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ANALISIS FAKTOR RISIKO DAN LUARAN DARI PENGGUNAAN TERAPI ANTIBIOTIK EMPIRIK JANGKA PANJANG PADA BAYI DENGAN BERAT LAHIR SANGAT RENDAH DALAM KONDISI SEPSIS Reza, Muhammad; Sampurna, Mahendra Tri Arif; Handayani, Kartika Darma; Angelika, Dina; Utomo, Martono Tri; Etika, Risa; Harianto, Agus
Majalah Kesehatan FKUB Vol 6, No 4 (2019): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (682.154 KB) | DOI: 10.21776/ub.majalahkesehatan.2019.006.04.4

Abstract

Terapi antibiotik berkepanjangan pada neonatus menyebabkan beberapa konsekuensi negatif meliputi resistensi antibiotik, sepsis awitan lambat, enterocolitis nekrotikan (EKN), lama rawat lebih panjang, dan peningkatan mortalitas. Semua faktor tersebut mempengaruhi efisiensi biaya pelayanan rumah sakit di era Jaminan Kesehatan Nasional. Penelitian ini bertujuan untuk menganalisis faktor risiko dan luaran dari terapi antibiotik berkepanjangan pada bayi berat lahir sangat rendah (BBLSR) dengan sepsis. Desain penelitian adalah studi retrospektif pada BBLSR dengan sepsis di Neonatal Intensive Care Unit (NICU), RSUD Dr. Soetomo, Surabaya sejak Januari-Desember 2017 dilakukan dengan membandingkan luaran antara kelompok I yang mendapat terapi antibiotik empirik kurang dari sama dengan 2 minggu dengan kelompok II yang mendapat terapi antibiotik empirik lebih dari 2 minggu empirik. Dari 87 bayi yang termasuk ke dalam studi, 37 bayi termasuk dalam kelompok I dan 50 bayi dalam kelompok II. Rerata durasi terapi antibiotik pada kelompok I dan kelompok II adalah 9,2±2,5 dan 17,9±3,2 hari, dengan lama rawat inap 19,7±8,5 dan 27,2±13,1 hari. Analisis faktor risiko menunjukkan bahwa BBLSR terutama 1000 gram (p < 0,001), ventilasi mekanik invasif (p < 0,001), ventilasi mekanik non-invasif (p < 0,001), korioamnionitis (p = 0,003), penyakit maternal (p = 0,004), kehamilan multipel (p = 0,03) merupakan faktor risiko mendapatkan terapi antibiotik empirik berkepanjangan. Luaran dari terapi antibiotik empirik berkepanjangan adalah 41 (47%) bayi mengalami sepsis awitan lambat,  15 (17%) bayi dengan EKN, dan 11 (12%) bayi meninggal. Mortalitas bayi dengan sepsis awitan lambat (p < 0,001) dan EKN (p = 0,02) lebih tinggi pada kelompok II dibandingkan kelompok I. Kesimpulannya, terapi antibiotik empirik berkepanjangan meningkatkan angka kejadian sepsis awitan lambat, enterocolitis nekrotikan, lama rawat, dan mortalitas BBLSR di NICU yang berdampak meningkatkan biaya pelayanan rumah sakit.  
Neonatal Therapeutic Intervention Scoring System (NTISS) in Rural Country: Mortality and Length of Stay (LOS) Predictive Score in Preterm Infant Desy Nurrosalia Wisnuwardani1 , Mahendra Tri Arif Sampurna2 , Martono Tri Utomo2 , Risa Etika2
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i4.11600

Abstract

Background: Preterm infants need comprehensive management due to high risk of mortality and morbidity. Proper treatment in NICU can decrease the mortality risk in them, but some of them may take long time before they can go home. Neonatal Therapeutic Intervention Scoring System (NTISS) hopefully can be a predictive score for the mortality and Length of stay (LOS) of a preterm infant, yet, it’s use is still very limited in Indonesia. The authors aim to analyze NTISS to predict mortality and length of stay of preterm infants in Indonesia. Method: This retrospective study conducted in March 2017 and collected medical record data of preterm infants treated in NICU from July 2016 - March 2017. The inclusion criteria were infants with gestational age <37 weeks, treated at NICU> 24 hours and complete medical record data. NTISS total scores are collected after 24 hours at the NICU. Results: A total of 108 infants met the inclusion criteria. The ratio of NTISS scores had an area under the curve (area under curve / AUC) of 0.879 (95% CI 0.259-0.913) with cutoff at 20.2. it had 91.3% and 74.1% in sensitivity and specificity respectively; 48.8% and 96.9% in positive and negative predictive value respectively; positive likelihood ratio 3.52; negative likelihood ratio 0.12; and 77% inaccuracy. There was no correlation between NTISS scores and length of stay (p = 0.084). Conclusion: NTISS can be used to predict the mortality of preterm infants.
ASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS Trias Kusuma Sari; Irwanto Irwanto; Risa Etika; Mahendra Tri Arif Sampurna; Ni Made Mertaniasih
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 2 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i2.10712

