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Intracardiac rhabdomyoma in a newborn with tuberous sclerosis I Kadek Suarca; Ida Bagus Agung Winaya; I Komang Kari
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Primary congenital cardiac tumors, especiallyintracardiac tumors, are rare in children.Rhabdomyoma is the most common oneand usually diagnosed in the first few days oflife. Referral from pediatric cardiac centers found thatthe incidence of cardiac tumors was 0.08%-0.20%.Rhabdomyoma represents 36%-42% in autopsy seriesand 79% in clinical series.

Hubungan antara Pemberian ASI Eksklusif dan Perkembangan Anak di RSUD Wangaya Denpasar, Bali, Indonesia Fransiskus Aditya Kristianto; I Wayan Bikin Suryawan; I Kadek Suarca
Cermin Dunia Kedokteran Vol 50 No 11 (2023): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i11.756

Background: Exclusive breastfeeding is considered as one of many crucial factors in child development. The research was conducted with the aim of to determine the relationship between exclusive breastfeeding and child development. Method: An observational analytic study with cross-sectional design; the independent variable was exclusive breastfeeding and the dependent variable was child development according to KPSP score. A total of 86 samples were obtained using consecutive sampling method. Data were analyzed using the Chi-square test. Result: A significant positive correlation between exclussive breastfeeding and child development (p=0.035). Conclusion: There is a correlation between exclussive breastfeeding and child development in children at Wangaya Denpasar Regional Hospital.

Hubungan antara Pemberian ASI Eksklusif dan Perkembangan Anak di RSUD Wangaya Denpasar, Bali, Indonesia Fransiskus Aditya Kristianto; I Wayan Bikin Suryawan; I Kadek Suarca
Cermin Dunia Kedokteran Vol 50 No 11 (2023): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i11.756

Background: Exclusive breastfeeding is considered as one of many crucial factors in child development. The research was conducted with the aim of to determine the relationship between exclusive breastfeeding and child development. Method: An observational analytic study with cross-sectional design; the independent variable was exclusive breastfeeding and the dependent variable was child development according to KPSP score. A total of 86 samples were obtained using consecutive sampling method. Data were analyzed using the Chi-square test. Result: A significant positive correlation between exclussive breastfeeding and child development (p=0.035). Conclusion: There is a correlation between exclussive breastfeeding and child development in children at Wangaya Denpasar Regional Hospital.

Re-evaluating WHO Warning Signs in Pediatric Dengue: Abdominal Pain, Not Vomiting, is Associated with Plasma Leakage Cynthia Cynthia; Andreas Eric; I Kadek Suarca; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1382

Background: Dengue virus infection represents a significant cause of morbidity and mortality in pediatric populations across endemic regions. The progression to severe disease is characterized by a critical phase of plasma leakage. The World Health Organization (WHO) has established warning signs to aid in clinical triage, yet the independent clinical significance of these signs, particularly abdominal pain and vomiting, requires more precise clarification to optimize patient management. Methods: This study was a retrospective, cross-sectional analysis conducted at Wangaya General Hospital in Denpasar, Indonesia. Electronic medical records of 172 pediatric patients hospitalized with a diagnosis of dengue between January and May 2024 were reviewed. The primary outcome was significant plasma leakage, defined as a hematocrit increase of 20% or more from the admission baseline. Bivariate and multivariate logistic regression analyses were performed to determine the association of abdominal pain and vomiting with plasma leakage, controlling for the confounding effects of age, gender, and the day of fever at assessment. Results: In the multivariate logistic regression model, the presence of abdominal pain was independently and significantly associated with an increased likelihood of plasma leakage (Adjusted Odds Ratio [aOR]: 2.15, 95% Confidence Interval [CI]: 1.05–4.41; p=0.036). Conversely, the association for vomiting was not statistically significant after adjustment for confounders (aOR: 1.25, 95% CI: 0.65–2.42; p=0.508). The co-occurrence of both symptoms was also identified as a significant indicator of plasma leakage in the adjusted model (aOR: 2.09, 95% CI: 1.01–4.34; p=0.047). Conclusion: In this retrospective analysis of a hospitalized pediatric study, abdominal pain emerged as a robust independent correlate of significant plasma leakage, whereas vomiting did not. This differential association suggests that abdominal pain should be weighted more heavily in the clinical assessment of children with dengue as a key indicator of ongoing or impending hemoconcentration. These findings, while limited by their retrospective nature, can help refine clinical risk assessment in resource-constrained settings.

