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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal MedScientiae
Nenny Agustanti
Division Of Gastroenterology And Hepatology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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Laporan Kasus: Tantangan Pengelolaan Krisis Hiperglikemia Pasien Penyakit Ginjal Kronik (PGK) Tahap Akhir dalam Hemodialisa Rutin Davin Takaryanto; Maya Kusumawati; Nenny Agustanti; Rudi Supriyadi; Ervita Ritonga; Nanny N. M. Soetedjo; Hikmat Permana
Jurnal MedScientiae Vol. 2 No. 1 (2023): April
Publisher : Fakultas Kedokteran dan Ilmu Kesehatan Ukrida

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Abstract

Introduction Hyperglycemic crisis is a life threatening medical emergency which occur in any individuals, including end stage renal disease (ESRD). The altered renal, glucose, electrolyte, and body fluid dysregulation seen in ESRD patients affects the management. Objective: Hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA) are life threatening hyperglycemic emergencies that warrant immediate and adequate management. The incidence of hyperglycemic crises among ESRD patients who undergo routine hemodialysis remains unknown. Furthermore, several available studies reported in case reports. Methods: We hereby report a case of hyperglycemic crisis of 61years old woman with medical history of type 2 diabetes mellitus (DM) and ESRD as the complication, she undergoes routine hemodialysis. Results: The patient was admitted with decreased consciousness that was preceded by dyspnea, active cough and fever. Then, the patient treated for the hyperglycemic crisis as in ESRD patient and for the with septic shock due to pneumonia. Conclusion: The management of hyperglycemic crises consist of fluid, potasium corection and insulin administration, however there were some adjustment in ESRD patients. At present therere were no spesific guidelines to manage hyperglicemic crisis and ESRD which is challenging.
Physalis angulata Linn. As a Potential Liver Antifibrotic Agent In Rats. Bestari, Muhammad Begawan; Rohmawaty, Enny; Rosdianto, Aziiz Mardanarian; Usman, Hermin A.; Saragih, Winda A. M.; Zuhrotun, Ade; Hendriani, Rini; Wardhana, Yoga Windhu; Ekawardhani, Savira; Wiraswati, Hesti Lina; Agustanti, Nenny; Dewi, Sumartini; Wijaya, Muhammad Palar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 3 (2023): VOLUME 24, NUMBER 3, December, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2432023206

Abstract

Background: No drug with a liver antifibrotic effect for treating non-alcoholic fatty liver disease (NAFLD) has been approved. Physalis angulata Linn., better known to Indonesian as ciplukan, has natural abilities in various metabolic and inflammatory diseases. This study aims to determine the effect of ethyl acetate fraction of P. angulata in the NAFLD rat model by examining alanine aminotransferase (ALT), cholesterol levels, and liver histopathological features, which are methods to evaluate the course of the disease and the potential antifibrotic effect.Method: This research is an in vivo study on male Wistar rats conducted at the Animal Laboratory, Faculty of Medicine, Universitas Padjadjaran, from September to November 2020. Rats were grouped randomly into seven groups of 5 each. The NAFLD models were created by giving a diet containing 20% margarine for four weeks. The intervention groups were given vitamin E, ethyl acetate fraction of P. angulata, and both combinations. The statistical analysis examined differences in each group based on their histopathological features, ALT, and cholesterol levels.Results: Histopathological results in the group given P. angulata at a dose of 0.32 mg resembled normal liver, and the ALT level was similar to vitamin E. The administration of P. angulata at 0.16 mg dose improved cholesterol levels.Conclusions: P. angulata ethyl acetate fraction at a dose of 0.32 mg improved the histopathological and serum ALT levels in the NAFLD rat model, which could be the basis for the mechanism of P. angulata's antifibrotic ability in NAFLD conditions.
Colonoscopy and Histopathologic Features in Chronic Diarrhea Patients at Dr. Hasan Sadikin General Hospital, Bandung Rasdianto, Devi Novianto; Nugraha, Eka Surya; Usman, Hermin Aminah; Agustanti, Nenny; Wahyudi, Yudi; Girawan, Dolvy; Bestari, Muhammad Begawan; Abdurachman, Siti Aminah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 3 (2022): VOLUME 23, NUMBER 3, December 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2332022188-192

