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All Journal Majalah Kedokteran Sriwijaya Paediatrica Indonesiana
Achirul Bakri
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Health Professions Medicine & Pharmacology Nursing Public Health

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Efek Pemberian Kombinasi Zinc dan Probiotik Terhadap Lama dan Frekuensi Diare Pada Penderita Diare Akut Rahmayani Rahmayani; Hasri Salwan; Achirul Bakri; Syarif Husin
Majalah Kedokteran Sriwijaya Vol 46, No 3 (2014): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v46i3.2702

Abstract

Salah satu tatalaksana diare menurut WHO adalah pemberian zinc. Zinc berperan memelihara integritas mukosa usus dan memperbaiki sistem imunitas. Probiotik terbukti efektif dalam saluran cerna. Probiotik menginduksi kolonisasi dan pertumbuhan flora normal di usus, mencegah perlengketan bakteri patogen pada mukosa, dan mengaktivasi sistem imun. Tujuan dari penelitian ini adalah menilai efektifitas pemberian kombinasi zinc dan probiotik terhadap lama diare dan frekuensi BAB pada penderita diare akut selama perawatan di rumah sakit. Penelitian ini merupakan uji klinik acak tersamar ganda (double blind) terhadap anak usia 6-59 bulan yang dirawat di bangsal anak RSUP dr. Moh. Hoesin Palembang dari bulan Juni-November 2011. Penderita dibagi menjadi dua kelompok,  kelompok yang mendapat zinc 20mg/hari dan probiotik (2x109 cfu/gr lactobacillus acidophilus dan bifidobacterium lactis) dan kelompok yang mendapat zinc 20 mg/hari dan plasebo. Terdapat 56 penderita yang memenuhi kriteria inklusi. Subjek penelitian terdiri dari laki-laki sebanyak 35 orang (62,5 %) dan 21 perempuan (37,5%). Umur rerata pada penelitian ini adalah 16,8 bulan dimana rerata pada kelompok zinc+plasebo adalah 15,6+7,4 bulan dan 18,14+12,3 bulan pada kelompok zinc+probiotik. Rerata lama diare pada kelompok zinc+probiotik 43,23+24,69 jam vs 47,12+32,27 jam pada kelompok zinc+plasebo (p=0,61). Rerata frekuensi BAB di RS pada kelompok zinc+probiotik 4,26+2,42 vs 4,19+2,97 kali/hari pada kelompok zinc+probiotik  (p=0,61). Lama diare dan frekuensi BAB pada kelompok suplementasi zinc+probiotik tidak berbeda bermakna dibandingkan dengan kelompok zinc+plasebo.
Benefits of domperidone in ambulatory acute diarrhea with severe vomiting Irene A. O.; Achirul Bakri; Erial Bahar; Rusdi Ismail
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (202.164 KB) | DOI: 10.14238/pi47.5.2007.207-10

Abstract

Background Recently, most patients with diarrheal disease (DD)cases are hospitalized not due to severe dehydration, but due tosevere vomiting which interferes with fluid and food intake. Useof anti-vomiting medicines is not recommended because of its“central” side effects. Domperidone has prokinetic and antiemeticeffects with only minimal extrapyramidal side effects.Objective To evaluate domperidone in preventing hospitalizationof DD patients in outpatient setting.Methods This randomized double blind, placebo-controlledclinical trial, was conducted from February to August 2005 atMohammad Hoesin Hospital, Palembang. We included patientsaged 6 to 59 months old with acute diarrhea who had vomited atleast 4 times in the last 24 hours, not in need of hospitalization,and agreed to participate. We excluded patients who had takenanti-vomiting drug, or those who had severe diseases, includingsevere malnutrition. The dose of domperidone was 1.25 mg per 5kg body weight.Results There were 183 subjects randomized, consisted of 91 whotook domperidone (treatment group) and 92 who took placebo(control group). The duration and decrease of vomiting frequencywere significantly different in favor of domperidone. Domperidoneprevented hospitalization significantly (P=0.001, OR=4.1, ARR= 20%, RRR=71%, NNT=5). No overt acute clinical side effectswere found.Conclusion Domperidone significantly shortened the duration anddecreased the frequency of vomiting in DD cases.
Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea Hasri Salwan; Isnada Isnada; Achirul Bakri; Rusdi Ismail; Erial Bahar
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.767 KB) | DOI: 10.14238/pi47.6.2007.265-9

