The effectiveness of Lactobacillus reuteri on serum bilirubin levels in neonatal hyperbilirubinemia with phototherapy

Background Hyperbilirubinemia occurs in 60% of full term and 80% of premature infants. Phototherapy is the main treatment, but it has side effects, sometimes requires hospitalization, and causes the baby to be separated from the mother. Underdeveloped gut microflora and increased enterohepatic circulation in newborns contribute to increased serum bilirubin levels in early life. Objective To assess the efficacy of adding probiotic L. reuteri on phototherapy in full-term neonates with hyperbilirubinemia. Methods In this double-blind, randomized clinical trial, full term infants with hyperbilirubinemia at Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia, were randomly assigned to either an intervention or control group. All subjects received phototherapy. The intervention group was also given five drops of L. reuteri once a day orally before phototherapy started, while the control group received a placebo. Bilirubin levels after 24-hour phototherapy were evaluated in both groups. Results A total of 42 term neonates met the inclusion criteria. The intervention group had a significantly greater decrease in total serum bilirubin (TSB) level (6,517 mg/dL) than did the control group (4,434 mg/dL) (P<0.001), as well in indirect bilirubin levels in the intervention group had decrease 6.40 mg/dL while in the control group 4.43 mg/dL after 24 hours of phototherapy (P<0.001). Conclusion In full-term neonates with hyperbilirubinemia who underwent 24-hour phototherapy, adding probiotic L. reuteri leads to a significantly greater reduction in total and indirect bilirubin levels compared to the control group

Pemakaian Ventilator Frekuensi Tinggi pada Bayi Asfiksia Berat

Asfiksia berat merupakan keadaan gawat darurat bayi baru lahir yang membutuhkan bantuan ventilasi mekanik segera. Ventilator merupakan alat bantu pernapasan yang dapat digunakan untuk memperbaiki ventilasi alveolar, pembuangan CO2, serta oksigenasi jaringan yang adekuat. Jenis ventilator mekanik yang sering digunakan, yaitu ventilator mekanik konvensional dan ventilator frekuensi tinggi. Ventilator mekanik konvensional mulai ditinggalkan karena efek samping yang ditimbulkannya. Kini telah dikembangkan penggunaan ventilator frekuensi tinggi dengan risiko barotrauma yang lebih rendah karena tekanan, volume dan frekuensi oksigen yang diberikan dapat diatur. Pada makalah ini dibahas pemakaian ventilator frekuensi tinggi pada bayi asfiksia berat

Intravenous Paracetamol and Patent Ductus Arteriosus Closure

Background: Standard medical treatments for patent ductus arteriosus (PDA) closure are, including indomethacin/ibuprofen and surgical ligation. Nowadays, a new strategy to close PDA is the use of paracetamol. The present study aimed to describe the use of intravenous (IV) paracetamol for PDA closure in neonates who present a contraindication to ibuprofen or ibuprofen failure with no possibility to perform surgical ligation due to major instability.Methods: The present study was conducted from January to December 2017 in the neonatal intensive care unit of Dr. Zainoel Abidin Hospital and Harapan Bunda Hospital, Banda Aceh, Indonesia, on neonates with hemodynamic significant PDA (hsPDA). All the subjects received IV paracetamol (15 mg/kg every 6 h) for 3 days. Thereafter, the ductus was evaluated by echocardiography on the 5th day after the regiment.Results: A total of 72 neonates were diagnosed with hsPDA and their average of gestational age was 34.26 weeks and their average of birth weight was 1945.69 g for 39 (54.2%) female neonates, 33 (45.8%) male neonates, 45 (62.5%) premature infants, and 27 (37.5%) full-term infants. About 26 (36.1%) infants had a closed PDAs on the 5th days of evaluation, 11 (15.3%) infants had regiment twice for closed PDA at the 10th days of evaluation, and 35 (48.6%) neonates had more closed PDA after three or four regiments. Successful closure with paracetamol was achieved in 51(70.8%) neonates, while 21 (29.2%) neonates failed the PDA closure.Conclusion: Based on the findings of the present study, IV paracetamol appears to be reasonably effective for PDA closure in both preterm and term infants. This should be the first-line of therapy choice when there are contraindications for the treatment with ibuprofen

Association between socioeconomic status and the prevalence of intestinal worm infection in primary school children

Background In Indonesia, medical problems are indicated by diseases associated with low socioeconomic status. The preva- lence of intestinal worm is still high in Indonesia. Objective The purpose of this study was to find the association between socioeconomic status and the prevalence of intestinal worm infection. Methods A cross sectional study was done on 120 primary school children in Suka Village, Karo District, North Sumatra Province. Subjects were selected by means of random sampling. Kato Katz method was used in stool examination. Socioeconomic status was referred from the Survey Keluarga Sejahtera (Wealth Family Sur- vey) 1998 by the BKKBN (the National Coordination Board on Family Planning). Data of socioeconomic status were collected by interview using a questionnaire and analyzed by chi square test; p value of <0.05 was considered to be statistically significant. Results Eighty-four subjects (70%) suffered from intestinal worm infection. There was no significant association between either age (p=0.811) or nutritional status (p=0.792) and intestinal worm infec- tion, but there was significant association between sex and intes- tinal worm infection (p=0.028). There was also association between intestinal worm infection and father’s education (p=0.044). Mother’s occupation had a significant association with intestinal worm in- fection (p=0.001), but father’s occupation (p=0.474) did not. Nei- ther parents’ income (p=0.429) nor socioeconomic status (p=0.098) was associated with intestinal worm infection. Conclusion There was significant association between intestinal worm infection and sex, father’s education or mother’s occupatio

Factors associated with the transmission of soil-transmitted helminthiasis among schoolchildren

Background Soil-transmitted helminthiasis (STH) is an important public health problem in Indonesia. Objective To find out factors influencing the transmission of STH in two different communities in North Sumatera, Indonesia. Methods A cross sectional study was done on 96 primary school children 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 and centrifuge floatation methods were used for stool and soil exami- nations, respectively. Data were collected by interviewing parents of children using a questionnaire and were analyzed using chi– square test by SPSS program version 11.0. Results There was no difference in the prevalence of STH in both villages (p>0.05). Parents’ knowledge and economic status had significant relationships with the prevalence of STH in Suka vil- lage (p0.05). In both villages, parents’ 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 in the two villages