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All Journal Medical Journal of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Gizi Klinik Indonesia Cermin Dunia Kedokteran MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute

Irsan Hasan

Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia

Author-ID : 277729

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

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Articles

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Liver Transplant in Hepatocellular Carcinoma: Indication and Prognostic Factors Gunawan - -; Irsan Hasan; Juferdy Kurniawan
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

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. There are several treatment modalities according to Barcelona treatment algorithm. Liver transplant is one of the curative option treatments, with its indication and prognostic factors. Carefully selected patients for liver transplant in HCC case will result in the same or slightly inferior survival rate compare with liver transplant in non-malignancy case.

Evaluation of GeneXpert for Quantification Viral Load Hepatitis C Virus Chyntia Olivia Maurine Jasirwan; Irsan Hasan; Andri Sanityoso Sulaiman; Rino Alvani Gani
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

Background: GeneXpert has been used for Mycobacterium tuberculosis testing, but is currently available for HCV RNA testing. GeneXpert assay is expected to be more accurate, efficient, and cost-effective for HCV viral load quantification. This study intended to evaluate the new method quantification of plasma HCV RNA by the GeneXpert in comparison to the Roche Cobas TaqMan 96 as standard diagnostic tools.Method: A total of 54 HCV-infected plasma samples with anti-HCV positive were examined by GeneXpert assay, followed with Cobas TaqMan 96 for quantification of HCV RNA. Correlation was performed by Pearson test (in log10) and diagnostic test by Chi-square test. Sensitivity and specificity of the GeneXpert assay measured by calculating 2x2 contingency table. Bland-Altman plot were generated to assess the mean difference between the two assays.Results: GeneXpert has strong correlation to the Roche Cobas TaqMan 96 (R=0.993; P value 0.001). GeneXpert has sensitivity of 100% (95% CI: 90–100%) and specificity of 90% (95% CI: 54.1–99.5%). The Bland Altmand plot showed that one sampel has 1 log difference with the Roche Cobas TaqMan 96 measurement result.Conclusion: There was a strong correlation in the measurement of HCV RNA by GeneXpert and moreover its assay also has an excellent overall performance compared to Cobas TaqMan 96. Thus, it can be considered as a reliable tools for HCV virological response monitoring.

Correlation between Branched Chain Amino Acids to Tyrosine Ratio and Child Pugh Score in Liver Cirrhosis Patients Irsan Hasan; Rino A Gani; Nurul Akbar; Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120051-3

Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain amino acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay. Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio. Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 + 1.2; Child Pugh B 6.0 + 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin (r = 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test. Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio. Keywords: Branched chain amino acids, tyrosine, liver cirrhosis

The Role of M2 Pyruvate Kinase in the Screening of Bowel Inflammation Ruswhandi -; Marcellus Simadibrata; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: This is a study to determine if M2 Pyruvate Kinase (M2-PK) can be used to screen the presence of bowel inflammation.Method: The study design being used is diagnostic test. In this study, we recruited 76 participants and performed colonoscopy examination as a gold standard and faecal M2-PK as the examined procedure.Results: From the result of this study, we identified the important role of M2-PK to screen the presence of bowel inflammation with the cut-off point of 1.05 U/mL compared to colonoscopy as gold standard with the sensitivity of 86.2%, specificity 81.8%, positive predictive value 96.6%, and negative predictive value 50%.Conclusion: From the result of this study, we suggested M2-PK examination to screen bowel inflammation in patients with lower gastrointestinal tract problems.

