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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Majalah Kedokteran Nusantara The Journal Of Medical School Sumatera Medical Journal Cermin Dunia Kedokteran Cermin Dunia Kedokteran

Munar Lubis

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Sumatera Utara

Author-ID : 565435

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Comparison of the efficacy of artesunate-amodiaquine with quinine-clindamycin for treatment of uncomplicated falciparum malaria in children Purnama Fitri; Armila Armila; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Background Drug-resistant Plasmodium falciparum malaria is amajor contributor to increasing malaria-related morbidity andmortality. Artesunate-amodiaquine is a potential combinationtherapy that shows improved treatment efficacy. Clindamycin incombination with quinine is also a safe and effective treatmentfor multidrug-resistant P. falciparum malaria.Objectives To compare the efficacy of artesunate-amodiaquine andquinine-clindamycin combination therapies for the treatment ofuncomplicated falciparum malaria.Methods This randomized open label trial in 23 2 children agedbetween one month and 18 years old took place in MandailingNatal, North Sumatra, from August to September 2006. The AAgroup received a 3-day oral course of artesunate (4 mg/kg BWonce a day) plus amodiaquine (10 mg/kg BW once a day). TheQC group received a 3-day course of clindamycin (5 mg of base/kgBW twice a day) plus a 7-day course of quinine (10 mg of salt/kgBW orally for the first four days, then 5 mg of quinine salt/kg BWfor the next three days). We performed thin and thick peripheralblood smears on days 0, 2, 7, and 28.Results A total of 232 eligible children were enrolled but only22 7 completed the study (114 in group AA, 113 in group QC).The cure rates were lOOo/o in both groups by the second day, andthere was no recrudescence in either group. We found more sideeffects in AA group compared with in QC group, i.e., headacheand vomiting.Conclusion Artesunate-amodiaquine and quinine-clindamycincombinations showed similar efficacy for the treatment of uncomplicatedP. falciparum.

Parascreen as an alternative diagnostic tool for falciparum malaria Jenny Ginting; Siska Mayasari; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
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/pi48.4.2008.220-3

Background Malaria is a parasitic disease with high morbidityand mortality. Rapid immunochromatographic are emerging todetect specific antigens of human plasmodia.Objective To determine the sensitivity and specificity ofParascreenfor the detection of Plasmodium falciparum in children.Methods A diagnostic test study was performed in MandailingNatal District, Penyabungan, North Sumatera. Subjects werepublic health center and hospital patients with symptoms of fever,pallor, headache, and diarrhea. Blood specimens were obtained forParascreen testing. Microscopy of Giemsa-stained blood samplesserved as the gold standard.Results One hundred and four subjects were studied. The sensitiv-ity and specificity ofParascreen were 76% and 100%, respectively.Positive and negative predictive values of the test were 100% and49%, respectively. Likelihood ratio was infinite for a positive testand 0.23% for a negative test.Conclusion Parascreen is a useful and highly specific di-agnostic tool for P. falciparum malaria

Acute kidney injury and mortality in critically ill children Putri Amelia; Munar Lubis; Ema Mutiara; Yunnie Trisnawati
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Background Mortality from acute kidney injury (AKI) can be ashigh as 60% in critically ill children. This high mortality rate isinfluenced by the severity of primary diseases, organ dysfunction,and the stage of acute kidney injury.Objective To assess for an as sedation between AKI and mortalityin critically ill children hospitalized in the pediatric intensive careunit (PICU).Methods A cross-sectional study was conducted from Aprilto July 2012. All patients aged 1 month to 18 years who werehospitalized in the PICU for more than 24 hours were included.Urine output and serum creatinine levels were evaluated daily.Patients were categorized according to the pediatric risk, injury,failure, loss, and end stage renal disease (pRIFLE) criteria. Chisquare, Fisher's exact, Mann-\X'hitney U, and Kruskal-Wallis testswere used to assess for an association between AKI, mortality,pediatric logistic organ dysfunction (PELOD) score, and lengthof PICU stay. AP value of < 0.05 was considered as statisticallysignificant.Results During the study period, 57 children were admitted,consisting of 25 (43.9%) females and 32 (56.1 %) males, witha median age of 43 months. The prevalance of AKI was 31.5%(18/57) and classified into stages: risk 13/18, injury 3/18, andfailure 2/18. The mortality rate for AKI was 16. 7%. There was noassociation between AKI and mortality (P=0.592). The PELODscores were found to be similar among patients (SD 11.3 2 vs. SD12.23; P=0.830), and there was no association between AKI andlength of PICU stay (P=0.819).Conclusion There is no association between AKI and mortalityin critically ill children admitted in PICU.

