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All Journal JURNAL ETIKA KEDOKTERAN INDONESIA The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Ali Sulaiman
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Medicine & Pharmacology Public Health

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Tinjauan Etika Dokter sebagai Eksekutor Hukuman Kebiri Soetedjo Soetedjo; Julitasari Sundoro; Ali Sulaiman
Jurnal Etika Kedokteran Indonesia Vol 2, No 2 (2018)
Publisher : Majelis Kehormatan Etik Indonesia PBIDI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (180.339 KB) | DOI: 10.26880/jeki.v2i2.18

Abstract

Dewasa ini, kejahatan seksual sangat mudah ditemui, mulai dari kasus pelecehan seksual hingga pemerkosaan yang berujung pada tindakan pembunuhan.  Kejahatan tersebut bahkan tidak memandang bulu, baik pria maupun wanita, dewasa hingga anak-anak dapat menjadi korban dari pelaku kejahatan seksual. Pedofil merupakan orang dengan gangguan dorongan seks berlebih dengan target anak-anak di bawah umur. Menanggapi peningkatan tren kejahatan pedofilia, pemerintah mengeluarkan UU No. 17 Tahun 2016 yang menetapkan hukuman kebiri kimia bagi para pelaku sebagai bentuk perlindungan terhadap anak. Dokter sebagai profesi yang memiliki kompetensi terbaik di bidang kesehatan (kemanusiaan) kemudian menghadapi dilema terkait tinjauan etik kedokteran yang ada terhadap kasus ini. Ikatan Dokter Indonesia (IDI) telah mengeluarkan fatwa penolakan dokter sebagai eksekutor kebiri yang dinilai dapat mencederai sumpah profesi, mengingat efektivitas kebiri yang masih dipertanyakan dan risiko komplikasi lain yang harus dihadapi terpidana dengan hukuman kebiri.
Bullying (Perundungan) di Lingkungan Pendidikan Kedokteran Anna Rozaliyani; Broto Wasisto; Frans Santosa; R Sjamsuhidajat; Rianto Setiabudy; Pukovisa Prawiroharjo; Muhammad Baharudin; Ali Sulaiman
Jurnal Etika Kedokteran Indonesia Vol 3, No 2 (2019)
Publisher : Majelis Kehormatan Etik Indonesia PBIDI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (158.152 KB) | DOI: 10.26880/jeki.v3i2.36

Abstract

Dalam lingkungan pendidikan kedokteran, bullying atau perundungan masih kerap terjadi. Korban perundungan umumnya peserta didik atau junior, sedangkan pelaku perundungan antara lain pendidik dan senior. Perundungan merupakan bentuk pelanggaran etik dasar dan hak asasi manusia, yang dapat berdampak buruk terhadap peserta didik, lingkungan kerja, maupun kualitas pelayanan kesehatan. Untuk itu diperlukan upaya komprehensif dengan menyertakan berbagai pihak terkait guna mencegah dan menghentikannya. Perbaikan kurikulum pendidikan yang mengutamakan prinsip kesetaraan dan etika kesejawatan, diharapkan dapat mencegah dan menghentikan tindakan perundungan secara bertahap dan sistematis.
Tinjauan Etik Layanan Konsultasi Daring dan Kunjungan Rumah Berbasis Aplikasi Pukovisa Prawiroharjo; Julitasari Sundoro; Jonathan Hartanto; Ghina Faradisa Hatta; Ali Sulaiman
Jurnal Etika Kedokteran Indonesia Vol 3, No 2 (2019)
Publisher : Majelis Kehormatan Etik Indonesia PBIDI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (170.502 KB) | DOI: 10.26880/jeki.v3i2.33

Abstract

Teknologi digital telah merambah berbagai aspek kehidupan, salah satunya adalah jasa layanan kedokteran berbasis aplikasi di gawai baik berupa konsultasi kedokteran maupun fasilitasi kunjungan rumah oleh dokter. Berbagai keuntungan dan kenyamanan dirasakan oleh pasien yang menggunakan layanan ini. Namun, layanan ini memerlukan berbagai adaptasi terutama dalam pertimbangan etik dan regulasi. Perusahaan aplikasi sebagai pihak ketiga dan penyedia layanan, seyogyanya juga mengambil tanggungjawab sebagai “fasilitas layanan kesehatan daring” termasuk menjaga rekam medik, mengelola komplain hingga sengketa medik, serta memiliki tata kelola organisasi layaknya fasilitas layanan kesehatan pada umumnya. Dokter yang menjadi subyek layanan perlu mawas diri dari kekeliruan dalam memberikan simpulan dan konsultasi, terlebih dalam memberikan resep obat. Terutama jangan sampai penyakit yang berpotensi mengakibatkan kematian atau kecacatan tidak teridentifikasi. Pemberian saran dan motivasi kepada masyarakat yang menjadi klien pengguna layanan untuk melanjutkan upaya diagnosis dan penanganan lebih lanjut ke fasilitas layanan kesehatan harus senantiasa dilakukan. Izin praktek dokter perlu diregulasi khusus sehingga dokter yang menjadi subyek layanan terlindung dari aspek hukum administratif. Pemerintah bersama organisasi profesi perlu meregulasi proses-proses yang berkaitan dengan perwujudan hal-hal tersebut.
Treatment of Chronic Hepatitis B Prasna Pramita; Rino A Gani; Ali Sulaiman
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: 10.24871/6120059-15

Abstract

Chronic hepatitis B is still a major health problem in Indonesia. Unfortunately, to date, treatment of chronic HBV (Hepatitis B virus) infection had not shown satisfactory Result. Monotherapy with alpha interferon or lamivudine have been widely used as treatment of chronic HBV. However, treatment response to Alpha interferon in Asian people was not satisfactory (15% - 20%), while monotherapy with lamivudine was not sufficient to eradicate HBV in chronically infected patients and commonly induce drug resistance. The occurrence of chronic hepatitis B resistant to lamivudine had encouraged development of newer agents such as adefovir, entecavir, emtricitabine and nucleoside analog. New therapeutic strategy using combination therapy should be considered if there is no sufficient response to monotherapy. Keywords: Treatment, chronic hepatitis B, combination therapy
Efficacy and Safety of In-Asia-manufactured Interferon alpha-2b in Combination with Ribavirin for Therapy of Naïve Chronic Hepatitis C Patients: A Multicenter, Prospective, Open-Label Trial Nurul Akbar; Ali Sulaiman; Rino Alvani Gani; Irsan Hasan; Laurentius Lesmana; Andri Sanityoso; Sjaifoellah Noer; FX Pridady; Soemarno Soemarno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/10120097-13

Abstract

Background: An open-label, multi center and non-comparative study was conducted to evaluate the efficacy and safety of a more affordable in-Asia-manufactured interferon á-2b product in combination with ribavirin to treat naïve chronic hepatitis C patients. Method: Thirty chronic naïve hepatitis C patients were treated with in-Asia-manufactured interferon   a-2b subcutaneously 3 MIU thrice weekly and ribavirin 800-1,200 mg daily for 48 weeks. Follow-up was done until 24 weeks after the end of treatment. Efficacy was assessed by examining serologic and biochemical parameters at pre and post-treatment. Safety was assessed by evaluating clinical symptoms and laboratory parameters. Results: The virological response and sustained virological response rates of all Hepatitis C Virus (HCV) genotypes were 83.3% and 76.7% respectively. Post-treatment, 80% patients had significant alanine transaminase (ALT) decreased into normal level and remained normal in 76.7% patients at 24th week follow up period. At that time, the ALT level and sustained virological response were lower in HCV genotypes 1 and 4 than in non-1 and non-4 genotypes. The most frequent adverse event was flu-like syndrome. Conclusion: The efficacy and safety study on combination therapy of in-Asia-manufactured interferon a-2b and ribavirin has shown a good result based on the current standard of interferon alpha and ribavirin combination therapy. Keywords: interferons, combination drug therapy, chronic hepatitis C, treatment efficacy, safety
Diagnostic Approach and Treatment of Choledocholithiasis Indah Gianawati; Ali Sulaiman; L A Lesmana; Toar JM Lalisang; Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200471-75

Abstract

Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy. Keywords: Choledocolithiasis, CBD, diagnostic approach
Primary Lymphoma of The Gastrointestinal Tract Agus Sudiro Waspodo; Kukuh B. Rachmat; Wirasmi Marwoto; Ali Sulaiman; A H Reksodiputro
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/21200136-40

Abstract

Chronic hepatitis due to hepatitis B virus (HBV) or hepatitis C virus (HCV) is still a major problem in terms of progressive liver damage, prevention and therapy in most parts of the world. Unfortunately, to date, there is still no specific and effective therapy for HBV. No therapy can be given to carrier, non- replicative and asymptomatic patients of chronic HBV infection. Lamivudine or alpha-interferon can be used for treatment of compensated, chronic hepatitis B infection with significant increase of aminotransferase. Approximately 40 % of patients can have seroconversion with this form of therapy. Chronic hepatitis D virus infection can be treat with alpha-interferon and in the final stage, may undergo liver transplantation. For chronic hepatitis C virus infection, alpha-interferon with ribavirin have been shown to have a better efficacy than alpha-interferon alone where the efficacy can reach 39 – 49 %.    Keywords: hepatitis, interferon, lamivudin,ribavirin
Levels of Adiponectin and Soluble Tumor Necrosis Factor-α Receptor 2 (sNFαR2) in Obese Males with or without Fatty Liver Agus Sulaeman; Syarifuddin Wahid; Ali Sulaiman; Gatot Susilo Lawrence
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (529.549 KB) | DOI: 10.24871/12120111-7

Abstract

Background: Increased lipolysis in obese patients will cause elevated free-fatty acid level leading to insulin resistance. There are varied inflammatory cytokines (sTNFαR2) and anti-inflammatory cytokines (adiponectin) in obese patients, with and without fatty liver (FL). The aim of this study was to determine sTNFαR2 and adiponectin levels in obese patients with and without fatty liver. Method: This study was an observational study with cross-sectional approach, which was conducted between September 2008 and August 2009. The patients were 94 obese male with waist circumference ≥ 90 cm based on criteria of the International Diabetes Federation. Fatty liver was detected by ultrasonography; while adiponectin and sTNFαR2 levels in blood were analyzed by using ELISA Method and blood examination at the clinical laboratory. Results: Levels of adiponectin and sTNFαR2 were different between obese patients with and without FL. The adiponectin level was 3.10 ± 1.14 in patients with FL and was 3.52 ± 1.07 in patients without FL; while the sTNFαR2 were 23.92 ± 6.00 (FL) and 20.61 ± 5.29 (without FL). In patients with low adiponectin level ( 3.33 µ g/L) and high sTNFαR2 level ( 21.78 pg/dL), there was relatively higher occurrence of fatty liver compared to the other patients. Conclusion: Obese patients with fatty liver have higher sTNFαR2 level than patients without fatty liver. Moreover, obese patients with fatty liver have lower adiponectin level compared to patients without fatty liver. Patients with low adiponectin level and high sTNFαR2 level have higher incidence of fatty liver than subjects with high adiponectin level and low sTNFαR2 level. Keywords: adiponectin, soluble tumor necrosis factor α receptor 2 (sTNFαR2), obese, fatty liver
Co-Authors A H Reksodiputro Agus Sudiro Waspodo Agus Sulaeman Andri Sanityoso Anna Rozaliyani Arman A Abdullah Broto Wasisto Frans Santosa FX Pridady Gatot Susilo Lawrence Ghina Faradisa Hatta Indah Gianawati Irsan Hasan Jonathan Hartanto Julitasari Sundoro Kukuh B. Rachmat L A Lesmana Laurentius Lesmana Muhammad Baharudin Nurul Akbar Prasna Pramita Pukovisa Prawiroharjo R Sjamsuhidajat Rianto Setiabudy Rianto Setiabudy Rino A Gani Rino Alvani Gani Sjaifoellah Noer Soemarno Soemarno Soetedjo Soetedjo Syarifuddin Wahid Toar JM Lalisang Wirasmi Marwoto