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All Journal Acta Interna : The Journal of Internal Medicine The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Suharjo B Cahyono

Department of Internal Medicine, Charitas Hospital, Palembang

Author-ID : 2968828

Health Professions Medicine & Pharmacology

Published : 5 Documents Claim Missing Document

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Articles

Overlap in Patient with Functional Dyspepsia and Unspecified Functional Anorectal Pain Suharjo B Cahyono; Neneng Ratnasari; Siti Nurdjanah
Acta Interna The Journal of Internal Medicine Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Functional gastrointestinal disorders (FIGD) represent a common and important class of disorders within gastroenterology. FIGD are a cause of great anxiety, distress and morbidity. FIGD disorders maybe manifest as overlapping syndrome. Patients with functional dyspepsia (FD) show frequent overlapping of other gastrointestinal disease, such as functional anorectal pain. These overlap patients have more frequent or more severe symptoms, poor health related quality of life and higher somatization scores, and they are more likely to experience anxiety, depression or insomnia compared to non-overlap patients. These disorders were diagnosed according Rome III criteria and excluded structural diseases. Multimodalities approach should be used during treatment patient with FGID. It was reported a male patient with functional dyspepsia and unspecified functional anorectal pain overlap. Keywords: Functional gastrointestinal disorders, functional dyspepsia, functional anorectal pain

Tuberculosis Peritonitis Patient with Septic Shock caused by Extended–Spectrum Beta Lactamases Producing Pseudomonas Aeruginosa Suharjo B Cahyono; Neneng Ratnasari; Putut Bayupurnama; Catharina Triwikatmani; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Society for Digestive Endoscopy

According to World Health Organization (WHO), tuberculosis (TB) is a worldwide pandemic. Up to 5% of patients with TB may have abdominal disease and 25-60% may have peritoneal involvement. Diagnosis of TB peritonitis is still challenging, and symptoms are usually insidious. The sensitivity of acid fast bacilli (AFB) is very low, ranging from 0-6%. Conventional mycobacterial culture takes up to 8 weeks to achieve results. Laparoscopic or laparotomy biopsy is uncomfortable for patient. The consequence of these problems is missing and delays in diagnosing TB peritonitis. In the end, it can results in significant morbidity and mortality. This case described a 20 year old female patient with TB peritonitis that suffered from septic shock caused by extended-spectrum beta lactamases (ESBL) producing Pseudomonas aeruginosa. In this case, TB peritonitis was diagnosed based on clinical features, high levels of adenosine deaminase (ADA) and a positive rapid DNA test with Xpert MTB/RIF. Keywords: tuberculosis peritonitis, extended-spectrum beta lactamases producing bacilli, adenosine deaminase, XpertMTB/RIF assay

Factors that Influence Cecal Intubation Rate in Unsedated Patients during Colonoscopy Suharjo B Cahyono; Putut Bayupurnama; Neneng Ratnasari; Catharina Triwikatmani; Fahmi Indrarti; Sutanto Maduseno; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Successful cecal intubation is a primary quality indicator in colonoscopies and the mostimportant factor in detecting abnormal lesion in the colon. There are many factors that influence cecal intubationrate during colonoscopy procedure. The aim of this study is to evaluate the factors that influence cecal intubationrate in unsedated patients during colonoscopy. Method: A retrospective study of colonoscopy performed at Sardjito General Hospital, Jogjakarta, from January 2012 to August 2013. Age, sex, bowel preparation, indication for colonoscopy, colonoscopist, andreasons of incomplete colonoscopy from 564 colonoscopy reports were recorded and analysed. Results: Overall successful cecal intubation rate was 408 (72.34%). Causes of incomplete colonoscopywere patients discomfort or pain 41.66%, looping/redundant 28.85%, poor bowel preparation 18.59%, fixation/adhesion 6.41%, and bleeding risk 4.49%. Female was more unsuccessful in cecal intubation than male (31.50%vs. 24.05%; p = 0.048). The successful cecal intubation rates for gastroenterologists compared to gastroenterology(GI) fellows were 77.92% vs. 49.55%; p 0.001, and poor bowel preparation was more difficult to reach cecalthan good preparation (57.58% vs. 23.69%; p 0.001). Multivariate logistic regression analysis demonstratedthat female and poor bowel preparation were independently associated with lower cecal intubation rate, andgastroenterologists were independently associated less unsuccessful to reach cecal. Conclusion: The overall successful cecal intubation rate was still below the set standard. Several identifiedfactors that may predict lower of cecal intubation rate: the skill and experience of colonoscopists (GI fellows),poor bowel preparation and female.Keywords: cecal intubation rate, colonoscopy, unsedated colonoscopy

Maximum Tolerated Volume and Plasma Acylated Ghrelin Levels after Drink Tests in Patients with Functional Dyspepsia Suharjo B Cahyono; Neneng Ratnasari; Putut Bayupurnama; Nurdjanah S
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: Impaired gastric accommodation and visceral hypersensitivity are major pathophysiological mechanism in functional dyspepsia (FD). Ghrelin, as gut hormone, may play a pathophysiological role in functional dyspepsia. Nutrient drink test was developed to assess impaired gastric accommodation in FD patients. The aims of this study are to compare maximum tolerated volume, postprandial symptoms and acylated ghrelin levels between dyspepsia functional patients and healthy subjects as controls.Method: A cross sectional study was conducted from July 2014 to November 2014, at Sardjito General Hospital, Yogyakarta. Twenties functional dyspepsia patients and 20 healthy subjects ingested nutrient drink tests (Ultra Milk contain 0.6 kcal/mL). The maximum tolerated volume was recorded. After ingested maximal tolerated volume, nausea, bloating and pain were rated using visual analogue scales (VAS) with 100 mm lines. The levels of acylated ghrelin was recorded before and 30 minutes after maximal drinking.Results: The demographic characteristics (age, sex, and body mass index) between dyspepsia patients and healthy subjects were compared. Patients with functional dyspepsia ingested 600 (350–1000) mL and healthy subjects ingested 1375 (1000–1900) mL (p 0.001). The total symptom scores were higher in dyspepsia patients compared healthy subjects; 215 (110–350) vs. 75 (50–120) (p 0,001). The fasting plasma levels of acylated ghrelin (20.65 : 2 – 31.37 pg/mL) in FD patients were significantly lower than healthy subjects (30.61 : 2 – 251.19 pg/mL) ( p = 0.012). Conclusion: Patients with functional dyspepsia ingested significantly lower volume and significantly have higher score symptoms than healthy subjects. The fasting plasma levels of acylated ghrelin in functional dyspepsia patients were significantly lower than healthy subjects.

Gallstones and Choledocolithiasis with Severe Cholestatic Jaundice in beta-Thalasemia Intermedia Patient Suharjo B Cahyono; Putut Bayupurnama; Neneng Ratnasari; Siti Nurdjanah
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

Geographically, b-thalassemia can be found in many countries including in Indonesia. Thalassemia intermedia referred to patients as being ‘too haematologically severe to be called minor, but too mild to be called major’. Patients with thalassemia intermedia usually present themselves to medical attention in later childhood or even adulthood and are sustainable without the need for regular transfusion therapy. Three main factors are responsible for the clinical sequele of thalassemia intermedia: chronic anemia, ineffective erythropoiesis, and iron overload.There are many complications related to b-thalassemia intermedia such as gastroentero-hepatology diseases (splenomegaly, gallstones, choledocolithiasis, predispose patients to liver fibrosis and cirrhosis), vascular, endocrine and bone diseases. About 55-63% thalassemia intermedia patients suffer from gallstone with 68–85% of these patients undergo cholecystectomy, and 67-90% patients undergo splenectomy. Therefore, ultrasound examination is required to be performed regularly during illness and before patient underwent surgery or splenectomy to detect the presence of gall stones. In this case report a patient with gallstones and choledocholithiasis was reported. Severe cholestatic jaundice in b-thalassemia intermedia was diagnosed six months before hospitalization. The patient underwent open cholecystectomy and exploration common bile duct stones. Keywords: beta-thalassemia intermedia, gallstones, choledocolithiasis, iron overload

Co-Authors Catharina Triwikatmani Fahmi Indrarti Neneng Ratnasari Nurdjanah S Putut Bayupurnama Putut Bayupurnama Putut Bayupurnama Putut Bayupurnama Siti Nurdjanah Siti Nurdjanah Siti Nurdjanah Siti Nurdjanah Sutanto Maduseno

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