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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia

Kaka Renaldi

Division Of Gastroenterology, Pancreatobiliary, And Digestive Endoscopy Department Of Internal Medicine, Faculty Of Medicine, Universitas Indonesia/ Dr. Cipto Mangunkusumo National General Hospital, Jakarta

Author-ID : 359336

Medicine & Pharmacology

Published : 27 Documents Claim Missing Document

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The Risk Factors of Pancreatic Cancer Patients in Dr. Cipto Mangunkusumo National Hospital, Jakarta During 2014-2019 Kaka Renaldi; Teddy Septianto; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 2 (2020): VOLUME 21, NUMBER 2, August 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Pancreatic cancer is a very rare cancer with age-adjusted rates ranging from about 5 to 10 new cases per 100,000 persons per year. It has one of the worst prognoses of any type of cancer, with a 5-year survival rate of only 4.6%. Several risk factors have been identified, including older age, smoking, familial history of pancreatic cancer, obesity, chronic pancreatitis, diabetes mellitus, and alcohol consumption.Method: This was a descriptive study describing the risk factors of patients who were diagnosed with pancreatic cancer in the period between 1 January 2014 – 1 January 2019 at the Cipto Mangunkusumo National Referral Hospital (RSCM) Jakarta. Data were obtained from the medical records and Endoscopic Retrograde Cholangiopancreatography (ERCP) database from the RSCM Gastrointestinal Endoscopy Center.Results: From January 2014 to January 2019 there were 123 patients with newly diagnosed pancreatic cancer in RSCM. The mean age was 52 years old. The incidence of pancreatic cancer is more common in men (53%) than women (47%). The most common risk factor identified is smoking which was found in 29% of patients, followed by obesity at 27.9% and a history of diabetes mellitus at 19.5%. Risk factors with a fairly low prevalence include alcohol consumption at 9.7% and chronic pancreatitis at 2.4%. No family history of pancreatic cancer is identified in any subject.Conclusion: Smoking, obesity, and diabetes mellitus are common risk factors in pancreatic cancer patients. In contrast, chronic pancreatitis, alcohol consumption, and family history of pancreatic cancer are less commonly identified in patients.

The Role of β-1.3/1.6-D-Glucan From Ganoderma lucidum Mycelium Extract in Ulcerative Colitis Marcellus Simadibrata; Aditya Rachman; Saskia Aziza Nursyirwan; Murdani Abdullah; Rabbinu Rangga Pribadi; Raja Mangatur Haloho; Anthony Eka Wijaya; Daniel Martin Simadibrata; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Ulcerative colitis (UC) is an idiopathic inflammatory disease that affects the colon. Current pharmacological modalities to treat UC have various side effects; therefore, there is a demand to develop a new alternative medicine that can reduce side effects and increase drug efficacy. One candidate for alternative therapy is Polysaccharide Peptide which is extracted from Ganoderma lucidum mycelium. This Polysaccaharide has an active compound of Β-1,3/1,6-D-Glucan which has strong immunomodulatory and anti-inflammatory properties. Various studies have reported that Ganoderma lucidum polysaccharides can reduce inflammatory markers such as TNF-α, IFN-γ, and IL-17A, which is produced by colonic mucosal inflammation. In addition, β-1,3/1,6-D-Glucan has shown improvements in inflammatory parameters and intestinal immunological barrier function animal studies with artificial colitis and requires further research in humans before clinical applications.

Survival of Pancreatic Cancer Patients in Dr Cipto Mangunkusumo National Referral Hospital Jakarta from November 2018 To December 2018 Kaka Renaldi; Atikah Isna Fatya; Sharifah Sakinah
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

Background: Pancreatic cancer is a leading cause for cancer deaths worldwide and its survival rate remains low. The one year- and five year-survival rate remain as low as 21% and 6-8% consecutively. Little is known about the survival rate of pancreatic cancer in Indonesia. This study aims to evaluate the survival rate of pancreatic cancer patients at Gastrointestinal Endoscopy Center, National Referral Hospital Dr. Cipto Mangunkusumo, Jakarta, during November 2018 to December 2018.Method: This retrospective cohort study extracted the registry data of newly diagnosed pancreatic cancer patients between November 2018 to December 2018 from the Gastrointestinal Endoscopy Center, Cipto Mangunkusumo Hospital, Jakarta. All patients were followed since they were diagnosed to two months after diagnosis or 31st December 2018 or to their date of death, whichever came first.Results: We found 12 newly diagnosed pancreatic cancer cases between November 2018 to December 2018. The mean age at diagnosis was 55 years old, with 58% male, 50% sundanese, and 75% patient come from low educated level. About 58% cases presented with cholangitis, and the mean bilirubin concentration at diagnosis was 26 mg/dL. All patient came with an obstructive jaundice symptoms, and 91% had endoscopic biliary drainage procedure. After 2 months of observation, we found 16% patient died due to unresolved infection.Conclusion: There were 12 cases of pancreatic cancer, of which 16% pancreatic cancer patients died within 2 months of follow up. Infection is the main cause of morbidity and mortality in pancreatic cancer patients.

