Background: COVID–19 cases in children are not as prevalent as in adults and tend to be milder. However, clinical profiles in pediatric COVID–19 cases in Indonesia have not been extensively studied. This study aims to know clinical profiles of pediatric COVID–19 cases in dr. R. Soedarsono General Hospital Pasuruan City from April–July 2020. Methods: This descriptive study used medical records of pediatric patients who were diagnosed with suspected, probable, confirmed, and close contact with COVID – 19. Total populations with complete data in medical records were included in the study. Results: Of 78 respondents, 41 (53%) were male, 42 (54%) were hospitalized, 18 (23%) were 1 until under 12 months and 12 until under 18 years old consecutively, 32 (41%) had moderate symptoms, and 31 (39%) had close contact with positive cases at home. The most common symptoms were cough (59%) and fever (54%). Most cases showed normal laboratory and radiologic findings. There were eight children with comorbidities, and most patients showed satisfying outcomes. Conclusions: Most pediatric patients with COVID–19 at dr. R. Soedarsono General Hospital from April to July 2020 showed moderate symptoms with good outcomes.
Background: Turner syndrome is characterized by abnormality of one X chromosome. Those with Turner syndrome are at risk of developing tuberculosis infection due to decreased immune function. Case: A 17-year-old girl came with complaints of short stature, amenorrhea, and no signs of secondary sexual growth. She also felt weak. On physical examinations, she weighed 24 kg, and her height was 119 cm. Her conjunctiva looked pale. She had a low set hairline, small mandible, short 4th metacarpal, and wide-spaced nipple. Her breast and genitalia did not grow (1st stage of Tanner classification). There was a lesion between her breasts. Laboratory results showed Hemoglobin 7 g/dL, MCV 62,6 fL, MCH 18,2 pg, MCHC 29 g/L, FSH >170 IU/L, LH 95,3 IU/L, Estradiol 11 pg/mL, Iron Ferrozine 7 mg/dL, TIBC 186 μg/dL, and Ferritin 50 ng/mL. Her Mantoux test showed induration with a diameter of 20-23 mm, and the Xpert MTB-RIF test showed low detection of MTB. Her bone age was appropriate for a 13-year-old girl. Histopathology test of her lesion showed chronic granulomatous inflammation. Her chromosome analysis showed Mos 45,X(56)/46,XX(44). She was diagnosed with Turner syndrome and tuberculosis. She received Progynova® 2 mg every 24 hours for 21 days, stopped for 10 days, and continued again for 21 days. She also got anti-tuberculosis drugs (pediatric regime). Conclusion: The clinical spectrums of Turner syndrome vary widely. Decreased immune function in Turner syndrome can lead to infections such as tuberculosis. Early diagnosis and treatment can prevent further morbidity.
Background: Diabetic ketoacidosis (DKA) has been well-known as the main complication that is a potentially fatal emergency in some teenagers with type 1 diabetes mellitus (DM). Although children with diabetes are not at high risk for severe COVID-19 infection, it can hypothetically lead to type 1 DM and severe DKA. The aim of this article is to briefly discuss a case of a teenager with DKA and COVID-19. Case: A 13 years old girl came in with abdominal pain, nausea, vomiting and dyspnea. She was alert but weak. Her blood pressure was 100/70 mmHg with 120 pulses and 35 breaths per minute. Oxygen saturation was at 99%. History of previous illness was denied. She was treated using a dyspepsia algorithm while waiting for the laboratory result. Later on, the test showed conditions of hyperglycemia, severe acidosis, ketonuria and a positive rapid COVID–19 antibody test. Hence, a diagnosis of DKA with probable COVID–19 was made and PCR for confirmation of COVID-19 diagnosis was scheduled. Oxygen support, rehydration, and insulin therapy were also given with a precautionary condition of possible COVID–19. In minutes, she developed respiratory distress that led her to be intubated and put on a ventilator. Due to a lack of facilities, a referral to a higher-level hospital was needed. However, since the referral process for probable COVID-19 patients required a long preparation, the patient died during the process. Conclusion: Besides early diagnosis and prompt treatment, a well-coordinated referral system is crucial in managing DKA patients with possible COVID–19.
