The Association Between Biliary Atresia and Cytomegalovirus Infection

Perinatal infection of cytomegalovirus (CMV) may cause cholestasis resembling biliary atresia. CMV infection is found in patients with biliary atresia. This simultaneous occurrence of biliary atresia and CMV infection prompted speculation that CMV may contribute to the progression of biliary atresia. This report has the objective to obtain the evidence regarding the association between biliary atresia and CMV infection. Two databases were searched to obtain the evidence: PubMed and Scopus. The study design which was selected for this report was case control due to its relevance to answer the clinical question. There were two case control studies which are appropriate to answer the clinical question. Both studies showed that biliary atresia is associated with CMV infection (OR>1). Biliary atresia is associated with CMV infection at the time of diagnosis, therefore the presence of CMV infection in neonatal cholestasis should not delay the investigation towards biliary atresia

Growth of Indonesian infants compared with World Health Organization growth standards

OBJECTIVE: The ability of the World Health Organization (WHO) growth standards to represent the growth of South East Asian infants has been questioned. The aim of this study was to provide contemporary data on the growth of Indonesian breast-fed and formula-fed infants, compared with the WHO growth standards. METHODS: A prospective cohort study of 160 normal healthy infants was undertaken in a suburban area of South Jakarta, Indonesia. Infants from 2-6 weeks of age were recruited, and consumed exclusively either breast milk or infant formula for at least 6 months, with follow-up until 12 months of age. RESULTS: Overall, the infants in this study were lighter (weight-for-age), were shorter (length-for-age) and had smaller head circumferences (head circumference-for-age) than the average WHO Growth Reference Study (WGRS) population but were of similar proportion (weight-for-length). Compared with the WGRS, the z-scores for weight-for-age, length-for-age and head circumference-for-age in the Indonesian children fell from birth to 6 weeks of age and then increased until 3 months of age in both the breast-fed infants and the formula-fed infants. At 6 weeks of age, the weight-for-age z-scores fell below -2 standard deviations (SD) for 16 (20.5%) breast-fed and 40 (51.3%) formula-fed infants, and the length-for-age z-scores fell below -2 SD for 31 (39.7%) breast-fed and 41 (52.6%) formula-fed infants. CONCLUSIONS: The WHO growth standards do not reflect the growth of this cohort of Indonesian infants and may overestimate the levels of underweight and stunted children. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01721512This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivatives 4.0 License, where it is permissible to download and share the work, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0.Pramita G. Dwipoerwantoro, Muchtaruddin Mansyur, Hanifah Oswari, Maria Makrides, Geoffrey Cleghorn, and Agus Firmansyah

Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

BACKGROUND: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. METHODS: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. RESULTS: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). CONCLUSIONS: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs

Financial Foreign Exchange Bank Analysis Through Strategic and Risk Management Approach

This paper discusses how the financial performance of foreign exchange bank in Indonesia that can be improved through the strategy and approach to risk management approach to measuring and analyzing the financial performance during the period 2003-200

Kartu menuju sehat/ Ronardy (edt.)

23 hal.: ill.; 30 cm

Kartu menuju sehat/ Ronardy (edt.)

23 hal.: ill.; 30 cm

Kartu menuju sehat/ Ronardy (edt.)

23 hal.: ill.; 30 cm

Kartu menuju sehat/ Ronardy (edt.)

23 hal.: ill.; 30 cm

Kartu menuju sehat/ Ronardy (edt.)

23 hal.: ill.; 30 cm