Objectives: We sought to analyze the neutrophil-to-lymphocyte ratio (NLR) as an alternative marker of neonatal sepsis. Methods: In this cross-sectional study, we undertook consecutive sampling in all inborn neonates admitted to the Neonatal Intensive Care Unit with clinical manifestations of neonatal sepsis. Neonates with congenital anomalies and referred neonates were excluded. Complete blood count, C-reactive protein (CRP), and blood culture were carried out as the septic workup examinations based on the local Clinical Practical Guidelines. NLR is obtained by dividing the absolute count of neutrophils from lymphocytes manually. A cut-off value of NLR is obtained using a receiver operating characteristic curve. Results: The median NLR value of the 104 neonates who met the inclusion and exclusion criteria was 3.63 (2.39–6.12). Neonates with NLR of 2.12 have the area under the curve of 0.630 (95% confidence interval (CI): 0.528–0.741) and 0.725 (95% CI: 0.636–0.814) when combined with CRP = 2.70 mg/dL. Neonates with NLR ≥ 2.12 in clinical neotnatal sepsis had almost double the risk of providing positive blood culture results (relative risk = 1.867, 95% CI: 1.077–3.235; p =0.011). Conclusions: NLR, calculated from complete blood count, can be used as an alternative marker of easy and relatively inexpensive neonatal sepsis, especially in developing countries, and detection of proven neonatal sepsis to be better when combined with CRP.

Background and Objectives: Neonatal sepsis is the third leading cause of neonatal death in the world. The patterns of pathogens causing neonatal sepsis varies in many countries. This study was aimed to identify hematological and microbiological profile of culture-proven neonatal sepsis in Indonesian tertiary neonatal intensive care unit (NICU). Materials and Methods: Hospital based cross-sectional study was conducted in all inborn neonates that were suspected sepsis neonatal over a period of six months from April to September 2019. Complete blood count, c-reactive protein (CRP) and blood culture were examined before antibiotic administration. Statistical analysis were calculated based on Chi-Square’s Test and Mann-Whitney U test and p <0.05 considered significant. Results: One hundred four inborn neonates admitted to NICU and diagnosed with suspected neonatal sepsis were recruited. Culture-proven neonatal sepsis were confirmed in 52 (50%) neonates, 13 (25%) in early-onset neonatal sepsis (EONS) and 39 (75%) in late-onset neonatal sepsis (LONS). The most common abnormal hematological profile were anemia and thrombocytopenia, with amount of 61.5% and 75%, respectively. High CRP only detected in 36.4% and only 18.5% experienced leukopenia. Gram negative bacteria responsible in 75% from total isolated pathogens. Klebsiella pneumoniae accounted for 48.1% followed by coagulase negative staphylococci (CONS) for 17.3% and Enterobacter cloacae for 11.5%. Conclusion: Anemia and thrombocytopenia were the top two hematological profile of culture-proven neonatal sepsis. Most causes of culture-proven neonatal sepsis were Gram negative bacteria and the dominant pathogen was K. pneumoniae.

In children, acute diarrhea and functional constipation (FC) are still more prevalent in Indonesia, especially in isolated islands, and need comprehensive management. This study aimed to determine the effect of community development from the Department of Child Health Faculty of Medicine, Universitas Airlangga, Surabaya, on Mandangin Island’s public knowledge about acute diarrhea and functional constipation in children. This cross-sectional study was conducted on 29 subjects from Mandangin Island, Sampang, Indonesia on 17th February 2022. Subjects were given education and dissemination as community development by pediatricians via hybrid and could ask questions and discuss at the end of the presentation. The subject’s knowledge was measured using a pre-and post-test questionnaire about children’s acute diarrhea and functional constipation. Each questionnaire (diarrhea and functional constipation) consisted of 5 questions, with a minimum score of 0 and the maximum score of 100. The subject's knowledge was compared before and after the webinar using Paired T-Test and p<0,05 was measured as significant. We assessed the subject’s age, gender, occupation, and last education. There was a significant increase in public knowledge about diarrhea (26,9±18,7; 55,1±24,3; p=0.000) and functional constipation pre-and post-webinar (24,8±18,2; 48,3±24,2; p=0.000). These findings support the importance of community development with education about acute diarrhea and functional constipation in children.

Background: Diarrhea is the most common cause of death in under-five children. Bloody diarrhea comprises around 10% of all cases of diarrhea and may lead to severe complications until death. This study examined the characteristics of bloody diarrhea in children under five years old in Dr. Soetomo General Hospital Surabaya from 2013 to 2017. Material and Methods: A retrospective, cross-sectional study was conducted using secondary data from Dr. Soetomo General Hospital's inpatients with bloody diarrhea from 2013 to 2017. Gender, age, nutritional status, clinical symptoms, degree of dehydration, and laboratory results were assessed, and the data were presented in percentage (%) Results: Fifty-six samples were included in this study. The main demographics were male (58,9%), aged 7-24 months (44,6%), and normal nutritional status (66,1%). Meanwhile, the most notable manifestations were stool mucous (55,3%), mild to moderate degree of dehydration (60,7%), and leukocytosis (62%). Eleven patients (39,2%) had temperatures ≥380C. Leukocytes were positive in 93.7% of the stools. Furthermore, amoeba was found in 46,8% of samples. The serum electrolyte result showed hyponatremia (18%) and hypokalaemia (15%). Conclusion: The primary demographics of bloody diarrhea in under-five children admitted to Dr. Soetomo General Hospital were males, 7-24 months of age, and with normal nutritional status. The most frequent manifestations were mucous in stool, mild to moderate dehydration, leucocytosis, as well as positive leucocytes and amoeba in the stool.