Abstract

Background Oral rehydration solution (ORS) has been provensuccessfully to overcome dehydration in diarrhea. The improvementof the effectiveness of ORS is still needed to overcome some failures.Gum Arabic (GA), an indigestable starch, can enhance ORSabsorption in mice with diarrhea. It is worthy to explore its benefitsin human. Since GA is non toxic to human being, it is regardedethical to conduct effectiveness study directly in clinical setting.Objective To evaluate the effectiveness of GA supplementationto ORS in managing inpatients diarrheal cases .Methods A double blind clinical trial was conducted during Marchto September 2004 in the Department of Child Health of M. HoesinHospital, Palembang. The subjects were randomly enrolled to GA-ORS (GA) group or ORS (SO) group. Indirect measurements wereconducted on ORS absorptive enhancement by evaluating theduration of diarrhea after hospitalization, frequency of defecationduring hospitalization, ORS consumption during hospitalization,and time laps of stool consistency conversion. The effectivenessanalysis was controlled for confounders.Results Supplementation of 0.5 gram GA to 200 ml ORS could decreasethe duration of diarrhoea 15.65 hours (P=0.000) during hospitalisation,frequency of defecation during hospitalization 1.171 times/days(P=0.002), ORS consumption 38.39 ml/kg BW (P=0.029), time ofstool consistency to become semisolid 15.84 hours (P=0.000), andbecome solid 14.45 hours (P=0.002). Vomiting during hospitalizationand aged group of 6-11 months were significant confounder. However,after controlling the outcome with these confounding factors, thebenefits of GA supplementation were still significant.Conclusions GA supplementation to ORS significantly shortenthe duration of diarrhea, decreases the frequency of defecation,consumption of ORS, time of stool consistency to becomesemisolid and solid in inpatients diarrheal cases.
Validation of PELOD-2 score as a predictor of life-threatening organ dysfunction in pediatric sepsis Yuyun Romaria Simanjuntak; Indra Saputra; Silvia Triratna; Achirul Bakri; Yulia Iriani
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.227-32

Abstract

Background The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction due to immune dysregulation against infection. It recommends the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score to evaluate life-threatening organ dysfunction. But the SOFA tool has not been adjusted for pediatric patients. The Indonesian Pediatrics Society (IPS) uses the same sepsis definition and recommends using the PELOD-2 score as an indicator of life-threatening organ dysfunction in children. Objective To evaluate the validity of the PELOD-2 score for predicting life-threatening organ dysfunction in pediatric sepsis. Methods A prospective cohort study was conducted in children with sepsis who were admitted to the PICU. Subjects were taken consecutively with inclusion criteria of 1 month-18 years of age, with organ dysfunction, having two or more symptoms of systemic inflammatory response syndrome (SIRS), and suspected or proven infection. PELOD-2 score, with and without lactate result, of each subject were plotted to receiver operating characteristic (ROC) curve, then we determined the most optimal cut off point to predict the life-threathneing organ dysfunction in pediatric sepsis based on the sensitivity and specificity of each score. Results Sixty-six patients were analyzed, with 40 males and 26 females aged 2 to 183 months (median 11 months). Twenty patients died while in the PICU. A PELOD-2 score (with lactate) cut-off ≥ 7 was determined by ROC curve, with sensitivity of 80% and specificity of 78%. The area under the curve (AUC) of PELOD-2 score (with lactate) was 84.8% (95%CI 74.7 to 95.9%). A PELOD-2 score (without lactate) ≥ 7 was the most optimum cut off based on its Youden index, it haD 70% of sensitivity and 80% of specificity. Conclusion PELOD-2 score ≥ 7 , with or without lactate component is the optimal cut-off for predicting life-threatening organ dysfunction in pediatric sepsis.
Co-Authors Erial Bahar Hasri Salwan Indra Saputra Irene A. O. Isnada Isnada Rahmayani Rahmayani Rusdi Ismail Silvia Triratna Syarif Husin Yulia Iriani Yuyun Romaria Simanjuntak