BACKGROUND: The COVID-19 pandemic determined a profound impact on the routine follow-up of type 1 diabetes (T1D) children. Telemedicine represents a critical tool to guarantee regular care for these patients in this form. AIM: The purpose of this study was to assess the impact of telemedicine programs during the COVID-19 pandemic era on T1D children. PATIENTS AND METHODS: Studies from PubMed, Cochrane, and Directory of Open Access Journals from December 2021, to February 18, 2022, were conducted to calculate the pooled mean difference using either a random or fixed-effect model in Review Manager version 5.3. Our study has applied to ensure that our procedures, including record collection, extraction of data, quality evaluation, and statistical analysis, adhere to the Preferred Reporting Items for Systematic Examination and Meta-Analysis guidelines. RESULTS: Three articles relevant to the current study (436 children). Our pooled analysis found that there was an impact of telemedicine in reducing the HbA1c (mean diff: 5.64 [95% confidence interval (CI) 3.71–7.57], p < 0.00001). However, the physical activity was not affected by the telemedicine program (mean diff: −37.25 [95% CI −317.53–243.02], p = 0.79). CONCLUSION: Our findings suggest that telemedicine has a role in T1D children controlling HbA1c during the COVID-19 pandemic. Meanwhile, telehealth has emerged as a promising alternate mode of health-care delivery. Its utility during the pandemic warrants further investigation.

Background: The coronavirus disease-19 (COVID-19) pandemic has significantly affected healthcare systems. Down syndrome (DS) is a chronic disease caused by trisomy of chromosome 21 which is associated with a variety of medical problems such as autoimmune 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. Objectives: The purpose of this study was to examine the barriers to medication adherence faced by DS patients during the COVID-19 pandemic. Methods: 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 years who came to the pediatric endocrinology polyclinic, routinely took oral medication before March 2020, 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 Results: 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. Conclusions: 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.

Background: The most frequent congenital endocrine disorder in children is congenital hypothyroidism (CH). In Indonesia, CH's prevalence is greater than the data currently available. However, CH newborn screening has only been carried out in a few locations across Indonesia. Therefore, there is a need to raise primary healthcare practitioners' understanding of the CH Screening Program. Materials and Methods: This study used a pre-posttest design to gauge the healthcare professionals' knowledge of newborn congenital hypothyroid screening. After intervention, a post-test was given. The categorical measures' descriptive statistical analysis results were presented as a mean, median, percentage (%), and frequency (n) distribution table. The improvement in healthcare professionals' understanding of newborn CH screening was evaluated using the Paired Samples test. The cutoff for statistical significance was p＜0.05 using SPSS version 20.0. Results: In our study, most of the participants were midwives with a total of 21/53 (39.62%) followed by nurses with 19/53 (35.83%). There was also an increase in the score where previously in the pretest only 1 person got a score above 80, then it increased to half of the participants, namely 49.06% (26/53) who got better scores. months and 37/54 (68.5%). With the Paired Sample test, we prove that there is a significant increase in the participants' scores, and the data obtained is p＜0.05, which means that there is an increase in the average data from the pretest to the post-test. Conclusion: There was an improvement in pre-posttest knowledge of healthcare who had been given education about CH newborn screening.

Background: Stunting is a condition of chronic nutritional deficiency which can negative short and long-term impacts on children. Malang Regency is one of the 100 priority districts for stunting intervention in Indonesia with 27.28% stunting prevalence. Puskesmas Wajak (Community Health Center) in Malang Regency has one national stunting locus and three district stunting loci. Based on this, it is necessary to describe the incidence of stunting in the Wajak Community Health Center Work Area based on the year 2020 as the latest data. Methods: A descriptive observational with a quantitative approach study was conducted in August-September 2021 with total sampling from secondary data of stunted children aged 0-59 months in “Weighing Month” of February 2020 was 510 children and in the “Weighing Month” of August 2020 was 327 children from thirteen villages in the Puskesmas Wajak. The data was then analyzed by univariate analysis which resulted in the distribution and percentage of the nominal variables and presented in the form of narratives, tables, and graphs. Results: Based on gender, most children have stunting than severe stunting, male: female, 89%:85.7% in February and 91.6%:95% in August. Based on age, the incidence of stunting mostly happened at the age of 24-59 months (59.4% and 63.3%). Conclusion: Stunting mostly happened in males than females and at the age of 24-59 months. Based on the distribution, the highest incidence of stunting was in Blayu and Sukoanyar villages.

Highlight: The diagnosis and therapy of Congenital Adrenal Hyperplasia (CAH) children with Adrenal crisis (AC) case report. Adrenal crisis (AC) is a life-threatening emergency that contributes to the high death rate of children with adrenal insufficiency. The early detection and prompt treatment can improve the outcomes of patients with CAH and AC.   Abstract: Adrenal crisis is the acute complication of the patient with congenital adrenal hyperplasia. Congenital adrenal hyperplasia (CAH) is a rare condition. Children with CAH commonly come to the emergency room due to acute complications. The condition has high mortality and thus needs early recognition. Newborn screening for CAH in Indonesia is not routinely performed and has not been suggested yet. The purpose of this case report was to report a case of adrenal crisis in a congenital adrenal hyperplasia patient focused on diagnosis and therapy. A female, 10 months old infant, was admitted to the emergency department with a chief complaint of a decrease of consciousness for 3 hours before admission and frequent vomiting since born. On physical examination, there was clitoromegaly. Laboratory showed 17-OH progesterone: 173 ng/dL (7-77 ng/dL) and karyotyping: 46 XX. Management of adrenal crisis is a stress dose of hydrocortisone and rehydration. Education is the key to optimal outcomes and normal growth and development.