Garuda - Garba Rujukan Digital

Mulyadi M Djer

Unknown Affiliation

Author-ID : 3462337

Health Professions Medicine & Pharmacology

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Articles

Inhibiting ability of benzathine penicillin G towards group A Streptococcus Î² -hemolyticus in 21 and 28 days after a single intramuscular injection Bambang Madiyono; Mulyadi M Djer; Sudigdo Sastroasmoro; Amin Subandrio; Erni Erfan
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background The effectiveness of a single intramuscularbenzathine penicillin G as a secondary prevention of acute rheu-matic fever after 28 days is still controversial. The latest studyshowed that serum penicillin concentration was below protectivelevel in 4 weeks after a single intramuscular injection.Objective This study was a preliminary study to compare the in-hibiting ability of benzathine penicillin G towards group A Strepto-coccus Î² -hemolyticus in 21 and 28 days after a single IM injectionby using Mueller-Hinton broth method.Methods The inhibiting ability was measured by the serum in-hibitory concentration and serum bactericidal concentration aftera single intramuscular injection of benzathine penicillin G 1.2 mil-lion units.Results The subjects were 28 patients, with mean age of 15.5years (SD 3.4). The numbers of male and female were equal. Meanserum inhibitory concentration in 21 days after a single injectionwas 926.4 (SD 3080.1) and after 28 days was 1540.9 (SD 4275.1),which was not significantly different (p=0.0662). Mean serum bac-tericidal concentration in 21 days after IM injection was 1579.6(SD 4265.7) and in 28 days was 2417 (SD 6849.4) and it was notstatistically different (p=0.2276).Conclusion This study concluded that there was no significantdifference in the inhibiting ability of benzathine penicillin G to-wards group A Streptococcus Î² -hemolyticus between 21 and 28days after a single intramuscular injection

Stent implantation into ductus arteriosus: a new alternative of palliative treatment of duct-dependent pulmonary circulation Mulyadi M Djer; Bambang Madiyono; Sudigdo Sastroasmoro; Sukman T Putra; Ismet N Oesman; Najib Advani; Mazeni Alwi
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Background The technical aspects of ductal stenting have beenreported, but little is known about the fate of the duct after stentimplantation.Objectives To determine the effects of PDA stenting on the degreeof cyanosis, blood oxygen saturation, long-term patency of PDA,and the growth of pulmonary artery and its branches, in patientswith duct-dependent pulmonary circulation.Methods This was a case series study conducted at the Depart-ment of Pediatric Cardiology, Institut Jantung Negara (National HeartInstitute), Kuala Lumpur, Malaysia from November 1996 to Septem-ber 2001 on patients with duct-dependent pulmonary circulation whounderwent stent implantation. All patients were followed-up until oc-clusion or block occurred or until the end of follow-up time. The evalu-ation consisted of clinical manifestations, electrocardiography, chestx-ray, echocardiography, and cardiac catheterization.Results Stent was successfully implanted in 60 patients (84%),failed in 7 patients (10%) and contra indicated in 4 patients (6%).There was significant improvement on the degree of cyanosis afterstent implantation (p<0.0001). The blood oxygen saturation signifi-cantly increased from 74% (ranged 42-93; SD 12) before proce-dure, to 90% (ranged 62-100; SD 8) afterward (p<0.0001). The meanduration of follow-up time was 14.2 months (ranged 2.5-50.8; SD13) and the minimal patency of PDA was 11.2 months (ranged 1.1-47.7; SD 10.7) after implantation. At the end of follow-up, the stentswere widely patent in 33 patients (55%), stenotic in 15 patients (25%)and spontaneously occluded in 12 patients (20%). There was in-creased growth of pulmonary artery as measured by McGoon ratiofrom 1.23 (ranged 0.4-2.3; SD 0.4) to 1.81 (ranged 0.7-0.9; SD 0.57),and no distortion of pulmonary artery and its branches found.Conclusion Stent implantation into ductus arteriosus decreasedthe degree of cyanosis, increased blood oxygen saturation, main-tained long-term patency of ductus arteriosus, and promoted theincreased growth of pulmonary artery without distortion of pulmo-nary artery and its branches

Heated, humidified high-flow nasal cannula vs. nasal CPAP in infants with moderate respiratory distress Adhi Teguh Perma Iskandar; Risma Kerina Kaban; Mulyadi M Djer
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Background Respiratory distress is the most common cause of morbidity in premature babies in the delivery room. Nasal continuous positive airway pressure (nCPAP) is widely used as the preferred modality of treatment, although it may cause nasal trauma. Heated, humidified high-flow nasal (HHHFN) cannula is an alternative oxygen therapy, yet the safety and efficacy has not been widely studied. Objective To compare the safety and efficacy of HHHFN and nCPAP in premature babies with gestational age > 28 to < 35 weeks and moderate respiratory distress. Methods We conducted a randomized, non-inferiority, clinical trial using HHHFN vs. nCPAP as a treatment for moderate respiratory distress within 72 hours after they had been used. The efficacy endpoints were treatment failure, length of device use, length of Kangaroo Mother Care (KMC), and full enteral feeding time. Safety assessment included pain score, nasal trauma, and systemic complications. Results No differences were found in terms of incidence of endotracheal intubation within < 72 hours of HHHFN (20%) compared to nCPAP (18%) (P=0.799). However, there was a significant difference in moderate nasal trauma in nCPAP (14%) compared to HHHFN (0%)(P=0.006). There were no significant differences of blood gas analysis results, full enteral feeding time, length of KMC, length of device use, and rate of complications (bronchopulmonary dysplasia/BPD, intraventricular hemorrhage/IVH, patent ductus arteriosus/PDA, necrotizing enterocolitis/NEC and late onset neonatal sepsis/LONS) between the nCPAP and HHHFN groups. Conclusion The HHHFN is not inferior to nCPAP in terms of the safety and efficacy as primary non-invasive therapy in premature babies of gestational age > 28 to < 35 weeks with moderate respiratory distress . Compared to nCPAP, HHHFN induced lower nasal trauma.

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