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Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

Mortality rate among maintenance hemodialysis (HD) patients with COVID-19 is alarmingly high. In Fatmawati General Hospital, most of HD patients with COVID-19 presented with acute respiratory distress syndrome (ARDS). Hemoperfusion (HP) is a blood purification therapy used to remove cytokines and inflammatory mediators to prevent ARDS worsening and organ failure. We report 6 cases of COVID-19 in maintenance HD patients. HP and HD were performed in two consecutive days when patient developed early ARDS as indicated by inflammatory markers elevation. HP and HD were conducted by using resin-containing cartridge and high-flux dialyzer, respectively, for 4 hours. Improvements in CRP levels, PaO2/FiO2 ratios, and chest X-rays were observed after 2 sessions of HP in most of our patients. Based on our clinical experience, the timing of HP delivery is critical and should be undertaken in the early phase of ARDS, but larger studies are still needed.

Introduction. Lower extremity peripheral artery disease (PAD) is one of diabetic macrovascular complication which has high rate of morbidity and mortality. Chronic inflammation has been known to have a role in the pathogenesis of PAD in diabetic patient. Recently, neutrophil lymphocyte ratio (NLR) has been used as a marker of chronic inflammation. This study aimed to determine the relationship between neutrophil lymphocyte ratio and lower extremity peripheral artery disease in type 2 diabetic patient in Cipto Mangunkusumo hospital. Methods. A cross sectional study was conducted on 249 patients with type 2 diabetes mellitus who underwent ankle brachial index (ABI) examination at Metabolic and Endocrinology Divison in Cipto Mangunkusumo Hospital between October 2015 – September 2016. The data were retrospectively collected from medical record. Lower extremity PAD was defined as having ABI value ≤ 0,9 by probe Doppler examination. Neutrophil lymphocyte ratio was categorized based on the median value and the relationship with lower extremity PAD were determined. Chi square test was used for bivariate analysis and logistic regression was used for multivariate analysis against confounding variables. Results. Lower extremity peripheral artery disease was found in 36 subject (14.5%). Median of NLR was 2.11. The median value of NLR was found higher in subjects with lower extremity PAD than without PAD (2.46 vs 2.04). There was an association between NLR value ≥ 2.11 and lower extremity PAD in type 2 diabetic patient (p=0.007; PR 2.46 and 95% CI 1.23 – 4.87). By using logistic regression, it was known that hypertension was the confounding variable. Conclusion. There is an association between neutrophil lymphocyte ratio and lower extremity peripheral artery disease in type 2 diabetic patients in Cipto Mangunkusumo Hospital.

Latar belakang. Infeksi saluran napas akut (ISPA) merupakan penyebab terpenting morbiditas dan mortalitas pada anak terutama usia 6-23 bulan. Beberapa faktor dianggap berhubungan dengan ISPA antara lain, jenis kelamin, usia balita, status gizi, imunisasi, berat lahir balita, suplementasi vitamin A, durasi pemberian ASI, pendidikan ibu, pendapatan keluarga, crowding, pajanan rokok, serta pengetahuan, sikap, dan perilaku ibu terhadap ISPA. Tujuan. Mengetahui angka prevalensi ISPA pada balita di Rukun Warga (RW) 04 Pulo Gadung serta faktor-faktor yang berhubungan. Metode. Penelitian potong lintang yang dilakukan pada 103 subjek menggunakan guided questionnaire yang valid dan reliable untuk mengetahui apakah terdapat diagnosis ISPA dalam satu bulan terakhir pada anak usia 6 bulan–59 bulan serta faktor-faktor yang berhubungan, di RW 04 Kelurahan Pulo Gadung, Jakarta Timur, pada bulan Desember 2008. Hasil. Prevalensi ISPA pada balita 40,8%, didapatkan hubungan bermakna antara pajanan asap rokok (p=0,006) dan riwayat imunisasi (p=0,017) dengan prevalensi ISPA pada balita. Namun tidak didapatkan hubungan antara jenis kelamin, usia, status gizi subjek, tingkat pendidikan responden, pendapatan keluarga, crowding, jumlah rokok, suplementasi vitamin A, durasi ASI total dengan prevalensi ISPA pada balita. Kesimpulan. Prevalensi ISPA pada balita cukup tinggi dan terdapat hubungan bermakna antara pajanan asap rokok dan riwayat imunisasi dengan prevalensi ISPA pada balita