Article Per Year (5 Year)
p-Index From 2021 - 2026
0
P-Index
This Author published in this journals
All Journal Paediatrica Indonesiana
Alan R. Tumbelaka
Unknown Affiliation
Health Professions Medicine & Pharmacology

Published : 4 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 4 Documents
Search

 1 
Soy protein sensitization in cow’s milk allergy patients Dina Muktiarti; Zakiudin Munasir; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (400.004 KB) | DOI: 10.14238/pi47.2.2007.78-82

Abstract

Background The management of cow’s milk allergy (CMA) isavoidance of cow’s milk as strictly as possible. Extensive hydrolyzedprotein and amino acid based formulas are recommended dietaryproducts for treatment of CMA. However, they have somedisadvantages, such as bitter taste and high cost. Alternativeprotein sources from vegetable proteins, such as soy, can be usedas milk-substitute. Previous studies showed the prevalence of soyallergy in CMA patients in Western countries ranged between 0to 63%, but the prevalence in Asia was not greater than 20% andno data about this prevalence in Indonesia.Objectives To determine the proportion of soy proteinsensitization in CMA patients and characteristics of CMA patientswho were sensitized to soy protein.Methods Fifty seven CMA patients who consumed soy proteinwere taken their blood sample to examine the soy-specific IgE.Results From 57 CMA patients, we found only 18% of patientswho were sensitized to soy protein. Seven out of ten CMA patientswho were sensitized to soy protein were under 12 months old.Atopic dermatitis was the most frequent clinical manifestation(8/10) and all of them had family history of atopic diseases. Soysensitization in IgE-mediated and non-IgE mediated CMA were6/10 and 4/10, respectively.Conclusions Proportion of soy sensitization in CMA patients inthis study was 18%. Soy protein can be used as an alternative forcow’s milk substitute in CMA patients.
Comparison of serial blood lactate level between dengue shock syndrome and dengue hemorrhagic fever (evaluation of prognostic value) M. Tatang Puspanjono; Abdul Latief; Alan R. Tumbelaka; Sudigdo Sastroasmoro; Hartono Gunardi
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (538.111 KB) | DOI: 10.14238/pi47.4.2007.150-5

Abstract

Background Dengue shock syndrome (DSS) mortality is still high.Monitoring of blood lactate level is important to evaluate shock.Objectives The study were to review the difference between bloodlactate level of DSS and that of dengue hemorrhagic fever (DHF),to correlate blood lactate level with hypoxia state as shock riskfactors (PaO 2 , oxygen saturation, and anion gap) and to determinethe cut-off point of blood lactate level to predict shock.Methods The study was carried out at the Department of ChildHealth, Medical School, University of Indonesia, CiptoMangunkusumo Hospital, Jakarta, from January until July 2006.Three mL venous blood specimen was collected from all subjectsfor peripheral blood, blood gasses, serology, and blood lactateexaminations. This study consisted of a retrospective cohort anda cross sectional method. Data were analyzed with Chi-squaretest. Continous data tested using Mann-Whitney method. Toknow the correlation between blood lactate level and shock riskfactors we use logistic regression test.Results In DSS group, 73% shows hyperlactatemia (lactate =2mmol/L). Conversion of lactate means between two groups issignificantly different from day one to day two and three. Therewas a negative correlation between lactate level and pO 2 andoxygen saturation. Oxygen saturation is the only value that hasclinical correlation. Regressions analysis can be applied using Y= 7.05–0.05 X equation. The cut-off point of lactate level asmarker for shock by using ROC curve is 32.015 mmol/L with 70%sensitivity and 83.3% specificity.Conclusions Hyperlactatemia in DSS can be considered as a signfor unappropriate treatment of shock. Blood lactate level can beused as a biochemical marker for tissue hypoxia, to assess severityof the disease, as monitoring of treatment, and has prognosticvalue of DHF cases.
Natural course of gastroesophageal reflux disease during infancy - six-month follow-up Eka Laksmi Hidayati; Agus Firmansyah; Alan R. Tumbelaka
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 (363.422 KB) | DOI: 10.14238/pi47.5.2007.211-5

Abstract

Background Very few data have been published about the naturalcourse of gastro-esophageal reflux (GER) symptoms duringinfancy; further, no risk factors of GER disease (GERD) have beenidentified.Objectives To determine the prevalence and natural course ofregurgitation in infancy and factors of gastroesophageal refluxdisease.Methods A cohort of 223 healthy infants who attended IntegratedHealth Services run by local housewife (Posyandu) of Ciputat –suburb of Jakarta – between March and November 2005.Information on subjects’ history of regurgitation and other reflux-related symptoms was obtained by interviewing mother and diaryrecord. Subjects were followed up to age of 1 year irrespective ofthe clinical status.Results At 6 months of age most infants (56.5%) had regurgitation1 to 3 days per week and only 2.7% infants regurgitated daily.Regurgitation 1 to 3 episodes per day was found in 92.8% ofsubjects. The proportion of infants regurgitation decreasedgradually with age; the proportion for the consecutive 6 to 11month was 100%, 65.5%, 33.6%, 14.3%, 3.6% and 1.3%,respectively. At the age of 1 year no infants was found to beregurgitated. Related symptoms included hiccup (58.3%),vomiting (23.3%) and back arching (2.2%). Feeding problemoccurred in 34.1% infants and occurred more likely in infantswho regurgitate daily compared to 4 – 6 day per week (OR 3.5;95%CI 2.2;5.6) and 1 – 3 day per week (OR 1.8; 95%CI 0.6;0.9).Conclusions Regurgitation in infancy disappears spontaneouslywith age. Reflux-related symptoms are hiccup, vomiting and backarching. Feeding problem occurs most likely in infants whoregurgitate daily.
Etiological patterns of bacterial meningitis in neonatal sepsis Andy Setiawan; Idham Amir; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.32-6

Abstract

Background Sepsis and meningitis are major causes of mortalityand morbidity in neonates. The prevalence of sepsis is around 1-4out of every 1000 live births, and one-fourth is accompanied bymeningitis. These numbers are higher in prematures.Objective To find out the prevalence and etiological patterns ofbacterial meningitis in neonatal sepsis, and the pattern of antibi-otic susceptibility for organisms causing bacterial meningitis.Methods This was a cross sectional study, conducted in the neo-natal ward and emergency room at Cipto Mangunkusumo Hospi-tal from October 2003 to October 2004.Results Seventy two neonates fulfilled the inclusion criteria andwere examined for blood and cerebrospinal fluid (CSF) cultures.Sixty out of 72 neonates were proven for sepsis. Bacterial menin-gitis was found in 18 neonates, and all cases were accompaniedby sepsis. Positive CSF cultures were found in 12 neonates. Theother six were diagnosed based on CSF cell count >32/μl.Acinetobacter calcoaceticus was the major causative organismsin this study. The organisms were highly resistant to first line anti-biotics, except for chloramphenicol. They were also sensitive toceftazidime (second line), meropenem, and imipenem.Conclusions The prevalence of bacterial meningitis in neonatalsepsis at Cipto Mangunkusumo Hospital was 18/60 in 2003-2004.The major causative organism was Acinetobacter calcoaceticus.Antibiotic resistance was very high and only chloramphenicol,ceftazidime, meropenem, and imipenem remain effective
Co-Authors Abdul Latief Agus Firmansyah Andy Setiawan Dina Muktiarti, Dina Eka Laksmi Hidayati, Eka Laksmi Hartono Gunardi Idham Amir M. Tatang Puspanjono Sudigdo Sastroasmoro Zakiudin Munasir