Abstract

Background: Diagnosing and managing patients with chronic diarrhea remains a clinical challenge due to its broad differential diagnoses. Colonoscopy with biopsy is often indicated to establish chronic diarrhea etiologies. However, to date, no data have been published describing the colonoscopic and histological findings in patients with chronic diarrhea at Dr. Hasan Sadikin General Hospital in Bandung. This study aimed to determine the features of colonoscopy and histology in patients with chronic diarrhea.Methods: This study employed a cross-sectional-descriptive design, utilizing secondary data from colonoscopy examinations conducted at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. Participants included adults aged 18 and above who had been diagnosed with chronic diarrhea and had completed both colonoscopy and biopsy procedures.Results: A total of 182 subjects with chronic diarrhea were included in the study. The majority were women (52%), with mean age of 46 years. Upon admission, the predominant clinical presentation was chronic diarrhea without hematochezia, observed in 75% of cases. Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. The most frequent colonoscopic features were hyperemic or edematous lesions, seen in 58% of subjects. The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies and inflammatory bowel disease (IBD) that is 14% 12%, respectively.Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The most frequently observed lesion was hyperemic mucosa. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD .
Correlation of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) with Liver Transient Elastography Results: An Evaluating Liver Fibrosis in Chronic Hepatitis B Patients Haryono, Haryono; Bestari, Muhammad Begawan; Agustanti, Nenny; Girawan, Dolvy; Wahyudi, Yudi; Abdurachman, Siti Aminah; Tjandrawati, Anna
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 1 (2023): VOLUME 24, NUMBER 1, April, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/241202312-22

Abstract

Background: Transient elastography (TE) is widely recognized as a reliable surrogate marker for grading the severity of liver fibrosis in chronic hepatitis B (CHB) patients. Mac-2 binding protein of glycosylation isomer (M2BPGi) is a novel non-invasive serum biomarker for liver fibrosis staging in various liver diseases, including CHB. This study aimed to evaluate the correlation of M2BPGi and liver stiffness (LS), as measured through TE, in predicting the degree of liver fibrosis in CHB patients.Methods: A cross-sectional study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, between September 2021 and January 2022. The study included patients diagnosed with chronic hepatitis B (CHB) based on clinical and biochemical assessments. All subjects underwent TE examination using Fibroscan®, and the M2BPGi levels were determined with an automated immunoassay analyzer HISCL-800, Sysmex, Japan. Statistical analysis was conducted using the Spearman rank correlation method, with a significance value of p0.05.Results: A total of 119 patients with chronic hepatitis B (CHB) were consecutively recruited (Male:Female = 66:53; median age: 43 years). The median M2BPGi level was 1.04 COI (range: 0.74–1.59), while the median liver stiffness (LS) was 7.3 kPa (range: 5.6–12.5). A moderate and statistically significant correlation was observed between M2BPGi and LS (r = 0.525; p 0.001). Median M2BPGi values by fibrosis stage were 0.89 COI for F0–F1, 0.88 for F2, 1.61 for F3, and 2.24 for F4 (p 0.001).Conclusion: This study revealed a moderate positive correlation between serum M2BPGi level and LS in CHB patients.
Co-Authors Ade Zuhrotun Ali Djumhana Ali Djumhana Ali Djumhana Andini, Dinda Andreas Jonathan Andreas Jonathan Anna Tjandrawati Bayu Laksono Begawan Bestari Davin Takaryanto Davin Takaryanto Dewi, Sumartini Dolvy Girawan Eka Surya Nugraha Emmy Hermiyanti Pranggono Enny Rohmawaty Guntur Darmawan Guntur Darmawan Guntur Darmawan Haryono - Haryono Haryono Hermin Aminah Usman Hesti Lina Wiraswati Hikmat Permana Irvan Nugraha Jessica Cynthia Febryani Juke Roslia Saketi Juke Roslia Saketi Kusumawati, Maya M Begawan Bestari Muhammad Begawan Bestari Muhammad Begawan Bestari Nanny N. M. Soetedjo Nugraha, Irvan Nur Atik Pranggono, Emmy Hermiyanti Rasdianto, Devi Novianto Rini Hendriani Ritonga, Ervita Rosdianto, Aziiz Mardanarian Rudi Supriyadi Rudi Wisaksana Rudi Wisaksana Rudi Wisaksana Saragih, Winda A. M. Savira Ekawardhani Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Soetodjo NMN Soetodjo NMN, Soetodjo Stefanie Hadi Supriami Susantina Prodjosoewojo Usman, Hermin A. Wijaya, Muhammad Palar Yelica Rachmat Yoga Windhu Wardhana Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi