Aim: This study aims to determine the pattern of insulin therapy in type 2 Diabetes Mellitus patient in Internal Medicine Policlinic Negara Hospital, Bali.Method: This research was an observational study with cross-sectional design at Internal Medicine Policlinic Negara Hospital, Bali period August 2018. A total of 177 samples were selected by total sampling technique.Result: According to the duration of action, majority of insulin usage was rapid acting insulin in 93 patients (52,5%). The most frequent combination of two insulin types was long-acting with rapid-acting insulin in 30 patients (33,7%), meanwhile the  most frequent combination of insulin and OHD was premixed insulin with gluconeogenesis inhibitor in 43 patients (48,9%). Fasting Plasma Glucose mean was 185,12 mg/dL, Post Prandial Plasma Glucose mean was 252,9 mg/dL. This study also found the Fasting Plasma Glucose ≥ 126 mg/dL count in 129 patients (72,9%), Post Prandial Plasma Glucose ≥ 180 mg/dl count in 133 patients (75,1%). The mean of systolic blood pressure was 128,81/ 78,53 mmHg, patients with targeted blood pressure <140/90 mm/Hg count in 110 patients (62,1%).Conclusion: The profile of insulin therapy in patients with Type 2 DM at Internal Medicine Polyclinic, Negara Hospital varies according to the indication in each patient. The most frequent type of insulin use is rapid acting insulin. Most patients with insulin therapy have not achieved targeted glycemic control, but have achieved the targeted blood pressure according to the PERKENI.

Introduction: Cerebral toxoplasmosis is one of the opportunistic diseases that present in patients with HIV/AIDS. One of the rare symptoms is unilateral papilledema due to cerebral toxoplasmosis. Case report: A 26-year-old male patient came with complaints blurred vision for 2 months. The patient had a history of pouting lips, and weakness face, arm, and legs on the left side of the body. The patient has been diagnosed with the observation of space occupying lesion Cerebri in November 2020. Patient with HIV stage IV (WHO) infection and CD4 14 cells/uL and viral load 5.43 x 105 copies /mL. Visual acuity left eye 6/18 PH 6/12, contrast sensitivity examination in both eyes 1.65, and the results of FD-15 are within normal limits, but the results of perimetry was enlargement of blind spot, relative afferent pupillary defect in the left eye, with optic nerve head swelling in the left eye. An MRI showed the presence of intracerebral neurotoxoplasmosis. Discussion: Papilledema is the manifestation of optic nerve abnormality due to an increase in intracranial pressure. Cerebral toxoplasmosis leads to asymmetric target lesion present with ring enhancement image on MRI with contrast which causes SOL and manifests as papilledema. Bilateral papilledema is a hallmark of increasing cerebrospinal fluid pressure, but unilateral papilledema is a rare case with a 2% of prevalence among papilledema cases. Two proposed mechanisms of atypical papilledema were anatomical nerve sheath anomalies and unilateral axoplasmic blockage of the lamina cribrosa. Conclusion: Early diagnosis and appropriate treatment have a very important role in determining the prognosis of patients with cerebral toxoplasmosis.

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Introduction: Prolonged computer use will lead to a group of symptoms such as dryness of eyes, tired, headache and others called Computer Vision Syndrome (CVS). The decrease of Mucin 5 AC (MUC5AC) level could be one of the signs of dry eye disease on persons with CVS.Objective: The purpose of this study is to describe the Mucin 5AC level in medical faculty students of Udayana University, Bali, Indonesia with CVS.Method: It is an observational cross-sectional analytic study at Medical Faculty Udayana University on October 2018. Thirty four subject selected  by purposive sampling and examined with Schirmer I test, Tear Break Up time (TBUT) test, and Mucin 5AC test. All of the subject then divided into CVS group and non-CVS group. Mucin 5AC level which less than 186.33 ng/mL categorized as low mucin, while more than 186.33 ng/mL categorized as normal mucin level. Data was analyzed by crosstabulation table and chi-square test with significant value p < 0.05.Result: Most of the students who diagnosed with CVS had lower mucin 5AC levels as much as 77,3% and 33,3% students with CVS had normal mucin 5AC level.  This study analyses found there is significant association between level of mucin 5AC with CVS. The students with low level of mucin 5AC had 6,8 higher risk tend to be CVS (OR=6,8; CI 95%= 1,42-32,37; p=0,012).Conclusion: Low level of mucin 5AC has association with the risk of CVS in the medical students with prolonged computer use.