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Ali Djumhana
Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, University of Padjadjaran/Hasan Sadikin General Hospital, Bandung
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Materials Science & Nanotechnology Nursing Public Health

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Insidensi dan Karakteristik Hepatotoksisitas Obat Antituberkulosis pada Penderita Tuberkulosis dengan dan tanpa Infeksi HIV Sumantri, Agung Firmansyah; Djumhana, Ali; Wisaksana, Rudi; Sumantri, Rachmat
Global Medical & Health Communication (GMHC) Vol 3, No 2 (2015)
Publisher : Fakultas Kedokteran Universitas Islam Bandung

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Abstrak   Salah satu penyulit dalam pengobatan tuberkulosis (Tb) adalah hepatotoksisitas obat antituberkulosis (OAT). Pasien Tb dengan infeksi human immunodeficiency virus (HIV) meningkatkan risiko kejadian hepatotoksisitas OAT. Hal ini menjadi tantangan dalam menghadapi pasien Tb-HIV. Penelitian ini bertujuan mengetahui insidensi dan karakteristik penderita hepatotoksisitas OAT pada Tb dengan dan tanpa infeksi HIV. Penelitian ini adalah penelitian  epidemiologi  klinik  yang  bersifat  deskriptif  observasional.  Penelitian dilaksanakan di  ruang  rawat jalan dan rawat inap RSUP Dr. Hasan Sadikin (RSHS) Bandung serta ruang rawat jalan RS Bungsu periode Juni– Oktober 2012. Terdapat 120 subjek terdiri atas 18 penderita dengan infeksi HIV dan 102 penderita tanpa infeksi HIV. Mayoritas usia penderita Tb dengan infeksi HIV yaitu ≤35 tahun (17/18 penderita), laki-laki (12/18 penderita), indeks massa tubuh <18,5 kg/m2 (10/18 penderita), dan Tb paru (16/18 penderita). Penderita Tb dengan infeksi HIV yang mengalami hepatotoksisitas terhadap OAT lebih banyak daripada penderita Tb tanpa infeksi HIV (9/18 vs 19/102 penderita). Insidensi hepatotoksisitas OAT sebesar 23,3%. Hepatotoksisitas OAT pada penderita Tb dengan dan tanpa infeksi HIV terjadi pada 2 minggu pengobatan OAT dengan derajat ringan. Simpulan, insidensi hepatotoksisitas OAT pada penderita Tb dengan infeksi HIV lebih tinggi daripada tanpa infeksi HIV. Kata kunci: Hepatotoksisitas OAT, HIV, tuberkulosis   Incidence and Characteristics of Hepatotoxicity Anti-tuberculosis Drugs in Tuberculosis Patients with and without HIV Infection   Abstract Hepatotoxicity is one of the complications in the treatment of tuberculosis (Tb). Tuberculosis patient with HIV infection has higher risk in hepatotoxicity, and this is a clinical obstacle in dealing with Tb-HIV treatment. The aims of this study were to find the incidence and characateristic of anti-tuberculosis hepatotoxicity in tuberculosis patients with and without HIV infection. A descriptive observational study was conducted in outpatient/inpatient RSUP Dr. Hasan Sadikin (RSHS) Bandung, and outpatient RS Bungsu period June–October 2012. There were 120 Tb patients consisted of 18 patients with HIV and 102 patients without HIV. Most of Tb patients with HIV occured in age ≤35 years (17/18 patients), male (12/18 patients), body mass index <18.5 kg/m2 (10/18 patients), and pulmonal Tb (16/18 patients). Tb patients with HIV had hepatotoxicity more than without HIV (9/18 vs 19/102 patients). The incidence of hepatotoxicity was 23.3%. Hepatotoxicity anti-tuberculosis drugs in Tb patients with and without HIV infection mostly occured in second week therapy with mild degree. In conclusion, anti-tuberculosis hepatotoxicity is higher in TB patients co-infected with HIV than non-HIV infections. Key words: Anti-tuberculosis hepatotoxicity, HIV, tuberculosis
The Efficacy of Fucoidan on Gastric Ulcer Juffrie, Mohammad; Rosalina, Ina; Damayanti, Wahyu; Djumhana, Ali; A, Ariani; Ahmad, Harjono
Indonesian Journal of Biotechnology Vol 11, No 2 (2006)
Publisher : Universitas Gadjah Mada

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Abstract

Hyperacidity causes gastric injury, and in severe situations, ulcer could develop. The growth factors known asthe basic fibroblast growth factor (bFGF) and the epidermal growth factor (EGF) have been recognized to promoteulcer healing. Fucoidan is extracted from a brown seaweed of Okinawa called Mozuku or Cladosiphon okamuranus.Fucoidan is effective for the healing of gastric ulcers by inducing epithelial cells to produce growth factors. The aimof this study is to explore the efficacy of fucoidan in patient who suffered by gastric ulcer. A randomized control trialdouble blind was conducted to 33 eligible samples. By using four-blocks random samples were divided into fucoidanand placebo groups. 100 mg of fucoidan was given to the fucoidan group and 100 mg of glucose was given to theplacebo group. Due to ethical reasons, for both groups were given a proton pump inhibitor. There was no differencein the age category between the fucoidan group (mean: 46.23 ± 14.8 years) and the placebo group (mean: 46.18 ± 18.4years) (p: 0.28). There was also no difference in sex between the fucoidan group (female: 10/33; male 7/33) and theplacebo group (female: 7/33; male: 9/33); p: 0.38. According to the SAKITA and MIWA criterias 32 patients fulfilledA1 which indicate active severe ulcer, and 1 patient fulfilled A2 which indicate active moderate ulcer. Most of theulcers were gastric ulcer. There was a significant improvement of the grade of ulcer in fucoidan group (94%) (16/17)compared to placebo group (37.5%) (6/16,p: 0.005). There was a significant reduction of abdominal pain after 5 daysin the fucoidan group, compared to the placebo group (p: 0.04). Vomiting tends to decrease in day 6 of the fucoidangroup however its proportion is similar with that of the placebo group (p: 0.9). Fucoidan is effective for ulcer healingand reducing ulcer symptoms.Key words : fucoidan, gastric ulcer, anti-peptic activity
Co-Authors Abdul A. Rani Agung Firmansyah Sumantri Ari F. Syam Ariani A, Ariani Aziz Rani Dolvy Girawan Harjono Ahmad, Harjono I. D.N. Wibawa Ina Rosalina Jamhari Jamhari Juke Roslia Saketi Marcellus Simadibrata Mohammad Juffrie, Mohammad Muhammad Begawan Bestari Murdani Abdullah Nenny Agustanti Pangarapen Tarigan Pangestu Adi Rachmat Sumantri Rudi Wisaksana Siti Aminah Abdurachman Soetodjo NMN, Soetodjo Wahyu Damayanti, Wahyu Yelica Rachmat