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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Smart Medical Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Indonesian Journal of Cancer
Agus Barmawi
Department Of Surgery, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Impressive Result of Gemcitabine and Cisplatin Combination Therapy in Post-Operative Residual Cholangiocarcinoma Patient Presenting with Hyperbilirubinemia, an Experience in Indonesian Tertiary Hospital Ibnu Purwanto; Agus Barmawi; Bambang Purwanto Utomo; Ahmad Ghozali
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62846

Abstract

Introduction: Cholangiocarcinoma (CCA) often presents at an inoperable or an advanced stage in which complete resection is not possible. In such scenario, chemotherapy often is the only option to improve patient’s survival. Severe hyperbilirubinemia, often associated with higher risk of developing chemotherapy-related adverse event, might complicates one’s decision in choosing chemotherapy regimen. Case Report: We present a case of 63-year-old post-operative CCA patient with residual mass and severe hyperbilirubinemia. The patient completed six cycles of gemcitabine (1000 mg/m2, day 1 and 8) and cisplatin (70 mg/m2, day 1) every 3 weeks with tolerable side effect. No sign of residual tumor was observed on CT-Scan performed one-month post chemotherapy. Conclusion: Combination of cisplatin and gemcitabine may offer safe treatment option for post-operative residual CCA patient presenting with hyperbilirubinemia.
A fatal acute appendicitis with sepsis and pneumonia was caused by melioidosis: a case report Abu Tholib Aman; Yuli Mawarti; Agus Barmawi; Faisal Heryono; Rizka Humardewayanti Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2922.603 KB) | DOI: 10.19106/JMedSci0052022020010

Abstract

We report anunderdiagnosed fatal case of melioidosis that involved dygestion system which complicated with pneumonia, and sepsis. The case was initially diagnosed as acute appendicitis, and subsequently the patient underwent an exploratory laparatomy and appendectomy. He was discharged afer 3 days of hospitalization. Thirty days afterward, he was admitted to another private hospital to experience another exploratory laparatomy with indication of pancreatitis, intra-abdominal organs adhesions, and postoperative enterocutaneous fistula (ECF), and hospitalized there for 25 days. He eventually suffered from sepsis, pneumonia, unclosed ECF, anemia, hypoalbuminemia, and electrolyte imbalance. He then referred to a tertiary teaching hospital and hospitalized there for a total 134 days until he passed away. His clinical condition was declining, despite a long course of broad spectrum antibiotics. Treatment delay, prolong hospitalization, and complications were the inevitable, although Burkholderia pseudomallei was finally identified 2 weeks prior to his death. This case highlight that melioidosis canassociate with acute appendicitis, and that the delay on its diagnosis and treatment may trigger complications and death.
Effectivity of glutathione and curcumin in hepatic fibrosis induced by cholestasis in Wistar rats Rodijaya Putra; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.683 KB) | DOI: 10.15562/ism.v12i2.997

Abstract

Background: Cholestasis occurs from the accumulation of bile product in the biliary tract due to obstruction of the hepatobiliary tract. Without early interventions, this condition will be continuing as chronic hepatic injury and form hepatic fibrosis, ending in cirrhosis. Glutathione (GSH) and curcumin were known as antioxidants and anti-inflammatory used as a therapeutic agent for the treatment of hepatopathy. This study aims to determine the effectivity of GSH and curcumin in the hepatic fibrosis mechanism induced by cholestasis. Methods: This is an experimental study using Wistar rats. They are divided into three groups of 5 rats each. All the rats regard the choledochus duct ligation surgery, rats without intervention define as first group (control), other rats treated with GSH as the second group and the third group consist of rats treated with curcumin. Data were analyzed using SPSS version 17 for Windows.Results: There was liver injury and hepatic fibrosis induced by cholestasis from this study. This condition was significantly lower in groups treated with GSH and curcumin (p<0.05). Therefore, there was a different result between GSH and curcumin in reducing the process of liver injury and hepatic fibrosis, but the difference was not statistically significant (p>0.05).Conclusion: GSH and curcumin were statistically effective in reducing liver injury and hepatic fibrosis induced by cholestasis. Despite, there were no significant difference results between them in reducing liver injury and hepatic fibrosis.
Pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal pada tikus Wistar galur murni Slamet Rahardja; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.982 KB) | DOI: 10.15562/ism.v12i2.1001

