فهرست مطالب muhammad faizi

Down’s syndrome (DS) is a prevalent autosomal disorder that is widely observed on a global scale. Children diagnosed with DS have several environmental and hormonal factors that impact their development. Vitamin D (VD) plays a crucial role in conferring a protective effect to the human body. However, there is a scarcity of study on VD and the factors that influence its level in Indonesian Down's syndrome children. The primary purpose of this research was to examine the levels of VD and the factors that influence them among children in Indonesia diagnosed with DS. Using a cross-sectional method of Indonesian DS and control children (aged 1 month to18 years), the subjects’ VD concentration was evaluated using Elisa and classified into sufficient and non-sufficient groups based on the results. The determinant factors consisted of the subjects’ characteristics: demographic characteristics, milk intake, sun exposure, and meat consumption. Kruskal-Wallis, Chi-Squared, Spearman’s correlation, and regression tests were used for statistical analysis; outcome was considered significant if p-values <0.05. Thirty children with DS and 30 healthy controls were recruited as participants. The mean VD levels in the DS and control groups were 38.74 ng/mL and 70.109 ng/mL, respectively. The rate of VD insufficiency was 33.3% and 26.7% in the DS children and healthy controls, respectively. A significant difference in age, milk intake, body mass index, sun exposure, and meat consumption was observed (p-values lower than 0.05). The VD concentration in the DS was below the control group. The key determining factors were the level of milk consumption and exposure to sunlight.

A rare bone condition known as osteogenesis imperfecta (OI) is brought on by an inherited connective tissue abnormality. Even within families who share a common mutation, symptoms might differ widely. H, a boy, aged 12, and F, a boy, aged 10, are siblings. Since they were 5 months old and 5 years old, their main complaint was repeated fractures in the lower extremities as a result of minor trauma. Only the mother's family had the same OI clinical manifestation characteristics. Physical examination revealed no signs of dentinogenesis imperfecta, blue sclera, hypermobility of the joints, or hearing problems. They have delayed growth and mild bone deformities. Pathologic fracture, cortical thinning, osteopenia, and pseudoarthrosis were all discovered during the radiology examination. The patient has received fixation, Biphosphonate injection, supportive care, and surgery. Therapy that was both definite and supportive was used to manage the patient. We monitored both patients physical and radiological examination, as well as  the quality of life using PedsQL 4.0 Generic Core Scales aged 8-12 years for Child and Parent Report for Children before and after a year of monitoring, we observed that both the patient's symptoms and quality of life had improved.

The coronavirus disease-19 (COVID-19) pandemic has significantly affected healthcare systems. Down syndrome (DS) is a chronic disease caused by trisomy of chromosome21 which is associated with a variety of medical problems such asautoimmune thyroid disease (AITD) that necessitate comprehensive routine treatment. During the COVID-19 pandemic, there was an increasing an unavailability, which became an impediment to chronic disease patients’ drug consumption.

The purpose of this study was to examine the barriers to medication adherence faced by DS patients during the COVID-19 pandemic.

An observational analytic study was conducted from January to July 2021 among parents of DS patients who registered in the pediatric endocrinology outpatient clinic of Dr. Soetomo General Hospital. Inclusion criteria include: The parents of DS with AITD patients aged 1 - 18 yearswhocameto the pediatric endocrinology polyclinic, routinely took oral medication beforeMarch2020, can fill out questionnaire forms independently, and signed the informed consent. Exclusion criteria were parents of DS patients who did not take regular medication, or started treatment after March 2020. Data were collected and analyzed using the Wilcoxon comparison test

There are 31 DS patients responded and completed the questionnaires. Adherence to hospital visits in DS with AITD patients before and during the COVID-19 pandemic showed significant differences (P = 0.001). The main barriers to follow-up visits during the pandemic were lockdown protocol which made travel difficult (28%). The compliance for taking medication was still high although 13 (41.9%) obtained the medicine without a prescription.

Changes in terms of medication adherence during the pandemic have highlighted the importance of improving DS patient’s access to healthcare. Shifting medication counseling to the nearest primary health care provider with supervision from a tertiary referral specialist appears to be a reasonable and potentially cost-effective strategy in improving treatment adherence especially in a pandemic setting.

 Children with type-1 diabetes mellitus (T1DM) often experience emotional and behavioral problems such as anxiety and depression. Social restrictions during the COVID-19 pandemic caused social restrictions and limited access to healthcare facilities, which may have worsened the metabolic control.

 This study aimed to analyze the behavioral problems among type 1 diabetes mellitus children with good and poor metabolic control during COVID-19 pandemic.

 This cross-sectional study was conducted in January - August 2021 in the Endocrine Outpatient Clinic of General Hospital Dr. Soetomo Surabaya. Type-1-DM children who fulfilled the inclusion criteria were divided into two groups based on metabolic control, including good (HbA1C ≤ 8) and poor (HbA1C > 8). The Pediatric Symptom Checklist-17 (PSC-17) was used as a screening tool with the domain internalizing problems (IP), externalizing problems (EP), and attention problems (AP). The data were analyzed using Pearson or Spearman test with Statistical Product and Service Solution (SPSS) version 18.0.

 In this study, 27 subjects (17 boys and 10 girls, aged 12.63 ± 3.39 years) were investigated. Of all subjects, only 8 subjects had good metabolic control during the COVID-19 pandemic. Furthermore, 33.3% of the participants had behavioral problems (14.8% IP; 18.5% EP). The frequencies of IP, EP, and AP in the good metabolic control group were 12.5%, 37.5%, and 0%, respectively; while those in the poor metabolic group were 15.8%, 10.5%, and 0%, respectively. There was no significant difference between the good and poor metabolic control groups in terms of behavior problems (P = 1.00, IP; P = 0.14, EP).

 No significant difference was found between good and poor metabolic control groups (P = 1.00, IP; P = 0.14, EP). However, the frequency of EP was higher in good metabolic control, and the frequency of IP was higher in poor metabolic control.