Blood Glucose Level and HbA1C in Pediatric Patients with Diabetes Mellitus Type 1

Background: Diabetes mellitus (DM) is a common disease found all over the world, including Indonesia. The DM often found in pediatric patients is DM Type 1. The DM patients with uncontrolled blood glucose will likely suffer multiple organ damage, most notably to the kidneys, eyes, heart, and nerves. To help monitor blood glucose levels, lab checkups such as fasting blood glucose, 2 hours postprandial, and Hemoglobin A1C (HbA1C) levels are done. The aim of this study was to determine the profile of blood glucose and HbA1C in pediatric patients  with DM Type 1.Methods: The study was held in August to October 2014, using descriptive method and cross sectional design. Data were obtained from 28 medical records of DM Type 1 patients in the Department of Child Health at Dr. Hasan Sadikin General Hospital. The variables of this study were blood glucose level and HbA1 in three consecutive examinations. The collected data was presented in tables.Results: The patients were 19 female and 9 male, most of the patients aged between 11–15 years old. Data reported that on first, second, and third examination, most subjects had both fasting blood glucose and 2 hours postprandial blood glucose levels over 180 mg/dl. On first and second HbA1c checkup, most subjects had values over 10%, and on third checkup had results ranging from 8 to 9.9%.Conclusions: Most patients are girls and aged between 11–15 years old. The most have uncontrolled blood glucoselevel and HbA1c levels. DOI: 10.15850/amj.v4n2.107

Correlation between Body Mass Index and Age at Menarche

Background: The decline of age at menarche has been reported in several countries, it occurred because of genetic, ethnic, and socioeconomic improvement in nutritional status and environment. The improvementof nutritional status has occurred globally all over the world including in Indonesia. One of the measuring tools in nutritional status is body mass index (BMI). The objective of the study was to assess the correlationbetween BMI and age at menarche.Methods: A cross-sectional study was carried out among girls aged 9–15 years old in Jatinangor, from May–November 2013. The sample of this study was chosen with cluster random sampling. Age at menarche information was collected through a questionnaire. Body mass index was calculated from measurement of body weight and height. Data was analyzed using Spearman correlation test.Results: Out of three hundred and sixty nine subjects participating in this study, sixty seven were included in the inclusive criteria. According to the classification of BMI of underweight, normal, overweight, andobese, there were 1, 55, 8, and 3 persons, respectively. Mean of BMI was 19.04 and mean age at menarche was 12.72 years, which showed a non significant result (r=-0.013; p= 0.458).Conclusions: Age at menarche was not correlated with BMI. [AMJ.2015;2(4):521–4] DOI: 10.15850/amj.v2n4.65

Performance of Xpert MTB/RIF and sputum microscopy compared to sputum culture for diagnosis of tuberculosis in seven hospitals in Indonesia

IntroductionTuberculosis (TB) is a major public health concern in Indonesia, where the incidence was 301 cases per 100,000 inhabitants in 2020 and the prevalence of multi-drug resistant (MDR) TB is increasing. Diagnostic testing approaches vary across Indonesia due to resource limitations. Acid-fast bacilli (AFB) smear is widely used, though Xpert MTB/RIF has been the preferred assay for detecting TB and rifampicin resistance since 2012 due to higher sensitivity and ability to rapidly identify rifampicin resistance. However, <1,000 Xpert instruments were available in Indonesia as of 2020 and the Xpert supply chain has suffered interruptions.MethodsWe compared the performance of Xpert MTB/RIF and AFB smear to facilitate optimization of TB case identification. We analyzed baseline data from a cohort study of adults with pulmonary TB conducted at seven hospitals across Indonesia. We evaluated sensitivity and specificity of AFB smear and Xpert MTB/RIF using Mycobacterium tuberculosis (Mtb) culture as the gold standard, factors associated with assay results, and consistency of Xpert MTB/RIF with drug susceptibility test (DST) in detecting rifampicin resistance.ResultsSensitivity of AFB smear was significantly lower than Xpert MTB/RIF (86.2 vs. 97.4%, p-value <0.001), but specificity was significantly better (86.7 vs. 73.3%, p-value <0.001). Performance varied by hospital. Positivity rate for AFB smear and Mtb culture was higher in subjects with pulmonary cavities and in morning sputum samples. Consistency of Xpert MTB/RIF with DST was lower in those with rifampicin- sensitive TB by DST.DiscussionAdditional evaluation using sputa from primary and secondary Indonesian health centers will increase the generalizability of the assessment of AFB smear and Xpert MTB/RIF performance, and better inform health policy.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT027 58236]

Knowledge and Attitude of Women in Reproductive Age toward Clubfoot in Cikeruh Village, Jatinangor Sub−district in 2014

Background: Clubfoot is a congenital anomaly which the ankle is twisted outward from the normal position. Clubfoot is the most common birth defect that can cause disability in the world. 150.000 – 200.000 babies are born with clubfoot every years. Clubfoot is a neglected disease. Immediate intervention is needed to treat the patient with Clubfoot. One of the most common barrier of the treatment is the knowledge and attitude of the society about Clubfoot. This study aimed to know the knowledge and attitude of the society especially women with reproductive age toward clubfoot in Cikeruh village Jatinangor sub−district in 2014. Methods: This research was conducted to 100 women with reproductive age with age interval 15−49 years old which live in Cikeruh village Jatinangor in 2014 with purposive sampling method. A questionnaire was used as instrument to collecting data which is later categorized by good, fair, and low for the knowledge and positive and negative for attitude. Results: From 100 sample women of reproductive age in Cikeruh village at 2014 who were asked about clubfoot, 39% had a good knowledge and 61% had a fair knowledge. There were 42% of respondent who had a negative attitude toward clubfoot and 58% had positive attitude. Conclusion: Majority sample women of reproductive age in Cikeruh village at 2014 have a fair knowledge about clubfoot. The ratio between positive and negative attitude toward clubfoot is almost 1:1 because of the minimal differences

