Guslihan Dasa Tjipta, Guslihan Dasa
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Penggunaan Metilxantin pada Bayi Prematur dengan Apne Idiopatik

Sari Pediatri Vol 6, No 3 (2004)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

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Abstract

Apne idiopatik pada bayi prematur terjadi tanpa faktor predisposisi yang teridentifikasi.Insidens apne idiopatik bervariasi, berbanding terbalik dengan usia gestasi. Awitan apneidiopatik biasanya terjadi pada hari kedua sampai hari ketujuh kehidupan, jarang padahari pertama. Diagnosis dibuat berdasarkan gejala klinis. Apne pada bayi prematur yangbukan disebabkan oleh faktor yang teridentifikasi dapat diobati dengan metilxantin(kafein, teofilin). Metilxantin merangsang ventilasi melalui mekanisme sentral ataudengan peningkatan kekuatan diafragma. Kafein lebih disukai daripada teofilin karenakafein mempunyai beberapa keuntungan dan efek samping yang lebih sedikit. Pemberianobat harus disertai monitoring konsentrasi plasma dan klinis yang hati-hati.

Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

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Abstract

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

Congenital Malformation Among Newborns at Dr. Pirngadi Hospital Medan During 1981 1984

Paediatrica Indonesiana Vol 29, No 1-2 (1989): January 1989
Publisher : Indonesian Pediatric Society

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Abstract

A study of the incidence of congenital malformation had been assessed among 15185 newborns delivered in the Neonatal Unit Dr. Pirngadi Hospital Medan during 1981-1984. Still-births were not included in this study.Out of these 15185 newborns there were 77 cases (0.51%) of congenital malformation. The four leading malformations were: pes-equinovarus 7 cases (9. 1 %), labiognathopalatoschizis, hidrocephalus and anencephalus 6 cases each (7.7%).The number of congenital malformation was higher in the age group of mothers older than 35 years (0. 78%) and in the group of babies born in the birth order as third and further (53.85%) and as first born babies (33.33%).From 77 cases with congenital malformation only 2 (2.56%) were operated soon after birth, while 49 cases (64.1%) went home without surgical intervention, and 28 cases (15.9%) died during hospitalization.

The effect of neonatal asphyxia on renal function

Paediatrica Indonesiana Vol 41, No 4 (2001): July 2001
Publisher : Indonesian Pediatric Society

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Abstract

Neonatal asphyxia can cause renal perfusion and dilution disorders and also glomerular filtration abnormality. The purpose of this study was to find renal dysfunction, which caused by neonatal asphyxia. The study was performed by cross sectional for newborn babies with asphyxia based on Apgar score in the first minute. Newborn babies without asphyxia were as control. In both group, the first micturition times were recorded, total urine output in 24 hours were counted, the mean of blood urea and creatinine serum level value examined and also glomerular filtration rate. Statistical analysis has been performed by using Fisher Exact test, Student t test and Wilcoxon Rank Sum test. All of babies in the asphyxiated and non asphyxiated group had the first micturition in 24 hours after delivery. Significant difference of oliguria incidence was found in the asphyxiated group compared to the control group (p<0,05). The mean of blood urea and creatinine serum level was significantly higher in asphyxiated (p<0,05). The mean of glomerular filtration rate in the asphyxiated group was not significantly different to the control group (p>0,05). According to the degree of asphyxia we found significantly different of renal dysfunction (p<0,05). It was concluded that the asphyxia could cause the occurrence of renal dysfunction. 

Effectiveness of single and double phototherapy on indirect hyperbilirubinemia in neonates

Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

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Abstract

Background Hyperbilirubinemia is a common problem in full term newborns and phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. Double phototherapy could increase the effectiveness of treatment.Objective To compare the effectiveness of single and double phototherapy and increasing spectral irradiance for decreasing serum bilirubin levels in neonates for indirect hyperbilirubinemia.Methods An open, randomized, controlled trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. Subjects were divided into two groups, those who received single phototherapy (n=30) and those who received double phototherapy (n=30) treatments. We included term newborns with neonatal jaundice in the first week of life. Serum bilirubin and average spectral irradiation levels were measured at baseline and after 12 hours and 24 hours of phototherapy treatment.Results The mean total bilirubin levels of the single and double phototherapy groups at the beginning of therapy were 17.6 mg/dL (SD1.41) and 17.5 mg/dL (SD 1.32), respectively, with no significant difference between values. During the study period the sum of average spectral irradiance by double phototherapy was significantly higher than that of single phototherapy (P < 0.05). A significantly greater decrease in bilirubin levels was observed in the double phototherapy group at 12 hours and 24 hours of phototherapy compared to the single phototherapy group (P = 0.001).Conclusion Double phototherapy is more effective than single phototherapy in reducing bilirubin levels in jaundiced newborns.

Rheumatic Fever and Rheumatic Heart Disease at the Department of Child Health, School of Medicine University of North Sumatera/ Dr. Pirngadi Hospital, Medan (1983 - 1985)

Paediatrica Indonesiana Vol 29 No 3-4 (1989): March 1989
Publisher : Indonesian Pediatric Society

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Abstract

A retrospective study on rheumatic fever and rheumatic heart disease in children was conducted at the Department of Child Health, Dr. Pirngadi Hospital Medon, during 1983 - 1985. The patients consisted of 43 females and 30 males. Most of the patients were over 12 years of age. Of the 73 patients there were 60 patients (82,19%) accompanied by valvular disorders. The most frequent major criteria of Jones found in this study were carditis and polyarthritis. Thirty one patients (42.46%) had functional status (NYHA) of grade II - IV, and 43 patients (58.90%) had cardiomegaly. The major ECG findings were enlargement of the atria or ventricles and first degree A V block. Compliance was only achieved in 25 (34.24%) cases. Rheumatic fever and rheumatic heart disease are still remain a challenge for the medical professionals in tireregion to cope with.

Pengaruh domperidon terhadap produksi ASI pada ibu yang melahirkan bayi premature

Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Mother who gave birth to premature babies often have difficulty getting adequate milk production. Various attempts to increase milk production have been made, including pharmacological interventions. One of the drugs that can be used is domperidone. Domperidone is a peripheral dopamine receptor antagonist, works by blocking the inhibitory effects of dopamine-mediated prolactin secretion, thereby increasing milk production. Three randomized double-blind study showed that domperidon can increase milk production without causing any side effects to the mother and baby.Keywords : domperidone; premature; breastfed

Osteopenia prematuritas dan upaya pencegahannya

Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 3 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Osteopenia of prematurity is a common problem encountered in preterm infants or infant with low birth weight. This is characterized by decreased bone mineral content due to inadequat nutritional intake and biochemical factors. This condition can make metabolic disorders in pathological bone fractures even in newborns. Incidence of osteopenia in low birth weight infants in 30%, whereas in infants less than 1000 g of about 55%, and infants less than 1500 g as much as 23%. For preterm infants, the features commonly associated with fracture are delivery at less than 28 weeks of gestation. Metabolic bone disease is often not detected at early stage and became known after appearing obvious abnormalities in the bone or in radiologic examination. Therefore, it is necessary to screening with serum biochemical examination of blood in serum levels of calcium, phosphate and alkaline phosphatase. In addition, it was important to intake of calcium and phosphorus are sufficient for bone mineralization. Key word : osteopenia of prematurity, preterm, calcium, calcium

Domperidone and maternal milk volume in mothers of premature newborns

Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

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Abstract

Background Mothers of premature newborns often have difficulty giving adequate breast milk volume to their infants. Domperidone is an antagonist of peripheral dopamine receptors and believed to increase breast milk production. In Indonesia, no study has been done to date on the effect of domperidone on maternal milk production in mothers of premature newborns.  Objective To evaluate the effect of domperidone on milk production in mothers of premature newborns who failed to lactate.Methods A randomized controlled trial was conducted from July to December 2012 in the Perinatology Unit, Haji Adam Malik Hospital, Medan. Mothers of premature newborns were given lactation counseling for 7 days in order to increase their milk production. Mothers who failed to lactate after that time were enrolled in the study. Fifty subjects were assigned to receive either domperidone or a placebo for 7 days. Milk volume was measured every 2 hours (from 7 am to 9 pm), in the 24 hours before starting therapy, and on the 7th and 10th days (the 10th day being 3 days after stopping therapy). Results This study involved 25 mothers in the domperidone groups and 25 others in placebo group. After 7 days of therapy, mean breast milk volume was significantly higher in the domperidone group than in the placebo group  [181.6 (SD 80.2) vs. 72.4 (SD 57.8) mL, respectively; 95%CI of differences 69.36 to 148.93; P=0.0001]. At day 10, breast milk production remained significantly higher in the domperidone group. Furthermore, in the domperidone group, no significant difference in mean breast milk volumes was noted between the 7th and 10th days (P=0.65). Conclusion In mothers of premature newborns who failed to lactate, domperidone therapy for 7 days causes significantly higher milk production compared to placebo. 

Procalcitonin as a diagnostic tool for bacterial neonatal sepsis

Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

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Abstract

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment can reduce the mortality rate. Blood culture is the gold standard for diagnosis of bacterial sepsis, but it requires 3-5 days for results. Since the disease may progress rapidly in neonates, a faster diagnostic test is needed. Measurement of procalcitonin levels may be a quick method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of procalcitonin to be between 92-100%. Objective To assess the use of procalcitonin as an early diagnostic tool for bacterial neonatal sepsis. Methods This diagnostic study was conducted from October 2011 to February 2012. Forty-three neonates in the Perinatology Unit at H. Adam Malik Hospital were suspected to have bacterial sepsis. They underwent routine blood counts, blood cultures, as well as C-reactive protein and procalcitonin measurements. Subjects were collected by consecutive sampling. The gold standard of sepsis was based on any microorganism found in blood culture. Results Of 43 neonates, 36 neonates had bacterial sepsis. We found that procalcitonin sensitivity was 100%, specificity 85.71%, positive predictive value 97.29% and negative predictive value 100%. The ROC curve showed a cut-off point of 0.929 (95%CI 0.713 to 0.953). Conclusion Procalcitonin is useful as an early diagnostic tool for bacterial neonatal sepsis.