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All Journal Medical Journal of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Gizi Klinik Indonesia The Indonesian Journal of Community and Occupational Medicine Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Occupational and Environmental Medicine Journal of Indonesia

Rino A Gani

Department Of Internal Medicine, Faculty Of Medicine, Universitas Indonesia, Jakarta, Indonesia

Author-ID : 268596

Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Choline-deficient High-fat Diet-induced Steatohepatitis in BALB/c Mice Saut Horas Hatoguan Nababan; Seruni Tyas Khairunissa; Erni Erfan; Nafrialdi Nafrialdi; Ening Krisnuhoni; Irsan Hasan; Rino Alvani Gani
Molecular and Cellular Biomedical Sciences Vol 5, No 2 (2021)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v5i2.193

Background: Non-alcoholic steatohepatitis (NASH) is an expanding cause of chronic liver disease worldwide, including Indonesia, with higher risk progression to cirrhosis and hepatocellular carcinoma. Preclinical experiments using several mice models have been conducted to clarify its complex pathogenesis. This study was designed to investigate whether BALB/c mice on a choline-deficient high-fat diet can be used as a model for NASH. Materials and Methods: BALB/c male mice were fed choline-deficient L-amino acid-defined high-fat diet (CDAHFD) or a standard diet for six weeks. The body and liver weights, liver histology, and plasma biochemistry were analyzed. The relative expression levels of tumor necrosis factor (TNF)α, transforming growth factor (TGF)β1, collagen-1α1 (COL1α1), glutathione peroxidase 1 (GPx1), and uncoupling protein 2 (UCP2) genes in the livers were analyzed using a two-step real time-polymerase chain reaction. Liver fatty acids composition was analyzed using gas chromatography with flame ionization detector (GC-FID). Results: CDAHFD induced steatohepatitis in BALB/c mice with increased plasma levels of alanine aminotransferase. The liver of CDAHFD-fed BALB/c mice showed upregulated relative expression levels of TNFα, TGFβ1, COL1α1, GPx1, and UCP2 genes. The liver fatty acid analysis showed a significant accumulation of saturated fatty acids (SFAs) and an increased ratio of n-6/n-3 polyunsaturated fatty acids (PUFAs) in the livers of CDAHFD-fed BALB/c mice. Conclusion: This study suggests that CDAHFD can induce steatohepatitis in BALB/c mice and therefore may be used as NASH mice model.Keywords: steatohepatitis, fatty liver, choline-deficient high fat diet, BALB/c

Kekuatan genggam tangan, skor Child Pugh, dan massa otot pada pasien dengan sirosis hati Amanda Trixie Hardigaloeh; Rino Alvani Gani; Irsan Hasan; Andri Sanityoso Sulaiman
Jurnal Gizi Klinik Indonesia Vol 14, No 3 (2018): Januari
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.34302

Background: Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Objective: Aim of this study is to assess the role of HGS measurement in malnutrition and its correlation with liver function and muscle mass.Method: This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary Clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test.Results: There were 115 patients liver cirrhosis at Hepatobiliary Clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54.15±10.55 years, median Child Pugh score 6 (5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44.43±8.12 kg. The median intake of energy 1334.82 (604.75-3023.7) kkal, median protein 45.87 (19-114.5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with Child Pugh score (p=0.046; r=-0.19) however it is correlated with muscle mass (p<0.00; r=0.70).Conclusion: There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between HGS with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.

Pathogenesis in Portal Hypertensive Gastropathy Due to Liver Cirrhosis Loli J Simanjuntak; Chudahman Manan; Marcellus Simadibrata; Rino A Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 3, December 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/53200495-101

The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other etiologic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2 (PGE2), and increased nitric oxyde (NO) which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis. Keywords: Pathogenesis, PHG, liver cirrhosis

Gastric Mucosa Mucous Layer Thickness in Liver Cirrhosis with Portal Hypertensive Gastropathy Compare to Functional Dyspepsia Loli J Simanjuntak; Chudahman Manan; Marcellus Simandibrata; Vera Yuwono; Rino Alvani Gani; Sabarinah Prasetyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200448-57

