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All Journal Acta Interna : The Journal of Internal Medicine Jurnal Teknologi Agroindustri Majalah Tegi Journal of Innovation and Technology JURNAL AGROINDUSTRI HALAL The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Agroindustri Berkelanjutan

Siti Nurdjanah

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Author-ID : 2968408

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Education Electrical & Electronics Engineering Energy Engineering Environmental Science Health Professions Industrial & Manufacturing Engineering Materials Science & Nanotechnology Mechanical Engineering Medicine & Pharmacology Social Sciences

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Correlation between the Severity of Liver Cirrhosis (Chil-Pugh Score) and QTc Interval Prolongation Rachmad Aji Saksana; Putut Bayupurnama; Fahmi Indrarti; Neneng Ratnasari; Sutanto Maduseno; Catharina Triwikatmani; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

ABSTRACT Background:Liver cirrhosis causes changes in cardiovascular system. Electrographic (ECG) abnormality commonly found in cirrhosis patients is QT interval prolongation. It is part of cirrhotic cardiomyopathy. QTc interval prolongation is correlated to the incidence of life-threatening arrhythmias. The objective of this study was to recognize the correlation between the severity of liver cirrhosis and QTc interval prolongation in patients with liver cirrhosis at Sardjito General Hospital, Jogjakarta.Method: The design of this study was cross-sectional. The subjects were hospitalized patients with liver cirrhosis at the Department of Internal Medicine, Sardjito Hospital, Jogjakarta between January 2011 and March 2012. ECG was performed in all patients and QTc interval was measured. The severity of liver cirrhosis was determined by Child-Pugh score. Spearman correlation analysis was used to determine the correlation between variables of QTc interval prolongation and Child-Pugh score.Results: A total of 73 patients were enrolled, including 51 (69.9%) male and 22 (31.1%) female patients with mean age of 54.05 ± 12.55 years (range 20-80). Liver cirrhosis was caused by hepatitis B virus in 36 (49.3%) patients, hepatitis C virus in 20 (27.4%) patients and other causes in 19 (26%) patients. The Child-Pugh score for liver cirrhosis was found as follows: child A in 10 (13.6%) patients, child B in 27 (36.9%) patients and child C in 36 (49.3%) patients. The correlation between the severity of liver cirrhosis and QTc interval prolongation was weak (r = 0.255; p = 0.029).Conclusion:Severity of liver cirrhosis has a weak positive correlation with QTc interval prolongation. Keywords: liver cirrhosis, QTc interval, Child-Pugh score

Serum Zinc Level and Urinary Zinc Excretion in Liver Cirrhotic Patient Catharina Triwikatmani; Putut Bayupurnama; Sutanto Maduseno; Neneng Ratnasari; Fahmi Indrarti; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/10120092-6

Background: Zinc deficiency is commonly found in liver cirrhotic patient, and it is usually caused by excessive urinary excretion that is exaggerated by diuretic agents. The objective of this study is to know the differences of zinc serum concentration according to the Child-Turcotte-Pugh (CTP) score and clinical factors that influence zinc serum level and 24-hour urinary zinc excretion. Method: The design of this study was cross-sectional. In adult patients with liver cirrhosis, blood samples were collected after patients had fasted for at least 8 hours. Zinc levels were measured by the flame atomic absorption spectrophotometry method. Correlation test was performed among numeric variables, as well as Mann-Whitney U test to measure mean differences of zinc serum concentration and of 24-hours urinary zinc excretion according to clinical factors. The level of significance was p 0.05. Results: During the period of May 1st - September 30th 2007, there were 36 eligible patients. The mean value of zinc serum levels was 63.70 ± 24.85 µg/dL. There were 24 (66.67%) patients with hypozincemia. The mean value of 24-hour-urinary zinc excretion was 787.52 ± 570.20 µg. There were 19 (52.8%) patients with urinary zinc excretion 550 µg/24 hour. The results of mean difference test of zinc serum concentration between CTP score B and C showed no statistical significance (p = 0.052). Urinary zinc excretion correlated to urine volume (r = 0.638, p = 0.000), and it was higher in hospitalized patients compared to outpatients. It also was higher in men compared to women. There were no statistically significant differences in zinc serum level, zinc urinary level, and urinary zinc excretion on the administration of diuretic agents. Conclusion: There were no significant differences of fasting zinc serum concentration in cirrhotic patients between the CTP scores B and C. In liver cirrhotic patients, urinary zinc excretion positively correlates to urine volume. Keywords: liver cirrhosis, serum zinc level, urinary zinc excretion

Hepatitis A Virus Infection in Guillain-Barré Syndrome Neneng Ratnasari; Siti Nurdjanah
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: 10.24871/32200258-62

Prodromal factors of Guillain-Barré syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS. We report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM anti HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period.

