Arfianti Chandra Dewi, Arfianti Chandra
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Severe Dengue or Covid-19 Related MIS-C? Diagnostic Challenges in Resource-Limited and Dengue-Endemic Regions Angelina; Dewi, Arfianti Chandra
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 17 No 1 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v17i1.5929

Abstract

Besides serological cross-reactivity and co-infection between dengue and SARS-CoV-2, diagnostic challenges arise because many people have had positive dengue IgG in dengue-endemic regions, and patients usually come after 4-5 days of fever. We report a case of 9-year-old girl, diagnosed with dengue with warning signs on admission because of fever, severe abdominal pain, thrombocytopenia, and positive dengue IgG. The subsequent course of the illness was not consistent with dengue infection because the shock happened during the febrile phase concurrent with rising leucocyte and platelet counts, the fever continued for longer than seven days, and there was bilateral non-purulent conjunctivitis with subconjunctival hemorrhage. She was diagnosed with MIS-C because of positive SARS-CoV-2 IgG and hyperinflammatory markers. Her clinical condition improved progressively after steroid administration. Clinical awareness about MIS-C is required to avoid misdiagnosis and improper treatment during or after the COVID-19 pandemic. Every clinician should consider MIS-C as a differential diagnosis if patients have inconsistencies with the course of dengue illness.
Difficulty walking as the main manifestation of scurvy in children: two cases from a resource-limited setting Angelina, Angelina; Aviana, Ruthie; Ardelia, Yolanda; Dewi, Arfianti Chandra; Sidauruk, Ratno Juniarto Marulitua
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.260-7

Abstract

Scurvy is a disease caused by a prolonged deficiency of vitamin C. It was first reported in Egypt in 1500 before century (BC) and formally described by the writings of Hippocrates as “the mouth feels bad, the gums are detached from the teeth, blood runs from the nostrils, black-colored ulcerations frequently appear on the legs, some of these heal, others not, and the skin is thin.”1,2 Scurvy has become an uncommon disease nowadays, especially in developed countries. However, there have been sporadic case reports of scurvy in children. One of the largest cohorts of scurvy cases in children took place in Thailand in 2003, where 28 children diagnosed with scurvy manifested with a limp or inability to walk.3
Analisis Kritis Terkait Manajemen dan Luaran Pasien Anak di Unit Perawatan Intensif Anak Level Sekunder Angelina, Angelina; Aviana, Ruthie; Ardelia, Yolanda; Dewi, Arfianti Chandra
Sari Pediatri Vol 26, No 2 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.2.2024.109-15

Abstract

Latar belakang. Setiap unit perawatan intensif anak (UPIA) memiliki karakteristik berbeda. Evaluasi terhadap manajemen dan luaran pasien penting untuk memperbaiki kualitas pelayanan. Data publikasi penelitian terkait UPIA umumnya dikerjakan pada level tersier.Tujuan. Melakukan tinjauan terhadap manajemen yang diberikan kepada pasien UPIA level sekunder, dan hubungannya dengan luaran pasien.Metode. Penelitian potong lintang retrospektif menggunakan data rekam medis pasien yang dirawat di UPIA Rumah Sakit Umum Daerah Balaraja selama tahun 2022. Data yang diambil mencakup data demografis (usia, jenis kelamin, berat badan), diagnosis utama, komorbiditas, terapi selama perawatan, dan parameter laboratorium. Hasil uji statistik disajikan dalam nilai p serta interval kepercayaan 95%, besarnya hubungan dinyatakan dengan nilai Odds ratio. Hasil. Seratus satu pasien masuk dalam penelitian. Sebagian besar berusia di bawah 1 tahun, dengan pneumonia dan infeksi sistem saraf pusat merupakan diagnosis terbanyak. Terdapat 32 pasien (31,6 %) meninggal dunia, penggunaan ventilator mekanik (OR36,75; IK95%:8,014-168,519; p<0,001) dan pemberian obat vasoaktif (OR11; IK95%:4,137-29,295; p<0,001) berhubungan bermakna dengan tingkat mortalitas. Kesimpulan. Sebagian besar pasien adalah bayi yang didominasi dengan masalah medis akibat infeksi. Tingkat mortalitas cukup tinggi, berhubungan bermakna dengan penggunaan ventilator mekanik invasif serta obat vasoaktif.