To explore how parents of Indonesian adolescents conceptualize adolescence and to identify the challenges faced in parenting adolescents, focusing on parents from different sociodemographic backgrounds. Focus group discussions (FGD) were undertaken with parents of adolescents aged 10–18 years old from different sociodemographic backgrounds (urban high socioeconomic; urban low socioeconomic; rural low socioeconomic) using a semi-structured interview guide. Content and thematic analysis were assisted by Nvivo version 12.6.0. Forty-three parents participated in four FGD. All parents recognized that adolescence was a distinct developmental stage, reflected in changing behaviors, escalation of peer influences and sexual development. Parents from poor, rural backgrounds had relatively limited understanding of the emerging capabilities of adolescents and had a narrow repertoire of responses to challenging behaviors, with heavy reliance on religious rules and punishment. Parents from higher socioeconomic backgrounds displayed a wider range of warmer, more engaging approaches that they reported using to shape their children’s behaviors. These findings highlight opportunities to enhance parenting skills, which appear most warranted in parents of adolescents from disadvantaged backgrounds. Embedding basic adolescent parenting information within community programs appears indicated, and enhancing religious leaders’ understanding of different approaches to parenting could be helpful in more religious communities. “What is already known on this subject? Parenting practices play an important role in adolescent health, development, and well-being. Parenting practices are influenced by socio-economic, demographic and cultural determinants. The evidence for how Indonesian parents conceptualize adolescence and how parenting practices might differ across diverse sociodemographic contexts is scarce. “What this study adds? While parents from different sociodemographic groups had a common conceptual understanding of some aspects of adolescence, there were substantial differences in their approaches to parenting. There are opportunities to enhance parenting skills, especially in more disadvantaged regions.

Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus (DM) in children caused by insulin deficiency. This condition is often unidentified or diagnosed late, and treated with inadequate therapy. Diabetic ketoacidosis can lead to several complications, the most fatal being cerebral edema. We present two cases of DKA with different clinical presentation and severity. Early identification and proper management of DKA can help improve outcomes and avoid complications.

Neonatal hemochromatosis (NH) is a rare fatal liver disease accompanied by hepatic and extrahepatic iron overload.1-3 Gestational alloimmune liver disease (GALD) is a materno-fetal alloimmune disorder and leading cause of NH.2,4,5 This condition allows an interplay between the maternal adaptive immune system and the fetus, resulting in an allograft to the mother. The mother becomes sensitized to an alloantigen expressed by the fetus and forms specific reactive antibodies. Immunoglobulin G (IgG) is transported through the placenta and attacks the fetal hepatocytes, resulting in severe loss of hepatocytes and fetal iron overload.3,6 Liver transplantation has been the only definitive treatment for NH for many years, with a survival rate of ±35%. Conventional therapy containing antioxidants and chelation agents reportedly have very poor success, with survival rate of only 10-20%. A new treatment paradigm involving intravenous immunoglobulin (IVIG) and exchange transfusion (ET) therapy has shown significant success in survival rate in NH, decreasing the need for liver transplantation.3,7,8 Here we present a case of NH caused by GALD and treated successfully with a combination of IVIG therapy and ET. We also aimed to evaluate the efficacy of IVIG and ET therapy for NH.