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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Incidence of Colorectal Cancer in Saiful Anwar Hospital, Malang January 2010- April 2015 Lia Sasmithae; Syifa Mustika
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (148.236 KB) | DOI: 10.24871/1832017165-168

Abstract

Background: Colorectal carcinoma is the third most common malignancy worldwide and the second most frequently found cause of mortality in the United States. In Indonesia, the number of colorectal cancer patients ranks 10th (2.75%) after other cancers (cervical, breast, lymph nodes, skin, nasopharyngeal, ovarium, soft tissue, and thyroid). The main key to success in managing this carcinoma is by detecting the cancer in early stage to enable curative treatment to be performed. But, unfortunately most patients in Indonesia seek for treatment in the advanced stage, causing low survival rate. Colorectal carcinoma requires multimodalities management and there is no uniformity of management approach in the national level. This study was aimed to identify the incidence, epidemiology, and risk factors which influence the occurrence of colon and rectal cancer in Saiful Anwar Hospital (SAH), Malang based on colonoscopy examination from January 2010-April 2015.Method: Descriptive study, with total sampling method. Samples were colon and rectal cancer patients in SAH, Malang who underwent colonoscopy within January 2010 – April 2015.Results: We found 472 eligible samples, which comprised of 50 individuals (11%) with the age of less than 36 years old, 326 individuals (69%) in middle aged group with the age of 36-65 years old, 96 individuals (20%) in older aged group with the age of more than 65 years old. Patients were predominantly male with 248 individuals (53%), while female patients were 224 individuals (47%). The most common location of the tumour was in the rectum, which was found in 380 individuals (74.15%). The most common clinical symptoms was bloody stool with mucus. From patients in this study, 87 individuals (18.43%) had history of smoking, 11 individuals (2.3%) had family history of cancer, and 58 individuals (12.28%) consumed traditional herbal drinks (jamu). Patients’ characteristics of colon cancer based on anatomical pathology results showed that the most common was moderately differentiated adenocarcinoma in 33 patients (61.11%), followed by well-differentiated adenocarcinoma in 14 patients (25.93%), and the least common was those with anatomical pathology results revealing unspecific adenocarcinoma in 7 patients (12.96%). Characteristics of patients with rectal cancer based on anatomical pathology results showed that the most commonly found was moderately differentiated adenocarcinoma in 72 patients (54.15%), well-differentiated adenocarcinoma in 34 patients (25.56%), unspecific adenocarcinoma in 24 patients (18.04%) and the least common was those with anatomical pathology results of mucinous adenocarcinoma found in 3 patients (2.25%).Conclusion: The conclusion of this study was colon and rectal cancer were frequently found in middle aged group. The most common location was rectum. Mainly found in male compared to female.
Comparing the Effects of Genistein, Silymarin, Lecithin on Improved Liver Necrosis Induced by Paracetamol Toxic Dose Administration in Rattus novergicus Wistar Strain Syifa Mustika; Supriono Supriono; Bogi Pratomo; Harijono Achmad
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (781.61 KB) | DOI: 10.24871/131201229-36

Abstract

Background: Paracetamol, a widely used antipyretic and analgesic drug has been known for its side effect of liver toxicity resulting from free radical formation leading to necrotic hepatocytes. Oral genistein may reduce lipid peroxidation and increase total antioxidant capacity in liver. The present study was aimed to compare the effects of administering genistein, silymarin and lecithin on improved necrotic hepatocytes in Wistar rats fed with toxic dose of paracetamol. Method: An experimental study was conducted at the Laboratory of Physiology and Anatomical Pathology, University of Brawijaya between May and September 2011. About 48 male rats were categorized into 4 groups. The first group was treated with 600 mg/kgBW of oral paracetamol. The other groups were treated with 600 mg/kgBW paracetamol and additional 2 mg/kgBW genistein, 50 mg/kgBW silymarin or 100 mg/kgBW lecithin. ALT, AST, bile acid, malondialdehyde (MDA) and glutation (GSH) levels were measured and centrilobular necrosis observed by histopathological examination. Data were analyzed statistically by ANOVA. Results: AST and ALT level were significantly lower in genistein group (p = 0.004 and p = 0.001). The lowest bile acid level was found in the lecithin group (p = 0.025); while lowest MDA level was found in silymarin group (p = 0.009). The highest GSH level was found in lecithin group (p = 0.001). The lowest percentage of centrilobular necrosis was found in genistein group (p = 0.001). Conclusion: Genistein, silymarin and lecithin supplementation improve liver necrosis induced by toxic dose of paracetamol. Among them, genistein is the most significant agent. Keywords: genistein, silymarin, lecithin, paracetamol, hepatotoxicity
Alcoholic Liver Cirrhosis in Young Female: Diagnostic and Therapeutic Challenge Syifa Mustika; Nina Nur Arifah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1521 KB) | DOI: 10.24871/1832017206-211

Abstract

Alcoholic liver cirrhosis is a disease due to excessive alcohol consumption that manifest as fatty liver, alcoholic hepatitis, and chronic hepatitis with fibrosis or liver cirrhosis. Alcohol consumption as much as 60-80 g per day for 20 years or more in male, or 20 g/day (approximately 25 mL/day) in female significantly increases the risk of hepatitis and fibrosis as much as 7-47%. The aim of this case report was to explore the diagnostic and therapeutic challenge of alcoholic liver disease in young aged female. A female, 24 years old, came with complaints of bloody vomiting, blacktarry stool, abdominal distention and history of alcohol consumption (canned beer 5%, equal to 56-70 g/day) for 9 years. Physical examination revealed anaemic conjunctiva (Hb 2.9 g/dL), ascites, hepatosplenomegaly, and bilateral legs oedema. Laboratory examinations showed thrombocytopenia (125000/uL) and hypalbuminaemia (2.65 gr/dL). AST and ALP were increased with the value of 175 U/L and 456 U/L, respectively. Albumin-globulin ratio was 0.93 g/dL with serum ascites albumin-gradient was 2.20 g/dL (ascites fluid albumin level was 0.45 gr/dL and serum albumin level was 2.65 gr/dL). Abdominal USG revealed hepatomegaly with coarse heterogenic ecoparenchyma, portal vein dilatation, and splenomegaly. Diagnosis of alcoholic liver cirrhosis was made based on clinical, laboratory, and radiologic findings, while biopsy result did not confirm the pathology. Patients condition improved with education of stop alcohol consumption and was given supportive therapy.
Barrett’s Esofagus Syifa Mustika; Bayu Eka Nugraha
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (824.84 KB) | DOI: 10.24871/202201996-103

Abstract

Gastroesophageal reflux disease (GERD) is a condition commonly managed in the primary care setting. Patients with GERD may develop reflux esophagitis as the esophagus repeatedly is exposed to acidic gastric contents. Over time, untreated reflux esophagitis may lead to chronic complications such as esophageal stricture or the development of Barrett’s esophagus (BE). BE may progress to oesophageal adenocarcinoma. There is currently a rising incidence of BE. The pathogenesis of BE is not well-understood although genetic and environmental factors play significant roles. BE is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. As patients with BE can be entirely asymptomatic, it is difficult to screen this population group. BE is present in 10%–20% of patients with GERD and has also been detected in patients who deny classic GERD symptoms and are undergoing endoscopy for other indications.
Role of Phytopharmacy as Hepatoprotector in Chronic Hepatitis Budi Herlianto; Syifa Mustika; Supriono - -; Bogi Pratomo; Harijono Achmad
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (218.804 KB) | DOI: 10.24871/1532014157-160

