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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Prima Yuriandro
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Medicine & Pharmacology

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Approach for Diagnostic and Treatment of Achalasia Andree Kurniawan; Marcellus Simadibrata; Prima Yuriandro; Lie Khie Chen
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 (431.146 KB) | DOI: 10.24871/1422013109-116

Abstract

Achalasia is a rare motor disorder of the esophagus and lower esophageal sphincter. The incidence is approximately 1/100,000 per year and the prevalence rate is 10/100,000. Achalasia is quite difficult to establishbecause the symptoms might be insidious and therefore not many people come to seek medical attention until it deteriorates to final stage of the disease. There are several modalities that can be used as diagnostic toolssuch as manometry, barium esophagogram, esophagoduodenoscopy, esophageal CT-scan, until the recent one, high-resolution manometry that can classify achalasia into three different types. The treatment options are the pharmacologic intervention, endoscopic treatment, minimal invasive surgery, and radical surgery.We reported a case of 20 year old female with achalasia who came with dysphagia symptom since three years before. The diagnosis was made by historytaking, physical examination and barium meal and esophagogastroduodenoscopy. The patient underwent pneumatic dilatation and since then the symptom was relieved.Keywords: achalasia, diagnostic, treatment
Factors Affecting Rapid Decline in Glomerular Filtration Rate in HIV/AIDS Patients Using Tenofovir Disoproxil Fumarate Yuriandro, Prima; Yunihastuti, Evy; Marbun, Maruhum Bonar H; Nugroho, Pringgodidgo
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. Tenofovir disoproxil fumarate (TDF) treatment in HIV/AIDS patient has particular effect to the kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1.72 m2 one year after using the drug). The incidence rate for rapid decline in GFR and factors affecting it are still contradictive and not assessed completely. This study was done to identify cumulative incidence and factors affecting TDF related nephrotoxicity. Methods. A retrospective cohort study was conducted in HIV/AIDS outpatient clinic Cipto Mangunkusumo Hospital Jakarta. We included patients who start taking TDF as their medication from January 2010 until January 2015 with consecutive sampling method. Inclusion criterias were minimum one year of TDF treatment and baseline GFR > 60 cc/minute/1.72 m2. The study used secondary data from medical record, therefore subject with no GFR evaluation after one year was excluded. Logistic regression test was used to evaluate variabel that could potentially affect rapid decline in GFR. Results. 164 subjects were included for analysis and we found rapid decline in GFR after one year of TDF medication in 87 subjects (cumulative incidence 53%; 95% CI 45-60.4%). Factors affecting rapid decline in GFR were male gender (RR 4.0; 95% CI 1.1-4.8), CD4 cell count below 100 cell/mm3 (RR 3.7; 95% CI 1.7-8.1), weight increase above 20 % (RR 4.0; 95% CI 1.0-4.8), and baseline GFR above 90 cc/min/1.72 m2 (RR 9.8; 95% CI 2.3-42.1). Conclusion. The incidence rate for rapid decline in GFR after a year of TDF medication in HIV/AIDS patients in Cipto Mangunkusumo hospital was 53%. Risk factors that affecting this nephrotoxicity were male gender, CD4 cell count below 100 cell/mm3, weight increase above 20%, and baseline GFR above 90 cc/min/1.72 m2.
Co-Authors Andree Kurniawan Evy Yunihastuti Khie Chen Marcellus Simadibrata Marcellus Simadibrata Maruhum B.H. Marbun Nugroho, Pringgodidgo