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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
Medicine & Pharmacology

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Conformance Level of Histopathological Examination in BiopsyPre Colonoscopy Compared to Histopathological Examinationin Surgery with Tumors in the Colon at The Endoscopy andGastrointestinal Centre of RSCM Fuadi, Ifransyah; Makmun, Dadang; Krisnuhoni, Ening
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Introduction. Level of agreement comparison between biopsy per colonoscopy examination is used to measure of the quality of a colonoscopy examination and needed to be identified. This study aims to identify level of agreement comparison between histopathologic examination of biopsy per colonoscopy and histopathologic examination per surgical. Methods. A cross sectional study was conducted by using medical records from patients with colon tumor who had undergone histopathologic examination with biopsy per colonoscopy and then confirmed by surgical procedure in PESC RSPUN dr. Cipto Mangunkusumo between 1st January, 2006 31st December, 2015. Level of agreement calculated using comparative agreement category test in order to obtain the value of kappa. Results. A total of 48 subjects were included in this study. Analysis result showed that level of real agreement, level of agreement by chance, and level of agreement not by chance was 79%, 77%, and 23%, respectively. The kappa value was 0,134. Conclusion. The level of agreement comparison between histopathologic examination of biopsy per colonoscopy compared with histopathologic examination per surgical at PESC RSCM between 2006-2015 period was not good.
Diagnostic Approach and Treatment of Instestinal Tuberculosis Murwaningrum, Artati; Abdullah, Murdani; Makmun, Dadang
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Tuberculosis (TB) has become a resurgent global problem with increasing numbers of patients. TB infection is still common and remains an important cause of morbidity and mortality, particularly in underdeveloped and developing nations. Intestinal tuberculosis (intestinal TB) rates are rising, consistet with the overall trend. In 2014 Indonesia has the second highest TB prevalence in South East Asia after Timor Leste. Intestinal TB is the sixth highest manifestation of extrapulmonal TB. Manifestations can be non-specific and mimic many conditions, including malignancies causes’ intestinal TB diagnosis more difficult to be accurately determined. Findings from endoscopy and radiological imaging are countless, and depend on the stage of the disease and the time at which investigations are carried out. Hence, diagnosis can be difficult. Until recently there is no single method to identify intestinal TB accurately, various investigative methods have been used to aid in the diagnosis of intestinal TB. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Combined clinical assessment and some modalities examinations are needed to determine intestinal TB. Patient whom has been diagnosed with intestinal TB will be given anti tuberculosis therapy and surgery if any complications occur.
Efficacy of Argon Plasma Coagulation Treatment in Radiation Colitis Patients and Its Confounding Factors Ariadno, Aru; Makmun, Dadang; Sulaiman, Andri S; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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Introduction. Argon plasma coagulation (APC) is widely used in the treatment of radiation colitis among patients with gynecology, colorectal and urology malignancy. This study aimed to measure the result of APC conducted on radiation colitis patients and its counfounding factors. Methods. An analytic descriptive study with retrospective cohort design was conducted among radiation colitis patients received APC treatment in Cipto Mangunkusumo Hospital, Jakarta. Data were collected from medical record database between April 2012 until October 2019. Results. As much as 180 radiation colitis patients received APC treatment fulfilled inclusion criteria with characteristics female patients (89.4%) and age >50 years old (83.9%) were included in this study. Types of tumor were dominated by gynecology malignancy (88.9%). As much as 81.3% subjects had successful APC treatment. Median number of efficacy of APC treatment in this study was 2 sessions. All of the subjects had anemia before the first APC treatment. There was improvement in Hb level, median Hb before the first APC treatment was 8 g/dL (3-11 g/dL) and median Hb level before the last APC treatment was 12 g/dL (10-14 g/dL). As much as 59.2% subjects who had successful APC treatment were no longer had anemia after APC treatment, improvement of anemia status was 1.628 times more likely in subjects who had successful APC treatment compared to subjects who did not have successful APC treatment (p=0.017). Age, gender, malignancy types, hypertension, and diabetes mellitus were not the confounding factors to anemia status in successful APC treatment. Conclusion. There was improvement in anemia status on radiation colitis patients receiving APC treatment in RSUPN-CM.