Re-evaluating WHO Warning Signs in Pediatric Dengue: Abdominal Pain, Not Vomiting, is Associated with Plasma Leakage Cynthia Cynthia; Andreas Eric; I Kadek Suarca; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1382

Background: Dengue virus infection represents a significant cause of morbidity and mortality in pediatric populations across endemic regions. The progression to severe disease is characterized by a critical phase of plasma leakage. The World Health Organization (WHO) has established warning signs to aid in clinical triage, yet the independent clinical significance of these signs, particularly abdominal pain and vomiting, requires more precise clarification to optimize patient management. Methods: This study was a retrospective, cross-sectional analysis conducted at Wangaya General Hospital in Denpasar, Indonesia. Electronic medical records of 172 pediatric patients hospitalized with a diagnosis of dengue between January and May 2024 were reviewed. The primary outcome was significant plasma leakage, defined as a hematocrit increase of 20% or more from the admission baseline. Bivariate and multivariate logistic regression analyses were performed to determine the association of abdominal pain and vomiting with plasma leakage, controlling for the confounding effects of age, gender, and the day of fever at assessment. Results: In the multivariate logistic regression model, the presence of abdominal pain was independently and significantly associated with an increased likelihood of plasma leakage (Adjusted Odds Ratio [aOR]: 2.15, 95% Confidence Interval [CI]: 1.05–4.41; p=0.036). Conversely, the association for vomiting was not statistically significant after adjustment for confounders (aOR: 1.25, 95% CI: 0.65–2.42; p=0.508). The co-occurrence of both symptoms was also identified as a significant indicator of plasma leakage in the adjusted model (aOR: 2.09, 95% CI: 1.01–4.34; p=0.047). Conclusion: In this retrospective analysis of a hospitalized pediatric study, abdominal pain emerged as a robust independent correlate of significant plasma leakage, whereas vomiting did not. This differential association suggests that abdominal pain should be weighted more heavily in the clinical assessment of children with dengue as a key indicator of ongoing or impending hemoconcentration. These findings, while limited by their retrospective nature, can help refine clinical risk assessment in resource-constrained settings.

Fatal Disseminated Tuberculosis in Vaccinated Children with Failed BCG Scar Formation: A Clinical-Pathological Correlation and Immunological Review Delicia Rudy; Prisillia Brigitta; I Kadek Suarca
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1510

Background: The Bacillus Calmette-Guérin (BCG) vaccine remains the cornerstone of preventative strategies against severe pediatric tuberculosis (TB), specifically disseminated forms such as miliary TB and tuberculous meningitis (TBM). While the formation of a cutaneous scar is historically viewed as a surrogate marker for successful vaccine uptake and delayed-type hypersensitivity (DTH), its absence is often clinically overlooked. This study investigates the correlation between the lack of BCG scarring, immunological anergy, and fatal disseminated disease outcomes. Case presentation: We report a clinical-pathological analysis of two pediatric patients admitted to a tertiary care center in Indonesia. Case 1, an 11-month-old male vaccinated at birth, presented with status epilepticus and was diagnosed with Probable TBM Stage III. Despite vaccination, he lacked a BCG scar and exhibited Tuberculin Skin Test (TST) anergy (0 mm). Case 2, a 2-year-8-month-old female vaccinated at birth, presented with Type 1 respiratory failure due to severe miliary TB. She demonstrated profound wasting and TST anergy (0 mm). Both patients succumbed to the disease (Day 9 and Day 14, respectively) despite aggressive management. Conclusion: The absence of a BCG scar in vaccinated children serves as a critical clinical indicator of "immunological silence." It correlates with a failure to mount the Th1-mediated granulomatous response necessary for containing lymphohematogenous spread. We recommend that scar failure be treated as a risk factor requiring enhanced surveillance and a lower threshold for preventative therapy.

Fatal Disseminated Tuberculosis in Vaccinated Children with Failed BCG Scar Formation: A Clinical-Pathological Correlation and Immunological Review Delicia Rudy; Prisillia Brigitta; I Kadek Suarca
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1510

Background: The Bacillus Calmette-Guérin (BCG) vaccine remains the cornerstone of preventative strategies against severe pediatric tuberculosis (TB), specifically disseminated forms such as miliary TB and tuberculous meningitis (TBM). While the formation of a cutaneous scar is historically viewed as a surrogate marker for successful vaccine uptake and delayed-type hypersensitivity (DTH), its absence is often clinically overlooked. This study investigates the correlation between the lack of BCG scarring, immunological anergy, and fatal disseminated disease outcomes. Case presentation: We report a clinical-pathological analysis of two pediatric patients admitted to a tertiary care center in Indonesia. Case 1, an 11-month-old male vaccinated at birth, presented with status epilepticus and was diagnosed with Probable TBM Stage III. Despite vaccination, he lacked a BCG scar and exhibited Tuberculin Skin Test (TST) anergy (0 mm). Case 2, a 2-year-8-month-old female vaccinated at birth, presented with Type 1 respiratory failure due to severe miliary TB. She demonstrated profound wasting and TST anergy (0 mm). Both patients succumbed to the disease (Day 9 and Day 14, respectively) despite aggressive management. Conclusion: The absence of a BCG scar in vaccinated children serves as a critical clinical indicator of "immunological silence." It correlates with a failure to mount the Th1-mediated granulomatous response necessary for containing lymphohematogenous spread. We recommend that scar failure be treated as a risk factor requiring enhanced surveillance and a lower threshold for preventative therapy.

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