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All Journal Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) The Indonesian Biomedical Journal Universa Medicina Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Gontar Alamsyah Siregar

Department Of Internal Medicine, Medical Faculty, University Of North Sumatra, Medan, Indonesia

Author-ID : 381791

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Correlation Between Esophageal Varices and Lok Score as a Non-invasive Parameter in Liver Cirrhosis Patients Iqbal Sungkar; Leonardo Basa Dairi; Gontar Alamsyah Siregar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Bleeding from gastro-esophageal varices is the most serious and life-threatening complication of cirrhosis. Endoscopic surveillance of esophageal varices in cirrhotic patients is expensive and uncomfortable for the patients. Therefore, there is a particular need for non-invasive predictors for esophageal varices. The aim of the present study was to evaluate association of esophageal varices and Lok Score as non-invasive parameter in liver cirrhosis patients.Method: This is a cross-sectional study of patients admitted at the Adam Malik hospital Medan between September to December 2014 with a diagnosis of cirrhosis based on clinical, biochemical, ultrasound, and gastroscopy. Lok Score was calculated for all patients, tabulated and analyzed.Results: Among 76 patients with esophageal varices, 55.3% was due to hepatitis B virus (HBV). The majority of patients were Child C with only 13,2% being Child Pugh class A. Majority of the population had F2 esophageal varices (42,1%), F1 (32,9%), and F3 (25%). There is significance difference between Lok Score and grading of esophageal varices, Lok score is higher in Large esophageal varices compared with small esophageal varises (0.92 ± 0.14 vs. 0.70 ± 0.29; p = 0.001). Lok Score cut-off value of 0,9141 was highly predictive in the diagnosis large esophageal varices with a sensitivity of 74.5%, specificity of 72%, positive predictive value of 84%, negative predictive value 58%, and accuracy was 73.7%.Conclusion: Lok Score was significantly associated with esophageal varices. Lok score is a good non-invasive predictor of large esophageal varices in cirrhotic patients.

Relationship Between Staging and Carcinoembryonic Antigen Serum Levels In Colorectal Cancer Patients' Agusrly, Chandra; Sungkar, Taufik; Siregar, Gontar Alamsyah
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 3 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

The staging can be used as one of the prognostic factors providing a clinical picture of the patient in the future in colorectal cancer patient. In addition, carcinoembryonic antigen (CEA) as tumor markers can determine the commonly used diagnosis and prognosis of colorectal cancer. Objective: The aims study was to investigate the relationship of the staging and carcinoembryonic antigen serum levels in colorectal cancer patients. Methods. This was an analytical study with a cross-sectional design. The sample used was colorectal cancer patients at H. Adam Malik General Hospital, Medan from January 2016 to December 2018. As many as 52 subject study who met the inclusion and exclusion criteria. The Kruskal-Wallis test was used to determine relationship between staging and CEA serum levels. Results: The median value of carcinoembryonic antigen levels in Stage I, II, III, and IV group was (2.74 ng/ml vs 6.16 ng/ml vs 2.52 ng/ml, vs 26.87 ng/ml; p=0.003) respectively. Conclusion: There was relationship between staging and carcinoembryonic antigen serum levels in colorectal cancer patient

Differences in Inflammatory Parameters of Child-Pugh B and Child-Pugh C Scores of Liver Cirrhosis with Hepatorenal Syndrome Panggabean, Lider Olmen; Siregar, Gontar Alamsyah; Lubis, Masrul
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 3 No. 1 (2021): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Background: Child-Pugh score is used to predict the poor prognosis of liver cirrhosis patients. The study objectives analyzed differences in inflammatory parameters of Child-Pugh B and Child-Pugh C of liver cirrhosis with hepatorenal syndrome. Method: Desain's study is cross-sectional in liver cirrhosis patients with hepatorenal syndrome.Â This research was approved by the Health Research Ethics Commission FK USU / RSUP H. Adam Malik Medan and meets the criteria of inclusion or exclusion. Diagnosis of Liver cirrhosis Child-Pugh B and Child-Pugh C score is done by clinical examination, laboratory, and ultrasound, CT scan, MRI. The hepatorenal syndrome was diagnosed using Criteria International Ascites Club, 2007. Results: The sample number of this study was 26 liver cirrhosis with hepatorenal syndrome patients consisting of Child-Pugh B patients 9 patients and Child-Pugh C patients 17Â patients. The comparison between Child-Pugh B and Child-Pugh C has significant differences in leukocyte, Na, Cl, SGOT, and CTP. There is a significant correlation between CTP and leukocytes, platelets, Cl, creatinine, GFR, albumin, total bilirubin, and glued bilirubin. Conclusion: There is no clear difference in the inflammatory parameters of the Child-Pug B and Child-Pug C scores in liver cirrhosis with hepatorenal syndrome.

Relationship Between BMI Degree and Non-Alcoholic Fatty Liver Disease Risk Factors Marpaung, Chairunnisa Fitri; Siregar, Gontar Alamsyah; Ilhamd
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 3 No. 1 (2021): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Background: Obesity is a major risk factor for cardiovascular disease, type 2 diabetes, high blood pressure, sleep apnea, psychological issues, some musculoskeletal conditions, and some cancers. The aim of the study to evaluate the correlation between BMI and risk factor of non-alcoholic fatty liver disease (NAFLD). Method: The research was conducted cross-sectionally in NAFLD patients who were treated at RSUP H Adam Malik Medan and got approval from the Ethics Commission for Health Research. Sample research is NAFLD patients who are taken in consecutive sampling that meets the criteria of inclusion and exclusion.Â Body mass index (BMI) is obtained by dividing a person's weight in kilograms by their height in square meters, define obesity (OB) if BMIÂ >Â 25,Â overweightÂ (OW) BMIÂ 23-24.9, and normoweight (NW) BMI 18.5-22.9. Diagnose NAFLD by performing ultrasound examination, resistin and adiponectin examination with ELISA (Sandwich Immunoassay), liver function according to IFCC (International Federation of Clinical Chemistry), and albumin checked by BCG method. Result: There were 67 patients (NM=32, OW=15, OB=20) NAFLD with an average age of 42.1Â± 11.9 years,Â Comparison of NAFLD risk factors in normoweight, overweight, and obesity, showing very significant results (all p<0.001). There is a very significant correlation between BMI and all NAFLD risk factors (all p<0.001). Conclusion: There are very significant correlates between BMI and all inflammatory factors of NAFLD.

Association of Child-Pugh Score with Renal Dysfunction in Liver Cirrhosis Patients Utomo, Edrick; Siregar, Gontar Alamsyah
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 3 No. 4 (2021): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Background Renal dysfunction remains a common and serious complication in cirrhotic patients and affecting the prognosis of the patient. Early prevention, diagnosis, and treatment are important to avoid any morbidity and mortality caused. This study aims to evaluate the association between the Child-Pugh score and its parameters with renal dysfunction in liver cirrhosis. Method This study was a retrospective cross-sectional by design. This study was conducted at Adam Malik General Hospital with a total sampling of liver cirrhosis inpatients in January 2017-December 2018 periods. Result Total 259 patients were included with data collected from the medical record. The results of statistical analysis with Chi-square and Fisherâ€™s Exact founded an association between Child-Pugh (p=0.003) and ascites (p=0.014) with renal dysfunction in liver cirrhosis patients. Meanwhile, hepatic encephalopathy was not found in an association with p-value=0.144. Mann-Whitney test used to evaluate median differences of albumin, bilirubin and international internalized ratio (INR) in groups of liver cirrhosis with and without renal dysfunction. The results, albumin was found significant differences with p-value=0.017. Bilirubin and INR were found no significant differences (p>0.05). Conclusion It was concluded association found between Child-Pugh score with renal dysfunction in liver cirrhosis patients.

The Differences of Pepsinogen I and H. Pylori Levels in Patients With Gastric Premalignant Lesion Lubis, Ainun; Siregar, Gontar Alamsyah
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 1 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i1.8792

Background: Gastric cancer is the fifth most common cancer worldwide, precancerous lesions is triggered by H. pylori infection and any other factors. Recent reports confirmed that serum pepsinogens are a valuable biomarker gastric cancer even before the discovery ofÂ H.Â pylori. Research Methods: This study is a cross-sectional study involving 80 confirmed patients with Gastric Premalignant Lesion at Adam Malik General Hospital, Permata Bunda General Hospital, Medan, on April-November 2018. These two variables is sought using the Mann Whitney test (normality test P < 0,05). H. pylori were diagnosed by positive result of examination of Carbon-14 urea breath test (C-UBT) or Campylobacter-like organism (CLO). Examination of Pepsinogen I measured by Abbott ARCHITECT Pepsinogen I Reagent Kit (Abbott Laboratories Inc., Chicago, IL, USA). Result: Of the 60 participants who confirmed has gastritis premalignant lesion according to the inclusion criteria. From the table of characteristic descriptive, it was found that 48 patients were male (60%) and 32 patients were female (40%). From CLO and 14C-UBT, it was found 35 patients were H. pylori-positive (43,8%) and 45 patients were H. pylori-negative (56,3%). Mean age was 51.03 Â± 10.97 Â years. Mean levels of Pepsinogen IÂ was 44.28 Â± 21.77. From the second table, it was found that 35 (43,8%) patientsÂ with H. pylori-positive has 47.84 mean levels of Pepsinogen I, and 45 (56,3%) patients with H. pylori-negative has 34,79 mean levels of Pepsinogen I. The results of Mann Whitney's correlation analysis found a significant correlation between Pepsinogen (PG) I and H. Pylori in patients with Gastric Premalignant Lesion (p < 0,05). Conclusion : It was found that there was a correlation between Pepsinogen (PG) I levels and H. Pylori in patients with Gastric Premalignant Lesion (p < 0,05).

Aspartate Aminotransferase to Platelet Ratio Index and FibroScan for Predicting Liver Fibrosis with Chronic Hepatitis B Tarigan, Elias; Yusuf, Rustam Effendi; Dairy, Leonardo Basa; Sembiring, Juwita; Sihombing, Mabel HM; Siregar, Gontar Alamsyah; Zain, Lukman Hakim
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Non-invasive test have been constructed and evaluated mainly for binary diagnoses. The accuracy of non-invasive tests such as aspartate aminotransferase to platelet ratio index (APRI) and transientelastography/FibroScan should be evaluated especially in clinical practice. The aim of the study was to evaluate the accuracy of detailed fibrosis classification available for APRI and FibroScan to liver biopsy in chronichepatitis B patients.Method: A cross sectional study was conducted in 51 patients with chronic hepatitis B. The patients underwent laboratory test, FibroScan and liver biopsy between April 2011 and July 2013 at Adam Malik Hospital, Medan.Liver biopsy was assessed based on the METAVIR score. Area under receiver operating characteristic curve (AUROC) predictive value was used to evaluate the accuracy of APRI and FibroScan. All data were analyzedusing SPSS 20.0.Results: APRI versus METAVIR diagnosed severe fibrosis and cirrhosis with sensitivity 40% and specificity 83.9%, positive predictive value (PPV) 61.5%, negative predictive value (NPV) 68.4%, positive likelihood ratio(LR) 2.48 and negative LR 0.72 with diagnostic accuracy 66.7%. The AUROC value was 0.619 (95% CI = 0.446 – 0.715); kappa = 0.255; p 0.05. FibroScan versus METAVIR predictive value with sensitivity 75% andspecificity 67.6% were PPV 60%, NPV 67.7%, positive LR 2.31 and negative LR 0.36 with diagnostic accuracy 70.6%. The AUROC value was 0.714 (95% CI = 0.567–0.861); kappa 0.409; p 0.05.Conclusion: FibroScan has better accuracy than APRI for predicting severe fibrosis and cirrhosis in patientswith chronic hepatitis B.Keywords: APRI, FibroScan, liver biopsy, chronic hepatitis B

Co-Authors Agusrly, Chandra Beby Dewi Sartika Betthin Marpaung Chandra Agusrly Dairi, Laura Darmadi Darmadi Darmadi Darmadi Darmadi Darmadi Darmadi Darmadi Dasril Efendi dharma Lindarto, dharma Elias Tarigan Fitri Armanti Karo Ilhamd Imelda Rey Iqbal Sungkar Juwita Sembiring Karo, Fitri Armanti Laura Dairi Leonardo Basa Dairi Leonardo Basa Dairi Leonardo Basa Dairi Leonardo Basa Dairy Lubis, Ainun Lubis, Sri Ningsih Lukman Hakim Zain Lydia Imelda Laksmi Lydia Imelda Laksmi, Lydia Imelda Mabel HM Sihombing, Mabel HM Mabel Sihombing Marpaung, Chairunnisa Fitri Masrul Lubis Panggabean, Lider Olmen Ricky Rivalino Sitepu Ricky Rivalino Sitepu Ricky Rivalino Sitepu Ricky Rivalino Sitepu Ricky Rivalino Sitepu, Ricky Rivalino Rivalino, Ricky Rizqi Arini Siregar, Rizqi Arini Rustam Effendi Rustam Effendi Rustam Effendi Yusuf, Rustam Effendi Sahat Halim Sahat Halim, Sahat Sahat Salim Sartika, Beby Dewi Siregar, Wira Prihatin Sri Maryuni Soetadi Sri Ningsih Lubis Sumondang Pardede Sungkar, Iqbal Sungkar, Iqbal Taufik Sungkar Taufik Sungkar Taufik Sungkar, Taufik Utomo, Edrick Widya Deli Satuti

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