Chairuddin P. Lubis
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Sumatera Utara / RSUP H. Adam Malik Medan

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Penanganan Demam pada Anak Inke Nadia Diniyanti Lubis; Chairuddin Panusunan Lubis
Sari Pediatri Vol 12, No 6 (2011)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.6.2011.409-18

Abstract

Fobia demam yang terjadi pada orang tua seringkali mendorong orang tua untuk mencari informasi mengenai penanganan demam pada anak. Definisi demam bervariasi, tetapi banyak yang mendefinisikan demam sebagai temperatur >38oC. Pengukuran suhu tubuh anak haruslah mempertimbangkan masalah ekonomis, juga merupakan pengukuran yang sederahana dan cepat dan tidak menimbulkan ketidaknyamanan pada anak. Berbagai penanganan demam telah diketahui secara umum termasuk dengan pemberian antipiretik maupun dengan metode fisik. Jenis antipiretik yang disetujui pemberiannya pada anak ialah parasetamol dan ibuprofen. Pemilihan antipiretik, cara pemberian, dan dosis antipiretik penting untuk diketahui oleh praktisi maupun orangtua dalam menangani demam, sehingga informasi yang lengkap harus diberikan kepada orang tua pada setiap kunjungan untuk mencegah kesalahan pemberian obat dan juga mencegah toksisitas antipiretik
Enterobiasis pada Anak Siska Mayasari Lubis; Syahril Pasaribu; Chairuddin P Lubis
Sari Pediatri Vol 9, No 5 (2008)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.878 KB) | DOI: 10.14238/sp9.5.2008.314-8

Abstract

Enterobiasis merupakan infeksi yang sering terjadi dalam satu keluarga atau pada orang yang tinggaldalam satu rumah. Infeksi cacing sering diduga pada anak yang menunjukkan rasa gatal di sekitar anuspada waktu malam hari. Anal swab merupakan metode terbaik dalam mendiagnosis enterobiasis.Pemeriksaan periodik disertai dengan pengobatan yang adekuat akan dapat membantu mengurangi kejadianenterobiasis pada anak. Meskipun demikian, masih terdapat kesulitan dalam mengontrol enterobiasis olehkarena mudahnya penularan dan reinfeksi
Efektivitas Kombinasi Artesunat-Klindamisin dengan Kinin-Klindamisin pada Pengobatan Malaria FalciparumTanpa Komplikasi pada Anak Erika S. Panjaitan; Syahril Pasaribu; Muhammad Ali; Munar Lubis; Chairuddin P. Lubis; Ayodhia P. Pasaribu
Sari Pediatri Vol 13, No 6 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp13.6.2012.420-5

Abstract

Latar belakang. Kombinasi antimalaria termasuk artemisinin sering tidak sesuai secara farmakokinetika sehingga berpotensi untuk resistensi. Untuk itu penilaian terhadap kombinasi artemisinin dengan obat yang mempunyai waktu paruh yang pendek diperlukan dalam pengobatan malaria falciparumtanpa komplikasi pada anak. Tujuan. Untuk membandingkan efektifitas kombinasi artesunat-klindamisin dengan kinin-klindamisin pada pengobatan malaria falciparumtanpa komplikasi pada anak.Metode. Penelitian dilakukan dengan metode uji klinis acak terbuka yang dilaksanakan pada bulan Oktober sampai November 2010 di Mandailing Natal, Propinsi Sumatera Utara. Subjek berusia 7 sampai 12 tahun dan dijumpai Plasmodium falciparumpada pemeriksaan darah tepi. Kelompok I menerima kombinasi artesunat-klindamisin (artesunat 4mg/kg, dan klindamisin 7mg/kg, per dosis). Kelompok II menerima kombinasi kinin-klindamisin (kinin 4 mg/kg dan klindamisin 7mg/kg, per dosis). Kedua kelompok beri obat dua kali sehari selama tiga hari berturut-turut. Parasitemia dihitung pada hari 1, 2, 3, 7, 14, dan 28. Analisis didasarkan intention to treat analysis.Hasil. Penelitian diikuti dua ratus anak. Adequate clinical parasitological respons dari artesunat-klindamisin dijumpai berbeda secara bermakna dibandingkan kinin-klindamisin 94% dan 62% (p=0,0001). Kesembuhan artesunat-klindamisin dicapai hari ke-3 dan ke-4 belas 97% (p=0,001). Kesembuhan kinin-klindamisin dicapai pada hari ke-14 dan ke-28 92% (p=0.236). Pada pengamatan tidak dijumpai efek samping yang serius.Kesimpulan.Kombinasi artesunat-klindamisin lebih efektif dari pada kinin-klindamisin pada pengobatan malaria falciparumtanpa komplikasi pada anak
Efikasi Kinin-Doksisiklin pada Pengobatan Malaria Falsiparum Tanpa Komplikasi Fitri Arianty Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Sari Pediatri Vol 10, No 4 (2008)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp10.4.2008.246-9

