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All Journal Medical Journal of Indonesia Makara Journal of Health Research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia

Dadang Makmun

Division Of Gastroenterology, Department Of Internal Medicine, Faculty Of Medicine/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Author-ID : 312963

Medicine & Pharmacology

Published : 59 Documents Claim Missing Document

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Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection Nikko Darnindro; Ari Fahrial Syam; Diah Rini Handjari; Dadang Makmun
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: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p 0.05). Generally, the prevalence rate among males was slightly lower than females (p 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.

Factors Found on the First Variceal-Bleeding Episode in Liver Cirrhosis Patients with Portal Hypertension Arnold Hasahatan Harahap; Dadang Makmun; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201015-18

Background: The dietary protein restriction that was commonly recommended to hepatic encephalopathy (HE) patients, often leads to malnutrition, whereas malnutrition can deteriorate cirrhosis prognosis. The aims of this study were to find out encephalopathy improvement that was measured by critical flicker frequency (CFF) test and nutritional status by measuring prealbumin level after L-Ornithine L-Aspartate (LOLA) treatment with adequate calories and protein intake in patients with HE. Method: Patients with liver cirrosis who visited Cipto Mangunkusumo hospital on June-October 2009 was evaluated by CFF test using HEPAtonormTM device. Encephalopathy was defined when CFF 39 Hz. Nutritional status was measured by the mid-arm muscle circumference (MAMC) and was stated as malnutrition when the MAMC was below the 15th percentile. Patients had been treated by 3 x 6 mg LOLA granules for 2 weeks, and adequate calories and protein intake with branched-chain amino acid (BCAAs) substitution. The change of encephalopaty was evaluated by the CFF test and the nutritional status by measuring prealbumin blood level. Results: There were 17 patients with liver cirrhosis who fulfilled the inclusion criteria. The mean CFF Result increased from 34.1 ± 2.5 Hz to 36.5 ± 2.9 Hz after LOLA treatment with the adequate calories and protein intake including BCAAs substitution, which was statistically significant (p 0.001) compared to before treatment. The prealbumin level also increased significantly compared before treatment, i.e. from 5.4 ± 2.1 mg/dL to 6.4 ± 2.6 mg/dL, p = 0.008. Conclusion: HE patients with malnutrition could be given adequate calorie and protein with BCAAs substitution to improve their nutritional status, and LOLA granules for the improvement of HE. Keywords: minimal hepatic encephalopathy, malnutrition, CFF, LOLA, prealbumin, BCAAs

Current Prevention and Management of Non Steroid Anti Inflammatory Drugs Associated Gastroenteropathy Fransiscus Ari; Dadang Makmun
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

Non-steroid anti-inflammatory drugs (NSAIDs) are the most frequently used drugs to treat inflammation and are used almost in the whole world. However, NSAID is one of the important causes of gastroenteropathy development. NSAIDs enteropathy is frequently undetected because most of them are asymptomatic and required sophisticated examinations to diagnose. Not only non-selective cyclo-oxygenases (COX) inhibitor that can cause NSAID gastropathy, but selective COX-2 inhibitors may also cause gastrointestinal complications. NSAID gastroenteropathy require further evaluation and it may differ between patients.Currently, there is no effective treatment available to treat gastrointestinal damage associated with NSAIDs administration. Identification of protective factors in gastrointestinal complication due to NSAIDs use is still a serious challenge. In this review, we will discuss the effect of NSAID administration towards gastrointestinal system, also the prevention and management strategies.Keywords: non-steroid anti-inflammatory drugs, gastroenteropathy, COX inhibitor, prevention, treatment

Dyspeptic Syndrome in Urban Population of Jakarta Marcellus Simadibrata; Murdani Abdullah; Ari Fahrial Syam; Achmad Fauzi; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Aan Santi; Ekowati Rahajeng
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201066-70