Abstract

C-reactive protein (CRP) is an acute-phase reactant protein that is primarily induced by the IL-6 action during the acute phase of an inflammatory or infectious process. Bacterial infection is a potent stimulus, leading to a rapid elevation of CRP levels within hours while the CBC and symptom are often misleading and/or absent. American Academy of paediatrics (AAP) is recommended routine blood examination test Complete Blood Count (CBC), C-reactive protein (CRP), and blood culture along with empirical antibiotic in neonates with early onset sepsis risk (EOS) risk even asymptomatic. Previous study is showed there were no correlation of CRP and EOS risk. The aim of this study is to evaluate the CRP and CBC profile in neonate with risk of EOS.  Methods of this study is using the sepsis risk calculator (SRC) to calculate the probability of neonatal early onset sepsis (EOS) based on maternal risk and infant’s clinical presentation. Neonates with ≥34 weeks of gestation who were started on antibiotic treatment after laboratory examination and blo odculture were taken. EOS risk estimation were compared including CRP, leukocyte, and thrombocyte count. ANOVA applied to distinguished laboratory examination between stratified risk groups. The result is showed using 82 subjects who met the inclusion and exclusion criterias, EOS risk level was stratified into green, yellow, and red group. The p value of CRP level, platelets, white blood cell were 0.35,0.54 and 0.48 where p value was considered as significant if < 0.5. The conclusion of this study is there were no correlation of CRP level and EOS riskASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS
Relationship Between Breastfeeding Self Efficacy and Exclusive Breastfeeding At Posyandu Working Area Of Pacarkeling Puskesmas Surabaya Fabella Elisa Cahyaningtyas; Farida Fitriana; Mahendra Tri Arif Sampurna
Jurnal KESANS : Kesehatan dan Sains Vol 1 No 5 (2022): KESANS : International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v1i5.61

Abstract

Background: Breast milk is the main and best food for babies, it contains essential nutrients and antibodies that babies need for their growth and development. Exclusive breastfeeding is an indicator listed in the Strategic Plan of the Ministry of Health for the period 2020-2024, even in the Strategic Plan of the previous period (2015-2019) in the performance indicators (IKK) of the Directorate of Community Nutrition, because it is closely related to the government's priority program, namely the acceleration of stunting reduction which was achieved 11 .6% of the target of 24.1%. The percentage of infants aged 0-6 months who received exclusive breastfeeding was 66.1% of the 40% target. (Ministry of Health, 2020). Even though this figure has met the national target, efforts to increase exclusive breastfeeding coverage must still be carried out as an effort to reduce stunting in Indonesia. Breastfeeding self-efficacy is a factor that can influence mothers to give exclusive breastfeeding to their babies. Methods and Samples: This research is a type of quantitative research, namely observational analytic using a case control approach. The number of samples is 69 respondents. The sampling technique used purposive sampling technique which was determined based on the right criteria. Results: The results of statistical tests get a p value of 0.038, p value <0.05, meaning H0 is rejected, H1 is accepted with an Odd Ratio value of 4.981. Conclusion: There is a relationship between self-efficacy of breastfeeding mothers and exclusive breastfeeding in the Posyandu Work Area of ??the Surabaya Boyfriend Health Center
Correlations between Maternal Knowledge, Attitude, and Posyandu Utilization on Nutritional Status in Children Under Five Prasticha, Anggraini Dian; Sampurna, Mahendra Tri Arif; Dewanti, Linda
Journal of Maternal and Child Health Vol. 8 No. 2 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (34.296 KB) | DOI: 10.26911/thejmch.2023.08.02.06

Abstract

Background: Malnutrition is a condition of deficiency, excess, or imbalance of nutrients from the amount of nutrients needed by the body. One of the ways to prevent malnutrition is by monitoring regularly through a program of public health activities, namely weighing toddlers. This study aims to determine the relationship between mother's knowledge, mother's attitude, and utilization of integrated health post (posyandu) in weighing toddlers with toddlers' nutritional status. Subjects and Method: A cross-sectional study was conducted in Semambung Village, Wonoayu District, Sidoarjo Regency, in August 2022. A total of 144 mothers and their children was selected using a proportionate stratified random sampling. The dependent variable is nutritional status. The independent variables are knowledge, mother's attitude, and posyandu utilization. The data were collected by a questionnaire. Data were analyzed by Chi square test and Odds ratio (OR). Results: Maternal irregular visit at integrated health post were at risk for having underweight (WAZ) (OR= 3.39; 95% CI= 1.46 to 7.84; p= 0.003) and stunted (WHZ) children (OR= 4.37; 95% CI= 1.20 to 15.84; p= 0.016). Conclusion: It can be concluded that there is no relationship between mother's knowledge, mother's attitude and nutritional status of toddlers. and there is a relationship between posyandu utilization and the nutritional status of children under five based on the WAZ and WHZ indexs.   Keywords: knowledge, attitude, posyandu utilization, nutritional status. Correspondence:Anggraini Dian Prasticha. Midwifery Program Study, Faculty of Medicine, Airlangga University, Indonesia, Jl. Mayjen Pro. Dr. Moestopo No. 47, Pacar Kembang, Tambaksari, Surabaya, East Java 60132, Indonesia. Email: anggraini.dian.prasticha-2019@fk.unair.ac.id. Mobile: +628123­520­5296.