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Agus Firmansyah
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Comparison of combination of probiotic and standard therapy compared to standard therapy on eradication of Helicobacter pylori infection in children Fransisca Theresia Aryani; Agus Firmansyah; Abdul Latief
Paediatrica Indonesiana Vol 50 No 1 (2010): January 2010
Publisher : Indonesian Pediatric Society

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Abstract

Background Helicobacter pylori (H. pylori) infection is thought to be the etiology of chronic gastritis, peptic ulcer, and risk factor for gastric cancer. Management of H. pylori infection in children is associated with several problems such as compliance to therapy, untolerated side effects, and antibiotic resistance. Probiotic is reported to give beneficial effect in the management of H. pylori infection and there is no study yet on the effect of probiotic in eradication of H. pylori infection in Indonesian children.Objectives To study the effect of additional probiotic in the standard therapy on the rate of H. pylori infection eradication in children and its side effect.Methods This was a double blind randomized controlled trial performed in 23 children with H. pylori infection at Kampung Melayu and Rawa Bunga District. The diagnosis was determined based on Helicobacter pylori stool antigen test (HpSA). Subjects were randomly assigned to either receive receive amoxiycilin, clarithromycin, omeprazole, and probiotic (2 x 109 cfu of Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12) or amoxicillin, clarithromycin, omeprazole dan placebo (maltodextrin). HpSA examination was evaluated again after 2 weeks of therapy.Results Two of 13 subjects in the treatment group and 6 of 10 subjects in the control group experienced side effects. Eradication rate in the treatment group is higher than the control group (13/13 vs 7/10) but the correlation between additional probiotic with the eradication rate of H. pylori is not statistically significant.Conclusions Probiotic can reduce the incidence of side effects due to antibiotic used in H. pylori eradication (2/13 vs 6/10, p < 0.012). [Paediatr Indones. 2010;50:38-41].
Qualitative evaluation of antibiotic usage in pediatric patients Hindra Irawan Satari; Agus Firmansyah; Theresia Theresia
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.303-10

Abstract

Background Antibiotics are among the most commonly prescribed drug for pediatric patients. Inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistence. Antibiotic uses can be evaluated quantitatively and qualitatively.Objective To qualitatively evaluate antibiotic use in patients using Gyssens algorithm.Methods We performed a descriptive, retrospective study of matient medical records of those admitted to the pediatric ward from January 1 – June 30, 2009. Records were screened for patient antibiotic use, followed by qualitative evaluation using Gyssens algorithm on data from patient who received antibiotic treatment.Results We found 49.2% of subject were prescribed antibiotics. The majority of patients given antibiotics were aged 1 month - 1 year (39.3%). Antibiotic use was categorized by therapy type : empirical, prophylactic, or definitive. We found empirical therapy in 73% of cases, prophylactic in 8%, and definitive in 15%. Cefotaxime was the most common antibiotic used (25.1%), followed by ceftazidime (14%) and cotrimoxazole (1%). 39.6% of subjects were given antibiotics appropriately, while 48.3% were given inappropriately. In 3.3% of patients, antibiotics were given without indication and in 8.8% there was insufficient data.Conclusions Of hospitalized patients receiving antibiotic treatment at the Departement of Child Health, Cipto Mangunkusumo Hospital, 39.6% were given antibiotic appropriately, while 48.3% were given antibiotics inappropriately. Cefotaxime was the most commonly used, as well as most inappropriately given antibiotic.
Knowledge of pediatrician on gastroesophageal reflux/gastroesophageal reflux disease in children: a preliminary study Edward Surjono; Agus Firmansyah; Jose R. L. Batubara
Paediatrica Indonesiana Vol 50 No 6 (2010): November 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.711 KB) | DOI: 10.14238/pi50.6.2010.336-9

Abstract

Background Gastroesophageal reflux (OER) is involuntary movement of gastric content into esophagus due to transient lower esophageal sphincter relaxation. This condition usually ignored by physician. Many GER cases have severe complication before properly managed. Ten years after incorporating GER into Indonesia pediatric training curriculum, the knowledge of GER among pediatrician need to be measured.Objectives To measure pediatrician's knowledge of GER/GERD in children.Methods This was a cross sectional study using questionnaire and interview.Result There were 387 respondents who filled the questionnaire and being interviewed. The majority of respondents were between 25-45 years old (33.6%). Respondents who graduated before the year 2000 were 48.3%, and after 2000 were 51.7%. Majority of respondents were general pediatrician (90.2%) and 41.3% working in teaching hospitals Among pediatricians graduated after year 2000,6 6%,5 0.5% and 57.5% could gave more than 80% correct answer to questions about general knowledge, diagnosis and management of GERD as compared to 49.2%, 42.2% and 47% subjects graduated before year 2000. More pediatricians graduated before year 2000 answered the questions on general knowledge, diagnosis and management < 60% correctly compared to those graduated after year 2000 (42.2%, 25.2% and 28.3% vs. 14%,11.5% and 12%, respectively). Fifty five of 160 (34.4%) respondents who working in teaching hospital gave more than 80% correct answer to questions about GERD. Compared to those working in non-teaching hospitals, only 17.6% were able to correctly answer more than 80% of questions.Conclusions Better knowledge about GER/GERD are found among pediatricians graduated after the topics has been introduced to the curriculum and among those practicing in teaching hospitals.
Effects of massage on behavior of full-term newborns Tri Sunarti Wahyutami; Soedjatmiko Soedjatmiko; Agus Firmansyah; Rulina Suradi
Paediatrica Indonesiana Vol 50 No 4 (2010): July 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.4.2010.187-92