Gambaran Endoskopi Saluran Cerna Bagian Atas pada Pasien Dispepsia Usia Lanjut di Rumah Sakit Cipto Mangunkusumo Agustian, Hendra; Makmun, Dadang; Soejono, Czeresna H.
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 2
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Pendahuluan. Salah satu masalah kesehatan yang sering terjadi pada pasien usia lanjut adalah gangguan saluran cerna bagian atas. Pada pasien usia lanjut dapat terjadi perubahan di lambung akibat proses penuaan antara lain perubahan integritas mukosa (berkurangnya kadar prostaglandin mukosa, integritas vaskuler menurun, dan penurunan aktivitas anti radikal bebas). Tindakan endoskopi merupakan tindakan yang relatif aman pada usia lanjut untuk menegakkan diagnosis saluran cerna bagian atas. Pemeriksaan endoskopi lebih awal sangat penting dilakukan untuk dapat mencegah penyulit yang mungkin terjadi akibat penyakit pada saluran cerna. Penelitian ini bertujuan untuk mengetahui karakteristik pasien dispepsia usia lanjut yang telah dilakukan pemeriksaan endoskopi saluran cerna bagian atas dan distribusi kelainan endoskopi saluran cerna bawah pasien dispepsia usia lanjut yang ditemukan. Metode. Desain penelitian yang digunakan adalah studi deskriptif potong lintang. Pemilihan subjek dilakukan dengan menelusuri data sekunder laporan endoskopi pasien usia lanjut di Pusat Pelayanan Endoskopi Saluran Cerna, Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, RSCM periode 2004-2008. Semua data subjek yang diambil dan memenuhi kriteria pemilihan subjek dimasukkan dalam penelitian. Hasil. Subjek penelitian terbanyak adalah laki-laki (51%) berbanding perempuan (49%). Suku terbanyak adalah suku Jawa (44,9%). Gambaran endoskopi yang paling sering ditemukan adalah gastritis (41,2%). Simpulan. Subjek penelitian terbanyak adalah laki dan suku Jawa. Gambaran endoskopi yang paling sering ditemukan adalah gastritis.
Faktor-faktor Risiko Terjadinya Proktitis Radiasi Kronik pada Pasien Kanker Leher Rahim yang Mendapatkan Terapi Radiasi Mulia, Mulia; Makmun, Dadang; Abdullah, Murdani; Supriana, Nana
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 3
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Pendahuluan. Proktitis radiasi merupakan komplikasi yang sering dijumpai akibat terapi radiasi pada pasien keganasan pelvis. Berbeda dengan proktitis radiasi akut yang umumnya self-limiting, proktitis radiasi kronik (PRK) dapat berdampak pada menurunnya kualitas hidup dan meningkatnya biaya kesehatan, morbiditas, dan bahkan mortalitas pasien. Penelitian ini bertujuan mengevaluasi insidens dan faktor-faktor risiko terjadinya PRK pada pasien kanker leher rahim (KLR) yang mendapatkan terapi radiasi. Metode. Dilakukan analisis retrospektif pada pasien-pasien KLR yang mendapatkan terapi radiasi di Departemen Radioterapi Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto Mangunkusumo, Jakarta selama kurun waktu 1 Januari 2010 sampai dengan 31 Desember 2010. Data mengenai pasien, faktor yang berhubungan dengan terapi radiasi, dan PRK akibat komplikasi lanjut dari terapi radiasi dikumpulkan dari catatan medik pasien. Hasil. Selama periode tersebut, terdapat 234 pasien yang memenuhi kriteria penelitian. Dengan median follow-up selama 30 bulan, didapatkan 12 pasien [5,1% (IK 95% 2,28-7,92%)] mengalami PRK (6 proktitis, 6 proktosigmoiditis). PRK terjadi pada 7-29 bulan setelah terapi radiasi selesai (median 14,5 bulan) dan 87% dari seluruh PRK terjadi dalam 24 bulan pertama setelah terapi radiasi. Dengan analisis multivariat Cox regresi, didapatkan hubungan bermakna antara dosis total radiasi yang diterima rektum >65 Gy (HR 7,96; IK 95% 2,30-27,50; p=0,001) dan usia ≥60 tahun (HR 5,42; IK 95% 1,65-17,86; p=0,005) dengan terjadinya PRK. Tidak didapatkan hubungan bermakna antara teknik radiasi 2 dimensional external radiation therapy (2D-XRT) (HR 1,36; IK 95% 0,41-4,51; p=0,616), riwayat histerektomi (HR 1,14; IK 95% 0,34-3,79; p=0,83), dan indeks massa tubuh (IMT) Simpulan. Insidens kumulatif PRK selama 3 tahun pada pasien KLR yang mendapatkan terapi radiasi adalah 5,1% (IK 95% 2,28-7,92%). Dosis total radiasi yang diterima rektum >65 Gy dan usia ≥60 tahun merupakan faktor risiko potensial terjadinya PRK pada pasien KLR yang mendapatkan terapi radiasi. Teknik radiasi 2D-XRT, riwayat histerektomi, dan IMT
Selective Serotonin Reuptake Inhibitors and Risk of Gastrointesinal Bleeding In Dyspepsia: An Evidence-Based Case Report Shatri, Hamzah; Zulkifly, Steven; Putranto, Rudi; Makmun, Dadang; Fauzi, Achmad; Maulahela, Hasan; Faisal, Edward; Irvianita, Vinandia; Ardani, Yanuar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023182-191

Abstract

Aim: This evidence-based case report aims to provide the latest evidence about the risk of gastrointesinal (GI) bleeding in selective serotonin reuptake inhibitor (SSRI) users with dyspepsia.Method: The literature search was conducted in four major electronic databases (PubMed, Cochrane, Scopus, ProQuest). The selected articles were sorted through screening abstract based on the inclusion and exclusion criteria. Critical appraisal was performed by using validated critical appraisal tool.Results: Of 247 records from extensive literature searching, three eligible studies (one randomized clinical trial and two cohort studies) were obtained to answer the clinical question. All studies showed SSRIs did not increase the risk of GI bleeding in patients with functional dyspepsia and peptic ulcer. However, the adverse event of SSRIs might be under-reported.Conclusion: According to the evidence, the risk of GI bleeding in SSRIs users with dyspepsia is still unclear. Larger size of sample of controlled trial study is recommended to be conducted to calculate the precise risk of GI bleeding in SSRI users with dyspepsia.
Sarkopenia sebagai Faktor Risiko Varises Esofagus Risiko Tinggi berdasarkan Stratifikasi Child-Pugh Pasien Sirosis Hati Sepmeitutu, Iwandheny; Kurniawan, Juferdy; Maulahela, Hasan; Rinaldi, Ikhwan; Shatri, Hamzah; Pramana, Triyanta Yuli; Makmun, Dadang; Lesmana, Cosmas Rinaldi A; Hidayat, Rudy; Laksmi, Purwita Wijaya; Sunardi, Diana
Jurnal Penyakit Dalam Indonesia
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Background The high prevalence of sarcopenia in chronic liver disease negatively impacts the quality of life and increases the risk of various complications of cirrhosis, one of which is the development of esophageal varices. The aim of this study was to determine the prevalence of sarcopenia in cirrhosis patients based on the severity of liver cirrhosis and to explore the association of sarcopenia with high-risk esophageal varices stratified by Child-Pugh. Methods This observational cross-sectional study involved patients with liver cirrhosis at Cipto Mangunkusumo Hospital between January and September 2023. Sarcopenia was defined as a reduction in muscle mass accompanied by decreased grip strength or walking speed, according to the AWGS 2019 criteria (Asian Working Group for Sarcopenia). Multivariate logistic regression analysis was conducted to evaluate the association between sarcopenia and high-risk esophageal varices. Results A total of 155 patients with liver cirrhosis were included in this study. The majority of liver cirrhosis patients were males, with hepatitis B being the most commonly found etiology. The prevalence of sarcopenia was found in 40.0% of Child-Pugh A patients, 53.8% of Child-Pugh B patients, and 50.0% of Child-Pugh C patients with a p-value of 0.411. The high-risk of esophageal varices was found more frequently in Child-Pugh B (53.8%) and Child-Pugh C (50.0%) compared to Child-Pugh A (25.6%) with a p-value of 0.013. Bivariate analysis showed that the presence of sarcopenia in liver cirrhosis patients has a statistically significant association with an increased risk of high-risk esophageal varices, especially in the Child-Pugh B and C subgroups of liver cirrhosis patients (OR = 7.50 (95% CI: 1.48 – 37.91, p<0.030)). However, no association was found between sarcopenia and high-risk esophageal varices in the Child-Pugh A subgroup (OR = 1.46 (95% CI: 0.65 – 3.29, p<0.477)). Conclusion Sarcopenia significantly increases the risk of high-risk esophageal varices in liver cirrhosis, especially in those with Child-Pugh B and C classification.
Systemic amyloidosis following inflammatory bowel disease, follicular lymphoma, and diffuse large B-cell lymphoma: a case report Sukrisman, Lugyanti; Makmun, Dadang; Krisnuhoni, Ening
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.247428

Abstract

Systemic amyloidosis is a rare disorder characterized by the widespread deposition of misfolded amyloid proteins in several organs, leading to organ failure and potentially death if not promptly recognized. The occurrence of inflammatory bowel disease (IBD), follicular lymphoma, and diffuse large B-cell lymphoma (DLBCL) developing into systemic amyloidosis is uncommon. Here is a case of a 55-year-old Asian woman with a history of IBD, follicular lymphoma, and abdominal DLBCL who developed systemic amyloidosis affecting her gastrointestinal, cardiac, and renal organs. Gastrointestinal symptoms (abdominal pain and melena) initially manifested in this patient with systemic amyloidosis. She underwent treatment with three cycles of rituximab and bendamustine. However, she passed away after 2 months of hospitalization due to multiple organ failure. Hence, physicians must be vigilant in recognizing amyloidosis as a potential complication of lymphoma or other inflammatory diseases, as early recognition can contribute to improved clinical outcomes.
Effectivity of Extracorporeal Shock Wave Lithotripsy (ESWL) and Stenting vs. Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis Maulahela, Hasan; Rumagesan, Djahalia; Abdullah, Murdani; Makmun, Dadang; Renaldi, Kaka; Simadibrata, Marcellus; Shatri, Hamzah; Fauzi, Achmad; Tandan, Manu
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 1 (2023): VOLUME 24, NUMBER 1, April, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/241202323-29

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) alone may not be sufficient for treating difficult common bile duct stones. To address this challenge, several other modalities exist, including extracorporeal shock wave lithotripsy (ESWL) and biliary stent placement. This study aims to investigate the effectiveness of ESWL following biliary stent placement, in comparison to biliary stent placement alone , in the treatment of difficult common bile duct stones.Methods: A retrospective cohort study was conducted using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. This study evaluated 126 subjects with difficult bile stones, who were divided into two groups: one group received biliary stent placement alone, while the other underwent extracorporeal shock wave lithotripsy (ESWL) following biliary stent placement. The effectiveness of each treatment was assessed based on the rate of complete clearance of bile stones.Results: Of the total participants, 72 underwent ESWL following biliary stent placement, while 54 received biliary stent placement alone. The rate of complete stone clearance was 69.1% in the ESWL group and 64.8% in the stent-only group. However, the addition of ESWL as an adjuvant therapy did not result in a statistically significant improvement (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy following biliary stent placement has the same level of effectiveness as biliary stent placement alone.
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