Background Although the incidence of diarrhea in Indonesia has declined in the last five years, the mortality rate in children under five years old is still high. Therefore, appropriate and comprehensive management of diarrhea is essential. There have been many studies on the role of zinc therapy and probiotic therapy in reducing the severity of acute diarrhea, but not many studies have compared the use of a combination of the two therapies tozinc therapy alone.Objective To compare the efficacy of zinc-probiotic combination therapy to zinc alone in reducing the severity of acute diarrhea.Methods We conducted a randomized, open-label, controlled trial from July 2009 to January 2010 in Adam Malik Hospital and Pirngadi Hospital, Medan. Children aged between 1 month and 5 years who met the criteria were divided into two groups. Group I received zinc sulphate (aged <6 months: 10 mg/day; aged 2:6 months: 20 mg/day) combined with heat-killed Lactobacillus acidophilus (3x101O CFU/day) for 10 days. Group II received only zinc sulphate at the same dosage as group I. Measurement of disease severity was based on the frequency of diarrhea (times/day) and the duration of diarrhea (hours) after initial drug consumption.Results Eighty subjects were enrolled, randomised, and divided equally into two groups. 40 children received zinc-probiotic in combination (group I) and the remainder (group II) received zinc alone. We observed significant differences in frequency of diarrhea (2.1 vs 3.1 times/day, P=0.001, 95%CI -1.62 to -0.49), and duration of diarrhea (52.1 vs. 72.6 hours, P=0.00l, 95%CI -30.91 to -10.18) in the two groups.Conclusion Combination of zinc-probiotic therapy was more effective in reducing the severity of acute diarrhea than zinc therapy alone in children under five years of age.
Latar belakang. Sepsis neonatus sebagai suatu sindrom klinis yang terjadi dalam satu bulan pertama kehidupan bermanifestasi sistemik dan dijumpai bakterimia. Insidens sepsis bervariasi dengan gejala klinis tidak khas dan progresivitas gejala dapat terjadi dalam 24 jam. Sepsis pada neonatus mempunyai tingkat mortalitas tinggi.Tujuan. Mengetahui profil dan mortalitas sepsis neonatus di Unit Perawatan Neonatus RSUP.H Adam Malik MedanMetode. Suatu penelitian deskriptif data rekam medis pasien sepsis neonatus di unit perawatan neonatas RSUP. Adam Malik Medan, sejak Januari 2008 sampai Desember 2010. Data pasien dilakukan pemeriksaan darah lengkap, C-reactive protein (CRP),dan kultur darah, serta antibiotik empiris. Pasien dengan data tidak lengkap dan menderita kelainan bawaan serius dieksklusi. Sampel dikelompokkan dua kelompok yaitu bayi pulang hidup dan meninggal.Hasil. Didapat 239 bayi diduga sepsis, di antaranya 158 terbukti sepsis, 103 dieksklusi (69 kelainan kongenital dan 34 data tidak lengkap). Pasien yang diikutsertakan 55 bayi yaitu 44 hidup dan 11 meninggal. Sepsis neonatus pada laki-laki lebih banyak dari perempuan, tetapi perempuan lebih banyak yang meninggal. Kepekaan kuman yang tinggi terhadap satu atau kedua antibiotik empiris terdapat pada 13 sepsis neonatus. Terbanyak meninggal sepsis neonatus dengan berat lahir rendah, prematur, kuman yang resisten terhadap kedua jenis antibiotik empiris, Gram negatif, dan jenis kuman Enterobacter sp.Jenis kuman yang paling banyak dijumpai adalah Staphylococcus sp.Kesimpulan. Sepsis salah satu penyebab utama kematian neonatus yang dipengaruhi oleh berat lahir rendah, prematuritas, resistensi kuman terhadap antibiotik empirik dan jenis kuman. Penyebab sepsis neonatus terbanyak adalah kuman Gram negatif yang berkontribusi terhadap angka mortalitas
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