BACKGROUND: Sleep disorders encompass disturbances in the amount, quality, or timing of sleep. Several factors have contributed to sleep disorders in adolescents, including the use of electronic devices. In the COVID-19 pandemic era, there is a rising trend of screen time. AIM: The objective of the study was to identify the prevalence of sleep disorders in adolescents and its relation with screen time during the COVID-19 pandemic era. METHODS: This is a cross-sectional study involving students aged 15–18 years at three State High School, Denpasar, and Santo Yoseph Senior High School, Denpasar, in August 2020, using purposive sampling method. Data collections on characteristics of the subjects and Pittsburgh Sleep Quality Index (PSQI) were performed using Google Forms. Statistical analysis was performed using Chi-square test. RESULTS: A total of 243 students participated in this study, of which 39 students were excluded due to chronic diseases and consumption of caffeine within 6 h before bedtime. Sleep disorder was found in 30.4% of subjects and mostly characterized by sleep duration of <8 h (62.9%). Analysis of the association between screen time and sleep disorders showed a significant result (PR = 3.8, 95%CI = 1.09–13.1, p = 0.02). CONCLUSION: The prevalence of sleep disorders in adolescents is considerably high. There is an association between screen time and sleep disorders that occur in adolescents during the COVID-19 pandemic era.

Acute respiratory distress syndrome (ARDS) is a lung disease characterized by severe diffuse inflammation and hypoxemia. The cause of ARDS can be pulmonary or extrapulmonary originated. The outcome of pulmonary and extrapulmonary pediatric ARDS are poorly described. The objective of this study was to determine the outcome differences between pulmonary and extrapulmonary pediatric ARDS. A retrospective study was carried out in 60 patients who admitted to the Pediatric Intensive Care Unit (PICU), Sanglah Hospital, between January 2018 until December 2019. All children aged 0-18 years old diagnosed with ARDS according to Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were included in this study. Length of ventilation, ventilator-free days, PICU length of stay, and PICU mortality as the outcome of this study were obtained from medical records. Statistical analysis was done using Chi-square and Mann-Whitney test. Most of the patients were supported by invasive ventilation with the severity of ARDS was mild to moderate. The underlying disease of pulmonary ARDS (ARDSp) was pneumonia (100%), whereas in extrapulmonary ARDS (ARDSexp) was sepsis (100%). Analysis of outcome showed significant difference in mortality (33.3% vs 73.3%, p=0.002). The mortality was higher among those in the moderate severity of oxygenation index (64.5%, p=0.001). No significant difference was found in length of ventilation and PICU length of stay. The ventilator-free days in ARDSp was higher (22 days vs 0 days, p=0.000) compared with the ARDSexp. This study concluded that patients with extrapulmonary ARDS had poorer outcomes (higher mortality and less ventilator-free day) compared with pulmonary ARDS. The severity of ARDS based on the oxygenation index measurement can be used to discriminate mortality.

Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.

Latar Belakang: Praktikum spirometri merupakan salah satu metode yang dipergunakan untuk menambah pemahaman mahasiswa tentang fisiologi respirasi, yang dalam pelaksanaannya membutuhkan beberapa persiapan, mulai dari peralatan sampai orang coba dengan persyaratan tertentu, yang terkadang sulit terpenuhi sesuai dengan kriteria/kondisi yang diharapkan. Salah satu metode praktikum yang berkembang saat ini adalah metode “dry lab,” yaitu metode yang memanfaatkan perangkat lunak (software). Tujuan dari penelitian ini adalah untuk mengetahui efektivitas penggunaan metode dry lab dibandingkan metode konvensional serta untuk mengetahui tingkat kepuasan mahasiswa terhadap metode dry lab. Metode: Penelitian ini merupakan penelitian eksperimen dengan menggunakan rancangan randomized pretest and posttest group design. Subjek penelitian adalah mahasiswa Fakultas Kedokteran Universitas Mataram Tahun Ajaran 2014/2015 yang telah menempuh Blok VI (Sirkulasi dan Distribusi) yang memenuhi kriteria penelitian. Subjek penelitian berjumlah 60 orang, dibagi dalam 2 (dua) kelompok, yaitu kelompok 1 dan 2. Pada tahap I, kelompok 1 melakukan praktikum spirometri dengan menggunakan metode dry lab dengan perangkat lunak PhysioEx 9.1 dan kelompok 2, menggunakan metode konvensional dengan alat spirometer digital. Pada tahap II, dilakukan pertukaran, kelompok 1 melakukan praktikum konvensional dan kelompok 2 praktikum metode “dry lab”. Data, berupa nilai pretest dan posttest yang diperoleh pada tahap I dianalisis dengan Uji Wilcoxon dan Mann-Whitney. Seluruh responden mengisi kuesioner kepuasan terhadap metode “dry lab”. Hasil: Hasil penelitian diperoleh bahwa rerata beda nilai pretest dan posttest pada masing-masing kelompok berbeda bermakna, (p < 0,05), dengan rerata peningkatan nilai pada kelompok 1 sebanyak 4,2 (75,9%) sedangkan pada kelompok 2 sebanyak 2,8 (40,7%). Tidak ada perbedaan bermakna antara nilai kelompok perlakuan yang menggunakan metode dry lab dan nilai kelompok perlakuan yang menggunakan metode konvensional (p > 0,05). Metode praktikum spirometri dengan metode “dry lab” maupun metode konvensional meningkatkan capaian nilai responden. Kesimpulan: Metode “dry lab” tidak lebih baik dalam meningkatkan capaian nilai dibandingkan metode konvensional.

BACKGROUND: Neonatal bacterial meningitis has a significant contribution on neonatal morbidity and mortality. It is the most common complication of late-onset neonatal sepsis. An understanding of the risk factors for bacterial meningitis in late-onset neonatal sepsis is required to provide comprehensive management. AIM: To identify the risk factors of bacterial meningitis in late-onset neonatal sepsis. METHODS: This is an analytical study with a case–control design, conducted in May 2019-February 2021, involving neonates aged 4–28 days who suffered from late-onset neonatal sepsis in Level II and III Neonatal Care Unit, Sanglah General Hospital Denpasar. Statistical analysis was performed using Chi-square and logistic regression. RESULTS: A total of 54 patients were analyzed in this study. The mean age of subjects with neonatal bacterial meningitis was 13 days and the majority of them were male (51.9%). The risk factor of bacterial meningitis in late-onset neonatal sepsis was gestational age <37 weeks with odds ratio 4.22 (95% confidence interval 1.28–13.86, p = 0.01). There was no significant association of birth weight <2500 g, neonatal asphyxia, and invasive procedure on neonatal bacterial meningitis. CONCLUSION: Gestational age <37 weeks is a risk factor for bacterial meningitis in late-onset neonatal sepsis.