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

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Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination Sumarmo Sumarmo; Mugiyo Mugiyo; Priutomo Priutomo; Sofyan Ismael; Muslim A. Nathin
Paediatrica Indonesiana Vol 22 No 7-8 (1982): July - August 1982
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi22.7-8.1982.119-25

Abstract

This paper describes our experience in treating neonatal meningitis with an intravenous Sulphametoxazole/Trimethoprim (SMZ-TMP) combination.Fifteen neonates ranging in age from 6 to 36 days were included in this study. Cerebrospiral fluid isolates were as follows:S. havana (3), S. oranienburg (2) and Haemolytic streptococci (1), the remaining 9 cultures were negative. Those bacteria isolated were all sensitive to SMZ/TMP. A solution of SMZ 80 mg/ml and TMP 16 mg/ml in 40% propylene glycol was used with a daily dose of 10 mgfkg B.W. TMP for the first 3 days followed by 6 mg/kg B.W. TMP for 18 days or longer, divided in two dose given intravenously every 12 hours.Thirteen patients recovered, but two died of neurological complications, one with ventriculitis and the other with a subdural empyema.No hematological or cutaneous or gastrointestinal side effects were observed. The liver and renal function tests performed on 5 out of the 15 patients on the first few days of hospitalization and 3 weeks later were all within normal lirnits. The use of parenteral SMZ-TMP in neonatal meningitis showed an encouraging result considering the fact rthat our previous mortality rate was 60%.
Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound Setyo Handryastuti; Ghaisani Fadiana; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.128 KB) | DOI: 10.14238/pi58.1.2018.5-12

Abstract

Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice.Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP.Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjects’ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist.Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice.Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.
Risk factors and the occurrence of cerebral palsy in high risk infants Setyo Handryastuti; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (261.929 KB) | DOI: 10.14238/pi58.2.2018.95-100

Abstract

Background The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.
Co-Authors Adji Saptogino Asril Aminulah Ferial Hadipoetro Idris Ghaisani Fadiana Mugiyo Mugiyo Muslim A. Nathin Priutomo Priutomo Setyo Handryastuti Sudigdo Sastroasmoro Sumarmo Sumarmo Sunartini Hapsara