Abstract

Pengobatan malaria masih merupakan masalah yang sering dihadapi karena terjadinya resistensi terhadap beberapa obat anti malaria. Kombinasi dua macam obat saat ini yang sering dipergunakan, terutama pada daerah hiperendemis, untuk meningkatkan efikasi dari obat tersebut. Kombinasi kinin-doksisiklin adalah salah satu kombinasi obat anti malaria yang dapat diberikan sebagai terapi alternatif untuk pengobatan malaria falsiparum tanpa komplikasi. Pada beberapa penelitian ditunjukkan bahwa kombinasi kedua obat ini mempunyai efikasi yang baik.
Efficacy of mebendazole and levamisole, alone or in combination, for soil-transmitted helminthiasis Ifo Faujiah Sihite; Muhammad Ali; Ayodhia P. Pasaribu; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (113.465 KB) | DOI: 10.14238/pi54.1.2014.9-14

Abstract

BackgroundThe World Health Organization (WHO) recommends four, single-dose drugs (albendazole, levamisole, mebendazole, and pyrantel pamoate) for management of soil­transmitted helminthiasis (STH). Previous studies have shown varied and inconsistent outcomes of these STH treatments.ObjectiveTo compare the efficacy of mebendazole and levami­sole, alone or in combination, for the treatment of STH.MethodsAn open randomized controlled trial was conducted in Secanggang, North Sumatera from August to October 2009. School-aged children with STH infection were randomized into three groups. Group I received a single dose of mebendazole (500 mg); group II received a single dose of levamisole (2.5 mg/kg); and group III received a single dose of mebendazole-levamisole combined. Stool samples were collected at baseline, and the 1st, 2nd, 3rd, and 4th weeks after treatment and examined by the Kato-Katz technique. Statistical analyses were Kruskal-Wallis test for cure rate and Analysis of Variance (ANOVA) test for egg reduction rate. ResultsSTH was diagnosed in 197 children with the following parasite species: Ascariasis (96 children, 48.7%), Trichuriasis (58 children, 29.4%), and mixed infection (43 children, 21.8%). We found no hookworm infection in any of our subjects. Groups I and III had significantly higher efficacy (P=0.0001) against STH (egg reduction rate 99.3% and 99.9%; cure rate 92.2% and 98.4%, respectively) at 4th week of treatment.ConclusionA single dose of mebendazole alone and combined with levamisole have better efficacy compared to a single dose of levamisole for the treatment of STH. The highest efficacy of these treatments is noted at the 4th week after drug administration
Albendazole alone vs. albendazole and diethylcarbamazine combination therapy for trichuriasis Windya Sari Nasution; Muhammad Ali; Ayodhia Pitaloka Pasaribu; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (118.303 KB) | DOI: 10.14238/pi54.2.2014.109-13

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Background Trichuris trichiura is one of the most commonsoil-transmitted helminths, estimated to infect l billion peopleworldwide. Several studies have compared the efficacies ofalbendazole and diethylcarbamazine, but the efficacy of acombination of these two drugs has been inconclusive.Objective To assess the effectiveness of a single dose ofalbendazole compared to a combination of albendazole anddiethylcarbamazine for trichuriasis treatment.Methods A randomized, clinical open trial was conducted fromJune to September 2009 on elementary school children withtrichuriasis from two villages in the North Sumatera Province.Stool specimens were collected at baseline and at days 7, 14,21, and 28 after treatment, and examined by the Kato Katzmethod. Subjects were randomized into two groups. Group Ireceived a single dose of albendazole (400 mg) and group IIreceived albendazole (400 mg) plus diethylcarbamazine (6 mg!kg). Statistical analyses used were Chi square test for cure ratesand Wilcoxon rank test for egg reduction rates.Results One hundred eight children were enrolled andrandomized into group l (53 children) and group II (55children). The prevalence of T. trichiura infection was 54.7%.There were no significant differences (P=0.52) in the curerate between groups I and II (66% and 60%, respectively) or inegg reduction rates at day 28 (54.5% and 60.07%, respectively,P= 0.10).Conclusion Albendazole alone and abendazole combinedwith diethylcarbamazine have similar efficacies for trichuriasistreatment, in terms of cure rates and egg reduction rates.
Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Wisman Dalimunthe; Charles Siregar; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
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 (231.223 KB) | DOI: 10.14238/pi47.5.2007.216-20