Abstract

Background Baby massage is one of the touch stimulation that could be applied as soon as possible after birth. Giving massage regularly will affect the behavior of newborn.Objectives To explore the effects of ten-day massage on infant's behavior.Methods A randomized control trial was done from December 200S to March 2009. Full-term newborm were randomly assigned into massage group or control group. Babies in massage group were given massage by their mothers and supervised by midwives. All babies were evaluated twice, i.e., on day 1 and day 11, using Brazelton Scale (Neonatal Behavior Assessment Scale). The behavior was compared between the two groups.Results A total of 72 full-term newborn infants appropriate for gestational age were included in this study. Infants in the massage group sbowed significant difference in adaptive behavior compared to control group. Those adaptive behavior consisted of habituation (WMD 1.08 CI 95% 0.67 to 1.49, P<0.0001), social interaction (WMD 1.54 Cl 95% 1.23 to 1.84, P<0.0001), motor system (WMD 1.35 CI 95% 1.14 to 1.55, P<0.0001), organization state (P<0.0001), range of state (WMD 1.35 CI 95% 0.95 to 1.55, P< 0.0001), autonomic system (WMD 0.53 CI 95% 0.23 to 0.84, P<0.0001), end reflexes (P<0.0001).Conclusions Massage gives better adaptive behavior and reflexes of full-term newborns compared to those without massage.
Absorption of carbohydrate derived from rice in children aged 1-3 years Agus Firmansyah; Daniel Effendi; Sri Rezeki Hadinegoro; Aswitha Boediarso; Badriul Hegar Syarif; Pramitra Gayatri
Paediatrica Indonesiana Vol 41 No 5-6 (2001): May 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.3.2001.132-40

Abstract

Many studies showsthat rice starch is well-absorbed in gastrointestinaltract, even better as a composition with electrolyte to overcome diarrhea. Although in small number, there is still a various prevalence of carbohydrate malabsorption, both with rice starch and with other starch. Khin-Maung-U found significant (66.5%) prevalence of rice starch in Burmese children malabsorption, whereas rice starch is readily obtained in countries with rice as the population staple food,so thatability to absorb rice starch in Indonesian children need to be studied. Breath hydrogen test (BHT) was performed in 86 Indonesian children aged 1-3 years on Pejaten Barat Subdistrict, Pasar Minggu, South Jakarta. Among the 86 children given meal test with rice starch cakes 80 g for eachchildren, 82 children (95.3%) can absorb rice starch well, but 4 children (4.7%) suffered from rice starch alabsorption. Currentlyit is unknown certainly the type of the malabsorption. Previous researchers found that rice malabsorption is due to enzyme deficiency and intestinal motility disturbance. In this study there were 16 children (18.6%) coming from social-economically underprivileged family, most of the mothers with junior high school and lower educational level, and the majority of parent occupation were on private and labor sectors. There was no significant relation (p >0.05) between diarrhea effects on rice starch malabsorption in 6 children (7%), history of low birth weight baby (15.1%), undernourished or malnutrition status in 35 children (40.7%), and worm and/or fungal infection in 17 children (19.8%).found that rice malabsorption is due to enzyme deficiency and intestinal motility disturbance. In this study there were 16children (18.6%) coming from social-economically underprivileged family, most of the mothers with junior high school andlower educational level, and the majority of parent occupation were on private and labor sectors. There was no significantrelation (p >0.05) between diarrhea effects on rice starch malabsorption in 6 children (7%), history of low birth weight baby(15.1%), undernourished or malnutrition status in 35 children (40.7%), and worm and/or fungal infection in 17 children(19.8%). [
Co-Authors Abdul Latief Aswitha Boediarso Badriul Hegar Syarif Daniel Effendi Edward Surjono, Edward Fransisca Theresia Aryani Hindra Irawan Satari Jose RL Batubara Pramitra Gayatri Rulina Suradi Soedjatmiko Sri Rezeki Hadinegoro Theresia Theresia Tri Sunarti Wahyutami