Non-alcoholic Fatty Liver Disease Related to Metabolic Syndrome: a Case-control Study Neneng Ratnasari; Hemi Senorita; Riska Humardewayani Adie; Putut Bayupurnama; Sutanto Maduseno; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Non-alcoholic fatty liver disease (NAFLD) is a benign condition, but it can go for years and progress to liver cirrhosis or eventually to liver cancer. Metabolic syndrome (MS) is a condition associated with NAFLD. This study was aimed to know the risk factors of NAFLD related to metabolic syndrome. Method: A case-control study was performed in NAFLD patients with or without MS and healthy individuals. All subjects were recruited from population that underwent routine medical check-up at Sardjito Hospital, Jogjakarta, during March 2007–August 2008. Diagnosis of NAFLD is defined based on clinical and liver ultrasound findings. Diagnosis of MS is defined by International Diabetes Federation on criteria for the diagnosis of MS. Data were analyzed by using T-test, ANOVA and linear regression. Odds ratio (OR) (95% CI and p 0.05) was calculated by cross-tab analysis. Results: There were 84 patients enrolled in the study (group I = 30 NAFLD + MS subjects; group II = 26 NAFLD patients; group III = 28 healthy). The data showed statistically significant Results in waist circumference, systole blood pressure, fasting glucose, triglyceride, high density lipoprotein (HDL) cholesterol level, homeostasis models assessment index ratio (HOMA-IR), free fatty acid (FFA), and adiponectin. The ANOVA and linear regression test among NAFLD groups showed significant difference only on HDL-cholesterol and FFA level. The lowest OR was 1.674 for HDL-cholesterol and highest OR was 13.571 for triglyceride. Conclusion: The independent factors of NAFLD related to metabolic syndrome are FFA and HDL- cholesterol level, even though a decreasing of HDL-cholesterol level has a lowest risk of NAFLD. Keywords: NAFLD, metabolic syndrome, FFA, adiponectin, HDL-cholesterol

Relationship between serum zinc concentration and neutrophil phagocytic function in liver cirrhosis patients Siti Nurdjanah; Sigit Widyatmoko; R M Arjono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 1, April 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/7120061-5

Background: Liver cirrhosis patients are susceptible to infection. The incidence of infections depends on several factors. One of the factors is decreasing immune system i.e. the deterioration of neutrophil phagocytic function. The deterioration of neutrophil phagocytic function is caused by complement deficiency, bowel endotoxemia, decreasing tuftsin activity, and zinc deficiency. Zinc deficiency is caused by impairment of bowel absorption and increasing zinc excretion by urine. Zinc influences the specific and non specific immune system. Aim: To determine whether there is relationship between serum zinc concentration with neutrophil phagocytic function in liver cirrhosis patients. Subject Method: This was a cross-sectional study from August 2004 until September 2005. Study population are ambulatory liver cirrhosis patients and in patient liver cirrhosis. Correlation analysis was done to asses relationship between zinc concentration and neutrophil phagocytic function, which used Nitro Blue Tetrazolium (NBT) dye reduction test. Result: There were 58 subjects fulfilled the criteria. The mean of serum zinc concentration was 114 mmol/L. The mean of NBT was 3.4 ± 3.1%. The coefficient correlation between zinc serum concentration and neutrophil phagocytic function was 0.13, p= 0.58. Conclusion: There was a weak and non significant positive correlation between serum zinc concentration with neutrophil phagocytic function in liver cirrhosis patients. Keywords: zinc, neutrophil phagocytic function, liver cirrhosis

Therapy of Chronic Viral Hepatitis Siti Nurdjanah
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: 10.24871/21200128-35

Chronic hepatitis due to hepatitis B virus (HBV) or hepatitis C virus (HCV) is still a major problem in terms of progressive liver damage, prevention and therapy in most parts of the world. Unfortunately, to date, there is still no specific and effective therapy for HBV. No therapy can be given to carrier, non- replicative and asymptomatic patients of chronic HBV infection. Lamivudine or alpha-interferon can be used for treatment of compensated, chronic hepatitis B infection with significant increase of aminotransferase. Approximately 40 % of patients can have seroconversion with this form of therapy. Chronic hepatitis D virus infection can be treat with alpha-interferon and in the final stage, may undergo liver transplantation. For chronic hepatitis C virus infection, alpha-interferon with ribavirin have been shown to have a better efficacy than alpha-interferon alone where the efficacy can reach 39 – 49 %. Keywords: hepatitis, interferon, lamivudin,ribavirin

Alterations in Blood Ammonium Level and Psychometric Test in Patients with Liver Cirrhosis after a Tempe Diet Neneng Ratnasari; Siti Nurdjanah
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: 10.24871/32200233-37

Background: Hepatic encephalopathy is found in 50-70% cases of liver cirrhosis. Management of hepatic encephalopathy is based on the hypothesis of ammonia and false neurotransmitters. A vegetable diet is the diet of choice, since vegetable proteins have a high biological value, contains non- ammonigenic essential amino acids, and contains fiber. The results of soy fermentation by Rhizopus sp can increase the nutritional value to make it easier for body digestion. Study aim: To determine improvements in hepatic encephalopathy by measuring the ammonium level and determining the psychometric test in patients with liver cirrhosis receiving a tempe diet compared to those receiving a liver diet (conventional diet). Method: This is a random open clinical trial with a proportional stratification according to the Child Pugh criteria. Study subjects are patients with liver cirrhosis who are hospitalized at the Internal Medicine Ward and ambulatory patients at the out-patient Gastro-hepatology Polyclinic of Dr. Sarjito Public General Hospital, from January 1999 to May 2000. The trial was conducted for 20 days, where the first (trial) group is given a tempe diet, while the second (control) group is given liver diet II/III (conventional). Measured outcomes include peripheral blood ammonium level, and psychometric test using the Numeric Connection Test (NCT). Results: In the first group, we found a significant reduction of ammonium level in Child-Pugh A patients and a non-significant reduction in Child-Pugh B/C patients, a non-significant psychometric test improvement in Child-Pugh A patients, and significant psychometric test improvement in Child-Pugh B/C patients. In group II: there is no significant difference in the changes in ammonium level or psychometric test in patients from both Child-Pugh categories. Conclusion: A 20-day tempe diet can reduce ammonium levels and improve results on the psychometric test. Keywords: lever cirrhosis, hepatic encephalopathy, tempe diet, numeric connection test, child-pugh criteria

Endoscopic Findings and Histopathological Pattern in Patients with Chronic Dyspepsia at Panti Rapih Hospital Jogjakarta Haryanto Rahardjo; Siti Nurdjanah; Putut Bayupurnama
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 1, April 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/9120084-6

Background: To determine the relationship between clinical manifestation of chronic dyspepsia and endoscopic findings along with histopathological pattern by descriptive analysis. Methods: This study was a retrospective study. Subjects were patients with chronic dyspepsia who underwent endoscopic examination and gastric biopsy between June 2005 and July 2006. Result: There are 10.17% normal endoscopic results of 79 patients with chronic dyspepsia and almost 90% show abnormal result in endoscopic examination. The histopathological pattern is normal in 2.53% and 97.47% demonstrate abnormal result. The prevalence of Helicobacter pylori due to gastric ulcer is 1.26% and chronic atrophic gastritis is 3.80%. Conclusion: Most of chronic dyspepsia patients have abnormal endoscopic and histopathologic result. Keywords: chronic dyspepsia, endoscopic findings, histopathological pattern, Helicobacter pylori

