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All Journal International Journal of Public Health Science (IJPHS) Majalah Kedokteran Bandung Universa Medicina JSMARTech : Journal of Smart Bioprospecting and Technology Narra J The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Maghfirah, Desi
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Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health

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Rare Case of Periampullary Duodenal Carcinoma Maghfirah, Desi; Abubakar, Azzaki; Yusuf, Fauzi; Riswan, Muhammad
Majalah Kedokteran Bandung Vol 53, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n1.1988

Abstract

Periampullary carcinoma is a malignancy that appears around the vatteri ampulla. This malignancy can originate from the pancreas, duodenum, and distal choledochal duct. Duodenal cancer is a very rare case, only about 0.3% of the gastrointestinal malignancies. Reported cases are increasing with the increasing use of esophagogastroduodenoscopy. The most frequently found carcinomas of the duodenum include adenocarcinoma, carcinoid, lymphoma, and leiomyosarcoma. The symptoms of these carcinomas are often not specific so the diagnosis is often late, leading to a poor prognosis. Early diagnosis and proper therapy provide a good prognosis.  The case reported here representeda 52-year-old woman presented with hematemesis melena, anemia, jaundice, epigastric mass, right hypochondrial pain, and weight loss. From the esophagogastroduodenoscopy, the mass was found to obstruct half of the duodenum lumen and bleeding, which was easily triggered, was observed in the second part of the duodenum. CT scan revealed a mass in the head of the pancreas with gall bladder hydrops and obstruction of the intra and extra-hepatic billier system. After a Whipple operation Laparotomy, the histology showed papillary adenocarcinoma duodenum. Patients then underwen chemotherapy with 5 fluorouracil regimen. Patient's clinical condition is currently improving and no complaint is conveyed by the patient.
Screening of COVID-19 Using Rapid Test Before Gastrointestinal Procedures; Experience in a Limited Resource Hospital Yusuf, Fauzi; Maghfirah, Desi; Muhsin, Muhsin
JSMARTech: Journal of Smart Bioprospecting and Technology Vol 2, No 1 (2020)
Publisher : JSMARTech

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jsmartech.2020.002.01.35

Abstract

Corona Virus Disease 2019 (COVID-19) is an emerging disease announced by World Health Organization (WHO) as a pandemic disease since March 2020. Several international guidelines suggested use of reverse transcriptase polymerase chain reaction (RT-PCR) test as screening tool before starting gastrointestinal (GI) procedures. Although RT-PCR is a gold standard, it has limitation as it is expensive and requires special expertise therefore difficult to implement in limited resource hospitals. Due to lack of RT-PCR tests available and in accordance with Indonesian government regulation, thirty patients in a tertiary referred hospital in Banda Aceh were screened with rapid test antigen and antibody for COVID-19 before underwent emergency and urgency GI procedures such as endoscopy, colonoscopy and abdominal ultrasonography. Several laboratory parameters and chest X-ray in all patients were assessed. All health care workers in procedure room were also tested with rapid antigen 1 week after the procedures. The study showed that laboratory parameters and chest X-ray were relatively normal for all patients. All procedures were conducted safely and leave no new COVID-19 case amongst health care workers. In conclusion, rapid test can be used in hospitals with limited resources, although RT-PCR test is still needed to confirm COVID-19 cases. Safe GI procedures can still be performed in limited resource hospital, although the possibility for disease transmission is still high. A modified guideline is needed in these hospitals in order to conduct safe GI procedures.
Management of non-cirrhotic variceal bleeding in pregnant women with Budd-Chiari syndrome in the early second trimester: A case report Abubakar, Azzaki; Yusuf, Fauzi; Maghfirah, Desi; Kurniawan, Kurniawan; Ezigbo, Eyiuche D.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.245

Abstract

Budd–Chiari syndrome is one of the post-hepatic causes of portal hypertension and a potential obstruction causes liver fibrosis. In pregnancy, obstruction of hepatic veins could occur due to stenosis or thrombosis. Variceal bleeding is the most fatal complication in pregnancy with co-existing Budd–Chiari syndrome, with 29.4% incidence of abortion and 33.3% perinatal mortality. The aim of this case report was to present the management of non-cirrhotic variceal bleeding in pregnant women with Budd–Chiari syndrome in the early second trimester. We report a  pregnant female at 13−14 weeks gestation presented to the hospital with profuse hematemesis. Doppler ultrasonography (USG) was utilized to confirm the diagnosis of Budd–Chiari syndrome-hepatic vein occlusion type in pregnancy. Abdominal USG revealed hepatomegaly with hepatic veins dilation, while endoscopy showed grade IV esophageal varices and grade IV gastric varices. Laboratory results indicated disseminated intravascular coagulation due to hemorrhage. The patient was given strict fluid resuscitation and three packed red cells transfusion to stabilize the hemodynamic. Bleeding was successfully managed by intravenous octreotide, tranexamic acid, and vitamin K. The case highlights that the management of non-cirrhotic variceal bleeding in pregnancy with Budd–Chiari syndrome requires a multidisciplinary approach and regular fetal monitoring to ensure optimal outcomes.
Gastrointestinal mucosal damages caused by ingestion of corrosive substances: A case study of hydrochloric acid and sodium hydroxide Yusuf, Fauzi; Abubakar, Azzaki; Maghfirah, Desi; Heltomi, Mirza; Isitua, Chinwe C.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.259

Abstract

Ingestion of corrosive substances is most common in children, while in adults causes more severe damages. Massive ingestion of corrosive substances results in severe damage to the gastrointestinal tract and oropharynx if not treated properly. Corrosive substances with pH<2 or >12 can result in severe esophageal damage with either colliquative (alkaline) or coagulative (acidic) necrosis and, at the same time various gastrointestinal injuries could lead to late post-corrosive complications. The aim of the case study was to report the gastrointestinal mucosal damages due to hydrochloric acid (HCl) and sodium hydroxide (NaOH) ingestion. A 55-year-old male patient was presented to the emergency room with a chief complaint of vomiting an hour before admission. Continuous vomiting with a volume of approximately 10–20 cc per vomit. The vomit was initially bluish and turned in to blackish brown over time. Other complaints included nausea, rapid breathing, heartburn, and burning mouth and throat, and had weakness and dizziness. The patient accidentally drank floor cleaning liquid containing HCl. The patient was diagnosed with hematemesis due to ulceration of esophageal, gastric, and duodenal mucosa induced by HCl. Tracheoesophageal fistula developed later in the patient as a long-term complication. Another a 22-year-old male patient was presented to the emergency room with chief complaints of nausea and vomiting an hour before admission. Headache and slight tightness were also experienced. The patient mouth felt burned pain in the solar plexus and frothy saliva. An hour earlier, the patient attempted suicide by drinking two bottles of floor cleaning liquid due to economic problems. The patient was diagnosed with erosive mucosal esophagogastroduodenum induced by NaOH. These cases highlight that intoxication with corrosive substances can complicate damage to the gastrointestinal mucosal and damage features depend on the type of substance concentration and quantity of the corrosive substance.
Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality? Abubakar, Azzaki; Yusuf, Fauzi; Firdausa, Sarah; Maghfirah, Desi; Gunawan , Andrie; Sari, Fitrah
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.264

Abstract

Hepatocellular carcinoma (HCC), a considerable leading cause of cancer-related deaths worldwide, is the most common primary liver cancer with poor prognosis and outcome. Many advances in prevention, screening, and new technologies in diagnostics and therapy have been achieved, but its incidence and mortality remain increasing. Co-infection of another viral disease in HCC patients with pregnancy might exacerbate the condition and double the mortality rate. The aim of this case report was to describe the co-infection of coronavirus disease 2019 (COVID-19) in an HCC patient during pregnancy. A 26-year-old woman with 16–17weeks of gestation was admitted to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia with shortness of breath. The patient also reported that the abdomen expanded rapidly in the last three weeks, followed by severe pain and collateral vein appearance. Laboratory findings revealed anemia, leukocytosis, HBsAg reactive, hypoalbuminemia, hyperbilirubinemia, elevated liver enzymes, increased alpha-fetoprotein (AFP), and cancer antigen 125 (CA-125). Ultrasonography indicated gestation with a single fetus, an enlarged liver with a 9.9 x 9.4 cm nodule, and massive ascites. The patient was also RT-PCR-confirmed COVID-19. On day 8 of hospitalization, the patient suddenly reported severe abdominal pain. Ultrasonography revealed fetal distress immediately followed by fetal death. Adequate management of cancer pain, continuous evacuation of ascites, and other supportive care could not save the patient who died on the day 17 of hospitalization. In this case, we found no proof that the patient experienced cirrhosis prior to HCC. Pregnancy through hormonal alteration is thought to be the aggravating factor that accelerates the progression of pre-existing liver disease into carcinoma and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worsened the outcome in this patient.
The impact of COVID-19 on resident doctors as the frontline in health services Maghfirah, Desi; Yusuf, Muhammad; Pamungkas, Subhan Rio; Firdausa, Sarah; Eljatin, Muhammad Ridho Akbar; Febriyanti, Sherina Arfi
International Journal of Public Health Science (IJPHS) Vol 13, No 2: June 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i2.22871

Abstract

As the number of confirmed cases of COVID-19 increases, the workload due to the pandemic can affect health workers and increase the risk of psychological stress. Psychological factors such as anxiety can cause various physiological responses, including gastroesophageal reflux disease (GERD) symptoms. The persistent symptoms of GERD can reduce the patient's quality of life. A cross-sectional survey was conducted in October 2021 at the Dr. Zainoel Abidin Regional General Hospital, Banda Aceh. A total of 91 Specialist Medical Education Program responded to the study. Data from respondents were collected through the generalized anxiety disorder-7 (GAD-7), GERD-Q, and WHOQOL-BREF questionnaires. The statistical analysis used was the contingency coefficient test. The results showed that 9.9% of respondents experienced suggestive GERD, minimal anxiety (92%), and good quality of life (51.6%). There was a significant relationship between anxiety levels and quality of life and the GERD prevalence of Specialist Doctor Education Program Participants during the COVID-19 pandemic (p<0.05). Most Specialist Medical Education Program participants did not suffer from GERD with minimal anxiety, followed by mild and moderate anxiety. The majority had a good and moderate quality of life during the COVID-19 pandemic.
Relationship between presenting symptoms and tumor location in colorectal cancer patients Ismida, Fitri Dewi; Maghfirah, Desi; Salam, Nurbahri L; Yusuf, Fauzi; Mulia, Vera Dewi; Purnomo, Avisena Gatot
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.321-328

Abstract

BackgroundColorectal cancer (CRC) often shows symptoms at an advanced stage, causing delayed diagnosis and poorer prognosis. Initial symptoms, or chief complaints, are usually identified through patient history and can vary based on tumor location. This can help in establishing a diagnosis. This study aimed to determine the relationship between presenting symptoms and tumor location in CRC patients at Zainoel Abidin Regional General Hospital, Banda Aceh. Methods This cross-sectional study was conducted using secondary data from medical records (2019–2022) for 163 CRC patients. Information on symptoms of patients were collected from patient files: anemia, anorexia, diarrhea, constipation, abdominal pain, rectal bleeding, and palpable abdominal mass. Tumor locations were classified as right colon, left colon, rectum, and left colon plus rectum. Bivariate analysis was used to analyze the data. Results Of the 163 patients, 98 (58%) were aged e”50 years, 82 (50.3%) were male, and 99 (60.7%) had rectal tumors. The percentage of patients presenting with rectal bleeding was significantly higher in rectal cancers (47.47%) as compared with cancers in the left colon (28.57%) and left colon and rectal (33.33%) cancers (p=0.000). The percentage of patients presenting a palpable abdominal mass was significantly higher in right colon (31.58%) compared with left colon (4.76%) and rectal cancer (1.01%) (p=0.000). ConclusionsTumor location in the right colon is associated with palpable abdominal mass, while rectal location is associated with rectal bleeding in CRC patients. Familiarity with clinical symptoms of CRC could make patients more sensitive to undergo more frequent screening for cancer.
Successful Management of Early Postoperative Small Bowel Obstruction Using Steroid: A Case Report Luthfi, Muhammad; maghfirah, Desi; Yusuf, Fauzi; Abubakar, Azzaki; Syahrin, Alfi; Purnomo, Avisena Gatot
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202475-83

