Obesity is increasing nowadays including in children and there is lack of information on the pathophysiology and their complication such as insulin resistance and dyslipidemia. This study was aimed to investigate the comparison of lipid profile in obese children with and without insulin resistance. A crossectional study held at an elementary school in Denpasar, Bali from August until September 2015. Independent t-test, Mann-Whitney test, and Multivariate analysis of covariance (MANCOVA) were performed to compare lipid profile in obese children with and without insulin resistance. A P-value less than 0.05 was considered statistically significant. A total of 50 obese children were analyzed. In this study, we found 12 subjects (24%) with insulin resistance. Nonsignificant associations were found between insulin resistance with total cholesterol, HDL, LDL, and ratio of HDL/LDL. A significant association was found between insulin resistance and triglyceride level after adjusted age and sex. There was a significant mean difference of triglycerides in the insulin resistance and noninsulin resistance groups in obese children.

Malaria is one of the public health problems that can cause death, especially in high-risk groups such as infants, toddlers and pregnant women. Indonesia as tropical area which malaria is spread throughout the archipelagos, especially in eastern Indonesia. Method: This study aims to determine the profile of malaria in pediatric patients of Waikabubak Hospital, East Nusa Tenggara Province for the period January 2021 to December 2021. This is retrospective analytic descriptive study, by accessing medical record data of patients. The research subjects were pediatric patients aged 1 month to 18 years old who suffered malaria. Results: In this study, 53 subjects were positive for malaria. Patient characteristics were dominated by female gender 28 subjects (52.8%), with the highest age group being 1-5 years old 26 (49.1%), body mass index was dominated by underweight as much as 44 (83%). The most common symptom was fever in 19 subjects (35.8%). Another complaint was fever with seizure 9 (17%). This study was dominated by subjects with tropical malaria as many as 31 (58.5%). The lenght of hospitalization in this study was dominated by 3 days as many as 39 (73.6%). The medications that often used were Dihydroartemisinin-Piperaquine (DHP) and Primaquine as many as 36 (67.9%). The most common comorbid disease in this study was pneumonia as many as 13 (24.5%). Conclusion: Malaria pediatric patients in Waikabubak Hospital are dominated by female toddlers aged 1-5 years old, underweight. The most common complaints were fever, length of hospitalization was generally 3 days with the most common diagnosis was tropical malaria and the frequent given medication were DHP and Primaquine.

Background: Group A-haemolytic streptococcus (GAS), one of the most frequent pathogens in pediatric group causing various diseases, from acute pharyngitis (AP) to severe complication such as acute rheumatic fever (ARF) and acute post-streptococcal glomerulonephritis (APSGN). GAS, round gram positive bacteria typically form pairs or chains, was reported causing 1.78 million cases with 500.000 death due to its severe complication in 2005. Case Illustration: A 9-year-old female patient came to emergency unit (ER) complained swollen face and legs since 5 days ago, accompanied by tea color urine and reduced frequency and volume of micturition. Patient also complained shortness of breath which getting worse since yesterday, easily fatigue and dizziness. Moreover her mother also admitted that her daughter had history of migratory joints pain 3 weeks before admission, with sore throat a month ago. Blood pressure was 110/70 mmHg, Ross score was 8. Physical examination showed puffy face, pretibial edema, heart auscultation we heard pansystolic murmur. Chest radiography showed cardiomegaly and congestive pulmonum while laboratory exam showed ASTO 200, urinalysis showed red color, cloudy clarity, protein 1+, erythrocyte 3+, leukocytes 1+, urinary microscopic examination: 30-40 erythrocytes, 8-12 leukocytes, electrocardiography showed sinus tachycardia, prolonged PR interval, right atrial enlargement, right ventricle hypertrophy with right axis deviation. Patient was diagnosed with APSGN, hypertension grade II and heart failure due to rheumatic heart disease. Summary: APSGN and ARF rarely occur together, the coincidence might be due to streptococci with nephritogenic and rheumatogenic same strains. Early detection and treatment of GAS are crucial to prevent complications.