Abstract

Background: Hepatitis is one of the health problems in Indonesia that require special treatment, in line with the increase of morbidity and mortality rate of this disease. Complications of hepatitis include liver cirrhosis and hepatocellular carcinoma. Indonesia, as a tropical country, has many medicinal plants that act as hepatoprotector, a substance that can protect liver from toxic agent. Use of medicinal plants is still considered as controversial treatment because there is still lack of studies. Medicinal plants with mix composition of phytopharmacy, such as: Curcuma xanthorrhiza, Arcangelesia flava, Nigella sativa, and Kleinhovia hospita show potency as hepatoprotector. The objective of this study is to analyse the function of phytopharmacy as hepatoprotector in chronic hepatitis.Method: This study is a clinical trial performed in the Gastroenterology Department and Outpatient Clinic in Saiful Anwar Hospital in May-June 2013. Chronic hepatitis B or C patients who have received antiviral therapy with 3 fold increase of the threshold value of transaminase level, were included in this study. In this study, patients consumed phytopharmacy tablet 3 times per day. After 7 days of treatment, patients’ serum transaminase levels (ALT and AST) were re-assessed. Statistical analysis of before and after treatment data was performed using Wilcoxon test and the result was significant with p 0.05.Results: From 10 patients, the average age was 50.3 years old. Sixty percent (60%) of them were male, with 50% suffered from chronic hepatitis B and the other 50% suffered from chronic hepatitis C. From this study, decrement of alanine transaminase (ALT) and aspartate transaminase (AST) after seven days of treatment were 45.06%, with p = 0.007 and 48.63%, with p = 0.007, respectivelyConclusion: Phytopharmacy supplementation in chronic hepatitis can decrease serum transaminase, however further study is needed. Keywords: chronic hepatitis, phytopharmacy, ALT, AST, hepatoprotector 
Overview of Serum Interleukin-18 (IL-18) Levels in Liver Cirrhosis Patients and Their Correlation to Hepatic Encephalopathy Anton Komala; Syifa Mustika; Bogi Pratomo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (587.26 KB) | DOI: 10.24871/192201867-73

Abstract

Background: The inflammatory process has an important role in the pathophysiology of hepatic encephalopathy (HE) in liver cirrhosis. IL-18 is a key mediator who plays a role in neuroinflamation processes that can lead to symptoms of HE. This study aimed to determine serum IL-18 levels in liver cirrhosis patients and to assess the association of serum IL-18 levels with HE.Method: A total of 52 subjects (32 patients with liver cirrhosis and 20 healthy controls) were enrolled in this study. Thirty two (32) patients with liver cirrhosis will be assessed for HE based on West-Haven criteria. All subjects were examined for serum IL-18 levels which is measured by ELISA method. We performed a comparative analysis between serum IL-18 levels of liver cirrhosis patients and healthy controls, a correlation analysis between serum IL-18 levels and HE, and a comparative analysis of serum IL-18 levels among degrees of HE.Results: Mean serum IL-18 levels in the liver cirrhosis group were 688.5 ± 674.3 pg/mL, and in the healthy controls group were 163.9 ± 100 pg/mL with p value = 0.01 (p 0.05). There was a significant correlation between IL-18 and HE (r = 0.85; p = 0.00). Serum IL-18 levels in covert and overt HE groups were significantly higher than those without HE (p 0.05).Conclusion: Serum IL-18 levels were significantly higher in liver cirrhosis patients than in healthy controls. There was a positive correlation between IL-18 and HE. Serum IL-18 levels in liver cirrhosis patients with HE were significantly higher than those without HE.
Change of Gut Microbiota and its Role in Tuberculosis Mustika, Syifa; Michaela, Cleine
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024336

Abstract

Introduction: Tuberculosis (TB) is a prevalent infectious illness and a leading cause of death globally. An alteration in the microbial communities heightens vulnerability to tuberculosis. The changes mentioned below are responsible for pulmonary disease, as well as a decrease in the body's ability to resist the invasion of harmful external microorganisms or the depletion of beneficial bacteria. Literature review: Adults diagnosed with pulmonary tuberculosis exhibited a stool microbiome that contained a greater abundance of anaerobic microorganisms. This was found to be linked to proinflammatory immunological pathways in the host and was also associated with the severity of tuberculosis. Relapsed tuberculosis was correlated with elevated Actinobacteria and Proteobacteria levels and decreased Bacteroidetes levels. The pathogenesis of Mycobacterium TB infection and the onset of tuberculosis symptoms may be influenced by changes in the gut-lung microbiome axis. Medication availability, efficacy, and adverse effects can be impacted by the gut flora in several ways. Currently, researchers recommend exploring the potential of combining TB medicine with gut-focused probiotics to improve treatment response and outcomes. Conclusion: The microbiome has the potential to be a modifiable risk factor for tuberculosis. The human microbiota may have a role in the development of M. tuberculosis and treatment for tuberculosis can disrupt the balance of microorganisms, leading to dysbiosis, which can in turn impact the host's immune system. Probiotics and postbiotics demonstrate anti-tuberculosis properties, suggesting their ability to address problems arising from the use of various antibiotics.Keywords: Tuberculosis, microbiome, gut-lung axis
The Effectiveness of Elbasir/Grazoprevir in Hepatitis C Patients with Stage 5 Chronic Kidney Disease (CKD) Mustika, Syifa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024302

Abstract

ABSTRACTIntroduction: Treatment of hepatitis C in end stage renal disease patients  still a clinical challenge. Elbasvir/grazoprevir is a type of direct acting antiviral (DAA) drug used in treatment of Hepatitis C virus patients with renal disease. However, research on effectiveness of elbasvir/grazoprevir in hepatitis c virus patients with stage 5 chronic kidney disease (CKD) was limited. Therefore, this study aims to describe the effectiveness of elbasvir/grazoprevir on hepatitis C patients with stage 5 chronic kidney disease (CKD).Method: This research using analytic observational design with cross-sectional study approach. The effectiveness of elbasvir/grazoprevir in hepatitis C patients with stage 5 chronic kidney disease (CKD) were evaluated the viral load, SVR12, and kidney function. Data were obtained from medical records of hepatitis C patients at Hepatology Outpatient Clinic dr. Saiful Anwar hospital from January 1st 2021 until December 31st 2022. Data analysis used the chi-square test, paired t test, and the Wilcoxon test with a significance level of p0.05 and 95% confidence level.Results: This study obtained 52 respondents. Most of the patients after treatment elbasvir/grazoprevir had an SVR12 value of 94.23%. Creatinine levels significant increase from 122±40 mg/dl to 133.05±36.12 mg/dl (p=0,032). Urea levels significantly different from 12±3 mg/dl to 12.18±3.56 mg/dl (p=0,446).Conclusion: Elbasvir/grazoprevir was effective to treat hepatitis C patients with stage 5 CKD. Keywords: Hepatitis C, stage 5 CKD, effectiveness, elbasvir/grazoprevir
Correlation of Short Chain Fatty Acid Levels in Patients Non-Alcoholic Fatty Liver Disease with Obesity Mustika, Syifa; Safira, Zahra; Rosandi, Rulli; ., Supriono; Wibowo, Bogi Pratomo; Muthiah, Mark
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 1 (2025): VOLUME 26, NUMBER 1, April, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/261202528-35

Abstract

Background: NAFLD has the potential to develop into severe diseases like NASH and cirrhosis and is often linked to obesity, although it can also occur in non-obese individuals, complicating diagnosis. SCFAs, produced by intestinal bacteria through the fermentation of dietary fibers, are essential for metabolic health and may influence liver fat and weight regulation. The purpose of this study was to explore the connection between SCFA levels and the severity of NAFLD, including liver fibrosis, in individuals both with and without obesity.Methods: A cross-sectional investigation of 16 NAFLD patients with obesity and 11 without, with stool samples analyzed for SCFA via gas chromatography. Obesity was defined by abdominal circumference. Data were analyzed using Spearman’s correlation, Eta’s correlation, and Pearson’s test.Results: Levels of SCFAs, including butyrate, propionate, and acetate, were significantly correlated in both obese and non-obese individuals diagnosed with NAFLD (r=0.618, p=0.001; p=0.019; p=0.037; p=0.012). Obesity was found to be positively associated with the severity of NAFLD (r=0.582, p=0.001). However, obesity did not exhibit a statistically significant connection with liver fibrosis (p = 0.351).Conclusion: Obese NAFLD patients exhibited decreased SCFA levels compared to non-obese individuals. Central obesity was linked to NAFLD severity but not fibrosis progression. SCFAs and obesity are crucial in the pathogenesis of NAFLD.Keywords: Central obesity, gut microbiota, NAFLD, SCFA
Approach to Patients with Increased Liver Biochemical and Function Tests : A Literature Review Mustika, Syifa; Gersom, Camoya; Kongkam, Pradermchai
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 1 (2025): VOLUME 26, NUMBER 1, April, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/261202559-67

Abstract

This review article provides a comprehensive examination of liver injury patterns, specifically focusing on hepatocellular and cholestatic patterns, and their respective diagnostic approaches. It highlights the importance of differentiating between these patterns through detailed clinical evaluations and the use of specific liver enzymes, including aminotransferases, bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, 5'-nucleotidase, and lactate dehydrogenase. The review further explores liver function tests, such as albumin and prothrombin time, which are crucial in assessing liver function and guiding clinical management. A wide range of liver diseases is discussed, with a focus on those exhibiting hepatocellular patterns, such as viral hepatitis, acute liver failure, fatty liver disease (both alcoholic and non-alcoholic), and drug-induced liver injury (DILI), as well as other conditions like ischemic and autoimmune hepatitis. Cholestatic illnesses such as primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), bile duct blockages, and genetic cholestatic syndromes are also investigated. This study seeks to improve physicians' and researchers' awareness of liver diseases, serve as a valuable resource for future research and teaching, and contribute to the improvement of diagnostic and therapeutic techniques in hepatology.Keywords : Cholestatic, hepatocellular, liver enzymes, liver functions
Co-Authors A.A. Ketut Agung Cahyawan W Achmad Rudijanto Adam Adam Ade Rahmawati Affa Kiysa Waafi Amalia, Dinda Amanda C Wowor Anton Komala Arifah, Nina Nur Bayu Eka Nugraha Bogi Pratomo Bogi Pratomo Bogi Pratomo Bogi Pratomo Bogi Pratomo Bogi Pratomo Brahmantyo, Herwindo Pudjo Budi Herlianto Budi Herlianto Budiarto, Andika Agus Caesar Ahmad Tidel Camoya Gersom Charisma Dian Simatupang Daryadijaya, Daya Daya Daryadijaya Dewi Santosaningsih Dewi Santosaningsih Dian Handayani Dian Handayani Dian Hasanah Diana Jeni H Diana Jeni H, Diana Jeni edy susanto Endang S. Rahayu Erlina B Fachrureza, Mochamad Fachrurrezza, Mochammad Faridah, Amirah Fathoni, Alfan Fiqih Faruz Gatya, Mifta Harijono Achmad Harijono Achmad Harijono Achmad Harijono Ahmad Hartaya, Arsy Hanandya Imroatussholihah, Al Indriyaningrum, Nurria Betty Indriyaningrum, Nurria Betty Jonny K. Fajar Kenty Wantri Anita, Kenty Wantri Komala, Anton Kongkam, Pradermchai Larasati, Putu Anissa Lia Sasmithae Lutfiyanto Nurhidayat M. Farid Rakhman Mariyatun Mariyatun, Mariyatun Marzuki, Mochammad Jalalul Michaela, Cleine Muli Yaman Muthiah, Mark Nabila Ramadhani Nabila, Salsala Sifa Nanik Triana Nasution, Muhammad Imanuddin Nina Nur Arifah Novita Apramadha Kartika Sari Nugraha, Bayu Eka Nugroho, Rama Tiar Nurlaili, Retti Nurmalita, Shafira Nurria Betty Indriyaningrum Pandu Tridana Sakti, Pandu Tridana Pramesi, Putrika C. Pratista Adi Krisna Pratomo , Bogi Prayitno, Tia Rahmi Priyanto, Tia Rahmi Putri, Dinda Amalia Eka Putri, Fildzah Karunia Rakhmadhan, Iraky Ramadi Satryo Wicaksono Ratnaningtyas, Yosefin RC Tarigan Renny Tandya Retti Nurlaili Reyhan , Muhammad Rosita, Firdha Ruliana Ruliana, Ruliana Rulli Rosandi Safira, Zahra Sagala, Ida Samichah Samichah Sasmithae, Lia Satiti, Ika Sembiring, Frinny Sholihah, Al Imroatus Sigit Triyus Priyantoro Sigit Triyus Priyantoro, Sigit Triyus Sopacua , Andre Supriono Supriono ., Supriono Supriono Supriono Supriono Supriono Supriono Supriono Susanti, Lia Susanto, Jefri P. Suyoso Suyoso Tarigan, RC Tiar Oktavian Effendi Triana, Nanik Vianty , Liku Wibowo, Bogi Pratomo Wijayanti Saputri, Nur Estu Yuni Rahmawati