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

Dolvy Girawan

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

Author-ID : 269729

Medicine & Pharmacology

Published : 16 Documents Claim Missing Document

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Gut Microbiota in Human Immunodeficiency Virus Infection Rudi Wisaksana; Guntur Darmawan; Nenny Agustanti; Dolvy Girawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, April 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Human microbiota, majority presents in human gastrointestinal tract, plays crucial role in body physiological functions, such as immune system. Human immunodeficiency virus (HIV) infection impairs gut barrier and alter the microbiota ecosystem, called dysbiosis. Different phase of HIV infection demonstrates different composition of gut microbiota. Antiretroviral treatment might improve the CD4 level, however, it inconsistently restore the gut ecosystem. Some studies in prebiotic and probiotic revealed the potential effect in reducing inflammation and restoring gut microbiota.

Primary Biliary Cirrhosis Irvan Nugraha; Guntur Darmawan; Emmy Hermiyanti Pranggono; Yudi Wahyudi; Nenny Agustanti; Dolvy Girawan; Begawan Bestari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Primary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome).

Probiotics in Ankylosing Spondylitis: A Possible Potency Sumartini Dewi; Stefanie Yuliana Usman; Guntur Darmawan; Dolvy Girawan
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

Ankylosing Spondylitis (AS) is a common autoimmune arthritis which prevalence ranging from 0.1% up to 1.4% globally. Furthermore, in Asian population the prevalence of AS was increasing overtime. Up until now, there were several treatment options available in treating AS in Indonesia. However, there was still some limitations in complete remission achievement and some have limitation in potential adverse drug reaction. Eventually, these affect both patients’s daily activity and their quality of life.There were studies demonstrated the association between intestinal dysbiosis and inflammatory rheumatic disorders. Previous studies also presented there was an altered composition of gut microbiota in AS patients. Probiotic in the other hand, has been known previously for its efficacy in treating intestinal dysbiosis. Hence, this review aimed to identify potencies, efficacy and safety of probiotics as AS treatment options.

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 .

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

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.

Remdesivir-Induced Hepatotoxicity: A Systematic Review of Clinical Evidence, Pharmacokinetics, and Safety Concerns Hamdan, Angkasa Ramatuan; Bestari, Muhamad Begawan; Girawan, Dolvy; Agustanti, Nenny; Husain, Okky; Hasan, Nadeem S.
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025228-236

Background: Remdesivir is widely used for the treatment of COVID-19, with its potential benefits currently under investigation. Concerns remain regarding its potential hepatotoxic side effects. Drug-drug interactions, specifically with CYP3A4 and P-glycoprotein inhibitors, may worsen hepatotoxicity. In this context, dexamethasone has been suggested to mitigate liver injury, but the role remains unclear. Therefore, this study aimed to explore the characteristics, mechanisms, and risk factors of remdesivir-induced hepatotoxicity through a systematic review of case reports.Methods: A systematic review was conducted using databases such as PubMed, Scopus, EBSCO, and BMJ Case Reports for cases published from 2020 to 2024. The keywords used were “remdesivir,” “hepatotoxicity,” “COVID-19,” and “liver failure.” Relevant case reports were selected based on predefined inclusion and exclusion criteria. Furthermore, data were extracted following the Joanna Briggs Institute (JBI) checklist for case reports.Results: Among 46 individual articles screened after the removal of duplicates, five that detailed a total of six patients were eligible for inclusion. Hepatotoxicity was frequently reported in elderly patients and those with chronic liver disease. Drug-drug interactions that include remdesivir and CYP3A4 inhibitors increased the risk of liver injury. Based on observation, dexamethasone was associated with reduced hepatotoxicity, primarily due to its anti-inflammatory effects. In patients with ALT 5× ULN, remdesivir administration was controversial. Some cases showed improvement, and others required discontinuation due to severe liver dysfunction.Conclusion: This study emphasized the necessity for safety evaluations and standardized liver function monitoring in patients receiving remdesivir. Further investigation is essential to define clinical guidelines and improve patient safety in antiviral treatments.

Co-Authors Achadiyani Agustanty, Nenny Ali Djumhana Ali Djumhana Angkasa Ramatuan Hamdan Anindita Laksmi Anna Tjandrawati Begawan Bestari Bestari, Muhamad Begawan Dewi, Sumartini Eka Surya Nugraha Emmy Hermiyanti Pranggono Fong, Sim Chee Guntur Darmawan Guntur Darmawan Guntur Darmawan Hadi Jusuf Hadi Jusuf Haryono - Haryono Haryono Hasan, Nadeem S. Hermin Aminah Usman Husain, Okky Iman Supandiman Iman Supandiman Irvan Nugraha Jansen Budiono Jansen Budiono Jessica Cynthia Febryani Juke Roslia Saketi Juke Roslia Saketi M Begawan Bestari Muhammad Begawan Bestari Nenny Agustanti Nugraha, Irvan Nur Atik Pranggono, Emmy Hermiyanti Rasdianto, Devi Novianto Rudi Wisaksana Rudi Wisaksana S A Abdurachman Sim Chee Fong Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Stefanie Hadi Supriami Stefanie Yuliana Usman Sumartini Dewi Tan Siauw Koan Usman, Stefanie Yuliana Warko Karnadihardja Yanti Mulyana Yanti Mulyana Yelica Rachmat Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi

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