Background The impact of COVID-19 towards psychology and mental health is anticipated to be significant and may affect the population disproportionately, especially adolescent as the vulnerable category. We aimed to analyze the impact of COVID-19 towards adolescents’ mental health. Main body A systematic search was conducted from Cochrane, Google Scholar, Scielo, and PubMed. Inclusion criteria included all types of studies which observed the effect of COVID-19 and its related causes, such as lockdown, on adolescents’ mental health. All studies were assessed for its level of evidence according to Oxford 2011 criteria and Newcastle Ottawa Scale (NOS). Three studies (Seçer and Ulaş, Int J Ment Health Addict: 1–14, 2020; Zhou et al., Eur Child Adolesc Psychiatry 29:749–58, 2020; Qu et al., Lancet: 1–17, 2020) showed that COVID-19 was a risk factor for mental health problems in adolescents while Oosterhoff et al. (J Adolesc Health 67: 179–185, 2020) showed that adolescents who preferred to stay at home during this pandemic reported less anxiety and depressive symptoms Conclusion COVID-19 has been found to be associated with mental health changes in adolescents which meant management of COVID-19 should also focus on mental health as well.

Background Little is known how COVID-19 is affecting children. Autopsies help gain an understanding of the pathophysiology of new and developing diseases. Numerous post-mortem studies had been conducted in adults with COVID-19, but few in children. Thereby, this systematic review aims to investigate the autopsy findings from pediatric COVID-19 patients. Results There were a total of 15 patients from eight studies. COVID-19 mainly affects the heart and lungs. Pathology findings from the heart of COVID-19 pediatric patients include diffuse inflammatory infiltrate, myocarditis, cardiomyocyte necrosis, pericarditis, and interstitial edema. Histopathology abnormalities observed in the lungs are diffuse alveolar damage, cytopathic changes, thrombi in arterioles and septal capillaries, lung congestion, focal acute hemorrhage and edema, focal exudative changes, and mild pneumocyte hyperplasia. In addition, pathological findings from other organs, such as the liver, kidney, brain, bone marrow, lymph node, skin, spleen, muscle, colon, parotid gland, and adrenal of COVID-19 pediatric patients are also included in this review. Conclusion Cardiomyocyte necrosis, interstitial edema, lung congestion, and diffuse alveolar damage are the most significant pathologic findings of the heart and lung in pediatric COVID-19 patients. More studies are needed to elucidate the pathophysiology of SARS-CoV-2 in autopsy findings and to determine the exact cause of death since it could be related to COVID-19 or other comorbidities.

Bacterial ventriculitis is one of the most common and serious complications of shunt placement. Shunt infection has varied management and is difficult to treat neurosurgically. We report a case of intraventricular empyema due to shunt infection. Standard management was failed for this case and reaccumulation of pus in the both ventricles. Neuroendoscopic surgery with intraventricular lavage and aspiration using cannula nasogastric tube (NGT) through a single burr hole, has successfully decreased the accumulation of intraventricular empyema. After lavage and aspiration, antibiotic can be distributed effectively to the affected area. Follow up imaging and cerebrospinal fluid (CSF) culture shown a good result and shorter length of stay in the hospital. Neuroendoscopy appears effective and safe for the management of bacterial ventriculitis due to shunt infection in infant. The strategy described in this report might be useful to treat intraventricular empyema.

