Pediatric Logistic Organ Dysfunction-2, Pediatric Risk Of Mortality-IV And Pediatric Index Of Mortality-3 For Predicting Mortality In Pediatric Surgery Patients With Sepsis

Background: Sepsis and shock septic still is one of the causes of morbidity and mortality that many in pediatric patients. The study is intended to determine the effectiveness of the systems Pediatric Risk of Mortality-IV(PRISM-IV), Pediatric Logistic Organ Dysfunction-2 (PELOD-2) and Pediatric Index of Mortality-3 (PIM-3) in predicting the outcome of patients. Methods: Data were taken from the medical record of patients. Medical records are then evaluated using the inclusion criteria and the criteria for exclusion. Data is processed statistically. Result: The number of survived subjects was 38 patients and the number of deaths was 26 patients. The regression test showed that to a relationship that significant between the value of scoring PRISM-IV against mortality with p 0.001 (p <0.05 CI 95%). The PIM-3 score was analyzed. The regression test showed that there is no significant relationship between the score PIM-3 against mortality with p 0.371 (p <0.05 CI 95%). Test relationship score PELOD-2 against mortality showed that patients who survived had a value score of PELOD 0, whereas the patients who died had a mean score of 3.6 (SD ± 4.5). The results of the test regression showed a significant relationship with p 0.018 ( (p <0.05 CI 95%) with the strength of the relationship R = 0.595. Conclusion: The PELOD-2 and PRISM-IV grading systems are equally good at predicting the outcome of pediatric surgical patients with sepsis. The PELOD-2 system has advantages in specificity and accuracy, while the PRISM-IV system has an advantage in sensitivity

Case Report: POST ESOPHAGECTOMY ESOPHAGEAL RECONSTRUCTION IN ESOPHAGEAL INJURY DUE TO CAUSTIC MATERIALS

The esophageal caustic injury is rare, but it requires precise and complex management. A variety of reconstruction techniques have been done, but despite the increasing volume, the incidence of complications is still relatively high. We reported the experience in our center in handling esophageal reconstruction in patients with caustic esophageal injury that caused oesophageal stricture between 2014-2017. This study used case series method with literature review. The results showed that between 2014-2017, there were 3 patients with caustic esophageal injury. All patients undergoing esophageal reconstruction surgery were included under conditions of malnutrition. Two were caused by HCl and the rest by NaOH. All patients underwent a resection of stricture segment of the esophagus, either using partial or total esophagectomy. Anastomosis leakage occurred in all cases, but improved with conservative treatment. The average length of hospitalization was 27 days. The intraoperative blood loss in patients ranged from 450-700 cc. In conclusion, proper preliminary management can provide approppiate preparation of the patients for definitive or reconstructive surgery, especially to avoid malnutrition. The ideal reconstruction still could not be established, and the rate of postoperative complications was still high. The length of patient hospitalization was also relatively long

Korelasi Ekspresi Cyclin Dl Dengan Stadium Klinis Dan Derajat Diferensiasi Histopatologi Pada Adenokarsinoma Kolorektal : Suatu studi penelitian di RSU Dr Soetomo Surabaya

Latar Belakang: Stadium klinis dan derajat diferensiasi histopatologis adalah salah satu faktor prognostic pada adenokarsinoma kolorektal. Pada adenokarsinoma kolorektal terjadi deregulasi eye hal tersebut menyebabkan perubahan memendeknya fase G I sehingga terjadi pereepatan pertumbuhan sel. Overekspresi eye/in D/ tidak hanya berhubungan dengan terjadinya rekure nsi tetapi juga berhubungan dengan stadium kanker, metastase regional dan menurunkan angka survival seeara keseluruhan. Tujuan: Mengetahui apakah peningkatan ekspresi eye/in DI mempunyai korelasi dengan Stadium kli nis dan derajat diferensiasi hi stopatologis adenokarsinoma koloreltal. Bahan dan Metodologi: Raneangan penelitian yang digunakan adalah observasional analit ik dengan pendekatan cross sectional. Sampel penelitian adalah blok paratin adenokarsinoma kolorektal yang tersimpan di laboratonum Patologi Anatomi RSU Dr.Sutomo selama tahun 2006-2007. Subyek peneiitian tereatat dalam dokumen medis di rekam medis RSU Dr.Sutomo Surabaya. Tiga puluh blok parafin akan dieat dengan hematoksi lin eosin dan diperiksa imunohistokimia dengan menggunakan monoklonal antibodi eye/in DI untuk melihat derajat diferensiasi dan ekspresi eye/in DI. Stadium kJinis ditentukan dan eatatan rekam medis. Gradasi intensitas dan jumlah sel yang tereat dinyatakan seeara semikuantitati f. Hasil yang didapat dianalisis dengan uji korelasi Spearman Rank-Order Corelation Test. Hasil : Dari 30 sam pel parafin blok dan rekam medik, didapatkan data sebagai berikut: 24 orang adalah pria (80%), Usia sampel adalah antara 26 tahun sampai dengan 79 tahun, dengan ratarata 53,63 tahun. Stadium klinis terbanyak yang didapatkan dan sampel adalah [fA (26,6%), diikuti de ngan III 8 (23,23%). Skor ekspresi eye/in DI terendah pada penelitian ini adalah 3 sebanyak 5 ( t6,7 %) sampel dan skor tertinggi adalah 9 sebanyak 10 (30%) Hasil uj i korelasi Spearman menunj ukkan ekspresi eye/in DI mempunyai korelasi yang signifikan dengan derajat diferensiasi histopatologi adenokarsinoma kolorektal dengan nilai koefiseien korelasi sebesar 0.5 13 (\T0,004/p<0,0 I) Hal ini berarti bahwa semakin kuat intensitas ekspresi eye/in DI maka semakin jelek derajat diferensiasi sel Sementara untuk hubungan antara ekspresi eye/in DJ dan stadium didapatkan r ~ 0.328 (\TO,077/p>O,O I). Hal ini berartibahwa tidak ada hubungan antara stadium klin is dengan ekspresi eye/in DI Kesimpulan : Ada hubungan yang bermakna antara ekspresi eye/in D/ dan derajat diferensiasi histopatologis, tetapi tidak ada hubungan yang bermakna anta ra ekspresi eye/ill DI dan stadium klinis keganasan kolorektal. Hal ini berarti bahwa semakin kuat intensitas ekspresi eye/in DI maka semakin jelek derajat di fe rensiasi sel

Predictor of Mortality in Complicated Intraabdominal Infection Patients at Dr. Soetomo General Hospital Surabaya

Abstract Link of Video Abstract: https://youtu.be/g_ys7cQCuDY Background: Complicated intraabdominal infection (cIAI) is a surgical emergency reported to be a major contributor to non-traumatic mortality worldwide. Identifying the mortality risk before any operation is important in guiding clinical decision-making and informed patient consent about the risk of complicated intraabdominal infection (cIAI). The study aimed to develop a novel scoring system for predicting postoperative mortality in cIAI. Methods: Data were collected retrospectively from all consecutive patients 396 patients met the inclusion criteria after excluding missing data undergoing cIAI surgery in Dr. Soetomo Hospital 2020 - 2022. Multivariate logistic regression analysis was performed to correlate the explanatory variable postoperative mortality. Data were analyzed using SPSS version 20.0 for Windows and MedCalc. Results: Postoperative mortality rate cIAI was 32,2% (128 of 396), and variables identified as the strongest predictors of postoperative mortality were age > 60 y.o (OR 3,196), systolic blood pressure 1,8 mg/dL (OR 2,180), creatinine serum ≥ 1,58 mg/dL (OR 4,290), cancer comorbidity (OR 3,578), and appendix perforation as negative predictor (OR 5,853). These parameters were included in the prediction model of the novel simplified Airlangga Scoring System. Conclusion: Despite the relatively low number of risk factors, the Airlangga score has been shown as a good predictor of postoperative mortality after cIAI. External validation is required in hospitals different from those in which the novel scoring system was developed

The Effect of Topical Curcumin Extract on Fibroblast Count and Collagen Density as an Indicator on Accelerating Clean Wound Healing Process: A Study on Wistar Rats.