Background: The World Health Organization (WHO) said that South East Asia has a high stunting prevalence, where it is estimated that 22.2% of toddlers are stunted globally. The reality is that there are still many cases of inaccurate measurement methods, which question the validity of stunting prevalence. This study aims to know if small group training is effective in reducing stunting prevalence in toddlers. Methods: This descriptive study was done at all Posyandu in Bugul Lor from August to September 2019. Populations in this study were all helpers at Posyandu. Samples in this study were all helpers who met inclusive criteria but didn’t meet exclusive criteria. The inclusion criteria were helpers who attended when the study was conducted (5 helpers in each Posyandu), and the exclusive criteria were illiterate helpers. We used measurement guidelines from IDAI. The Group workshop started with a briefing about making sure that all tools were correctly set. Next, all helpers were asked to do height measurements, and if there was any error, we showed them how to do it correctly and let them do it again. We then compared the data before and after the intervention. Data from February 2019 were used as data before the intervention. Results: No helper in 10 Posyandu measured correctly. But after the group workshop, a helper from 8 Posyandu could measure correctly. Stunting prevalence in Bugul Lor decreased by about 4%. Conclusion: Group workshop seems to be effective in reducing stunting prevalence in toddlers.
Background: Syphilis is one of the most common sexually transmitted infections every year. In mothers who do not receive treatment, transmission of infection from mother to fetus can occur, causing congenital syphilis. The purpose of this study was to describe the characteristics of cases of congenital syphilis in Wangaya Hospital, Denpasar. Methods: This descriptive study used the medical records of pediatric patients at the Wangaya Hospital, Denpasar, for the period January 2020 to October 2021. The inclusion criteria used were newborns diagnosed with congenital syphilis with complete medical record data. The exclusion criteria used were newborns suffering from congenital syphilis accompanied by other infections, namely Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex, and other congenital disorders not related to syphilis. Results: Of the 47 study subjects who met the inclusion criteria, 68.1% of cases were asymptomatic and 31.9% symptomatic, 68.1% of term pregnancy, 31.9% preterm, low birth weight 29.8%, very low 4 .3%, and 66% normal body weight. Clinical manifestations found in symptomatic cases were respiratory distress (27.7%), jaundice/jaundice (21.3%), anemia (19.1%), skin lesions/rash (12.8%), sepsis (10 .6%), leukocytosis (10.6%), and thrombocytopenia (10.6%). Outcome of survival was 93.6% and death was 6.4% of cases. Conclusion: Most cases of congenital syphilis are asymptomatic. In symptomatic cases, the characteristic clinical manifestations that are often encountered are respiratory distress, jaundice, anemia, skin rash, sepsis, leukocytosis, and thrombocytopenia. Recognizing the characteristics of congenital syphilis cases early is very important to reduce mortality from the disease. Latar Belakang: Sifilis merupakan salah satu infeksi menular seksual yang banyak terjadi setiap tahunnya. Pada ibu yang tidak mendapatkan pengobatan, dapat terjadi transmisi infeksi ibu ke janin sehingga menyebabkan kejadian sifilis kongenital. Tujuan penelitian ini adalah untuk mengetahui gambaran karakteristik dari kasus-kasus sifilis kongenital di RSUD Wangaya kota Denpasar. Metode: Penelitian deskriptif ini menggunakan rekam medis pasien anak di RSUD Wangaya kota Denpasar periode Januari 2020 hingga Oktober 2021. Kriteria inklusi yang digunakan adalah bayi baru lahir yang didiagnosis sifilis kongenital dengan data rekam medis yang lengkap. Kriteria eksklusi yang digunakan adalah bayi baru lahir yang menderita sifilis kongenital disertai infeksi lainnya, yaitu Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex, maupun kelainan kongenital lain yang tidak berkaitan dengan sifilis. Hasil : Dari 47 subjek penelitian yang masuk di dalam kriteria inklusi, 68,1% kasus asimptomatik dan 31,9% simptomatik, kehamilan aterm 68,1%, kurang bulan 31,9%, berat badan lahir rendah 29,8%, sangat rendah 4,3%, dan berat badan normal 66%. Manifestasi klinis yang ditemukan pada kasus simptomatik, yaitu distres nafas (27,7%), ikterus/jaundice (21,3%), anemia (19,1%), lesi/ruam kulit (12,8%), sepsis (10,6%), leukositosis (10,6%), dan trombositopenia (10,6%). Luaran hidup 93,6% dan meninggal 6,4% kasus. Kesimpulan : Sebagian besar kasus sifilis kongenital tidak bergejala atau asimptomatik. Pada kasus bergejala, karakteristik manifestasi klinis yang sering ditemui adalah distres nafas, jaundice, anemia, ruam kulit, sepsis, leukositosis, dan trombositopenia. Mengenali karakteristik kasus sifilis kongenital sejak dini sangat penting untuk mengurangi mortalitas dari penyakit.
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