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Jose Meky Mandei

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Author-ID : 3458748

Health Professions Medicine & Pharmacology

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Confusions and dilemma around hepatic dysfunction associated falciparum malaria: A case report and brief review of the literature Eka Sianti; Jose Meky Mandei
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Malaria remains a big burden in East Indonesia. Severe malaria assaults children in endemic area and leads toenormous morbidities and mortalities.According to the World Health Organization's criteria,recognition of one or more of the following clinicalfeatures should raise the suspicion of severe malariai.e, cerebral malaria (unrousable coma), severe anemia(hemoglobin <5 g/dl), renal failure (creatinine serum> 3 mg/dl), pulmonary edema or adult respiratory distresssyndrome (ARDS), hypoglycemia (glucose < 40 mg/dl),circulatory collapse or shock, disseminated intravascularcoagulation (DIC), repeated generalized convulsions,acidosis (pH < 7 .25), macroscopic hemoglobinuria,hyperparasitaemia ( > 5% of the erythrocytes infested byparasites), or jaundice (bilirubin> 3 mg/dl).l-3Jaundice in malaria due to hepatic dysfunction isa classical case, nevertheless, there are some confusionsand dilemmas in managing it.1 We report a case withjaundice due to hepatic dysfunction and hemolysisassociated falciparum malaria that we treated inGeneral Hospital of Fakfak, West Papua, and providea brief literature review on the matter.

Comparative efficacy of artesunate and sulphadoxine-pyrimethamine combination with artesunate and amodiaquine combination in uncomplicated falciparum malaria in children Jose Meky Mandei; Novie Homenta Rampengan; Suryadi Nicolaas; Napoleon Tatura; Ari Lukas Runtunuwu; Tony Homenta Rampengan
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/pi48.4.2008.240-5

Background Malaria is still an important cause of mortalityand morbidity in children and adults in tropical countries.Multidrug resistance againts chloroquine and sulphadox-ine-pyrimethamine had brought to an introduction ofartemisinin-based combination.Objective To assess the alternative treatment of uncompli-cated falciparum malaria in children using artesunate andsulphadoxine-pyrimethamine combination comparing toartesunate and amodiaquine combination.Methods This is a single-blind randomized trial. Sixty-seven children aged six months to 13 years, were recruited.Thirty-three children were treated with artesunate 4 mg/kgbw/day for three days with an additional sulphadoxine-pyrimethamine (pyrimethamine 1-1.5 mg/kgbw) singledose on the first day, while 34 children were treated withartesunate and amodiaquine base 10 mg/kgbw/day for thefirst two days, then 5 mg/kgbw/day on the third day. Bodytemperature and parasite count were recorded everydayfor at least seven days. The outcomes were fever clearancetime, parasite clearance time, cure rate and side effects. Sta-tistical analysis was performed using the student t-test.Results The statistical analysis showed that there wereno difference between these two groups either in feverclearance time (P>0.05), or in parasite clearance time(P>0.05). The cure rate was 100% in both groups. Vomit-ing was found in one patient treated with artesunate andamodiaquine combination.Conclusion The combination of artesunate and sulpha-doxine-pyrimethamine and combination of artesunateand amodiaquine were found to be equally effective in thetreatment of uncomplicated falciparum malaria in children

Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome Suryadi Nicolaas Napoleon Tatura; Novie Homenta Rampengan; Jose Meky Mandei; Ari Lukas Runtunuwu; Max FJ Mantik; Tony Homenta Rampengan
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) is characterized bysevere vascular leakage and hemostasis disorder. It is the cause of death in 1 to 5 percent of cases. WH 0 management guidelines for resuscitation remain empirical rather than evidence-based.Objective To find out the alternative fluids to replace plasmaleakage in DSS.Methods We performed a prospective study and randomizedcomparison of plasma and gelatin solution for resuscitation ofIndonesian children with DSS. We randomly assigned 25 subjectswith DSS to receive plasma and 25 children to receive gelatinfluid. Statistical analyse were performed using chi-square test,Fisher's exact test, t test, Mann-Whitney test.Results The increment of pulse pressure width and the decrement of hematocrit in subjects treated with gelatin were higher than that of plasma atfour-hour therapy (P=0.002 and P=0.017). Only one patient died caused by unusually manifestation of DSS. The increment of body temperature in subjects treated with plasma was higher than that of gelatin at four-hour therapy (P=O.Oll). The decrement of platelet count in subjects treated with gelatin were less than that of plasma (P=0.018). The increment of diuresis rate in subjects treated with gelatin was higher than that of plasma at twenty-hour therapy (P<O.OOOl). The decrement of respiratory rate in subjects treated with gelatin was higher than that of plasmaat twenty-eight hour therapy (P=0.018). There was no differencein studied variables : total volume rate, blood pressure, pulse rate, re-shock rate, clinical fluid overload, allergy reactions, bleeding manifestations, and length of stay (P>0.05).Conclusions Gelatin solution can be used as volume replacementin resuscitation of DSS if blood plasma is not available especiallyat four-hour therapy.

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