Abstract

Background: Electrical trauma can cause injury to the body tissues it passes through, causing death. The injury is part of the process of cell damage, including the digestive organs. This study aims to determine the effect of the duration of electrical trauma on the nervous system of the gastrointestinal tract histopathologically.Methods: This study was experimental with the research subjects were 24 pure strain Wistar rats, which were divided into 4 groups. The first group is the control group (K) without treatment. Then, group (X) was exposed to electricity for 15 seconds, group (Y) was given exposure for 30 seconds, and group (Z) was exposed to 60 seconds. From the preparations, the number of nerve cells was counted. Data were analyzed with SPSS version 20 for Windows.Results: There was a significant effect on the duration of electrical trauma on the number of the gastrointestinal tract nervous system histopathologically (p<0.05). In the control group (K), the number of nerve cells for the stomach was 91.33±0.60, followed by the ileum (89.50±07.09), and colon (94.33±6.18). In group (X), the number of nerve cells in the stomach was 79.50±11.823, followed by the ileum (62.00±15.31), and colon (78.83±5.04). In group (Y), the number of nerve cells for gastric was 45.33±7.66, followed by ileum (34.00±16.27), and colon (47.17±9.56). Meanwhile, in the group (Z), the number of nerve cells for the stomach was 2.40±0.55, followed by the ileum (1.40±1.52), and colon (1.80±1.10). Thus, there was a significant difference between the study groups (p<0.001).Conclusion: The duration of electrical trauma significantly affects the number of the gastrointestinal tract nervous system histopathologically.  Latar Belakang: Trauma listrik dapat menimbulkan perlukaan pada jaringan tubuh yang dilewatinya hingga menyebabkan kematian. Perlukaan tersebut merupakan bagian dari proses kerusakan sel, termasuk pada organ digestif. Penelitian ini bertujuan untuk mengetahui pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal secara histopatologi. Metode: Penelitian ini bersifat eksperimental dengan subyek penelitian adalah 24 ekor tikus Wistar galur murni, yang terbagi dalam 4 kelompok. Kelompok pertama merupakan kelompok kontrol (K) tanpa perlakuan. Kelompok (X) diberi paparan listrik selama 15 detik, kelompok (Y) diberi paparan selama 30 detik, dan kelompok (Z) diberi paparan selama 60 detik. Dari preparat, dilakukan penghitungan terhadap jumlah sel saraf. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat pengaruh yang bermakna pada lama trauma listrik terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologis (p<0,05). Pada kelompok kontrol (K), jumlah sel saraf untuk gaster adalah 91,33±0,60, diikuti dengan ileum (89,50±07,09), dan kolon (94,33±6,18). Pada kelompok (X), jumlah sel saraf pada gaster adalah 79,50±11,823, diikuti dengan ileum (62,00±15,31), dan kolon (78.83±5.04). Pada kelompok (Y), jumlah sel saraf untuk gaster adalah 45,33±7,66, diikuti dengan ileum (34,00±16,27), dan kolon (47,17±9,56). Sedangkan pada kelompok (Z), jumlah sel saraf untuk gaster adalah 2,40±0,55, diikuti dengan ileum (1,40±1,52), dan kolon (1,80±1,10). Didapatkan perbedaan bermakna  antara kelompok penelitian (p<0,001).Kesimpulan: Lama trauma listrik memiliki pengaruh secara bermakna terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologi.
The comparison of Body Mass Index (BMI) and Muscle Mass Index (MMI) as a mortality predictor in patients with malignant jaundice at Dr. Sardjito General Hospital, Yogyakarta, Indonesia Briand Iggreinus Pollah; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (455.468 KB) | DOI: 10.15562/ism.v12i2.1083

