Background: Tuberculosis (TB) mono-infection has radiological features and typical clinical manifestation that are easily recognized by clinicians. These radiological features and clinical manifestation are often found to show atypical features in subjects coinfected with Tuberculosis-Human Immunodeficiency Virus (HIV), making TB diagnosis and early management challenging to establish. Objective: This study aims to determine the relationship between clinical and radiological presentation of pulmonary TB patients with HIV coinfection at the Central General Hospital Sanglah, Bali. Methods: This research was an observational analytic study with a cross-sectional method. A total of 54 TB-HIV coinfected patients were analyzed to their sociodemographic characteristics, clinical manifestations and chest radiographic features. Results: The majority of subjects were of productive age (26-61 years), male (64.8%) and belonged to the heterosexual group (90.7%). Weight loss (75.9%), cough (64.8%) and oral candidiasis (53.7%) are the most common clinical manifestations found in subjects, especially in subjects with CD4+ >200 cells/mm3 . Atypical radiological features such as infiltration/consolidation (59.3%), fibrosis (16.7%) and hillar lymphadenopathy (14.8%) are the most commonly obtained radiological features of the subjects. From the results of the bivariate analysis, it was found that radiological in the form of infiltration/consolidation were more commonly found in subjects with CD4+ <200 cells/mm3 (OR=1.254; 95% CI 1.059-1.568). Conclusion: Based on the research that has been done, it can be concluded that there are no typical radiological features and clinical manifestation in patients with TB-HIV infection.

Background: Hypertension is known as independent factor in correlation with coronary artery disease (CAD) and play important part in atherosclerotic process. In an animal model with hypertension which endothelin-1 play as a vasoconstrictor, there was overexpression of endothelin-1 in the vessel walls. This overexpression suggests a role of endothelin-1 in hypertension patient, especially among CAD.Material and methods: This was a cross-sectional study. A total 226 subjects were analysed, consisted of 127 subjects with CAD and 99 healthy population. The CAD subjects were patients underwent elective coronary angiography with signifi cant CAD lesion. The healthy population were respondents of Sleman-HDSS survey (year 2019). Hypertensive subjects were defi ned those with history of hypertension from anamnesis. Diabetic subjects were excluded. The endothelin-1 was measured from peripheral serum samples by ELISA method. The comparative analysis was performed with Mann-Whitney test and the correlation was performed with Spearman correlation test.Results: Mean serum endothelin-1 level was 2.1±1.2 pg/mL in hipertensive and 2.6±1.6 pg/mL in normotensive (p=0.063) among CAD subjects. Among healthy population, mean serum endothelin-1 level was 1.7±0.7 pg/mL in hypertensive and 1.8±0.8 pg/mL) in normotensive, (p=0.675). In addition, Spearman correlation between serum endothelin-1 and systolic blood pressure showed correlation coeffi cient -0.045 (p = 0.543) in CAD subjects and -0.165 (p=0.069) in healthy population which indicated inverse correlation between those parameters in both populations. Conclusion:Serum endothelin-1 level did not differ signifi cantly based on hypertensive status both in CAD and healthy population. There was a tendency toward decreased serum endothelin-1 level in hypertensive subjects.

Background and Aims This study aims to determine the risk factors of diabetes mellitus type 2 (DMT2) and chronic kidney disease (CKD) in a patient with all types of cardiovascular disease (CVD). Methods and Results This study was carried out using the analytical observational and cross-sectional design methods. Data were collected from 219 patients diagnosed with all types of CVD at Sanglah Hospital from January 2021 – April 2021. The result showed that the majority of the patients were male (n = 116, 53%), with a median of age 53 (14-80). Coronary artery disease (CAD) was the most common CVD found in patients (n = 111, 50.7%), while the most common comorbidity in patients were CKD (n = 162, 74%). Obesity (p = 0.030; PR: 1.879; 95%CI: 1.097-3.219) and CAD (p = 0.029; PR: 1.774; 95%CI: 1.046-3.011) were significantly associated with DMT2, while age (p = 0.000; PR: 1.435; 95%CI: 1.180-1.745), and hypertension heart disease (HHD) (p = 0.008; PR: 1.243; 95%CI: 1.072-1.440) were significantly associated with CKD. Meanwhile, age &gt; 50 years old (p = 0.004; PR: 5.740; 95%CI: 1.384-23.803), HHD (p = 0.035; PR: 2.385; 95%CI: 1.050-5.419), and CAD (p = 0.009, PR: 4.091; 95 %CI: 1.253-13.354) were significantly associated with DMT2 comorbid with CKD. In logistic regression analysis, age (p = 0.015; PR: 2.909; 95%CI: 1.235-6.852), and obesity (p = 0.023, PR: 2.765; 95%CI: 1.149-6.307) were significantly associated with DMT2. Conclusion Clinical characteristics and medical history of the patient are significantly associated with DMT2 and CKD. Early intervention against these factors tends to improve the outcome of the patient.

Background and Aims Cardiovascular disease accompanied by underlying comorbidities increases morbidity, worsens the outcome of therapy and decreases a patient's quality of life. Therefore, this study aims to determine the distribution and association between various comorbidities and cardiovascular diseases. Methods and Results This study was carried out using the analytical observational and cross-sectional design methods. Data were collected from 219 patients diagnosed with all types of cardiovascular diseases (CVD) at Sanglah General Hospital from January 2021 to April 2021. The result showed that the majority of the patients were male (n = 116; 53%) with a median age of 53 (14-80) years. Furthermore, approximately 140 patients (63.9%) had more than one CVD, and comorbid (n = 123, 56.2%). The most common CVD and comorbid found in patients were coronary artery (n = 111; 50.7%) and chronic kidney (n = 162; 74%) diseases, respectively. The strongest associations within CVDs were between valvular and rheumatic heart diseases (PR: 12,121; 95%CI: 3,813-38,535). Meanwhile, diabetes mellitus (PR: 1.38; 95%CI: 1.061-1.797), chronic kidney disease (PR: 1.818; 95%CI: 1.213-2.724), dyslipidemia (PR: 1.715; 95%CI: 1.319-2.230), and obesity (PR: 1.473; 95% CI: 1.123–1.932) were strongly associated with the incidence of coronary artery disease. Patients with diabetes mellitus had a higher risk of having more than one cardiovascular disease (PR: 1.463; 95%CI: 1.016-2.107). Conclusion Cardiovascular disease accompanied by underlying comorbidity has a significant effect on the course of the disease. Early identification and intervention against these comorbidities and CVDs prevents morbidity and improves the patient’s outcome.