Vitamin D is reported to affect immune system and prevent autoimmunity. Some studies show that low vitamin D levels in patients with type 1 diabetes are associated with glycemic control and inflammatory status. The study was cross sectional design with subjects T1DM patients aged 1-18 years, and healthy subjects with similar age. Plasma levels of vitamin D (25(OH)D3) was measured using ELISA. Glycemic control measured by hemoglobin A1c (HbA1c). Inflammatory status measured by examination of IL-10 using ELISA method. Comparison of vitamin D levels, HbA1c levels and IL-10 levels were analyzed by independent samples t-test. The relationship between vitamin D levels, HbA1c, and IL-10 were analyzed by Pearson's correlation. Our subjects were 20 T1DM patients and 20 healthy controls. Our study showed that vitamin D (25(OH)D3) levels was significantly lower than in healthy controls (20.82±5.53 ng/ml vs 33.14±2.17 ng/ml; p=0.000), HbA1c levels was significantly higher than in healthy controls (10.08±5.02% vs 5.02±0.18%; p=0.000), IL-10 levels was significantly lower than in healthy controls (16.50±4.57 ng/ml vs 73.52±7.11 ng/ml; p=0.000). Vitamin D levels were correlated with HbA1c (p= 0.000; r=-0.871), correlated with IL-10 (p= 0.000; r= 0.853). HbA1c levels were correlated with IL-10 levels (p= 0.000; r=-0.878). Low vitamin D levels are common in T1DM patients. There were significant differences in vitamin D levels, IL-10, and HbA1c among T1DM patients compared to normal subjects. Vitamin D levels were associated with HbA1c levels and IL-10 levels in T1DM.

Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by pancreatic β-cell destruction and considered to be correlated with oxidative stress. This study aimed to investigate the association of oxidative stress [superoxide dismutase (SOD) and malondialdehyde (MDA) levels], inflammation [interleukin 10 (IL-10)], and glycemic control (HbA1c) in pediatric T1DM patients. This study included 25 T1DM subjects and 25 healthy control subjects and was designed as a cross-sectional study. SOD, MDA, and IL-10 levels were measured by ELISA. We obtained that that IL-10 and SOD levels were significantly decreased in the T1DM group, but MDA and HbA1c levels were significantly elevated in the T1DM group. IL-10 levels were positively correlated with SOD levels and negatively correlated with MDA and HbA1c. SOD levels were negatively correlated with HbA1c levels. MDA was positively correlated with HbA1c levels. IL-10 and SOD levels were significantly decreased, but MDA and HbA1c levels were significantly elevated in the T1DM group.

Introduction:Elizabethkingia meningoseptica is a Gram-negative Bacillus associated with various nosocomial infections. These bacteria cause meningitis, sepsis, bacteremia, pneumonia, infections of the skin and soft tissue, ocular infections, sinusitis, epididymitis, and endocarditis. They can be opportunistic pathogens in newborns and immunocompromised patients.Case Presentation: The current study reported a case of bacteremia caused by E. meningoseptica in an infant presented with clinical presentations suggestive of necrotizing fasciitis with cerebral salt wasting and disseminated intravascular coagulation. Based on clinical diagnosis and preliminary blood culture report, the patient started receiving intravenous antibiotic (cefepime plus fludrocortisone) and fluid therapy for electrolyte imbalance. The patient also had fasciotomy and an amputation through the distal phalanges due to necrotizing fasciitis. The patient improved clinically after eight weeks of treatment. Conclusions: E. meningoseptica bacteremia is commonly associated with complications; therefore, an appropriate and adequate antibiotic therapy, and also intensive care procedures and multidisciplinary interventions were crucial for the management of this case.

Introduction: Congenital hypothyroidism is defined as a state of thyroid hormone deficiency present at birth. Congenital hypothyroidism must be diagnosed immediately because delay in therapy may cause irreversible neurological deficits, such as mental retardation in children. However, this condition can be prevented by screening in newborns so that congenital hypothyroidism can be diagnosed and treated early, and can result in better neurological development. This study aims to determine the congenital hypothyroidism ratio in Malang from March to November 2020. Methods: The descriptive analysis method was used in this research. The subjects were neonates aged 0 – 28 days with a gestational age of 36 weeks and were involving the Health Office in both the Regency and the City of Malang. The data about identity, gender, age at screening, and gestational age were collected. A laboratory screening test was performed by taking a blood sample from the heel or vein for a TSH test. If the result was positive with a TSH value > 20 U/mL, the subject would be recalled for having a confirmation test and referred to a pediatric endocrinologist. Results: There were 2024 (88.34%) subjects were successfully screened from a total of 2291 subjects. The recall rate for congenital hypothyroidism was 1:2024 (0.04%). Conclusion: The ratio of congenital hypothyroidism cases in Malang from March to November 2020 was higher than the global ratio, which was 1:3000. The high rate of congenital hypothyroidism in Malang indicated the need for congenital hypothyroidism screening in newborns.

BACKGROUND: Cardiovascular disease (CVD) is one the cause of mortality in patients with type 1 diabetes (T1D). The development of CVD is mainly triggered by atherosclerosis, which is associated with the inflammatory process. AIM: The current study was aimed to investigate the association of Vitamin D level and premature atherosclerosis in adolescents with T1D, mainly through the regulation of various cytokines (interferon-γ [IFN-γ], IL-17, interleukin-10 [IL-10], and transforming growth factor-β1 [TGF-β1]). METHODS: This study was designed as a cross-sectional study involving 40 T1D and 40 healthy control who came to the outpatient clinic, Saiful Anwar Hospital, Malang, Indonesia, within the study period (January 2019-July 2019). RESULTS: Our data demonstrated that the IFN-γ and IL-17 levels were significantly higher (p < 0.001), whereas the TGF-β1 and IL-10 levels were significantly lower (p < 0.001) in T1D group compared with control. Furthermore, T1D also has higher carotid intima-media thickness (cIMT) value and lower flow-mediated dilatation (FMD) value compared to the control group (p < 0.001). Level of 25(OH)D3 was strongly associated with reduced cIMT and elevated FMD (p < 0.005). The direct effect of 25(OH)D3 on cIMT and FMD was higher than the indirect effect of Vitamin D through TGF-β1, IL-10, IL-17, and IFN-γ. The cutoff value of 25(OH)D3 levels for the risk of atherosclerosis was 12.8 ng/dL (sensitivity 85.7% and specificity 86.7%). CONCLUSION: The level of Vitamin D in the T1D group was significantly lower than those in healthy children and Vitamin D deficiency substantially influences the formation of premature atherosclerosis.