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Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on children’s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.
Comparison of the efficacy of artesunate-amodiaquine with quinine-clindamycin for treatment of uncomplicated falciparum malaria in children Purnama Fitri; Armila Armila; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.775 KB) | DOI: 10.14238/pi49.2.2009.91-6

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Background Drug-resistant Plasmodium falciparum malaria is amajor contributor to increasing malaria-related morbidity andmortality. Artesunate-amodiaquine is a potential combinationtherapy that shows improved treatment efficacy. Clindamycin incombination with quinine is also a safe and effective treatmentfor multidrug-resistant P. falciparum malaria.Objectives To compare the efficacy of artesunate-amodiaquine andquinine-clindamycin combination therapies for the treatment ofuncomplicated falciparum malaria.Methods This randomized open label trial in 23 2 children agedbetween one month and 18 years old took place in MandailingNatal, North Sumatra, from August to September 2006. The AAgroup received a 3-day oral course of artesunate (4 mg/kg BWonce a day) plus amodiaquine (10 mg/kg BW once a day). TheQC group received a 3-day course of clindamycin (5 mg of base/kgBW twice a day) plus a 7-day course of quinine (10 mg of salt/kgBW orally for the first four days, then 5 mg of quinine salt/kg BWfor the next three days). We performed thin and thick peripheralblood smears on days 0, 2, 7, and 28.Results A total of 232 eligible children were enrolled but only22 7 completed the study (114 in group AA, 113 in group QC).The cure rates were lOOo/o in both groups by the second day, andthere was no recrudescence in either group. We found more sideeffects in AA group compared with in QC group, i.e., headacheand vomiting.Conclusion Artesunate-amodiaquine and quinine-clindamycincombinations showed similar efficacy for the treatment of uncomplicatedP. falciparum.
Parascreen as an alternative diagnostic tool for falciparum malaria Jenny Ginting; Siska Mayasari; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.220-3

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Background Malaria is a parasitic disease with high morbidityand mortality. Rapid immunochromatographic are emerging todetect specific antigens of human plasmodia.Objective To determine the sensitivity and specificity ofParascreenfor the detection of Plasmodium falciparum in children.Methods A diagnostic test study was performed in MandailingNatal District, Penyabungan, North Sumatera. Subjects werepublic health center and hospital patients with symptoms of fever,pallor, headache, and diarrhea. Blood specimens were obtained forParascreen testing. Microscopy of Giemsa-stained blood samplesserved as the gold standard.Results One hundred and four subjects were studied. The sensitiv-ity and specificity ofParascreen were 76% and 100%, respectively.Positive and negative predictive values of the test were 100% and49%, respectively. Likelihood ratio was infinite for a positive testand 0.23% for a negative test.Conclusion Parascreen is a useful and highly specific di-agnostic tool for P. falciparum malaria
Association between socioeconomic status and the prevalence of intestinal worm infection in primary school children Sri Alemina Ginting; Isra Firmansyah; Dedi Satria Putra; Dachrul Aldy; Syahril Pasaribu; Chairuddin P Lubis
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.86 KB) | DOI: 10.14238/pi44.3.2004.106-10

Abstract

Background In Indonesia, medical problems are indicated bydiseases associated with low socioeconomic status. The preva-lence of intestinal worm is still high in Indonesia.Objective The purpose of this study was to find the associationbetween socioeconomic status and the prevalence of intestinalworm infection.Methods A cross sectional study was done on 120 primary schoolchildren in Suka Village, Karo District, North Sumatra Province.Subjects were selected by means of random sampling. Kato Katzmethod was used in stool examination. Socioeconomic status wasreferred from the Survey Keluarga Sejahtera (Wealth Family Sur-vey) 1998 by the BKKBN (the National Coordination Board onFamily Planning). Data of socioeconomic status were collected byinterview using a questionnaire and analyzed by chi square test; pvalue of <0.05 was considered to be statistically significant.Results Eighty-four subjects (70%) suffered from intestinal worminfection. There was no significant association between either age(p=0.811) or nutritional status (p=0.792) and intestinal worm infec-tion, but there was significant association between sex and intes-tinal worm infection (p=0.028). There was also association betweenintestinal worm infection and father’s education (p=0.044). Mother’soccupation had a significant association with intestinal worm in-fection (p=0.001), but father’s occupation (p=0.474) did not. Nei-ther parents’ income (p=0.429) nor socioeconomic status (p=0.098)was associated with intestinal worm infection.Conclusion There was significant association between intestinalworm infection and sex, father’s education or mother’s occupation