Randomized Double-blind Controlled Trial: Benefits of Lactobacillus reuteri in Chronic Functional Constipation Patients Taolin Agustinus; Marcellus Simadibrata; Irsan Hasan; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 3 (2015): VOLUME 16, NUMBER 3, December 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Chronic functional constipation is a common problem that affects between 15-25% of the population and cause symptoms and disorders that creates discomfort, morbidity, and high costs for health care. Recently, the consumption of probiotics in treating chronic constipation in adults have been investigated. However, there are still limited and controversial evidences available from controlled trials. The aim of this study was to evaluate the effects of Lactobacillus reuteri (L. reuteri) in improving the Agachan constipation score, the number of L. reuteri in the feces and the fecal pH in the patients with chronic functional constipation.Method: A double-blind, placebo randomized controlled trial (RCT) was conducted in 40 adults (12 males/28 females with mean age 45.95 ± 16 years) affected by chronic functional constipation according to Rome III criteria. Patients were randomly assigned to receive a supplementation of L. reuteri or placebo for 4 weeks.Results: At week 4, the decrease in Agachan constipation score was from 17.00 to 8.00 with p 0.001, the increase number of L. reuteri was from 6.80 x 107 to 2.12 x 108 with p 0.001 and the decrease of pH feces was from 5.44 (SD 0.70) to 4.78 (SD 0.56) with p 0.001 in the L. reuteri group, otherwise in the placebo group there were no significant results in Agachan constipation score, the number of L. reuteri and fecal pH assessed.Conclusion: L. reuteri is more effective than the placebo group in improving the Agachan constipation score, increasing the number of L. reuteri in the feces and decreasing the fecal pH in adult with chronic functional constipation.

Prolonged QTc-Interval in Liver Cirrhotic Patient: Prevalence and Its Relationship with Severity of Liver Dysfunction Iman Firmansyah; Irsan Hasan; Laurentius Lesmana; Idrus Alwi; Pudji Rahardjo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 1, April 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/5120041-6

Background: The aim of the study was to determine the prevalence of prolonged QTc -interval and it’s relationship with the severity of liver dysfunction in liver cirrhotic patient in the outpatient clinic of Hepatology, Dr. Cipto Mangunkusumo General National Hospital Methods: cross sectional study. Eighty one subjects was recruited and being followed as a consecutive non random sampling. The patient was divided according to the modified Child-Pugh classification and undergo to the ECG examination (with minimal 2 leads have measured QT-interval; one of these is II, aVL, V2 or V3 lead). Result: The prolonged QTc-interval prevalence in liver cirrhotic patient was found in 55 subjects (67,9%) with the mean 448.6 msec (SD = 28,9; 95% CI = 442.2 - 454.8). Using the Forward Stepwise Method in multivariate analysis to the independent variables (p 0.05) was found only the modified Child-Pugh classification had strongly correlation with the prolonged QTc-interval (OR = 11.2; 95% CI = 3.57-35.47; p = 0.000) Conclusion: The prolonged QTc-interval prevalence in liver cirrhotic patient is 67.9%. The prolonged QTc-interval were strongly associated with the severity of liver dysfunction. Keywords: The prolonged QTc-interval, liver dysfunction, liver cirrhosis

Gastric pH Comparison Between Mild and Severe Cirrhotic Portal Hypertensive Gastropathy Asep Saepul Rohmat; Dadang Makmun; Irsan Hasan
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

Background: One of the causes of upper gastrointestinal bleeding in patients with liver cirrhosis is thepresence of portal hypertensive gastropathy (PHG). The prevalence of PHG in patients with liver cirrhosis isquite high but there is still inconsistency regarding the studies about gastric pH in cirrhosis patient. The aim of this study is to compare the gastric pH in mild and severe PHG due to liver cirrhosis.Method: Cross sectional method with consecutive sampling was done to all liver cirrhotic patients who came to Clinic of Gastroenterology and Hepatology in Cipto Mangunkusumo hospital from March to May 2014. Sixtytwo patients with portal hypertensive gastropathy underwent endoscopy to measure the degree of gastropathy based on Mc Cormack classification ad the mean basal gastric pH using pH-metric.Results: There are 50 (80.6%) male patients and 12 (19.4%) female patients participated in this study. Portal hypertensive gastropathy is mostly caused by hepatitis C (56.5%), hepatitis B (32.3%), non-hepatitis (8.1%) and alcohol (3.2%). The mean of gastric pH in all liver cirrhosis patients with portal hypertensive gastropathy was 2.13.The mean gastric pH in liver cirrhosis patient with mild portal hypertensive gastropathy (2.00 mEq/L) was lower than the gastric pH in severe portal hypertensive gastropathy (2.25 mEq/L) with significant differences (p0.05)Conclusion: The gastric pH in liver cirrhosis patient between mild and severe portal hypertensive gastropathy are significantly different Keywords: gastric pH, liver cirrhosis, portal hypertensive gastropathy, pH-metric

