Background and purpose: Infant Mortality Rate (IMR) nationally in 2012 was 32 per 1000 live births and 29 per 1000 live births in Bali. This figure was higher than the target of the Millennium Development Goals (MDGs) in 2015 which amounted to 23 per 1000 live births. One of many factors that increase risk of infant mortality is neonatal sepsis. Research on neonatal sepsis has been done in Sanglah General Public Hospital but it was only a descriptive study. This study was conducted to determine the socio-demographic factors, clinical, environmental and invasive procedures associated with neonatal sepsis in the Sanglah General Public Hospital.Methods: The study design was a case control with a sample of 30 cases and 30 controls that were selected randomly by matching on birth month of the register book of 1 January to 31 December 2014 at the Perinatology Unit Sanglah Hospital. The case groups were patients who were diagnosed with sepsis, and the control groups were not the sepsis. Data were collected from medical records of patients using extraction form. Bivariate analysis was conducted to determine crude OR and multivariate logistic regression method to determine adjusted OR.Results: Bivariate analysis showed that factors that increase risk of neonatal sepsis were mothers who did not work or worked as laborers (OR=3.5; 95% CI: 1.1 to 11.7), low birth weight (LBW) babies (OR=6,6; 95% CI: 1.9 to 24.2), infant care in an incubator (OR=4.1; 95% CI: 1.2 to 14.3), infusion (OR=9.3; 95 % CI: 1.7 to 92.1) and the administration of oxygen (OR=7.0; 95% CI: 1.9 to 29.7). Multivariate analysis showed that the only variable significantly increases risk of sepsis was low birt weight (OR=20.2; 95% CI: 1.4 to 289.7).Conclusion: LBW was the risk factor of neonatal sepsis at Perinatology Unit, Sanglah General Public Hospital.
INTRODUCTION: Seckel syndrome is a rare case. It belongs to an autosomal recessive disorder. It commonly leads to osteodysplastic, microcephaly, and dwarfism, which are proportional to prenatal onset. Microcephaly, bird-headed-like appearance, and mental retardation are common dysmorphic in the future. This case report present a patient with Seckel syndrome and this case will be discussed comprehensively. CASE REPORT: A patient 9-month-old girl came to the hospital with a chief complaint of growth disturbance. Her growth was not the same as her peer. She was stunted and failed to thrive. Microcephaly and a dysmorphic face (bird-headed) appeared with a broad face, prominent forehead, large eyes, prominent curved nose, and micrognathia were found in physical examination. Her organ was in normal condition. According to the radiology examination, the bone age was appropriate for the age of a newborn (<3 months). Patient had global developmental delay. Based on clinical manifestation patient can be witnessed with Seckel syndrome, to confirm the diagnosis chromosomal test is needed. There is no specific treatment. Management for the patient was growth and developmental intervention. CONCLUSION: Seckel syndrome is a rare disease. The diagnosis was challenging and sometimes could miss diagnosed with another syndrome. In this case, the diagnosis was made by clinical presentation and laboratory examination. There was no specific treatment. We assess the patient with Seckel syndrome. A gene or chromosome examination is needed. Meanwhile, the examination was limited and need a high cost. Educating the family about the patient’s condition has been done.
Latar belakang dan tujuan: Angka Kematian Bayi (AKB) secara nasional tahun 2012 sebesar 32/1000 KH dan untuk Provinsi Bali sebesar 29/1000 KH. Angka ini masih lebih tinggi dari target Millenium Development Goals (MDGs) tahun 2015 sebesar 23/1000 KH. Salah satu dari banyak faktor yang meningkatkan risiko kematian bayi adalah sepsis neonatorum. Penelitian tentang sepsis neonatorum pernah dilakukan di RSUP Sanglah namun hanya penelitian deskriptif. Penelitian ini dilakukan untuk mengetahui faktor sosiodemografi, klinis, lingkungan dan tindakan invasif yang berhubungan dengan sepsis neonatorum di RSUP Sanglah.Metode: Rancangan penelitian adalah kasus kontrol dengan jumlah sampel 30 kasus (pasien yang didiagnosa sepsis neonatorum) dan 30 kontrol (pasien bukan sepsis neonatorum) dipilih secara acak dan matching berdasarkan bulan kelahiran bayi dari buku register 1 Januari-31 Desember 2014 di ruang perinatologi RSUP Sanglah. Data dikumpulkan dari rekam medis pasien dengan formulir ekstraksi data. Analisis secara bivariat untuk mengetahui crude OR dan multivariat dengan metode regresi logistik untuk mengetahui adjusted OR.Hasil: Analisis bivariat menunjukkan bahwa faktor yang meningkatkan risiko sepsis neonatorum adalah ibu yang tidak bekerja dan bekerja sebagai buruh dengan OR=3,5 (95%CI: 1,1-11,7), bayi berat lahir rendah (BBLR) dengan OR=6,6 (95%CI: 1,9-24,2), perawatan bayi dalam inkubator dengan OR=4,1 (95%CI: 1,2-14,3), pemberian infus dengan OR=9,3 (95%CI: 1,7-92,1) dan pemberian oksigen dengan OR=7,0 (95%CI: 1,9-29,7). Analisis multivariat menunjukkan bahwa satu-satunya variabel yang bermakna meningkatkan risiko sepsis neonatorum adalah BBLR dengan OR=20,2 (95%CI: 1,4-289,7).Simpulan: BBLR merupakan faktor risiko sepsis neonatorum di ruang perinatologi RSUP Sanglah Denpasar.
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