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All Journal YARSI Medical Journal Cermin Dunia Kedokteran The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal MedScientiae Jurnal Kedokteran Meditek

Suzanna Ndraha

Universitas Kristen Krida Wacana

Author-ID : 469277

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

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Impaired Glucose Metabolism in Liver Cirrhosis Suzanna Ndraha; Fendra Wician; Marshel Tendean; Ivan DP Sunardi; Mardi Santoso
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Approximately 30% of patients who suffer cirrhosis maybe diabetic, called hepatogenous diabetes (HD). Insulin resistance seems to be the pathophysiologic basis for HD. Aims of this study were to evaluate the glucose metabolism disorders in liver cirrhosis patients and to observe the insulin resistance in HD.Method: This study was conducted from February-July 2013 in Koja Hospital Jakarta. In the first phase, with observational design, inclusion criteria were liver cirrhosis and exclusion was an acute complication. We recorded their oral glucose tolerance test (OGTT). Patients who met the HD criteria were continued to the second phase, using analytic design, and were compared with type 2 diabetes mellitus (T2DM) patients as control. Mean differences of 2-hours postprandial plasma glucose/fasting plasma glucose (2hPPG/FPG) ratio, as well as fasting insulin levels between both groups were assessed.Results: Twenty four patients were included in our study. Normal glucose tolerance test were noted in 7 (29%) patients, impaired glucose tolerance (IGT) in 6 (25%) patients and HD in other 11 (46%) patients. In the second phase, we obtained the ratio of 2hPPG/FPG in HD was 2 ± 0.5 and T2DM was 1.5 ± 0.4 (p = 0.01). Mean fasting insulin levels in HD was 10.8 ± 4.2 μIU/mL, while T2DM was 9.3 ± 5.3 μIU/mL (p = 0.5). The ratio of 2hPPG/FPG was higher in HD compared to T2DM, assuming the role of insulin resistance in HD.Conclusion: There were impaired glucose metabolism in liver cirrhosis patients, as well as hepatogenous diabetes. Insulin resistance and hyperinsulinemia appeared to play role in HD.Keywords: hepatogenous diabetes, type 2 diabetes mellitus, 2hPP/FPG ratio, fasting insulin level

Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female Henny Tanadi Tan; Suzanna Ndraha; Helena Fabiani; Fendra Wician; Mardi Santoso; Marshell Tendean
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HDis different from type 2 DM in clinical signs and management.A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient wasdiagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubinand liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound resultshowed liver cirrhosis with ascites.The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administrationof oral antidiabetic agent which could affect the liver function.Keywords: hepatogenous diabetes, liver cirrhosis, diabetes mellitus, chronic hepatitis B infection

Effect of Omeprazole to Dyspeptic Symptom on Ramadan Fasting Patient based on Dyspepsia Symptoms Severity Index Scores Eddy Chandra; Suzanna Ndraha; IDN Wibawa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Dyspepsia is a symptoms collection of discomfort at the upper abdomen. Ramadan Fasting is a worship that must be run by all Moslems that do not eat and drink for ± 12 hours. Proton pump inhibitors are drugs commonly given to patients with dyspepsia with mechanism controlling gastric acid secretion. The aim of this study is to find the effect of omeprazole to the patient with dyspepsia and undergo Ramadan fasting.Method: Using analytic study design, conducted in outpatient in Koja Hospital Jakarta from June - July 2013, for patients with dyspepsia who will undergo Ramadan fasting. Subjects are divided into 2 groups; one group was given omeprazole while others were given a placebo. Before and after 2 weeks of fasting, dyspepsia symptoms severity index scores (DSSI) was taken which assessed changes in both groups and compared using student T-test.Results: DSSI scores on average before the intervention of both groups (n = 30) was not significant (p = 0.9). In the placebo group obtained increasing of DSSI score from 27.7 ± 14 to 36 ± 14.8 (p = 0.001), whereas in the omeprazole group obtained increasing of score only from 27.2 ± 9.4 to 30 ± 9.9 (p = 0.08). In the placebo group score worsened by 8.3 ± 7.2 but in the omeprazole group with only 2.7 ± 5.7 (p = 0.02).Conclusion: There was a significant decrease of DSSI scores in fasting patient with omeprazole. Therapy with omeprazole 20 mg twice daily during the month of fasting can reduce the abdominal complain in patient with dyspepsia.Keywords: dyspepsia, DSSI, fasting, Ramadan

