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All Journal Medicina Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Penyakit Dalam Udayana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Hendra Koncoro
Department of Internal Medicine, Faculty of Medicine, University of Udayana Sanglah Hospital, Denpasar
Humanities Education Environmental Science Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Other

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Kadar Resistin Serum Berhubungan Dengan Skor Child-Turcotte Pugh Pada Penderita Sirosis Hati Koncoro, Hendra; Primadharsini, Putu Prathiwi; Mariadi, I Ketut; Somayana, Gde; Suryadarma, I Gusti Agung; Purwadi, Nyoman; Wibawa, I Dewa Nyoman
Jurnal Penyakit Dalam Udayana Vol 1 No 1 (2017): JPD Vol. 1 No.1 2017
Publisher : PAPDI BALI

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Abstract

Latar Belakang: Sirosis hati (SH) sering disertai tingginya resistensi insulin dan kondisi proinflamasi. Resistin yang merupakan suatu adipokin, diketahui memiliki hubungan dengan resistensi insulin dan inflamasi. Studi-studi resistin pada SH memperlihatkan hasil yang bervariasi. Tujuan penelitian ini adalah untuk mencari hubungan kadar resistin serum dengan skor Child-Turcotte Pugh (CTP) pada penderita SH. Metode: Penelitian observasional, studi potong lintang ini dilaksanakan di RSUP Sanglah dari September 2014 sampai dengan Juni 2015 dengan menggunakan 75 pasien sirosis hati sebagai sampel. Kriteria inklusi mencakup pasien sirosis hati tanpa memandang etiologinya dan berusia 12 tahun atau lebih. Variabel yang diperiksa pada penelitian ini yaitu skor CTP (kadar albumin serum, kadar bilirubin total serum, nilai waktu protrombin, kadar international normalized ratio (INR), tanda ascites, tanda ensefalopati hepatikum), kadar C-reactive protein (CRP), dan kadar resistin serum. Hasil: Enam puluh lima persen dari 75 sampel adalah laki-laki dan sisanya perempuan. Sebelas diantaranya (14,7%) adalah kelas CTP A, 31 (41,3%) kelas CTP B, dan 33 (44%) kelas CTP C. Rerata kadar CRP adalah 15,05 ± 15,86 mg/L. Rerata kadar resistin adalah 23,39 ± 17,79 ng/mL. Hasil uji korelasi didapatkan korelasi positif yang sedang antara kadar resistin dan skor CTP (r = 0,438; p < 0,001). Korelasi positif sedang juga didapatkan antara CRP dan resistin (r = 0,478; p < 0,001). Simpulan: Kadar resistin memiliki korelasi sedang dengan skor CTP pada pasien SH. Kadar resistin didapatkan lebih tinggi kadarnya pada SH yang berat. Hal ini menunjukkan adanya kondisi inflamasi dan resistensi insulin seiring dengan peningkatan derajat beratnya SH.
seorang penderita tuberkulosis diseminata dengan komplikasi penyakit ginjal kronis Koncoro, Hendra; Kandarini, Yenny; Sudhana, Wayan; Widiana, I Gde Raka
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

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Tuberkulosis diseminata dapat melibatkan berbagai organ dan secara klinis timbul dengan bermacam-macam tanda dan gejala.Penyakit ginjal kronis merupakan salah satu komplikasi yang disebabkan oleh penyebaran hematogenik Mycobacterium tuberculosis ke traktus urogenital. Diagnosis dini dan inisiasi terapi yang tepat merupakan hal penting dalam pencegahan komplikasi lanjut penyakit ini. Dilaporkan sebuah kasus dengan tuberkulosis diseminata yang memperlihatkan keterlibatan paru dan organ ekstra-paru. Kasus ini memperlihatkan tuberkulosis paru, serviks, dan urogenital yang dikonfirmasi dengan pewarnaan sputum basil tahan asam, biopsi serviks, dan biopsi buli buli. Pewarnaan sputum basil tahan asam menunjukkan hasil 3+, sedangkan biopsi serviks dan buli buli menunjukkan radang kronik granulomatosa dengan multinucleated giant cell tipe Langhans. Kadar blood urea nitrogen (BUN) 11 mg/dL dan kreatinin serum 2,58 mg/ dL dengan hidronefrosis ringan kiri pada saat dirawat. Setelah diagnosis ditegakkan, pasien diterapi dengan obat anti-tuberkulosis dan membaik dengan kadar BUN 13,55 mg/ dL dan kreatinin serum 0,9 mg/ dL setelah satu bulan terapi.[MEDICINA.2016;50(3)63-70]
Sarcopenia is Associated with Poor Performance Status in Indonesian Patients with Hepatocellular Carcinoma Koncoro, Hendra; Hasan, Irsan; Lesmana, C Rinaldi; Aditama, Humala Prika; Salamah, Thariqah; Rizka, Aulia; Wahyudi, Edy Rizal; Shatri, Hamzah; Teng, Wei
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (614.006 KB) | DOI: 10.24871/231202217-23