Background: Dyspeptic syndrome is experienced by many patients who visit general practitioners and gastroenterologist. In Indonesia, a small number of epidemiological data about dyspeptic syndrome are available. The aim of this study was to obtain data on prevalence, characteristics and factors/lifestyle associated with dyspeptic syndrome in urban population of Jakarta. Method: The study was conducted by interview to 1,645 respondents representing the population of Jakarta in the year 2007 using the Steps WHO version 1.4 instruments. The selection of respondents was performed by multistage cluster random sampling, i.e. each municipality is represented by one district and each was represented by a number of villages and respondents interviewed at random. Dyspeptic syndrome is defined whenever there is one or more complaints of nausea, vomiting, belching, epigastric pain, no appetite, early satiety, bloating. Scoring was performed for each category of questions using wstep1 method prior to the analysis. Data analysis was performed with Chi-square test or t-test. Results: Of the 1,645 respondents, the prevalence of dyspeptic syndrome was 58.1%. The most apparent clinical complaint ranges consecutively, i.e. nausea 30.1%, epigastric pain 28.7%, bloating 23.8%, etc. Dyspeptic syndrome is significantly more often experienced by female respondents (p 0.001). Dyspeptic syndrome were more common in respondents who have less/no fruit (p 0.001) and vegetables (p = 0.049) intake. Dyspeptic syndrome is more common in respondents with anxiety and depression (p 0.001) also in respondents who consume non-steroidal anti-inflammatory drugs (NSAIDs) (p 0.001). Conclusion: Prevalence of dyspeptic syndrome in Jakarta urban population is 58.1%. Dyspeptic syndrome was more common in female, respondents who have less / no fruit and vegetables intake, in respondents who experienced anxiety and depression and respondents who consume NSAIDs. Keywords: dyspeptic syndrome, Jakarta, urban population, prevalence

Vasoactive Intestinal Peptide-Secreting Tumor Femmy Nurul Akbar; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009120-124

Vasoactive intestinal peptide-secreting tumor (VIPoma) is one of the tumors which cause “ watery diarrhea, hypokalemia, hypochlorhydria and acidosis syndrome” (WDHHA syndrome). These tumor caused by to non-insulin-secreting pancreatic islet tumor that associated with elevated vasoactive intestinal polypeptide (VIP) plasma level. VIP is a potent stimulator of gut cyclic adenosine monophosphate (cAMP) production, which leads to massive secretion of water and electrolytes mainly potassium. Over expression of VIP causes diarrhea and cancerous growth. The other clinical features of VIPomas such as hypercalcemia, abdominal discomfort, tetany, facial flushing are associated with the actions of VIP, which stimulate intestinal secretion, inhibit gastric acid secretion. VIP also regulates the synthesis, secretion, and action of neuroendocrine hormones such as secretin, glucagon, prostaglandin E, somatostatin and pentagastrin as well as cytokines and chemokines. Diagnosis is based on clinical, laboratory test show elevation VIP level, electrolyte and acid base imbalance also imaging such as CT scan or magnetic resonance imaging (MRI) which shows primary tumor in the pancreas and metastasis especially in the liver. Somatostatin receptor scintigraphy may be useful in identifying extrapancreatic VIPomas, i.e. the sympathetic chain, colon, bronchus and occult or distant metastases. Initial treatment is to correct volume, electrolyte, and acid-base abnormalities with intravenous normal saline, potassium chloride, and, sodium bicarbonate. Somatostatin or long acting ocreotide is effective in reducing serum VIP levels and promptly controlling diarrhea. Interferon alpha and glucocorticoid may be useful for reducing symptoms. Surgical resection depends on staging of pancreatic tumor. Keywords: VIPoma, WDHHA syndrome, VIP, non insulin secreting pancreatic islet tumor

Chronic Radiation Proctosigmoiditis in Patients with Cervical Cancer Juliyanti -; Dadang Makmun
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

Complications in rectum and sigmoid due to radiation are usually called radiation proctosigmoiditis. It can be acute or chronic based on the onset of symptoms during radiation treatment. There are some treatment modalities aimed for reducing rectosigmoid bleeding and improving symptoms of chronic radiation proctosigmoiditis, which include medication, endoscopy and surgery. Most data about the effectiveness of those various modalities are provided by short-term studies with small sample size.A female patient, 59 years old, came with a chief complaint of passing persistent fresh bright red bloody stool since 1 year before admission. The patient was then diagnosed with stage IIIB cervical cancer and she received 25 times of external radiation, 3 times of internal radiation and 3 times of chemotherapy. She was diagnosed with chronic radiation proctosigmoiditis and treatment to stop the bleeding was carried out by performing argon plasma coagulation through colonoscopy. The problems in the patient were formulated as chronic radiation proctosigmoiditis with malnutrition and iron deficiency anemia due to chronic bleeding. Non-pharmacological and pharmacological medications were administered.Keywords: radiation proctosigmoiditis, argon plasma coagulation, medication

Hematochezia in Young Patient Due to Crohn’s Disease Anna Mira Lubis; Marcellus Simadibrata; Dadang Makmun; Ari F Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 2, August 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/72200654-56

