The Association between Obesity and Severity of Dengue Hemorrhagic Fever in Children at Wangaya General Hospital

BACKGROUND: Dengue is a mosquito-borne disease caused by any one of four closely related Dengue virus (DENV 1-4). The clinical sign Dengue virus infection can vary from mild (mild febrile illness), Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) to Dengue Hemorrhagic Fever with shock (Dengue Shock Syndrome, DSS). AIM: This study was designed to determine the relationship of obesity with the severity of Dengue Hemorrhagic Fever in children. METHODS: It is a case-control study. The data of patients were retrospectively collected from the Department of Child Health at the Wangaya General Hospital between March 2019 to May 2019. It uses consecutive sampling. The total sample of 22 children with DHF with shock and 22 children with DHF without shock were investigated. Statistical analysis has been performed by SPSS Statistics 20.0 for Mac (IBM Corp., Armonk, New York, USA). DHF positive results were compared by the Chi-square test and binary logistic regression. RESULTS: Prevalence of DHF with shock is fifty per cent's and DHF without shock is 50%. Prevalence of obesity is 40.9%. The result of binary logistic regression analysis of obesity in children and the severity of DHF was significantly correlated with P-value 0.004 and OR = 7.734. CONCLUSION: Obesity is associated with the severity of Dengue Hemorrhagic fever in children

The Association between Obesity and Severity of Dengue Hemorrhagic Fever in Children at Wangaya General Hospital

BACKGROUND: Dengue is a mosquito-borne disease caused by any one of four closely related Dengue virus (DENV 1-4). The clinical sign Dengue virus infection can vary from mild (mild febrile illness), Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) to Dengue Hemorrhagic Fever with shock (Dengue Shock Syndrome, DSS). AIM: This study was designed to determine the relationship of obesity with the severity of Dengue Hemorrhagic Fever in children. METHODS: It is a case-control study. The data of patients were retrospectively collected from the Department of Child Health at the Wangaya General Hospital between March 2019 to May 2019. It uses consecutive sampling. The total sample of 22 children with DHF with shock and 22 children with DHF without shock were investigated. Statistical analysis has been performed by SPSS Statistics 20.0 for Mac (IBM Corp., Armonk, New York, USA). DHF positive results were compared by the Chi-square test and binary logistic regression. RESULTS: Prevalence of DHF with shock is fifty per cent's and DHF without shock is 50%. Prevalence of obesity is 40.9%. The result of binary logistic regression analysis of obesity in children and the severity of DHF was significantly correlated with P-value 0.004 and OR = 7.734. CONCLUSION: Obesity is associated with the severity of Dengue Hemorrhagic fever in children

Goldenhar Syndrome: A Case Report

BACKGROUND: Goldenhar syndrome is a multiple congenital disorder with classic characteristics regarding the face, eyes, ears. The incidence of this case is between 1:3.500 to 1:5.600. Early detection and good management can have good outcomes. A newborn with this condition can have a normal life and intelligence. CASE PRESENTATION: A baby girl was born spontaneously at Wangaya General Hospital with APGAR minutes 1, 5, and 10 scores respectively 3, 5, and 8. Infant birth weight was 2.600 grams, body length was 47 cm, and head circumference was 31 cm with estimated age 32-34 weeks. Clinically showing an asymmetrical face, mouth toward the right side without hypoplasia, the eyelids appear asymmetrical with the right eyelid not open when the left eyelid is open, and the two ears not fully formed and diagnosed as Goldenhar Syndrome. From the physical examination, the ear canal is not formed, intact palate, normal eyeball no abnormalities in the spine and found murmur during the systolic-diastolic phase of the heart. Evaluation of the function of vision and hearing has not been concluded. Abdominal ultrasound showed first-degree picture of bilateral hydronephrosis, and from echocardiography, a PDA was found. TORCH profiles in infant were positive for IgG anti-CMV, IgG anti-rubella, and IgG anti-HSV 1. The prognosis, in this case, is good and periodic evaluation needs to be done in 6 months. CONCLUSION: Multidisciplinary examination and management, in this case, are needed so that appropriate therapeutic planning can be carried out as well as periodic evaluations in monitoring the child's growth and development

