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All Journal Damianus Journal of Medicine The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Arif Sejati
Unknown Affiliation
Health Professions Medicine & Pharmacology Public Health

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Gastric Outlet Obstruction due to Peptic Ulcer Disease Arif Sejati; Achmad Fauzi
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 (661.551 KB) | DOI: 10.24871/1222011123-126

Abstract

Gastric outlet obstruction is a rare complication of peptic ulcer disease, resulting from acute or chronic inflammatory changes. Patient may present asymptomatic or may have mild gastrointestinal symptoms. Some complications may include indirect systemic disorders such as water, acid-base, and electrolyte imbalance, which could be fatal. Acute management should include gastric decompression, correction of water and electrolytes abnormalities, as well as reduction of spasm and edema by using acid-supressants. After the patient has been stabilized, more definite measures should be taken such as endoscopic dilatation or surgery and treatment of peptic ulcer itself. Nowadays, endoscopic dilatation has been performed by using through-the-scope balloon dilating catheters. The diameter of balloon is usually increased gradually over several sessions. Long-term recurrence after endoscopic baloon dilatation has been reportedly low. Keywords: peptic ulcer, gastric outlet obstruction, endoscopic baloon dilatation
Use of Clinical Parameters and Strain Echocardiography to Predict Stenosis Severity based on Gensini’s Score in Stable Coronary Artery Disease Sejati, Arif; Alwi, Idrus; Muhadi, Muhadi; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. In patient with stable coronary artery disease (CAD), severity of stenosis is closely related to prognosis. It is known that several clinical parameters and recently-developed strain echocardiography can predict severity of stenosis. Assessment of clinical parameters, altogether with strain echocardiography is expected to make better prediction. This study aim to determine whether clinical factors, i.e. age, sex, diabetes, typical angina, and history of myocardial infarction, and strain echocardiography parameter, i.e. global longitudinal strain (GLS), can predict severity of coronary artery stenosis measured with Gensini score,and to further develop a prediction model based on significant parameters. Methods. This is a cross-sectional study taken at Dr. Cipto Mangunkusumo National Central General Hospital during period March – May 2019. Patient with stable CAD scheduled to undergo coronary angiography is recruited consecutively. Bivariate analysis using chi-square is performed to each predictor. Significant predictors are further analysed using backward stepwise logistic regression. A prediction model is then developed based on significant predictors by multivariate analysis. Results. The study group include 93 subjects. Significant predictors on bivariate analysis include diabetes melitus (OR 2.79; 95% CI:1.08-7.23), history of myocardial infartion (OR 4.04; 95% CI:1.51-10.80), typical angina (OR 5.01; 95% CI:1.91-13.14), and GLS ≥-18.8 (OR 30.51; 95% CI:10.38-89.72). Significant predictors on multivariate analysis are typical angina (OR 4.48; 95% CI:1.39-14.47) and GLS ≥18.8 (OR 17.30; 95% CI:5.38-55.66). Predicton model is not developed because there are only two significant predictors. Conclusions. Typical angina and GLS are predictors of stenosis severity in patient with stable CAD. Age, sex, diabetes, and history of myocardial infarction are not significant predictors. A prediction model can not developed because there are only 2 significant predictors.
Kardiomiopati pada Penderita Infeksi HIV Sejati, Arif; Wijaya, Ika Prasetya
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 2
Publisher : UI Scholars Hub

