Unspecific congenital toxoplasmosis in a two-month-old baby.

A two-month-old baby boy diagnosed with unspecific congenital toxoplasmosis was referred by a pediatrician to the Clinical Parasitology referral center at the Faculty of Medicine, Universitas Indonesia. Baby was post-hospitalized in the NICU and required ventilation support for one month. Furthermore, there was history of from various medical conditions, such as intracranial bleeding, convulsion, hypertrophic cardiomyopathy, retinopathy, and renal failure. After two month, there was no significant weight gain, anti-Toxoplasma IgM showed positive results, and anti-Toxoplasma IgM and IgG of the mother were also positive. Baby and mother were successfully treated with pyrimethamine, cotrimoxazole, and folinic acid for one month. At 2 years, there signs of normal motoric, eye, and hearing development with underdeveloped kidneys. Therefore, pre-pregnancy counseling and education aimed at preventing toxoplasmosis during pregnancy should be increased and conducted routinely by health workers or trained cadres to reduce the risk of fetal defects.

Case Report: The Role of Multilead Laser Needle and Laser Pen with Dietary Interventions on Grade 2 Obesity.

Background: Obesity is an accumulation of excessive fat tissue that can affect health. Acupuncture has a positive effect on leptin, ghrelin, insulin resistance, glucose metabolism, lipids, serum immunoglobulin levels, and decreased appetite. Laser as an acupuncture modality can be a good option because it is easy to apply, noninvasive, and painless. Laser acupuncture works using a laser pulse to stimulate acupuncture points with a therapeutic effect similar to needle acupuncture. Case: A 19-year-old woman came to the acupuncture clinic of Cipto Mangunkusumo Hospital (Jakarta, Indonesia) wanting to lose weight and slim down. Acupuncture was done at the following points CV12, ST25, SP15, ST40, ST36, and SP6 with a laser needle multilead continuous wave 4 J for each point with power density 40 mW for 7 minutes. Acupuncture was done with a laser pen RJ-Laser continuous wave 0.5 J for each hunger point with power density 50 mW for 25 seconds, therapy was performed 3 times a week for 2 months. Results: Decrease in body weight and a decrease in abdominal circumference were noted after 24 sessions. The highest peak of weight loss at the 18th session was 11.5 cm in the umbilicus circumference, above the umbilicus by 6.5 cm, below the umbilicus by 9 cm, then stable with the final result of a decrease in the umbilicus circumference of 10 cm, above the umbilicus by 4 cm, and under the umbilicus by 5 cm. Decrease in random blood sugar was noted from 122 to 100 mg/dL. Conclusion: A combination of laser needle multilead and laser pen had good results in this case and may be useful for weight loss and a decrease in abdominal circumference in obese patients.

The Prevalence of Intestinal Protozoan Infections among Children in Southwest Sumba Based on the Type of Water Sources.

BACKGROUND: Intestinal protozoan infection is a public health problem in Indonesia, particularly in regions lacking clean water sources such as Perokonda and Perobatang villages, Southwest Sumba Regency, East Nusa Tenggara Province. The residents of Perokonda and Perobatang villages use wells and unprotected open springs respectively. Therefore, this study aims to determine the prevalence of intestinal protozoan infections in these two villages. MATERIALS AND METHODS: This was a cross-sectional study, carried out in Perokonda and Perobatang from August 2016 to August 2017. A total of 291 children aged 6 months to 18 years were used as subjects. Furthermore, fecal examinations were carried out by preparing smears, which were stained with lugol solution and examined under the microscopes by four experienced technicians. The data were processed using SPSS version 20 and analyzed by chi-square test. RESULTS: Among the 291 samples, the prevalence of intestinal protozoan infections was 20%, with 23.4% in Perokonda and 17.2% in Perobatang. The predominant species found were Blastocystis hominis (34.5%), Giardia lamblia (19.0%), and Entamoeba coli (15.5%). Moreover, approximately 69.0% of single infections were found while 31.0% were mixed and associated with 2 to 3 protozoan species. There were no significant differences between the prevalence of intestinal protozoan infections and the children in Perokonda and Perobatang villages (confidence interval 0.83 - 2.62, P = 0.19). CONCLUSION: The type of water sources has no relationship with the species of intestinal protozoan infecting children in Perokonda and Perobatang.

Diagnosis and Identification of Blastocystis Subtypes in Primary School Children in Jakarta.

Blastocystis hominis is an enteric protozoan with many subtypes. It is frequently found in children and may cause chronic diarrhea. This study revealed Blastocystis subtypes among primary school children and comparison of molecular technique and culture method in Blastocystis diagnosis. A total of 141 stools were collected, examined microscopically, selected into the Blastocystis and negative parasite groups, for diagnostic comparison between culture and 18S rRNA polymerase chain reaction (PCR) methods. Positive PCR amplicons were subsequently sequenced for subtyping. The PCR results revealed 89%, 78%, 80% and 88% sensitivity, specificity and positive and negative predictive values, respectively, in comparison with the culture method (McNemar, p > 0.05). Sixteen PCR samples were successfully sequenced and resulted in three Blastocystis subtypes 1, 3 and 4. In conclusion, PCR was sensitive enough and can be used to exclude Blastocystis infection up to 88% of the cases. Subtypes 3 and 1 were the main subtypes found in apparently healthy school children in Jakarta.