Zinc Supplementation Effect on the Bronchial Cilia Length, the Number of Cilia, and the Number of Intact Bronchial Cell in Zinc Deficiency Rats

BACKGROUND: Airway epithelium is the first line of defense against a variety of exposures. Inflammatory processes, hyperresponsiveness and zinc deficiency cause epithelial damage. Zinc is involved in apoptosis and microtubule formation. However, its role in the integrity of bronchial mucosa and cilia is unclear.METHODS: To assess the effect of zinc on the integrity of the bronchial epithelium, 24 male Rattus norvegicus strain Wistar rats were randomized into four experimental groups: normal zinc diet group without zinc supplementation, normal zinc diet group with 60 ppm zinc supplementation, zinc deficient diet group without zinc supplementation, and zinc deficient diet group with 120 ppm zinc supplementation. Bronchial mucosal integrity was measured with the number of epithelial cells, and the number and length of cilia.RESULTS: Number of cell in normal zinc diet group was 8.8±1.82, while it was only 8.1±1.08 in zinc deficient diet group (p<0.001). Number of cilia per cell was 4.6±1.08 in normal zinc diet group, compared to 4.0±0.79 in zinc deficient diet group (p<0.001). Ciliary length also differ by 7.68±0.66 μm in normal zinc diet group and only 5.16±0.91 μm in zinc deficient diet group (p<0.001).CONCLUSION: Zinc supplementation of the normal zinc diet group affected the length of bronchial cilia. Zinc supplementation of the zinc deficient diet group affected the integrity of the bronchial epithelium, which was shown by the number and length of cilia, and the number of epithelial cells.KEYWORDS: zinc, bronchial epithelial integrity, cilia length, number of cilia, epithelial cell

A Retrospective Study: Risk Factor Analysis of Secondary Bacterial Infection in Pediatric Atopic Dermatitis Patients

Background: Atopic Dermatitis (AD) is a complex multifactorial disease that includes defects in skin architecture, immune dysregulation, and changes of skin flora, and it predominantly occurs in infancy and childhood. The defects in skin barrier structures are mentioned as one of the factors that facilitates bacterial colonization. Bacterial infection in AD can worsen the inflammation. It requires treatment with antibiotics, which takes longer therapy time, higher costs, and ultimately affects the patient’s quality of life and his/her family members. Purpose: To find out the epidemiology, diagnosis, management of AD, and analyze the risk factors of secondary bacterial infection in new AD patients at the Pediatric Dermatology Division, Dermatovenereology Outpatient Clinic, Dr. Soetomo General Academic Hospital. Methods: This was a retrospective study with a total sampling method. The research data were medical records of new AD patients at the Pediatric Dermatology Division, Dermatovenereology Outpatient Clinic, Dr. Soetomo General Academic Hospital Surabaya from January 2012 to December 2018. Result: There were 404 new patients with AD at the Pediatric Dermatology Division from January 2012 to December 2018, and 210 of them were accompanied by secondary bacterial infection. There was a correlation between a history of dry skin (p=0.000) with the incidence of secondary bacterial infection in AD patients. Conclusion: In this study, AD patients with a history of dry skin had a risk of complication such as bacterial secondary infection

Molecular Epidemiology and Clinical Features of Rotavirus Infection Among Pediatric Patients in East Java, Indonesia During 2015–2018: Dynamic Changes in Rotavirus Genotypes From Equine-Like G3 to Typical Human G1/G3

Group A rotavirus (RVA) is the most important cause of severe gastroenteritis among children worldwide, and effective RVA vaccines have been introduced in many countries. Here we performed a molecular epidemiological analysis of RVA infection among pediatric patients in East Java, Indonesia, during 2015–2018. A total of 432 stool samples were collected from hospitalized pediatric patients with acute gastroenteritis. None of the patients in this cohort had been immunized with an RVA vaccine. The overall prevalence of RVA infection was 31.7% (137/432), and RVA infection was significantly more prevalent in the 6- to 11-month age group than in the other age groups (P &lt; 0.05). Multiplex reverse transcription-PCR (RT-PCR) revealed that the most common G-P combination was equine-like G3P[8] (70.8%), followed by equine-like G3P[6] (12.4%), human G1P[8] (8.8%), G3P[6] (1.5%), and G1P[6] (0.7%). Interestingly, the equine-like strains were exclusively detected until May 2017, but in July 2017 they were completely replaced by a typical human genotype (G1 and G3), suggesting that the dynamic changes in RVA genotypes from equine-like G3 to typical human G1/G3 in Indonesia can occur even in the country with low RVA vaccine coverage rate. The mechanism of the dynamic changes in RVA genotypes needs to be explored. Infants and children with RVA-associated gastroenteritis presented more frequently with some dehydration, vomiting, and watery diarrhea, indicating a greater severity of RVA infection compared to those with non-RVA gastroenteritis. In conclusion, a dynamic change was found in the RVA genotype from equine-like G3 to a typical human genotype. Since severe cases of RVA infection were prevalent, especially in children aged 6 to 11 months or more generally in those less than 2 years old, RVA vaccination should be included in Indonesia’s national immunization program

