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All Journal Hemera Zoa Medika Alkhairaat : Jurnal Penelitian Kedokteran dan Kesehatan World Nutrition Journal Respiratory Science The Indonesian Journal of Community and Occupational Medicine The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia

Ari Fahrial Syam

Division Of Gastroenterology, Department Of Internal Medicine, University Of Indonesia/Cipto Mangunkusumo Hospital, Jakarta

Author-ID : 399120

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

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Clinical Manifestation and Diagnosis of Cryptosporidiosis in Adult Infected with HIV Nunung Ainur Rahmah; Ening Krisnuhoni; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 3, December 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/43200396-99

Cryptosporidiosis is a rare infection caused by a coccidian parasite, Cryptosporidium, which could cause diarrhea in humans, especially those who are immunocompromised Cryptosporidiosis could cause self- limited diarrhea infection in immunocompetent hosts, but in immunocompromised hosts, especially those with AIDS, the diarrhea can be chronic and severe. To date, no known effective therapeutic agents have been identified. The following is one case report of cryptosporidiosis of a 27 year-old male admitted with chronic diarrhea since 2 months. Endoscopy of the ileum and colon showed hyperemia, erosion and edema, and biopsy was performed. Histopathological examination of ileum showed an atrophic villous and atypical degeneration. There was a number of circular cryptosporidium lining up along the surface of epithelium. There was inflammatory cell infiltration, consisting of lymphocytes, eosinophils and a few neutrophils in the lamina propria. Serological examination revealed an HIV-positive result. Keywords: Cryptosporidiosis, HIV, diarrhea

Hospital-based Survey on Knowledge and Attitude toward Colorectal Cancer Screening among Indonesian Population Murdani Abdullah; Achmad Fauzi; Ari Fahrial Syam; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Joseph JY Sung; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200951-55

Background: Several western countries have recommended colorectal cancer (CRC) screening, however the yield of CRC screening is still low. The acceptability of CRC screening is influenced by people’s knowledge and attitude. This study was conducted to evaluate the knowledge and attitude of Indonesian people toward CRC screening. Method: Adult Indonesian population aged 19–65 years was recruited in this hospital-based survey. Knowledge and attitude toward CRC screening were assessed by using structured questionnaires consisting of nine chapters. Result: There were 614 respondents recruited in this study. Most respondents (36.2%) incorrectly pointed out abdominal pain or pain around anus as the symptom of bowel cancer. Regarding CRC risk factors, eating fruits or vegetables rarely was the most frequent answer (28.5%) encountered. Only one-third (28%) of respondents mentioned colonoscopy as the Method for CRC screening. There were 38.1% of respondents who believed that CRC screening test might be harmful to the body. Up to 70.8% of the respondents agreed and strongly agreed that CRC screening test might cause physical discomfort. Two fifth (41.5%) of respondents believed that CRC screening test was embarrassing. More than half (58.8%) of respondents were afraid of having the CRC screening test. The test was too expensive according to 79.5% of respondents. Conclusion: The knowledge on CRC symptoms, risk factors, and screening tests is still low among Indonesian population. Our study result indicates that the lack of knowledge and the discouraging attitude among Indonesian population will be the major barriers to implement CRC screening in Indonesia. Keywords: colorectal cancer, screening, knowledge, attitude

