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All Journal Majalah Kedokteran Nusantara The Journal Of Medical School The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Mabel Sihombing
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Health Professions Medicine & Pharmacology

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Korelasi antara skor Child-Pugh dengan gastropati hipertensi portal pada penderita sirosis hati Faisal Parlindungan; Mabel Sihombing
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction : Hypertensive portal gastropathy (PHG) is a pathologic appearance on the gastric mucosa which can cause acute or chronic bleeding in liver cirrhotic patients. The pathogenesis of PHG is controversial and there is no agreement on the effect of liver dysfunction to PHG. This study aims to evaluate correlation between liver dysfunction severity that is assessed by Child-Pugh score and PHG in liver cirrhotic patients.Methods : This is an analytic cross sectional study. The demographics and clinical data were recorded, laboratory tests were performed (albumin, INR and bilirubin) to calculate Child-Pugh score, and patients underwent esophagogastroduodenoscopy (EGD) to assess PHG. Correlation between Child-Pugh score and PHG were tested with Spearman correlation analysis. Cut-off value of Child-Pugh score was determined with receiver operating characteristics (ROC) analysis which is followed by diagnostic performance analysis.Results : From 41 subjects, there were 8, 18, 15 patients with Child-Pugh class A,B, and C respectively. On endoscopic examination, there were 10,19, and 12 patients without PHG, with mild PHG, and with severe PHG respectively. There is a positive correlation between Child-Pugh score and the severity of PHG (r = 0.556; P = 0.0001). Among Child-Pugh score components, ascites and bilirubin showed positive correlation with PHG. Using cut off point of • 7, Child Pugh score showed 87.1% sensitivity, 40% specificity, 81.8% PPV, 50% NPV, 1.45 LR(+), 0.32 LR(-), accuracy diagnostic was 75.6% and the AUROC was 0.65 (95% CI:0.437-0.860; P = 0.163)Conclusion: Child-Pugh score has a positive correlation with severity of PHG, in which higher Child-Pugh score is correlated with more severe PHG.Keywords : Child-Pugh Score; portal hypertensive gastropathy; liver cirrhotic; endoscopy
Level of Gastrin Serum and Ulcer Size on Gastric Ulcer Correlated to Helicobacter pylori Infection Dasril Efendi; Rustam Effendi; Leonardo Basa Dairy; Juwita Sembiring; Betthin Marpaung; Mabel Sihombing; Sri Maryuni Soetadi; Lukman Hakim Zain
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: 10.24871/1032009113-116

Abstract

Background: Previously has been defined that peptic ulcer has strongly correlated to Helicobacter pylori (H. pylori) infection. But it hasn’t determined about correlation of gastrin serum level to the ulcer severity on H. pylori infection. The aims of this study were to find the percentage of H. pylori infection on peptic ulcer cases and its correlation to the gastrin serum level. Method: This is analytic cross sectional study in 50 patients with gastric ulcer who came to Adam Malik hospital from February to October 2007. The correlation between gastrin serum level and the size of ulcer with positive and negative Urea Breath Test (UBT) group was analyzed by unpaired student t- test. The correlation between gastrin serum level and ulcer size were investigated with Pearson correlation test and linier regression. Result: Fifty eligible patients, 33 (66%) had positive UBT and 17 (34%) were negative. There were statistically significant difference on gastrin serum level in positive UBT and negative respectively (p = 0.017). There were also significant difference between mean of ulcer size in positive UBT and negative respectively (p = 0.025). There were correlation between gastrin serum level and ulcer size (r = 0.315; p = 0.026). It can predict the increasing ulcer size in 0.012 mm every 1 pg/mL of gastrin serum elevated. Conclusion: Patients with positive UBT has greater ulcer size and higher gastrin level as compared to the negative group. There were positive correlation between gastrin serum level to the size of ulcer in peptic ulcer patients and increase of ulcer size followed with elevated of gastrin serum level. Keywords: Helicobacter pylori infection, gastrin serum level, ulcer size
Diagnostic Findings and ERCP Treatment in Patients with Obstructive Jaundice during two years at H. Adam Malik Hospital, Medan Gontar A. Siregar; Juwita Sembiring; Mabel Sihombing; Betthin Marpaung; Sri Sutadi; Abiran Nababan; Lukman Hakim Zain; Pengarapen Tarigan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200339-42

