Munar Lubis
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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (571.454 KB) | DOI: 10.14238/pi44.3.2004.95-100

Abstract

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
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (415.354 KB) | DOI: 10.14238/pi44.4.2004.127-32

Abstract

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 chi–square test by SPSS program version 11.0.Results There was no difference in the prevalence of STH in bothvillages (p>0.05). Parents’ 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,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 inthe two villages.
Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Wisman Dalimunthe; Charles Siregar; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.223 KB) | DOI: 10.14238/pi47.5.2007.216-20

Abstract

Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on children’s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.
Rasiotekanan darah terhadap tinggi badan dalam diagnosis hipertensi pada remaja Kristina Ambarita; Oke Rina Ramayani; Munar Lubis; Isti Ilmiati; Rafita Ramayati; Rusdidjas dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 2 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Diagnosis of hypertension in children and adolescents according to the Fourth Report from the National High Blood Pressure Education Program (NHBPEP) Working Group on Children and Adolescents 2004 is complicated, influenced by gender, age, and height. This resulted in an effort to find alternative ways to overcome the lack of practical diagnostic tool hypertension in adolescents. Current research is centered on the use of anthropometric variables to detect hypertension in adolescents. Height is a factor that plays an important role in determining blood pressure because of body size affects blood pressure. The blood pressure to height ratio is a simple method that can be used for diagnosing hypertension in adolescents. This ratio is not influenced by age which means determining the cut-off point of hypertension is not according to age specific, and the ratio is not adjusted in height so that this ratio can be used in adolescents who are short or tall. This ratio has a high sensitivity and specificity in the diagnosis of hypertension, which is high capabilities in the detection of hypertension and to determine non hypertension in adolescents.Keyword :adolescence, blood pressure to height ratio, diagnosis, hypertension
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

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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
Parental knowledge, attitude and practice on malaria in Mandailing Natal district Syafruddin Haris; Sri Sofyani; Bidasari Lubis; Munar Lubis; Syahril Pasaribu; Iskandar Z. Lubis
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 (355.312 KB) | DOI: 10.14238/pi47.4.2007.161-5

Abstract

Background Malaria is still considered to be an important healthproblem in Indonesia. Malaria has been found in islands withdifferent degree of endemicity. Behavior of the community isone of the factors affecting the incidence of malaria in MandailingNatal district.Objective To know the parental knowledge, attitude, and practiceamong parents whose children suffered from malaria or not.Methods A cross sectional study was conducted in six primaryschools and one health centre in October 2004. Subjects wereparents whose children were malaria positive and malaria negativebased on laboratory examination. Sample size was 85 parents foreach group. Selected respondents were interviewed usingstructured questionnaire. Degree of knowledge, attitude, andpractice on malaria were established using scoring system withinthree categories: good, less, and poor. Data were collected andpresented using chi-square and P<0.05 was considered as a levelof significant.Results The mean age of 85 parents whose children were positivemalaria, was 38.47 years (SD 6.67) and the mean age of thosewhose children were negative malaria was 40.41 years (SD 8.05).Parent’s education level was 62.9% primary school and 90% oftheir children were school-aged. There were significant differenceson parental knowledge, attitude and practice in each group(P<0.05). There was also a significant correlation betweenoccupation and knowledge, but not between parental educationlevel and parental age. Parental knowledge and attitude on theincidence of malaria in Mandailing Natal district were good,though their practice were poor.Conclusion There are significant differences on parentalknowledge, attitude and practice, between parents whose childrenwere positive and negative for malaria.
Gangguan ginjal akut pada keadaan kritis Putri Amelia; Munar Lubis; Yunnie Trisnawati
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 2 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Acute kidney injury is characterized by a reversibe increase in the blood concentration of creatinine an nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis approprietly. Acute kidney injury is increasingly recognized as a cause of increased morbidity in critically ill children and adults, and affects patient survival. Acute kidney injury is known to be an independent risk factor for mortality, and research pursues optimization of diagnosis, management, and outcome.Key words : acute kidney injury; critical ilness
Peningkatan kadar troponin I sebagai prognostik mortalitas pada anak dengan syok septik Emil Salim; Munar Lubis; Yunnie Trisnawati; Gema N. Yanni; Rina A.C. Saragih; Aridamuriany D. Lubis
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 2 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Septic shock remains a major cause of morbidity and mortality in children admitted to pediatric intensive care unit. The incidence of septic shock increased in 30-40 years, with estimate 7% of total deaths in children due to severe sepsis and septic shock. The cardiovascular system is one of the most commonly affected organ in a state of severe sepsis and septic shock. Troponin I is a good marker for assessing the extent of heart muscle damage and elevated levels of troponin I in sepsis patients reflects the severity of the disease, myocardial dysfunction, and poor prognosis. Septic shock patients with impaired cardiac function have an increased risk of mortality 70% to 90% when compared to patients with or without cardiac dysfunction.Keywords : septic shock; troponin I; mortality
Short-term impact of acute uncomplicated malaria on the cognitive performance of school children living in an endemic area Masyitah Masyitah; Lily Rahmawati; Sri Sofyani; Munar Lubis; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi49.2.2009.82-6

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Background In Indonesia, malaria remains a public healthproblem. In North Sumatra between 2000 and 2004, an estimated50,670 clinical cases occurred every year, leading to the deathsof 9-10 people per year.Objectives To determine the short-term impact of acute uncompli-cated malaria on the cognitive performance of school children.Methods A prospective study was conducted on students at fourelementary schools in Madina, North Sumatra, Indonesia, fromAugust 15 to September 3, 2006. Subjects were classified intomalaria and non-malaria groups based on microscopically confirmedblood smears; they were selected by means of random sampling.Cognitive performance was measured with two examination paperson mathematics and Indonesian language before and two weeksafter artesunate and amodiaquin treatment for three days in themalaria group. Independent or paired t-tests were used to analyzedifferences in mean scores of cognitive performance.Results From 925 children examined, 384 suffered from malaria.One-hundred and thirty three children were recruited from themalaria group and 132 children were recruited from the non-malaria group. There was no difference in the distribution ofgeneral characteristics of the subjects. There was a significantdifference in cognitive performance between the malaria andnon-malaria groups (P<0.0001) before and after treatments. Inthe malaria group, there was a significant difference in cognitiveperformance before (mean 38.9; SD 15.19) and after treatment(mean 72.9; SD 10.41) with P<O.OOOl.Conclusion Acute uncomplicated malaria significantly affectsthe cognitive performance of school children living in a malaria-endemic area.
Pengaturan cairan pada acute lung injury Monalisa Elizabeth; Munar Lubis; Yunnie Trisnawati
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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Mechanical ventilation is a life-saving technology for patients who develop acute lung injury (ALI) and investigators have conducted numerous investigations to determine the optimal support method and has been used for several decades. The incidence of ALI is quoted to be between 17 and 34 per 100,000 patients for year. Mechanical ventilation is indicated in patients with severe hypoxemia despite oxygen therapy, severe hypercapnia, or excessive work of breathing. Fluid management with the goal to obtain zero fluid balance in ARDS patients without shock or renal failure significantly increases the number of days without mechanical ventilation. Liberal and conservative fluid strategies are therefore complementary and should ideally follow each other in time in the same patient whose hemodynamic state progressively stabilizes.Key words : constipation; functional; children; medical therapy