Latar belakang. Infeksi susunan saraf pusast memiliki morbiditas dan mortalitas apabila tidak ditangani secara tepat. Penanganan yang tidak sesuai juga berisiko tinggi untuk menimbulkan kecacatan pada kemudian hari. Tipe-tipe infeksi susunan saraf pusat dapat berupa meningitis, ensefalitis dan meningoensefalitis yang memiliki etiologi dan manifestasi klinis yang beragam.Tujuan. Penelitian ini bertujuan untuk mendeskripsikan karakteristik klinis pada setiap infeksi sistem saraf pusat baik dari segi manifestasi klinis, radiologis, serta terapi pada setiap pasien.Metode. Anak berusia 0-18 tahun yang didiagnosis meningitis, ensefalitis dan meningoensefalitis dari Januari 2015 hingga September 2019 diinklusikan pada studi potong lintang ini. Data diambil melalui rekam medis.Hasil. Terdapat 45 pasien yang memenuhi kriteria inklusi dan eksklusi dan laki-laki mendominasi pada studi ini (57,8%). Meningitis ditemukan pada 37,8% pasien, ensefalitis pada 22,2% pasien, dan meningoensefalitis pada 40% pasien. Tuberkulosis menjadi etiologi tersering yang ditemukan pada studi ini sebesar 71,1%. Median durasi rawat inap terpanjang ditemukan pada pasien dengan meningoensefalitis (15,5 hari) dan kortikosteroid merupakan pengobatan yang sering digunakan untuk mengatasi infeksi susunan saraf pusat.Kesimpulan. Infeksi SSP lebih sering terjadi pada anak di bawah <5 tahun. Sebagian besar anak-anak datang dengan penurunan kesadaran akut dan TB masih merupakan penyebab utama dari infeksi SSP. Pasien dengan meningitis TB atau meningoensefalitis TB datang dengan derajat MRC 2-3 yang berkorelasi dengan morbiditas dan mortalitas tinggi sehingga diagnosis dan tatalaksana yang tepat diperlukan oleh para klinisi untuk memperbaiki luaran pasien.

Background Community-acquired pneumonia (CAP) is the leading cause of death in children globally. Indonesia is ranked 1st in South East Asia with the highest burden of pneumonia. Identification of risk factors is necessary for early intervention and better management. This study intended to describe CAP’s clinical signs and laboratory findings and explore the risk factors of severe CAP among children in Indonesia. Methods This was a retrospective study of childhood hospitalizations in Siloam General Hospitals and Siloam Hospitals Lippo Village from December 2015 to December 2019. Demographic data, clinical signs, and laboratory findings were collected and processed using IBM SPSS 26.0. Results This study included 217 participants with 66 (30.4%) severe pneumonia cases. Multivariate analysis shows that fever that lasts more than 7 days (ORadj = 4.95; 95%CI 1.61–15.21, Padj = 0.005) and increase in respiratory rate (ORadj = 1.05, 95%CI 1.01–1.08, Padj = 0.009) are two predictors of severe pneumonia. Meanwhile, a normal hematocrit level (ORadj = 0.9; 95%CI 0.83–0.98, Padj = 0.011) and children with normal BMI (ORadj = 0.7; 95%CI 0.57–0.84, Padj < 0.001) are significant independent predictors of severe pneumonia. The Hosmer-Lemeshow test shows that this model is a good fit with a P-value of 0.281. The AUC for this model is 0.819 (95%CI = 0.746–0.891, P-value < 0.001) which shows that this model has good discrimination. Conclusion Pediatric CAP hospitalizations with fever lasting > 7 days and tachypnea were at higher risk for progressing to severe pneumonia. A normal hematocrit level and a normal BMI are protective factors for severe pneumonia.

Objectives: Recently, the subject of reopening schools has raised several concerns, especially on the possibility of new COVID-19 cluster cases. The parent's role is essential in this matter. Therefore, this study aims to understand the parents' knowledge, attitude, and behavior toward COVID-19 in Indonesia. Methods:  A cross-sectional study was conducted on 206 Indonesian parents. A 55-items questionnaire was used to assess the knowledge, attitude, and behavior of subjects. In this study, median split tests, Kruskal-Wallis, Cronbach's α, and Pearson correlation test were used. Results:  Subjects were found to have high levels of knowledge, especially in the knowledge of COVID-19 as a contagious viral disease (98.5%), and the necessity for children to maintain personal hygiene to prevent COVID-19 (98.5%). Subjects' attitudes were highest at understanding how to prevent COVID-19 (95.1%) and teaching children how to avoid COVID-19 (98.1%). Subjects' attitude was lowest at hearing the news of the death of COVID-19 scares them (72.8%), and on how their child(ren) are getting bored at home because of COVID-19 (69.9%). Subjects' are shown to have high levels of behavior in every question. This study found a significant correlation between socioeconomic status and subjects' knowledge (p = 0.007). Conclusion:  This study revealed a lack of understanding of prevention strategies among low-income households. Hence, there is a need for targeted messaging and health education in low-income settings that consider the challenges they may face when attempting their children to practice COVID-19 prevention if schools reopen. Keywords: COVID-19, Knowledge, Attitude, Behavior, Parents, Indonesia

