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Abdurachman Sukadi
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Agreement of simplified Fencl-Stewart with Figge-Stewart method in diagnosing metabolic acidosis in critically ill children Rotua Sinaga; Abdurachman Sukadi; Dadang Hudaya Somasetia
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.663 KB) | DOI: 10.14238/pi47.4.2007.144-9

Abstract

Background The traditional Henderson-Hasselbalch approach hasproven to be imprecise in critically ill patients. Stewart’s approachcan detect metabolic acidosis missed by traditional approach,including acidosis caused by increased unmeasured agreement(UA). The complexity of Stewart’s method leads to developmentof simpler modifications, simplified Fencl-Stewart and Figge-Stewart method. Agreement between both modifications isunknown.Objective This study aimed to measure the agreement of simplifiedFencl-Stewart with Figge-Stewart method in diagnosing metabolicacidosis in critically ill children.Methods The was performed in Hasan Sadikin General Hospital,Bandung from July to August 2006, involving <14 year-old criticallyill children. Blood samples for gas analysis, sodium, potassium,chloride and albumin measurement were taken simultaneously. Testresult was analyzed with simplified Fencl-Stewart and Figge-Stewartmethod and recorded with Excell spreadsheet. PASS was used forinterim analysis and DAG_Stat for raw agreement indices andKappa calculations.Results Forty-five (31 males, 14 females) children were enrolled.Acid base disturbances based on Stewart’s method were identifiedin 10 subjects with normal base excess and nine with normalbicarbonate. Significant increase of UA was detected in 11 of 45subjects with simplified Fencl-Stewart method, compared to thatof 12 subjects with Figge-Stewart method. Raw agreement indicesshowed 95.65% and 98.51% agreement for positive and negativeresult, Kappa was 0.94 (P=0.0000).Conclusions Excellent agreement is shown between simplifiedFencl-Stewart and Figge-Stewart method in diagnosing metabolicacidosis in critically ill children. Increased UA can be assessedwith both methods.
Preterm and low birth weight as risk factors for infant delayed development Anggraini Alam; Abdurachman Sukadi; Nelly Amalia Risan; Meita Dhamayanti
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.517 KB) | DOI: 10.14238/pi48.1.2008.1-4

Abstract

Background In developed countries, birth weight of less than1,500 g contributes in infant delayed development. It might bedifferent in developing countries.Objective This study aimed to determine whether preterm infantswith birth weight of 1,500 to 2,499 g are risk factors for delayeddevelopment at 7-10 months of age.Methods We analyzed singleton infants at 7-10 months ofcorrected age, born with birth weight of 1,500 to 2,499 grams,preterm-appropriate for gestational age (or LBW group), and at7-10 months of chronological age, born with birth weight >2,500g-term-appropriate for gestational (non-LBW group) in a hospital-based retrospective cohort study. Data were taken from medicalrecords in Hasan Sadikin Hospital, Bandung, from September2003 to May 2004. We excluded infants with major congenitalanomalies, hyaline membrane disease, assisted ventilation, orexchange transfusion. Multiple regression logistic analysis wasperformed for data analysis.Results The percentage of delayed development in LBW groupwas higher than in non-LBW group (17.1% vs. 1.6%). Logisticregression analysis revealed that low birth weight was a risk factorfor delayed development (RR=5.13, 95%Cl 1.55;16.96, P=0.007).Other biological risk factors for delayed development arehyperbilirubinemia (RR=3.32, 95%Cl 1.29;8.54, P=0.013) andsepsis (RR=2.74, 95%Cl 1.15;6.52, P=0.023).Conclusions Preterm-appropriate for gestational age with birthweight of 1,500 to 2,499 g are risk factors for infant delayeddevelopment after being adjusted to other biological risk factors.
Association between serum vitamin D level and tuberculosis in children Ahmad Zaeni Syafii; Abdurachman Sukadi; Budi Setiabudiawan
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (102.242 KB) | DOI: 10.14238/pi48.6.2008.350-3

