindonesia.com | pcu2019palembang@gmail.com email: pcu2019palembang@gmail.com, erlin@gpdindonesia.com
Ph. 021-7254424: Fax. 021-7396261:
Erlin (+628111662664) Damar (+628111332664)
 scientific schedule
GREETING
Day 1, Saturday 6 April 2019 Day 2, Sunday 7 April 2019
Time Programme Speaker Time Programme Speaker

07.00 - 08.00 Registration & Coffee Morning

Session I:
08.00 - 09.20 Moderator : dr. Noormanto, SpAK
08.00 - 08.20 Opening Cardio vascular problems in preterm infant

Chairman of the Organizing Committee dr. Ria Nova, SpA(K)

Dr. dr. Rinawati Rohsiswatmo,
08.00 - 08.20 Should we treat hypotension in preterm infant?
Chairman of Cardiology Working Group SpA(K)
dr. Noormanto, SpA(K)
Indonesian Pediatric Society

Chairman of Indonesian Pediatric Society of

South Sumatera Branch
dr. Silvia Triratna, SpA(K) 08.20 - 08.40
Current evidence of pharmacotherapy to close
patent ductusarteriosus in preterm infant
Dr. dr. Ni Putu Veny Kartika
Yantie, SpA(K) With the advance of pediatric cardiology, pediatrician
Session I:
08.20 - 09.10 Challenges in Pediatric Cardiology Service and
Moderator : Prof. dr. Rusdi
08.40 - 09.00 Pulmonary hypertension and prematurity
Dr. dr. Nikmah Salamia Idris, in general and pediatric cardiologist specifically have to
Ismail , SpA(K) SpA(K),PhD
Training in ASEAN

09.00 - 09.20 Discussion

improve their knowledge and competence in the current
Challenges in Pediatric Cardiology Service in the Prof. Dr. dr. Sukman Tulus Putra,
08.20 - 08.40
Era of ASEAN Economic Community SpA(K). FACC, FESC
09.20 - 09.35 Coffee break treatment of childhood cardiac diseases. In regard to
Future Trends of Pediatric Cardiology Training Dr. Hasri Samion MD, M.Med, Session II:
08.40 - 09.00
in Asia Paci�ic Region FNHAM, FAsCC 09.35 - 10.55 Evidence, ethic, and expand competency in
Moderator : dr. Achirul Bakri,
SpA(K)
those objectives that Pediatric Cardiology Update VII
Congenital Heart Disease
09.00 - 09.10 Discussion

Opening of Industrial Exhibition Echocardiography for pediatrician: Do we need Dr. Haifa binti Abdul Latiff, MBBS, will be held in Palembang on April 6th and 7th, 2019.
09.35 - 09.55
09.10 - 09.30 to expand the competency? M.Med, FNHAM,FAsCC
Coffee break The event will encompass exploration of topics
Adult Congenital Heart Disease Optimal Care in Prof. Dr. Teddy Ontoseno, dr.,
09.55 - 10.15
09.30 - 10.45
Session II: Moderator : dr. Ria Nova,
Congenital Heart Disease: from Basic to Practice SpA(K)
limited resources SpA(K) frequently encountered by pediatricians and general

09.30 - 09.50
Heart Failure in Congenital Heart Disease: From
dr. Sasmito, SpA(K)
10.15 - 10.35 EBM: Treat the disease or the patient?
Prof. Dr. dr. Sudigdo
Sastroasmoro, SpA(K)
practitioners, in hope that childhood cardiac diseases
Hemodynamic Changes to Treatment

09.50 - 10.10 Cyanosis & Cyanotic Spell: What Pediatrician Should

dr.Know
Sri Lilijanti,
& Do? SpA(K)
10.35 - 10.55 Discussion can be detected as early as possible and initial treatment
Session III:

10.10 - 10.30
Recurrent Pneumonia in Congenital Heart
dr. M.Ali, SpA(K)
10.55 - 12.15 The Role of primary care provider in the
Moderator : dr. Renny
Suwarniaty, ,SpA(K)
can be provided even with limited resources, before
Disease: Treatment Approach management of acquired heart disease

10.30 - 10.50 Discussion Rheumatic fever: Primary Vs. secondary

referral to tertiary services.
10.55 - 11.15 dr. Tina Tobing, SpA(K)
prophylaxis in clinical practice

10.50 – 12.00
Session III: Moderator : dr. Silvia Triratna, The Pediatric Cardiology Update VII is organized by
Pediatric Cardiac Emergencies SpA(K)
11.15 - 11.35 Myocarditis diphtheria: Old enemy has back! dr. Agus Priyatno, SpA(K)
Pediatric Cardiology Working Group in conjunction
Pediatric Chest Pain: How to Identify Risk
10.50 - 11.10 dr. Alit Utamayasa, SpA(K)
Factors for Serious Condition
11.35 - 11.55
Practical approach of endocarditis prevention in
daily practices
Dr. dr. Sri Endah R, SpA(K) with the Indonesian Pediatric Society Branch of South
11.10 - 11.30
Identi�ication of Arrhythmias in Children: Tips & Prof. Dr.dr. Mulyadi M. Djer,
Tricks SpA(K) 11.55 - 12.15 Discussion Sumatera, Department of Child Health of Sriwijaya
Moderator : dr. Santoso Soeroso,
Shock Cardiogenic vs. Shock Sepsis: Practical
12.15 - 12.45
Lunch symposium: Nutritional care in children SpA(K), MARS University Medical Faculty/ Dr. Mohammad Hoesin
11.30 - 11.50 dr. Rizky Ardiansyah, SpA(K) with heart disease Speaker : dr. Julius Anzar,
Approach of Diagnosis and Treatment
SpA(K)
General Hospital Palembang, and the Indonesian
11.50 - 12.00 Discussion 12.45 - 13.15 Break and Pray
Moderator : Dr. dr. David
WORKSHOP Physicians Association South Sumatera Region.
Lunch Symposium : Kaunang, SpA(K)
12.00 - 12.30
The role of IVIG treatment in Kawasaki disease Speaker : Dr. dr. Nadjib WS 1 WS 2 WS 3 WS 4
Advani, SpA(K), M.Med(Paed)
Identi�ication of
How to Interpret Basic Pediatric
12.30 - 13.00 Break and Pray
13.15-17.15
Pediatric ECG Made Critical Congenital
Easy Heart Disease
Cardiac Sounds in Echocardiography Chairman
WORKSHOP Children (Part 2)
in Daily Practice
WS 1 WS 2 WS 3 WS 4
Dr. dr. Anindita dr. Rahmat Budi dr. Herlina dr. Shirley Leonita,
Identi�ication of
How to Interpret Basic Pediatric Soetadji, SpA(K) Kuswiyanto, SpA(K) Dimiyati,SpA(K) SpA(K)
Pediatric ECG Made Critical Congenital
Cardiac Sounds in Echocardiography
dr. Ria Nova, SpA(K)
13.00 - 17.00 Easy Heart Disease
Children (Part 1)
in Daily Practice

Dr. dr. Anindita dr. Rahmat Budi dr. Herlina Dimiyati, dr. Shirley Leonita,
Soetadji, SpA(K) Kuswiyanto, SpA(K) SpA(K) SpA(K)