Urinary tract infection (UTI) is one of the most common bacterial infections affecting children. Early recognition and prompt treatment of UTIs are important to prevent progression of infections and to avoid late sequeale. The aim of the study was to identify the bacterial agents of urinary tract infections in children and to study sensitivity to antibiotics. Urinary specimens were collected from children suffering from urinary tract infections, who were either inpatients or outpatients between January 1999 and December 2003. Of a total of 563 urine specimens, bacteriuria was found in 276 (49.02%) of patients. Females showed a higher prevalence of infection (51.1%) than males (48.9%). Mean age was 63 months, median age was 60 months (range 1 month to 12 years). The microorganisms isolated from children included Escherichia coli (48.9%), Acinetobacter anitratus (9.8%), Klebsiella pneumoniae (9.4%), Staphylococcus positive coagulase (5.8%), Proteus mirabilis (4.7%), others (21.4%). Escherichia coli was sensitive to nitrofurantoin (74.8%), nalidixic acid (69.6%), cefotaksim (48.9%), Amoxcillin clavulanat acid (37.8%), fosfomicin (35.6%), gentamicin (34.1%), ceftriaxone (31.8%), amikacin (19.2%), cotrimoxazole (15.6%), ciprofloxacin (11.1%), cefuroxim (3.7%), netilmicin (8.9%), amoxcilin (2.9%), chloramphenicol (2.2%), ampicilin (2.2%). Resistant to ampicillin dan chloramphenicol 97.8%. Acinetobacter anitratus sensitive to nalidixic acid (62.96%), Amoxcillin clavulanat acid (48.15%), gentamicin (40.74%), co-trimoxazole (33.33%), nitrofurantoin (25.93%), amoxcilin (25.93%), amikacin (11.11%), netilmycine (11.11%), ampicillin (7.40%), ciprofloxacin (7.40%), cefotaxim (7.4%), ceftriaxon (7.4%), cefuroxim (3.7%). Resistant to chloramphenicol dan fosfomicin 100%. Klebsiella pneumoniae sensitive to netilmicin (73.08%), nalidixic acid (69.23%), nitrofurantoin (46.12%), gentamicin (30.77%), ceftriaxon (26.92%), Amoxcillin clavulanat acid (26.92%), cefotaxim (25.07%), amikacin (23.07%), co-trimoxazole (23.07%), ciprofloxacin (23.07%), fosfomicin (19.23%), cefuroxim (3.85%), amoxicilin (1.35%). Resistant to chloramphenicol dan ampicilin 100%. Escherichia coli was responsible for 48.9% of all infections and sensitve to nitrofurantoin, nalidixic acid, cefotaxim and amoxicillin-clavuanat, but resistant to ampicillin and chloramphenicol.Keywords: Urinary Tract Infection, bacterial agents, sensitivity to antibiotics PENDAHULUAN Infeksi Saluran Kemih (ISK) adalah infeksi yang ditandai dengan pertumbuhan dan perkembang biakan bakteri dalam saluran kemih, meliputi infeksi di parenkim ginjal sampai kandung kemih dengan jumlah bakteriuria yang bermakna (1,2,3).Penyakit ISK merupakan masalah kesehatan masyarakat di Indonesia yang perlu mendapatkan perhatian yang serius. Diperkirakan 8% anak wanita dan 2% anak laki-laki pernah mengalami ISK pada masa kanak-kanaknya (4). Insidens ISK belum diketahui dengan pasti. Swedia melaporkan pada tahun 1999 didapatkan 2,2% pada anak laki-laki dan 2,1% pada anak wanita pada usia 2 tahun, dan ...

