Background Acute glomerulonephritis (AGN) is a form of glom-erulonephritis characterized by sudden and explosive onset of glom-erular injury symptom. It usually occurs after recent infection bygroup A beta-hemolytic streptococcus. AGN among Indonesianchildren seems to be less frequently reported than that among othercountries.Objective To determine the current profile of AGN among Indo-nesian children hospitalized in eleven teaching centers.Methods This was a descriptive, cross-sectional study, based ona review of the standard medical records of 509 children with AGNhospitalized in 11 teaching centers in Indonesia over a five-yearperiod (1997-2002). Data extracted from the medical records con-sisted of history of illness, clinical and laboratory findings, and chestX-rays.Results Age of the patients at the onset of AGN ranged from 2.5 to15 years, with peak age of 8.5 years. The majority (76.4%) wasabove 6 years old with male predominance (58.3%). About 68.9%and 82% of the patients came from low socioeconomic and low edu-cational status families. Antecedent upper respiratory infections wereobserved in 45.8% cases and pyoderma in 31.6%. The diseaseseemed to be more commonly elicited by streptococcal infectionthan by other infections, as proved by an elevated anti-streptolisinO (ASO) titer (66.6%) and decreased C 3 concentrations (60.4%).The frequent clinical features included periorbital edema (76.3%),hypertension (61.8%), and gross hematuria (53.6%). The most preva-lent laboratory findings were microhematuria (99.3%), proteinuria(98.5%), raised erythrocyte sedimentation rate (85.3%). The initialchest X-rays showed pleural effusion (81.6%) and cardiomegaly(80.2%), whereas echocardiogram documented pericardial effusion(81.6%). Acute pulmonary edema (11.5%), hypertensive encepha-lopathy (9.2%), and acute renal failure (10.5%) were frequent com-plications noted in our study.Conclusion Despite no adequate data on throat or skin cul-tures, AGN among Indonesian children seems mostly to bepoststreptococcal AGN as proved by the elevated ASO titerand decrease in serum C 3 concentration

Background Although vaccination programs have succeeded in reducing the incidence of diphtheria, it remains a health problem in Asia, including Indonesia. Objective To investigate the clinical spectrum and outcomes of pediatric diphtheria in Wahidin Sudirohusodo Hospital. Methods This study was a retrospective review of childhood diphtheria medical records from January 2011 to December 2017 in Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Recorded data consisted of age, gender, nutritional and immunization statuses, signs and symptoms, throat swab culture results, complications, and outcomes.    Results Of 28 subjects aged 9 months to 17.10 years, the majority were >5 years (57.1%) and male (60.7%). Subjects’ mean age was 6.15 years and 82.1% of cases were well nourished. Overall, 85.7% had received complete immunizations, while 14.3% were not immunized, having received neither basic nor booster vaccines. The presenting manifestations were fever, pseudomembranes, and sore throat in all subjects, enlarged tonsils (78.57%), dysphagia (67.86%), cough (57.14%), headache (57.14%), hoarseness (67.86%), bull neck (25%), and myocarditis (14.3%). Most subjects had hospital stays of >10 days (67.9%). Mortality was 14.3%, usually in those admitted with a late, deteriorating condition and dying before getting optimal treatment. Poor outcome was significantly associated with the lack of basic or booster immunizations, poor nourishment, bull neck, myocarditis, and hospital stays < 5 days (P<0.05 for all).  Conclusion The clinical spectrum and outcomes of pediatric diphtheria in this study are relatively similar to reports from other hospitals. Mortality was mostly in patients who lack basic or booster immunizations, are poorly nourished, or have bull neck, myocarditis, or hospital stays < 5 days.

Background Urinary tract infections (UTI) is a common healthproblem in children. Its occurrence depends on several predis-posing factors and individual immunocompetence. Childrenwith protein energy malnutrition (PEM) have impaired immunefunction. Thus early detection and prompt treatment of associatedinfections in children with PEM are very important.Objective To determine the relationship between PEM and theoccurrence of UTI in children.Methods This cross sectional study conducted in Dr. Wahidin Sud-irohusodo Hospital and Labuang Baji General Hospital, Makassarbetween March 1, 2007 and June 30, 2007. The target populationincluded PEM patients aged 2 to 5 years. Well-nourished patientsmatched for age and sex were selected for control group.Results Out of 220 patients, 25 had UTI consisted of 12 malesand 13 females. Eighteen of them had PEM and 7 were well-nourished subjects. There was a statistical significant difference(P=0.019) in the occurrence of UTI between children with PEMand in well- nourished children. The relationship between PEMand UTI as determined by prevalence ratio value (PR) was 2.6with 95% confidence interval (CI) of 1.1 to 5.9, suggested therisk of getting UTI was 2.6 times higher in children with PEM ascompared to normal controls.Conclusions The frequency of UTI in PEM was 16.4%. Chil-dren with PEM have the risk of getting UTI 2.6 times higheras compared to well-nourished children

Background Nephrotic syndrome is primarily a pediatric disorderHyperlipidemia is an important characteristic of nephrotic remission can be found in frequent relapse nephrotic syndrome. Objective To determine plasma lipids as risk factor for relapsing nephrotic syndrome. Methods Thirty children with nephrotic syndrome were included were enrolled as control. Blood specimens were collected to determine phases. Follow up was carried out six months after remission to determine the occurrence of relapsing nephrotic syndrome. Results syndrome and nephrotic syndrome in remission. There were no

Sindrom nefrotik kelainan minimal (SNKM) berdampak pada kesehatan fisik anak sertamental anak dan orang tua karena penyakit ini sering relaps, pengobatan lama, dantoksisitas obat yang serius. Pengobatan yang tidak adekuat potensial membahayakanhidup anak karena infeksi sekunder dan dapat menyebabkan tromboemboli, kelainanlipid, dan malnutrisi. Tata laksana SNKM meliputi tata laksana suportif, tata laksanakomplikasi, dan tata laksana spesifik dengan obat imunosupresif untuk induksi danmempertahankan remisi tanpa toksisitas obat yang serius. Sampai saat ini, kortikosteroidmasih merupakan pilihan pertama pada anak dengan SNKM dan obat imunosupresiflain digunakan bila tidak respons dengan pengobatan standar kortikosteroid atau padarelaps frekuen atau dependen steroid. Pemberian kortikosteroid sebaiknya tidak segeradimulai setelah onset gejala karena remisi spontan dapat terjadi pada 5% kasus SNKMkecuali kalau edema menetap atau gejala berat pada onset awal.