Abstract A factor that plays an important role in the process of wound healing is fibroblast, where fibroblasts can trigger the formation of collagen. Turmeric (Curcuma longa) containing curcumin and volatile oil is believed to accelerate fibroblast proliferation and collagen synthesis. This study compared the effectiveness of curcumin extract topical and tulle in the acceleration the process of wound healing in rat skin. This was an experimental study using Rattus novergicus. The rats were divided into four groups: Group of wounds that treat with carbomer, NaCl 0.9%, tulle and curcumin extract topical, then they were compared by the fibroblast count and collagen density. In this study, there were significant differences in the number of fibroblasts among the four groups (p = 0.034). We found that mean fibroblast count in group of wounds treated with curcumin extract topical was higher than that treated with tulle, and we obtained p = 0.045. There was no difference in collagen density score between groups of wounds treated with curcumin extract topical and tulle. There was a significant difference of fibroblast count in curcumin extract topical group compared to tulle group. However, there was no significant difference in collagen density score between both of them

Phase 2 Study Assessing the Bactericidal Effects of Electrolyzed Oxidized Water as an Antiseptic towards the Reduction of The Peristomal Germ Density Level in Child Colostomy in Dr. Soetomo Hospital, Surabaya Alliacea (Singawalang) Leaves

Abstract Many risk factors cause infection in the surgical site. This study examined the bactericidal effect of oxidized electrolyte water (EOW) as an antiseptic against decreasing levels of peristomal germ density in children colostomy areas, selected experimental studies of phase 2 study. This study was conducted in pediatric patients with a colostomy who were going to undergo stoma lid surgery to prove the bactericidal effect of EOW on the density of pediatric stoma area. Frequency distribution of the number of pre-antiseptic bacteria of the research sample was 30 samples. There were 1 preparation (3.3%) with 0-1,000 bacteria, 4 preparations (13.3%) with 1,000-10,000 bacteria, and 25 preparations (83.3%) with bacteria >10,000. The results of the examination showed the number of post-antiseptic germs on 27 preparations (90%) with the number of germs of 0-1,000, 0 preparations (0%) with the number of germs of 1,000-10,000, and 3 preparations (10%) with the number of germs >10,000. This test obtained a significant difference between the 2 groups (p = 0.001), showing a significant difference between the pre-antiseptic EOW and post-antiseptic EOW groups. EOW can significantly reduce the level of skin germ density in children with colostomy peristoma

Effect of Bovine Dried Amniotic Membranes as Prosthesis of Abdominal Fascial Defect Closure Reviewed from The Level of Density CollagenType I and III in Rattus novergicus Wistar Strain

Abstract Collagen types I and III is an important component of abdominal fascia and aponeurosis. Dried amniotic membrane is rich in the extracellular matrix, dominated by types I and III collagen, which has the potential to improve the wound healing process. This study aimed to analyze the differences in density of types I and III collagen in abdominal fascia defects closed with and without bovine dried amniotic membranes. This was an experimental research design using Rattus norvegicus divided into two groups. The first group was directly covered with a skin flap closure, while the second group used bovine dried amniotic membrane. Evaluation of type I and III collagen density was assessed using an immunohistochemical examination and a collagen density score, the Pathological Visual Score. In the evaluation of type I collagen density, the score in the control group was 1 (68.8%), 0 (25%), and 3 (6.3%). Whereas in the treatment group was a score of 2 (50%), a score of 1 (43.8%), and a score of 0 (6.3%). The density of type III collagen showed that the scores in the control group were a score of 1 (50%), a score of 0 (31.3%), and a score of 2 (18.8%). Meanwhile, the treatment group obtained a score of 2 (68.8%), a score of 1 (31.3%), and a score of 0 (0%). There was an increase in the density of collagen types I and III in the abdominal fascial defect reconstructed using bovine dried amniotic membrane