Ultrasound-Diagnosed Non-Alcoholic Fatty Liver Disease among Medical Check Up Patients Suharjo B Cahyono; Putut Bayupurnama; Neneng Ratnasari; Sutanto Maduseno; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Non-alcoholic fatty liver disease (NAFLD) is recognised as one of the most important causes of chronic liver disease and has become an important health issue in many countries. The aim of the study wasto evaluate the prevalence and risk factors of NAFLD patients based on ultrasound diagnosed in medical check up setting.Method: In this study, of 2,105 patients undergoing medical check up in Charitas Hospital, Palembang between January 2011 to August 2013, 115 NAFLD patients and 113 non-NAFLD patients as controls were included. Diagnosis of NAFLD was based on ultrasound appearance, patients did not consume alcohol, with negative HBsAg and hepatitis C virus antibodies.Results: The prevalence of NAFLD in medical check up patients was 7.9% whereas 39% patients had normal body mass index (BMI) ( 25 kg/m2). Patients with NAFLD compared with non-NAFLD patients had higher values of BMI (p 0.001), triglycerides (p = 0.001), aspartate aminostransferase (AST) (p 0.001), alanine aminotransferase (ALT) (p 0.001), fasting glucose (p = 0.002), and lower HDL cholesterol (p = 0.001). Obesity was the strongest associated factor for NAFLD (95% CI = 1.87-7.85; OR = 3.83; p 0.001), followed by high glucose levels (95% CI = 1.38 - 8.31; OR = 3.83; p = 0.008) and hypertriglyceridemia (95% CI = 1.38 - 4.11;OR = 2.38; p = 0.002).Conclusion: About 7.9% patients suffered from NAFLD. Approximately 39% medical check up patients had NAFLD with normal BMI. Obesity, hypertriglyceridemia and high glucose levels were the risk factors for NAFLD.Keywords: non-alcoholic liver disease, body mass index, prevalence, metabolic syndrome

Colorectal Cancer in Young Patient: A Distinguished Disease Entity? Siti Nurdjanah; Suryo Taroeno; Putut Bayupurnama; Sutanto Maduseno; Neneng Ratnasari
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: 10.24871/62200537-41

Background: Some studies suggested that colorectal cancer at young age had a distinct biological characteristic: more advanced stage at time of diagnosis, poorer differentiated, and consisted of large proportion of mucin producing tumors. Aim of the study: To analyze clinical and histopathological differences between young aged colorectal cancer patients ( 40 years old) and the older patients Methods: A cross-sectional retrospective study was conducted among our colorectal cancer patients in a general hospital between 1999-2004, using C.18, C.19, C20 ICD X code in medical record searching. It was requested that the patients had surgical treatment in Dr. Sardjito General Hospital. An inconclusive clinical staging and/or histological data were among the exclusion criteria. Chi-square, Fisher’s exact test, T-test, and Mann Whitney U-test was performed to analyze the difference between patients 40 years old and ³ 40 years old, in respect to diagnostic staging, histological type, histological grade (differentiation), CEA level, hemoglobin, albumin, tumor location, and chief complain. With p 0.05 was considered as significant. Results: Sixteen young aged ( 40 years old) and 72 older patients had been identified. No differences in gender proportion and mean of symptoms to diagnosis period between two groups. No statistical differences between young aged and the older patients in diagnostic staging, histological grade and type, CEA level, and hemoglobin. Young aged patients had higher albumin value at presentation (p = 0.014), all had left sided tumors (p = 0.035), more complain of anal pain (p 0.001), and less change of bowel habits complain (p = 0.009) Conclusion: The study results had failed to confirm the difference in respect to diagnostic staging, histological type and grade, CEA level, and hemoglobin. Most of our young aged patients had left sided tumors with chief complain of anal pain, and less complain of change of bowel habits Keywords: Young aged colorectal cancer patients, cross sectional analysis, clinical and histological difference

Co-Authors Anggy Putri Ernani Arif Nur Widodo Azhari Rangga Catharina Triwikatmani Deshinta Putri Mulya Dewi Sartika Dite Ari Prapti Doddy Afprianto Fahmi Indrarti Haryanto Rahardjo Hemi Senorita Heribertus Gunadi Ica Dwi Kusuma Wardani Ida Ayu Putu Sri Widnyani Lingga Kaila Azahra Muhammad Arif Muhammad Robikhul Ikhsan Neneng Rasari Neneng Rasari Neneng Ratnasari Neti Yuliana Novita Herdiana Otik Nawansih Prasetio Kirmawanto Putut Bayupurnama R M Arjono Rachmad Aji Saksana Rani Juniarti Riska Humardewayani Adie Samsu Udayana Nurdin Sigit Widyatmoko Subeki Suharjo B Cahyono Suharjo Broto Cahyono Suryo Taroeno Susilawati Sutanto Maduseno Tri Okta Viani Udin Hasanudin

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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy