Globally, rotavirus is the leading cause of diarrhea-related hospitalizations and deaths among young children, but the burden of rotavirus disease in Indonesia is poorly documented. From January through December 2006, we conducted prospective surveillance (inpatient and outpatient) among children aged <5 years at 6 hospitals in 6 provinces of Indonesia, using standardized methodology. Of 2240 enrolled children hospitalized for diarrhea, 1345 (60%) were rotavirus positive. Of 176 children enrolled in outpatient clinics in 3 hospitals, 73 (41%) were rotavirus positive. Among children hospitalized for diarrhea, dehydration was more common among those who tested positive for rotavirus than among those who did not (91% vs 82%; P < .05), as was vomiting (86% vs 67%; P < .05). Children aged 6-23 months experienced 72% of all rotavirus episodes. Rotavirus prevalence increased slightly in the cool, dry season. The most commonly detected genotypes were G9 (30%) and P[6] (56%). G1P[6] and G9P[6] accounted for 34% and 21% of strains, respectively. A high proportion of genotype P[6] was detected, in combination with the common G types G1 and G9. Available rotavirus vaccines would likely be efficacious against the most common circulating strains, but continued monitoring of uncommon genotypes is needed.
The development of SLE-like symptoms and SLE-related autoantibody production was observed more commonly than expected, with an increased risk in patients with SLE-related HLA haplotypes, increased serum IL-10 levels and ANA in speckled patterns. The data suggest that immunomodulation associated with sulphasalazine treatment may contribute to the development of lupus-related reactions in genetically predisposed individuals.
In this study, we have compared the effects of the World Health Organization oral rehydration solution (WHO ORS) and an ORS containing short polymers of glucose (Amylyte ORS) at a high caloric density (five times) and comparable osmolality, on stool output, duration of diarrhea, weight gain and fluid and electrolyte balance, in randomized, open-labeled, controlled clinical trials in five centers. A total of 198 male children (4 months to 10 years) with acute diarrhea ( <72 h after onset) were assigned by random allocation to either WHO ORS or Amylyte ORS at five centers in Asia. Children were stratified according to grade of dehydration (mild, moderate or severe) and the initial purging rates during the first 6 h (low ( < 2 ml/kg/h), moderate (2-5 ml/kg/h) and high ( > 5 ml/kg/h) purgers). The clinical characteristics of the children in the two treatment groups were comparable. Amylyte ORS reduced stool volumes significantly in children with severe dehydration (285.4 +/- 74.2 versus 75.5 +/- 20.0 ml/kg; p< 0.05) and in children with a high initial purging rate (200.3 +/- 42.8 versus 130.5 +/- 9.1 ml/kg; p < 0.05). This was accompanied by a significant (276.4 +/- 14.6 versus 227.6 +/- 11.8 ml/kg; p < 0.01) reduction in ORS requirements in the Amylyte ORS treated group, the effect being greatest in children with severe dehydration (491.5 +/- 108.5 versus 155.7 +/- 27.3 ml/kg; p < 0.01) or high initial purging rates (394.2 +/- 66.2 versus 316.8 +/- 34.8 ml/kg; p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Background Type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease characterized by T cell-mediated destruction of pancreatic islets. The genetic factors involved consist of at least five vulnerability genes: HLA, INS, CTLA-4, PTPN22, and IL2RA/CD25. Objective To investigate for associations of PTPN22-1123 G>C SNP and CTLA-4 +49A/G polymorphisms with T1DM. Methods Case and control groups underwent CTLA-4 +49A/G gene examination from June to December 2017, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results The study population consisted of 30 T1DM patients and 30 healthy subjects with no family history of diabetes or autoimmune diseases. With regards to the PTPN22-1123 G>C SNP, significantly more subjects with T1DM had the GC genotype than the GG genotype (OR 7.64; 95%CI 1.48 to 39.29; P=0.007). For the CTLA-4 +49A/G polymorphism, although the total number of G alleles in the case group was more than that of the control group (OR 2.286; 95%CI 0.804 to 6.945; P=0.118), there were no significant relationships between the frequency of G alleles (P=0.248) and genotypes GG or AG (P=0.293) with the incidence of T1DM. However, the PTPN22-1123 G>C SNP had a significantly positive association with T1DM, and may be considered as a risk factor for T1DM. In contrast, the CTLA-4 +49A/G polymorphism was not recognized as a risk susceptibility factor for T1DM. Conclusion These study confirms an association between PTPN22-1123 G>C SNP and T1DM, but no significant association between CTLA-4 +49A/G polymorphism and T1DM.
Background Neonatal bacterial sepsis is a major cause of neonatal morbidity and mortality worldwide. Blood culture as a gold standard, as well as C reactive protein (CRP), micro erythrocyte sedimentation rate (micro ESR), white blood count (WBC), and immature-to-total (I/T) ratio as a sepsis screens are currently used methods, but their utility may be limited due to delayed reporting. Platelet indices are one of the parameters which can be helpful in the diagnosis of neonatal bacterial sepsis. Objective To evaluate the use of platelet indices, either alone or in combination, with other laboratory screening parameters to diagnose neonatal bacterial sepsis. Methods Neonates admitted to the Neonatal Unit of RSUP Dr. Muhammad Hoesin Hospital, Palembang, South Sumatera, and showing symptoms of sepsis were included in this study. Subjects underwent testing for blood culture, sepsis screen (CRP, micro ESR, WBC, I/T ratio), and platelet indices [platelet count, mean platelet volume (MPV), and platelet distribution width (PDW)]. Results The 107 neonates who fulfilled the inclusion criteria consisted of 42 neonates with proven bacterial sepsis (positive blood culture), 10 neonates with probable bacterial sepsis (positive sepsis screen and negative blood culture), and 55 with clinical bacterial sepsis (negative in both blood culture and sepsis screen). There were no significant differences in platelet count among the proven bacterial sepsis, probable bacterial sepsis, and clinical bacterial sepsis groups. Platelet count < 150,000/ml, PDW ³ 16.8 fL, MPV ³ 10.8 fL and combinations of the three, were highly specific markers for proven sepsis, with specificities of 92.3%, 97%, 75.4%, and 80%, respectively. However, all of these parameters were poor predictive markers for positive cultures in neonatal clinical bacterial sepsis, with sensitivities of 19%, 7.1%, 35.7%, and 23.8%, respectively. Conclusion Platelet indices have high specificity but low sensitivity for the prediction of proven neonatal bacterial sepsis.
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