Objective: Infections contributed to higher morbidity and mortality in people living with HIV/AIDS (PLWHA) in both developed and developing countries. This study aimed to describe the spectrum of opportunistic infections (OIs) and associated factors among PLWHA on highly active antiretroviral therapy (HAART) at Merpati Clinic, Wangaya Regional General Hospital in Denpasar, Bali. Methods: This was a retrospective study. All of PLWHA, who still receiving HAART at Merpati Clinic from January 2018 to January 2020, who met inclusion and exclusion criteria, were included as subjects in this study. All data were collected through a review of the complete medical record of patients. Results: The prevalence of OIs in this study was 43.4%. Most PLWHA who experienced OIs were male (68.8%), age ≤40 y old with a median of age 36 y old, educational status senior high school (57.7%), married (62.1%), employed (89.7%), CD4 cell count ≥ 200 cells/µl (67.6%) and transmission route of HIV non-Intravenous (IV) drug user (99.2%). Sex, age, marital status, and CD4 cell count were significantly associated with OIs, p=0.000, p=0.005, p=0.005, and p=0.000, respectively. Conclusion: The commonest OI in this study was pulmonary tuberculosis. The presence of OIs was associated with sex, age of HIV diagnosis, marital status, and CD4 cell count. With the knowledge of OIs spectrum, clinicians are expected to be able to prevent, diagnose and treat OIs promptly to decrease the morbidity and mortality caused by OIs efficiently.

Objective: To assess Quality of life (QoL) and its associated factors in people living with HIV/AIDS (PLWHA) who taking highly active antiretroviral therapy (HAART) in Wangaya Hospital in Denpasar, Bali, Indonesia. Methods: A cross-sectional study was conducted during February 2019 to January 2020 at Wangaya Hospital in Denpasar, Bali, Indonesia. QoL was assessed using the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L), EQ-5D index value, and the EuroQol visual analogue scale (EQ-VAS). The data was analyzed using Statistical Package for Social Science (SPSS) software package version 26.0. Bivariate analysis was tested using the cross-tabulation Gamma, Kruskal-Wallis and post hoc Mann-Whitney test. P value<0.05 was considered as statistically significant. Results: A total of 584 PLWHA took HAART for at least 3 mo. The median index value and EQ-VAS were 1.0 (range-0.514–1.0) and 100.00 (range 30-100), respectively. Most patients had problems in ‘anxiety/depression’ and ‘pain/discomfort’ domains. Predictors of better QoL included men, married, good adherence, and treatment duration>24 mo (p<0.05). Predictor of poorer QoL included an advanced HIV clinical stage(p=0.001). Conclusion: The QoL scores of PLWHA receiving HAART in our study were high; hence the QoL of PLWHA was good. The good QoL can be taken as the goal for HIV treatment in order to have a successful HAART therapy.

<p>Osteoporosis lebih sering pada wanita pasca menopause karena perubahan hormon yang menyebabkan ketidakseimbangan antara resorpsi dan pembentukan tulang. Osteoporosis dapat menyebabkan patah tulang yang akan berdampak meningkatkan morbiditas dan mortalitas. Terapi saat ini bertujuan untuk mencegah patah tulang serta menjaga dan meningkatkan densitas mineral tulang. Bifosfonat merupakan obat yang paling sering digunakan untuk terapi osteoporosis pasca menopause. The US Food and Drug Administration (FDA) telah menyetujui 4 agen bifosfonat, yaitu alendronat, risedronat, ibandronat, dan asam zoledronat. Bifosfonat memiliki beberapa efek samping yang perlu diperhatikan akibat penggunaan jangka panjang. Kepatuhan pengobatan osteoporosis memiliki hubungan kuat dengan risiko patah tulang.</p><p>Osteoporosis is more common in post-menopausal women, as hormonal changes cause an imbalance between bone resorption and formation. Osteoporosis can cause fractures that may contribute to morbidity and mortality. Current therapies aim to prevent fractures, maintain and increase bone mineral density. Biphosphonates are the most widely used drugs for postmenopausal osteoporosis treatment. The US Food and Drug Administration (FDA) has approved 4 biphosphonate agents: alendronate, risedronate, ibandronate, and zoledronic acid. Biphosphonates have several side effects that need to be considered due to long-term use. Compliance and adherence in the treatment of osteoporosis has a strong relationship to risk of fractures.</p>

Solid cancer patients have higher risk to get Venous Thromboembolism (VTE) compared to normal population, particularly on solid cancer patients with histopathology type of adenocarcinoma, advanced stage, cancer treatment, and immobilized. VTE can be in the form of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE). PE incident in cancer patients resulted in high mortality between 30 to 80% and often not properly diagnosed because 81% of the cases did not show any symptoms. This is a serial case from six cancer patients who were diagnosed with PE. According to the Revised Geneva Score, three patients were in the category of high risk, and three patients were in moderate risk of PE. All six patients had elevated D-dimer value, and therefore, according to the algorithm from the International SocietyonThrombosisand Hemostasis (ISTH) in 2017, the confirmation of PE diagnosis is to be done by performing gold standard imaging test, where perfusion lung scan is considered one of it. All six patients had the type of cancer histopathology of adenocarcinoma, with advanced stage, had various VTE risk factors, and showed symptoms, such as shortness of breath, pleuritic chest pain, swelling on extremity, and hemoptysis. Patients who were diagnosed with PE received anticoagulant treatment according to the standard therapy. Vigilance must be exercised if PE is suspected, particularly in cancer patients with high or moderate Revised Geneva Score. It is expected that screening will lead to adequate management which then result on the reduction of mortality due to PE.

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