Relationship Between Vascular Endothelial Growth Factor and Severity of Hepatocellular Carcinoma Arles - -; Rino Alvani Gani; Ari Fahrial Syam; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Severity of hepatocellular carcinoma (HCC) that is assessed using Barcelona Clinic Liver Cancer (BCLC) classification is a main prognostic factor of hepatocellular carcinoma. Assessment of the serum level of Vascular Endothelial Growth Factor (VEGF) is considered to reflect the severity of HCC. However, there is still no fundamental basis of the association of severity of HCC with the serum VEGF level. The objective of this study is to know the relationship between serum VEGF levels with the severity of HCC by assessing the average difference of serum VEGF level in various severity of HCC.Method: This study was a cross sectional study to identify the association between serum VEGF levels with the severity of HCC based on BCLC classification. This study was performed in Cipto Mangunkusumo Hospital between January and May 2015. Statistical tests used to evaluate the association between serum VEGF level with BCLC classification was one-way ANOVA analysis, and continued with post hoc Tukey Schaffe analysis.Results: A total of 61 subjects with HCC were included into this study. In this study, we did not find subjects with stage 0 BCLC. The average of serum VEGF level in stage A BCLC was 288.26 ± 156.6 pg/mL; stage B BCLC: 434 ± 164.8 pg/mL; stage C BCLC: 785.57 ± 194.25 pg/mL; stage D BCLC: 1537.97 ± 660.62 pg/mL. One-way ANOVA analysis showed significant difference (P 0.001) between serum VEGF level and HCC severity based on BCLC classification. Post hoc Tukey Schaffe analysis showed the presence of significant difference between stage A and C BCLC (p 0.05) and stage A and D BCLC (p 0.001), stage B and D BCLC (p 0.001), and stage C and D BCLC (p 0.001). There was no significant difference between stage A and B BCLC, and between stage B and C BCLC.Conclusion: It was found that serum VEGF level increased in accordance to the HCC severity based on BCLC classification, particularly for stage B BCLC and above.

Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms Radhiyatam Mardhiyah; Ari Fahrial Syam; Siti Setiati
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

Gastroesophageal reflux disease (subsequently abbreviated as GERD) is a disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food.

Recent Updates of Helicobacter pylori Infection: from Epidemiology Study to Guideline Issues Laurentius A Pramono; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Helicobacter pylori (H. pylori) infection is still a big issue in gastroenterology field. Its relationship withgastrointestinal malignancies now is widely known and the extra-gastrointestinal manifestation of this epidemicbring new problems. Although the prevalence is decreasing in developed countries, the resistance rate of somestrains to standard therapy needs more attention and new strategies. Recent epidemiology studies revealed that H. pylori infection is a specific population disease. Many trials and meta analyses revealed new evidences and horizons in the management of this infection. This review updated and highlighted pathophysiology, clinicalaspect, and new epidemiology data on H. pylori infection which is published in the last five years.Keywords: Helicobacter pylori, update, epidemiology ABSTRAKInfeksi Helicobacter pylori (H. pylori) masih merupakan permasalahan besar di bidang gastroenterologi.Hubungannya dengan keganasan saluran cerna saat ini telah dikenal secara luas dan manifestasinya di luarpencernaan pada epidemi ini membawa masalah baru. Meskipun prevalensinya menurun di negara-negara maju,namun tingkat resistensi dari beberapa terapi standar membutuhkan lebih banyak perhatian dan strategi baru.Penelitian epidemiologi baru-baru ini mengungkapkan bahwa infeksi H. pylori didapatkan pada populasi tertentu.Banyak percobaan dan metaanalisis yang mengungkapkan bukti dan wawasan baru dalam penatalaksanaannya.Ulasan ini memperbarui dan menyoroti patofisiologi, aspek klinis, dan data epidemiologi baru pada infeksi H.pylori yang telah dipublikasikan dalam lima tahun terakhir.Kata kunci: Helicobacter pylori, memperbarui, epidemiologi

Abnormalities of the Small Bowel in Chronic Non-Infective Diarrhea: A Histopathological Study Marcellus Simadibrata Kolopaking; Vera Yuwono; Ari Fahrial Syam; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; L A Lesmana; Nurul Akbar; Chudahman Manan; Iwan Ariawan
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: 10.24871/42200329-38

Background: The incidence of chronic non-infectious diarrhea cases is increasing in line with the developments of medical technology and science. The objective of this study was to uncover the histopathologic abnormalities of the small bowel in cases of chronic non-infectious diarrhea. Methods: All chronic non-infectious diarrhea patients in Cipto Mangunkusumo Hospital from 1996 until 2000 were included in this study. For the control group, we used 37 endoscopically-normal patients with functional dyspepia with the same characteristics (sex and age). All of the patients underwent gastroduodeno-jejunoscopic and ileocolonoscopic examinations. Patients with infection were excluded from this study. Biopsies were taken from the duodenal bulb, descending duodenum, jejunum near the Treitz ligament, terminal ileum, and colon. Histopathological tests were performed on all of the biopsies. Result: Histopathological examination was carried out on 31 patients and 37 control patients. In the duodenal bulb, the width of villi, lymphocyte infiltration, eosinophil infiltration, stage of inflammation, and polymorphonuclear cells infiltration were all lower in the chronic non-infectious diarrhea group than in the control group (p 0.01). In the descending part of duodenum and jejunum, lymphocyte infiltration, the stage of inflammation, and polymorphonuclear cell infiltration were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Within the terminal ileum, lymphocyte infiltration, the stage of inflammation and lymphoid follicle hyperplasia were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Conclusion: Histopathologically, increased lymphocyte infiltration, inflammation and lymphoid follicle hyperplasia were discovered in specified areas of small intestine in chronic non-infectious diarrhea patients. Keywords: Histopathological examination, chronic non-infectious diarrhea, lymphocyte infiltration, mucosal inflammation, lymphoid follicle hyperplasia

Nutritional Management in Acute Pancreatitis Luh Putu Listya; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 1 (2016): VOLUME 17, NUMBER 1, April 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Acute pancreatitis induce a catabolic stress that increase systemic inflammatory response with worsening nutritional status. Current approach in acute pancreatitis therapy was still symptomatic because of no definitive therapy yet to prevent any inflammatory and proteolytic cascade. One of the most important thing to consider in acute pancreatitis therapy was nutritional management. “Pancreatic rest” concept that formerly used have been known to increase cost, sepsis incidence due to catheter use, and also metabolic and electrolyte disorder. Nowadays, “gut rousing” concept was preferable compared to “pancreatic rest” concept, support that nutritional management was needed to stimulate and generate intestinal function. Enteral nutrition administration have to consider patient’s hemodynamic status. Necrosis incidence, respiratory failure, intensive care, and mortality was found to be lower in patients given enteral nutrition in first 48 hours compared to after 48 hours. Nutrition administration via nasogastric tube or nasojejunal tube was still in doubt while several studies showed that nasogastric tube administration was safe and tolerated, otherwise could be evaluated in larger population sample study. Nutrition and metabolic monitoring was also an important part to reach nutritional goals and reduce complications.

Association between Severity of Dyspepsia and Urea Breath Test Results in Patients with Positive Helicobacter pylori Serology Catarina Budyono; Haris Widita; Ari fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Active Helicobacter pylori infection is considered to cause more severe dyspepsia symptoms compared to inactive infection. This study was aimed to determine the association between severity of dyspepsia and urea breath test (UBT) results in subjects with positive H. pylori serology.Method: This study was a cross-sectional study in 60 subjects with positive H. pylori serology in Provincial General Hospital of West Nusa Tenggara. Severity of dyspepsia was measured using modified Glasgow Dyspepsia Severity Score (GDSS) questionnaire. Diagnosis of active H. pylori infection was made using 14C UBT examination.Results: Proportion of active H. pylori infection in subjects with positive serology was 20%. The average of modified GDSS score in all patients was 1.95 (SD + 1.78), with minimal score of 0 and maximal score of 7. There was a statistically significant difference between average of modified GDSS score and positive and negative UBT results, (p = 0.027). The cut-off point value of modified GDSS to diagnose positive UBT was 3.8. Results of diagnostic test with modified GDSS as a test and UBT results as the gold standard indicated sensitivity of 41.6% and specificity of 85.4%. Conclusion: There was a significant difference between modified GDSS score in patients and positive and negative H. pylori infection. In areas which did not have UBT examination, eradication in patients with positive serology and GDSS score of more than or equal to 4 could be considered.

