Rusdi Ismail
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Benefits of domperidone in ambulatory acute diarrhea with severe vomiting Irene A. O.; Achirul Bakri; Erial Bahar; Rusdi Ismail
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 (202.164 KB) | DOI: 10.14238/pi47.5.2007.207-10

Abstract

Background Recently, most patients with diarrheal disease (DD)cases are hospitalized not due to severe dehydration, but due tosevere vomiting which interferes with fluid and food intake. Useof anti-vomiting medicines is not recommended because of its“central” side effects. Domperidone has prokinetic and antiemeticeffects with only minimal extrapyramidal side effects.Objective To evaluate domperidone in preventing hospitalizationof DD patients in outpatient setting.Methods This randomized double blind, placebo-controlledclinical trial, was conducted from February to August 2005 atMohammad Hoesin Hospital, Palembang. We included patientsaged 6 to 59 months old with acute diarrhea who had vomited atleast 4 times in the last 24 hours, not in need of hospitalization,and agreed to participate. We excluded patients who had takenanti-vomiting drug, or those who had severe diseases, includingsevere malnutrition. The dose of domperidone was 1.25 mg per 5kg body weight.Results There were 183 subjects randomized, consisted of 91 whotook domperidone (treatment group) and 92 who took placebo(control group). The duration and decrease of vomiting frequencywere significantly different in favor of domperidone. Domperidoneprevented hospitalization significantly (P=0.001, OR=4.1, ARR= 20%, RRR=71%, NNT=5). No overt acute clinical side effectswere found.Conclusion Domperidone significantly shortened the duration anddecreased the frequency of vomiting in DD cases.
Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea Hasri Salwan; Isnada Isnada; Achirul Bakri; Rusdi Ismail; Erial Bahar
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.767 KB) | DOI: 10.14238/pi47.6.2007.265-9

Abstract

Background Oral rehydration solution (ORS) has been provensuccessfully to overcome dehydration in diarrhea. The improvementof the effectiveness of ORS is still needed to overcome some failures.Gum Arabic (GA), an indigestable starch, can enhance ORSabsorption in mice with diarrhea. It is worthy to explore its benefitsin human. Since GA is non toxic to human being, it is regardedethical to conduct effectiveness study directly in clinical setting.Objective To evaluate the effectiveness of GA supplementationto ORS in managing inpatients diarrheal cases .Methods A double blind clinical trial was conducted during Marchto September 2004 in the Department of Child Health of M. HoesinHospital, Palembang. The subjects were randomly enrolled to GA-ORS (GA) group or ORS (SO) group. Indirect measurements wereconducted on ORS absorptive enhancement by evaluating theduration of diarrhea after hospitalization, frequency of defecationduring hospitalization, ORS consumption during hospitalization,and time laps of stool consistency conversion. The effectivenessanalysis was controlled for confounders.Results Supplementation of 0.5 gram GA to 200 ml ORS could decreasethe duration of diarrhoea 15.65 hours (P=0.000) during hospitalisation,frequency of defecation during hospitalization 1.171 times/days(P=0.002), ORS consumption 38.39 ml/kg BW (P=0.029), time ofstool consistency to become semisolid 15.84 hours (P=0.000), andbecome solid 14.45 hours (P=0.002). Vomiting during hospitalizationand aged group of 6-11 months were significant confounder. However,after controlling the outcome with these confounding factors, thebenefits of GA supplementation were still significant.Conclusions GA supplementation to ORS significantly shortenthe duration of diarrhea, decreases the frequency of defecation,consumption of ORS, time of stool consistency to becomesemisolid and solid in inpatients diarrheal cases.