Showing papers by "Gadjah Mada University published in 1979"

Feeding children with diarrhea.

Abstract: This study was designed to test early and rapid feeding of children with diarrhea. The daily weight the time to reach the normal diet or hospitalization duration relapse or prolongation of diarrhea were evaluated. The sample of 40 Indonesian babies with diarrhea was randomly divided into group A and Group B. The age range was from 4 to 24 months and the body weight range was from 5.7 to 9.6 kg with 2 out of 40 cases malnourished and weighing less than 60% Harvard standard for age. Rehydration with intravenous fluid drip or glucose oral electrolyte solution was completed within 4-6 hours. Continued fluid losses were replaced. Refeeding was initiated immediately upon completion of rehydration. Group A refeeding followed the classic schedule to reintroduce foods slowly starting with dilute formula and working up to a full diet in 9-11 days. Group B was scheduled to reach full strength formula by the 3rd day and normal diet in the 4th. The mean of daily weight gain of group A was 6 g per day and group B was 49 g per day. This was a highly significant difference. There was a clear association between calorie intake and daily weight gain and this difference was significant. The mean of time to reach the normal diet or hospitalization time from group A was 10 days and group B was 5 days. This was a statistically significant difference. The duration of diarrhea in both groups was 3 days. Relapse of diarrhea occurred in 2 cases from group A and 1 case from group B. Those who were given rapid early and adequate refeeding had a weight gain 8 times greater than the other group who followed the classic schedule of reintroducing foods slowly. Study findings indicate that rapid adequate calorie intake is acceptable for refeeding showing no significant prolongation or relapse of diarrhea.

The use of antibiotics in childhood diarrhea.

Abstract: A comparative study was undertaken in Indonesia to assess the effect of antibiotic therapy in the treatment of acute diarrheal disease in infants. 120 children age 2-60 months suffering form acute gastroenteritis with varying degrees of dehydration who were treated at the Gadjah Mada University Hospital in Yogyakarta Indonesia between August and December 1975 were included in the study. Approximately 1/2 the group was treated with antibiotics; the other 1/2 was not. Both groups received oral rehydration therapy. No significant differences were found between the 2 groups as to duration of the diarrhea and duration of hospitalization. It is concluded that antibiotics are not generally indicated in cases of acute diarrheal disease. The only requirements in treatment seems to be maintenance of the fluid electrolyte balance.

Training course for village nutrition programs.

Abstract: The aims and objectives of a training course to train the trainers for village nutrition programs in Indonesia are described along with the selection and preparation of participants course syllabus and the various field and classroom activities. Certain aspects of both the program and training course are unique to Indonesia but the principles of community nutrition and education techniques are applicable to many varied situations. The training course is aimed at workers who will be training villagers and overseeing the initiation and the operation of the various program activities envisioned. The assumption is that participants will enter the course with a firm background knowledge of nutrition and some grasp of the precepts of public health. The participants are divided into groups of 6-7 persons in order to ensure a heterogeneous mix of experience geography and professional background. The general course objective was to educate persons designated as trainer for specified districts who will be prepared to train village level volunteers to organize and operate the village nutrition programs. Course content includes the following: nutrition; anthropometry; village weighing program; supplementary feeding; nutritional first aid; simple curative health services; home gardening; and organization/management. The specific objectives for each of the course content areas are outlined. A precourse reading assignment is sent to each participant 6 weeks prior to the training. The assignment includes 4 concise pamphlets covering basic nutrition simple anthropometry a village weighing guide and a supplementary feeding program guide. Accompanying these pamphlets is a detailed examination to be used as a self test by the participant to assure an adequate standard of baseline knowledge on entering the course. Emphasis during the course is on small group (5-7 members) problem solving activities in the classroom and in the field. All lectures are illustrated with slides and briefly stenciled outlines that provide all necessary information. This approach encourages participants to interact more freely with the speaker and to grasp concepts rather than trying to record facts. A set of detailed written guides to provide clear instructions for action on return home is provided to all participants. A course schedule is outlined in detail.

Milk lactose: the amount tolerated in post diarrheal children.

Abstract: The study purpose was to examine the effect of early refeeding with full lactose on diarrhea in infants. In addition an attempt was made to determine if the use of lactose itself might cause further abnormalities. 21 infants with diarrhea who varied in age from 2-15 months were studied. Their body weights were 3.7 to 9 kg; 2 of the infants were malnourished. Stool sugar content and pH were measured on admission and after milk consumption. As soon as they had been rehydrated with intravenous or oral glucose-electrolyte those children who had stool sugar content more than .25% were refed with low lactose milk (LLM) which contained .8% lactose; those with less than .50% were refed with locally manufactured lactose formula (SGM) containing 4.2% lactose beginning with 1/3 dilution and increased daily to 2/3 and then a full strength formula. 3-5 days after rehydration all cases were given normal formula. Small intestinal biopsies were done in all cases prior to milk consumption. A followup study of intestinal biopsy was performed about 3 months after discharge. 8 of 21 cases had stool sugar content of .50% to 2% on admission but only 2 of them had stool pH less than 6. 5 of these 8 cases had frequent (more than 10 times per day) watery and voluminous stools on admission. After milk consumption only 1 of 21 developed these symptoms and this case had had negative stool sugar on admission. The other 21 cases had stool sugar content less than .50% and stool pH above 5. In regard to the intestinal mucosal appearance under dissecting microscope leaves or broad villi were seen in 9 specimens convuluted or flat convolutions were found in 9 specimens and 1 specimen showed flat mucosa with the openings of crypts seen. These appearances in general corresponded with the respective histological findings. The findings indicate that the abnormalities of small intestinal structure of the diarrhea cases on admission are at least partially because of acute gastrotenteritis. On the basis of the findings it is concluded that full-lactose diets can be started in all gastroenteritis infants as early as 3 days after admission in hospital acute stage.