ABSTRACT
Objectives: This study evaluated the efficacy of Polyethylene glycol 4000 for fecal disimpaction in children with cerebral palsy. Materials & Methods: A randomized control trial study was conducted on children with cerebral palsy between February - March 2017 in the pediatric neurology outpatient clinic Dr. Soetomo Hospital. Children aged 2-16 years with fecal impaction randomly assigned into polyethylene glycol 4000 (PEG 4000) and saline enema group. Polyethylene glycol 4000 was given at a dosage of 0.7 g/kg and enema using normal saline 15ml/kg twelve hourly. Constipation was diagnosed using ROME IV criteria, and abdominal palpation identified fecal impaction. Efficacy was evaluated by clinical observation and adverse symptom monitoring. Data were analyzed by statistical software using an independent t-test (p<0,05). Results: Thirty-two children were randomized into the study. Muscle relaxant was discovered in 17/32 patients. Sex, age, and body weight were not statistically different between groups. The resolution of fecal impaction was significantly different between PEG 4000 and saline enema (21.69 hours and 39 hours respectively; p=0.001). Application of muscle relaxant and severity of the disease did not involve treatment efficacy. There was no adverse symptom reported during treatment. Conclusion: Polyethylene glycol 4000 results in fecal disimpaction faster than enema in constipated children with cerebral palsy.
ABSTRACT
Background: The objective of this study was to investigate the clinical manifestation of norovirus infection between norovirus genogroup and severity of acute diarrhea in pediatric patients at the Dr. Soetomo Hospital, Surabaya, Indonesia. Methods: This cross-sectional study involved 31 participants aged 1-60 months admitted to the hospital with acute diarrhea from April 2012 to March 2013. Norovirus genogroups (GI and II) were identified from patient stool using reverse transcription polymerase chain reaction (RT-PCR). Severity was measured using the Ruuska and Vesikari scoring system. Results: In total, 94 stool samples were obtained, of which 31 (19%) were norovirus positive. Norovirus GI was found in one sample with mild diarrhea. Norovirus GII was found in 30 samples (96.8%); one sample with mild diarrhea (3.3%), 20 samples with moderate diarrhea (66.7%), and nine samples with severe diarrhea (30%). Conclusion: Norovirus GII was the most prevalent cause of acute diarrhea and 30% of the cases manifested as severe diarrhea.
Subject(s)
Caliciviridae Infections , Norovirus , Caliciviridae Infections/complications , Caliciviridae Infections/diagnosis , Child , Child, Preschool , Cross-Sectional Studies , Diarrhea/etiology , Female , Humans , Indonesia , Infant , MaleABSTRACT
The purpose of this study was to investigate extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates from pediatric (aged 0 to 3 years) diarrhea patients in Surabaya, Indonesia, where this kind of survey is rare; our study included assessment of their antibiotic susceptibilities, as well as ESBL typing, multilocus sequence typing (MLST), and diarrheagenic E. coli (DEC)-typing. ESBL-producing E. coli were detected in 18.8% of all the samples. Many ESBL-producing E. coli had significantly lower susceptibility to gentamicin (p ï¼ 0.0001) and the quinolones nalidixic acid (pï¼0.004) and ciprofloxacin (p ï¼ 0.0001) than non-producers. In ESBL-producing E. coli, 84.0% of strains expressed CTX-M-15 alone or in combination with other ESBL types. MLST revealed that 24.0% of ESBL-producers had sequence type 617, all of which expressed the CTX-M-15 gene; we also detected expression of 3 DEC-related genes: 2 enteroaggregative E. coli genes and 1 enteropathogenic E. coli gene. In conclusion, CTX-M-15-type ESBL-producing E. coli ST617 appear to have spread to Indonesia.
