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All Journal JISIP: Jurnal Ilmu Sosial dan Pendidikan Journal La Edusci RETEL Journal: Journal on Publication of The Research on Teaching and Language Jurnal Pacu Pendidikan Dasar The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Multidisiplin Sahombu Indonesian Journal of Education Research and Technology (IJERT)
Hirlan Hirlan
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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

 1 
The Efficacy of Low Dose Captopril Adjuvant for Natriuresis in Patient with Liver Cirrhosis with Ascites Who Have Received Furosemide and Spironolacton Suyatmi Suyatmi; Bantar Suntoko; F. Sumanto; Hirlan Hirlan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2320011-5

Abstract

Background: The ideal therapy for ascites in liver cirrhosis is a low sodium diet and a combination of furosemide and spironolacton. However, this still sometimes does not produce satisfactory Results, even after increasing the dose of the diuretic. Such failure occurs due to the influence of the Renin Angiotensin Aldosterone (RAA) system. Low doses of ACE inhibitors (captopril) should improve renal blood flow and increase filtration at the glomeruli, thus increasing natriuresis without causing haemodynamic imbalance. Study aim: To discover the natriuretic and diuretic effects of low dose captopril adjuvant in patients with liver cirrhosis who have received furosemide and spironolacton by measuring urinary sodium and 24-hour urine output. Materials and method: This study was conducted on in- and out- patients with liver cirrhosis and Ascites at the Dr. Kariadi Central Public Hospital, Semarang, who met the inclusion and exclusion criteria. The study took place from June 1st, 1997 to March 31st, 1998, and included 40 cases of liver cirrhosis with ascites. Study design: Open comparative randomized clinical trial with permuted blocks. All of the patients received a low fat diet, 40 mg of furosemide, 3x50 mg of spironolacton for 2 weeks, and patients with a urinary sodium level was below 80 mEq/L were randomized into two groups: group A receiving 3 x 6.25 mg of captopril, and group B receiving standard therapy.  Results:  Variable            Pre- treatment       Post – treatment      p  Group A : Urinary sodium level (meq/L)   65.450 ± 16.577       109.950 ± 49.109     0.001 24-hour urine output (cc)     1138.750 ± 480.438     1381.250 ± 394.441    0.004 Group B: Urinary sodium level (meq/L)  68.30 ± 12.85         91.750 ± 64.04      0.103 24-hour urine output (cc)       1390 ± 448.27        1392.50 ± 713.46     0.988   The pre- and post- treatment Results for Group A were significantly different. The pre- and post- treatment Results for Group B were not significantly different. Conclusion: Low dose (3 x 6.25 mg) captopril adjuvant in patients with liver cirrhosis and ascites who have received standard doses of furosemide and spironolacton could increase natriuresis and diuresis without causing haemodynamic imbalance.    Key words: Captopril, liver cirrhosis, ascites
Effect of Conjugated Hyperbilirubinemia on the Prognosis of Patients Hospitalized in Intensive Care Unit at Kariadi Hospital Semarang Agung Prasetyo; Djallalluddin Djallalluddin; Hirlan Hirlan; Agus Suryanto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010108-111

Abstract

Background: In critically-ill patients, liver dysfunction plays a significant role on patient’s morbidity and mortality in the intensive care unit (ICU). Metabolic, hemodynamic and inflammatory factors also contribute in liver damage. Bilirubin is one of clinical markers for liver dysfunction. Some literatures indicated that patients with hyperbilirubinemia have higher mortality rate. The aim of this study was to assess the death prognosis of critically-ill patients with hyperbilirubinemia. Method: This study was an observational, prospective, and cohort study. All patients at the ICU of Kariadi hospital with hyperbilirubinemia were consecutively recruited over 8-month period from May 1st 2008 to January 31st 2009. Hyperbilirubinemia was defined as serum bilirubin levels ≥ 1.3 mg/dL for at least 72 hours and no hyperbilirubinemia was observed when the patients were admitted to the hospital. Results: Of 79 subjects who fulfilled inclusion criteria, the incidence of hyperbilirubinemia in critically-ill patients was 39.2%. About 56 subjects were enrolled in the study. Among them, 28 subjects showed hyperbilirubinemia and the other 28 subjects were included in the control group. There was no significant difference regarding the baseline characteristics of hyperbilirubinemia group and non- hyperbilirubinemia group. At the end of the study, the mortality rate in hyperbilirubinemia patients were 60.7% and 21.3% in the non-hyperbilirubinemia patients. The relative risk (RR) of death was 2.8; (95% CI = 1.3 - 6.1; p = 0.003). Conclusion: The incidence of hyperbilirubinemia was high in critically ill-patients hospitalized in the ICU of Kariadi hospital. The incidence of death between non-hyperbilirubinemia and hyperbilirubinemia subjects was significantly different. The significant relative risk of death indicates that hyperbilirubinemia may have influences on the mortality rate of critically-ill patients hospitalized in the ICU.   Keywords: liver dysfunction, hyperbilirubinemia, death
Gallstone and Diabetes Mellitus Hery Djagat Purnomo; Hirlan Hirlan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/93200886-90

Abstract

Diabetes Mellitus (DM) is a metabolic disease which has high prevalence among the population. The prevalence is increasing in accordance to life style changes in the society. Gallstone is frequently found in diabetic patients especially in women with type 2 DM. Nevertheless, studies on the prevalence of gallstone among diabetic patients population have shown inconsistent/contradictive results. Insulin resistance which is frequently found in type 2 DM patients is the underlying factor that correlates obesity, central adiposity, and low physical activity with gallstone disease. Two important physiological reasons in diabetic patients that may increase the risk of gallstone formation are: (1) Increased total cholesterol synthesis that causes bile becomes more easily transformed into cholesterol stone (lithogenic); (2) Diabetic patients have larger size and probably reduced motility of the gallbladder that cause increased formation of cholesterol crystals. However, recent study demonstrated that DM that merely exists without any contribution of other factors is not significant to increase the risk of gallstone formation. The gallstone management in diabetic patients is the same as the management in non-diabetic patients. Elective surgery with laparoscopic cholecystectomy is the treatment of choice for symptomatic cases. Drug treatment is indicated for patients with cholesterol stone, small stone (diameter 5 mm), and well-functioned cystic duct. Keywords: diabetes mellitus, gallstone, insulin resistance, cholesterol synthesis, motility, laparoscopic cholecystectomy
Co-Authors A.A. Ketut Agung Cahyawan W Agus Suryanto Agus Suryanto Bantar Suntoko Bantar Suntoko Dewi Puspita Ningsih Didik Indiarso Djallalluddin Djallalluddin F. Sumanto Hadi Wijaya Hasanah, Miswatun Hery Djagat Hery Djagat Purnomo Hery Djagat Purnomo Jayawarsa, A.A. Ketut M.Pd S.T. S.Pd. I Gde Wawan Sudatha . Mukminah Mukminah Mukminah, Mukminah Sriyani Sriyani Suyatmi Suyatmi Suyatmi Suyatmi Wahyu Stiawan