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All Journal Althea Medical Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Muhammad Begawan Bestari

Division Of Gastroentero-hepatology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Padjajaran/Hasan Sadikin General Hospital, Bandung

Author-ID : 242201

Medicine & Pharmacology

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Hepatoprotective Effect of Trigona spp. Bee Propolis against Carbon Tetrachloride-Induced Liver Injury in Rat Amelia, Rachel; Achadiyani, Achadiyani; Bestari, M. Begawan
Althea Medical Journal Vol 3, No 3 (2016)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (289.842 KB)

Background: Oxidative stress reaction can cause liver injury. This process can be prevented by antioxidant activities which can break the destructive chain caused by free radical substances in the liver. Propolis produced by Trigona spp. bee is known to have a high level of antioxidant. The aim of this study was to examine the effect of Trigona spp. bee propolis on liver histological toxicity caused by carbon tetrachloride-induced oxidative stress.Methods:This experimental study was conducted in September 2013 at the Animal Laboratory of Departement of Pharmacology and Therapy, Faculty of Medicine Universitas Padjadjaran. Twenty-four healthy male Wistar rats as objects were adapted for one week and randomly divided into 3 groups. Group I was the control negative, group II was given carbon tetrachloride on day 14, group III was given Trigona spp. bee propolis on day 1-14. On day 14, group III was injected CCl4 intraperitoneally. The quantitative data were statistically analyzed using the one way ANOVA and Tukey test with p value < 0.05.Results: Group I showed the liver contained normal cells, without significant injury of the membrane, round and complete nucleus. The average number of liver cell was 464 Â± 9.59281 cells/field; group II underwent necrosis and the average of the cells was 146 Â± 7.56885 cells/field; group III showed some normal liver cells, and some necrotic area with the normal liver cells average was 263 Â± 14.10860 cells/field. The p-value=0.00.Conclusions: Trigona spp. bee propolis has a hepatoprotective effect against CCl4-induced liver injury histologically. [AMJ.2016;3(3):481â5]DOI: 10.15850/amj.v3n3.861Â

Hepatoprotective Effect of Trigona spp. Bee Propolis against Carbon Tetrachloride-Induced Liver Injury in Rat Rachel Amelia; Achadiyani Achadiyani; M. Begawan Bestari
Althea Medical Journal Vol 3, No 3 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4873.743 KB)

Background: Oxidative stress reaction can cause liver injury. This process can be prevented by antioxidant activities which can break the destructive chain caused by free radical substances in the liver. Propolis produced by Trigona spp. bee is known to have a high level of antioxidant. The aim of this study was to examine the effect of Trigona spp. bee propolis on liver histological toxicity caused by carbon tetrachloride-induced oxidative stress.Methods:This experimental study was conducted in September 2013 at the Animal Laboratory of Departement of Pharmacology and Therapy, Faculty of Medicine Universitas Padjadjaran. Twenty-four healthy male Wistar rats as objects were adapted for one week and randomly divided into 3 groups. Group I was the control negative, group II was given carbon tetrachloride on day 14, group III was given Trigona spp. bee propolis on day 1-14. On day 14, group III was injected CCl4 intraperitoneally. The quantitative data were statistically analyzed using the one way ANOVA and Tukey test with p value < 0.05.Results: Group I showed the liver contained normal cells, without significant injury of the membrane, round and complete nucleus. The average number of liver cell was 464 ± 9.59281 cells/field; group II underwent necrosis and the average of the cells was 146 ± 7.56885 cells/field; group III showed some normal liver cells, and some necrotic area with the normal liver cells average was 263 ± 14.10860 cells/field. The p-value=0.00.Conclusions: Trigona spp. bee propolis has a hepatoprotective effect against CCl4-induced liver injury histologically. [AMJ.2016;3(3):481–5]DOI: 10.15850/amj.v3n3.861

Clinical and Endoscopic Features in Helicobacter Pylori Infection: Literature Review Ghina Tsuraya Salsabila Budiman; Muhammad Begawan Bestari; Sri Suryanti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Helicobacter pylori is a common infection worldwide and can cause functional dyspepsia, gastritis, and peptic ulcers, leading to gastric cancer. The very diverse clinical outcomes and symptoms of this infection are difficult to distinguish from one another. Endoscopy is one of the methods used to detect Helicobacter pylori infection. Still, it has various endoscopic features, has the possibility of false-negative results, and requires skill to get the maximum results.This study found that infection can cause various clinical manifestations due to different virulence factors of Helicobacter pylori bacteria. In functional dyspepsia, the patient's most common symptoms are epigastric pain, nausea, and vomiting. In gastritis, Helicobacter pylori infection often causes chronic gastritis with topographic features of pangastritis, and endoscopic features that are usually found are redness, swelling, and regular arrangement of collecting venules (RAC). The most common symptom in peptic ulcers is pain that occurs after eating or at night, and this infection can cause duodenal and gastric ulcers. Currently, the relationship between Helicobacter pylori infection and gastroesophageal reflux disease (GERD) is controversial. In gastric cancer, the most common symptoms are weight loss and repeated vomiting. This infection is more likely to causes intestinal-type gastric cancer.

