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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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Effect of Coconut Milk Supplementation to Nutritional Status Parameters in Liver Cirrhosis Patients Suwito Indra; Rino Alvani Gani; Ari Fahrial Syam; Hamzah Shatri
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

Background: Liver cirrhosis is on of health problems in Indonesia. Decreasing number of liver cells in cirrhosis cause some complications, one of which is malnutrition. In Indonesia, coconut milk is one of nutrients sources which quite popular. Coconut milk is thought to have hepatoprotective effect and be able to be eliminated by cirrhosis patients. A study about effect of coconut milk supplementation to nutritional status parameters in liver cirrhosis patients is really needed.Method: This study is a randomized controlled trial with parallel design. This study is conducted in Cipto Mangunkusumo Hospital Jakarta from February to March 2014. Patients are given late night snack (LNS) in form of agar that contained 25 grams of sugar and additional 50 cc coconut milk in group I (experimental group) and additional drink that contained 25 grams of sugar in group II (control group). Variables that measured to look changes in nutritional status between the two groups are triceps skinfold thickness (TSF), mid arm muscle circumference (MAMC), body mass index (BMI), body fat mass (BFM), prealbumin levels and serum albumin levels.Results: A total of 35 patients with liver cirrhosis in this study to the completion. There are three parameters of nutritional status that increasing better in the group receiving a LNS from combination of carbohydrates and coconut milk, compared to group receiving carbohydrates alone. Those three parameters are mean (SD) MAMC with amount of 9.41 (6.43) mm in group I and 4.68 (5.76) mm in group II, p = 0.028. Median (range) BFM changes 0.67 (-2.47-3.80) kg in group I and 0.21 (-4.96-1.99) kg in group II, p=0,373. Mean (SD) serum albumin level change 0.17 (0.31) g/dL in group I and 0.07 (0.41) g/dL in group II, p = 0,426. There is an increase in the TSF measurement in all subjects after one month of LNS supplementation, but not found any significant differences of TSF changes between the two groups. While the measurement of BMI and serum prealbumin did not show any significant changes after treatment in all subjects research.Conclusion: One month LNS 200 kkal supplementation with combination of carbohydrates and coconut milk have a better effect on the improvement of nutritional status in patients with liver cirrhosis, compared to carbohydrates alone. This shown by the better parameters of MAMC, BFM and increased serum albumin in group I, compared to group II.

Association between HBV DNA Level and Intrahepatic HBcAg Protein Expression of Hepatocytes in Patients with Chronic Hepatitis B Devy Serevina; Ening Krisnuhoni; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201079-82

Background: Correlation between serum Hepatitis B viral deoxyribonucleic acid (HBV DNA) and hepatitis B core antigen (HBcAg) protein expression in the liver regarding hepatitis B e-antigen (HBeAg) status have not been well studied. This study was aimed to demonstrate association between serum HBV DNA and HBeAg levels with HBcAg expressions in the liver. Method: A total of 55 naive chronic hepatitis B (CHB) patients were enrolled. All samples were tested for HBeAg serum by serological test enzyme-linked immunosorbent assay (ELISA) and HBV DNA was determined by polymerase chain reaction (PCR) HBsAg and HBcAg were evaluated immunohistochemically in the liver tissue Results: Of 55 patients, 44 (80%) were HBeAg positive and 11 (20%) were HBeAg negative. There was a positive correlation between serum HBV DNA and HBcAg expression in the nuclei (r: 0.383; p = 0.004). There was association between HBcAg expression in the nucleus and qualitative HBeAg (p = 0.017). Conclusion: In the patient with chronic HBV, there is a very significant positive correlation between the level of viral replication and HBcAg expression in the nucleus of hepatocytes. Moreover, there is association between HBcAg expression in the hepatocytes nucleus and HBeAg serum level. These finding lead to the proposition that nucleus localization of HBcAg protein function to amplify the pool of cccDNA in the replication cycle of HBV.. Keywords: HBV DNA, Imunohistochemistry, HBcAg

Acalculous Cholecystitis Prevalence on Abdominal Ultrasonography Examination of HIV/HCV Co-infection Patients in Cipto Mangunkusumo Hospital Bambang Sutopo; Unggul Budihusodo; Irsan Hasan; Rino Alvani Gani; Evy Yunihastuti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201032-34

Background: Acalculous cholecystitis is commonly found in patients with human immunodeficiency virus (HIV) compared to general population. Surprisingly, the signs and symptoms are unremarkable. On the other hand, HIV/hepatitis C virus (HCV) co-infection is a common finding. The aim of this study was to evaluate whether HCV infection has any influence to HIV patients concerning acalculous cholecystitis prevalence. Method: A cross-sectional study was performed in HIV/HCV patients who visited AIDS study group clinic at Cipto Mangunkusumo hospital during September 2008 to February 2009. The patients who met the criteria were examined physically and underwent abdominal ultrasonography. Routine blood count, alanine aminotranferase, aspartate aminotransferase, cluster of differentiation 4 (CD4) and serum albumin were recorded. Results: Of 63 patients underwent ultrasonography examination, we found acalculous cholecystitis in 33 patients (52.3%), cholelithiasis and cholecystitis in 2 patients, and 28 patients were considered normal. Patients with CD4 less than 200 cells, tend to have acalculous cholecystitis more than those who had CD4 more than 200 cells. Conclusion: The prevalence of acalculous cholecystitis among HIV/HCV co-infection is higher compared to those with HIV infection alone. Keywords: acalculous cholecystitis, HIV/HCV co-infection, CD4