The Efficacy of L-Ornithine L-Aspartate Granules and Normal Protein Diet in Minimal Hepatic Encephalopathy with Malnutrition Suzanna Ndraha; Irsan Hasan; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201011-14

Background: The dietary protein restriction that was commonly recommended to hepatic encephalopathy (HE) patients, often leads to malnutrition, whereas malnutrition can deteriorate cirrhosis prognosis. The aims of this study were to find out encephalopathy improvement that was measured by critical flicker frequency (CFF) test and nutritional status by measuring prealbumin level after L-Ornithine L-Aspartate (LOLA) treatment with adequate calories and protein intake in patients with HE. Method: Patients with liver cirrosis who visited Cipto Mangunkusumo hospital on June-October 2009 was evaluated by CFF test using HEPAtonormTM device. Encephalopathy was defined when CFF 39 Hz. Nutritional status was measured by the mid-arm muscle circumference (MAMC) and was stated as malnutrition when the MAMC was below the 15th percentile. Patients had been treated by 3 x 6 mg LOLA granules for 2 weeks, and adequate calories and protein intake with branched-chain amino acid (BCAAs) substitution. The change of encephalopaty was evaluated by the CFF test and the nutritional status by measuring prealbumin blood level. Results: There were 17 patients with liver cirrhosis who fulfilled the inclusion criteria. The mean CFF Result increased from 34.1 ± 2.5 Hz to 36.5 ± 2.9 Hz after LOLA treatment with the adequate calories and protein intake including BCAAs substitution, which was statistically significant (p 0.001) compared to before treatment. The prealbumin level also increased significantly compared before treatment, i.e. from 5.4 ± 2.1 mg/dL to 6.4 ± 2.6 mg/dL, p = 0.008. Conclusion: HE patients with malnutrition could be given adequate calorie and protein with BCAAs substitution to improve their nutritional status, and LOLA granules for the improvement of HE. Keywords: minimal hepatic encephalopathy, malnutrition, CFF, LOLA, prealbumin, BCAAs

Child Pugh C and Male Gender were Related to Nutritional Status of Liver Cirrhosis Patients in Koja Hospital Jakarta Suzanna Ndraha; Marcellus Simadibrata
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: 10.24871/1032009110-112

Background: Malnutrition is found in 65-90% patients with liver cirrhosis. Malnourished patients with cirrhosis have a higher rate of complications. Aim of this study was to evaluate the prevalence and risk of malnutrition in liver cirrhosis patients at Koja hospital, Jakarta. Method: All liver cirrhosis patients visited Koja hospital during January - March 2009 was evaluated. An inclusion criterion was liver cirrhosis. An exclusion criterion was unable to speak Indonesia. The distributions of age, gender, body mass index (BMI), triceps skin-fold thickness (TSF), mid-upper arm circumference (MUAC), mid-arm muscle circumference (MAMC), Child Pugh classification were assessed. The criteria of malnutrition was done according to MAMC and BMI. Result: There were 38 liver cirrhosis patients fit the criteria. Twenty five (65.8%) cases were classified as malnutrition according to MAMC, 21 (55.3%) were classified as malnutrition according to BMI. Four patients (10.5%) were Child Pugh scores A, 15 Child Pugh B (39.5%) and the rest 19 patients (50.0%) were Child Pugh C. There was a trend correlation between malnutrition according to MAMC and Child Pugh criteria but not statistically significant. Conclusion: In our study we found 65.8% of liver cirrhosis patients were malnourished according to MAMC. Malnutrition was higher in male, as well as in Child Pugh score C. MAMC is more accurate than BMI in assessing nutritional status in liver cirrhosis. Keywords: liver cirrhosis, nutritional status, MAMC, BMI, Child Pugh score

Hubungan Gaya Hidup Terhadap Kejadian GERD (Gastroesophageal Reflux Disease) di RSUD Koja Jakarta Utara Suzanna Ndraha; Grace Abigaelni Harefa; Bhannu Khumar
Jurnal MedScientiae Vol. 2 No. 3 (2023): Desember
Publisher : Fakultas Kedokteran dan Ilmu Kesehatan Ukrida