Abstract

Background A possible association between vitamin 0 andtuberculosis has been described. In adult, vitamin 0 is consideredto have a role in protecting tuberculosis. On the other hand,tuberculosis infection can decrease serum vitamin 0 level.Objective To find out the difference between serum vitamin 0level in children with and without tuberculosis, and to find theassociation of serum vitamin 0 level with tuberculosis.Methods A cross sectional study was conducted in Cibabat Hospital,Ban dung from July to October 2007. We selected children :S 14years, diagnosed as tuberculosis, and had positive response aftertwo month treatment; for control we selected randomly siblingsor neighbors who didn't have tuberculosis. We excluded childrenwith liver abnormalities and immunocompromized children.Mann-Whitney test and OR method with 95% confidence intervalwas used to analyze the data.Results Thirty-nine children with tuberculosis (21 boys, 18 girls)and 39 children without tuberculosis (19 boys, 20 girls) as wereenrolled. Mean serum vitamin 0 level of children with and withoutTB were 4 7 (SO 25) pmol/L and 125 (SO 3 7) pmol/L, respectively(P=O.OOl). All children without tuberculosis had normal vitamin0 level while of those with tuberculosis, 14 children had normallevel and 25 children were deficient (corrected OR: 139, 95%CI8 to 238).Conclusion Serum vitamin 0 level is low in children withtuberculosis.
The risk for delayed development in low birth weight, appropriate for gestational age preterm infants Stanza Uga Peryoga; Abdurachman Sukadi; Sambas Wiradisuria
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.154-9

Abstract

Background Preterm infants, particularly those who have hadsevere asphyxia, hyperbilirubinemia, and sepsis, tend to be at riskfor neurodevelopmental impairment.Objective The purpose of this study was to assess the risk for de-layed development in low birth weight (LBW), appropriate for gesta-tional age (AGA) preterm infants compared to that in term, non-LBWinfants, and to investigate the roles of severe asphyxia, sepsis, andhyperbilirubinemia as potential risk factors for delayed development.Methods This was a hospital-based retrospective cohort studyinvolving preterm, LBW and term, non-LBW infants conducted inHasan Sadikin Hospital, Bandung. The Bayley InfantNeurodevelopmental Screener (BINS) test was performed to as-sess the risk of delayed development at 3 months of corrected agefor the preterm infants and at 3 months of chronological age for theterm infants. Bivariate analysis using the chi-square test and mul-tivariate analysis using logistic regression were performed.Results One hundred and twelve infants fulfilled eligibility criteria,consisting of 52 preterm, LBW and 60 term, non-LBW infants. Basedon the BINS test, of the preterm, LBW infants, 32 (61%) were atlow risk, 11 (21%) at moderate risk, and 9 (17%) at high risk fordelayed development. Of the control infants, 49 (82%) were at lowrisk, 10 (17%) at moderate risk, and 1 (1.7%) at high risk for de-layed development. Logistic regression analysis showed signifi-cant association between accompanying diseases such as sepsis(OR=25.60; P=0.001) and hyperbilirubinemia (OR=16.07; P=0.001)with delayed development. Despite more than twofold odds fordelayed development in infants with severe asphyxia (OR=2.51)and LBW-prematurity (OR=2.47), the association was statisticallyinsignificant (P=0.20 and P=0.15, respectively).Conclusions In preterm infants appropriate for gestational age,prematurity and low birth weight alone may or may not predisposeto delayed development at 3 months of age. However, the risk fordelayed development in such infants is increased when sepsis orhyperbilirubinemia is present
Co-Authors Ahmad Zaeni Syafii Anggraini Alam BUDI SETIABUDIAWAN Dadang Hudaya Somasetia Meita Dhamayanti Nelly Amalia Risan Rotua Sinaga Sambas Wiradisuria Stanza Uga Peryoga