Bacterial Infection in Liver Cirrhosis Rika Bur; Rino A. Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 3, NUMBER 2, August 2002
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/32200250-57

Patients with liver cirrhosis frequently have infection which can deteriorate further the already impaired liver function. The most common form of infection in this particular patients are spontaneous bacterial peritonitis, urinary tract infection, and respiratory infection. Causative organism mostly Gram negative micro organism and originate from the gastrointestinal tract. The weaken of immune defense mechanism and also the altered gastrointestinal tract motility can explained most of these infection. This paper will review the bacterial infection in liver cirrhosis with some guidance in the management. Key words: Liver cirrhosis, spontaneous bacterial peritonitis, systemic antibiotic treatment

Portal Hypertensive Gastropathy: the Twilight Zone Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 2 (2014): VOLUME 15, NUMBER 2, August 2014
Publisher : The Indonesian Society for Digestive Endoscopy

As one of the major complication of liver cirrhosis, portal hypertensive gastropathy (PHG) should be an interesting topic to study. Until now the exact mechanism on how this phenomenon happened is yet, not clear.1 The occurrence of PHG is quite high in patient liver cirrhosis and some relationship occurred between PHG and portal hypertension. In liver cirrhosis patients, PHG may be closely associated with hepatic vein pressure gradient(HVPG).2 However, PHG may not be directly associated with portal pressure because the mucosal damage not linearly correlated with portal hypertension, hence other mechanism involved in the etiopathogenesis of PHG. In this regards, the most important factor related to PHG is the pressure in the splanchnic vasculature. Based on histopathology study in PHG, vascular congestion resulted from increased portal pressure reduced oxygen for gastric mucosa, hence exposed mucosal layer to irritants.2 Moreover, the congestion somehow increased the production of nitric oxide, either through the shearstress locally or as the result of increase production of splanchnic vasculature due to portal hypertension.

CD4+ and CD8+ Counts in Liver and Their Correlation with Necroinflammatory and Fibrosis Grades in Chronic Hepatitis C Chyntia Olivia Maurine; Rino Alvani Gani; Ening Krisnuhoni; Kuntjoro Harimurti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

ABSTRACTBackground: Studies on the characteristics CD4+ and CD8+ in hepatitis C and their correlation with the severity of the disease have been rarely conducted. This study was aimed to obtain the mean difference between CD4+ and CD8+ count in liver to evaluate their correlation with fibrosis and necroinflammatory grades in chronic hepatitis C. Method: A cross-sectional study was conducted between March and July 2010 with 30 liver biopsies obtained from patients with non-B and non-HIV chronic hepatitis C who visited the Outpatient Clinic of Hepatology Unit at Cipto Mangunkusumo Hospital in January 2008–February 2010. Fibrosis and necroinflammatory grades were determined using METAVIR methods on liver biopsies. The mean values of CD4+ and CD8+ in portal tracts and hepatic lobules in liver biopsy specimens were evaluated. Statistical analysis was performed by using independent T-test and Spearman test. Results: There was a difference in mean CD4+ counts between portal tracts and the lobules (95% CI = 4.3-17.9; p = 0.002) and also differences in mean CD8+ counts in portal tracts and hepatic lobules (95% CI = 15.4-35.6; p 0.001). There was no correlation between CD4+ and CD8+ counts, either in portal tracts or the lobules, and inflammatory grades as well as the liver fibrosis. Conclusion: CD4+ and CD8+ counts are greater in portal area compared to the hepatic lobules, with greater CD8+ counts than CD4+. However, both CD4+ and CD8+ counts are not correlated to the severity of liver damage. Keywords: CD4+, CD8+, intrahepatic, chronic hepatitis C, METAVIR