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/JMedScientiae.v2i3.2909

The risk factors of GERD include medication, food, hormone, structural and body mass index (BMI) and other lifestyle factors. Aim of this study is to determine the correlation between lifestyle (smoking, BMI, coffee consumption, spicy food consumption, alcohol, sleeping without pillow, eating late at night) and GERD in Koja Regional Hospital. This study using logistic regression analysis with accessible population was all patients visited Internal Medicine Clinic in Koja Regional Hospital. Data were collected in Augustus 2019-September 2019, using questionnaires and interviews. There were 102 subjects, 68% female, 47% aged > 50 years 47%. Only 27% smoking, 42% BMI above normal, 8% drink alcohol, 26% sleeping without pillow, 38% eating late at night, 45% coffee consumption, 84% consumed spicy foods. Logistic regression analysis found the correlation between smoking, BMI, coffee consumption, spicy food consumption, alcohol, sleeping without pillow, eating late at night altogether and GERD in Koja Regional Hospital. But using partial logistic regression analysis, only spicy food consumption had significant correlation with GERD in Koja Regional Hospital. Spicy food consumption had risk to have GERD 14,671 times than who did not.

Sepuluh Penyakit Terbanyak di Bagian Rawat Inap Penyakit Dalam RSUD Koja Mardi Santoso; Suzanna Ndraha; Puspitasari Puspitasari
Jurnal Kedokteran Meditek vol. 13 no. 33 Januari-April 2005
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v13i33.154

Hubungan antara Dislipidemia Diabetik Dengan Prevalensi Hipertensi Ada Pasien yang Dirawat di Bagian Penyakit Dalam RSUD Koja Periode Juni 2001 - Juni 2005 Mardi Santoso; Suzanna Ndraha; Agustina Merdekawati
Jurnal Kedokteran Meditek vol. 13 no. 34 Mei-Agustus 2005
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v13i34.156

Prevalensi Komplikasi Infeksi pada Penderita Diabetes Mellitus di Rawat Inap RSUD Koja Periode Tahun 2000-2005 Mardi Santoso; Suzanna Ndraha; Novpi Susanto
Jurnal Kedokteran Meditek vol. 13 no. 34 Mei-Agustus 2005
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v13i34.160

Model Perawatan Pasien Demam Berdarah Dengue di RSUD Koja Periode Juni 2002-2005 Evan Evan; Suzanna Ndraha; Mardi Santoso
Jurnal Kedokteran Meditek vol. 14 no. 38 September-Desember 2006
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v14i38.180

Co-Authors Ade John Nursalim Afdilla, Winda Agustina Merdekawati Amirah, Fathin Anthony Hadi Wibowo Anughrahani, Lilie Asmara, Yoseph Rohedi Yosi Bhannu Khumar Caesar, Zulfikar Cecep Kusmana Chairani, Putri Defranky . Derza Polas, Caesaredo Desima . Dhilion, Har R Singh Diana Wijaya Didi Kurniadhi Donny Oktavius Dwicahya Putra, Hervico Eddy Chandra El, Zegovine Evan Evan Farras, Zahra Fathin Amirah Febyan Febyan Febyan, Febyan Fendra Wician Fendra Wician Fransisca Fransisca Fransisca, Fransisca Grace Abigaelni Harefa Hans Hernando Hanung Adi Nugroho Har R Singh Dhilion Helena Fabiani Helena Fabiani Helena Fabiani Helena Yap Helena Yap, Helena Henny Tanadi Tan Henny Tannady Tan IDN Wibawa Imelda Imelda Inneke Kusumawati Susanto Irianta, Ketut Irsan Hasan Ivan DP Sunardi Jean Nadya PR Juli, Ni Nyoman Julian Leonard Sumampouw Kamala, Yurri KHAIRUL HUDA, KHAIRUL Laura Sabrina, Ratih Marcel, Ricco Marcellus Simadibrata Marcellus Simadibrata Mardi Santoso Mardi Santoso Mardi Santoso Mardy Santoso Maria Cindy Lingra Sari Marshel Tendean Marshell Tendean Marshell Tendean Marshell Tendean Marshell Tendean Marshell Tendean Melfrits Rinell Siwabessy Mukhamad Najib Nathania Putri Ni Nyoman Juli Nicholas Wijayanto Novpi Susanto Oktavius, Donny Pradyanthi, I Gusti Ayu Cintya Puspitasari Puspitasari Putri Chairani Putri, Nathania R. Sapto Hendri Boedi Soesatyo Rianas, Wiwin Ricco Marcel Rizal Rinaldy Ronald . Ronald ., Ronald Rumawas, Marina Astrid Saptoyo Argo Morosidi Saptoyo Argo Morosidi, Saptoyo Argo Sarah A E Retraubun Sumampouw, Julian Leonard Sunanda Naibaho Surjadi Sujana Tendean, Marshell Wibowo, Anthony Hadi Wijayanto, Nicholas Wilfried H. Sibuea Yuni Ayu

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