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Journal : JOURNAL LA MEDIHEALTICO

Diagnostic Comparison of Elevated Fecal Leukocytes and sTREM-1 in Children with Acute Diarrhea Caused by Bacterial Infection Yudiyanto, Ade Rachmat; Firmansyah, Agus; Karyanti, Mulya Rahma
Journal La Medihealtico Vol. 6 No. 3 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i3.2153

Abstract

Diarrhea is a health problem that most often occurs in children. Various etiologies of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. The study aims to know how much the diagnostic value of fecal leukocytes test compared to sTREM-1. A cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Children, aged 6-60 months with acute diarrhea due to bacterial infections with sTREM-1 > 470 pg/mL as many as 2 of 64 subjects and fecal leukocytes > 10/HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0.63. Fecal leukocyte test > 10/HPF as a diagnostic confirmation is not good in diagnosing acute diarrhea due to bacterial infection.
Effectiveness of Omeprazole Compared to Placebo for Recurrent Abdominal Pain in Adolescents: A Randomized Controlled Clinical Trial Yudiyanto, Ade Rachmat
Journal La Medihealtico Vol. 6 No. 4 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i4.2415

Abstract

Recurrent abdominal pain (RAP) is a common somatic complaint in adolescents, contributing to significant morbidity, impaired quality of life, and frequent school absenteeism. Although often functional in origin, proton pump inhibitors (PPIs), particularly omeprazole, are frequently prescribed under the assumption of acid-related pathology. However, clinical evidence supporting this practice in adolescents remains limited. This study aimed to evaluate the efficacy of omeprazole compared with placebo in reducing pain frequency, duration, and intensity in adolescents with RAP. A prospective, randomized, single-blind, placebo-controlled trial was conducted from August to November 2009 involving 123 adolescents aged 11–14 years who met Apley’s criteria for RAP. Participants were recruited from six junior high schools and randomized into two groups: omeprazole 20 mg once daily (n=59) or placebo (n=64), administered for 14 days. Primary outcomes included pain frequency (episodes/month), pain duration (minutes/episode), and intensity (Wong-Baker FACES Pain Scale). Assessments were performed at baseline and monthly for three months post-intervention. Results showed no significant differences between groups in pain duration or intensity (p > 0.05). Although a significant reduction in pain frequency was initially observed with omeprazole, further analysis revealed baseline imbalances, preventing attribution of this effect to the drug. Both groups demonstrated clinical improvement, reflecting a strong placebo response. In conclusion, omeprazole 20 mg daily for 14 days did not demonstrate superiority over placebo in reducing RAP frequency, duration, or intensity. These findings do not support routine empirical use of omeprazole for undifferentiated functional RAP in adolescents.