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Tonny Sadjimin
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Health Professions Medicine & Pharmacology

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Effect of enalapril in children with steroid resistant primary nephrotic syndrome L. P. Primi Atmikasari; M. P. Damanik; Tonny Sadjimin
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (404.407 KB) | DOI: 10.14238/pi47.2.2007.55-9

Abstract

Background A significant proportion of children with nephrotic syndrome become steroid dependent or steroid resistant who need further medication with cytostatic or other immunosuppressive drugs such as cyclophosphamide or chlorambucil. Unfortunately studies show that the drugs give no good results and cause adverse effects.Objective To establish the effect of enalapril in decreasing proteinuria in children with steroid resistant nephrotic syndrome.Methods We conducted a clinical trial in Nephrology Division, Pediatrics Department, Dr. Sardjito General Hospital from January 2004 to October 2005. Subjects were randomized to either receive prednisone and enalapril (Enalapril Group) or prednisone and cyclophosphamide (CPA Group). The main parameter was proteinuria level, which was examined at the beginning of the study and then every two weeks for eight weeks.Results Remission rate in enalapril group was 96% whereas in CPA group was 82% (P=0.09). Proteinuria level reduction in Enalapril Group from the beginning until the end was 606.92 mg/dl (99%) whereas in CPA Group the reduction was 712.97 mg/dl (91%). Statistically, there was no significant difference in the average decrease of proteinuria level between both groups (P=0.30). Odds ratio for overall adverse events in combined prednisone and enalapril therapy group compared to combined prednisone and cyclophosphamide therapy group was 0.29 (CI 95% 0.17;0.41).Conclusion Combined prednisone and enalapril has similar effect tocombined prednisone and cyclophosphamide in children with steroidresistant nephrotic syndrome. Overall adverse events in combinedprednisone and enalapril group was lower than that in combinedprednisone and cyclophosphamide group.
Quality assurance for increasing growth monitoring and promotion (GMP) performance Oktora Wahyu; Endy Paryanto; Tonny Sadjimin
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.434 KB) | DOI: 10.14238/pi47.3.2007.95-9

Abstract

Background Measuring body weight of under-five children is oneof the Family Nutritional Improvement Program or UsahaPerbaikan Gizi Keluarga (UPGK) activities which was integratedin Integrated Health Post (Posyandu) activities. Growthmonitoring and promotion (GMP) has been used as the maincomponent of the health and nutritional program in severaldeveloping countries. Unfortunately, this activity did not run asexpected. This study aimed to understand how quality assurance/total quality management (QA/TQM) influence the performanceof the GMP.Methods This 6 month operational research included 76 Posyandusin four subdistricts of Jogyakarta Province. The results of thePosyandus’s GMP score performance were used as a basis toimprove the performance for the next consecutive months withQA system. Data were transformed as a score index. Student’s t-test was used to analyze the data.Results The quality assurance could increase the performance ofGMP, which was done in Posyandus intervention group for 3consecutive months. The baseline scores for both groups were0.47±0.12 vs 0.42±0.17 (P=0.302), at the second monthmonitoring: 0.58±0.07 vs 0.42±0.16, for the intervention group(P<0.001). The mothers’ index (percentage of the children underfive attendance and mothers who brought KMS at weighingsession), however, did not significantly change.Conclusion Total quality management increased the generalperformance of Posyandus, but the program could not influencethe mothers’ index.
Co-Authors Endy Paryanto L. P. Primi Atmikasari M. P. Damanik Oktora Wahyu