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All Journal Indonesian Journal of Medicine Journal of Maternal and Child Health
Nugroho, Irfan Dzakir
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Medicine & Pharmacology Public Health

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Comparison Neutrophil to Lymphocyte Count Ratio with C-Reactive Protein as a Predictor for Neonatal Sepsis Nugroho, Irfan Dzakir; Hidayah, Dwi; Salimo, Harsono
Indonesian Journal of Medicine Vol 6, No 2 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Accurate early detection of bacteriemia plays an important role in the treatment and prognosis of infected neonates, but is constrained by the limitations of spe­cific sepsis markers for detecting bacteriemia. NLCR or neutrophil to lymphocyte count ratio in adult population shows a more sen­sitive parameter in predicting infection and has the advantage of being economical and widely available. The role of NLCR in the neonatal population has not been widely studied. The purpose of this study was to analyze NLCR versus CRP as a predictor of neonatal sepsis.Subjects and Method: This study take ana­lytic observatinal with diagnostic test approach to subject with sepsis risk factor and neonatal sepsis at dr. Moewardi hospital from April until May 2017. Characteristics data as gestational age, gender, birth weight, IT ratio, leucocyte count, neutrophil and lym­phocyte count, NLCR, CRP and blood culture. Data presented descriptively and statistical analysis was performed.Results: No significant correlation between subject’s characteristics and neonatal sepsis. NLCR with cutoff point for 2.22 has sensi­ti­vity, specificity, positive and negative pre­dictive value for 87.5%, 75%, 70% and 90%, respec­ti­vely. CRP with cutoff point for 0.25 has sensi­tivity, specificity, positive and nega­tive predic­tive value for 83.3%, 55.6%, 55.6% and 83.3% respectively. While IT-rasio has sensitivity, spe­cificity, positive and negative predictive value for 29.2%, 91.7%, 70% and 66%, respectively.Conclusion: NLCR has a satisfactory pre­dictive value for neonatal sepsis that widely available and economic predictor alternative with cutoff point for 2.22.Keywords: NLCR, CRP, predictor, neonatal sepsisCorrespondence: Irfan Dzakir Nugroho. Masters Program in Family Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java.Indonesian Journal of Medicine (2021), 06(01): 112-118https://doi.org/10.26911/theijmed.2021.06.02.02 
Neutrophil-Lymphocyte Ratio as a Diagnosis Predictor in Pediatric COVID-19 Patients at Dr. OEN Kandang Sapi Hospital, Surakarta, Central Java, Indonesia Retno Edi, Dyah Wulaningsih; Nugroho, Irfan Dzakir
Journal of Maternal and Child Health Vol. 6 No. 6 (2021)
Publisher : Journal of Maternal and Child Health

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Background: COVID-19 is a global pandemic and affects all ages, even newborns. Until March 2021, there were 127 million cases of COVID-19 worldwide. In Indonesia, there were almost 1.5 million cases. The main symptoms of COVID-19 are fever and cough, simple laboratory tests such as measuring the neutrophil-lymphocyte ratio (NLR) are also included in the EWS (early warning score) so that they can be used to diagnose COVID-19 with a cut-off limit value of 3.13. The purpose of this study was to determine the value of NLR as a predictor of diagnosis in pediatric patients confirmed by RT-PCR Swab examination at Dr. Oen Kandang Sapi Hospital, Solo, Surakarta.Subjects and Method: A diagnostic test study that assessed the sensitivity, specificity, negative predictive value and positive predictive value of the NLR value as a predictor of COVID-19 diagnosis in pediatric patients confirmed by RT-PCR Swab examination at the time level of March 2020 - March 2021. Data were taken from electronic medical records of inpatients and sampling was done by consecutive admission sampling.Results: A total of 153 study subjects with 34 PCR (+) patients and 119 PCR (-) patients. The characteristics of the study sample were seen from gender, age, symptoms, chest x-ray and patient outcomes. The NLR cutoff limit value for pediatric COVID-19 patients is 1,625 with an AUC (area under curve) of 0.504. The NLR value of 1.625 has a sensitivity of 0.588 (58.8%) and a specificity of 0.513 (51.3%). The PPV (positive predictive value) was 0.256 (25.6%), the NPV (negative predictive value) was 0.813 (81.3%), the PPR (positive predictive ratio) was 1.207 and the NPR (negative predictive ratio) result was 0.803.Conclusion: The NLR cutoff value of 1,625 with a sensitivity of 58.8% cannot be used as a predictor of COVID-19 diagnosis in pediatric patients at Dr. Oen Kandang Sapi Hospital, Solo, Surakarta.Keywords: COVID-19, children, pediatrics, diagnostic lab, NLR, neutrophil to lymphocyte ratioCorrespondence:
Co-Authors Dwi Hidayah Dyah Wulaningsih Retno Edi, Dyah Wulaningsih Harsono Salimo