The Difference Expressions of EBNA-1 in Epstein-Barr Virus Infection in Low and High Grade Colorectal Carcinoma Epistel Pangujian Simatupang; Marcellus Simadibrata; Rino Alvani Gani; Dyah Ratna Budiani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Colorectal carcinoma is a common malignancy with the highest mortality rate. Epstein- Barr virus (EBV) as the virus that most commonly infect humans, also can infect the body in a latent and induce the occurrence of malignancy. This study aimed to prove an association between EBV virus infection with degree of colorectal carcinoma by examining the main EBV oncogene expression, namely Epstein-Barr nuclear antigen-1 (EBNA-1), in low grade and high grade colorectal carcinoma. Method: Cross-sectional study was performed in 14 colorectal cancer patients in Moewardi Hospital, Surakarta between July 2011 and January 2012. The biopsy specimens were stained for EBNA-1 expression using immunohistochemical technique. Statistical analysis was performed using T-test and Mann-Whitney by SPSS software version 19.0 for windows. Results: Of the 14 patients, there were 7 patients with low grade colorectal carcinoma and 7 patients with high grade colorectal carcinoma. EBNA-1 expression was found in epithelium of low grade and high grade colorectal carcinoma with p = 0.01; CI = -5.24-0.88. We also assessed the expression of EBNA-1 on lymphocytes B of low grade colorectal carcinoma and high grade colorectal carcinoma with p = 0.043. Conclusion: Significant differences in the expression of EBNA-1 was found in association with EBV infection either in low grade and high grade colorectal carcinoma. The role of EBNA-1 as tumor initiator needs to be elucidated further. Keywords: carcinoma colorectal, Epstein-Barr virus, EBNA-1

Problems in Diagnosis Approach for Carcinoma of Pancreatic Head Ratu Ratih Kusumayanti; Marcellus Simadibrata; Murdani Abdullah; Rino Alvani Gani; Lies Luthariana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 2, August 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/92200864-69

Incidences of pancreatic cancer worldwide have been known to be increased. It is the fifth leading cause of death in United State of America. Seventy percent occurs in the head of the pancreas. Major risk factors are related to age, black race, smokers, high-fat diet, chronic pancreatitis, diabetes mellitus and alcohol consumption. Some clinical symptoms such as jaundice, abdominal pain, unexplained weight loss or ascites can occur early or even late in the course of disease. Diagnosing pancreatic cancer sometimes can be difficult, regarding to discrepancy between clinical symptoms and radiological findings. It is important to take good history of the patient, thorough examination, and combine several modalities in diagnosing tumor of pancreatic head. In this case report, a 54 year-old female, came to the hospital with abdominal swelling and jaundice. Physical examination revealed liver and spleen enlargement and edema on both lower extremities. The laboratory result showed increment in Carcinoembryonic Antigen (CEA) and carbohydrate antigen 19-9 (CA19–9) level, without marked increase in bilirubin level. Dilatation of the pancreatic duct was found in this patient, without any sign of bile stone. Endoscopic Retrograde Cholangiopancreatography (ERCP) in this patient was failed to have significant result. Keywords: carcinoma of pancreatic head, papilla vater carcinoma, diagnosis, ERCP, jaundiceHF

COVID-19 Related to Liver Impairment and Its Impact on Chronic Liver Disease Andri Sanityoso Sulaiman; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Saut HH Nababan; Kemal F Calista; Cosmas Rinaldi A Lesmana; Irsan Hasan; Rino Alvani Gani; Baiq Kirana DN Mandasari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 3 (2020): VOLUME 21, NUMBER 3, December 2020
Publisher : The Indonesian Society for Digestive Endoscopy

By late December 2019, a novel beta-coronavirus, named as COVID-19 (2019-nCoV), was discovered in Wuhan, Hubei Province, China which epidemiologically linked to a Huanan seafood market in Wuhan. Coronavirus Disease 2019 or COVID-19 cases are growing rapidly from Wuhan to many countries, finding the health care system unprepared to face this threat. No effective drugs are clinically approved to manage the disease and strategies to protect the most vulnerable from developing severe illness and infection is still unclear. Information on how COVID-19 virus infection may affects many organs, especially the liver and the relevance of pre-existing liver disease in patients as a risk factor for the infection or disease severity are still scarce and inconclusive. Besides, the recommendation and consideration in liver transplant patients, hepatocellular carcinoma, or patient on immunosuppressive therapy still need further analysis Therefore, the information on the mechanism and treatment of COVID-19 related liver injury in patients with or without pre-existing liver disease should be considered.

Study of Transaminases in Heroin Addicts Rino A Gani; Agus Sudiro Waspodo; Unggul Budihusodo; Irsan Hasan; Muhammad Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2120011-4

A recent increase in the number of drug users particularly of heroin has been noted in the community. A cross-sectional study on the level of transaminases as a representation of liver damage in drug users was done in privated hospital in Jakarta. Exclusion criteria were fever, serious illness or the multiple use of addictive drugs based on a urinary test. The hepatitis B surface antigen (HBsAg) was examined using reverse passive hemaglutination assay (RPHA) and the antibody of hepatitis C virus core-protein (anti- HCV) with dipstick anti-HCV. AST and ALT levels were determined using an automatic chemical analyzer. Of 132 patients who fulfill the criteria, 83.5 % were injection drug users (IDU). Means AST and ALT were significantly higher in IDU. Anti-HCV positive patients with increased AST and ALT were significantly higher compared to anti-HCV negative. The increase of transaminase was also consistent in injection drug users although no viral marker could be detected. In conclusion, the examination of transaminases in drug users especially IDU is important besides tests for hepatitis viral markers because there is often an increase with or without viral infection and this can be associated with hepatocellular damage. Key words: Transaminase, heroin addicts, hepatitis

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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