Purpose: To analyze risk factors and various nutrients associated with stunting among children aged 6-60 months. Methods: This is a case-control and cross-sectional study between 40 stunting cases and 40 controls. Data on possible risk factors associated with stunting were obtained through direct interviews and using a questionnaire. Examination of vitamin D, zinc, albumin, and ferritin levels was performed on both groups. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Co., Armonk, NY, USA) to determine risk factors for stunting and to assess the relationship between nutritional levels and stunting. Results: The incidence of stunting was highest in children aged 12-36 months. Children with low weight and very low weight for age comprised of 55% and 22.5%, respectively, of the study participants. The highest mother's educational level was junior high school (40%). History of low birth weight (LBW) was more commonly observed in the stunting group than that in the control group (25.0% and 7.5%, respectively; p=0.034, odds ratio, 0.310 [95% confidence interval, 0.122-0.789]). Approximately 7.5% of cases had premature birth. Exclusive breast feeding was found to be not correlated with stunting. The mean zinc level in the stunting group was 34.17 ng/mL, which was different from that in the control group (50.83 ng/mL) (p=0.023). Blood ferritin, vitamin D, albumin, and calcium levels were not strongly correlated with stunting. Conclusion: LBW is the main risk factor contributing to stunting and is strongly associated with low zinc level.
Dengue fever is a major global public health challenge in tropical and subtropical countries. The clinical spectrum of dengue infection ranges from mild illness to the life-threatening severe forms of the disease with plasma leakage, severe bleeding, or multi-organ failure, which may be fatal. The term expanded dengue syndrome is used for atypical manifestations of dengue fever. This study presented a case of expanded dengue syndrome with status epilepticus in a 9-month-old boy hospitalized with the chief complaint decreased of consciousness with fever and seizures. From the physical examination, there was a decrease in consciousness with GCS 9 accompanied by fever, ascites, and gastrointestinal bleeding. On laboratory examination, hyponatremia, increased transaminase enzymes, and hypoalbuminemia with positive dengue IgM were found. The patient had specific clinical features of expanded dengue syndrome with status epilepticus the appropriate anti-convulsion, vasopressor, and fluid management was given to the patient. In cases of dengue virus infection, it is important to prevent other potential complications such as expanded dengue syndrome with status epilepticus. Early diagnosis of expanded dengue syndrome simultaneously with adequate treatment will prevent the complications of the disease.
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