Prevention of Dengue Hemorrhagic Fever (DHF) by Planting Lemongrass at SMK 17 Agustus 1945 Surabaya

Dengue Hemorrhagic Fever (DHF) is a disease caused by the dengue virus which is transmitted through the bite of the Aedes aegypti and Aedes albopictus mosquitoes. Dengue Hemorrhagic Fever (DHF) is caused by the dengue virus and is transmitted by the Aedes aegypti mosquito, which is characterized by a sudden fever of two to seven days without a clear cause, weakness or lethargy, restlessness, heartburn accompanied by signs of bleeding on the skin in the form of bleeding spots, bruising or rashes. sometimes nosebleeds, bloody stools, vomiting blood, decreased consciousness or shock. This PKM aims to provide detailed information about DHF and how to prevent DHF using lemon grass. After participating in this lesson, participants are expected to be able to understand what dengue is, the benefits of lemongrass and know how to plant lemongrass in their neighborhood. The method used in this research is to conduct counseling and distribute pretest and posttest. The results show that this community service program can increase students' knowledge by 64.3% related to the dangers of dengue fever, the benefits of lemongrass as a mosquito repellent plant and how to plant lemongrass correctly.

Professor Renting Li’s Combination of Internal and External Treatment of Traditional Chinese Medicine in Treating Radiation Enteritis

Radiotherapy is a common treatment for abdominal and pelvic malignancies with bone metastases. However, some patients develop radiation enteritis (RE) during the treatment or 2 months or more after the treatment, which seriously affects their quality of life. At present, the curative effect of western medicine is poor. Professor Renting Li believes that radiation kills tumor cells but at the same time, it damages the healthy Qi of the human body. Radiation causes heat and poison to accumulate in the intestinal tract, consumes and hurts Yin fluid, burns the vein, leads to deficiency of healthy Qi and poor detoxification, as well as cause blood stasis after a period of time. All these result in the combination of heat, blood stasis, and poison, manifesting as abdominal pain, diarrhea, mucus in stools, purulent and bloody stools, etc. Therefore, Professor Renting Li proposed the use of traditional Chinese medicine retention enema combined with oral traditional Chinese medicine to reduce symptoms, remove toxins, and improve the quality of life of patients.

Newborns with Bloody Stools—At the Crossroad between Efficient Management of Necrotizing Enterocolitis and Antibiotic Stewardship

The onset of bloody stools in neonates often results in antibiotic treatment for suspected necrotizing enterocolitis (NEC). Food protein-induced allergic proctocolitis (FPIAP) is an often-neglected differential diagnosis. We performed a retrospective analysis of antibiotic exposure at our tertiary center from 2011 to 2020 that included three time periods of differing antimicrobial stewardship goals. We compared these data with the conventional treatment guidelines (modified Bell’s criteria). In our cohort of 102 neonates with bloody stools, the length of antibiotic exposure was significantly reduced from a median of 4 to 2 days. The proportion of treated neonates decreased from 100% to 55% without an increase in negative outcomes. There were 434 antibiotic days. Following a management strategy according to modified Bell’s criteria would have led to at least 780 antibiotic days. The delayed initiation of antibiotic treatment was observed in 7 of 102 cases (6.9%). No proven NEC case was missed. Mortality was 3.9%. In conclusion, with FPIAP as a differential diagnosis of NEC, an observational management strategy in neonates with bloody stools that present in a good clinical condition seems to be justified. This may lead to a significant reduction of antibiotic exposure. Further prospective, randomized trials are needed to prove the safety of this observational approach.

Idiopathic mesenteric phlebosclerosis (IMP) with sepsis and death: a case study

Idiopathic mesenteric phlebosclerosis (IMP) is a rare clinical manifestation of ischemic enteropathy. There are no specific manifestations in the early stages. Digestive symptoms only present in the advanced stage. Diagnosis relies on extensive calcification of the mesenteric venule and extensive intestinal wall thickening via computed tomography (CT) scanning. A 50 years old Chinese woman who had taken herbal medicine for three years was diagnosed with IMP. All treatment after admission was in vain and she died 30 days thereafter. Therefore, when a patient with long-term oral intake of herbal medicine, which contains geniposde, presents with unknown ischemia, abdominal pain, mucinous stools, bloody stools, attention should be paid to screen IMP.

