ABSTRACT
BACKGROUND AND AIM: Multisystem inflammatory syndrome in children (MIS-C) is a syndrome of fatal multisystem inflammation. This case report aims to describe our successful experience in managing children with MIS-C associated with previous SARS-CoV-2 infection and to help clinicians identify the spectrum of MIS-C signs and symptoms. METHOD(S): Case Reports RESULTS: A 6-year-old previously healthy boy was referred to our hospital with fever, dyspnea, vomiting, and abdominal pain for seven days before admission. Leucocytosis, elevated inflammatory and cardiac biomarkers were noted. Renal and liver function decreased. An echocardiogram showed dilated LV with EF 30% and a normal chest x-ray. High anti-SARSCoV- 2 titer (>250 U/mL) with negative for SARS-CoV-2 RTPCR was in accordance with the previous infection 8 weeks prior. He received intravenous furosemide, dobutamine, ceftriaxone, intravenous immunoglobulin (IVIG), and heparin in the pediatric intensive care unit and was discharged on the 11th day of treatment. The second case was a 10-yearold boy admitted to the hospital with a high fever (41.5O C), conjunctival hyperemia, diarrhea, and diffused abdominal pain for two days before hospitalization. History of COVID-19 was noted in the previous 4 weeks. Laboratory blood examination showed thrombocytopenia, elevated inflammatory markers, D-dimer, NT-pro BNP, negative for SARS-CoV-2 RT-PCR, and positive for IgG SARS-CoV2. Echocardiogram and chest x-ray were unremarkable. He received ceftriaxone, IVIG, Methylprednisolone, and enoxaparin. The patient was discharged after eight days of hospitalization. CONCLUSION(S): These two cases presented MIS-C following a history of mild COVID-19 infection. The successful management relied on the proper and timely administration of IVIG, corticosteroid, and anticoagulant.
ABSTRACT
BACKGROUND: The coronavirus disease-19 (COVID-19) pandemic is of special concern in all parts of the world, including Indonesia. The number of active cases also continues to increase in most provinces in Indonesia, especially in the Special Region of Yogyakarta. This condition requires health workers to collaborate well in suppressing and handling COVID-19 patients. AIM: The aims of this study were to find out how collaboration occurs between health workers in handling COVID-19. This study identifies opportunities and challenges for Interprofessional Collaboration (IPC) health workers at the Primary Health Center of Bantul Regency. METHODS: The design of this study was a cross-sectional study. We used the purposive sampling method to recruit participants. This study was followed by 200 participants who were health workers at the Primary Health Center in Bantul Regency. We used a questionnaire as the instrument. The questionnaire consists of four dimensions of IPC such as knowledge, collaboration, service, and the role of a pharmacist. The data obtained were statistically analyzed using Chi-square and Spearman. RESULTS: The result showed that IPC health worker at Health Primary Center of Bantul was categorized as good (45%). However, IPC at the Health Primary Center is still not optimal. There were top three obstacles in collaborating, namely, lack of time, perception of complicated bureaucracy, and lack of trust from health workers about their knowledge and skill.Based on spearman test p-value for age, gender, education level, years of service, occupation were 0.764;0,732;0.808;0.189;0.582;0.746. This result showed that the sociodemographic characteristics of the participants did not significantly affect the IPC (P>0.05). CONCLUSIONS: The main key in practicing IPC was building a good work team, good communication and relationship, responsibility for each other’s, keep learning from each other and being critical, and maintaining the ethics of each profession. Thus, effective and efficient collaboration will be established.
ABSTRACT
BACKGROUND: In patients with coronavirus disease-19 (COVID-19), respiratory failure is a serious condition that requires immediate respiratory supports. Various clinical conditions can be determinant factors to the need for used of ventilators. AIM: The aim of the study was to determine factor related to the used of ventilators among COVID-19 patients transferred to intensive care unit Sardjito Hospital. METHODS: Using a cross-sectional design, a total of 171 of 300 medical records selected in accordance to the inclusion criteria. Association of each clinical characteristics and outcome variable used contingency coefficient and Spearman rank tests, while multivariate logistic regression model was performed for hypothesis testing. The area under curve (AUC) was test to determine model fit of the logistic approach. RESULTS: There was a significant correlation between age (p = 0.004), blood sugar levels (p < 0.001), and oxygen saturation (p < 0.001), and the used of ventilator. Patients with hypoxia and severe hypoxia had odds of using ventilation supports 5 times and 114 times (OR = 5.623) and (OR = 114.3). The AUC test indicated that null hypothesis was rejected. CONCLUSION: The clinical characteristics were associated with age, blood sugar levels, and oxygen saturation. Patients with COVID-19 who admitted to hospital with hypoxia and severe hypoxia increased the odds of the use ventilators.