Diare Akut pada Balita di Puskesmas Tanah Kali Kedinding Surabaya

Diarrhea is a disease that still be a health problem in the world, including Indonesia. The number of cases of diarrhea in children under five in East Java had increased in prevalence from 6.6% in 2013 to 10.7% in 2018. Deaths in diarrhea usually occurred&nbsp; as a result of severe dehydration which 70% -80% of them were children under-5 years. This study aimed to know the characteristics of children under-5 years who had acute diarrhea at Tanah Kali Kedinding Primary Health Care in September 2018 - January 2019. This type of research was a descriptive study, where the results was only a picture, using a cross-sectional approach. Statistical analysis was performed to describe the characteristics of each patient by using a frequency descriptive test. The results of this study found that in September 2018 - January 2019, of 116 children under-5 years suffering from acute diarrhea in the Tanah Kali Kedinding Health Care, Surabaya, most of them were females, within 1-2 years, had exclusive breastfeeding, had parents with the last education graduated from high school and family income under minimum of wage in Surabaya. It is hoped that this research will become a source of information for the Government and Primary Health Care to reduce the incidence of acute diarrhea.Diare merupakan penyakit yang keberadaannya masih menjadi masalah kesehatan di dunia, termasuk Indonesia. Angka kasus diare yang menyerang balita di Jawa Timur mengalami kenaikan prevalensi dari 6,6% di tahun 2013 menjadi sebesar 10,7% di tahun 2018. Kematian pada kasus diare biasanya terjadi akibat dehidrasi berat dengan 70-80% diantaranya berusia balita. Penelitian ini bertujuan untuk mengetahui karakteristik balita dengan diare akut di Puskesmas Tanah Kali Kedinding pada bulan September 2018 – Januari 2019. Jenis penelitian ini merupakan penelitian deskriptif dengan menggunakan pendekatan cross-sectional yang hasilnya hanya merupakan gambaran. Analisa statistik dilakukan untuk menggambarkan karakteristik dari setiap pasien dengan menggunakan uji deskriptif frekuensi. Hasil penelitian ini ditemukan bahwa pada bulan September 2018 - Januari 2019, dari 116 balita yang menderita diare akut di Puskesmas Tanah Kali Kedinding, Surabaya, mayoritas dari mereka berjenis kelamin perempuan, berada dalam rentang umur 1-2 tahun, mempunyai riwayat pemberian ASI eksklusif, mempunyai orang tua dengan pendidikan terakhir tamat SMA dan pendapatan keluarga yang dibawah UMK Surabaya. Diharapkan penelitian ini menjadi sumber informasi bagi Dinas Kesehatan dan Puskesmas setempat untuk mengurangi kejadian diare akut

Clinical Findings in Biliary Atresia: A Literature Review

Abstract Biliary atresia is an obstructive disease affecting the biliary tract. Patients with biliary atresia often appear similar to normal infants, leading to delayed detection in many cases. There are several clinical symptoms and typical laboratory findings that typically manifest in patients with biliary atresia. As the age of the patient advances, the manifestations worsen, potentially leading to the development of cirrhosis, liver failure by the age of 1, and other complications. The aim of this review is to understand the clinical finding of biliary atresia patients, facilitating early detection and intervention to reduce the likelihood of the disease progressing to a more severe stage. Delay in the diagnosis of biliary atresia can result in a poor prognosis

RISK FACTORS INFLUENCING ENTEROCOLITIS DEVELOPMENT IN PEDIATRIC PATIENTS WITH HIRSCHSPRUNG’S DISEASE

Background: Hirschsprung-associated enterocolitis (HAEC) is one of the worst and most common complications of Hirschsprung’s disease (HD). The mortality rate of HD patients with enterocolitis is still considered to be higher compared to that of those without enterocolitis. Purpose: This study aimed to identify and evaluate potential risk factors for HAEC development. Methods: A cross-sectional study was conducted using secondary data from the medical records of HD patients treated from January 2015 to September 2018 at Regional Public Hospital (RSUD) Dr. Soetomo, Surabaya. The inclusion criteria were HD patients who had or had not experienced enterocolitis. The analysis was done by comparing the presence of risk factors between groups of HD patients with and without preoperative and/or postoperative HAEC. The results were presented as the median value and frequency. To evaluate further, a prevalence ratio (PR) with a 95% confidence interval was performed. The Mann–Whitney U test was also performed with a significance level of p < 0.05 for one factor: length of aganglionic intestinal segments. Results: This study showed that 12 of the 40 HD patients studied (30%) had experienced enterocolitis. The risk of developing HAEC was associated with patients who had a history of previous enterocolitis (PR 6.60 [2.94 < PR < 14.80]). Regarding surgical details, patients who had had surgery only once (31.30% compared to 14.30%), surgery with one surgical method (29.40% compared to 20.00%), and a primary procedure had a higher incidence of HAEC (29.40% compared to 27.30%). Conclusion: HD patients with a history of previous enterocolitis were found to have a higher risk of developing HAEC

Diare Kronis pada Anak Berusia di Bawah Lima Tahun

Diarrhea is an endemic disease in Indonesia and has the potential to cause outbreaks that are often accompanied by death, even the mortality rate during outbreaks in 2017, amounting to 1.97%, had not yet reached the expected target by the government, which is less than 1%. This study aims to determine the distribution of sex, age, nutritional status based on weight/age, and how to leave the hospital for chronic diarrhea patients and to know the correlation between nutritional status based on weight/age and death cases of chronic diarrhea in children under five years old treated at RSUD Dr. Soetomo in the period 2015-2019. This research was a retrospective analytical and descriptive study using secondary data from a patient's electronic medical record. Results showed that out of 45 chronic diarrhea patients, 28 (62,2%) were male, 16 (35,6%) children were in the 0 - 5 months age group, 18 (40,0%) children had good nutritional status, 39 (86,7%) children were discharged from the hospital, and there was a significant correlation between nutritional status based on weight/age and death cases of chronic diarrhea in children (p = 0,017). It could be concluded that the majority of children with chronic diarrhea were male, were in the 0 - 5 months age group, had good nutritional status, and were discharged from the hospital which meant that their condition had improved or cured and there was a significant correlation between nutritional status based on weight/age with death cases of chronic diarrhea in children.Diare merupakan penyakit endemis di Indonesia dan berpotensi menyebabkan terjadinya KLB yang sering disertai dengan kematian, bahkan angka kematian saat KLB pada tahun 2017, sebesar 1,97%, belum mencapai target yang diharapkan oleh pemerintah, yaitu kurang dari 1%. Penelitian ini bertujuan untuk mengetahui distribusi jenis kelamin, usia, status gizi berdasarkan BB/U, dan cara keluar rumah sakit pasien diare kronis serta mengetahui hubungan status gizi berdasarkan BB/U dengan kasus meninggal diare kronis pada anak berusia di bawah lima tahun yang dirawat di RSUD Dr. Soetomo periode tahun 2015-2019. Penelitian ini merupakan penelitian analitik dan deskriptif retrospektif dengan menggunakan data sekunder dari rekam medik elektronik pasien. Hasil penelitian didapatkan bahwa dari 45 pasien diare kronis, 28 (62,2%) anak berjenis kelamin laki-laki, 16 (35,6%) anak berada pada kelompok usia 0 – 5 bulan, 18 (40,0%) anak memiliki status gizi baik, 39 (86,7%) anak dipulangkan dari rumah sakit, dan terdapat hubungan yang signifikan antara status gizi berdasarkan BB/U dengan kasus meninggal diare kronis pada anak (p=0,017). Berdasarkan hasil tersebut dapat disimpulkan bahwa mayoritas anak dengan diare kronis berjenis kelamin laki-laki, berada pada kelompok usia 0 – 5 bulan, memiliki status gizi baik, dan dipulangkan dari rumah sakit yang berarti mengalami perbaikan kondisi atau kesembuhan serta terdapat hubungan yang signifikan antara status gizi berdasarkan BB/U dengan kasus meninggal diare kronis pada anak

Gambaran Tingkat Pengetahuan Ibu Tentang Diare Pada Balita Di Wilayah Kerja Puskesmas Bantimala

Abstrak Penyakit diare sampai saat ini masih merupakan penyebab kematian utama didunia, terhitung 5-10 juta kematian/tahun. Tujuan Khusus dari penelitian ini mengidentifikasi karakteristik responden meliputi usia, pendidikan dan pekerjaan ibu di wilayah kerja Puskesmas Bantimala, mengidentifikasi karakteristik balita yang meliputi usia dan jenis kelamin balita di wilayah Puskesmas Bantimala, mengidentifikasi gambaran tingkat pengetahuan ibu tentang diare pada balita di wilayah kerja Puskesmas Bantimala, mengidentifikasi gambaran tingkat pengetahuan ibu tentang diare pada balita berdasarkan usia ibu, pendidikan dan pekerjaan ibu di wilayah kerja Puskesmas Bantimala. Metode Penelitian ini merupakan penelitian kuantitatif dengan desain deskriptif. Sampel berjumlah 107 orang yang diperoleh melalui accidental sampling dan pengambilan data dengan menggunakan kuesioner. Hasil penelitian menunjukkan ibu yang memiliki pengetahuan baik sebanyak 58 orang (54,2%). Tingkat pengetahuan baik pada umur 20-35 tahun sebanyak 33 orang (55,9%), tingkat pengetahuan baik juga terdapat pada ibu yang memiliki pendidikan menengah sebanyak 31 orang (55,4%) dan pada ibu yang tidak bekerja sebanyak 49 orang (80,3%). Sebagian besar balita yang mengalami diare pada usia 12-36 bulan sebanyak 85 orang (79,4%), dan usia >36- 59 bulan sebanyak 22 orang (20,6%). Laki-laki sebanyak 56 orang (52,3%) dan perempuan sebanyak 51 orang (47,7%). Kesimpulan. Ibu yang berada di Wilayah kerja Puskesmas Bantimala memiliki tingkat pengetahuan yang baik. Sedangkan pada karaktersitiknya rata-rata ibu yang berpengetahuan baik berada pada usia 20— 35 tahun, sarjana (S1) dan bekerj

Molecular Detection of a New Pathotype Enteroaggregative Haemorrhagic Escherichia coli (EAHEC) in Indonesia, 2015

Enteroaggregative haemorrhagic Escherichia coli (E. Coli, EAHEC) has been identified as the agent responsible for one of the largest outbreaks of gastroenteritis and Haemolytic-uremic syndrome (HUS) that is transmitted through food in Germany in 2011. The hypervirulent pathotype has a unique combination of two pathogens namely enterohemorrhagic E.coli strain (EHEC) which produces shiga/verotoxin and enteroaggregative E.coli toxins (EAEC) which produces toxins similar to ST and hemolysin. The toxin produced by the EAHEC strain is a hybrid pathotype that combines the virulence potential of the EAEC and EHEC strains that will damage the microcirculation, cause vasculitis and other toxic effects. The purpose of this study was to determine the percentage of samples infected with enteroaggregative hemorrhagic E. coli bacteria (EAHEC) in pediatric diarrhea patients at DR. Soetomo Hospital, Surabaya, Indonesia, 2015. This study used PCR (Polymerase Chain Reaction) method to detect enteroaggregative E. coli strains (CVD432 and aaic genes) and enterohemorrhagic E.coli (eae gene).The results showed that 33 out of 40 (82.5%) stool samples examined were detected enteroaggregative E. coli (EAEC), 4 out of 40 (10%) enterohemorrhagic E. coli (EHEC) and 3 out of 40 (7.5%) enteroaggregative haemorrhagic E. coli bacteria (EAHEC) , which caused diarrhea in pediatric diarrhea patients at Dr. Soetomo General Hospital. The unique combination of genomic features of the Surabaya outbreak strain, containing characteristics from pathotypes EAEC and EHEC, suggested that it represents a new pathotype enteroaggregative haemorrhagic E. coli (EAHEC). It is expected that development of specific primer design and sequencing are needed to continue in this research