Effect of Aloe vera Extracts towards the Fibroblast Number and Collagen Thickness on Clean Skin Wound Healing on Rattus Novergicus

Abstract Currently, there are many agents that can improve the healing process, one of which is Aloe vera extract. This study aimed to prove the effect of Aloe vera and tulle extracts on the healing of clean wounds on rat skin. This was a laboratory experimental study in white rats using the treatment of Aloe vera, tulle, and normal saline extract on clean skin wounds. Data on body weight and age of the sample used in this study were all homogeneous (p >0.05). The mean number of fibroblasts in control group was 72.18±28.35, Aloe vera group was 129.3±33.27, and tulle group was 84±18.85. The Aloe vera administration group had more fibroblasts and was statistically significant compared to the other groups (p = 0.011), although there was no significant difference in the collagen thickness score among three groups (p = 0.801). Aloe vera extract can increase the number of fibroblasts in the clean wound healing process

Effects of Dried Bovine Amniotic Membrane as Prosthetics of Abdominal Fascial Defect Closure Observed by the Expression of Platelet-Derived Growth Factor in Rattus norvegicus Wistar Strain

Abstract Abdominal wall defect is a condition often occurring after surgery or trauma. Amniotic membrane is believed to contain growth factors including epidermal growth factors (EGF), platelet-derived growth factor (PDGF), and transforming growth factor-beta. This study aimed to analyze differences in PDGF levels in abdominal fascia defects in which closure was performed with and without dried bovine amniotic membrane. This was an experimental research design on experimental animals of 32 Rattus norvegicus Wistar strain divided into two groups, control and treatment. PDGF evaluation was measured using the immunohistochemical examination. Measurements were made subjectively by two anatomical pathologists separately with a scoring system. Evaluation of PDGF expression examination was assessed by the intensity and percentage of positive cells. There was no significant difference in PDGF intensity (p = 0.763) between the treatment and control groups. Meanwhile, the PDGF extension found a significant difference (p = 0.005). PDGF expression was obtained by multiplying the intensity score by extension, and the results obtained were significantly different (p = 0.008). PDGF expression in the treatment group was higher than in the control group. Closing the abdominal fascial defect using dried bovine amniotic membranes can increase PDGF expression

The Prevalence, Etiology and Treatment of Gastroduodenal Ulcers and Perforation: A Systematic Review

(1) Background: Gastroduodenal perforation (GDP) is a life-threatening condition caused by a spontaneous or traumatic event. Treatment should be based on the mechanism of damage, timing, location, extent of the injury, and the patient’s clinical condition. We aimed to examine several etiologic factors associated with gastroduodenal perforation and to search for the best method(s) for its prevention and treatment. (2) Methods: We conducted extensive literature reviews by searching numerous studies obtained from PubMed, Science Direct, and Cochrane for the following keywords: gastroduodenal perforation, Helicobacter pylori, NSAIDs’ use, side effects of GDP, laparoscopy, and surgery. The primary outcome was the reported occurrence of GDP. (3) Results: Using keywords, 883 articles were identified. After applying the inclusion and exclusion criteria, 53 studies were eligible for the current analyses, with a total number of 34,692 gastroduodenal perforation cases. Even though the risk factors of gastroduodenal perforation are various, the prevalence of H. pylori among patients with perforation is considerably high. As technology develops, the treatment for gastric perforation will also improve, with laparoscopic surgery having a lower mortality and complication rate compared to open surgery for GDP treatment. (4) Conclusions: H. pylori infection plays the most significant role in GDP, more than NSAIDs, surgery, chemotherapy, or transplantation. Treatment of H. pylori infection is essential to decrease the prevalence of GDP and speed up its recovery. However, urgent cases require immediate intervention, such as laparoscopic or open surgery