Abstract

Background: Jaundice is found to be a clinical manifestation of malignancy. Around 70% of all jaundice cases are caused by malignancy. Another complication of malignancy is decreasing the Muscle Mass Index (MMI), also called sarcopenia. MMI in malignant jaundice increases the mortality rate. Body Mass Index (BMI) is describing the nutritional status of a person. Due to malnutrition, morbidity and mortality increase. This study aims to compare the MMI and BMI in patients with malignant jaundice to predict the outcome of mortalityMethods: This study is a retrospective cross sectional non-experimental epidemiologic analysis. Samples were taken from medical reports at Sardjito Hospital from April 2019 - March 2020. A CT scan calculated MMI at the third lumbar vertebrae. BMI was evaluated by body weight (kg) divided by height (m) square (kg/m2). Data were analyzed using SPSS version 20 for Windows.Results: Most of respondents were males (55.0%), following by age > 50 (62.5%), stage 3 (62.5%), ASA 2 (92.5%), albumin < 3.5 g/dL (82.5%), CA19-9 > 37 U/ml (57.5%), CEA < 5 ng/ml (62.5%), and total bilirubin > 1.5 mg/dL (90.0%), normal BMI (62.5%), survive (77.5%), and low MMI (72.5%). There was no significant relationship between MMI (OR: 5.71; 95%CI: 0.60-134.12) and BMI (OR: 0.15; 95%CI: 0.02-1.34) to the mortality risk (p>0.05).Conclusion: MMI had a higher incidence of mortality compared to BMI in malignant jaundice. However, there was no significant relationship between MMI and BMI to predict mortality.
Differences of alt-ast level and snail gene expression between patients with metastasis and non-metastasis colorectal cancer Chrisna Budi Satriyo; Hendra Susanto; Adeodatus Yuda Handaya; Nurcahya Setiawan; Imam Sofii; Agus Barmawi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art5

Abstract

Background: Colorectal cancer (CRC) is a malignant epithelial tumour in the colon and rectum, and its main cause is distant metastasis. The main process of distant metastasis is the epithelial-mesenchymal transition (EMT) that may cause mesenchymal phenotype and malignant capabilities of tumour cells. Then it is regulated by one of transcription factors, the Snail.Objective: This study aims to determine differences between Snail gene expression in CRC that has not metastasized and Snail gene expression in CRC that has metastasized. Methods: The subjects of this study consisted of two groups of patients. The first group consisted of 20 patients with CRC (tumour), and the second group consisted of 12 patients with CRC with metastasis (metastasis tumour). The Snail gene expression was measured in both groups by using the RT-qPCR method and supported by laboratory examination to measure ALT and AST. Then all obtained data were analysed by using a statistical software analysis.Results: This study indicated that there were differences of the Snail gene expression between both the groups, and the highest expression was in the metastatic tumour group with a significance level of 0.002 (p<0.05). This was also supported by AST and ALT which were significantly correlated between both the groups. The correlation value on the AST was 0.506 with a significance level of 0.003, and the ALT correlation value was 0.532 with a significance level of 0.002. Conclusion: This study suggested that the Snail was a potential marker of metastasis in the CRC. Therefore, further research is needed to determine the role of Snail regulation in the CRC metastasis.
Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series Singgih Annas Fuadhi; Adeodatus Yuda Handaya; Agus Barmawi; Imam Sofii; Nurcahya Setyawan
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 2, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss2.art15

Abstract

Laparoscopic common bile duct exploration (LCBDE) is a relevant therapeutic option in managing cholecysto-choledocholithiasis. The success of this procedure is highly dependent on selecting an appropriate method, either transcystic or transcoledocal. Intraoperative choledochoscopy proves its importance in evaluating the condition of the choledochal duct and sphincter of Oddi. In this case series, we report 2 cases of patients with complaints of right upper abdominal pain and jaundice. Both patients were diagnosed with multiple cholecysto-choledocholithiasis at Dr. Sardjito Hospital, Yogyakarta. The interventional measures applied to both patients were transcystic and transcoledocal exploration. In the first patient, the transcystic method was chosen because the cystic duct was widening up to 9 mm in diameter. While in the second patient, the transcoledocal method was taken because the diameter of the cystic duct was still within normal limits. The duration of surgery in transcystic surgery was shorter than in transcoledocal surgery, with a time ratio of 129 minutes versus 162 minutes. Postoperatively, both patients were discharged on the second day after the procedure, and both experienced recovery without any significant complications. Overall, LCBDE has been shown to be safe to perform. The one-stage surgical approach has been shown to reduce the risk of complications, cost, and duration of treatment required. The choice between the transcystic or transcoledocal method should be based on each patient’s clinical condition.
Choledochal Cysts in Female Adult: Diagnostic Pitfall and Conservative Therapy for Bile Leak Singgih Annas Fuadhi; Agus Barmawi; Imam Sofii; Nurcahya Setyawan; Adeodatus Yuda Handaya
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.72426

Abstract

Introduction: Choledochal cysts that are accompanied by obstructive jaundice are a rare case. These cysts can cause intrahepatic or extrahepatic ductal dilatation. Their diagnosis is difficult, particulary in adults. Proper management can prevent further complications.Methods: A serial case report of a patient with a choledochal cyst.Results: 2 female patients aged 21 years and 22 years have a painful and fixed lump in the upper right abdomen. The first patient also complained jaundice. Laboratory results showed an increase in total bilirubin and direct bilirubin. The second patient didn’t complaint about jaundice or increased bilirubin, and she had a cholecystectomy when she was ten. The diagnosis was confirmed by a contrast abdominal CT scan, showing type 1A Todani choledochal cysts in both patients. Management of the first patient was cyst excision, cholecystectomy, and Roux n Y hepaticojejunostomy. In the second patient, adhesiolysis, cyst excision, and Roux n Y hepaticojejunostomy were performed. The second patient had no postoperative complications.Conclusion: Choledochal cysts are a rare congenital condition in adulthood. n both cases, two patients were manage surgically. Bile leakage complications can be manage conservatively. Diagnostic and management of choledochal cysts must be correct to prevent pitfall and complications.
HALP and PNI Score as Predictors of Nutritional Status in the Incidence of Incisional Hernia after Laparotomy in Colorectal Cancer Patients: A Case-Control Study Nurasti, Wawan Suci; Handaya, Adeodatus Yuda; Barmawi, Agus; Anwar, Sumadi Lukman
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1215

Abstract

Background: Colorectal cancer ranks as the third most common cancer in the world. If patients can still be resected, surgical therapy is carried out. An incisional hernia is one of the complications after laparotomy surgery. Nutritional status can influence the incidence of incisional hernias after laparotomy. Colorectal cancer patients must have their nutritional status assessed using a simple scoring. This research aims to evaluate Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) and Prognostic Nutritional Index (PNI) scores as a predictor of incisional hernia after laparotomy surgery in colorectal cancer patients at Dr. Sardjito General Hospital, Yogyakarta. Methods: This study uses a case-control study design which consisted of two groups, a case group of colorectal cancer patients with incisional hernias after laparotomy surgery and a control group of colorectal cancer patients without incisional hernias. The independent variable was nutritional status which was assessed by HALP and PNI score, and the dependent variable was incisional hernia. This research by taking data from laboratory patients at Dr. Sardjito General Hospital, Yogyakarta. For multivariate analysis, a logistic regression test was used with a significance value of p 0.05. Results: There is a relationship between the stage of cancer and the comorbid diabetes mellitus with the incidence of incisional hernias after laparotomy, this can be seen in the results of the chi-square test. Advanced stage has an OR of 13 (P=.001; OR=13; 95% CI 3.551-47.597), while comorbid diabetes mellitus has an OR of 6.571 (P=.002; OR=6.571; 95% CI 2.109-20.479). However, there is no correlation between the HALP and PNI score with the incidence of incisional hernia after laparotomy. The multivariate analysis results in HALP score have a significant correlation between the nutritional status and the incidence of incisional hernia with OR=17.981 (p= 0.037 OR=17; 95% CI 1.198-269.803). Conclusions: The HALP score can be used as a screening predictor in the incidence of incisional hernia after laparotomy for colorectal cancer patients.
Co-Authors Abu Tholib Aman Adeodatus Yuda Handaya Ahmad Ghozali Anwar, Sumadi Lukman Briand Iggreinus Pollah Chrisna Budi Satriyo Faisal Heryono Hendra Susanto Ibnu Purwanto Imam Sofii NEVIATY PUTRI ZAMANI Nurasti, Wawan Suci Nurcahya Setiawan Nurcahya Setyawan Rizka Humardewayanti Asdie Rodijaya Putra Singgih Annas Fuadhi Singgih Annas Fuadhi Slamet Rahardja Yuli Mawarti