Comparison of oxygen saturation measured by pulse oximetry and arterial blood gas analysis in neonates Srie Yanda; Munar Lubis; Yoyoh Yusroh
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

Background Arterial blood gas is usually beneficial to discern thenature of gas exchange disturbances, the effectiveness of com-pensation, and is required for adequate management. AlthoughPaO 2 is the standard measurement of blood oxygenation, oxygensaturation measured by pulse oximetry (SapO 2 ) is now a custom-ary noninvasive assessment of blood oxygenation in newborn in-fants.Objective To compare oxygen saturation measured by pulse oxi-metry (SapO 2 ) and arterial blood gas (SaO 2 ), its correlation withother variables, and to predict arterial partial pressure of oxygen(PaO 2 ) based on SapO 2 values.Methods A cross sectional study was conducted on all neonatesadmitted to Pediatric Intensive Care Unit (PICU) during February2001 to May 2002. Neonates were excluded if they had impairedperipheral perfusion and/or congenital heart defects. Paired t-testwas used to compare SapO 2 with SaO 2 . Correlation between twoquantitative data was performed using Pearsonâ€™s correlation. Re-gression analysis was used to predict PaO 2 based on SapO 2 val-ues.Results Thirty neonates were included in this study. The differ-ence between SaO 2 and SapO 2 was significant . There were sig-nificant positive correlations between heart rate /pulse rate andTCO 2 , HCO 3 ; respiratory rate and TCO 2 , HCO 3 , base excess (BE);core temperature and HCO 3 , BE; surface temperature and pH,TCO 2, HCO 3, BE; SapO 2 and pH, PaO 2 ; and significant negativecorrelation between SapO 2 and PaCO 2 ; the correlations were weak.The linear regression equation to predict PaO 2 based on SapO 2values was PaO 2 = -79.828 + 1.912 SapO 2 .Conclusion Pulse oximetry could not be used in place of arterialblood gas analysis available for clinical purpose

The effectiveness of chloroquine compared to Fansidar in treating falciparum malaria Emil Azlin; Ichwan HH Batubara; Wisman Dalimunte; Charles Siregar; Bidasari Lubis; Munar Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Background The most difficult problem in eradicating malaria isthe resistance of P. falciparum to drugs. Mandailing Natal has thehighest malaria incidence in North Sumatera.Objective This study aimed to investigate the efficacy of chloro-quine and Fansidar in treating falciparum malaria.Methods A randomized double-blind study was done from April toMay 2001. Eighty-three patients with acute uncomplicated P.falciparum malaria infection were randomized into two groups.Group I (35 patients) received chloroquine and group II (48 pa-tients) received Fansidar. Blood examinations were performed onthe 1 st , 2 nd , 7 th , and 28 th days.Results The resistance of P. falciparum to drugs in the chloro-quine group were found in 10 patients with R II and 1 patients withR III, while in the Fansidar group, there were 14 patients with R II.Conclusion The efficacy of chloroquine and Fansidar in treatingfalciparum malaria was not significantly different

Hemolytic anemia in falciparum and vivax malarial patients based on serum bilirubin examination Yoyoh Yusroh; Bidasari Lubis; Syahril Pasaribu; Munar Lubis; Tiangsa Sembiring; Adillida Adillida
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Objective To examine hemolysis in falciparum and vivax malarialpatients based on serum bilirubin examination.Methods A cross sectional study was conducted on childrenyounger than 15 years of age who visited public health center inthe district of Mandailing Natal with complaints of fever, shivering,pale, jaundice, diarrhea, or headache between April 9 th and April19 th 2001. Variables recorded were age, gender, body weight, bodyheight, symptoms and signs, anti malarial drugs, and laboratorytest results. Thin and thick blood smears were done as diagnostictools of malaria. Thin blood smear was also performed to deter-mine the level of malaria parasites in blood (parasitemia) and toexamine the morphology of red blood cells. Hemolysis was deter-mined by bilirubin examination.Results In P. falciparum malaria, there was a moderate correlation(r=0.68, p<0.0001) between parasitemia and indirect bilirubin con-centration. While in P. vivax malaria, there was only a weak corre-lation (r=0.46, p=0.007) between parasitemia and indirect bilirubinconcentration. It was also found that in falciparum malaria, para-sitemia, total and indirect bilirubin concentrations were significantlyhigher than that in vivax malaria, with p values of 0.009, 0.015 and0.003, respectively.Conclusion Hemolysis in falciparum malaria is more severe thanthat in P. vivax malaria, with marked elevation of indirect bilirubin.The elevation of serum bilirubin correlated with parasitemia

