AIM: Although absolute values for C-reactive protein (CRP) and procalcitonin (PCT) are well known to predict sepsis, it remains unclear how their diagnostic value in major burn patients as metabolic changes in burn patient mimic signs and symptoms for sepsis. This paper attempts to clarify these points for both of the markers. METHODS: A comprehensive literature search of PubMed, Scopus, DOAJ, Web of Science, and the Cochrane Library databases for studies published up to June 1, 2020, that evaluated PCT and/or CRP as a marker for diagnosing sepsis in burn patients was conducted. Review Manager 5.3 was used to analyze the data. RESULTS: A total of 11 literatures were obtained. The combined sensitivity and specificity for PCT as assessed by meta-analysis were 88% and 89%, respectively. The combined sensitivity and specificity of CRP were described as 85.5% and 57.5%, respectively. Meta-analysis cannot be performed for CRP parameters because there are only two literatures that include CRP diagnostic test values. DISCUSSION: PCT and CRP have additional diagnostic value for sepsis in patients with major burns. The pooled sensitivity and specificity of PCT are excellent. Although the difference in sensitivity between PCT and CRP is not very large, there are distinct differences in specificity. A low CRP specificity value will show many “false positives” when CRP is used as a biomarker. CONCLUSION: PCT provides a better diagnostic value than CRP in cases of sepsis in major burn patients. More study on combination of biomarker, clinical presentation, and microbial culture for diagnosing sepsis are needed. Further large-scale research with cohort or case control design should be done.

Background: Colorectal cancer is one of the most common cancer in Indonesia. The etiology of colorectal cancer is still unknown, but many risk factors believed may causing colorectal cancer, one of them is fiber intake of foods consumed every day like vegetables, fruits, and peanuts. There is an instrument that can be used to assess fiber intake per day. Aim: The study aimed to know how the correlation between fiber intake and colorectal cancer patient are in Sanglah General Hospital. Method: The design is a case-control analytic study, obtained total of 104 samples that divided into case group (52 samples) and control group (52 samples), in which secondary data with medical record data and also primary data with questionnaire are collected. Data were analyzed using the SPSS program. Result: Of the 104 samples that divided into case group and control group with 1:1 ratio, patients who diagnosed with colorectal cancer had a history of low fiber intake higher 6.75 times than peoples who not diagnosed with colorectal cancer (OR=6.75; 95% CI 2.85-15.96; P<0.001). Conclusion: Patients who diagnosed with colorectal cancer had a history of low fiber intake per day higher 6.75 times than samples which did not diagnose with colorectal cancer.

Pediatric reconstruction of the cranial defect is a challenging task, the standard reconstruction method has been bone grafting. The reconstruction of complex facial defects should satisfy both aesthetic and functional requirements. In the case of large defects, the use of craniofacial prostheses using autogenous bone is the material of choice because of its potential for revascularization and its osteoconductive properties. A 3-year-old patient has facial disfgurement as result from bone defciency following anterior skull base tumour resection. To minimize the associated functional and cosmetic problems, a number  of reconstructive options are available to the surgeon including the use of autogenous and alloplastic implants. A computed tomography (CT) 3-dimensional reconstruction scan showed a large craniofacial defect as residual radical skull base tumour resection. A transcranial approach by a neurosurgeon and plastic surgery was performed to reconstruct the defect using autologous rib bone graft. Six months after the reconstruction surgery, a defect of the craniofacial was narrowing without cranial nerve defcits.Complex reconstructions of extensive defects in craniofacial area can be achieved using autologous bone grafts. They yield reasonable functional and aesthetic outcomes and noticeably improves the qualityof life.