Crohn’s disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower GI bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease. We reported a case of Crohn’s disease in young male who suffered from severe lower GI bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn’s disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved. Keywords: hematochezia, young male, Crohn’s disease, surgery

The Use of Balanced Scorecard to Support Achievement of Business Plan in Digestive Endoscopy Center, 2013 Murdani Abdullah; Dadang Makmun; Achmad Fauzi; Aan Santi
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

Background: Digestive Endoscopy Center, Cipto Mangunkusumo Hospital was established in 2011 in which the concept was developed as center of excellence (CoE). The business plan was created based on safety and patient satisfaction, fast, accurate, quality and one stop services. 2013 is the 2nd year in Digestive Endoscopy Center business plan development and it is expected to increase in many aspects. The aim of this study is to measure the performance of business plan in Digestive Endoscopy Center.Method: This study was conducted from April-December 2013 with quantitative method and cross sectional studies on 76 subjects and also used secondary data from endoscopy’s reports. The balanced scorecard contains 4 measurements, such as financial approach, customer approach, internal process approach, and learning and growth approach. Results: The financial approach resulted that income from 2 types of patients (cash and insurance) were increased in 2013. The customer approach resulted a high satisfaction rate with mean 4.69 of 5 for patient satisfaction and the employee satisfaction increased in 2013 (mean: 3.88 of 5) and in 2010 (mean: 3.64 of 5). Internal process approach was measured using facilities and infrastructure discovered is increased too. Learning and growth approach resulted that accumulation of trainings, achievement of target of the trainings was increased.Conclusion: The achievement of bussiness plan has been evaluated using balanced scored card and showed that there is a balance on the financial approach, customer approach, internal process approach, and learning and growth approach.Keywords: business plan, digestive endoscopy center, balance scorecard

Hospital-based Survey on Knowledge and Attitude toward Colorectal Cancer Screening among Indonesian Population Murdani Abdullah; Achmad Fauzi; Ari Fahrial Syam; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Joseph JY Sung; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200951-55

Background: Several western countries have recommended colorectal cancer (CRC) screening, however the yield of CRC screening is still low. The acceptability of CRC screening is influenced by people’s knowledge and attitude. This study was conducted to evaluate the knowledge and attitude of Indonesian people toward CRC screening. Method: Adult Indonesian population aged 19–65 years was recruited in this hospital-based survey. Knowledge and attitude toward CRC screening were assessed by using structured questionnaires consisting of nine chapters. Result: There were 614 respondents recruited in this study. Most respondents (36.2%) incorrectly pointed out abdominal pain or pain around anus as the symptom of bowel cancer. Regarding CRC risk factors, eating fruits or vegetables rarely was the most frequent answer (28.5%) encountered. Only one-third (28%) of respondents mentioned colonoscopy as the Method for CRC screening. There were 38.1% of respondents who believed that CRC screening test might be harmful to the body. Up to 70.8% of the respondents agreed and strongly agreed that CRC screening test might cause physical discomfort. Two fifth (41.5%) of respondents believed that CRC screening test was embarrassing. More than half (58.8%) of respondents were afraid of having the CRC screening test. The test was too expensive according to 79.5% of respondents. Conclusion: The knowledge on CRC symptoms, risk factors, and screening tests is still low among Indonesian population. Our study result indicates that the lack of knowledge and the discouraging attitude among Indonesian population will be the major barriers to implement CRC screening in Indonesia. Keywords: colorectal cancer, screening, knowledge, attitude

National Consensus on the Use of Sedation Drugs in the Gastrointestinal Endoscopic Procedures Daldiyono Daldiyono; Abdul Aziz Rani; Marcellus Simadibrata; Ari Fahrial Syam; Achmad Fauzi; Dadang Makmun; Murdani Abdullah; Indra Marki; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, AUGUST 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Gastrointestinal endoscopy is rapidly developing and several gastrointestinal endoscopy equipment are available for both diagnostic and therapeutic purposes. Proper sedation is critical in performing endoscopic procedures, both for patients and physicians. This consensus is used as a guideline and not as a legal standard in performing endoscopic services. This consensus explained the definition, indication, contraindication, and complication prevention during sedation. Factors affecting the need of sedation is patient factors, procedure factors, and sedation level. Diagnostic or therapeutic upper gastrointestinal tract endoscopy which not complicated can be performed with minimal sedation or moderate sedation, while deep sedation can be considered for longer and more complex procedures. Furthermore, assessment and selection of sedation was explained, followed by the guide to choose pharmacological sedation and analgesics. Currently, diazepam, midazolam, propofol, fentanyl, and pethidine is the most likely used sedation during gastrointestinal endoscopy, with midazolam as the preferred medication of choice. This consensus also explained the antidote of each drug and the recovery after procedure. This consensus aimed to improve gastrointestinal endoscopic procedure services in Indonesia.