Background: This study aimed to investigate gastric mucosa mucous layer thickness in portal hypertensive gastropathy (PHG) compare to normal mucosa in functional dyspepsia and its correlation with several variables such as child class, severity of esophageal varices and gastropathy. Methods: Biopsy specimens were taken from the antrum and corpus from both group of patients with PHG and functional dyspepsia. The specimen was given cryometric for frozen section. Tissue were sliced by sagital section 11 µm, placed in object glass, fixed and stained to evaluate mucous thickness and giemsa stained to observe Helicobacter pylori. Measurement of mucous thickness was done upward muscularis mucosa started from upper epithelial layer from foveale tip until outer mucous layer on 15 points which were marked randomly and calculate the mean value by micrometer (µm). Results: Mean value of antral mucous thickness in PHG was 13.30 ± 6.5 µm, while in the functional dyspepsia it was 25.59 ± 5.66 µm. Statistical analysis for both kinds of mucous thickness was p0.001. Mean corpus mucous thickness in PHG was 10.6 ± 6.81 µm, while mucous thickness in dyspepsia was 32.54 ± 6.51 µm. Statistical analysis revealed p0.001. This result showed significant difference of mucous thickness of antrum and corpus statistically between PHG and dyspepsia as control group. Conclusion: The study had proven the presence of decreased gastric mucosa mucous layer thickness in corpus and antrum in PHG. Thus, therapeutic approach to increase mucous thickness must be considered in patients with PHG. Keywords: Gastric mucosa, PHG, liver cirrhosisemistry

Alpha-1 Acid Glycoprotein Cut-off Value as Diagnostic Biomarker in Hepatocelular Carcinoma with Liver Cirrhosis Maulana Suryamin; Rino A Gani; Murdani Abdullah; C Martin Rumende
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Hepatocellular carcinoma (HCC) remains a major problem throughout the world, especially in diagnostic and therapeutic management. Previous studies stated that alpha-1 acid glycoprotein (AAG) was a potensial biomarker in diagnostic of HCC. This study assessed the best cut-off value of AAG as a diagnostic biomarker of HCC with liver cirrhosis.Method: This was a cross-sectional, diagnostic study, conducted from January to October 2013 in Cipto Mangunkusumo Hospital. The subjects were HCC with liver cirrhosis patients and as control were liver cirrhosis patients. Abdominal ultrasonography (USG), abdominal 3 phase contrast computerized tomography (CT) scan, and liver biopsy, if necessary, were done. All patients were having AAG examination, then the result was analyzed using receiver operating characteristic (ROC) curve and assessment of some cut-off values was done.Results: There were 25 HCC with liver cirrhosis patients and 37 liver cirrhosis patients as control included in this study. HCC with liver cirrhosis patients were 92% male and 8% were female, over 50 years old (72%). HBV infection was the most common etiology and most of the patients had multiple nodules in the liver (80%). ROC curve showed the area under the curve (AUC) was 81.44%.Conclusion: The best cut-off value of AAG to be aware of HCC with liver cirrhosis was 61 mg/dL and as a diagnostic was 136 mg/dL. Keywords: hepatocelullar carcinoma, alpha-1 acid glycoprotein, cut-off

Hepatic Stellate Cells and Liver Disease Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Non Cirrhotic Portal Fibrosis Ralph Girson; Andri Sanityoso; Rino A Gani; Wirasmi Marwoto; Murdani Abdullah; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200560-64

Diagnosis of non cirrhotic portal fibrosis was considered when the following criteria were fulfilled evidence of portal hypertension (oesophageal varices, hypersplenism, ascites, or increased hepatic venous pressure gradient), Doppler ultrasound showing patent portal and hepatic veins, and liver biopsy showing sign of cirrhosis. Non cirrhotic portal fibrosis clinically characterized by splenomegaly, anemia, portal hypertension, and histopathological examination portal tract showing fibrosis and sclerosis. Portal hypertension are most caused by a cirrhotic liver (85%), there are only a few reports on non cirrhotic portal hypertension, mostly in Japan and India. We reported a case of non cirrhotic portal fibrosis in young male. The clinical complications of portal hypertension are variceal bleeding and pancytopenia due to hypersplenism. Variceal band ligation and splenectomy were performed. The patient showed good clinical response. Keywords: portal hypertension, non cirrhotic portal fibrosis, young male

Efficacy of Combination Sofosbuvir, Pegylated-Interferon, and Ribavirin for Treatment of Hepatitis C Virus Genotype 1 Infection in Indonesia Andri Sanityoso Sulaiman; Rino Alvani Gani; Irsan Hasan; Cosmas Rinaldi A Lesmana; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Kemal Fariz Kalista; Muhammad Yusuf Hanif
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Background: The presence of direct-acting antiviral (DAA) has improved the treatment of HCV infection and making it more preferable than Pegylated-interferon (PegIFN) and Ribavirin (RBV) based treatment. However, treatment with all DAA combination regimen is limited and expensive in low health care affordability country including Indonesia. The appearance of generic sofosbuvir (SOF) facilitate the utilization of SOF plus PegINF with or withour RBV combination. Therefore, in this study we assessed the efficacy of SOF+RBV and SOF+RBV+PegINF combination for treatment of chronic hepatitis C infections patient with genotype 1 in Indonesia.Method: We performed retrospective study comprising 128 patients in Cipto Mangunkusumo Hospital with chronic hepatitis C, genotype 1, infection. 36 patients was treated with PegINF+SOF+RBV and 92 patients was treated with SOF+RBV with the duration of therapy was 12 and 24 weeks in both arms. The primary endpoint was sustained virologic response after treatment completion (SVR12).Results: In the end of treatment, 99.2% patients achieved undetected HCV RNA in 12 weeks and 24 weeks duration of therapy (100% in PegINF+SOF+RBV group and 98.9% in SOF+RBV group). The SVR12 of PegINF+SOF+RBV reach 100% meanwhile The SVR12 of SOF+RBV reach 88%. No different in SVR12 between cirrhotic and non-cirrhotic patient in PegINF+SOF+RBV group while in SOF+RBV group, the SVR12 was lower in cirrhotic patients (82.9%) compared to non-cirrhotic patients (92.2%). In multivariate analysis, HIV co-infection is associated with lower SVR12 in SOF+RBV group.Conclusion: 12 weeks and 24 weeks of PegINF+SOF+RBV and SOF+RBV is effective in the treatment of genotype 1 chronic hepatitis C infection.

The Clinical Efficacy and Safety of Simvastatin in the Management of Portal Hypertension in Cirrhotic Patients: A Systematic Review Raksheeth Agarwal; Matthew Billy; Oliver Emmanuel Yausep; Radhian Amandito; Vito Filbert Jayalie; Rino Alvani Gani
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: Variceal bleeding is a serious complication of portal hypertension in liver cirrhosis. Current guidelines recommend non-selective beta blockers (NSBBs) and endoscopic variceal ligation for primary prophylaxis of variceal bleeding. However, NSBBs are associated with low response rates and systemic adverse effects. Simvastatin has been shown to reduce portal hypertension in previous studies. Our aim was to assess its clinical efficacy and safety in reducing portal hypertension in cirrhotic patients. Method: We searched PubMed, The Cochrane Library, ScienceDirect, ProQuest, CINAHL, Scopus, and Clinicaltrials.gov, and manually browsed abstracts of major hepatology conferences for selection of studies. We selected randomized controlled trials with a population of cirrhotic patients, simvastatin as an intervention, HVPG change as an outcome, and English as the primary language. The quality of selected studies was assessed using the Cochrane Risk of Bias tool. We extracted change in HVPG from baseline to post-treatment as the principal summary measure, with safety as the secondary outcome.Results: Two full articles were included for qualitative analysis. Both studies reported reductions in HVPG from baseline to post-treatment in the simvastatin group, with this reduction being significantly higher as compared to the control group. Adverse effects were homogenously distributed in both groups, and good safety was reported by both studies. Simvastatin’s HVPG lowering effects are possibly additive to those of NSBBs. Conclusion: Simvastatin effectively reduces HVPG in cirrhotic patients with portal hypertension, although more clinical trials are needed to validate these results. Simvastatin could potentially be combined with NSBBs to achieve greater results.

The Effect of Domperindone on Intestinal Motility and Bacterial Overgrowth in Patients with Liver Cirrhosis Yustar Mulyadi; Rino Alvani Gani; Murdani Abdullah; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

ABSTRACTBackground: Spontaneous bacterial peritonitis (SBP) is a common serious complication of liver cirrhosis mainly caused by bacterial translocation (BT) into ascites fluid. The most essential issue that affects BT is small intestinal bacterial overgrowth (SIBO), which usually caused by gastrointestinal dysmotility. This study was aimed to evaluate the prokinetic effects of domperidone on gastrointestinal motility and small intestinal bacterial overgrowth and the correlation between restoration of motility and the incidence of SIBO in patients with liver cirrhosis.Method: A cross-over double blind clinical trial was conducted on patients who were treated at the ward and outpatient clinic from Division of Hepatology in Cipto Mangunkusumo Hospital, Jakarta and Soedarso Hospital, Pontianak between September 2010 and March 2011. All patients suffered from liver cirrhosis with ascites, gastrointestinal dysmotility and SIBO were included in the study. Out of 34 eligible patients, 16 patients received placebo and 18 patients received prokinetics (domperidone). Wilcoxon test was performed to analyze the comparison of SIBO before and after treatment in the placebo group; while paired T-test was employed for the prokinetics (domperidone) group. To evaluate improved balance of SIBO in the placebo and domperidone group, a Chi-square test was performed.Results: In the placebo group, 61.8% patients experienced SIBO; while in the prokinetics group, SIBO occurred only in 2.9% patients. Restored gastrointestinal motility took place in the prokinetics group with reduced median value for orocaecal transit time from 120 minutes into 90 minutes (p = 0.0001). In contrast, it went worse in the placebo group, i.e. from 90 minutes into 110 minutes (p = 0.002). There was a significant correlation between restored gastrointestinal motility and SIBO (p = 0.0001). Similarly, so does the effect of administering prokinetic agent on restored gastrointestinal motility (p = 0.0001) and SIBO (p = 0.0001).Conclusion: The administration of prokinetics has been proven effective to restore gastrointestinal motility that may lead to reduced incidence of SIBO in patients with liver cirrhosis. Keywords: prokinetics, breath hydrogen test, dysmotilitas, bacterial overgrowth