Higher Risk of Hepatocellular Carcinoma Progression in the Population of Untreated Immune-Tolerant Phase Chronic Hepatitis B Patients: An Evidence Based Alessa Fahira; Irsan Hasan
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: Hepatitis B infection is a major health problem worldwide, currently occurring in 350-400 millions of people. If not treated properly, hepatitis B infection may progess into chronic hepatitis B (CHB)—which may developed into hepatocelullar carcinoma (HCC). The first phase of CHB, the immune-tolerance (IT) phase, is marked with minimal necroinflammatic activity and a lower risk in the development of a more chronic liver condition, by hence antiviral therapy is not recommended. Recent studies however, shows that there are apparently histological activity and immune specific response towards HBV, accompanied by extensive clonal expansion of hepatitis in the IT phase, hence questioning its risk for the development of HCC. This evidence-based case report is meant to comprehensively review the effect of antiviral treatment in IT-phase CHB patients from available studies.Method: Pubmed, ProQuest, Cochrane, Scopus, Sciencedirect and EBSCOhost were comprehensively searched for systematic review and cohort prognostic researches studying the impact of anti-virals treatment for CHB patients in IT-phase. Three studies were selected and critically appraised. Data were then summarized descriptively.Results: The three studies included in this study were retrospective cohort studies. One study stated that the treated IT-phase group had significantly reduced risk for HCC (HR = 0.234; log-rank p = 0.046), compared to the untreated IT-phase group. One study found that untreated IT phase is asscociated with significantly higher risk of HCC (HR = 2.54; 95% CI: 1.54 to 4.18; p 0.001) compared to the treated immune-active (IA) phase group. The last study stated a higher adjusted hazard ratio (aHR) of the UIT in predicting HCC risk was 2.327 (95% CI 0.475–11.391; p = 0.297), if compared to the IA group.Conclusion: While studies shows apparent results regarding the treatment of CHB patients in the IT-phase and its benefit in reducing cumulative incidence of HCC, its clinical advantage is soon to be discovered. The results were inconclusive, and the initiation of treatment in CHB patients within the IT-phase cannot yet be recommended until further research.

The Discrepancy of Colonoscopical and Histopathological Findings in Infectious Colitis: Focus on Amebic Colitis Salius Silih; Marcellus Simadibrata; Murdani Abdullah; Abdul Aziz Rani; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009105-109

Background: Result of colonoscopic examination in infectious colitis was varying. The aim of this study was to recognize the correlation between colonoscopical and histopathological findings in patients with infectious colitis at Cipto Mangunkusumo hospital, Jakarta. Method: A cross-sectional study had been conducted. There were 227 patients with infectious colitis with unidentified etiology and 17 patients with amebic colitis. In both groups, several variables had been studied including sex, age group and indication of colonoscopy by using Chi-square test. The relationship between hematochezia and amebic colitis event was also studied by using Chi-square test. To recognize the ability of colonoscopy test in diagnosing amebic colitis, we conducted diagnostic test by searching the sensitivity and specificity. Result: In both groups of infectious colitis, we found male more frequent than female. There was a significant difference mean of age in both group of infectious colitis (p = 0.04). The mean age of amebic colitis group was younger (35.86 ± 14.36 years) than the other infectious colitis group (45.34 ± 15. 90 years). The incidence of amebic colitis was more frequent in hematochezia than in non -hematochezia (p 0.001). The sensitivity and specificity of colonoscopy in diagnosing amebic colitis were 35% and 97%, respectively. Conclusion: There was a tendency of developing amebic colitis in patients with hematochezia than non-hematochezia. In diagnosing the presence of amebic colitis, colo noscopy examination has lo w sensitivity and high specificity. Keywords: discrepancy, infectious colitis, amebic colitis, colonoscopy, histopathological finding