Co-Authors -, Darmadi Aan Santi Aan Santi Aan Santi Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani ACHMAD FAUZI Achmad Fauzi Achmad Fauzi Adang Bachtiar Adi Winarto Ahmad Fauzi Ali Imron Yusuf Amanda P Utari, Amanda P Andreas Pekey Andreas Pekey, Andreas Andri Sanityoso Andri Sanityoso Anggilia Stephanie Anggilia Stephanie, Anggilia Anna Mira Lubis Ardani, Yanuar Ari F Syam Ari F Syam Ari Fahrial Syam Ari, Franciscus Ariadno, Aru Ario Perbowo Ario Perbowo, Ario Arnold Hasahatan Harahap Artati Murwaningrum, Artati Asep Saepul Rohmat Asep Saepul Rohmat, Asep Saepul Bambang Sutopo Barry A Putra Bona Adhista Budi Tan Oto C Rinaldi A Lesmana Catarina Budyono Catarina Budyono, Catarina Cecep Kusmana Chudahman Manan Chudahman Manan Chudahman Manan Czeresna H. Soejono, Czeresna H. Daldiyono Daldiyono Daldiyono Daldiyono Daldiyono Hardjodisasto Darmadi - Dasril Nizam Deddy Gunawanjati Dharmika Djojoningrat Diah Rini Handjari Diah Rini Handjari Diana Sunardi Djumhana Atmakusuma Djumhana Atmakusuma, Djumhana Dondin Sajuthi E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Ekowati Rahajeng Ekowati Rahajeng Elli Arsita Elli Arsita Ening Krisnuhoni Erni Sulistiawati Faisal, Edward Fauzi Ahmad Muda Femmy Nurul Akbar Femmy Nurul Akbar Franciscus Ari Fransiscus Ari Fransiscus Ari, Fransiscus Guno, Tri Hapsoro Hamzah Shatri Hapsari, Puspita FC Hasan Maulahela Hasan Maulahela, Hasan Hayatun Nufus Hayatun Nufus Hendra Agustian, Hendra Hilda Nurmalihah I Gusti Bagus Wiksuana Ifransyah Fuadi, Ifransyah Ikhwan Rinaldi Indra Marki Indra Marki Irsan Hasan Irvianita, Vinandia Ivan Onggo S Jaffray DP Rambak Jeffri Gunawan Joseph JY Sung Juferdy Kurniawan Juliyanti - Juliyanti -, Juliyanti Julwan Pribadi Kaka Renaldi Katharina Setyawati Laurentius Aswin Pramono Laurentius Aswin Pramono Leonard Nainggolan Leonard Nainggolan Lianda Siregar Lugyanti Sukrisman Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Moch Ikhsan Mokoagow Mohammad Adi Firmansyah Mulia Mulia Murdani Abdulah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nana Supriana Nikko Darnindro Nikko Darnindro Novie Rahmawati Zirta Nur Rasyid Nur Rasyid Nurul Akbar Nurul Akbar Oktaramdani, Tessa Paulus Kusnanto Purwita Wijaya Laksmi Putra, Barry A Radhiyatam Mardhiyah, Radhiyatam Riahdo Saragih Rio Zakaria Rio Zakaria Rolan Sitompul Roy Soetikno Rudi Putranto Rudy Hidayat Rudy Kurniawan Rumagesan, Djahalia S, Ivan Onggo S.M. Lumban Tobing Sedijono Sedijono Segal Abdul Aziz, Segal Abdul Sepmeitutu, Iwandheny Seri Mei Maya Ulina Siti Setiati Steven Sumantri Suhendro Suhendro Suhendro Suhendro Sukamto Koesnoe Sulaiman, Andri S Suryantini Suryantini Suryantini Suryantini Syahidatul Wafa, Syahidatul Tandan, Manu Teddy Septianto Telly Kamelia Telly Kamelia Tessa Oktaramdani Tjahjadi Robert Tedjasaputra Tri Hapsoro Guno Triyanta Yuli Pramana Wulyo Rajabto Yusuf Misbach Zulkifly, Steven

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