BACKGROUND: The discovery of antiretroviral (ARV) drugs in 1996 led to a shift in the causes of mortality and morbidity of patients with HIV/AIDS. Initially, the cause of mortality and morbidity was associated with opportunistic infection HIV/AIDS-related complication, but now are more associated with non-AIDS complication such as cardiovascular disease. Atherosclerosis is a major cause of cardiovascular disease. The atherosclerosis was assessed by measuring carotid intima-media thickness (CIMT) using B mode ultrasound (USG), which is one of the diagnostic tools in indicating the presence of atherosclerotic plaque. AIM: This study aims to evaluate the ratio of CD4 / CD8 towards carotid intima-media thickness.METHODS: Design of study was analytic cross-sectional. This study was conducted in May – July 2017 in HIV patients who taken consecutively came to the VCT polyclinic of Sanglah hospital. Statistical analysis used Spearman correlation test to evaluate the correlation between the CD4/CD8 ratio and carotid intima-media thickness and multiple linear regression to predict carotid intima-media thickness through CD4/CD8 ratio.RESULTS: Total from 50 samples, data characteristic were 33 males (66%) and 17 females (34%), mean of age 30.60 ± 5.58 years, median of CD4/CD8 ratio 0.275 (0.02-1.39) and median of CIMT 0.75 (0.4-1.5) mm. There is a strong negative correlation (r = -0.85; p = 0.001) CD4/CD8 ratio with CIMT. The calculation of the prediction of carotid intima media thickness can be calculated through the equation Y = 0.727 -0.791 (X1) + 0.012 (X2), where X1 is CD4/CD8 ratio and X2 is the age of the patient.CONCLUSION: there is a significantly strong negative correlation between the CD4/CD8 ratio and CIMT in HIV patient who comes to VCT polyclinic of Sanglah Hospital. The smaller CD4/CD8 ratio, the value of CIMT will be thicker, and vice versa.
Background COVID-19 infection can show various manifestation, including neurologic manifestations, such as anosmia, ageusia, or dysgeusia, and causes the neurologic disorder such as stroke, Guillain-Barre syndrome, encephalopathy, and many more. Aim To briefly review neurologic manifestation in COVID-19 infection in the Asia region (South East Asia and the Western Pacific Region). Material and methods This review uses the PRISMA statement and checklist. The source for reviewed article was performed in PubMed that were published between December 2019 to September 2020 with the latest 1 year of publication. Study titles were first screened, then reviewed by title and abstract and then the last review, we tested full text and applied eligibility criteria. Results We found a total of 9 retrieved articles from the electronic database. Among these 9 articles, 5 of them are case report, 1 case series, 1 prospective multi-center cohort study, 1 retrospective multi-center study, and 1 retrospective observational study. All articles reported confirmed COVID-19, confirmation by positive swab test using the real-time RT-PCR method, with neurologic manifestations, disorder, or syndrome on presentation or found during hospital stay. In case of neurologic disorder or syndrome, the studies reported encephalitis and ADEM, acute cerebrovascular disease, acute symptomatic seizure, and Guillain-Barré syndrome with acute cerebrovascular disease as the most common neurologic disorder associated with COVID-19 infection, followed by encephalitis. Conclusion COVID-19 also affects the brain, which may result in a global or focal neurologic manifestation. Healthcare provider treating patient with COVID-19 infection should also be aware of neurologic manifestation associated with COVID-19 infection to improve patient’s outcome. Guillain-Barre syndrome, encephalopathy, and many more. This review will briefly review neurologic manifestation in COVID-19 infection in the Asian region (South East Asia and the Western Pacific Region. A total of 9 retrieved articles from the electronic database reported confirmed COVID-19, confirmation by RT-PCR method, with neurologic manifestation, disorder, or syndrome on presentation or found during hospital stay. Healthcare provider treating patient with COVID-19 infection should also be aware of neurologic manifestation associated with COVID-19 infection to improve patient’s outcome.
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