A mental health survey was conducted in Palembang, Indonesia, to test the hypothesis that rapid socioeconomic and cultural change is detrimental to mental health. The 30-item General Health Questionnaire, translated into Bahasa Indonesia, was administered to a probability sample of 1670 adults (94.9% of the target sample). The Present State Examination was conducted on a weighted subsample of 100, using a 2-phase design. Overall morbidity rates were surprisingly similar to those in industrialized countries. A strong association was found between psychological symptoms and poverty. Persons belonging to communities that had progressed substantially in standards of living had fewer symptoms. The evidence points to a possibly beneficial effect of economic progress on mental health. Longitudinal data are needed to confirm this.
Latar belakang. Duktus arteriosus persisten (DAP) pada bayi kurang bulan (BKB) dapat menimbulkan gangguan hemodinamika sehingga perlu segera ditutup. Salah satu cara penutupan adalah dengan obat penghambat siklooksigenase (COX), khususnya ibuprofen. Mengingat efek samping yang ditimbulkan ibuprofen, parasetamol yang bekerja menghambat peroksidase mulai diperkenalkan sebagai alternatif dengan efektifitas setara dan efek samping yang minimal. Tujuan. Membandingkan efektifitas dan keamanan antara parasetamol intravena dan ibuprofen oral untuk penutupan DAP pada BKB. Metode. Uji klinis terbuka, acak terkontrol pada bayi dengan usia gestasi ≤37 minggu yang dikonfirmasi DAP dengan menggunakan ekokardiografi. Dilakukan randomisasi blok untuk menerima parasetamol intravena atau ibuprofen oral. Hasil utama yang dinilai adalah respon terapi penutupan duktus arteriosus (DA), efek samping yang timbul, dan kejadian reopening. Hasil. Penutupan DAP terjadi pada 33 dari 36 (91,6%) BKB yang mendapat parasetamol intravena dan 29 dari 40 (72,5%) yang mendapat ibuprofen oral (p=0,03). Pada kelompok ibuprofen, efek samping yang timbul berupa trombositopenia (28,5%) dan perdarahan saluran cerna (25,7%), sedangkan pada kelompok parasetamol intravena tidak dijumpai efek samping. Reopening terjadi hanya pada satu bayi di kelompok ibuprofen oral. Kesimpulan. Parasetamol intravena lebih efektif dan lebih aman dibandingkan ibuprofen oral untuk penutupan DAP pada BKB. Sari Pediatri 2015;17(4):279-84. Kata kunci: duktus arteriosus persisten, bayi kurang bulan, parasetamol intravena, ibuprofen oral The Comparison of Effectiveness and Safety between Intravenous Paracetamol and Oral Ibuprofen for Persistent Ductus Arteriosus in Preterm InfantsOktaviliana Sari,* Ria Nova,* Herman Bermawi,* Erial Bahar** Background. Persistent ductus arteriosus (PDA) in preterm infants can cause hemodynamic disturbances, that it must be closed immediately. PDA can be closed using cyclooxygenase inhibitor agents (COX), mainly ibuprofen. Because the side effects, intravenous paracetamol, a peroxidase inhibitor was recently introduced as an alternative terapy for ductal closure with similar effectiveness and minimal side effects. Objectives. To compare the effectiveness and safety of intravenous paracetamol and oral ibuprofen for PDA closure in preterm infants.Methods. An open label randomized controlled study was done in seventy six preterm infants (gestational age ≤37 weeks) with echocardiographically confirmed PDA. Infant were randomly assigned to received either intravenous paracetamol or oral ibuprofen. The main outcome was the success of ductal closure and secondary outcomes were adverse effects and reopening. Results. PDA closure was achieved in 33 of 36 (91.6%) infants receiving intravenous paracetamol and in 29 of 40 (72.5%) infants receiving oral ibuprofen (p=0.03). In the ibuprofen group, thrombocytopenia and gastrointestinal bleeding were found in 28.5% and 25.7% infants respectively, while in the paracetamol group, no adverse effect was observed. There ...
Background A daily sedation interruption (DSI) protocol in ventilated patientsis an effective method of improving sedation management that decreases the duration of mechanical ventilation. In adult patients, it is a safe and effective approach, as well as common practice. For ventilated children,its effectiveness and feasibilityare unknown.Objective To compare continuous sedation and DSI in mechanically-ventilated children with respect todurationof mechanical ventilation, the time needed for patients to awaken, and the frequency of adverse events.Method This randomized, controlled, open-label trial, was performed in a pediatric intensive care unit (PICU). Forty children on mechanical ventilation were included. Patients were randomly assigned to receive either continuous sedation or DSI. The duration of mechanical ventilation was the primary outcome, while the time for patients to awaken on sedative infusion and the frequency of adverse events were secondary outcomes.Results Forty patients were randomized into the continuous sedation protocol (18 subjects) or into the DSI protocol (22 subjects). The median (interquartile range) duration of mechanical ventilation was significantly shorter in the DSI compared to the continuous sedation group [41.50 (30-96) hours vs. 61 (30-132) hours, respectively; (P=0.033)]. The time for patients to awaken was also significantly lower in the DSI than in the continuous sedation group [median (interquartile range): 28 (24-78) vs. 45.5 (25-12) hours, respectively; (P=0.003)]. The frequencies of adverse events were similar in both groups. The severity of illness contributed to outcome variables.Conclusion The duration of mechanical ventilation and the time for patients to awaken are significantly reduced in the DSI group compared to the continuous sedation group.
Background. Sudden deafness is an emergency in the Ear Nose Throat Department, a subset of sensorineural hearing loss within a 72-hour window period and consists of a decrease in hearing of 30 decibels affecting at least three consecutive frequencies. The therapy given is corticosteroids, systemic corticosteroids or intratympanic corticosteroids injection, or both. The prognosis of sudden deafness depends on several factors. Patient with sudden hearing loss does not always have the same result in hearing improvement. This study was aimed to determine the factors that affect the results of intratympanic corticosteroid injection therapy in patients with sudden deafness.Methods. This study is an observational study with a cross-sectional design. The data were collected using medical records on 96 ears given intratympanic corticosteroid injection therapy at Dr. Mohammad Hoesin Hospital Palembang from July 2018 to February 2021.Results. From 96 ears conducted in the study, the improvement of therapeutic results on intratympanic corticosteroid injection in patients with sudden deafness was 72.9%. The study found factors that influenced the outcome of therapy, namely age (p=0.002), the onset of therapy (p = 0.003), and the use of a combination of systemic steroids (p=0.010). From the logistic regression test, it was found that the factors that most influenced the results of intratympanic corticosteroid injection therapy were young age 18-40 years (p=0.016) with (OR) 6.654 (CI95% 1.418-31.222) and therapy onset less than two weeks (p=0.027) with (OR) 3.108 (95% CI 1.134-8.515).Conclusions. The factors associated with the improvement in the outcome of intratympanic corticosteroid injection therapy in patients with sudden hearing loss were patient age and early onset of therapy.
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