Sepsis is a major problem in neonatal care that has not been resolved. This condition is becoming one of major cause of morbidity and mortality in neonates especially in developing countries. Neutrophil lymphocytes count ratio (NLCR) is a new marker of infection that is easy, rapid method and less expensive that can be done in limited health care facilities. A retrospective study with cross sectional design was conducted on 84 neonates with sepsis. The data was collected from medical records from April 2018 to September 2018 in Perinatology Division Sanglah hospital. ROC curve is was done to determine the value cut-off point, sensitivity and specificity of NLCR. With cut-off point of 2.31 NLCR has prevalence, sensitivity, specificity, positive predictive value (PPV) and negative pedictive value (NPV) of 26.1%, 81.8%, 66.1%, 46.1% and 91.1%. NLCR is potential to be used in the diagnosis of neonatal sepsis.

Neonatal appendicitis (NA) is an extremely rare acute abdomen condition, moreover, if it is a chronic suppurative one. The definite risk factor of NA is barely unknown. The signs and symptoms are often nonspecific and appear after perforation occurs. Most of the cases were found unexpectedly during surgery suspected as other diagnoses. A 7-day-old male neonate presenting lethargic and hypoglycemia since 1 st day of life. Patient drunk breast milk right after since he was born. Meconium was produced <24 h. On the 3 rd day of hospitalization, he experienced bilious vomiting and abdominal distension, so nasogastric tube was installed. Physical examination revealed decreased bowel sound. Investigation showed leucocytosis, slightly increased procalcitonin and abdominal X-ray showed that gas distribution lasted until third part of duodenum followed by minimal gas distribution in the distal part of duodenum. The patient was suspected as distal duodenum stenosis or proximal jejunum. Intraoperatively, it was found that there was second part duodenum malrotation and open Ladd’s procedure was done. During Ladd’s procedure, a perforated appendix was also found. The histopathology result revealed that it was a chronic suppurative appendicitis. Patient was discharged in good condition 20 days after surgery. NA is a rare condition with nonspecific signs and symptoms which was usually found accidentally during surgery suspected as other diagnoses.

Objective Finding the characteristics and risk factors associatedwith prognosis in children suffering from intracranial hemorrhage.Methods This was a retrospective medical record review of chil-dren (older than 1 month old) admitted with intracranial hemor-rhage to the Department of Child Health the Sanglah Hospital,Denpasar, during the period of January 1998 to December 2000.Prognostic factors were identified by chi-square and multivariateanalysis with significance of p<0.05Results There were 56 patients eligible for the study. Among themwere 35 (63%) males and 21 (27%) females. Forty-three (77%)were less than one year of age, 40 (71%) without history of traumaand the major clinical manifestation was paleness (89%). The mostcommon location was subdural bleeding, 21 patients (38%). Fac-tors associated with prognosis was the bleeding location (p<0.05)Conclusions Intracranial hemorrhage was more common in malesand in infants. The most common clinical manifestation was pale-ness. Bleeding location was associated with prognosis

Eritropoetin merupakan molekul glikoprotein yang terdiri dari 165 asam amino dan 4 gugus karbohidrat dengan berat molekul sekitar 34 k dalton. Peran eritropoetin dalam produksi sel darah merah melalui meningkatkan survival, proliferasi dan diferensiasi dari progenitor eritroid pada sumsum tulang. Eritropoetin berikatan dengan reseptor selanjutnya terjadi aktivasi ras/mitogen intraselular yang berperan dalam proliferasi sel. Regulasi produksi eritropoetin adalah peran dari hypoxia-inducible transcription factor-1 (HIF-1). Pada bayi yang lahir prematur terjadi penurunan kadar Hb yang berlebihan dibandingkan dengan bayi cukup bulan. Banyak faktor yang mempengaruhi anemia prematuritas, salah satu di antaranya adalah kurang respon eritropoetin terhadap penurunan kadar Hb. Penggunaan eritropoetin rekombinan mengurangi frekuensi transfusi darah dan meningkatkan retikulosit dengan cepat. Eritropoetin rekombinan belum merupakan standar pengobatan anemia prematuritas secara universal (Sari Pediatri 2008;9(6):375-80). Eritropoetin merupakan faktor pertumbuhan hematopoetik pertama yang dapat dibuat, yaitu eritropoetin rekombinan (epoetin alfa).4 Bersama dengan kemajuan teknologi DNA, eritropoetin rekombinan yang baru telah ditemukan yaitu Darbepoetin-α (NESP). Darbepoetin-α sedikit berbeda dengan eritropoetin aslinya. Darbepoetin-α memiliki berat molekul 38,5 k dalton, 5 rantai ikatan dengan oligosakarida dibandingkan 3 rantai oligosakarida pada eritropoetin aslinya, total karbohidrat 52% dibandingkan 40% pada eritropoetin yang asli, mempunyai waktu paruh yang lebih panjang yaitu sekitar 48,8 jam dibandingkan 12-48 jam pada pemberian secara subkutan. Sedangkan ikatan reseptor pada tempat bekerja eritropoetin sama dengan eritropoetin asli. 2Pada tikus diperlukan sekitar 0,4 IU eritropoetin perhari untuk mempertahankan pruduksi sel darah merah, sedangkan pada manusia belum diketahui. Pada anemia atau hipoksia terjadi peningkatan kadar