Doctors have a greater risk of acquiring COVID-19 due to occupational exposure. Personal protective equipment (PPE) is an essential factor in reducing COVID-19 transmission. We aimed to evaluate the risk of moderate-severe COVID-19 infection and behavior adaptation in PPE usage among doctors who survived COVID-19 in Indonesia. This was an online population-based cross-sectional survey among Indonesian doctors of COVID-19 survivors. Bivariate and multivariate analyses were performed to determine factors associated with moderate-severe COVID-19 infection. A total of 389 doctors who survived COVID-19 infection across in Indonesia was included in this study. Most participants were young doctors (20-39 years: 69.7%), general practitioners (50.4%), working in COVID-19 designated hospitals (62.5%), and worked more than 40 hours/week (57.8%). Factors associated with moderate-severe COVID-19 were IMA moderate occupational risk (aOR 4.14, 95% CI: 1.11-15.47), age 40-59 years (aOR 3.24, 95% CI: 1.99-5.29), working in COVID-19 designated hospital (aOR 1.89, 95% CI: 1.18-3.01), and higher BMI (aOR 1.88, 95% CI: 1.00-3.54). N95 respirator and other PPEs use improved after these doctors recovered from COVID-19 infection in isolation and non-isolation rooms. In conclusion, working COVID-19 designated hospital, moderate occupational risk, higher BMI, and age 40-59 were associated with moderate-severe COVID-19 among doctors in Indonesia.

Background: After successful of antiretroviral therapy, highly effective direct acting antiviral (DAA) make HCV elimination reasonable in HIV/HCV co-infected patients. However, in achieving this target, there are still barriers to start DAA treatment, particularly in the area of liver fibrosis assessment that determine the duration of therapy. We aimed to assess the diagnostic performance of APRI and FIB-4 for diagnosing cirrhosis in HIV/HCV co-infected patients using hepatic transient elastography (TE) as gold standard.Method: This is a retrospective study on HIV/HCV co-infected patients who concomitantly performed hepatic TE measurement, APRI, and FIB-4 evaluation before HCV treatment initiation at a tertiary hospital in Jakarta from 2014 to 2019. Sensitivity, specificity and diagnostic accuracy of indirect biomarkers for liver stiffness measurement (LSM) ≥ 12.5 kPa was determined by receiver operator characteristics curves. Results: 223 HIV/HCV co-infected patients on stable antiretroviral therapy were included, of whom 91.5% were male with mean age of 37 (SD 5) years. Only 28.7% of patients were classified as cirrhosis (F4). Using TE as gold standard (≥12.5 kPa), the low threshold of APRI (1) had specificity 95%, sensitivity 48.4%, correctly classified 81.6% of patients, with moderate performance, AUC at 0.72 (95% CI 0.63-0.80). The optimal cut-off of FIB-4 was 1.66 [specificity 92.5%, sensitivity 53.1%, AUC at 0.73 (95% CI 0.65-0.81)] and correctly classified 81.1% of the patients.Conclusion: APRI score > 1 and FIB-4 score > 1.66 had moderate performance with high specificity in diagnosing cirrhosis. These biochemical markers could be used while TE is not available.

The population of cattle in the village of cliffs of high rank has enormous potential. This capacity is very good if used in the manufacture of organic fertilizer because in general cow dung waste has not been processed and utilized properly by the people of the village of cliffs of high rank. Agricultural activities of the high-ranking cliff village community which continuously result in the use of chemical fertilizers continue to increase, thus the use of organic fertilizers is an alternative in reducing community dependence in using chemical fertilizers in agriculture. The objectives of this community service are, 1) to carry out socialization and training to the community, 2) to understand more about the manufacturing procedure, the tools used, the materials used, how to use them on plants, and the benefits of manure. cows as an environmentally friendly organic fertilizer. The results of this dedication show that the manufacture of organic fertilizer requires the addition of materials, namely sawdust, rice water, coconut water, and brown sugar solution with the aim of increasing the nutrients of organic fertilizer. The application of organic fertilizers on agricultural land can reduce the manufacture of chemical fertilizers, but can improve the nutrients in the soil. Abundant cow dung is a great result for fixing nutrients in soils that are already highly dependent on chemical fertilizers. Therefore, the manufacture of organic fertilizers needs to be continuously disseminated to the community, especially farmers in rural areas who lack information and technology. This is possible through activities, knowledge and training. This service program is carried out using two methods, namely: face-to-face socialization, the practice of making organic fertilizers.

