Rusdi Ismail
Department of Child Health, Universitas Sriwijaya Medical School/Moh. Hoesin Hospital, Palembang, South Sumatera

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Role of Persistent Diarrhea Control in Declining Infant and Childhood Mortality in Indonesia Rusdi Ismail
Paediatrica Indonesiana Vol 34 No 7-8 (1994): July - August 1994
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (801.35 KB) | DOI: 10.14238/pi34.7-8.1994.187-96

Abstract

In diarrheal diseases control program (CDD), the mechanism of diarrheal diseases (DD) death can be classified into: dehydration, dysentery, complication, and persistent diarrhea. The aim of the presentation is to predict the share of these components and to highlight the role of persistent diarrhea. Demographic figures were inferred from the Census and the 1985 Inter-Censal Survey data. Rates on DD were inferred from the National Household Health Surveys and relevant reports. The mechanisms of death were inferred from the pattern of DO death in Palembang General Hospital. By fair prediction, in infants, 1.5 lives will be saved per 1000 live births through COD Program, 88% is the share of persistent diarrhea control, and 20% of better management of DD complicated with other diseases. In 1-4 years of age, the figures are 68% and 38%, respectively. The share of promoting rehydration and dysentery management will be minimal in declining infant mortality rate (MR) and childhood death rate (CDR) between 1992 and 2000. The share of COD in declining IMR and CDR must depend on a better management of persistent and complicated DD.
Nasogastric Drip Rehydration Therapy in Acute Diarrhea with Severe Dehydration Syamsul Hidayat; Srie Enggar K. D.; Nancy Pardede; Rusdi Ismail
Paediatrica Indonesiana Vol 28 No 3-4 (1988): March - April 1988
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (456.931 KB) | DOI: 10.14238/pi28.3-4.1988.79-84

Abstract

WHO recommended severe dehydration without shock in acute diarrhea to be rehydrated by nasogastric drips (NGD) of oral rehydration solution (oralit). In this respect the criteria of a still palpable and countable pulse, the absence of meteorism and absence of complication, the reverse warranting iv fluid therapy, can be used as practical guidelines to identify the patient "without shock". A clinical trial comparing the result of NGD oralit rehydration therapy to that of intravenous Ringer-lactate on small children with diarrhea and severe dehydration was conducted. Seventy jive patients admitted to the Department of Child Health Palembang General Hospital from January up to July 1986, aged 1 to 59 months, suffering from acute diarrhea with severe dehydration fulfilled to above mentioned criteria. Randomly 36 were assigned to NGD rehydration therapy using WHO standard ORS (in Indonesia is named as oralit) and 39 were rehydrated with iv Ringer lactate solution, given in four hours consisting of 40ml/kg BW, 30ml/kg BW, 20 ml/kg BW and 20ml/kg BW in the first, second, third and fourth hours respectively. Based on the failure rate of rehydration in the first four hours, the recurrence of dehydration after rehydration and the side effects of fluid therapy, it was concluded that acute diarrhea cases with severe dehydration who fulfilled the above mentioned criteria can be rehydrated by NGD oralit as effective and safe as by iv Ringer lactate.