Nephrotic syndrome (NS) in children is a common recurrent disease. Most of the cases are due to minimal change disease with a favorable outcome. The mayority of children have minimal change disease and 90 -95% will respond to steroid therapy. Response to steroid therapy carries a greater prognostic weight than the histologic features. The aim of the study was to describe the outcome of Nephrotic Syndrome in children and to determine risk factors for these complications. Children with NS were admitted to Pediatric Department Saiful Anwar Hospital Malang, January 2000 -December 2003 evaluated prospectively for one year. Data was sought on steroid responsiveness, remission, relapse rates, infection, and trombosis. Patients were classified into five categories. Including: relapse, infrequent relapsing (IFRNS), frequent relapsing (FRNS), steroid dependent (SDNS) and steroid resistant (SRNS). Baseline age, gender, clinical manifestation and laboratory finding were used to predict category of the disease. Definition of NS, remission and relapse were based on the ISKDC guidelines. Of 91 children with NS, 75 (82,4%) children had steroid sensitive nephrotic syndrome (SSNS) while 16 (17,6%) children were classified SRNS. In the SSNS group 42 (56%) of children were over 6 years of age and there were 51 (68%) males and 24 (32%) females. SRNS children had a significantly proportion of females 62,5% compared to males. Age, hypertension, oedem and laboratory finding were not significantly different between SSNS and SRNS group. The median time to remission in all categories of SSNS children was 15 days (range 5-27), 32 (35,2%) of children were in remission by one week, 48,4% by >1-3 weeks and 16,5% by >3 weeks. Relapses occurred in 60 (65,9%) patients , the median time to relapse was 22 weeks (range 1-50). 35 (31,9%) children were classified as IFRNS, 17,6% FRNS and 16,5% SDNS. The proportion of females varied significantly across all categories with the lowest proportions in the FRNS and SDNS categories. Median time to relapse was significantly (p < 0,05) lowest in SDNS categories. 31(34,1%) children from all categories developed infection. 5,4 % with pneumonia and 28,6% with urinary tract infection. Trombosis complication did not occur in any patient. 1 (1,09%) patients from SRNS category had developed chronic renal failure at one year follow up. SSNS remains the most common of NS with males more likely to have steroid sensitive disease. 35,2% of children responding to steroid remission occurred within one week. Time to relapse but not time to remission was found to be a reasonably accurate predictor of NS.Keywords: Nephrotic syndrome, steroid sensitive nephrotic syndrome (SSNS), relapse, steroid dependent Nephrotic syndrome (SDNS) PENDAHULUANSindrom nefrotik (SN) adalah suatu sindrom klinik dengan gejala : 1. Proteinuria masif (≥ 40 mg/m 2 LPB/ jam atau rasio protein/kreatinin pada urin sewaktu > 2 mg/mg atau ≥ 2+ ) 2. Hipoalbuminemia ≤ 2,5 g/dL 3. Edema 4. Hiperkolesterolemia (> 250 mg/dL) Walapun jarang, SN sering p...

Objectives Inflammatory bowel disease (IBD) is a medical condition that represents a pathological form of inflammation, causing damage to the colonic mucosa. Adjunctive vitamin D therapy may activate the Wnt/β-catenin pathway that results in cell differentiation and proliferation via stem cell signalling. This study aims to evaluate the effect of vitamin D on β-catenin and cytokeratin 20 (KRT20) as markers of Wnt pathway activation for colonic cell repair. Methods For the experiment, we used 30 musculus mice strains of BALB/c, which were categorised into five groups; the control group (K−) and four other groups, where colitis was induced by dextran sulphate sodium (DSS) for seven days. On the seventh day, the remaining three groups were administered vitamin D with an initial dose of 0.2 μg/25.0 g, 0.4 μg/25.0 g and 0.6 μg/25.0 g until day 14. An objective index of disease activity and a histological score were required as markers of inflammation to evaluate the results of the clinical trials. Results β-catenin and KRT20 showed a significant increase in the proliferation index of vitamin D at a dose of 0.6 μg/25.0 g (91.50 ± 4.09 and 48.75 ± 2.28, respectively; p < 0.05) compared to the colitis group. Conclusions This study demonstrates that vitamin D could be used as an induction agent of Wnt activation for healing colonic mucosa via multipotent stem cells.

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Febrile seizures are the most-common form of seizures in children with fever and evidence from clinical and experimental studies suggests the potential role of immune generated products in their genesis. The balance between pro-inflammatory (IL-1β) and anti-inflammatory (IL-10) cytokines influences the regulation of infections and plays a role in the pathogenesis of febrile seizures. In existing literature, there is no research into the correlation between IL-1β and IL-10 levels as well as ratio of IL-1β to IL-10 in estimating the risk of febrile seizures in seizure-prone children aged 3 months to 5 years. In this study, IL-1β, IL-10 levels and ratio of IL-1β to IL-10 in the risk of febrile seizures were investigated, and respondents were divided into 3 groups, febrile seizures, febrile without seizures and healthy children without histories of febrile seizure. A cross-sectional design was used and each group had 17 co-respondents. Levels of IL-1β and IL-10 were measured using ELISA. Data were analyzed by SPSS 15. Findings showed there were significant differences between IL-1β and IL-10 as well in the ratio of IL-1β to IL-10 between febrile seizures patients and healthy children. It was concluded that there were significant correlations between IL-1β and IL-10 levels as well as IL-1β to IL-10 ratios in estimating the risk of febrile seizures.