Polypectomy of Esophageal Polyp due to Esophagitis Ari Fahrial Syam; Marcellus S. Kolopaking; Chudahman Manan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 3, NUMBER 2, August 2002
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/32200263-65

Esophageal polyp can be found by chance during endoscopic examination. Polyps can be formed by changes in the esophageal mucosa due to reflux esophagitis. We report a case of multiple esophageal polyp in a patient with complaints of recurrent regurgitation without heartburn. Endoscopy demonstrated multiple polyps at the distal esophagus. Anatomic pathology evaluation of the polyp demonstrated mucosa lined with squamous epithels demonstrating elongation of the papilla and deposition of acute and chronic inflammatory cells, indicating chronic esophagitis with hyperplastic epithels. In this case, we conducted recurrent ligation of the multiple polyps. Evaluation at 2 weeks after the final ligation demonstrated no polyp remains, and the post-ligation ulcer was found. Evaluation at 1 month following treatment found diminished complaints. From this case, we can conclude that endoscopy is an important investigation modality to establish the diagnosis in cases of chronic gastrointestinal complaints. Ligation is a choice for the management of esophageal polyps. Key words: Esophageal polyp, polipectomy, ligation

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.

Co-Authors -, Arles - -, Suhendro - -, Suhendro - A.A. Ketut Agung Cahyawan W Aan Santi Aan Santi Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani ACHMAD FAUZI Achmad Fauzi Achmad Fauzi Achmadsyah, Armand Adiwinata, Sheila Adjeg Tarius Afifah Is Agasjtya Wisjnu Wardhana Agnes Kurniawan Agustinus, Taolin Ahani, Ardhi Rahman Ahimsa, Titos Ahimsa, Titos Ahmad Aulia Ahmad Fauzi Ali Imron Yusuf Alkindi Bahar Amanda Pitarini Utari Andi Kristanto Andreas Pekey Andreas Pekey, Andreas Andree Kurniawan Andri Sanityoso Andri Sanityoso Andri Sanityoso Anggie Indari Anggilia Stephanie Anggilia Stephanie, Anggilia Anis Karuniawati Ari, Franciscus Arles - - Armen Muchtar Armen Muchtar Arya Govinda Aryanto Basuki Awang, Iqbal I Aziz Rani Bambang Pontjo Priosoeryanto Bambang Setyohadi Beatrice Belinda Phang Bhanu S Kumar Birry Karim Bona Adhista Bradley Jimmy Waleleng Bradley Jimmy Waleleng Budi Tan Oto C Martin Rumende C Rinaldi A Lesmana Caputra, Hadyanto Catarina Budyono Catarina Budyono, Catarina Ceva W. Pitoyo Christy Efiyanti Chudahman Manan Chudahman Manan Chudahman Manan Chyntia Olivia MJ Cindy Rahardja Cleopas Martin Rumende Dadang Makmun Daldiyono Daldiyono Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dante Saksono Harbuwono Deddy Gunawanjati Dedy Gunawanjati Sudrajat Dharmika Djojoningrat Diah Rini Handjari Diah Rini Handjari Diany N Taher Didi Kurniadhi Didi Kurniadhi Djulzasri Albar Dwi Suseno E Mudjaddid E Mudjaddid, E E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Eka Ginanjar Ekowati Rahajeng Ekowati Rahajeng Elizabeth Merry Wintery Ellen Susanti Elli Arsita Elli Arsita Elza Febria Sari Elza Febria Sari Endang Susalit Endang Susalit Ening Krisnuhoni Esthika Dewiasty, Esthika Euphemia Seto, Euphemia Evita H Effendi Evy Yunihastuti Fajar Raditya Fauzi Ahmad Muda Feriadi Suwarna FJW Ten Kate Florentina Caroline Puspita Franciscus Ari Futihati Ruhama Zulfa Gerie Amarendra Ginova Nainggolan Ginova Nainggolan GNJ Tytgat Grace Nami Sianturi Gunawanjati Sudrajat Hadyanto Caputra Hamzah Shatri Hamzah Shatri Hantoro, Ibnu Fajariyadi Haris Widita Haris Widita Haryanto Rahardjo Hasan Maulahela Hasan Maulahela Hasan Maulahela, Hasan Hayatun Nufus Hayatun Nufus Helsi Helsi Heru Sundaru Hery Djagat Purnomo Hery Djagat Purnomo Hotmen Sijabat I Gusti Bagus Wiksuana Ikhwan Rinaldi Ilham Ahmadi Ilum Anam Ilum Anam, Ilum Ina Susianti Timan Indra Marki Indra Marki Indra Marki Indra, Suwito Iqbal I Awang Ira Laurentika Irsan Hasan Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jeffri Gunawan Joseph JY Sung Josephin Rasidi Julwan Pribadi Jumhana Atmakusuma Kaka Renaldi Karmel Tambunan Katharina Setyawati Khaira Utia Yusrie Kharia Utia Khie Chen L A Lesmana Laksmi, Purwita W. Laurentika, Ira Laurentius A Pramono Laurentius A Pramono, Laurentius A Laurentius Aswin Pramono Laurentius Aswin Pramono Laurentius Lesmana Laurentius Lesmana Leonard Nainggolan Leonard Nainggolan Leonita Ariesti Putri Listya, Luh Putu Luciana Budiati Sutanto Luciana Budiati Sutanto Luh Putu Listya Lusy Erawati Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Marcellus S Kolopaking Marcellus S. Kolopaking Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata K Marcellus Simadibrata Kolopaking Marthino Robinson Mazni, Yarman Menaldi Rasmin Moch Ikhsan Mokoagow Murdani Abdulah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nata Pratama Nikko Darnindro Nikko Darnindro Nikko Darnindro Novie Rahmawati Zirta Nugroho, Prionggodigdo Nunung Ainur Rahmah Nur Rasyid Nur Rasyid Nurul Akbar Nurul Akbar Oktaramdani, Tessa Paulus Kusnanto Phang, Beatrice Belinda Pringgodigdo Nugroho, Pringgodigdo Prionggodigdo Nugroho Purwita W Laksmi, Purwita W Puspita, Florentina Caroline Putri, Leonita Ariesti Rabbinu Rangga Pribadi Radhiyatam Mardhiyah Radhiyatam Mardhiyah, Radhiyatam Rahardja, Cindy Ralph Girson Ralph Girson Gunarsa Randy Adiwinata Randy Adiwinata, Randy Ranty, Stefanus Satrio Rasco Sandy Sihombing, Rasco Sandy Rasidi, Josephine Resti Mulya Sari Riadi Wirawan Riadi Wirawan Riahdo Saragih Rino A Gani Rino A Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rio Zakaria Rio Zakaria Rio Zakaria Rolan Sitompul Rudi Putranto Ryan Herardi Ryan Ranitya Sari, Cut Yulia Indah Sayid Ridho Sedijono Sedijono Seri Mei Maya Ulina Sheila Adiwinata Simon Salim Siti Setiati Siti Setiati Stefanus Satrio Ranty Stella Evangeline Bela Stephanie Dewi, Stephanie Steven Sumantri Suhendro - - Suhendro Suhendro Suhendro Suhendro Suhendro Suwarto, Suhendro Sumaryono Sumaryono Sumaryono Sumaryono Suryantini Suryantini Suryantini Suryantini Suwito Indra Suzana Ndraha Syafruddin A. R. Lelosutan Taufiq Taufiq Taufiq Taufiq Teguh Hardjono Tena Djuartina, Tena Tessa Oktaramdani Timoteus Richard Timoteus Richard, Timoteus Tito Ardi Titos Ahimsa Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Tri Isyani Tungga Dewi Vera D Yoewono Vera Yoewono Vera Yuwono Wardhana, Agasjtya Wisjnu Willy Brodus Uwan Willy Brodus Uwan, Willy Brodus Wina Sinaga Wirasmi Marwoto Wirasmi Marwoto Wulyo Rajabto

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