Abstract

Background: Sarcopenia has a notable impact on the prognosis of hepatocellular carcinoma (HCC). The prevalence of sarcopenia in patients with HCC is relatively high, with studies reporting rates between 39% and 41.7%. A substantial proportion of individuals diagnosed with HCC also exhibit muscle wasting and reduced muscle function. This study aims to determine the prevalence of sarcopenia in Indonesian patients with HCC (based on the Japanese Socuety of Hepatology (JSH) JSH criteria) and to examine its correlation with poor performance status.Methods: We performed a cross-sectional study of 85 HCC patients between January and October 2021). The skeletal muscle index at L3 (L3 SMI) was measured on CT scans (applying JSH cut-offs for sarcopenia). Clinical data, including Eastern Cooperative Oncology Group (ECOG) performance status, were collected. Bivariate analyses and logistic regression were performed to identify factors associated with sarcopenia.Results: A total of 85 HCC patients (median age: 52 years) were included in the analysis. Sarcopenia was observed in 49.4% of the cohort. Bivariate analysis revealed a statistically significant association between sarcopenia and an ECOG performance status of 2+ (p = 0.003), as well as a MELD-Na score of ≥15 (p = 0.023). In multivariate analysis, poor ECOG-PS remained independently associated with sarcopenia (adjusted OR 4.17; 95% CI 1.50–11.56, p = 0.006).Conclusion: Sarcopenia is highly prevalent among Indonesian HCC patients, and it is strongly associated with poor ECOG performance status. 
A Multimodal Approach to the Management of Diverticular Abscess with Paraesophageal Hernia Complication Pauliana, Pauliana; Koncoro, Hendra; Prawidiyanto, Albertus Ardian; Gora, Cosmas; Irman, Irman; Tambun, Renaningtyas
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i10.16411

Abstract

This study aims to evaluate the management of acute diverticulitis complicated by hernia and the role of electroacupuncture in managing postoperative ileus. The case involved a 51-year-old male patient who presented with left lower abdominal pain, fever, and defecation disorder. Physical examination showed signs of infection with localized peritonitis, while laboratory tests revealed neutrophilia. CT scan showed diverticulitis with abscesses in the descending and sigmoid colon, as well as free air around the colon and perihepatic region, and paraesophageal hernia. The patient underwent left hemicolectomy with Hartmann's procedure. Postoperatively, the patient developed ileus which was treated using electroacupuncture. The results showed that the relationship between diverticulosis and hernia is due to connective tissue changes. Approximately 10-20% of diverticulosis cases progress to acute diverticulitis. CT scan is the gold standard for diagnosis, staging and management of diverticulitis. In cases of Hinchey III diverticulitis, laparoscopic washing does not give better results compared to colonic resection. The Hartmann procedure is recommended for patients with multiple comorbidities. Electroacupuncture proved to be an effective adjunctive therapy in managing postoperative ileus. The conclusion of this study is that a multimodal approach, including surgery and complementary therapies such as electroacupuncture, is essential in the management of diverticulitis and its complications. The implication of this study is the need for a holistic approach in managing patients with acute diverticulitis, especially in cases with multiple comorbidities and risk of postoperative complications.
Co-Authors Aditama, Humala Prika Aulia Rizka, Aulia C Rinaldi A Lesmana E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Gde Somayana Gora, Cosmas I Dewa N Wibawa, I Dewa N I Dewa Nyoman Wibawa I Gde Raka Widiana I Gusti Agung Suryadarma I Ketut Mariadi I Komang WD Putra, I Komang WD IDN Wibawa Irman Irman Irsan Hasan Johan, Maisie ME Luh Putulin Indrayani, Luh Putulin Nyoman Purwadi Pauliana, Pauliana Philipi, Benny Prawidiyanto, Albertus Ardian Putu Prathiwi Primadharsini Setijoso, Rafael Eddy Setijoso, Rafael Eddy Tambun, Renaningtyas Tambun, Renaningtyas Teng, Wei THARIQAH SALAMAH, THARIQAH Wayan Sudhana Yenny Kandarini