Surfactant Therapy for Meconium Aspiration Syndrome in Dr. Soetomo General Hospital: A Case Series.

Abstract INTRODUCTION: Meconium staining of amniotic fluid (MSAF) is a natural phenomenon in pregnant mothers and their fetuses. MSAF may lead to developing Meconium Aspiration Syndrome (MAS). Surfactant replacement therapy has recently emerged as a therapy in MAS, but no guideline outlines how to administer it properly. CASE PRESENTATION: We present two term neonates with severe MAS cases focusing on the bolus surfactant replacement therapy. The first baby was given surfactant at 23 hours after birth and the second baby at 8 hours after birth. We used Survanta (beractant) in the dose of 100 mg/kg BW in both cases. Clinical improvement was observed 24 hours after surfactant bolus administration with different clinical characteristics, treatment approaches, and outcomes. CONCLUSION: In conclusion, therapeutic surfactant bolus in severe MAS may improve outcomes without significant adverse side effects

A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required

Effect of Glutamine Enteral Supplementation in Post-Operative Intestinal Obstruction Neonates: A Randomized Control Trial. .

Abstract Surgical treatments targeted for infants suffering congenital intestinal obstruction are advantageous to increase clinical outcomes. However, the post-surgical period might encourage them to depletion of glutamine (Gln). This study aims to evaluate the efficacy of Gln to supply feeding requirements for infants during post-gastrointestinal tract surgical recovery. It was conducted in infants with congenital anomalies involving gastrointestinal (GI) and undergoing surgery using a double-blind, randomized trial design. The population was divided into control and trial groups. Afterward, the comparison of outcomes following the intervention is analyzed to determine the benefits of Gln supplementation. Eighteen of 20 infants were diagnosed with a congenital malformation that involved the GI tract after birth. As reported in 10 infants, anorectal malformation accounted for most of the types of malformations. There was no significant difference in clinical outcomes shown by infants supplied with Gln enteral diet and those who were not, in their birth weight and median time to full-enteral feeding (FEF). Enteral nutrition support using Gln enriched diet does not improve feeding tolerance for infants with congenital GI anomalies during post-surgical care. Concerning the novelty, this study found that the effect of Gln supplementation on babies undergoing GI surgical management is not significantly different from placebo

Nurse workload, missed nursing care, and the contributing factors in the Neonatal Intensive Care Unit in a limited resource setting: A case from Indonesia [version 1; peer

Abstract Background: Nurses who are in charge of the Neonatal Intensive Care Units (NICUs) have a different workload and work assignments compared to other units. Evidence suggests that higher nurse workloads will increase the risk of missed nursing care. Missed nursing care in the NICU will eventually worsen the neonatal prognosis. This is a major problem in developing countries, which currently still have a high neonatal mortality rate. Methods: This was a cross sectional study using questionnaires to collect data from 48 nurses who work in Dr. Soetomo Hospital NICU from April 15th 2021 to July 25th 2021. The collected data was then processed with descriptive statistics, meanwhile the correlation between workload with missed nursing care was analyzed with Pearson and Spearman correlation. Results: The total mean of NICU nurse workload score according to the NASA-TLX (National Aeronautics and Space Administration Task Load Index) was 68.36, indicating a moderate overall workload, with effort as the highest component. Overall, 91.67% of the nurses had missed at least 1 out of 21 basic neonatal nursing care components. Labor resource factor was the most frequent missed nursing care factor, in which urgent patient situations were the most frequent problem. There was no significant correlation between the total nurse workload and the frequency of any missed nursing care (P=0.536). Conclusions: Effort was the biggest component of the NICU nurse total workload. The most frequently missed nursing care was giving emotional support for the patient’s parents and/or family. Labor resource factor was the most frequent problem which caused missed nursing care. However, there is no statistically significant correlation between the total workload with the frequency of missed nursing care

Determinants of neonatal deaths in Indonesia: A national survey data analysis of 10,838 newborns

Background Neonatal mortality is one of the key impediments in achieving global sustainable development goals, especially in lower middle income countries (LMICs). As an LMIC with the highest reported neonatal mortality rate in Southeast Asia, Indonesia faces inequitable distribution of health facilities across the archipelago. Therefore, in this paper, we aim to evaluate the determinants of neonatal mortality rate in Indonesia to search for better strategies to overcome this problem. Methods We conducted an analysis of the 2017 Indonesia Demographic Health Survey dataset of 10,838 live-born infants born from singleton pregnancies in 2017. Using a hierarchical approach, multivariate analysis was conducted to identify potential factors (including socioeconomic, household, and proximate determinants) that contributed to neonatal mortality. Results The lack of participation in postnatal care [odds ratio (OR) = 20.394, p = 0.01)] and delivery complications other than prolonged labour (OR = 2.072, p = 0.02) were the maternal factors that significantly associated with increased risk of neonatal death. Regarding neonatal factors, low-birth-weight infants appeared to be more vulnerable to neonatal death (OR = 12.489, p = 0.01). Conclusion Low participation in postnatal care, development of labour complications, and low birth weight were associated with higher neonatal mortality. It implies that in a limited resource and geographically challenging country such as Indonesia, improving the quality and optimizing services of public hospitals with equitable distribution of quality health care services in all regions should be prioritized in the efforts of reducing neonatal mortality rate

Proceedings of the 3rd International Conference on Community Engagement and Education for Sustainable Development

This proceeding contains articles on the various ideas of the academic community presented at The 3rd International Conference on Community Engagement and Education for Sustainable Development (ICCEESD 2022) organized by the Universitas Gadjah Mada, Indonesia on 7th-8th December 2022.  ICCEESD is a biannual forum for sharing, benchmarking, and discussing HEI’s activities in developing Education for Sustainable Development towards community engagement. Education for Sustainability as a teaching strategy for resolving community challenges through formal, informal, or non-formal education is expected to benefit from various community service best practices by academics, researchers, and students. The 3rd ICCEESD has “Strengthening Education for Sustainability Towards Better Community Engagement” as its theme this year. It is expected that the 3rd ICCEESD will provide a forum for the presenters and participants to exchange best practices, policies, and conceptual implementation of Education for Sustainability towards better community engagement and explore ideas to address community needs.  Conference Title: 3rd International Conference on Community Engagement and Education for Sustainable DevelopmentConference Theme: Strengthening Education for Sustainability Towards Better Community EngagementConference Acronyms: ICCEESD 2022Conference Date: 7th-8th December 2022Conference Location: Grand Rohan Jogja Yogyakarta, IndonesiaConference Organizer: Universitas Gadjah Mada, Indonesi