Relationship between Gastroesophageal Reflux Disease Questionnaire (GERD-Q) Score and Reflux Oesophagitis in Gastroesophageal Reflux Disease (GERD) Suspected Patients in Bandung Dosmer Oloan Simarmata; Yudi Wahyudi; Muhammad Begawan Bestari; Rudi Supriadi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Gastroesophageal reflux disease is a disease with heterogen symptoms, with no gold standard available to diagnose this condition. Questionnaire is a diagnostic tool that may enable an objective symptom assessment. GERD-Q questionnaire consist of 6 components of questions, formed from 4 various components of reflux symptoms (positive predictors of GERD) and 2 as negative predictors of GERD. This study aimed to observe the relationship between GERD-Q score and reflux oesophagitis in GERD suspected patients.Method: This study was an analytic cross-sectional study, conducted in March to July 2019. Study participants were patients visiting the Endoscopy Unit in Hasan Sadikin Hospital, Cibabat District General Hospital, and Al Islam General Hospital, who were then evaluated using GERD-Q and later underwent endoscopy examination. The severity of reflux oesophagitis observed through endoscopy was evaluated using the Los Angeles classification. Endoscopy readings was performed by one experienced doctor.Results: Thirty-six patients were examined; 17 (47.2%) patients suffered from reflux oesophagitis, including 13 cases with grade A (76.5%) and 4 cases with grade B (23.5%). There were no cases with grade C or grade D was found. Patients who suffered from reflux oesophagitis with GERD-Q score ≥ 8 were 15 patients (65.2%) and GERD-Q score 8 were 2 patients (15.4%). Chi Square test analysis with confidence interval of 95% revealed p = 0.004 (p 0.05). Biserial point correlation coefficient was 0.643 with p 0.001.Conclusion: There was a strong relationship between GERD-Q score and reflux oesophagitis. The higher the GERD-Q score, the higher the possibility to suffer from reflux oesophagitis.

The Effectiveness of Emergency Endoscopic Retrograde Cholangiopancreatography in Patients with Severe Acute Cholangitis Muhammad Begawan Bestari; Nenny Agustanti; Yelica Rachmat; Dolvy Girawan; Ali Djumhana; Juke Roslia Saketi; Siti Aminah Abdurachman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010128-131

Background: The aim of this study was to assess the frequency, indications, yield and outcome of emergent endoscopy retrograde cholangiopancreatography (ERCP) in severe acute cholangitis patients. Method: Records of all cholangitis patients undergoing ERCP were reviewed over a six months period. Indications, findings, therapeutic interventions and survival were analyzed. Indications for urgent drainage were temperature greater than 38ºC, increasing abdominal pain, jaundice and any organ involvement. Results: Of 80 ERCPs, 19 (23.75%) were severe acute cholangitis patients underwent emergency ERCP. The common bile duct was the duct of interest in all patients and was cannulated in 100%. The most common findings were choledocholithiasis (42.1%) and pancreatic head cancer (42.1%), followed by cholangiocarcinoma (10.5%) and papil vater carcinoma (5.3%). There were 12 (63.2%) septic shock patients with systolic blood pressure less than 90 mmHg and heart rate greater than 90 beats/minute who required inotropic drugs. Endoscopic biliary drainage was performed using 8.5 F biliary stent (73.7%) or common bile duct (CDB) stones removal (26.3%). The overall 30 days mortality was 0. Conclusion: Emergency ERCP in severe acute cholangitis is associated with improvement of clinical and some laboratory parameters without a complication of acute pancreatitis. In cases of chIoledocholithiasis, it can be performed with stone extraction as well as stent insertion Keywords: severe acute cholangitis, emergent ERCP, endoscopic stenting in difficult hilar biliary stricture

Role of Radial Endoscopic-ultrasound (EUS) to Establish Diagnosis of Undetermined Causes of Obstructive Jaundice: A Case Series Eka Surya Nugraha; Dolvy Girawan; Nenny Agustanti; Yudi Wahyudi; Muhammad Begawan Bestari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Identification the causes of obstructive jaundice are challenging. Recent radiologic imaging techniques improve diagnostic yield to determine jaundice causes. However, small lesions particularly in pancreas or periampullary area that lead to jaundice, often unrecognize with conventional radiologic imaging. Radial endoscopic-ultrasound (EUS) is the most sensitive modality to identify the lesions-related obstructive jaundice, remarkably in the lack of high-resolution radiologic facilities. We presented four cases of obstructive jaundice, without obvious obstruction causes from conventional radiologic imaging or abdominal ultrasound. All patients underwent radial EUS, pancreatic head mass revealed in 2 patients, and distal stenosis of the common bile duct without evidence of mass was found in 2 other patients. The masses size were 16 mm and 39 mm in diameter. Due to linear EUS and EUS guided fine needle were unavailable in our center, confirmation biopsy was undone. Three patients were performed endoscopic retrograde cholangiopancreatography (ERCP) for dilatation and inserting stents, and one patient referred to the surgeon. In conclusion, radial EUS aided to diagnose the definite causes of jaundice despite in the less-equipped of high-resolution radiologic imaging.

