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Zinc supplementation in preterm infants and growth indicators in a developing country Kaban, Risma Kerina; Azis, Henri; Prawitasari, Titis; Kautsar, Ahmad; Lusyati, Setya Dewi; Insani, Nadia Dwi
Paediatrica Indonesiana Vol 63 No 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.443-9

Abstract

Background Zinc is one of the micronutrients that is found deficient in preterm infants. To date, no parenteral zinc supplements are available in Indonesia and there is no recommendation established for routine zinc supplementation in preterm infants. Objective To evaluate the impact of zinc supplementation on growth indicators and morbidity in preterm infants. Methods This double-blind, randomized controlled trial included preterm infants aged 28-32 weeks who were assigned to one of two groups: the first group received a 10 mg zinc supplementation, while the second (control) group received a placebo. At discharge or at a maximum of 40 weeks post-menstrual age (PMA, calculated from the first day of the mother's last menstrual period), the following were evaluated : growth indicators (weight, length, and head circumference), serum zinc level, zinc supplementation side effects, and morbidity rate (intraventricular hemorrhage/IVH, necrotizing enterocolitis/NEC, btonchopulmonary dysplasia/BPD). Data were analyzed with independent T-test using SPSS version 22 software. Results Seventy-eight subjects were assigned to the zinc supplementation group and 76 subjects were assigned to the placebo group. Serum zinc level and mean body weight increment were significantly higher in the zinc group compared to the placebo group (P=0.00 and P=0.02, respectively). There were no significant differences between groups in mean body length or head circumference increment, nor in morbidity rate. Conclusion Preterm infants who received zinc supplementation have higher serum zinc level and mean body weight increment compared to the placebo group. No side effects are observed to have been caused by zinc supplementation.
Hukum Dokter Dalam Pengambilan Keputusan Medis Kritis Pada Pasien Azis, Henri; Jaeni, A.; Karsoma, Ateng
Journal of Innovative and Creativity Vol. 5 No. 3 (2025)
Publisher : Fakultas Ilmu Pendidikan Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/joecy.v5i3.3927

Abstract

Due to clinical complexities in practice, physicians in the Neonatal Intensive Care Unit (NICU), particularly neonatologists, are often confronted with emergency situations that demand rapid and accurate medical decision-making. The Indonesian legal system has not explicitly recognized or regulated protections for the exercise of medical discretion in such emergency conditions. Law No. 17 of 2023 on Health and the Indonesian Penal Code (KUHP), such as Article 359 on negligence causing death, still regulate physicians’ responsibilities under general legal frameworks without considering the specific characteristics of medical emergencies. This creates legal risks for physicians, even when their actions are consistent with clinical procedures and undertaken solely for the patient’s safety. The findings of this research conclude that: (1) The forms of legal accountability for physicians in critical conditions are complex and have not fully reflected substantive justice, comprising four relevant models: first, individual accountability, where physicians are personally liable for the medical actions they take; second, collective accountability, which reflects the reality of medical practice in the NICU; third, fault liability, where physicians can be held accountable if proven negligent; and fourth, strict liability, the most challenging form, where physicians may still be prosecuted even without proof of fault or negligence. (2) Legal protection for physicians performing medical actions as part of professional discretion in neonatal emergencies should take two forms: preventive legal protection, which is proactive in nature, ideally providing physicians with strong and legitimate legal safeguards—such as explicit statutory provisions granting them authority to act in emergencies to save patients without requiring prior written consent from families; and repressive legal protection, which includes legal assistance from professional organizations such as the Indonesian Medical Association (IDI), ethical review by the Indonesian Medical Discipline Honorary Council (MKDKI), or defense through litigation.