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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

Endoscopic Sclerotherapy and Band Ligation in Secondary Prophylaxis of Esophageal Variceal Treatment Catharina Triwikatmani; Putut Bayupurnama; Sutanto Maduseno; Neneng Ratnasari; Fahmi Indrarti; Siti Nurdjanah
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: 10.24871/1132010121-124

Background: Variceal bleeding is the most severe outcome of portal hypertension. Endoscopic sclerotherapy and band ligation are endoscopic treatment modalities for both active variceal bleeding and secondary prophylaxis. Endoscopic sclerotherapy has been carried out in Sardjito hospital since 1998, while band ligation has only been carried out since 2007 year. The aim of this study was to evaluate the long-term Result of endoscopic sclerotherapy and endoscopic band ligation in secondary prophylaxis of esophageal variceal eradication. Method: This is not a prospective study and is not randomized. The Results of patients who underwent endoscopic sclerotherapy and endoscopic band ligation from July 2003 to June 2009 were compared. Patients were evaluated for re-bleeding and recurrence rates. Results: Two hundred and seventy seven patients underwent endoscopic sclerotherapy and endoscopic band ligation during the period. One hundred and nine patients with varices eradication data; 49 patients who underwent sclerotherapy and 60 patients who underwent band ligation were followed for 1-119 (15.54 ± 20.70) months. The numbers of sessions for eradication were 4.33 ± 1.16 and 2.23 ± 0.59 for endoscopic sclerotherapy and endoscopic band ligation respectively (p 0.001). Re-bleeding and recurrence rates were 38.64% and 84.21% for endoscopic sclerotherapy, and 25.93% and 70% for endoscopic band ligation (p 0.05). Conclusion: Endoscopic band ligation is more effective than sclerotherapy in the eradication of esophageal varices. Keywords: esophageal varices, sclerotherapy, band ligation, secondary prophylaxis

The Role of Insulin Resistance in Diabetic Patients with Chronic Liver Disease Neneng Ratnasari; Siti Nurdjanah; Putut Bayupurnama; Sutanto Maduseno
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: 10.24871/9120081-3

Background: The association between diabetes and chronic liver disease has been well documented. However, the mechanism remains unknown. The aim of this study was to investigate the insulin resistance in chronic liver disease and normal liver in diabetic patient. Method: A total of 31 diabetic, non-alcoholic patients with multiple oral hypoglycemic drugs, either with or without lipid abnormalities were enrolled in this study. Subjects were recruited from outpatient clinic of Department of Endocrine at Dr. Sardjito Hospital, Jogjakarta, Indonesia from May-June 2004. This was a cross sectional study. Fasting insulin and glucose level, liver function test, body mass index, and the presence of fatty liver by ultrasound were examined. Insulin resistance was estimated by calculating fasting insulin and glucose plasma level as the homeostasis model assessment (HOMA) index ratio. Data was described with mean ± SD and analyzed by independent sample t-test. Results: Thirty one patients were enrolled to the study, i.e. 8 patients with normal liver and 23 patients with fatty liver. Only 14 patients agreed to continue the study including 10 patients with fatty liver and 4 patients with normal liver. Mean of age was 59.1 ± 8.7 and mean value of BMI was 24.62 ± 3.05. The liver function test revealed normal Results. Triglyceride, cholesterol, fasting glucose level, and HOMA index (2.77 ± 1.95 vs. 1.66 ± 1.02) in patients with fatty liver were higher than patients with normal liver. No correlation was found between fasting insulin level as well as HOMA index and mean value of BMI (obese and non-obese) as well as hypertension. There was significant correlation between triglyceride level and fasting insulin among fatty liver patients (p = 0.048; CI 95% -7.404; -0.032). Conclusion: The non-alcoholic fatty liver disease in diabetic patients with normal liver enzymes and multiple oral hypoglycemic drugs appear to be related with insulin resistance and hypertriglyceridemia. Keywords: fatty liver, diabetic, insulin resistance

Detecting Liver Fibrosis: a Non-Invasive Era Putut Bayupurnama
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

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How to Negotiate Difficult Colonoscopy to Optimize Cecal Intubation Rate Suharjo B Cahyono; Putut Bayupurnama
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Colonoscopy is the current standard method for evaluating colon. Cecal intubation rate is an important indicator of colonoscopy quality. In up to 10–20% colonoscopies, cecal intubation may be considered difficult.There are several consequences of low cecal intubation rate: it limits the efficacy of colonoscopy, increasing risk of complications and cost, and missing in detecting adenoma colorectal or other abnormal mucosa lesion.Failure to intubate the cecal can be a result of: (1) patients factors (female, older, diverticular disease, history of abdominal surgery, low body mass index, history of constipation, laxative use); (2) endoscopist factors (prior experience, the specific techniques and instrument used; (3) or some combination thereof. In an effort to solve these problems endoscopist should increase their technical manoeuvres (minimizing inflation and looping, using water–aided method, appropriate use of positional changes and abdominal pressure) and use various accessories methods (inserting a biopsy forceps through the biopsy channel, pediatric colonoscopy, variable stiffness colonoscopy).Keywords: cecal intubation rate, difficult colonoscopy, colonoscopy quality, water–aided colonoscopy

Histopathological pattern of gastric biopsies of Helicobacter pylori positive patients in Sardjito General Hospital, Yogyakarta Putut Bayupurnama
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 1, NUMBER 1, December 2000
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112000%p

Objective: To determine the gastric histopathological types of H. pylori positive patients. Materials and Methods: Study design was prospective study. Consecutive patients who were suffering chronic dyspepsia underwent endoscopic examination between August 1998 and December 1999. The biopsy specimens were taken from the gastric antrum and corpus and sent to the pathologist for histopathological typing and H. pylori examinations. H. pylori were also confirmed with CLO and IgG- Helicobacter pylori test. Results: There were 92 patients (48 male (M) and 44 female (F)) who underwent endoscopical gastric biopsies between August 1998 and December 1999. Fifty six (60.87%) patients suffered from chronic superficial gastritis, 11 (11.96%) from chronic atropic gastritis, 2 (2.17%) from chronic gastritis with metaplasia, 3 (3.27) from gastric ulcer, and 2 (2.17%) from gastric signet-ring cell carcinoma. Twenty one (22.8%) patients was found to be H. pylori positive based on histopathologic examination with CLO and IgG-H. pylori tests. Those were 5 (8.90%) patients with chronic superficial gastritis, 7 (63.63%) chronic atrophic gastritis, 3 (100%) gastric ulcer, 2 (100%) chronic gastritis with metaplasia, 1 (50%) signet-ring carcinoma. The age range of the H. pylori positive patients were between 16 and 76 years old. Conclusion: There were twenty one (22.8%) H. pylori positive patients out of 92 endoscopied patients and a high percentage tendency of H. pylori positively in chronic atrophic gastritis, gastric ulcer, and chronic gastritis with metaplasia, although most of the patients had chronic superficial gastritis. Further study with larger sample is needed to get clearer picture of H. pylori distribution based on gastric histopathological types. Key words: histopathological type, gastric biopsy, H. pylori, gastritis

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