RESEARCH into rheumatic heart disease has progressively yielded a series of important facts and a good deal that is still speculative. It has been shown that many tissues, especially vascular structures, throughout the body are injured in attacks of rheumatic fever, and that the most serious damage occurs in the heart, to the myocardium and to its valves. It is generally considered now to have been conclusively shown that infections of body tissues with type A hsemolytie streptococci play a causative and key role in the pathogenesis of this disease, but only a small proportion of human beings infected with type A streptococci develop rheumatic heart disease. It is also widely held that the rheumatic lesions in the myocardium, including the so-called Aschoff bodies, are non-myogenic lesions of the connective tissue and do not involve the heart muscle fibres. However, G. E. Murphy,' in a long and very detailed paper, subsequently reprinted as a monograph,\" has set out to demonstrate that this last-mentioned interpretation is not correct, and that it is the heart muscle and plain muscle fibres which are affected. He was able to produce typical cardiac changes in a small proportion of rabbits with multiple focal infections due to type A heemolytie streptococci, and these gave material for study at various stages of the cardiac changes. In addition, he made a detailed microscopic study of the hearts of over 100 patients who had died with active rheumatic heart disease and of the left atrial appendages removed from 150 other patients at the time of mitral commissurotomy. The histopathological findings are presented in considerable detail with 162 beautiful reproductions of coloured sections of cardiac tissue illustrating the points made in the text. A study of the text and the slides makes clear the author's claims that the changes in the myocardium, both in man and in rabbits, are really in the muscle cells and not in the fibrous tissue.

Rheumatic heart disease

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

Sleep and sleep disorders.

http://www.thelancet.com/article/S2589537022001821/pdf

Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

The present study provides a systematic review of level 1 and level 2 screening tools for the early detection of autism under 24 months of age and an evaluation of the psychometric and measurement properties of their studies. Methods: Seven databases (e.g., Scopus, EBSCOhost Research Database) were screened and experts in the autism spectrum disorders (ASD) field were questioned; Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and Consensus-based Standard for the selection of health Measurement INstruments (COSMIN) checklist were applied. Results: the study included 52 papers and 16 measures; most of them were questionnaires, and the Modified-CHecklist for Autism in Toddler (M-CHAT) was the most extensively tested. The measures' strengths (analytical evaluation of methodological quality according to COSMIN) and limitations (in term of Negative Predictive Value, Positive Predictive Value, sensitivity, and specificity) were described; the quality of the studies, assessed with the application of the COSMIN checklist, highlighted the necessity of further validation studies for all the measures. According to COSMIN results, the M-CHAT, First Years Inventory (FYI), and Quantitative-CHecklist for Autism in Toddler (Q-CHAT) seem to be promising measures that may be applied systematically by health professionals in the future.

https://www.mdpi.com/2076-3425/10/3/180/pdf

Systematic Review of Level 1 and Level 2 Screening Tools for Autism Spectrum Disorders in Toddlers.

There is a close relationship between a person's mental health and gastrointestinal disorders. Psychogenic dysphagia is a rare condition related to swallowing disorders with no structural cause or organic diseases such as neurological deficits or other physical disorders. The mechanism of this swallowing disorder is still not well understood. Based on various studies that have been conducted, the condition of psychogenic dysphagia has comorbidity with psychological disorders such as anxiety disorders, depression, and post-traumatic stress. In this case report, we will present a case of a 7-year-old male patient who had difficulty swallowing due to fear of vomiting with disturbed psychosocial conditions, and no organic disorders were found after the examination. The BDI examination showed a score of 18, which is within the border of clinical depression. So that the patient was diagnosed with psychogenic dysphagia which was included in the category of Avoidant/Restrictive Food Intake Disorder in DSM 5. Holistic and multidisciplinary treatment was needed in this case. It was also reported that the success of medical treatment to reduce the patient's vomiting symptoms from pediatrics and psychologist department, combined with supportive psychotherapy and family-based treatment increases the patient's recovery rate.

Psychogenic dysphagia in children, and the success of family-based treatment

Background: Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired  reciprocal social interaction and communication, and by a restricted, repetitive or stereotyped behavior.  Early detection of autism is recommended on all toddlers from the ages of 9 months because of  increasing in prevalence. The Modified Checklist for Autism (M-CHAT) in Toddlers, a Revised with  Follow-Up (M-CHAT-R/F) is a 2-stage parent-report screening tool to assess a risk for ASD and it  demonstrates an improvement compared to the original M-CHAT. It is translated to Indonesian  language by Soetjiningsih and colleagues, and it needs to be validated. Methods: This is a diagnostic  accuracy study conducted at Sanglah Hospital, Bali, conducted from March 2015 to December 2016.  We included children 18-48 months in this study. The parents of the outpatient children in the growth  and development clinic of Sanglah Hospital were asked to fill out the Indonesian M-CHAT-R/F form.  In the same visit, the Autism Spectrum Disorder (ASD) assessment according to the DSM-5 as a gold  standard was done by the researchers, without knowing the M-CHAT -R/F result. The assessment  comparison based on M-CHAT-R/F and DSM-5 was analyzed to obtain the AUC intersection on ROC  curve that gives the best sensitivity and specificity. Results: We found 10.71% of our outpatient was  diagnosed with autism according to DSM 5, when they are 18-24 months old. The Indonesian version  of M-CHAT-R/F as an ASD screening tool has 88.9% in sensitivity and 94.6% in specificity.  Conclusion: Our results suggest that the Indonesian translation of the M-CHAT-R/F is an effective  screening instrument for ASD, particularly when a two-step screening process is used.

Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia

BACKGROUND: Sleep disorders encompass disturbances in the amount, quality, or timing of sleep. Several factors have contributed to sleep disorders in adolescents, including the use of electronic devices. In the COVID-19 pandemic era, there is a rising trend of screen time.


AIM: The objective of the study was to identify the prevalence of sleep disorders in adolescents and its relation with screen time during the COVID-19 pandemic era.


METHODS: This is a cross-sectional study involving students aged 15–18 years at three State High School, Denpasar, and Santo Yoseph Senior High School, Denpasar, in August 2020, using purposive sampling method. Data collections on characteristics of the subjects and Pittsburgh Sleep Quality Index (PSQI) were performed using Google Forms. Statistical analysis was performed using Chi-square test.


RESULTS: A total of 243 students participated in this study, of which 39 students were excluded due to chronic diseases and consumption of caffeine within 6 h before bedtime. Sleep disorder was found in 30.4% of subjects and mostly characterized by sleep duration of <8 h (62.9%). Analysis of the association between screen time and sleep disorders showed a significant result (PR = 3.8, 95%CI = 1.09–13.1, p = 0.02).

CONCLUSION: The prevalence of sleep disorders in adolescents is considerably high. There is an association between screen time and sleep disorders that occur in adolescents during the COVID-19 pandemic era.

/pdf/prevalence-of-sleep-disorders-in-adolescents-and-its-3qjzpek3qz.pdf

Prevalence of sleep disorders in adolescents and its relation with screen time during the COVID-19 pandemic era

http://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200602.11.pdf

Correlation Between Quality of Life and Severity of Valve Abnormalities in Children with Rheumatic Heart Disease

https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200602.19.pdf

I Gusti Agung Ngurah Sugitha Adnyana

Papers

Psychogenic dysphagia in children, and the success of family-based treatment

Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia

Prevalence of sleep disorders in adolescents and its relation with screen time during the COVID-19 pandemic era

Correlation Between Quality of Life and Severity of Valve Abnormalities in Children with Rheumatic Heart Disease

Association of Nurturing at Daycare with Lower Risk of Suspected Emotional and Behavioral Disorders in 3-6 Year-old Children