Impact of diagnostic delay to the clinical presentation and associated factors in pediatric inflammatory bowel disease: a retrospective study

Background Undelayed diagnosis is thought to be a major determinant for good prognosis in pediatric inflammatory bowel disease (PIBD). However, factors predicting diagnostic delay and the consequences of this remain poorly defined. We investigated these issues in a well-defined cohort of PIBD patients. Methods Comprehensive electronic data were collected from 136 PIBD patients retrospectively. Diagnostic delay was further classified into < 6 and ≥ 6 months, and < 12 and ≥ 12 months. Logistic regression was used to calculate whether the delay was associated with clinical features and/or risk of complications and co-morbidities at diagnosis. Results The median age of patients was 12.4 years and 43.4% were females. Altogether 35.5% had Crohn´s disease (CD), 59.1% ulcerative colitis (UC) and 6.6% IBD undefined (IBD-U). The median delay before diagnosis was 5.0 months in all, 6.6 months in CD, 4.1 months in UC, and 9.8 months in IBD-U (UC vs. CD, p = 0.010). In all but IBD-U most of the delay occurred before tertiary center referral. Abdominal pain predicted a delay > 6 months in all PIBD (OR 2.07, 95% CI 1.00–4.31) and in UC patients (3.15, 1.14–8.7), while bloody stools predicted a shorter delay in all PIBD (0.28, 0.14–0.59) patients and in CD (0.10, 0.03–0.41) patients. A delay > 6 months was associated with a higher frequency of complications (2.28, 1.01–5.19). Conclusions Delay occurred mostly before specialist consultation, was longer in children presenting with abdominal pain and in CD and was associated with risk of complications. These findings emphasize the roles of active case-finding and prompt diagnostic evaluations.

Non-allergic benign infantile proctocolitis: a neglected nosographic entity

The presence of rectal bleeding in the first months of life is very often diagnosed as food protein-induced allergic proctocolitis (FPIAP). The symptoms typically start in infancy, and most cases resolve by age 12 months. Infants with FPIAP usually present bloody stools mixed with mucus, with or without reduced stool consistency. Most affected infants are generally healthy-appearing. We used the story of an infant with rectal bleeding as a reminder that there is also the possibility of a form of benign non-allergic proctocolitis that is not usually included in the differential diagnosis. In the absence of warning signs and in case of infant well-being, it should be the first clinical entity to suspect. Therefore, we suggest we should wait at least 2 months before starting to eliminate cow milk or other foods from the diet.

Enteric illness outbreaks reported through the National Outbreak Reporting System, United States, 2009–19

Background The National Outbreak Reporting System (NORS) captures data on foodborne, waterborne, and enteric illness outbreaks in the United States. The aim of this study is to describe enteric illness outbreaks reported during 11 years of surveillance. Methods We extracted finalized reports from NORS for outbreaks occurring during 2009–2019. Outbreaks were included if they were caused by an enteric etiology or if any patients reported diarrhea, vomiting, bloody stools, or unspecified acute gastroenteritis. Results A total of 38,395 outbreaks met inclusion criteria, increasing from 1,932 in 2009 to 3,889 in 2019. Outbreaks were most commonly transmitted through person-to-person contact (n=23,812, 62%) and contaminated food (n=9,234, 24%). Norovirus was the most commonly reported etiology, reported in 22,820 (59%) outbreaks, followed by Salmonella (n=2,449, 6%) and Shigella (n=1,171, 3%). Norovirus outbreaks were significantly larger, with a median of 22 illnesses per outbreak, than outbreaks caused by the other most common outbreak etiologies (p&lt;0.0001, all comparisons). Hospitalization rates were higher in outbreaks caused by Salmonella and E. coli outbreaks (20.9% and 22.8%, respectively) than those caused by norovirus (2%). The case fatality rate was highest in E. coli outbreaks (0.5%) and lowest in Shigella and Campylobacter outbreaks (0.02%). Conclusions Norovirus caused the most outbreaks and outbreak-associated illness, hospitalizations, and deaths. However, persons in E. coli and Salmonella outbreaks were more likely to be hospitalized or die. Outbreak surveillance through NORS provides the relative contributions of each mode of transmission and etiology for reported enteric illness outbreaks, which can guide targeted interventions.

Sphacelation with auto-anastomosis of the intestine: a rare outcome of intussusception in a child—a case report

Background Intussusception is the telescoping of a proximal segment of the bowel into a distal segment. It can be idiopathic or pathological. Children commonly present with colicky abdominal pain, vomiting, a palpable abdominal mass, and bloody stools. Our case describes the unusual presentation of bowel sphacelation with auto-anastomosis in a child with intussusception and its clinical progression. Case presentation A 3-year-old boy with underlying stage IV rhabdomyosarcoma of the left orbit presented with high-grade fever and diarrhea for 1 day. He was treated for neutropenic sepsis in view of low absolute neutrophil count and recent history of chemotherapy. During his admission, he developed abdominal distension, high bilious aspirates, and diarrhea with bloody stools. Abdominal X-ray showed dilated bowel loops. Impression was septic ileus with coagulopathy. He was treated with blood transfusion and bowel rest. On the 6th day of illness, he passed out a tubular structure per rectum which was confirmed to be a segment of gangrenous bowel by histopathological examination. A diagnosis of intussusception with bowel sphacelation was made. He was treated conservatively, and his obstruction was resolved. He was discharged well with no abdominal symptoms during follow-up. Conclusion Intussusception is a common cause of small bowel obstruction in children. A high index of suspicion of intussusception should be maintained in children presenting with vomiting and bloody stools complemented by ultrasound to avoid missing this diagnosis. Sphacelation of the intussuscepted bowel with auto-anastomosis is a rare presentation of intussusception with a favorable outcome.