Kidney injury molecule type-1, interleukin-18, and insulin-like growth factor binding protein 7 levels in urine to predict acute kidney injury in pediatric sepsis.

Background: This study aimed to observe the role of urinary kidney injury molecule (KIM-1), interleukin (IL-18), and insulin-like growth factor-binding protein 7 (IGFBP-7) levels in predicting acute kidney injury (AKI) in children with sepsis. Material and Methods: This prospective cohort observational study was conducted at Dr. RSUP. Wahidin Sudirohusodo, Makassar, South Sulawesi, from January to December 2021. Inclusion criteria were septic patients treated in the pediatric intensive care unit (PICU) aged 1 month to 18 years with normal serum creatinine or normal urine output (>5 ml/kg/body weight (BW)/h in 6-12 h). Patients with a history of kidney disease, prior urinary tract infection, or history of using nephrotoxic drugs were excluded. Results: There was a significant difference in urinary KIM-1, IL-18, and IGFBP-7 levels between septic patients with and without AKI. The cut-off point for urinary KIM-1 level in sepsis with and without AKI was 1.666 ng/ml, with sensitivity of 82.5%, specificity of 82.2%, and a relative risk (RR) [95% confidence interval (CI)] of 6.866 (95% CI, 3.329-14.165). The cut-off point for urinary IL-18 levels was 3.868 ng/ml, with sensitivity of 92.50%, specificity of 91.78%, and RR of 20.078 (95%CI, 6.593-61.142). The cut-off point for urinary IGFBP-7 levels was ≥0.906 ng/ml with a sensitivity of 75.00%, specificity of 75.34%, and RR of 4.063 (95% CI, 2.206-7.483). Conclusion: Urinary KIM-1, IL-8, and IGFBP-7 levels could be used to predict AKI in septic patients. Urinary IL-8 has a higher sensitivity and specificity as a predictor of AKI in patients with sepsis.

Correlation between vitamin D deficiency and fasting blood glucose levels in obese children.

BACKGROUND: This study aimed to determine the relationship between Deficiency of vitamin D and hyperglycemia in children with obesity. METHODS: This cross-sectional study was carried out between February and April of 2020. This study's subject population consisted of high school students aged 11 to 17 who were obese. The 25 (OH) level of Vitamin D was determined using the Chemiluminescence Immune Assay method. Subjects were divided into 4 groups; vitamin D deficiency with hyperglycemia, vitamin D deficiency without hyperglycemia, normal vitamin D with hyperglycemia, and normal vitamin D without hyperglycemia. RESULTS: The prevalence of hyperglycemia was 28 (54.9%) in the vitamin D deficiency group and 17 (378%) in the normal vitamin D group, respectively. Statistical analysis revealed no statistically significant difference between the two groups (p = 0.093). With p = 0.031, there was a significant difference in the mean value of fasting blood sugar levels between the two groups. The frequency of hyperglycemia was 54.9 percent in the vitamin D deficiency group and 37.8 percent in the normal vitamin D group. Fasting blood sugar levels were lower in obese children with vitamin D deficiency than in children with normal vitamin D. CONCLUSION: Fasting blood sugar levels were correlated with vitamin D levels in obese children, but clinically insignificant. However, the research is ongoing, so, it is critical to conduct early screening for Vitamin D and fasting blood sugar levels in order to reduce the risk of metabolic and cardiovascular diseases.

Progesterone Receptor Expression and Score Differences in Determining Grade and Subtype of Meningioma.

Background Meningioma is the most common brain tumor in which therapy and monitoring depend on the histopathological grade (World Health Organization [WHO] Grade). Progesterone receptor (PR) expression was reported positive in meningothelial cells and meningiomas with various degrees of positivity. We evaluated PR expression to determine its correlation with WHO Grade and each subtype of meningioma. Materials and Methods This study used 70 samples of paraffin block that were diagnosed as meningioma and classified into WHO Grade I, II, and III. The paraffin blocks were sectioned in 5 µm thickness and immunohistochemically stained with the anti-PR antibody. Results PR expression was found positive in WHO Grade I and II groups, but negative in WHO Grade III group with the score of +2 found in clear cell and atypical subtype. These results were statistically significant with p -value < 0.05. Conclusion PR can be used as an additional marker to determine WHO Grade and subtype of meningioma.

Risk Factors and Nutritional Profiles Associated with Stunting in Children.

PURPOSE: To analyze risk factors and various nutrients associated with stunting among children aged 6-60 months. METHODS: This is a case-control and cross-sectional study between 40 stunting cases and 40 controls. Data on possible risk factors associated with stunting were obtained through direct interviews and using a questionnaire. Examination of vitamin D, zinc, albumin, and ferritin levels was performed on both groups. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Co., Armonk, NY, USA) to determine risk factors for stunting and to assess the relationship between nutritional levels and stunting. RESULTS: The incidence of stunting was highest in children aged 12-36 months. Children with low weight and very low weight for age comprised of 55% and 22.5%, respectively, of the study participants. The highest mother's educational level was junior high school (40%). History of low birth weight (LBW) was more commonly observed in the stunting group than that in the control group (25.0% and 7.5%, respectively; p=0.034, odds ratio, 0.310 [95% confidence interval, 0.122-0.789]). Approximately 7.5% of cases had premature birth. Exclusive breast feeding was found to be not correlated with stunting. The mean zinc level in the stunting group was 34.17 ng/mL, which was different from that in the control group (50.83 ng/mL) (p=0.023). Blood ferritin, vitamin D, albumin, and calcium levels were not strongly correlated with stunting. CONCLUSION: LBW is the main risk factor contributing to stunting and is strongly associated with low zinc level.