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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
Nitric Oxide and von Willebrand Factor Levels as Markers of Endothelial Dysfunction in Liver Cirrhosis Juwita Sembiring; Suara Ginting; Abiran Nababan; Lukman Hakim Zain; Pengarapen Tarigan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 3, NUMBER 3, December 2002
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/33200269-75

Abstract

Introduction: A number of investigators have shown that endothelial dysfunction in liver cirrhosis can be indicated by increased levels of nitric oxide (NO) and von Willebrand factor (vWF). The cause of this increase is still unclear. It is believe to be correlated with hyperdinamic circulation and endotoxemia, which are common in liver cirrhosis. The Aim of This Study: To compare the levels of NO and vWF in liver cirrhosis patients with those in healthy control subjects, and to investigate whether there is a correlation between levels of NO and vWF with the severity of the disease according to the Child Pugh Criteria Material and Method: This study was conducted from February until June 2001 in 35 liver cirrhosis patients at Dr. Pirngadi and H. Adam Malik Hospital and some private hospitals in Medan. The mean age of patients with liver cirrhosis was 54  + 12.26 years, the youngest being 31 years and the oldest 75 years, and 20 healthy controls while the mean age of the control subject was 55.20 + 13.04 years, the youngest being 31 years and the oldest 76 years. Based on Child Pugh criteria, 9 were classified as Child Pugh class A, 13 in class B, 13 in class C. The criteria for liver cirrhosis were based on clinical examination, laboratory findings and liver ultrasound examination. Cirrhotic patients with hypercolestrolemia, hypertension, heart failure, myocardial infraction, renal failure diabetes, COPD were those on drugs, such as antibiotics and branchodilators were excluded from the study. Result: The mean level of NO in patients with liver cirrhosis was 6.2600  + 4.4456 mM, while the mean NO level in control subjects was 3.2325  + 3.2355 mM, p0.05. The mean level of NO in Child Pugh class A patients was 6.6889  + 3.9757mM, compared to control p0.05; in Child Pugh class B the mean level was 4.8308  + 2.4642 mM compared to control p0.05. There was a significant increase in the level of NO associated with the severity of liver cirrhosis. The mean level of vWF in patients with liver cirrhosis was 399.514  + 175.313% while the mean vWF level in control subjects was 139.100 + 51.144%, p0.05. The mean level of vWF in Child Pugh class A patients was 231.778 ± 43.8576%, compared to control p0.05; in Child Pugh class B was 365.846 + 110.034%, compared to control p0.05, in Child Pugh class C was 549.308 + 164.483%, compared to control p0.05. There was significant increase in the level of vWF correlated with severity of liver cirrhosis. Conclusion: The level of NO was significant higher in liver cirrhosis patients compared to control subjects, but there was no correlation between the increase in the level of NO with the severity of the disease. The levels of vWF was significantly higher in liver cirrhosis patients compared to control, and there was a correlation between increased levels of vWF and the severity of the disease.  Key Words: Liver cirrhosis, Child Pugh criteria, nitric oxide (NO), von Willebrand Factor (vWF)
KARAKTERISTIK PENDERITA HEMOROID DARI HASIL PEMERIKSAAAN KOLONOSKOPI DI RSUD DR. PIRNGADI MEDAN Butar - Butar, Syarifuddin Hizkia; Tarigan, Pengarapen; Lumongga, Fitriana
Jurnal Kedokteran Methodist Vol. 13 No. 1 (2020): Jurnal Kedokteran Methodist
Publisher : Universitas Methodist Indonesia

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Abstract

Background : Hemoroid is enlargement of superior hemorrhoidal plexus vein.hemorrhoid will become more serverif no action is taken immediately. Usia> 45 years had higher risk of developing hemorrhoids. Man has the risk factor affected by hemorrhoids and this incident also experienced by women who are pregnant and someone who is obes. Eventually, there will be bulging hemorrhoids that can not be put back into the anus, so the operation should be carried out. Method :This study was an description research with cross sectional method and and from colonoscopy result and using secondary data obtained from medical record of Pirngadi Medan Hospital period of 2013-2015. Sample selection is done using consecutive sampling method and was obtained from medical record. Result : male subjects who suffered hemorrhoids more record from age is 36-45 years are 33 subjects ( 52,3%), and from gender, male subjects who suffered hemorrhoids are 55 subjects (63,5%), and profession who suffered hemorroids are farmers 29 subjects (36,5%), and finally,education subject who suffered hemorrhoids are SLTA 33 subjects (35,6%). There wa relation between age with the degree of hemorrhoids. Conclution ; Total sample obtained as many as 79 people suffering from hemorroids. The higher a person’s age the hemorroid that he sustained will get worse.
Hubungan Gagal Ginjal Kronik dengan Diabetes Mellitus Tipe 2 Tarigan, Gracecilia; Tarigan, Pengarapen; Siahaan, Jekson Martiar
Jurnal Kedokteran Methodist Vol. 13 No. 2 (2020): Jurnal Kedokteran Methodist
Publisher : Universitas Methodist Indonesia

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Abstract

Background : Many factors can cause chronic kidney disease, namely DM, Hypertension, Polycystic Kidney Disease, Chronic Interticial Nephritis. The results of the 2018 Riskesdas the prevalence value of chronic kidney disease in Indonesia was 3.8% and increased by 1.8% from 2013 data. In DM patients, kidney disorders can be found, kidney disorders can be a complication that causes a decrease in the patient's quality of life. Disorders that occur in the kidneys due to diabetes are characterized by the appearance of microalbuminuria, which means that the amount of albumin excretion in the urine between 20 and 199 ug / minute. The aim of this study was to determine the relationship between type 2 diabetes mellitus and chronic kidney disease. Methods : The research method used was a Literature Review, using secondary data. The data were collected using a documentation techniques. The research journals used were 6 journals with inclusion criteria for the publication date of the last 5 years, the language used was Indonesian or English, with the research subjects of patients with a diagnosis of chronic kidney disease with type 2 diabetes mellitus and a full text publication. Conclusion : There is an association between diabetes mellitus type 2 with chronic kidney disease which can be seen in (microalbuminuria, Blood sugar rate, Hypertension and HbA1C)