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Jantung adalah salah satu organ yang dapat menjadi sumber morbiditas dan mortalitas pada penderita Human Immunodeficiency Virus (HIV)/ Acquired Immunodeificiency Syndrome (AIDS) namun jarang mendapat perhatian khusus. Sebelum era penggunaan highly active antiretroviral therapy (HAART) kelainan jantung khususnya kardiomiopati cukup sering ditemukan. Kardiomiopati didefinisikan sebagai kelompok penyakit heterogen yang dihubungkan dengan disfungsi mekanik dan/atau elektrik yang biasanya (namun tidak selalu) didapatkan hipertrofi atau dilatasi ventrikel yang abnormal dan disebabkan oleh beragam penyebab, kebanyakan genetik. Kardiomiopati pada pasien dengan HIV dapat digolongkan ke dalam kardiomiopati dilatasi yang didapat. Kardiomiopati pada penderita HIV/AIDS disebabkan oleh berbagai faktor: virus HIV, miokarditis, obat-obatan, dan status nutrisi. Pencegahan dan pengobatan dini HIV/AIDS menjadi faktor penting dalam mengurangi morbiditas dan mortalitas akibat kardiomiopati.
Sindrom Gitelman dengan manifestasi paralisis hipokalemia pada wanita hamil Adisuhanto, Marcella; Santosa, Yudistira Panji; Sejati, Arif; Riani, Mutiara; Steffanus, Mario; Yuwono, Angelina; Wiranatha, Jennifer; Cendana, Adrian Surya; Iryaningrum, Maria Riastuti
Bahasa Indonesia Vol 23 No 1 (2024): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v23i1.4231

Abstract

Pendahuluan: Sindrom Gitelman merupakan kondisi tubulopati kehilangan garam yang ditandai dengan alkalosis metabolik dengan hipokalemia, hipomagnesemia, dan hipokalsiuria. Kasus sindrom Gitelman pada kehamilan jarang dipublikasikan hingga saat ini. Laporan Kasus: Seorang wanita berusia 23 tahun pada kehamilan ketiga dengan usia gestasi 21 minggu datang dengan kelemahan pada kedua tungkai dan kekakuan pada kedua tangan, kemudian terdiagnosis dengan sindrom Gitelman (SG). Pasien memiliki riwayat emesis gravidarum dan defek septum atrium (DSA). Pada pemeriksaan neurologis didapatkan penurunan kekuatan motorik pada kedua tungkai. Pemeriksaan elektrolit menunjukkan adanya hiponatremia, hipokalemia, hipokalsemia, dan hipomagnesemia, serta terdapat peningkatan kadar natrium, kalium, dan klorida pada urin. Ekokardiografi menunjukkan adanya defek septum atrium sekundum dengan left-to-right shunt. Selama perawatan, pasien diberikan natrium, kalium, kalsium, dan magnesium secara intravena yang kemudian dilanjutkan secara oral. Pasien kemudian melahirkan bayi yang sehat dan tidak ditemukan komplikasi selama dan sesudah persalinan. Dua bulan setelah persalinan, pasien kontrol ke poliklinik penyakit dalam dan kondisinya stabil dengan dosis suplementasi kalium yang diturunkan. Diskusi: Pasien dengan SG mengalami gangguan dalam kon-servasi kadar kalium dan magnesium. Kondisi ini dapat diperburuk dengan perubahan fisiologis yang terjadi selama kehamilan, meliputi ekspansi volume serta meningkatnya aliran darah ke ginjal dan laju filtrasi glomerulus, yang berkontribusi terhadap hipo-kalemia. Selain itu, terdapat peningkatan kebutuhan kalium dan magnesium pada populasi ibu hamil. Efek protektif yang menurun juga semakin memperburuk penurunan kadar kalium dan magnesium. Simpulan: Diagnosis dan tatalaksana yang baik dapat membantu ibu hamil dengan SG dan DSA menjalani persalinan dengan lancar dan melahirkan bayi yang sehat.
Co-Authors ACHMAD FAUZI Achmad Fauzi Adisuhanto, Marcella Cendana, Adrian Surya E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Idrus Alwi Idrus Alwi Ika Prasetya Wijaya Maria Riastuti Iryaningrum Mario Steffanus Muhadi Muhadi Muhadi Muhadi, Muhadi Riani, Mutiara Wiranatha, Jennifer Yudistira Panji Santosa Yuwono, Angelina