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Upper Gastrointestinal Malignancy among Dyspepsia Patients in Cipto Mangunkusumo Hospital Jakarta Ali Imron Yusuf; Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani
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: 10.24871/103200992-95

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Background: Upper gastrointestinal (GI) malignancy was still a health problem in all over the world. The prevalence of the upper GI malignancy vary among Asian countries. Data from Indonesia was scarcely reported. The aim of this study is to determine the frequency of upper GI malignancy among dyspepsia patients who underwent esophagoduodenoscopy (EGD) procedure. Method: This is a retrospectives study from subject with dyspepsia that had underwent upper GI endoscopy at the Department of Internal Medicine Cipto Mangunkusumo hospital from January 2005 to December 2007. All complete data from medical report and histopathology appearance will be recorded. Results: Out of 2,116 subjects underwent endoscopy due to dyspepsia, 110 (5.19%) subjects was diagnosed as cancer. This upper GI malignancy consisted of gastric cancer in 63 (2.97%) cases, esophageal cancer 32 (1.51%) and duodenal cancer 15 (0.71%). The mean ages of the subjects was 53.36 ± 10.97 years, age less than 45 years was 20 (18.20%) subjects, more than 45 years was 90 (81.18%), male 71 (64.50%) subjects, female 39 (35.50%). Most of them had alarm signs 96 (87.30%). Histopathology finding showed adeno-carcinoma in 75 (68.20%) cases, signet ring cell carcinoma in 14 (12.70%), squamous cell carcinoma in 8 (7.30%), others in 13 (11.80%). Out of 59 gastric cancer, 48 (76.20%) cases was located at distal part while the rest 11 (17.50%) cases was located at the proximal gaster, and 4 (6.30%) in diffuse. By the ethnics founded Javanese 37 (33.60%) subjects, Betawinese 22 (20.00%), Sundanese 12 (10.90%) and Batak 13 (11.80%). Conclusions: Upper GI malignancy was found in five percent of subjects with dyspepsia who undergo colonoscopy. The three most frequent malignancies were gastric carcinoma, esophageal carcinoma, and duodenal carcinoma respectively. Most of gastric adenocarcinoma was located at distal stomach. Keywords: upper gastrointestinal malignancy, dyspepsia, endoscopy, alarm sign, histopathology
Zinc Deficiency in Adults with Acute Diarrhea, is It a Public Health Issue Murdani Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.519 KB) | DOI: 10.24871/122201171-

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Leptospirosis and Pancreatitis Complication Diany N Taher; Murdani Abdullah; Marcellus Simadibrata; Herdiman T Pohan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/61200527-30

Abstract

Leptospirosis is a wide-spread zoonosis in the world, especially in the tropical countries. Ninety percent of cases are characterized by abrupt fever and have good prognosis, but in 10% of cases, exacerbation will occur and the mortality rate is about 10%. Leptospirosis may strike the entire organ, including gastrointestinal tract. Pancreatitis in leptospira is characterized by increased serum amylase levels, with mean values of five times normal. Early diagnosis and prompt treatment will engender good prognosis. Treatment of acute pancreatitis caused by leptospira is similar with other acute pancreatitis treatment caused by other agents. The pathophysiology of leptospira infection includes endotoxin, hemolysis and lipase. Keywords: Leptospirosis, pancreatitis, diagnosis
Irritable Bowel Syndrome: Diagnosis and Treatment Muhammad Syafiq; Marcellus Simadibrata K; Murdani Abdullah; E. Mujaddid
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, NUMBER 1, April 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/41200314-21

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Irritable bowel syndrome (IBS) is the most common functional disorder of the gastrointestinal tract. As a result of the lack of specific diagnostic testing and absence of circumscribed biology markers of the disease, its diagnosis is based on a myriad of symptoms. The term irritable bowel syndrome was probably first coined in 1944 by Peters and Bargen. In 1849, Cumming described the clinical manifestations of Irritable Bowel Syndrome. Irritable bowel syndrome is defined on the basis of the recently modified Rome criteria as the presence of at least 12 weeks (not necessarily consecutive) of abdominal discomfort or pain in the preceding 12 months that cannot be explained by structural or biochemical abnormalities, and that has at least two of the following three features: pain relieved with defecation, an onset associated with a change in the frequency of bowel movements (diarrhea or constipation), or an onset associated with a change in form of stool (loose, watery, or pellet-like). The syndrome can be divided into three subcategories according to the Modified Rome criteria II; those with a predominant symptom of diarrhea, constipation, or constipation alternating with diarrhea. There are several criteria for irritable bowel syndrome, one of which is the Manning criteria, applied in many epidemiological and clinical studies to identify irritable bowel syndrome. However, many investigators disagree with this criteria due to a seemingly poor validity in men. In an attempt to bring order to the specialty, consensus-based approach is adopted by a group of international experts, which led to the development of the Rome criteria for irritable bowel syndrome (Table 1). Extra-intestinal symptoms, including headache, backache, urinary and gynecologic symptoms, and fatigue, are more common in the constipation-predominant subgroup.
Non Cirrhotic Portal Fibrosis Ralph Girson; Andri Sanityoso; Rino A Gani; Wirasmi Marwoto; Murdani Abdullah; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200560-64

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Diagnosis of non cirrhotic portal fibrosis was considered when the following criteria were fulfilled evidence of portal hypertension (oesophageal varices, hypersplenism, ascites, or increased hepatic venous pressure gradient), Doppler ultrasound showing patent portal and hepatic veins, and liver biopsy showing sign of cirrhosis. Non cirrhotic portal fibrosis clinically characterized by splenomegaly, anemia, portal hypertension, and histopathological examination portal tract showing fibrosis and sclerosis. Portal hypertension are most caused by a cirrhotic liver (85%), there are only a few reports on non cirrhotic portal hypertension, mostly in Japan and India. We reported a case of non cirrhotic portal fibrosis in young male.  The clinical complications of portal hypertension are variceal bleeding and pancytopenia due to hypersplenism. Variceal band ligation and splenectomy were performed. The patient showed good clinical response.   Keywords: portal hypertension, non cirrhotic portal fibrosis, young male
Clinical Effects of an Amino Acid and Glucose Solution in Non-surgical Gastrointestinal Patients of Internal Medicine Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.823 KB) | DOI: 10.24871/1232011155-159

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Background: This study was performed to assess the efficacy and safety of intravenous amino acid and glucose solution with electrolytes in non-surgical gastrointestinal patients. Method: This single, open, and pre-post study was conducted in the internal medicine ward at Cipto Mangunkusumo Hospital between June 2007 and March 2008. Patients were administered solution of amino acid, glucose, and electrolytes via peripheral vein at a dose of 1000 mL/day for one week period. Non-operative gastroenterology patients with age between 16 and 65 years were eligible in this study; patients were excluded if they had diabetes mellitus, severe hepatic or renal dysfunction, electrolyte disturbance, and obesity. The data were analyzed by paired t-test and McNemar test using SPSS version 16. Results: Fifteen patients consisted of 8 (53.5%) female, mean age was 38.47 ± 14.73 years. The body mass index (BMI) at screening was 14.50 ± 2.11 kg/m2. Patients’ BMI increased in day-1, day-3, and day- 7 into 14.5; 14.58; 14.80 kg/m2, respectively (p 0.05). The increasing of prealbumin, albumin, transferin, and total protein were 7.30 mg/dL vs 11.16 mg/dL; p = 0.018; 2.71 g/dL vs 3.12 g/dL; p = 0.024; 102.37 mg/dL vs 141.95 mg/dL; p = 0.016; 6.24 g/dL vs 6.85 g/dL; p = 0.019, respectively. The clinical symptoms of nausea and weakness in patients decreased from 53.3% to 6.7%; p = 0.016, and 66.7% to 6.7%; p = 0.004. Conclusion: This parenteral nutrition solution was effective to improve clinical nutrition parameters. Keywords: amino acid and glucose solution, non-surgical gastrointestinal patients, peripheral parenteral nutrition
The Effect of Domperindone on Intestinal Motility and Bacterial Overgrowth in Patients with Liver Cirrhosis Yustar Mulyadi; Rino Alvani Gani; Murdani Abdullah; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.612 KB) | DOI: 10.24871/1332012130-135

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ABSTRACTBackground: Spontaneous bacterial peritonitis (SBP) is a common serious complication of liver cirrhosis mainly caused by bacterial translocation (BT) into ascites fluid. The most essential issue that affects BT is small intestinal bacterial overgrowth (SIBO), which usually caused by gastrointestinal dysmotility. This study was aimed to evaluate the prokinetic effects of domperidone on gastrointestinal motility and small intestinal bacterial overgrowth and the correlation between restoration of motility and the incidence of SIBO in patients with liver cirrhosis.Method: A cross-over double blind clinical trial was conducted on patients who were treated at the ward and outpatient clinic from Division of Hepatology in Cipto Mangunkusumo Hospital, Jakarta and Soedarso Hospital, Pontianak between September 2010 and March 2011. All patients suffered from liver cirrhosis with ascites, gastrointestinal dysmotility and SIBO were included in the study. Out of 34 eligible patients, 16 patients received placebo and 18 patients received prokinetics (domperidone). Wilcoxon test was performed to analyze the comparison of SIBO before and after treatment in the placebo group; while paired T-test was employed for the prokinetics (domperidone) group. To evaluate improved balance of SIBO in the placebo and domperidone group, a Chi-square test was performed.Results: In the placebo group, 61.8% patients experienced SIBO; while in the prokinetics group, SIBO occurred only in 2.9% patients. Restored gastrointestinal motility took place in the prokinetics group with reduced median value for orocaecal transit time from 120 minutes into 90 minutes (p = 0.0001). In contrast, it went worse in the placebo group, i.e. from 90 minutes into 110 minutes (p = 0.002). There was a significant correlation between restored gastrointestinal motility and SIBO (p = 0.0001). Similarly, so does the effect of administering prokinetic agent on restored gastrointestinal motility (p = 0.0001) and SIBO (p = 0.0001).Conclusion: The administration of prokinetics has been proven effective to restore gastrointestinal motility that may lead to reduced incidence of SIBO in patients with liver cirrhosis. Keywords: prokinetics, breath hydrogen test, dysmotilitas, bacterial overgrowth 
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

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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
Life Style Factors Influencing Serum Pepsinogen Levels in Healthy Japanese: A Prospective Study Murdani Abdullah; Fumiaki Kitahara; Tadashi Sato; Yuichiro Kojima; Abdul Aziz Rani; Masayuki A. Fujino
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, NUMBER 1, April 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/4120036-10

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Background: Gastric cancer mass screening using serum pepsinogen has been recognized and several advantages of this methods over photofluorography have been shown by previous study. Aims: To determine the factors influence the serum pepsinogen levels in healthy subjects. Subjects Methods: One thousand and one hundred fourteen subjects who were screened for gastric cancer as part of a periodic health check. Blood samples were taken after fasting and stored below –20 ° C, until pepsinogen levels were assayed. Results: The subjects consist of 338 males (mean age 52.6+14.0) and 776 females (mean age 49.0+11.9). Age ranges from 19 to 81 years. The overall prevalence of chronic atrophic gastritis using a criterion PG I £ 70 hg/ml and PG I/II ratio £ 3.0 was 21.99 % in 1996 and 23.97 % in 2000. Bivariate analysis revealed a significant association between age, more salt consumption, fish favorable over meat and less than three time meal intake covariates with the lowering of PG I/II ratio. Smoking, drinking, BMI, weight and gender did not affect the changes of PG I/II ratio. Conclusion: Age and more salt consumption covariates have a strongest association with the decreased of PG I/II by multivariate analysis. Keywords: pepsinogen, dietary, drinking, smoking, atrophic gastritis
Papilla Vaterƒs Tumor in Elderly: an Interdisciplinary Issue Eric Daniel Tenda; Murdani Abdullah; Kuntjoro Harimurti; Edy Rizal Wahyudi; Czeresna Heriawan Soejono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010155-159

Abstract

Tumors of the papilla Vater are very rare. Papilla Vater’s tumors are benign or malignant tumors in the ampulla of Vater and periampullary region. Blockage of ampulla leads to the development of obstructive jaundice; intermittent cholangitis, epigastric discomfort and weight loss. Treatment possibilities include endoscopic ampulectomy, surgical transduodenal excision of tumors of the ampulla and pancreatoduodenectomy (PDE). Prognosis depends on histological typing of the tumor and their clinical stage. We report a case of papilla Vater’s tumor in elderly with comorbidities based on literature review. A 68-year-old female patient was referred for evaluation of intra and extra hepatic bile duct dilatation noted on abdominal ultrasonography. She complained of intermittent epigastric and right upper abdominal pain, with yellowish skin for two months. The laboratory findings showed leukocytosis, hyperbilirubinemia, abnormal liver function test, and high Ca 19-9. An endoscopic retrograde cholangiopancreatography (ERCP) revealed a distal obstruction caused by papilla Vater’s tumor. Abdominal computed tomography (CT) with contrast, revealed a dilated common bile duct and pancreatic duct. The histologic evaluation was highly suggestive for dysplasia. She is now on a schedule for a Whipple procedure. To make a true diagnosis and optimal treatment of papilla Vater’s tumor is multimodal. By doing a comprehensive geriatric assessment, with a careful modality selection, a Whipple procedure can be performed in elderly (65 years) safely. The post operative morbidity and mortality depends on their multi morbidity. Surgical, endoscopic, or radiologic biliary decompression; relief of gastric outlet obstruction; and adequate pain control may improve the quality of life but do not affect overall survival rate. By building a great interdisciplinary teamwork, the quality of life increased as follows.Keywords: papilla Vater tumor, elderly, Whipple procedure
Co-Authors Aan Santi Abdul Aziz Rani ACHMAD FAUZI Adang Bachtiar Afifah Is Ahmad Fauzi Ahmad Soefyani Ahmar Abyadh Aida Lydia Ali Imron Yusuf Anastasia Yoveline Andri Sanityoso Ari F Syam Ari Fahrial Syam Ariadi Humardani Arif Mansjoer Arman A Abdullah Arman Adel Abdullah Birry Karim Bona Adhista Budi Tan Oto C Martin Rumende Ceva W. Pitoyo Chairul R Nasution Chatarina Umbul Wahyuni Chudahman Manan Chyntia Olivia MJ Cleopas Martin Rumende Czeresna Heriawan Soejono Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Dasril Nizam Debby Desmarini Deddy Gunawanjati Dharmika Djojoningrat Diah Rini Handjari Diany N Taher Djumhana A Dolly Dolven Kansera Dono Antono E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri E. Mujaddid Edy Rizal Wahyudi Ekowati Rahajeng Ellen Susanti Elli Arsita Ening Krisnuhoni Eric Daniel Tenda Evy Yunihastuti Fadilah Fadilah Fahmi Razi Darkuthni Fransiska Hardi Fumiaki Kitahara Guntur Darmawan Haryanto Surya Hasan Mihardja Herdiman T Pohan Hiroyuki Otsuka Hotmen Sijabat Ibrahim Basyir Ika Prasetya Wijaya Ikhwan Rinaldi Indra Marki Irfan Maulani Irsan Hasan Irwin Tedja Ivo Novita Sah Bandar Jacobus Albertus Jane Estherina Jeffri Gunawan Jeffry Beta Tenggara Joseph JY Sung Julwan Pribadi Jumhana Atmakusuma Kaka Renaldi Katharina Setyawati Khie Chen Kuntjoro Harimurti Lies Luthariana Luluk Yunaini Lusiani Lusiani M Purnomo Isnaeni M Usman SM Marcellus Simadibrata Marcellus Simadibrata K Marthino Robinson Maruhum B.H. Marbun Masayuki A Fujino Masayuki A. Fujino Masdalina Pane Moch Ikhsan Mokoagow Mohammad Adi Firmansyah MUHAMMAD SYAFIQ Nata Pratama Novie Rahmawati Zirta Nur Rasyid Okto Dewantoro Pamela Abineno Pamela Abineno Damaledo Paulus Kusnanto Puji Sari Rabbinu Rangga Pribadi Raden Nur Ista Ralph Girson Ratu Ratih Kusumayanti Reinaldo Alexander Riahdo Saragih Rino A Gani Rino Alvani Gani Rizka Puteri Iskandar Rizki Yaruntradhani Ryan Ranitya Saleha Sungkar Salius Silih Sally Aman Nasution Sedijono Sedijono Seri Mei Maya Ulina Sofy Meilaini Steven Sumantri Suryantini Suryantini Suzana Ndraha Tadashi Sato Tito Ardi Tjahjadi Robert Tedjasaputra Toman L Toruan Tri Juli Edi T Velma Herwanto Vera Yuwono Wirasmi Marwoto Wulyo Rajabto Yonathan, I Wayan Murna Yuichiro Kojima Yustar Mulyadi