In children, acute diarrhea and functional constipation (FC) are still more prevalent in Indonesia, especially in isolated islands, and need comprehensive management. This study aimed to determine the effect of community development from the Department of Child Health Faculty of Medicine, Universitas Airlangga, Surabaya, on Mandangin Island’s public knowledge about acute diarrhea and functional constipation in children. This cross-sectional study was conducted on 29 subjects from Mandangin Island, Sampang, Indonesia on 17th February 2022. Subjects were given education and dissemination as community development by pediatricians via hybrid and could ask questions and discuss at the end of the presentation. The subject’s knowledge was measured using a pre-and post-test questionnaire about children’s acute diarrhea and functional constipation. Each questionnaire (diarrhea and functional constipation) consisted of 5 questions, with a minimum score of 0 and the maximum score of 100. The subject's knowledge was compared before and after the webinar using Paired T-Test and p<0,05 was measured as significant. We assessed the subject’s age, gender, occupation, and last education. There was a significant increase in public knowledge about diarrhea (26,9±18,7; 55,1±24,3; p=0.000) and functional constipation pre-and post-webinar (24,8±18,2; 48,3±24,2; p=0.000). These findings support the importance of community development with education about acute diarrhea and functional constipation in children.

Intravenous lipid emulsions (IVLE) is one of the compositions of the parenteral nutrition (PN) that recommended in children who cannot meet their caloric requirements especially after small intestinal surgery and diff erentiated by their infl ammatory eff ects. The fi rst generation IVLE is proinfl ammatory, the second and the third are infl ammatory neutral, while the fourth (fi sh-oil-enriched) is anti-infl ammatory. The objective of this study is to investigate the eff ect of fi shoil enriched IVLE on systemic infl ammatory response syndrome (SIRS) in children after small intestinal surgery. A retrospective study using medical record was undertaken in children after small intestinal surgery admitted Dr. Soetomo Hospital, Surabaya in 2016-2017. Children with duodenal and jejunoileal atresia who had PN for at least three days were included. The types of IVLE used are FOLE and non-FOLE. Defi nition of SIRS was based on International Pediatric Sepsis Consensus Conference in 2005. A total of 25 children were included in this study. There were 44% children received FOLE and 48% received non-FOLE while 8% children received no IVLE. Median duration and dose of IVLE was 8 (5-15,5) days and 1,8 (1,25-2) g/kg/day. SIRS was signifi cantly more common in girls (OR 9 95%CI 1,3-63,0; p=0,036) and in the non-FOLE children (OR 8,0 95% CI 1,24 – 51,50; p=0,022).

Gastric injury is an event that often occurs due to many factors, such as the use of drugs, stress factors, infections, chemicals, etc. The use of histamin 2(H2) receptor antagonist drugs and pump inhibitors have become the choice for gastric injury treatment so far and requires a relatively long time. The widespread use of probiotics has been shown to affect the healing process of digestive tract disorders, for example in the small intestine. This study aimed to investigate the effect of Lactobacillus plantarumIS-10506 in acceleratingthe healing of gastric injury induced by ketorolac in the rat. The experimental study used 64 Wistar rats divided into 4 groups, group 1 (control), group 2(ketorolac administration), group 3 (ketorolac and probiotic administration), and group 4(preventive treatment with probiotic before, ketorolac administration, and treatment with probiotic). Each group was divided into 4 subgroups based on the day of sacrifice, days 1, 5, 7, 10. The healing of gastric injury evaluating by epithelial defects improvement and fibroblast cells by hematoxylin and eosin (HE) staining.The group induced by ketorolac (group 2) showed the highest epithelial defect score (p=0.048) on day 1. The repair of the epithelial defect in group 3 and group 4 were significantly increased on day 5, while group 2remains defectiveon day 5(p=0.019). Fibroblast cells of groups 3 and 4 decreased significantly more than others on day 10(p=0.024). Lactobacillus plantarum IS-10506 influences the healing acceleration of gastric injury by ketorolac by enhancing epithelial regenerationand fibroblast cells.

Childhood Functional Gastrointestinal Disorder (FGID) knowledge is important for healthcare workers (HCWs), particularly in isolated islands, such as Mandangin island, Sampang, Indonesia. Video conferencing technology has been globally used as medical education media to educate among HCWs. This study examined the effectiveness of video conferencing technology about Childhood FGID in limited resources HCWs. This cross-sectional study was conducted among 20 HCWs from Mandangin’s community health center along with community medicine by the Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital. The subject was assessed for general characteristics and FGID pre-test to examine HCWs’ knowledge before the seminar through video conferencing. FGID pre-test was consisted of seven questions and randomized for FGID post-test after the seminar and the question-answer part was done. The pre-and post-test was compared using the Wilcoxon rank sum test using SPSS version 20.0. Among 20 subjects, 80% were female, and 45% had the last education of Diploma Degree (D-3). There was a significant difference between pre-and post-test among subjects (p<0,05), of which 16 (80%) subjects had an increase in post-test compared to the pre-test result. Health education using videoconferencing technology effectively increased knowledge about childhood FGID in limited resources healthcare workers and expected to be a sustainable program in the community health center.