Correlation between parasitemia and spleen size in patients with P. falciparum infection Dini Lailani; Munar Lubis; Bidasari Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Background Spleen is an important organ in immunity to malariainfection which is always affected in malaria patients. Enlargementof the spleen is one of the main clinical symptoms of malaria. Levelof parasitemia is related to the risk of complications.Objective To describe the correlation between parasitemia andspleen size in patients with P.falciparum infection.Methods One hundred and four patients including children andadults with fever, pale, jaundice, diarrhea, and headache who vis-ited public health centers in 5 villages in Mandailing Natal, NorthSumatera were enrolled in this study. The diagnosis of malariawas based on blood smears stained by Giemsa method, while thespleen size was measured using Hackett method. Correlation be-tween parasitemia and spleen size was tested by Spearman rankcorrelation.Results Splenomegaly was found in 37 of 104 patients (35.6 %)with the size of H1 in 10.6 %, H2 in 15.4 %, H3 in 9.6 %. The meanparasite count between patients with and without splenomegalywas different, and the difference was significant between patientswith spleen size of H0 and H3. The higher the parasitemia, thebigger the spleen size was (r=0.291; p=0.03).Conclusion There was a correlation between parasitemia andspleen size in falciparum malarial infection

Factors associated with the transmission of soil-transmitted helminthiasis among schoolchildren Isra Firmansyah; Sri Alemina Ginting; Munar Lubis; Iskandar Z Lubis; Syahril Pasaribu; Chairuddin P Lubis
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background Soil-transmitted helminthiasis (STH) is an importantpublic health problem in Indonesia.Objective To find out factors influencing the transmission of STHin two different communities in North Sumatera, Indonesia.Methods A cross sectional study was done on 96 primary schoolchildren in Suka village (located on a mountain area) and 96 pri-mary school children in Pantai Cermin village (a coastal area). Sub-jects were recruited by simple random sampling. Kato Katz andcentrifuge floatation methods were used for stool and soil exami-nations, respectively. Data were collected by interviewing parentsof children using a questionnaire and were analyzed using chiâ€“square test by SPSS program version 11.0.Results There was no difference in the prevalence of STH in bothvillages (p>0.05). Parentsâ€™ knowledge and economic status hadsignificant relationships with the prevalence of STH in Suka vil-lage (p<0.05), but not in Pantai Cermin (p>0.05). In both villages,parentsâ€™ education did not have a significant relation with STH,while there were significant relations between STH and hygiene,environment, or soil contamination by worm eggs (p<0.05).Conclusion There were significant relationships between hygiene,environment, or soil contamination and the prevalence of STH inthe two villages.

The effect of vitamin A supplementation on morbidity due to Plasmodium falciparum Adillida Adillida; Yoyoh Yusroh; Munar Lubis; Bidasari Lubis; Tiangsa Sembiring; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Objective To investigate the effect of vitamin A supplementationon malaria morbidity.Methods The study was a randomized double-blind placebo-con-trolled trial, conducted in Panyabungan, Mandailing Natal, NorthSumatera from April 2001 to April 2002. Children aged 6-60 monthssuffering from falciparum malaria were randomly assigned to highdose vitamin A or placebo every 4 months for a year. All childrenwere treated in accordance with health center policy. Malaria mor-bidity was assessed from health center visit due to fever, diarrhea,cough, or abdominal pain. Parents gave reports if their child re-ceived malaria treatment from other health centers.Results The number of febrile episodes (probable malaria illness)was lower in the treatment group than that of control, but not sig-nificant. The parasitemia was not different between both groups.There was a significant difference in spleen enlargement betweenthe treatment group and control (p=0.04). There was no differencein health center visit between the two groups.Conclusion The findings suggest that vitamin A supplementationhas only effect on spleen enlargement in malaria.

Oral-dental hygiene and oral microorganisms in children with and without congenital heart disease Erniwaty P Panggabean; Lily Irsa; Rosihan Anwar; Munar Lubis; Rusdidjas Rusdidjas; Syahril Pasaribu
Paediatrica Indonesiana Vol 45 No 3 (2005): May 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.3.2005.127-31

Objective This study was done to compare the dental and oralhygiene status of children with and without congenital heart dis-ease (CHD) by investigating oral microorganisms and dental andoral hygiene indices.Methods A cross-sectional study was done on children aged 2 to15 years from April 2002 to December 2003 at the Department ofChild Health, Haji Adam Malik Hospital, Medan. There were twosubject groups, the first consisting of children with CHD and thesecond of those without. The dental and oral hygiene status wasdetermined by determining caries index and oral hygiene index.Swabs from the subjectsâ€™ upper first molars were taken and cul-tured to determine the types of microorganisms present. Data wereanalyzed using the chi-square test, Fisherâ€™s exact test, and t-test.Results There was a significant difference in mean oral hygieneindex between children with (mean 2.75; SD 1.85) and without(mean 1.45; SD 0.78) CHD (P<0.001). Positive bacterial cultureswere more frequent in children with CHD than in those without.The proportion of normal anaerobes was significantly higher in chil-dren with CHD (P=0.038). Such a significant difference was notfound for normal aerobes, pathogenic aerobes, and pathogenicanaerobes. In children with CHD, there was no significant asso-ciation between mean caries index and oral hygiene index withculture results. In those without CHD, a significant association wasfound between the caries index components of decayed tooth in-dex (P=0.003) and DMF-T (P=0.022) with culture results.Conclusions Oral-dental hygiene in children with CHD is poorrelative to that in children without CHD. Microorganism growth ap-pears more likely in children with CHD than in those without

Co-Authors Adillida Adillida Aileen Clarissa Dauhan Amir S. Madjid, Amir S. Antonius H. Pudjiadi Aridamuriany D Lubis Aridamuriany D Lubis Aridamuriany D. Lubis Aridamuriany Dwiputri Lubis Aridamuriany Dwiputri Lubis Armila Armila Arto, Karina Sugih Austin Simon Tjowanta Ayodhia P. Pasaribu Ayodhia Pitaloka Pasaribu Bambang Supriyatno Beatrix Siregar Beatrix Siregar, Beatrix Bidasari Lubis Bugis Mardina Lubis C. Saragih, Rina Chaerul Yael Chairoel Yoel Chairuddin P. Lubis Chairuddin P. Lubis Chairuddin P. Lubis Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel Chairul Yoel, Chairul Charles Siregar Charles Siregar Cynthea Prima Destariani Danny Dasraf Dewi Shandi Laila, Dewi Shandi Diana Aulia Dini Lailani Ditho Athos P. Daulay Effa Triani Effa Triani Efori Gea Elmeida Effendy Ema Mutiara Emil Azlin Emil Salim Endang D. Hamid Erika S. Panjaitan Erna Mutiara Erna Mutiara Erna Mutiara Erniwaty P Panggabean Fauzi Rizal Fujiati, Isti Ilmiati Gabriel P. Gema N. Yanni Gema Nazri Yani Gema Nazri Yanni Gema Nazri Yanni Gema Nazri Yanni Gunanti . Hakimi Hakimi Hasibuan, Syahreza Helmi M. Lubis Hendy Zulkarnain Hindra I. Satari, Hindra I. Ichwan HH Batubara Indah Nur Lestari Iskandar Z Lubis Iskandar Z. Lubis Isra Firmansyah Isra Firmansyah Isti Ilmiati Jenny Ginting Johannes H. Saing Johnny Arsyad Jose Rizal Latief Batubara Jose RL Batubara Jufitriani Ismy Jufitriany Ismi Kristina Ambarita Kristina Ambarita Lestari, Indah Nur Lily Irsa Lily Rahmawati Lubis, Inke Nadia Mahadi Mahadi Manihar D. Marbun Melda Deliana Melda Deliana Melda Deliana Monalisa Elizabeth Muhammad Adib Mahara Muhammad Ali Muhammad Ali Muhammad Ali Nafianti, Selfi Nasution, Badai Buana Nelly Rosdiana Nora Sovira Oke Rina Ramayani Oke Rina Ramayani Oke Rina Ramayani, Oke Rina Purnama Fitri Putri Amelia Putri Amelia Putri Amelia Putri Hasria Sri Murni Rafita Ramayanti Rafita Ramayati Rafita Ramayati Ria Puspitasari Ria Puspitasari Ridwan M. D. Rina A.C. Saragih Rina A.C. Saragih, Rina A.C. Rina Amalia C Saragih Rina Amalia C. Saragih Rina Amalia C. Saragih Rina Amalia Karomina Saragih Rina C. Saragih Rismala Dewi Rizki Aryo Wicaksono Rizki Aryo Wicaksono ROSIHAN ANWAR Rosmayanti Siregar Rosmayanti Siregar, Rosmayanti Rusdidjas dr Rusdidjas Rusdidjas Rusdidjas Rusdidjas Saptawati Bardosono Saragih, Rina Amalia Sembiring, Krisnarta Siregar, Gurnal Rai Gandra Siska Mayasari Siti Helmyati Sri Alemina Ginting Sri Sofyani Srie Yanda Sulaiman Yusuf Suryani Ginting Syafruddin Haris Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syahril Pasaribu Syamsidah Lubis Syarif, Erlita Wienanda Syilvia Jiero T. Murad El Fuad Taralan Tambunan Tiangsa Sembiring Tjut Dharmawati Tri Faranita Tri Faranita Trina Devina Wahyudi Wahyudi Wijaya, Richo Wisman Dalimunte Wisman Dalimunthe Yanni, Gema Nazri Yanni, Gema Nazri Yoyoh Yusroh Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Yunnie Trisnawati Zakiudin Munasir

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