Reliability of Hepatus® for Evaluating Liver Fibrosis in Chronic Hepatitis B Jessica Cynthia Febryani; Muhammad Begawan Bestari; Haryono -; Dolvy Girawan; Nenny Agustanti; Yudi Wahyudi; Siti Aminah Abdurachman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 2 (2022): VOLUME 23, NUMBER 2, August 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Abstract BackgroundAmong non-invasive strategies available for liver fibrosis assessment, transient elastography is widely used, as it is non-invasive and can be repeated. Hepatus® (Mindray, China) is one novel instrument for measuring liver stiffness that is now available in the market with lower price than its precursor, FibroScan® (Echosens, Paris). MethodIn this cross sectional study, CHB patients in single center were recruited consecutively in October 2021-December 2021. The patients were examined for LSM with two transient elastography instruments in one visit. The first instrument was Hepatus® (Mindray, China) and the second one was FibroScan® (Echosens, Paris). Both measurements were done by the same operator. ResultsA total of 68 CHB patients were enrolled in this study. Median score of LSM by Hepatus® and FibroScan® were 7.6 (5.92-11.88) and 7.35 (5.63-11.80) respectively. Spearman rank analysis for correlation showed a significant correlation between the results of the two instruments ( r= 0.8, p 0.05). The number of patients with significant fibrosis (≥8 kPa) identified by Hepatus® and FibroScan® were 28 (41%) and 29 (43%) respectively. McNemar test yielded no significant difference of the results (p= 1.000), and Cohen’s kappa measure of agreement showed moderate agreement (κ = 0.789 and p 0.005). ConclusionHepatus® identified similar number of significant fibrosis patients with FibroScan®, with the results of liver stiffness measurement between the two instruments correlated significantly. Hepatus® has a potential as an alternative tool for measuring liver stiffness with a more economic price. KeywordsHepatus®, FibroScan®, transient elastography, liver fibrosis, CHB

The Efficacy of Generic Daclatasvir-Sofosbuvir as Pan-Genotypic Regiment for Hepatitis C Virus (HCV) Infected Patients in Bandung Indonesia Muhammad Begawan Bestari; Eka Surya Nugraha; Siti Aminah Abdurachman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 1 (2020): VOLUME 21, NUMBER 1, April 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Direct-acting antivirals (DAAs) have altered the prognosis of hepatitis C virus (HCV) disease but its access is limited by socioeconomic factors. Generic DAAs with lower prices were available in Indonesia in 2016. The aim of this study was to determine the efficacy of generic daclatasvir-sofosbuvir.Method: We performed an observational study from January to December 2016 in a tertiary care center in Bandung, Indonesia. Data were obtained from medical registry. All study subjects received oral daclatasvir (60 mg, once daily) and sofosbuvir (400 mg, once daily) for 12 weeks for noncirrhotic chronic HCV patients and 24 weeks for cirrhotic chronic HCV patients. The main endpoint criterion was sustained virologic response at post-treatment week 12 (SVR12).Results: We enrolled 32 subjects (20 noncirrhotic, 12 cirrhotic). All noncirrhotic subjects (eighteen were previously untreated patients) and cirrhotic subjects (all were previously untreated patients) achieved SVR12 of 100%. These high rates of SVR12 were observed in all patients with HCV infection regardless of the genotype. ALT normalization was achieved in all patients 12 weeks after therapy. The most common adverse events were fatigue and nausea.Conclusion: Once-daily oral generic daclatasvir-sofosbuvir showed good efficacy and safety. Furthermore, it yielded a high rate of SVR among patients infected with HCV of all genotypes.

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

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

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 .

Co-Authors Achadiyani Ade Zuhrotun Agustanty, Nenny Ali Djumhana Ali Djumhana Amelia, Rachel Anna Tjandrawati Dewi, Sumartini Dolvy Girawan Dosmer Oloan Simarmata Eka Surya Nugraha Emmy Hermiyanti Pranggono Enny Rohmawaty Ghina Tsuraya Salsabila Budiman Guntur Darmawan Haryono - Haryono Haryono Hermin Aminah Usman Hesti Lina Wiraswati Jessica Cynthia Febryani Juke Roslia Saketi Juke Roslia Saketi Nenny Agustanti Nugraha, Irvan Pranggono, Emmy Hermiyanti Rachel Amelia Rasdianto, Devi Novianto Rini Hendriani Rosdianto, Aziiz Mardanarian Rudi Supriadi Saragih, Winda A. M. Savira Ekawardhani Simarmata, Dosmer Oloan Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Sri Suryanti Supriadi, Rudi Usman, Hermin A. Wijaya, Muhammad Palar Yelica Rachmat Yoga Windhu Wardhana Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi

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