Background Sepsis is life-threatening organ dysfunction caused by a regulated immune response to infection. Sepsis remains the most common cause of death in infants and children worldwide. The Pediatric Logistic Organ Dysfunction (PELOD-2) score, one of the most widely used scoring systems in pediatric sepsis patients, has been shown to be accurate in predicting mortality. The platelet-to-lymphocyte ratio (PLR) is a new clinical indicator of inflammation in a variety of diseases including sepsis. Objective To investigate the relationship between PLR, PELOD-2 score, and clinical outcomes in pediatric patients with sepsis. Methods This retrospective cohort study was conducted in the Pediatric Intensive Care Unit (PICU), Prof R.D. Kandou Hospital, Manado, North Sulawesi, from February to August 2020. Subjects’ PELOD-2 score and PLR were recorded once within the first 24 hours of PICU admission. We analyzed patients’ PELOD-2 score, PLR, and mortality rate, with 95% confidence interval (CI) for each value. Results Of 96 children with sepsis admitted to the PICU during the study period, 87 patients (46 boys; 52.9%) met the inclusion criteria. In total, 50 (57.47%) patients were non-survivors. Mean PLR values among survivors [77.54 (SD 50.08)] was significantly lower compared to the values among non-survivors [157.13 (SD 67.38)]; as well as the PELOD-2 score in the survivors group [12 (SD 1.32)] was significantly lower than its value in the non-survivors [14.65 (SD 2.09)]. Spearman’s analysis showed a moderately positive correlation between PLR and PELOD-2 score (r=0.444; 95%CI 0.44 to 1; P<0.01). Biserial point correlation analysis revealed a significant association between PLR and mortality rate (rpb=0.566; P<0.0001),with elevated PLR related to an increased risk of mortality. Conclusion There are positive correlations between PLR, PELOD-2 score, and mortality rate in pediatric patients with sepsis. Higher PLR and PELOD-2 score are associated with higher mortality.

Background Children with language delay have deficits in the ability to learn and use language, either expressive and/or receptive despite otherwise normal development. Language delay could be influenced by either internal factors (within the child) and external factors (from the environment). Timely identification and modification of these risk factors can allow early intervention to reduce child disability and are associated with better long-term outcomes. Objective To identify possible risk factors related to language delay in children, such as bilingualism, socioeconomic status, maternal and caregiver education level, use of digital media, absence of story reading sessions, breastfeeding patterns, siblings, parenting methods, and maternal occupation. Methods This observational, analytic study included 102 children aged 24-36 months from four daycare centers in Manado, North Sulawesi, selected by cluster random sampling. Parents were interviewed to gather demographic information of child age, gender, presence of older siblings, maternal occupation, socioeconomic status, maternal/caregiver educational level, use of digital media, absence of story reading sessions, breastfeeding patterns, parenting methods, and bilingual environment. Children’s language development was assessed by the Capute Scales. Results Multivariate analysis revealed 2 factors significantly associated with increased risk of language delay; namely absence of storybook reading (OR=0.16; 95%CI 0.03 to 0.72; P=0.017) and bilingualism (OR=12.58; 95%CI 1.57 to 100.81; P=0.017). Conclusion Story reading sessions is associated with decreased risk of language delay, shile bilingualism is associatd with increased risk of language delay.

Amelioration of obesity-related metabolic disorders via supplementation of Caulerpa lentillifera in rats fed with a high-fat and high-cholesterol diet.

Objectives School readiness is an overall condition of someone which makes him/her ready to give response or answer in a certain way to various situations. This study aims to determine the factors related to school readiness. Methods This is an analytic observational study with cross-sectional design, conducted at 4 elementary schools in Malalayang district, Manado, Indonesia between August – November 2018 (n=150). The significant value used is p <0.01. Data wasanalyzed using SPSS for Windows version 23. Results Of 150 subjects there were 109 children who were ready for school and 41 children who were not ready for school. Of the five factors studied, it was found that stunted affected school readiness (OR 21.6; 95% CI: 6.68-70.32, p<0.000), maternal education status affected school readiness (OR 4.1; 95% CI: 1.75-9.63, p<0.001), socio-economic status affects school readiness (OR 5.1; 95% CI: 2.35-11.11, p<0.000), and preschool affect school readiness (OR 6.8; 95% CI: 3.1-14.9, p<0.0001). In multivariate analysis, there were three factors that had an association with school readiness, namely height, preschool participation and socioeconomic status (OR 34.4; 95% CI: 7.19-166.6, p<0.001, OR 6.5; 95% CI: 2.28-18.55 p<0.0001, OR 4.8l; 95% CI: 1.59-14.92 respectively). Conclusion There were associations between height, maternal education status, socio-economic status and participation in preschool with school readiness. There was no association observed between the employment status of mothers and school readiness. Height of the children was strongly associated with school readiness.

Objectives Neonatal sepsis is a major contributor to morbidity and mortality worldwide. Although blood culture is the gold standard of sepsis diagnosis, it often lacks sensitivity and diagnostic speed. Platelet-to-lymphocyte ratio (PLR) is a widely available, effective, simple, and affordable marker that can predict early onset neonatal sepsis (EONS). Objective To assess the correlation between PLR and EONS as well as the diagnostic value of PLR for predicting EONS. Methods This study included all inpatient neonates with suspected early-onset neonatal sepsis at Dr. R. D. Kandou Hospital, Manado, North Sulawesi, Indonesia. Neonates were categorized into sepsis (confirmed by positive blood culture results) and non-sepsis (negative blood culture results) groups. Bivariate analysis, including the chi-square test for categorical data and independent t-test for numerical data, was performed to identify any significant associations between the platelet-to-lymphocyte ratio (PLR) and EONS. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were calculated to determine the optimal PLR cut-off point to predict EONS. Results In this study, we investigated the relationship between PLR and early-onset neonatal sepsis (EONS) in 176 neonates with suspected EONS. Blood cultures confirmed sepsis in 84 neonates (47.7%), with Klebsiella pneumoniae being the most common causative organism. We found a significant positive correlation between PLR and EONS (p<0.001), and a PLR cut-off point of 61.806 was identified to predict EONS with high sensitivity (90.2%) and specificity (85.7%) Conclusion Our study demonstrates a strong positive correlation between PLR and EONS, and a PLR cut-off point of 61.806 can be used as a valuable marker for predicting EONS in neonates with suspected sepsis. These findings could aid in the early identification and treatment of neonates with sepsis, ultimately improving patient outcomes.