Hubungan ASI eksklusif dengan Kejadian Stunting pada Anak Usia 12-59 bulan di RSUD Wangaya Kota Denpasar

Stunting masih menjadi masalah kesehatan dan Indonesia menduduki peringkat ke-5 dunia. Pada tahun 2010 dan 2013 ,insiden stunting meningkat dari 35,6% hingga 37,2% . Stunting  terjadi akibat kekurangan gizi kronis sehingga tinggi badan atau panjang badan anak tidak mencapai sesuai usianya dengan nilai z-score < -2 sesuai dengan standar WHO. Stunting dapat mempengaruhi kemampuan kognitif  dan pertumbuhan yang tidak  optimal saat dewasa.Gangguan pertumbuhan sering terjadi mulai dari masa kehamilan hingga usia anak mencapai 2 tahun. Oleh karena itu, pemenuhan nutrisi selama 1000 hari pertama kehidupan sangatlah penting untuk masa depan. Salah satu faktor yang menyebabkan stunting adalah kurangnnya asupan gizi  yang baik terutama saat bayi yaitu ASI.  Stunting masih menjadi masalah kesehatan dan Indonesia menduduki peringkat ke-5 dunia. Pada tahun 2010 dan 2013 ,insiden stunting meningkat dari 35,6% hingga 37,2% . Stunting  terjadi akibat kekurangan gizi kronis sehingga tinggi badan atau panjang badan anak tidak mencapai sesuai usianya dengan nilai z-score < -2 sesuai dengan standar WHO. Stunting dapat mempengaruhi kemampuan kognitif  dan pertumbuhan yang tidak  optimal saat dewasa.Gangguan pertumbuhan sering terjadi mulai dari masa kehamilan hingga usia anak mencapai 2 tahun. Oleh karena itu, pemenuhan nutrisi selama 1000 hari pertama kehidupan sangatlah penting untuk masa depan. Salah satu faktor yang menyebabkan stunting adalah kurangnnya asupan gizi  yang baik terutama saat bayi yaitu ASI

Early onset type 1 diabetes mellitus in an infant during COVID-19 pandemic: case report

Type 1 diabetes mellitus (T1DM) is an endocrine disorder, marked by elevated blood glucose level caused by autoimmune process destroying the β-cells of the pancreas which mostly affects children. It is an often-overlooked condition, with low awareness among clinicians and parents alike which led to late diagnosis and patients often presenting with acute complications. Often triggered by a viral infection, here we presented an interesting case of early onset T1DM presenting with Diabetic ketoacidosis (DKA) during a COVID-19 pandemic. A female infant, aged 1 years and 2 days old, presented with dyspnea and fever. Physical examination was otherwise normal, without any rhonchi or wheezing found during pulmonary auscultation. Nasopharyngeal swab and SARS-CoV-2 antigen test was found negative. Laboratory workup found random blood glucose level of 577 mg/dl accompanied by acidosis and ketonuria. The patient also had elevated white blood cells and platelet counts. She was admitted for treatment in the Pediatric intensive care unit (PICU) with therapeutic regiments consisting of slow intravenous insulin infusion, potassium chloride intravenous fluid, antibiotics, and antipyretics. Close monitoring of blood glucose ensues and the patient was treated for 5 days followed by outpatient therapy with mixed insulin treatment twice per day. This case was interesting as T1DM usually manifested in older children with median age of diagnosis ranging from 8 to 13 years old, depending on population. T1DM diagnosed in children younger than 6 years old are classified early onset and it is especially rare to found in infants. Although the patient tested negative for SARS-CoV-2 antigen, the onset of the case coincides with a recent surge of cases locally. It meant that we cannot rule out possibility of prior unknown exposure or infection which may precipitate the condition