Co-Authors -, Arles - -, Suhendro - -, Suhendro - A. D. Handayu A.A. Ketut Agung Cahyawan W Abdul Aziz Rani Adang Sabarudin Adityo Susilo, Adityo Agus Sudiro Waspodo Agus Waspodo Ahimsa, Titos Ahimsa, Titos Aida Lydia Alexander Michael Joseph Saudale Ali Sulaiman Ali Sulaiman Alvina Widhani, Alvina Amanda Trixie Hardigaloeh Anandhara Indriani Khumaedi Anandhara Indriani Khumaedi, Anandhara Indriani Anandita, Faizal Ablansah Andi Utama ANDI UTAMA Andri Sanityoso Andri Sanityoso Andri Sanityoso Sulaiman Aprilicia, Gita Ari Fahrial Syam Arles - - Baiq Kirana DN Mandasari Bambang Sutopo Banjarnahor, Riri Oktavani Begawan Bestari Bhanu S Kumar C Martin Rumende C Martin Rumende C Rinaldi A Lesmana Christopher F. Jaya Chudahman Manan Chudahman Manan Chyntia Olivia M. Jasirwan Chyntia Olivia Maurine Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Daldiyono Daldiyono Daldiyono Daldiyono Devy Serevina Dewi Sumaryani Soemarko DIAH ISKANDRIATI Diah Iskandriati Dyah Ratna Budiani E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Ening Krisnuhoni Epistel Pangujian Simatupang Erni Erfan, Erni Evy Yunihastuti Fera Ibrahim FX Pridady Griscalia Christine H. M.S. Noer H.M. Sjaifoellah Noer Hanif, Muhammad Yusuf Hardigaloeh, Amanda Trixie Heriawan Soejono Ichwan Baihaki Ignatius R Tenggara, Ignatius R Ihsanil Husna Ika Prasetya Wijaya Ikhwan Rinaldi Imelda Maria Loho Imelda Maria Loho, Imelda Maria Indra Marki Indra Marki Indra, Suwito Irsan Hasan Irsan Hasan Irsan Hasan Isman Firdaus Jacobus Albertus Jasirwan, Chyntia Olivia M Jenny Bashiruddin Joyce Bratanata Joyce Bratanata, Joyce Juferdy Kurniawan Julius R Samban Kaka Renaldi Kemal F Calista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista, Kemal Fariz Kuntjoro Harimurti L. A. Lesmana Laurentius A Lesmana Laurentius A Lesmana, Laurentius A Laurentius Lesmana Laurentius Lesmana Lianda Siregar Lianda Siregar Lies Luthariana Loli J Simanjuntak Lutfie Lutfie, Lutfie Marcellus Simadibrata K Marcellus Simandibrata Marsen Isbayuputra Maryati Surya Matthew Billy Maulana Suryamin Maulana Suryamin, Maulana Mesanti, Oska Muchtaruddin Mansyur Muhammad Sjaifoellah Noer Muhammad Yusuf Hanif Murdani Abdullah Nababan, Saut Horas Hatoguan Nafrialdi Nafrialdi Nanang Sukmana Nanang Sukmana Nurjati Chairani Siregar Nurul Akbar Nurul Akbar Oliver Emmanuel Yausep Oska Mesanti Prasna Pramita Pratiwi, Amalia Nur Profitasari Kusumaningrum Radhian Amandito Raksheeth Agarwal Ralph Girson Ralph Girson Gunarsa Ratu Ratih Kusumayanti Reny Mulatsih Retno Asti Werdhani Rika Bur Sabarinah Prasetyo Sabarudin, Adang Saut HH Nababan Seruni Tyas Khairunissa Silmi Mariya Siti Boedina Kresno Siti Setiati Sjaifoellah Noer Soemarno Soemarno Soemarno Soemarno Sri Agustini Kurniawati Sri Agustini Kurniawati, Sri Agustini Suhendro - - Suhendro Suhendro Suhendro Suhendro Suhendro Suhendro Sulaeman, Andri Sanityoso Susan Tai Suwito Indra Suzanna Immanuel Syahrizal Syarif Teguh H Karjadi Teguh H Karjadi, Teguh H Teguh H. Karjadi, Teguh H. Teguh Haryono Karjadi Teguh Haryono Karjadi, Teguh Haryono Teressa, Maria Titos Ahimsa Toar J.M. Lalisang Unggul Budihusodo Vera Yuwono Vito Filbert Jayalie, Vito Filbert Wirasmi Marwoto Wirasmi Marwoto Yustar Mulyadi Zubairi Djoerban Zubairi Djoerban

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