Mixed Infection of Vivax and Falciparum Malaria with Severe Manifestations of Malaria at the General Hospital of the Christian University of Indonesia: A Case Report

Malaria is still a health problem in Indonesia. The number of malaria cases according to the 2018 RISKESDAS reached 8076 cases, and the highest number was obtained from Papua province with 3,334 cases. Multiple infection malaria in Indonesia according to RISKESDAS 2018, has a rate of 0.01% of the total cases, namely Plasmodium Falciparum malaria and Plasmodium non Falciparum malaria. A 47 year old man was referred from the clinic with complaints of high fever preceded by chills 10 days before being admitted to the hospital. Accompanied by shortness of breath, unable to get off the treatment bed due to feeling very weak, nauseous, sick and having a bulging stomach. Physical examination revealed a pale conjunctiva, ronkhi in the lower field of the right lung, dim percussion in the basal of the left lung, hepatomegaly, splenomegaly, shifting dullness. Ring form vivax, on chest X-ray found a left pleural effusion. It is known that the patient previously lived in Papua from September 2018 to May 2019. During treatment, the patient was given artesunate injection therapy, dihydroartemisin + piperaquine and primaquin for seven days of treatment. At the end of the treatment, another chest X-ray was performed and re-examination of the peripheral blood smear, no more pleural effusions were found and no parasites were found on re-examination of the peripheral blood smear. Mixed infection of vivax and falciparum malaria, is a rare case that may occur in endemic areas where both plasmodium can be found. The prevalence in Indonesia according to RISKESDAS is only about 0.01% of all malaria cases in Indonesia.

Enhancing Secondary Students’ Conceptual Understanding of States of Matter Through Practical Work

This study presents findings of a small-scale action research carried out in one of the private schools of Gilgit-Baltistan. The study was conducted in a chemistry classroom with Grade 9 students and the class teacher. The research explored how practical work, in Grade 9 chemistry facilitates students' conceptual understanding of the selected concepts (States of Matter). The study was conducted over five weeks in two cycles. In the reconnaissance stage, two classes were observed, a pre-test, a focused group interview of six students and an interview of the teacher was taken. In cycles 1 and 2, the chemistry teacher and I planned and taught six lessons using this strategy. Data was collected through classroom observations, interviews and pre and post-test. The findings of the study revealed that students started getting familiarized with practical work; as a result there was a shift from a teacher directed class to a student led class. In the teacher directed class, the students did practical work according to the teachers' instructions. However, at the end of the 6th lessons, students developed the process skills i.e. investigated the topic, observed the process accurately, collected the data, and drew conclusions. The findings of the study also showed a considerable progression in terms of a shift from individual work to Collaborative work, resulting in confidence building and a shift from memorizing to engaging in practical science. Moreover, the significant difference (p < 0.001) in paired sample t-test showed a positive impact of the intervention on students learning. The study highlighted time, teacher and students' misconceptions, lack of laboratory resources, space, and students' lack of self-confidence as challenges in implementing practical work in the classroom. However, cognizant to its significance the study has implications for school in terms of students' better learning and effective teaching. Therefore, schools need to relook its method of teaching from theory to practices and teacher need to change their theoretical based teaching to practical based teaching.