Astari, Anak Agung Ayu Mita
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Analysis of Prevalence and Contributing Factors for Advanced HIV Disease at Wangaya Denpasar General Hospital: January 2022 to December 2023 Astari, Anak Agung Ayu Mita; Suryana, Ketut
Bali Medical and Wellness Journal Vol. 1 No. 1 (2024): Bali Medical and Wellness Journal
Publisher : PT BMW Journal Sejahtera

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71341/bmwj.v1i1.8

Abstract

Background: Advanced HIV disease (AHD) remains a significant health concern and a leading cause of mortality among individuals living with HIV/AIDS. Understanding the psychosocial factors influencing AHD, such as social support, access to healthcare resources, and mental health conditions like depression, is vital for effective intervention. Aim: This study aimed to determine the prevalence of AHD and identify the factors associated with it at Wangaya Denpasar General Hospital from January 2022 to December 2023. Methods: A cross-sectional study was conducted involving all newly diagnosed AHD patients at the Merpati clinic, Wangaya General Hospital, during the specified period. Participants were selected based on inclusion and exclusion criteria, and data were collected through a comprehensive review of patients' medical records. Results: Out of 128 newly diagnosed individuals living with HIV/AIDS (PLWHA), 84 (65.6%) were classified as having AHD. The majority of PLWHA with AHD were male (73.8%), under 50 years of age (82.1%), without a college education (94.0%), unemployed (83.3%), married (54.8%), had medical insurance (90.5%), contracted HIV through heterosexual contact (90.5%), were referred from other medical facilities (82.1%), and reported having social support (98.8%). Significant factors associated with AHD included lack of college education (p=0.000), unemployment (p=0.000), marital status (p=0.037), and referral source (p=0.010). Conclusion: The findings indicate that lack of college education, unemployment, marital status, and being referred from other medical facilities are significant factors associated with AHD. To mitigate AHD-related morbidity and mortality, it is essential to enhance education and training programs focused on HIV/AIDS and to promote provider-initiated HIV testing and counseling. This approach could facilitate earlier prevention and diagnosis of HIV.
Urinary Tract Infections and Inadequate Insulin Therapy as a Precipitating for Diabetic Ketoacidosis in Type 1 Diabetes Mellitus: A Case Report Astari, Anak Agung Ayu Mita; Wulandari, Dewi Catur
Bali Medical and Wellness Journal Vol. 1 No. 1 (2024): Bali Medical and Wellness Journal
Publisher : PT BMW Journal Sejahtera

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71341/bmwj.v1i1.5

Abstract

Background: Diabetic ketoacidosis (DKA) is a severe acute metabolic complication associated with diabetes mellitus. It is particularly prevalent in patients with Type 1 diabetes, where inadequate insulin therapy can lead to significant morbidity and mortality. Case: We present the case of an 18-year-old girl diagnosed with Type 1 diabetes mellitus. She arrived at the hospital exhibiting shortness of breath and was found to have a C-peptide level of 0.33, which, alongside her history of irregular insulin injections, indicated poor adherence to insulin therapy. Upon physical examination, the patient appeared lethargic, had apathetic consciousness, a tachycardic heart rate of 127 beats per minute, and an elevated axillary temperature of 37.8°C. Notably, Kussmaul breathing was also observed. Results: Laboratory findings revealed elevated white blood cell count (15,950/μL), hyperglycemia (blood sugar level of 379 mg/dL), and severe metabolic acidosis, as indicated by arterial blood gas analysis (pH 6.89, HCO3 1 mmol/L). Urinalysis demonstrated the presence of albumin (+1), glucose (+2), ketones (+3), leukocytes (+3), and bacteria. The patient required intensive care monitoring for five days before being transitioned to the general ward for an additional three days of treatment. Conclusion: DKA is characterized by hyperglycemia, hyperketonemia, and metabolic acidosis, all of which are indicative of insufficient insulin therapy in patients with Type 1 diabetes. This case highlights the critical importance of adherence to insulin therapy for achieving optimal glycemic control. Effective management and discipline in treatment are essential to prevent DKA and reduce its associated mortality.