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

Co-Authors -, Gunawan - -, Gunawan - Abdul Aziz Rani Abdul Aziz Rani Abdul Rahman M Aditama, Humala Prika Agus Sudiro Waspodo Agus Waspodo Agustinus, Taolin Alessa Fahira Ali Sulaiman Ali Sulaiman Alvin Nursalim Alvin Nursalim Amanda Trixie Hardigaloeh Anandhara Indriani Khumaedi Anandhara Indriani Khumaedi, Anandhara Indriani Andi Utama ANDI UTAMA Andri Sanityoso Andri Sanityoso Andri Sanityoso Sulaeman Andri Sanityoso Sulaiman Aprilicia, Gita Ari Fahrial Syam Arnold Hasahatan Harahap Asep Saepul Rohmat Asep Saepul Rohmat, Asep Saepul Aulia Rizka, Aulia Azzaki Abubakar Azzaki Abubakar, Azzaki Baiq Kirana DN Mandasari Bambang Sutopo C Rinaldi A Lesmana C. Martin Rumende C. Martin Rumende, C. Martin Chyntia Olivia M. Jasirwan Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Dadang Makmun Danang Agung Yunaidi Deskian Kostermans Deskian Kostermans, Deskian Diah Iskandriati E Mudjadid E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edi Mulyana Edi Mulyana, Edi Edy Rizal Wahyudi Ening Krisnuhoni Eric Daniel Tenda Erni Erfan, Erni Esthika Dewiasty, Esthika Evy Yunihastuti Felix F Widjaja, Felix F FX Pridady Gita Aprilicia Gita Aprilicia Griscalia Christine Griskalia Christine Gunawan - - Guntur Darmawan H. M.S. Noer Hamzah Shatri Hamzah Shatri Hanif, Muhammad Yusuf Hardigaloeh, Amanda Trixie Hendra Koncoro Hilman Zulkifli Amin Idrus Alwi Idrus Alwi Idrus Alwi Ignatius Bima Prasetya, Ignatius Bima Iman Firmansyah Iman Firmansyah Imelda Maria Loho Imelda Maria Loho, Imelda Maria Indra Marki Indra Marki Jasirwan, Chyntia Olivia M Jeffry Beta Tenggara Juferdy Kurniawan Karmel Tambunan Kartika, Ronald Winardi Kemal F Calista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista, Kemal Fariz L A Lesmana L. A. Lesmana Laniyati Hamijoyo, Laniyati Laurentius A Lesmana Laurentius A Lesmana, Laurentius A Laurentius Lesmana Laurentius Lesmana Leonard Nainggolan Liana W. Susanto Lianda Siregar Lies Luthariana Lies Luthariana Lutfie Lutfie, Lutfie Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Martha Iskandar Maryati Surya Maulana Suryamin, Maulana Mondrowinduro, Prionggo Muhammad Sjaifoellah Noer Muhammad Yamin Lubis Muhammad Yamin Lubis, Muhammad Yamin Muhammad Yusuf Hanif Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nababan, Saut Horas H. Nafrialdi Nafrialdi Nurul Akbar Nurul Akbar Paramita Khairan, Paramita Paulus Kusnanto Prionggo Mondrowinduro Pudji Rahardjo Pudji Rahardjo Raymond R. Tjandrawinata Rino A Gani Rino A Gani Rino A. Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Ruswhandi - Ruswhandi -, Ruswhandi Salius Silih Sartika, Katarina Dewi Saut HH Nababan Saut Horas H. Nababan Saut Horas Hatoguan Nababan Saut Horas Hatoguan Nababan Saut Horas Hatoguan Nababan Seruni Tyas Khairunissa Silmi Mariya Siti Setiati Sjaifoellah Noer Soemarno Soemarno Soemarno Soemarno Suhendro Suhendro Suhendro Suwarto Suhendro Suwarto, Suhendro Sulaeman, Andri Sanityoso Suradji, Eka Widrian Susan Tai Suzanna Ndraha Syahrizal Syarif Taolin Agustinus Teguh H. Karjadi Teguh H. Karjadi, Teguh H. Telly Kamelia Tendean, Marcel Teng, Wei Teressa, Maria THARIQAH SALAMAH, THARIQAH Unggul Budihusodo Wiguna, Candra Wijaya, Indra Wismandari Wisnu Yaldiera Utami Yaldiera Utami, Yaldiera Yong, Bernard Jonathan Christian Zulkifly, Steven

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