Community Response to the Impact of Thunderstorm Asthma Using Smart Technology

Background: The most severe thunderstorm asthma (TA) event occurred in Melbourne on the 21st November 2016 and during this period, daily pollen information was available and accessible on smart devices via an App. An integrated survey within the App allows users to self-report symptoms. Objective: To explore patterns of symptom survey results during the period when the TA event occurred. Methods: Symptom data from the Melbourne Pollen Count and Forecast App related to asthma history, hay fever symptoms, and medication use was explored. A one-week control period before and after the event was considered. Chi-square tests and logistic regression were used to assess associations between sex, age, symptoms, and medication use. Results: Of the 28,655 responses, during the 2016 pollen season, younger (18 to 40 years) males, with no hay fever and no asthma were the most single and regular responders. During the TA event for new users, sex was only significantly associated with hay fever (p = 0.008) of which 60.2% of females’ responses reported having hay fever, while 43% of males’ responses did not. Those with mild symptoms peaked during the TA event. Conclusions: Many individuals completed the survey on the app for the first time during the TA event indicating the potential of digital technologies to be used as indicators of health risk among populations at risk of TA events.</p

Comparison of the Hemagglutination Inhibition Test and IgG ELISA in Categorizing Primary and Secondary Dengue Infections Based on the Plaque Reduction Neutralization Test

Secondary dengue infection by heterotypic serotypes is associated with severe manifestations of disease, that is, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The World Health Organization (WHO) has recommended criteria based on the hemagglutination inhibition (HI) test to distinguish between primary and secondary dengue infections. Since the HI test has practical limitations and disadvantages, we evaluated the accuracy of WHO HI criteria and compared it with criteria based on an IgG enzyme-linked immunosorbent assay (ELISA) using a plaque reduction neutralization test (PRNT) as the gold standard. Both WHO HI criteria and IgG ELISA criteria performed strongly (16/16) in determining primary infection. However, to determine secondary infection, the IgG ELISA criteria performed better (72/73) compared to the WHO HI criteria (23/73)

Correlation between Body Mass Index and Age at Menarche

Background: The decline of age at menarche has been reported in several countries, it occurred because of genetic, ethnic, and socioeconomic improvement in nutritional status and environment. The improvement of nutritional status has occurred globally all over the world including in Indonesia. One of the measuring tools in nutritional status is body mass index (BMI). The objective of the study was to assess the correlation between BMI and age at menarche. Methods: A cross-sectional study was carried out among girls aged 9–15 years old in Jatinangor, from May–November 2013. The sample of this study was chosen with cluster random sampling. Age at menarche information was collected through a questionnaire. Body mass index was calculated from measurement of body weight and height. Data was analyzed using Spearman correlation test. Results: Out of three hundred and sixty nine subjects participating in this study, sixty seven were included in the inclusive criteria. According to the classification of BMI of underweight, normal, overweight, and obese, there were 1, 55, 8, and 3 persons, respectively. Mean of BMI was 19.04 and mean age at menarche was 12.72 years, which showed a non significant result (r=-0.013; p= 0.458). Conclusions: Age at menarche was not correlated with BMI

The characteristics of bacteremia among patients with acute febrile illness requiring hospitalization in Indonesia

Blood culturing remains the "gold standard"for bloodstream infection (BSI) diagnosis, but the method is inaccessible to many developing countries due to high costs and insufficient resources. To better understand the utility of blood cultures among patients in Indonesia, a country where blood cultures are not routinely performed, we evaluated data from a previous cohort study that included blood cultures for all participants. An acute febrile illness study was conducted from July 2013 to June 2016 at eight major hospitals in seven provincial capitals in Indonesia. All participants presented with a fever, and two-sided aerobic blood cultures were performed within 48 hours of hospital admission. Positive cultures were further assessed for antimicrobial resistance (AMR) patterns. Specimens from participants with negative culture results were screened by advanced molecular and serological methods for evidence of causal pathogens. Blood cultures were performed for 1,459 of 1,464 participants, and the 70.6 (1,030) participants that were negative by dengue NS1 antigen test were included in further analysis. Bacteremia was observed in 8.9 (92) participants, with the most frequent pathogens being Salmonella enterica serovar Typhi (41) and Paratyphi A (10), Escherichia coli (14), and Staphylococcus aureus (10). Two S. Paratyphi A cases had evidence of AMR, and several E. coli cases were multidrug resistant (42.9, 6/14) or monoresistant (14.3, 2/14). Culture contamination was observed in 3.6 (37) cases. Molecular and serological assays identified etiological agents in participants having negative cultures, with 23.1 to 90 of cases being missed by blood cultures. Blood cultures are a valuable diagnostic tool for hospitalized patients presenting with fever. In Indonesia, pre-screening patients for the most common viral infections, such as dengue, influenza, and chikungunya viruses, would maximize the benefit to the patient while also conserving resources. Blood cultures should also be supplemented with advanced laboratory tests when available. © 2022 This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication