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Yazid Dimyati
Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Health Professions Medicine & Pharmacology

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Journal : Paediatrica Indonesiana

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Outcomes of tuberculous meningitis in children: a case review study Yazid Dimyati; Anna Tjandradjani; Irawan Mangunatmadja; Dwi Putro Widodo; Hardiono D. Pusponegoro
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.5.2011.288-93

Abstract

Background Tuberculous meningitis is a severe extrapulmonary complication of tuberculosis, with high morbidity and mortality rates.Objective To assess the relationship between presenting clinical characteristics and outcomes of pediatric tuberculous meningitis.Methods We present a case review study of all children diagnosed with tuberculous meningitis in Cipto Mangunkusumo Hospital, Jakarta between January 1998 and December 2004. We compared demographic, clinical, and diagnostic characteristics to clinical outcomes.Results We included 43 patients. Common characteristics on admission were young age (mean 3.2 years), stage II and III tuberculous meningitis (91%), and neurological symptoms existing for more than 1 week, including convulsions (52%), unconsciousness (23%), meningeal irritation (56%), and cranial nerve palsy (67%). A common feature of tuberculous meningitis on computed tomography scan of the brain was hydrocephalus in 19/24 cases. Clinical outcomes were neurological sequelae (88%) and death (12%). Factors associated with poor outcome in univariate analyses were young age, as well as stage II and III tuberculous meningitis.Conclusions Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage has already occurred. Outcome is directly associated with age and the stage of tuberculous meningitis. Earlier diagnosis may significantly improve outcomes. [Paediatr Indones. 2011;51:288-93].
Amitriptyline for migraine prophylaxis in adolescents Yazid Dimyati; Astri Nurhayati Zulkifli; Pranoto Trilaksono; Johannes H. Saing; Bistok Saing
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.338-44

Abstract

headaches in children and adolescents. Amitriptyline efficacy as a prophylactic treatment for migraine in adults has been widely studied, but there is limited data on its use in children and adolescents.Objective To determine the efficacy of amitriptyline for prophylactic treatment of migraine in adolescents.Methods We conducted a single-blind, randomized, clinical trial study in Medan, North Sumatra, from July to October 2009. All participants had migraines, according to the International Headache Society criteria. They were divided into two groups, receiving either 10 mg amitriptyline or a placebo daily for 3 months. Headache frequency (days per month), headache duration (hours) and information to assess functional disability according to the Pediatric Migraine Disability Assessment Scale (PedMIDAS) were recorded by subjects. Efficacy was measured before, during and after intervention.Results A total of 98 patients, aged 12 – 19 years (mean age 14.7 years) enrolled and were divided into the amitriptyline and placebo groups. Compared with baseline, there were significant differences in headache frequency and PedMIDAS score in the amitriptyline group (P=0.001, 95% CI 2.02 to 2.94 and P=0.001, 95% CI 7.64 to 9.76, respectively), but not in the placebo group (P >0.05) after 3 months of treatment. We also found that amitriptyline significantly decreased headache frequency, duration, and functional disability compared to the placebo, after 3 months of treatment (P < 0.05).Conclusion Amitriptyline was effective for prophylactic treatment of migraine in adolescents after 3 months of intervention.
Food and migraine in adolescents Magda Bouhairet; Muhammad Ali; Bistok Saing; Johannes Harlan Saing; Yazid Dimyati
Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.4.2011.223-6

Abstract

Background Migraine headaches are a common problem worldwide, especially in adolescents. They are usually chronic, with frequent relapses. Therefore, any dietary risk factor for headaches has important implications on migraineurs. However, the association between migraine and diet needs to be examined further.Objective To investigate the association between diet and migraine in adolescents.Methods We conducted a cross-sectional study in August to September 2009 on 13 - 18 year old adolescents in a senior high school in Medan, North Sumatera. We included subjects diagnosed with migraine, according to the International Headache Society (IHS) criteria. Ninety participants completed the questionnaire. Foods we observed for a link to migraine included milk, chocolate, ice cream, cheese, bread, instant noodles, meatballs, chili sauce, sweetener, yoghurt, pizza, and other foods and beverages.Results Of the 90 participants with migraines, there were more females (61.1%) than males. There were statistically significant associations between migraine and triggering foods (P = 0.045, 95% CI 0.59 to 0.79) as well as between migraine and family history of migraine (P = 0.043, 95% CI 0.46 to 0.66). Stress (P = 0.164), menstruation (P = 0.369), and sound or light (P= 0.577) had no significant association with migraine. A wide variety of foods and beverages were implicated as migraine precipitants. The most common were chili sauce (75.8%), ice cream (71.0%), milk (67.7%), instant noodles (67.7%), chocolate (61.3%), peanuts (59.7%), cheese (54.8%) and meatballs (54.8%).Conclusion Food and family history have a significant association with the occurrence of migraine in adolescents. 
Co-Authors Anna Tjandradjani Astri Nurhayati Zulkifli Bistok Saing Dwi Putro Widodo Hardiono D. Pusponegoro Irawan Mangunatmadja Johannes H. Saing Johannes Harlan Saing Magda Bouhairet Muhammad Ali Pranoto Trilaksono