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Sylviati M Damanik
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Effect of probiotic on the fecal slgA level in preterm infants (A randomized double-blind placebo control study) Lucia P Retnaningtyas; Subijanto M Sudarmo; Ariyanto Harsono; Sylviati M Damanik
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/pi48.4.2008.246-52

Abstract

Background Secretory immunoglobulin A (slgA) plays animportant role in the defense of gastrointestinal tract. Preterminfants that developed abnormal pattern of bowel colonizationmay benefit from strategy to support maturation of humoral im-munity and endogenous production of slgA by early colonizationwith probiotic.Objective To evaluate the effect of pro biotic on the fecal slgAlevel in newborn preterm infants.Methods A randomized control study of newborn pre term infantswas conducted in NICU Dr Soetomo Hospital, Surabaya inNovember-December 2007. Pro biotic group was given multi-strain pro biotic containing 107 cfu of Lactobacillus acidophil us,Bifidobacterium longum, and Streptococcus faecium once dailyfor 14 days from second day of life. Fecal slgA was determined byELISA before and after intervention. Subjects who got respiratorydistress syndrome (RDS) or sepsis during the study was droppedout. Statistical analysis used in this study were chi-square, inde-pendent sample t-test, Mann-Whitney, Wilcoxon Signed-Rankstest, and multivariate analysis of variance (a=O.OS).Results Forty seven neonates were enrolled, seven of them weredropped out. Forty analyzed neonates were divided in probiotic(n = 20) and placebo group (n = 20). The basic characteristics oftwo groups were similar. At first examination, median of fecal slgAlevel did not differ significantly between groups (P=0.512), 0.164and 0.174mg/g feces in probiotic and placebo group respectively.There was higher increment of fecal slgA level in pro biotic thanplacebo group post treatment(1.735 versus 1.449 mg/g feces,P=0.003).Conclusion Preterm infants may benefit from probiotic becauseof the clear tendency to increase fecal slgA secretion
The use of score for neonatal acute physiology perinatal extention II (SNAPPE II) in predicting neonatal outcome in neonatal intensive care unit Mia R A; Risa Etika; Agus Harianto; Fatimah Indarso; Sylviati M Damanik
Paediatrica Indonesiana Vol 45 No 6 (2005): November 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.6.2005.241-5

Abstract

Background Scoring systems which quantify initial risks have animportant role in aiding execution of optimum health services by pre-dicting morbidity and mortality. One of these is the score for neonatalacute physiology perinatal extention (SNAPPE), developed byRichardson in 1993 and simplified in 2001. It is derived of 6 variablesfrom the physical and laboratory observation within the first 12 hoursof admission, and 3 variables of perinatal risks of mortality.Objectives To assess the validity of SNAPPE II in predicting mor-tality at neonatal intensive care unit (NICU), Soetomo Hospital,Surabaya. The study was also undertaken to evolve the best cut-offscore for predicting mortality.Methods Eighty newborns were admitted during a four-month periodand were evaluated with the investigations as required for the specifi-cations of SNAPPE II. Neonates admitted >48 hours of age or afterhaving been discharged, who were moved to lower newborn care <24hours and those who were discharged on request were excluded. Re-ceiver operating characteristic curve (ROC) were constructed to derivethe best cut-off score with Kappa and McNemar Test.Results Twenty eight (35%) neonates died during the study, 22(82%) of them died within the first six days. The mean SNAPPE IIscore was 26.3+19.84 (range 0-81). SNAPPE II score of thenonsurvivors was significantly higher than the survivors(42.75+18.59 vs 17.4+14.05; P=0.0001). SNAPPE II had a goodperformance in predicting overall mortality and the first-6-daysmortality, with area under the ROC 0.863 and 0.889. The best cut-off score for predicting mortality was 30 with sensitivity 81.8%,specificity 76.9%, positive predictive value 60.0% and negativepredictive value 90.0%.Conclusions SNAPPE II is a measurement of illness severity whichcorrelates well with neonatal mortality at NICU, Soetomo Hospital.The score of more than 30 is associated with higher mortality
Co-Authors AGUS HARIANTO Ariyanto Harsono Fatimah Indarso Lucia P Retnaningtyas Mia R A Risa Etika, Risa Subijanto M Sudarmo