Neonatal iodine status survey by thyroid-stimulating hormone screening in Surabaya

Background Iodine deficiency disorders (lDD) are a significant public health problem globally. Iodine deficiency may cause subclinical hypothyroidism during pregnancy and early infancy. Neonatal thyroid screening of serum thyroidstimulating hormone (TSH) to detect hypothyroidism may also be used to determine the prevalence of IDD in a population. Previous studies reported mild ID D status in different parts of Indonesia. Objective To evaluate the iodine status of neonates born in Mitra K eluarga Surabaya Hospital (MKSH) by TSH screening over a 6year period. Methods T his is a crosssectional and hospitalbased study conducted in MKSH from January 2005 to December 2010. Of the 5,619 infants born in MKSH during the study period, 3,349 (59.6%) healthy infants took part in this study. Blood specimens for TSH measurement were collected from subjects 2 to 6 days after birth, and sent to a reference laboraratory for evaluation. Using the neonatal TSH values, the iodine deficiency level of the group was determined according to the WHO/UNICEF/ International Council for the Control of IDD criteria. Results A total of 3,349 newborn babies underwent neonatal TSH screening in MKSH. Subjects' mean TSH concentration was 5.14 mIU!L. A TSH concentration> SmIU!L was found in 1270 (37.9%) subjects, 166 (27.6%) in 2005, 252 (44.0%) in 2006, 331 (47.1 %) in 2007, 356 (57.7%) in 2008, 114 (20.7%) in 2009 and 51 (16.8%) in 2010. On the basis of the WHO/UNICEF/ International Council for the Control of Iodine Deficiency Disorder criteria, this frequency corresponded to a moderate level of IDD. Twentytwo neonates had TSH > 20 mIU!L from which 2 infants were confirmed positive for hypothyroidism. Conclusion A 6year study of 3,349 newborns screened for TSH revealed that 37.9% of subjects had TSH concentration of more than SmIU!L. This frequency indicates a moderate level of IDD in the study population. [Paediatr Indones. 2012;52:289,93]

Gambaran Hematologi Anemia Defisiensi Besi pada Anak

Latar belakang.Anemia defisiensi besi (ADB) menjadi masalah kesehatan di dunia, baik di negara maju maupun negara berkembang seperti di Indonesia. Sekitar 30% penduduk dunia menderita anemia dan lebih dari setengahnya merupakan anemia defisiensi besi. Dampak negatif yang diakibatkan oleh anemia defisiensi besi pada anak balita sangat serius. Tujuan.Mengetahui gambaran hematologis anemia defisiensi besi pada anak yang dirawat di RSUD Wangaya Denpasar. Metode.Penelitian deskritif potong lintang, pada anak yang dirawat di RSUD Wangaya Denpasar pada periode Januari – Juni 2009, umur 6-59 bulan. Diagnosis anemia defisiensi besi berdasarkan kriteria WHO, diberikan pengobatan bagi yang menderita ADB dengan sulfas ferosus (SF) selama 1 bulan. Hasil.Didapatkan 75 anak usia 6–59 bulan yang dirawat di RSUD Wangaya dengan anemia. Sebagian besar (52%) laki-laki, terbanyak usia 12 – 35 bulan (46,7%) dan 65,3 % menderita dengan rerata kadar Hb, MCHC, SI, TIBC, saturasi transferin berturut-turut adalah 9,9 g/dl , 31,8 g/dl, 37,9 Ug/dl, 361 Ug/dl dan 12,3 %, HCT 30,7% dan feritin serum 75,6 ug/L. Pengobatan dengan SF selama 1 bulan menunjukkan peningkatan Hb 1 gr/dl dan HCT 2,8%. Kesimpulan.Anak yang dirawat dengan anemia 65,3% anemia defisiensi besi dan. sebagian besar (57,1%) mempunyai status besi yang kurang. Selama 1 bulan pengobatan dengan sulfas ferosus terjadi peningkatan Hb 1 gr % dan HCT 2,8