Introduction: Diarrhea is still a public health problem in developing countries, including Indonesia, because of its high morbidity and mortality. Breast milk is one of the important factors to reduce mortality and morbidity due to diarrhea. The aim of this study was to determine the relationship of exclusive breastfeeding to the occurrence of acute diarrhea. This research is analytic research with cross sectional method. Method: The study was carried out in Community Health Centre III Subdistrict of North Denpasar from October to November 2018. The research subjects were taken by consecutive sampling. Data analysis used the prevalence ratio calculation and chi square test to determine the relationship between exclusive breastfeeding and the incidence of diarrhea. Result: In this study the results of acute diarrhea patients in the exclusive breastfeeding group were 17 children and non-exclusive breastfeeding as many as 31 children. Subjects who did not experience acute diarrhea in the excluded breastfeeding group were 28 children and in the non-exclusive breastfeeding group as many as 14 children. The results of statistical analysis showed the value of p=0.003 (p<0.05) PR=0.514 CI 95% (0.115-0.656). Conclusion: Exclusive breastfeeding has a significant relationship with the incidence of acute diarrhea and is a protective factor for the incidence of diarrhea.
Background: Cholelithiasis in children is uncommon and challenging to diagnose because the patient is often asymptomatic and the clinical feature doesn't clearly depict cholelithiasis or cholecystitis. This case study aims to describe a rare case of cholelithiasis with chronic cholecystitis in a ten-year-old boy.Case Presentation: A ten-year-old boy presented with umbilical pain, nausea, and emesis. Physical examination showed there is no tenderness in all abdominal quadrants with a negative Murphy sign. Laboratory results revealed elevated white blood cell count 20.42x103/?L, elevated erythrocyte sedimentation rate 47.2 mm/hour, normal liver function tests, urine, and stool analysis. He underwent transabdominal ultrasound twice. The latest transabdominal ultrasound showed cholelithiasis, free fluid around the pelvic region due to suspected visceral organ perforation. Laparoscopic cholecystectomy was performed without complication. The result of pathology anatomy examination was chronic cholecystitis. The patient was discharged 3 days after surgery in good condition. The long-term prognosis of the patient was good.Conclusion: Even though the patient is male with good nutritional status (not obese), the patient was in the mean age that was identified as a key contributor to this disease. Ultrasonography examination is a screening modality that is still an excellent diagnostic tool with 95% accuracy even though it is highly operator dependent. Laparoscopic cholecystectomy is a gold standard for management even in children with decreased pain and shorter lengths of stay in the hospital.
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