Abstract

Background: The methods of ERCP have been used for diagnostic and therapeutic purposes to pass bile fluid and extract stones from the bile duct in patients with obstructive extrahepatic jaundice. Method: A retrospective study was performed on patients with obstructive extrahepatic jaundice patients who underwent ERCP during a two-years time period from January 1999 to December 2000. ERCP was performed with a premedication of 10 mg midazolam, followed by a chollangiography contrast containing 1 mg/dl of Garamicin and 25 mg of Pethidine if sphincterotomy was performed. Results: From 126 patients with obstructive extrahepatic jaundice treated with ERCP, the male to female ratio was 1.86:1. The majority of the (group) of patients were between 51-60 years of age (33.3 % ). The youngest patient (group) was 24 years and the oldest 97 years. The diagnostic study found the following cases: normal 3 cases (2.8%), bile duct stone 46 cases (43.4%), carcinoma of ampula vater 20 cases (18.9%), CBD tumor 7 cases (6.6%), carcinoma of head of pancreas 2 cases (1.9%), diverticle 4 cases (3.8%), duodenal tumor 1 case (0.9%), carcinoma of ampula vater and bile duct stone 1 case (0.9%), SOD 5 cases (4.7%), CBD stricture 1 case (0.9%) and failure 16 cases (15.1%). The patients receivied the following treatment: sphyncterotomy 36 cases (51.4%), stent application 11 cases ( 15.7%), sphincterotomy with stent 18 cases (25.7%) and basket method 5 cases (7.1%). Keywords: ERCP, obstructive jaundice
S-Index and APRI Score to Predict Liver Fibrosis Chronic in Hepatitis B and C Patients Elias Tarigan; Leonardo Basa Dairy; Juwita Sembiring; Mabel Sihombing; Gontar Alamsyah Siregar; Lukman Hakim Zain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.107 KB) | DOI: 10.24871/142201364-68

Abstract

Background: A great interest has been dedicated to the development of non invasive predictive models in recent years to substitute liver biopsy for fibrosis assessment and follow-up. The aim of this study was to comparethe accuracy between S-index and aspartate aminotransferase to platelet ratio index (APRI) to FibroScan for predicting liver fibrosis in chronic hepatitis B and C patients.Method: A cross-sectional study was conducted in 40 patients with chronic hepatitis B and C between January 2010 - May 2011 at Division of Gastroentero-hepatology, Department of Internal Medicine, Adam Malik Hospital, Medan. Patients underwent laboratory examination and FibroScan, then used predictive values to assess the accuracy of S-index scores and APRI compared to FibroScan. The analysis was performed using SPSS 15.0.Results: S-index identified significant fibrosis in 87.5% patients with sensitivity (Se) 87.5% and specificity (Sp) 100%. About 67.5% of 40 patients could be identified correctly. S-index also could accurately predict the absence or presence of cirrhosis in 87.5% of the total 40 patients, with NPV 91.7% and PPV 81.25%, respectively. APRI for significant fibrosis has Se 85.7%, Sp 88%, PPV 88.8%, NPV 69.2%; while Se 53%, Sp 88%, PPV 72.7%, NPV 75.8% for liver cirrhosis. AUROC value for S-index was higher than APRI in predicting significant fibrosis and cirrhosis, i.e. 0.938 vs. 0.917 and 0.873 and 0.707, respectively.Conclusion: The S-index has a higher accuracy than APRI in predicting significant fibrosis and cirrhosis in patients with chronic hepatitis B virus and hepatitis C virus infection.Keywords: S-index, APRI score, FibroScan, chronic hepatitis B and C
The Profile of Upper Gastrointestinal Endoscopy in Deli Serdang Hospital Herryanto Lumbantobing; Leonardo Basa Dairi; Juwita Sembiring; Mabel Sihombing; Betthin Marpaung; Sri Maryuni Sutadi; Lukman Hakim Zain
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 | DOI: 10.24871/121201134-37