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.

Management of Gastric Motility Disorder Mustika Dian Permana; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Gastric motility disorder or gastroparesis is an objective slowing of gastrointestinal emptying syndrome, in the absence of mechanical obstruction, with cardinal symptoms such as rapid feeling of fullness, fullness sensation after eating, nausea, vomiting, bloating, and upper abdominal pain. Patients with gastroparesis are at risk of weight loss, malnutrition, and lack of vitamins and minerals, as well as increasing morbidity and mortality. The prevalence and incidence data of gastroparesis do not describe the true reality, because of the complexity of diagnosis. Beside Diabetes mellitus, many other causes should also be considered. Several studies have shown that nausea, vomiting and fullness sensation in abdominal are the most associated symptoms with gastroparesis. A 4-hour solid phase gastric emptying scintigraphy is the diagnostic standard for the slowing of gastric emptying. Lowest effective dose metoclopramide starting with a dose of 3 x 5 mg is the first line for pharmacological therapy. For persistent or refractory gastroparesis with pharmacologic therapy, gastric electrical stimulation (GES) and surgical therapy may be considered. The management should involve relevant medical team by not forget to consider patient comfort.

Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation Hasan Maulahela; Kaka Renaldi; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Small bowel ectopic varices is a rare etiology for obscure gastrointestinal bleeding. Ectopic varices in the absence of portal hypertension can be caused by congenital or familial conditions (e.g. malformation of vessel). Bleeding caused by ectopic varices can be massive and life threatening. Single Balloon Enteroscopy (SBE) is one of diagnostic modalities for obscure gastrointestinal bleeding. We report one case of obscure overt gastrointestinal bleeding with sub-acute onset. Previous esophagogastroduodenoscopy and colonoscopy cannot found the source of bleeding. On the enteroscopy we found varices at proximal jejunum with active bleeding during procedure. We applied hemostatic powder to stop the bleeding and proceed to surgery. Surgery was performed by enteroscopy guide. The jejunum section with varices was resected and the pathology confirmed the malformation of arteriovenous. Currently there is no available guideline or randomized study for the treatment of ectopic varices. Treatment options include ligation, sclerotherapy, surgery and interventional radiology. In this patient we choose surgery because of massive gastrointestinal bleeding.

Through-the-scope Polyethylene Balloon Dilations in Benign Corrosive Esophageal Stricture Complicated with Temporomandibular Joint Dislocation Elli Arsita; Achmad Fauzi; Jeffri Gunawan; Kaka Renaldi; Ari Fahrial Syam; Murdani Abdullah; Marcellus Simadibrata; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Esophageal dilation is a non-surgical management for anatomic and functional abnormalities causing both benign and malignant esophageal stricture. The basic goals of stricture dilation include safe and efficacious lumenal enlargement plus prevention of restenosis. These could be achieved using through- the-scope (TTS) balloon dilations, ranged in diameter of 4 to 40 mm, they will allow dilation of previously inaccessible strictures in the esophagus, stomach, small bowel, and colon. There are 5,000–15,000 cases of stricture due to ingestion of corrosive substances in United States every year. The following case would demonstrate a 28-year-old male with depressive disorder who attempted a suicide by ingesting corrosive substances two months before admission. Subsequently he started having difficulty in swallowing even soft foods. The complaint was gradually increasing until a month before admission he went through endoscopic examination and a corrosive esophageal stricture found. Hence after, he underwent dilation using Savary bouginage with fluoroscopy and through-the-scope (TTS) balloon dilations. The patient underwent a series of dilation treatment and demonstrated vigorous improvement. Problems raised as the patient was complicated with temporomandibular joint (TMJ) dislocation due to traumatic injury after ingesting corrosive substances. The consideration in management of esophageal stricture with complications will be discussed further in this article. Keywords: esophageal stricture, corrosive substances, dysphagia, temporomandibular joint dislocation, through-the-scope polyethylene balloon dilation

Prevention and Management of Refeeding Syndrome Andika Indrarespati; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Refeeding Syndrome is a syndrome which occurs as a result of food administration in poorly nourished individuals. In this syndrome, there are wide range of biochemical alterations, clinical manifestations, and complications, starting from mild (asymptomatic) to severe (death). This syndrome was initially proposed in 1950s; however, there is still no agreement for its clear definition, causing clinicians to be less aware and tend to overlook this condition. Clinical manifestations which usually appear include electrolyte imbalances (hypophosphatemia, hypokalemia, hyponatremia, hypomagnesemia) and vitamin B1 deficiency. The main principle in management of refeeding syndrome is prevention, where clinicians need to identify this condition in the early stage in high risk individuals, supervision during refeeding, and administration of appropriate diet.

Influence of Fucoidan in Mucus Thickness of Gastric Mucosa in Patients with Chronic Gastritis Kaka Renaldi; Marcellus Simadibrata; Ari Fahrial Syam; Abdul Aziz Rani; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Chronic gastritis is commonly found with complains of dyspepsia, which may decrease work productivity. Imbalance between agressive and defensive factors is the cause of chronic gastritis. Therapy is mostly directed to the agressive factors, particularly gastric acid and very few studies are directed on defensive factors. Mucus is the first defense mechanism of gastric mucosa. Fucoidan is a phytopharmaca, which is thought to increase the thickness of gastric mucosa. The objective of this study was to know the thickness of gastric mucosa in patients with chronic gastritis and to evaluate the effect of fucoidan to the gastric mucosa thickness in patients with chronic gastritis. Method: In this double-blinded randomized clinical trial study, 41 patients in the Endoscopy Unit Cipto Mangunkusumo Hospital between October 2009 and October 2010 were enrolled consecutively. Selected patients were divided into 2 groups: a group was given fucoidan and another group was given placebo. Statistical analysis was done using T-test. Results: Of 41 chronic gastritis patients, only 34 patients completed this study. There was difference of mucus thickness of gastric mucosa in patients with chronic gastritis; in the antrum 42.59 µ m (± 8.67) and in the corpus 44.28 µ m (± 9.64). This study also showed that fucoidan administration increased the mucus thickness in the antrum by 7.42 µ m and in the corpus by 7.74 µ m compared to placebo significantly. Conclusion: Fucoidan increased the mucus thickness of gastric mucosa in patients with chronic gastritis. Keywords: mucus thickness, chronic gastritis, fucoidan

High-Protein Dietary Supplementation and Nutritional Status Improvement of Malnourished Patients in Hospital Care Marcellus Simadibrata; Fiastuti Witjaksono; Yohannessa Wulandari; Raja Mangatur Haloho; Rabbinu Rangga Pribadi; Murdani Abdullah; Aditya Rachman; Anthony Eka Wijaya; Batara Bisuk; Daniel Martin Simadibrata; Rizka Mutiara; Kaka Renaldi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.

Co-Authors -, Resultanti Abdul Aziz Rani Abdul Aziz Rani Achmad Fauzi Achmad Fauzi Achmad Fauzi ACHMAD FAUZI Aditya Rachman Aditya Rachman Aditya Rachman, Aditya Adityo Susilo, Adityo Aisyah - Amanda P Utari, Amanda P Amanda Pitarini Utari Andika Indrarespati Anshari Saifuddin Anshari Saifuddin, Anshari Anthony Eka Wijaya Anthony Eka Wijaya Ari F Syam Ari F Syam Ari Fahrial Syam Ari Wijayanti Atikah Isna Fatya Batara Bisuk Chudahman Manan Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Daldiyono Daniel Martin Simadibrata Daniel Martin Simadibrata E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Elli Arsita Elli Arsita Ening Krisnuhoni Fatya, Atikah Isna Fiastuti Witjaksono Firman, Fauzan Hertrisno Friatna, Yudha Haloho, Raja Mangatur Harini Oktadiana Harini Oktadiana, Harini Hasan Maulahela Hasan Maulahela Hasan Maulahela, Hasan Hidayat, Leonardus Wibowo Hilda Nurmalihah Hosea, Fransiscus Nikodemus Ika Prasetya Wijaya Ikhwan Rinaldi Indah Situmorang Indra Marki Indra Marki Indrarespati, Andika Jaffray DP Rambak Jeffri Gunawan Kusumaningrum, Profitasari Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Meutia Gebrina Meutia Gebrina, Meutia Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Mustika Dian Permana Mustikarani, Dewi Mutiara, Rizka Muzellina, Virly Nanda Nury Dyah Nury Dyah, Nury Permana, Mustika Dian Prabowo, Muhamad Reza Pradana Soewondo Pradana Soewondo Pratiwi, Amalia Nur Rabbinu Rangga Pribadi Rabbinu Rangga Pribadi Raja Mangatur Haloho Raja Mangatur Haloho Raymond R. Tjandrawinata Rezky Aulia Nurleili, Rezky Aulia Rino Alvani Gani Rizka Mutiara Roy Soetikno Rudy Kurniawan Rumagesan, Djahalia Saskia Aziza Nursyirwan Saskia Aziza Nursyirwan Saskia Aziza Nursyirwan, Saskia Aziza Shakinah, Sharifah Sharifah Sakinah Simadibrata, Daniel Martin Susanto, Liana W Tandan, Manu Teddy Septianto Wulandari, Yohannessa Yohannessa Wulandari

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