Teratomas are the most common germ cell tumor, and further classified into mature or immature. Immature teratoma comprise less than one percent of all teratomas and with the peak incidence at birth until four years. They were diagnosed by history taking, physical examination, laboratory, imaging, and pathological anatomy as a gold standard. This report presents our experience of diagnosed, giving treatment with or without surgery and chemotherapy in three patients with teratoma. We report three cases of teratoma, at age six months, eight months and four years old with site of cases are retroperitoneal immature teratoma, cervical teratoma and ovarian immature teratoma. History taking of these patients, they have same symptom such as enlargement of the mass. Two cases were noticed after birth and progressively getting bigger until six and eight months old. One case was noticed when the patient had abdominal pain and was suspected with appendicitis at first. The computed tomography (CT) scan of these cases showed a mass as a part of teratoma and confirmed with pathological anatomy. Two cases were immature, and one case was mature teratoma. Two patients undergone surgery resection and continue with chemotherapy (cisplatin, etoposide, and bleomycin) for 10-14 weeks showed a good result until now and showed no residual mass anymore form CT scan, but one patient did not undergo surgery and chemotherapy yet. Early diagnosis of teratomas is leading us to a definitive therapy and showed a good result.
Background: High blood pressure is a risk factor for cardiovascular disease and neurological disease among children and adults. The American Heart Association recommended blood pressure evaluation among children aged more than 3 years for early detection of complications. Nutritional status was considered to have association with elevated blood pressure in children. Objective: To assess the association between nutritional status and the blood pressure of preschool children in Denpasar, Bali. Methods: This was a descriptive analytic cross-sectional study. Four hundred and fifty-six children aged 3-6 years who attended Kindergarten 2019 in Denpasar were enrolled by the cluster random sampling design. Results: From 456 samples obtained ratio between boys and girls was 1,1: 1. Median age of the sample was 5 years (3-5 years old). The majority of nutritional status was well nourished (52.2%) and obesity was found 11.8%. majority children had normotension (64%), and followed by pre-hypertension (25.4%), hypertension stage 1 (8.6%) and hypertension stage 2 (2%). Bivariate analysis showed that obesity and sex were risk factor for toddler having higher level of blood pressure with. Multivariate analysis showed children with obesity and boys are 2.8- and 1.8-times more likely to have hypertension (CI 95% 1.72-4.81; CI 95% 1.24-2.76, respectively). Low birth weight and prematurity were not found to be significantly related to level of blood pressure. Conclusion: Children with obesity were found to be significantly related to elevated blood pressure (hypertension).
Introduction: Mortality in septic children continues to be high in Indonesia. Biomarkers for evaluating outcome of children with sepsis are important in deciding further diagnostic examinations or therapies. However, the serum cholinesterase predicting value for mortality in children is still unknown.Objectives: To evaluate the ability of serum cholinesterase as a prognostic factor for mortality in children with sepsis. Method:This was a prospective cohort study in the Paediatric Intensive Care Unit (PICU) at Sanglah Hospital, Bali, Indonesia. A total of 78 children aged 28 days to 18 years with sepsis were included and divided into survivor and non-survivor groups.Children with incomplete medical record data, severe protein energy malnutrition, inhibitor cholinesterase therapy, liver dysfunction, HIV infection, malignancy, diabetes mellitus and chronic kidney disease were excluded. Serum cholinesterase level was measured when sepsis was diagnosed. Statistical analysis used Chi-squared test or Mann-Whitney test for bivariate analysis and Poisson regression for multivariate analysis.Results: Proportion of septic children aged below 5 years was 68.4% in non-survivor group and both groups were predominantly male. Serum cholinesterase <5413.5 U/L was associated with mortality in both bivariate analysis (relative risk 5. 33 (2.518-11.297) and multivariate analysis (adjusted relative risk 5.294 (95% CI 2.
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