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Darlan Darwis
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Hyperlactacemia in critically ill children: comparison of traditional and Fencl-Stewart methods Hari Kushartono; Antonius H. Pudjiadi; Susetyo Harry Purwanto; Imral Chair; Darlan Darwis; Abdul Latief
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (563.506 KB) | DOI: 10.14238/pi47.1.2007.35-41

Abstract

Background Base excess is a single variable used to quantifymetabolic component of acid base status. Several researches havecombined the traditional base excess method with the Stewartmethod for acid base physiology called as Fencl-Stewart method.Objective The purpose of the study was to compare two differentmethods in identifying hyperlactacemia in pediatric patients withcritical illness.Methods The study was performed on 43 patients admitted tothe pediatric intensive care unit of Cipto MangunkusumoHospital, Jakarta. Sodium, potassium, chloride, albumin, lactateand arterial blood gases were measured. All samples were takenfrom artery of all patients. Lactate level of >2 mEq/L was definedas abnormal. Standard base excess (SBE) was calculated fromthe standard bicarbonate derived from Henderson-Hasselbalchequation and reported on the blood gas analyzer. Base excessunmeasured anions (BE UA ) was calculated using the Fencl-Stewartmethod simplified by Story (2003). Correlation between lactatelevels in traditional and Fencl-Stewart methods were measuredby Pearson’s correlation coefficient .Results Elevated lactate levels were found in 24 (55.8%) patients.Lactate levels was more strongly correlated with BE UA (r = - 0.742,P<0.01) than with SBE (r = - 0.516, P<0.01).Conclusion Fencl-Stewart method is better than traditionalmethod in identifying patients with elevated lactate levels, so theFencl-Stewart method is suggested to use in clinical practice.
Seroepidemiology of Helicobacter pylori in primary school students in Krotek, Cibeber Village, Serang District, Banten, Indonesia Ratu Nurjanah; Pramita G. Dwipoerwantoro; Darlan Darwis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.659 KB) | DOI: 10.14238/pi49.5.2009.264-9

Abstract

Background Helicobacter pylori infection is a common infection.Risk of infection in rural areas is six times higher than in urbanareas.Objectives To study the prevalence of H. pylori infection in primary school students in rural area and its contributing factors.Methods A cross-sectional study was performed in a rural primaryschool in Serang district, Banten, West Java. Serology of H. pyloriwas tested using Bio M pylori kit (Mataram, Indonesia).Results Forty two of 125 subjects (33.6%) had positive H. pyloriserologies. Bivariate analysis found that the the family habit ofeating together from one container increased the infection risk5.93 times (95% Cl 3.07 to 11.43). Source of drinking waterfrom common river increased the risk 9.88 times (95% CI 3.03to 32.24). Bed and bedroom sharing increased the risk 1.55 times (95% CI 1.23 to 1.95) and 2.22 times (95% CI 1.65 to 2.99), respectively. Multivariate logistic regression analysis including all variables with P <0.25 showed that the most significant factor contributing to H. pylori infection is common river as family drinking water source (OR 24.97, 95% CI 3.9 to 159.76), followed by family habit of eating together from one container (OR 10.23, 95% CI 3.05 to 34.27), and bed or bedroom sharing (OR 9.48, 95% CI 2.4 7 to 36.38).Conclusion Prevalence of H. pylori infection in rural schoolstudents is 33.6%. There are significant associations betweenH. pylori infection and family habit of eating together from onecontainer, bed sharing with other family members, and familydrinking water source from common river.
Comparison of continuous infusion and bolus administration of tramadol in postoperative children Jeanne-Roos Tikoalu; Darlan Darwis; Bambang Madiyono
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (393.351 KB) | DOI: 10.14238/pi43.5.2003.165-70

Abstract

Objective To appraise the efficacy of tramadol therapy given bycontinuous infusion and bolus in handling child’s postoperative painthat is mostly inadequate.Methods This was a randomized, single-blinded clinical trial withparallel design. The study was done in the operation room, recov-ery room, pediatric intensive care unit, pediatric surgery, and pedi-atric ward of Cipto Mangunkusumo Hospital, Jakarta, Indonesia.There were sixty patients, 1-12 year-old, with elective operationbetween January and April 2002. Both groups received bolus of2mg/kg tramadol as an initial dose. Twenty-nine subjects receivedcontinuous infusion of 0.22 mg/kg/h tramadol in 15 minutes after-wards. The other 31 subjects received the same boluses for every6 hours. Before each tramadol administration, evaluation was doneby observer using objective pain scale (OPS) and evaluation sheetthat had been tested before the study. The study was done within24 hours post surgery.Results In the first 6 postoperative hours, mean total dose givenby continuous infusion was significantly greater than that given bybolus (p=0.006). On the contrary, mean total dose given within 24hours by continuous infusion was significantly less than that givenby bolus (p=0.037). All subjects showed OPS result of 36 in 0 minute.After that, the result decreased, except in 9 subjects it was still >6in the 15 th minute. Vomiting was the commonest side effect.Conclusion Continuous infusion of tramadol within 24 hours canbe recommended as an analgesic in postoperative children
Macronutrient malabsorption in acute diarrhea: Prevalence and affecting factors Lilis D. Hendrawati; Agus Firmansyah; Darlan Darwis
Paediatrica Indonesiana Vol 45 No 5 (2005): September 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.5.2005.207-10

Abstract

Introduction Diarrhea remains a major problem for communityhealth in Indonesia. More than 25% of children with severe diar-rhea suffer from malabsorption syndrome.Objectives This study aimed to determine the age range of chil-dren with acute diarrhea, the prevalence of macronutrient malab-sorption, and the relationship between age and bacterial infec-tion in macronutrient malabsorption.Methods This was a cross-sectional study, subjects were chil-dren aged 0-59 months with acute diarrhea whose stools wereobtained and examined in the laboratory of GastrohepatologyDivision, Department of Child Health, Cipto Mangunkusumo Hospi-tal, Jakarta from January 2002 to December 2003.Results Children with acute diarrhea were mostly in the agerange of 0-11 months (61%). The prevalence of lactose malab-sorption was 11%, carbohydrate malabsorption was 19%, andfat malabsorption was 51%. Moreover, the age group of 0-11months had a 1.5 times greater possibility of lactose and fatmalabsorption compared to that of 12-59 months. The 12-59 monthsage group had a greater possibility of suffering carbohydratemaldigestion (70%). The group of children who did not sufferfrom bacterial infection had a higher prevalence of lactose mal-absorption (54%), carbohydrate maldigestion (65%), and fatmalabsorption (58%).Conclusions Acute diarrhea occurred more frequently in theage of 0-11 months. There was a significant correlation betweenthe age groups of 0-11 months and 12-59 months in experiencingmacronutrient malabsorption. Lactose malabsorption, carbohy-drate maldigestion, and fat malabsorption were encountered morefrequently in the group that did not have bacterial infection
Co-Authors Abdul Latief Agus Firmansyah Antonius H. Pudjiadi Bambang Madiyono Hari Kushartono Imral Chair Jeanne-Roos Tikoalu Lilis D. Hendrawati Pramita G. Dwipoerwantoro Ratu Nurjanah Susetyo Harry Purwanto