Sputum quality is crucial in finding infectious bacteria that will be used to guide definitive antibiotic therapy. Errors in reporting isolated bacteria will affect the rate of patients' morbidity, mortality, and increase patient care costs. This study aims to find out the relationship between sputum quality and isolated bacteria at a Tertiary Referral Hospital, Denpasar, Bali-Indonesia. The study was conducted for 6 months in the Sanglah Hospital Clinical Microbiology laboratory. There were 726 sputum specimens examined and categorized based on Murray Washington criteria. After Gram examination, all specimens were inoculated on aerobic culture media. We classified 41.4% of poor-quality sputum specimens, and non-pathogenic bacteria were isolated from 70.2% of that specimen dominated by Streptococcus mitis (42.53%). Whereas, isolated pathogens were obtained from 54.4% of good-quality sputum specimens dominated by Klebsiella pneumonia (30.86%). Statistical analyses showed that there is a relationship between isolated bacteria and the sputum quality (OR = 3.844; p < 0.001). Good-quality sputum is 3.8 times more likely to isolate pathogenic bacteria than poor-quality sputum. In the Pearson Chi-Square test, the likelihood of isolating pathogenic bacteria from good-quality specimens was significant too ( p < 0.001). The results of this study indicate that poor-quality sputum specimens are still found. Therefore, the capacity of good sputum collection must be improved. Supervision of the application of standard sputum culture operational procedures must be more rigorously carried out.

Background: Lower Urinary Tract Symptoms (LUTS) after Transurethral Resection of the Prostate (TURP) occur in one-third of Benign Prostatic Hyperplasia (BPH) patients, may be caused by persistent prostatic inflammation and fibrosis. Objective: This study aims to evaluate the role of inflammation and fibrosis in pathological mechanism of LUTS among patients with BPH who underwent TURP by assessing their PSA, TNF-α, and TGF-β level. Design, Setting, and Participant: Data in this study were analyzed with the 2-way hypothesis. The study used odds ratio to define the risk factors of LUTS after TURP. The samples of the study are BPH patients after TURP aged 50-80 years old. Interventions: No intervention(s). Outcome Measurements and Statistical Analysis: The data analyzed using SPSS version 21.0 for Windows. Results and Limitations: There were 34 cases of LUTS and 42 controls without LUTS. We found that there were an increased levels of TNF-α (> 46.95 pg/ml) (OR 55.6, 95% Confidence Interval [CI] 11.1-278.4, p=0.00) and TGF-β (> 207.63 pg/ml) (OR 16.7, 95%CI 5.3-52.8, p=0.00). The result of multiple linear logistic regression analysis obtained equation Y= 0.033 x TNF-α + 0.031 x TGF-β. Population Attributable Risk (PAR) % TNF-α is 60%, PAR % TGF-β is 53%. Conclusion: Combination of elevated levels of TNF-α (>46.95 pg/ml) and TGF-β (>207.63) in prostate tissue is the risk factors for the occurrence of LUTS after TURP. Patient Summary: In this study, we enrolled 76 patients who were diagnosed with BPH and urinary retention. After TURP, there were 34 cases of LUTS and 42 controls without LUTS. We found that the levels of TNF-α and TGF-β between cases and controls were significantly different. We conclude that the combination of elevated levels of TNF-α and TGF-β in prostate tissue is the risk factors for the occurrence of LUTS after TURP.

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Introduction: Breast cancer is the most common type and lethal cancer affecting women. Meanwhile, vinorelbine is one of the chemotherapy agents used for luminal and non-luminal breast cancer. Therefore, this study aims to determine the survival difference between patients with luminal and non-luminal subtype breast cancer treated with vinorelbine.Methods: This study was a retrospective cohort. Women with breast cancer treated with vinorelbine were classified based on estrogen receptor (ER), progesteron receptor (PR), human epidermal growth factor receptor-2 (HER-2) markers, and subtypes. The subjects were followed up to chemotherapy visits with vinorelbine recorded in the medical record. The survival analysis between subtypes was analyzed by the Kaplan-Meier curve.Results: : One hundred women were obtained with a mean age of 52.36 ± 10.45 years. Based on immunohistochemistry, 60% were ER-positive, 53% were PR positive, and 57% were HER-2- positive. Based on the subtype, 67% were luminal, while 33% were non-luminal. All subjects had a mean survival duration of 155.38 days (95% CI 128.05-182.71). The stratified survival analysis showed a significant difference in survival duration based on HER-2 marker and subtype. The subjects with HER-2 positive survived longer with a mean of 203.37 days (190.72–216.02) than those with HER-2 negative with a mean of 90.10 days (65.68-114.53) (p<0.001). In addition, the subjects with the luminal subtype survived longer with a mean of 174.84 (142.72-206.94) than those with non-luminal with a mean of 90.10 (65.68-114.53) (p = 0.04).Conclusion: There was a significant difference in survival duration between women with breast cancer treated with vinorelbine chemotherapy who were HER-2 positive, HER-2 negative, and luminal and non-luminal subtypes.