Objective The uncertainty of dengue's progression from infection to its severe form represents a major health care challenge, especially in children. Clinical identification of impending clinical manifestations of severe dengue (SD), along with proper and immediate management, is crucial. Thus, this study assesses the ability of warning signs to predict SD infection in pediatric patients. Methods This cross-sectional study utilized purposive sampling using medical records from January 2015 to December 2020. Children aged 0 to 18 years diagnosed with dengue fever and SD according to the World Health Organization's 2009 criteria were included. Discussion Multivariate analysis revealed that abdominal pain (odds ratio [OR]: 16.34; 95% confidence interval [CI]: 3.78–70.64; p < 0.001), fluid accumulation (OR: 10.51, 95% CI: 1.17–94.3; p = 0.036), mucosal bleeding (OR: 4.77; 95% CI: 1.27–17.91; p = 0.021), lethargy (OR: 94.37; 95% CI: 4.92–180.79; p = 0.003), hepatomegaly (OR: 17.57; 95% CI: 2.14–144.13; p = 0.008), and increased hematocrit concurrent with a rapid decrease in platelets (OR: 6.89; 95% CI: 1.79–26.51, p = 0.005) were associated with SD infection, with a high quality of discrimination (area under the curve [AUC] = 0.96) and a high quality of fit (p = 0.73). Receiver operating characteristic analysis demonstrated that 1.5 warning signs was the optimal cut-off for predicting SD infection, with a sensitivity of 90.9 and a specificity of 89.8%. Conclusion All six warning signs were significantly associated with SD infection. The optimal cut-off for predicting SD was 1.5 warning signs.

Background Hypertension is a rarely recognized complicationof acute lymphoblastic leukemia (ALL). The incidence ofhypertension in ALL patients in Indonesia remains unknown,but the most common risk factors are corticosteroid use duringinduction-phase chemotherapy and renal leukemic infiltration.Objective To determine the incidence of hypertension in childrenwith ALL, and to assess for associations of high-dose corticosteroids,renal infiltration, and hyperleukocytosis to hypertension.Methods This was a cross-sectional study involving 100 childrenaged 2-18 years. Subjects were newly diagnosed ALL patients andthose underwent induction-phase chemotherapy in the PediatricWard or Outpatient Clinic at Cipto Mangunkusumo or DharmaisHospitals.Results Hypertension occurred in 6 (10%) of 60 newly diagnosedALL patients and 8 (20%) of 40 patients who had receivedhigh-dose corticosteroids, but the difference was not statisticallysignificant (OR=2.25; 95%CI 0.72 to 7.07; P=0.239). Hypertensionwas reported in 8 of 29 subjects who received dexamethasone,but in none of the subjects who received prednisone. However, thedifference in these subgroups was also not statistically significant.Renal enlargement was found in 1 of 14 hypertensive patients, butit was not associated with hypertension (OR=0.80; 95%CI 0.52to 1.24; P=0.417). Hyperleukocytosis was also not associated withhypertension (OR= 0.79; 95% CI 0.20 to 3.11; P=1.000).Conclusion The incidence of hypertension in ALL patients was14%. Hypertension is not associated with renal infiltration orhyperleukocytosis. Furthermore, hypertension is not associatedwith corticosteroid dose, though is found only in subjects whoreceive dexamethasone. [Paediatr Indones. 2014;54:372-6.].