Abstract

Background: Upper gastrointestinal endoscopy profile has been reported by many hospitals; however, there has never been from Deli Serdang hospital, North Sumatera. The aim of study was to determine the profile of upper endoscopy at Deli Serdang hospital. Method: The study was conducting retrospectively 453 patients during the period of December 2006– December 2008 at the Endoscopy Unit Department of Internal Medicine Deli Serdang hospital. Data were obtained from medical records including the age, sex, race, indications, and endoscopic diagnosis. All data were reported descriptively. Results: Out of 453 patients who underwent upper gastrointestinal endoscopy, 241 (53.20%) patients were male. The mean age was 66.3 ± 15.6. Most patients (51.88%) were between 40-59 years of age. Regarding the ethnicity, there were 30.91% Bataknese patients, 21.85% Javanese, 18.98% Karonese, 14.79% Malays, and 13.47% patients of other ethnicities. Dyspepsia was the mostly found indication, which was found in 75.94% patients. It was followed by hematemesis/melena in 15.01% patients and other indications in 6.84% patients. About 33.11% patients had normal upper gastrointestinal diagnosis; while gastritis was found in 26.93% patients, erosive gastritis in 18.98% patients, gastric/duodenal ulcer in 8.83%, and esophageal varices in 5.74% patients. Conclusion: About 453 patients have undergone upper gastrointestinal endoscopy during 2 years period. This study shown greater number of male patients compared to female and the patients were most frequently between 40-59 years old. Normal upper gastrointestinal diagnosis was the most frequently found in this study. Keywords: upper gastrointestinal endoscopy, profile, indications, endoscopic diagnosis
Profile of Colorectal Cancer Patients in Endoscopic Unit at Dr. Pirngadi Hospital - Medan Rustam Effendi; Dasril Efendi; Leonardo Basa Dairy; Juwita Sembiring; Mabel Sihombing; Betthin Marpaung; Sri Maryuni Soetadi; Gontar Alamsyah Siregar; Lukman Hakim Zain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/93200878-81

Abstract

Background: Colorectal cancer is the third most prevalent cancer and the second leading cause of cancer death worldwide every year. Rates of this malignancy vary by country. In Indonesia, the prevalence is estimated to have an increased tendency. The objectives of this sudy was to examine the prevalence and profile of colorectal cancer, which are diagnosed by endoscopic examination. Method: The study was conducted retrospectively, by examining the Result of endoscopic findings of patients with rectal bleeding, altered bowel habit, chronic diarrhea, unexplain abdominal pain, and other signs and symptoms at The Endoscopic Unit Department of Internal Medicine, Dr. Pirngadi hospital from January 2004 to June 2008. Results: We found 197 patients with colorectal cancer (CRC) from 760 patients examined by colonoscopy (25.9%). One hundred and one patients (51.3%) out of 197 CRC patients were female. Most were in the group of age 51-60 years (28.9%). The most frequent ethnic of the patients were Bataknese (46.2%). The most common symptom was rectal bleeding (70.6%). The most common location of CRC was in the rectum (74.6%). Histopathologic Result was adenocarcinoma. Conclusion: The prevalence of colorectal cancer in this study were twenty six percents. Rectal bleeding appeared to be the most common sign in this study. Rectum was the most common site of the cancer. Most of patients were Bataknese. Patients were at advanced stage and most of them were having well-differentiated adenocarcinoma.   Keywords: colorectal cancer, rectal bleeding, altered bowel habits, colonoscopy
Co-Authors Abiran Nababan Betthin Marpaung Dasril Efendi Elias Tarigan Faisal Parlindungan Gontar A. Siregar Gontar Alamsyah Siregar Herryanto Lumbantobing Juwita Sembiring Leonardo Basa Dairi Leonardo Basa Dairy Lukman Hakim Zain Pengarapen Tarigan Rustam Effendi Rustam Effendi Sri Maryuni Soetadi Sri Maryuni Sutadi Sri Sutadi