Type 1 diabetes mellitus (T1DM) is a chronic disease caused by insulin deficiency resulting from autoimmune destruction of pancreatic beta cells. Increased risk of fractures and osteoporosis in T1DM is associated with reducing osteoblast proliferation, survival, and activity. Osteocalcin (OC) is a marker of late-stage osteoblast differentiation. It might be positively modulated by vitamin D. This study was aimed to investigate the effect of vitamin D3 supplementation on the level of 25(OH)D3, HbA1c, and OC in children with T1DM. A randomized clinical trial was conducted to measures the levels of 25(OH)D3, HbA1c, and OC in children with T1DM supplemented with vitamin D3. Many 26 children with T1DM were equally assigned into two groups: control (standardized insulin treatment) and treatment group (standardized insulin treatment + vitamin D3 2000 IU/day). Subject characteristics showed that the subjects were predominantly female (15/26), well-nourished (19/26), the average age is 12,31 ± 3,069 year, and the dose of insulin average is 1,17 ± 0,233 IU/kg BW/day. Our data demonstrated that vitamin D3 treatment significantly increased the level of 25(OH)D3 and improved glycemic control, represented by a low HbA1c level. However, there was no significant difference in OC level in both groups (independent t-test, p > 0.05). Further analysis showed no significant relationship between the level of 25(OH)D3, HbA1c, and OC. We concluded that vitamin D3 supplementation improves children's glycemic control with T1DM, but no significant alteration on OC levels.Keywords: HbA1c, Osteocalcin, T1DM, Vitamin D

Masalah yang terjadi di banyak negara salah satunya adalah Diabetes Melitus tipe 1. Prevalensi DM tipe 1 di Indonesia masih belum jelas. DM tipe 1 disebabkan berkurangnya sekresi insulin akibat kerusakan fungsi sel β pankreas oleh karena respon autoimun. Diabetik osteopati merupakan salah satu komplikasi DM, yaitu peningkatan terjadinya osteoporosis. Penelitian ini bertujuan mencari korelasi antara kadar 25(OH)D3, kontrol glikemik dengan mengukur kadar HbA1c dan osteocalcin , sebagai penanda biokimia struktur tulang. Dua puluh enam anak dengan DM tipe 1 adalah sebagai subjek penelitian. Data dianalisis secara statistik dengan menggunakan Shapiro Wilk, korelasi Pearson dan Spearman. Karakteristik sampel menunjukkan jenis kelamin didominasi perempuan 58%  dan didominasi dengan gizi baik (73%). Status vitamin D didominasi defisiensi (61,5%). Kadar HbA1C <7,5 % sebanyak 27%. Rerata usia pasien adalah 12,31 ± 3,069 tahun, dosis insulin 1,17±0,233 IU, kadar GDP 115,08±46,742 mg/dL, dan kadar GDS 144,65±76,365 mg/dL. Tidak didapatkan korelasi yang signifikan antara kadar HbA1c (p=0,472, r=-0,148) dan osteocalcin (p=0,407, r=0,17) dengan kadar 25(OH)D3. Demikian juga antara osteocalcin dan kadar HbA1c. Kesimpulan tidak diapatkan korelasi antara kadar osteocalcin , kadar HbA1c,  dan kadar 25(OH)D3.

Impaired growth is still a problem that needs attention in Indonesia. There are still many incidents of children with short stature due to lack of nutrition, undernourished toddlers, and even malnutrition. Therefore, the detection of child growth still needs to be improved. The Covid-19 pandemic has made parents of patients afraid and anxious to take their children to health facilities, so that monitoring of their growth is neglected, especially in pediatric patients with chronic diseases. This community service activity is intended to provide training to parents of patients on how to measure anthropometric status in pediatric patients with chronic diseases so that parents are expected to be able to screen or detect growth disorders early and independently. Therefore, education and training are held with the aim of increasing the knowledge and skills of parents in examining the anthropometric status of children. Evaluation is done by asking questions and practicing anthropometric status checks at the beginning and end of the activity and good numbers of material uptake by participants are obtained so that participants can independently assess the child's anthropometric status and get an increase in skills. The knowledge of the patient's parents about awareness of growth and development screening is still lacking so that it can affect the detection of developmental disorders in children. With this activity, it can provide the ability of the patient's parents to equip themselves to monitor the growth of their child.

Mental health in children and adolescents with chronic illnesses is still a problem that is rarely a concern in Indonesia. There are still many incidents of children and adolescents with depression due to the length of treatment they are undergoing, disease activity, psychological conditions, and support from the environment and family. Therefore, the detection of depressive disorders in children and adolescents still needs to be improved. The Covid-19 pandemic has made parents of patients afraid and anxious to bring their children to health facilities, so monitoring of mental health has been neglected, especially in pediatric and adolescent patients with chronic illnesses. This community service activity is aimed at providing counseling regarding the signs and symptoms of depression detection. Evaluation was carried out by filling out a questionnaire using the Children Depression Inventory (CDI). The conclusion from this activity is that 20% of children and adolescents with chronic illnesses experience mild depression, so further evaluation and intervention is needed

Introduction: In the past few years, there has been increased recognition that children, who have a history of traumatic incidences, can develop post-traumatic stress disorder (PTSD), just like in adults. Case: We presented a case of PTSD in a 3-year-old child hospitalized in the hospital for two days due to combustion (deep dermal burn injury) in his left hand, stomach, and both of his legs. The patient started to experience parasomnia such as nightmares, raves, difficulty to sleep and awakened from sleep (for one month from the beginning of wound treatment and debridement). The patient also had two re-experiencing symptoms: nightmare and emotional distress (anxiety, anger) after a traumatic stimulus. From his temperament scale and character assessment, there was dysregulation disorder. From the PEDSQL parent's reports, there was also decreased quality of life. Conclusion: First-line therapy of PTSD for the pediatric population is supportive psychotherapy with trauma-focused cognitive behavioral therapy (TF-CBT) that results in a remarkable improvement in child's psychiatric outcome.