Abstract

Background: Early Postoperative Small Bowel Obstruction (EPSBO) is a primary factor contributing to death and morbidity after pelvic and abdominal surgery. Although it is frequently regarded as a surgical emergency, the most recent research indicates that non-operative management is always preferable unless there are complications.Case: A 53-year-old woman came with symptoms of small bowel obstruction and a history of hysterectomy three weeks earlier. The patient refused surgical intervention, so a conservative approach was taken. She was given methylprednisolone 500 mg/day in two doses daily for three consecutive days, in addition to nasogastric tube insertion and symptomatic therapy. After three days of follow-up, the patient showed symptoms improvement, and the abdominal X-Ray and CT Scan showed no abnormal findings.Discussion: The majority of Early Postoperative Small Bowel Obstruction (EPSBO) cases, according to the most recent research, may be managed without surgery. Additionally, due to their anti-inflammatory properties, some medications, like corticosteroids, have been found to be beneficial and effective for EPSBO. This is because they may help resolve the obstruction and lessen the edema and fibrin deposition associated with EPSBO following abdominal surgery.Conclusion: Conservative therapy with steroids appears promising due to its lower risk profile and greater patient comfort. However, the exact mechanism and its efficacy in treating EPSBO have yet to be fully concluded, so further research is still needed. 
A Rare Case Of Acute Pancreatitis Cause by Newly Diagnosed Graves’ Disease: A Successful Therapeutic Option Abubakar, Azzaki; Yusuf, Fauzi; Maghfirah, Desi; Gunawan, Andrie; Zufry, Hendra; Edward, Meutia Nailan; Ho, Khek Yu
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, AGUSTUS, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025195-200

Abstract

Acute pancreatitis is a frequent disorder whose severity level varies from mild to life-threatening. This condition is characterized by abrupt inflammation of the pancreas. A 53-year-old male was having upper right abdominal pain and epigastric pain which began four hours after hospitalization. This case highlights the complexities of managing acute pancreatitis in a patient with Graves' disease, where hyperthyroidism may worsen pancreatitis and vice versa. Graves' disease is an autoimmune disorder causing hyperthyroidism, which can complicate pancreatitis management, particularly when treated with methimazole, which has been associated with acute pancreatitis. This case suggests a potential link between untreated Graves' disease and idiopathic acute pancreatitis. In patients presenting with unexplained pancreatitis, evaluation for hyperthyroidism may be warranted. The novelty of this case lies in the exclusion of all conventional etiologies and the possible role of autoimmune thyroid disease in pancreatic inflammation.
Co-Authors Alfi Syahrin, Alfi Azzaki Abubakar, Azzaki Edward, Meutia Nailan Eljatin, Muhammad Ridho Akbar Ezigbo, Eyiuche D. Fauzi Yusuf, Fauzi Febriyanti, Sherina Arfi FIRDAUSA, SARAH Gunawan , Andrie Gunawan, Andrie Heltomi, Mirza Hendra Zufry, Hendra Ho, Khek Yu Isitua, Chinwe C. Ismida, Fitri Dewi Kurniawan Kurniawan Muhammad Luthfi Muhammad Yusuf Muhsin Muhsin Mulia, Vera Dewi Purnomo, Avisena Gatot Riswan, Muhammad Salam, Nurbahri L Sari, Fitrah Subhan Rio Pamungkas, Subhan Rio