Background After successful of antiretroviral therapy, highly effective direct acting antiviral (DAA) make HCV elimination reasonable in HIV/HCV co-infected patients. However, in achieving this target, there are still barriers to start DAA treatment, particularly in the area of liver fibrosis assessment that determine the duration of therapy. We aimed to assess the diagnostic performance of APRI and FIB-4 for diagnosing cirrhosis in HIV/HCV co-infected patients using hepatic transient elastography (TE) as gold standard.Method This is a retrospective study on HIV/HCV co-infected patients who concomitantly performed hepatic TE measurement, APRI, and FIB-4 evaluation before HCV treatment initiation at a tertiary hospital in Jakarta from 2014 to 2019. Sensitivity, specificity and diagnostic accuracy of indirect biomarkers for liver stiffness measurement (LSM) ≥ 12.5 kPa was determined by receiver operator characteristics curves. Results 223 HIV/HCV co-infected patients on stable antiretroviral therapy were included, of whom 91.5% were male with mean age of 37 (SD 5) years. Only 28.7% of patients were classified as cirrhosis (F4). Using TE as gold standard (≥12.5 kPa), the low threshold of APRI (1) had specificity 95%, sensitivity 48.4%, correctly classified 81.6% of patients, with moderate performance, AUC at 0.72 (95% CI 0.63-0.80). The optimal cut-off of FIB-4 was 1.66 [specificity 92.5%, sensitivity 53.1%, AUC at 0.73 (95% CI 0.65-0.81)] and correctly classified 81.1% of the patients.Conclusion APRI score > 1 and FIB-4 score > 1.66 had moderate performance with high specificity in diagnosing cirrhosis. These biochemical markers could be used while TE is not available.

Background After successful of antiretroviral therapy, highly effective direct acting antiviral (DAA) make HCV elimination reasonable in HIV/HCV co-infected patients. However, in achieving this target, there are still barriers to start DAA treatment, particularly in the area of liver fibrosis assessment that determine the duration of therapy. We aimed to assess the diagnostic performance of APRI and FIB-4 for diagnosing cirrhosis in HIV/HCV co-infected patients using hepatic transient elastography (TE) as gold standard. Method This is a retrospective study on HIV/HCV co-infected patients who concomitantly performed hepatic TE measurement, APRI, and FIB-4 evaluation before HCV treatment initiation at a tertiary hospital in Jakarta from 2014 to 2019. Sensitivity, specificity and diagnostic accuracy of indirect biomarkers for liver stiffness measurement (LSM) ≥ 12.5 kPa was determined by receiver operator characteristics curves. Results 223 HIV/HCV co-infected patients on stable antiretroviral therapy were included, of whom 91.5% were male with mean age of 37 (SD 5) years. Only 28.7% of patients were classified as cirrhosis (F4). Using TE as gold standard (≥12.5 kPa), the low threshold of APRI (1) had specificity 95%, sensitivity 48.4%, correctly classified 81.6% of patients, with moderate performance, AUC at 0.72 (95% CI 0.63-0.80). The optimal cut-off of FIB-4 was 1.66 [specificity 92.5%, sensitivity 53.1%, AUC at 0.73 (95% CI 0.65-0.81)] and correctly classified 81.1% of the patients. Conclusion APRI score ≥ 1 and FIB-4 score ≥1.66 had moderate performance with high specificity in diagnosing cirrhosis. These biochemical markers could be used while TE is not available.