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Abdul Aziz Rani
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Medicine & Pharmacology

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Identification and Stenting of Malignant Obstructive Jaundice : Determining the Success Rates of ERCP Budi Tan Oto; Achmad Fauzi; Ari Fahrial Syam; Marcellus Simadibrata; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.041 KB) | DOI: 10.24871/131201219-22

Abstract

Background: Malignant and benign lesions may cause obstructive jaundice. The treatment of these conditions includes biliary stenting drainage, percutaneous transhepatic biliary drainage (PTBD), or surgical procedures. In advanced malignant jaundice, stent placement often turns out to be difficult. The aim of this study was to determine the success rates of malignant obstructive jaundice detection utilising endoscopic retrograde cholangiopancreatography (ERCP) and its stent placement procedure. Method: We conducted a retrospective study in 139 patients who undergone ERCP in Cipto Mangunkusumo Hospital between October 2004 and July 2008. Data was analyzed descriptively with SPSS version 17.0. Results: Of 139 study subjects, 131 (94.2%) of them had clinical obstructive jaundice (direct bilirubin indirect bilirubin level). There were 73 (55.7) male patients, with age range of 20-84 years. Among 114 patients with identified cause of obstruction, 57 (50%) patients had undergone stent placement; however, only 32 (56.1%) patients had successful stent placement. Our descriptive analysis showed that age and sex did not affect the stent success rates, and malignancy was showed to be a factor of stent failure. Conclusion: ERCP appears to be reliable enough for identifying the cause of obstructive jaundice in most patients. In this study, the achieved success rate of stent placement is more than 50%. Moreover, such rate is lower in the malignant obstructive jaundice than the non-malignant counterparts. Papillary carcinoma is the most frequent cause of malignant obstructive jaundice. Keywords: ERCP, obstructive jaundice, stenting, malignancy
Upper Gastrointestinal Abnormalities in Esophagogastroduodenoscopy Examination: Descriptive Study in PSUPAU Endoscopic Unit Julwan Pribadi; Sedijono Sedijono; Suryantini Suryantini; Marcellus Simadibrata; Ari Fahrial Syam; Murdani Abdullah; Achmad Fauzi; Dadang Makmun; Chudahman Manan; Daldiyono Daldiyono; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/93200882-85

Abstract

Background: The Endoscopy Unit of Indonesian Air Force Central Hospital Dr. Esnawan Antariksa, Jakarta, Indonesia, has just been established in late 2004 and it is still in developing process. This study was aim to depict the profile of patients who underwent esophagogastroduodenoscopy procedure in the unit. Method: This study was a retrospective study that analyzed data in endoscopic registry of patients who underwent esophagogastroduodenoscopy (EGD) examination from September 2004 to December 2007. Result: Total of 108 patients underwent EGD examination, comprised of 66 (61%) males and 42 (39%) females, with average age of 45.4 years old (range 16-77 years old). The most frequent indication for EGD was dyspepsia 63%, followed by hematemesis-melena 26% and dysphagia 5.5%. Among patients with dyspepsia, EGD revealed organic abnormalities in 71% patients, with descriptions of erosive gastritis 35%, gastritis 18%, bile reflux 7%, esophagitis 5% and gastric ulcer 3%. Among patients with hematemesis-melena, EGD revealed abnormalities, which were described as erosive gastritis 48%, esophageal varices bleeding 22%, gastric ulcer 18%, caustic injury 4%, and esophagitis 4%. Conclusions: EGD is an important procedure to ascertain the occurence of organic abnormalities in patient with gastrointestinal symptoms and signs e.g. dyspepsia and gastrointestinal bleeding. More than half of patients with dyspepsia showed organic abnormalities. Among patients with hematemesis-melena, erosive gastritis is more common than variceal bleeding. Keywords: esophagogastroduodenoscopy, dyspepsia, upper gastrointestinal bleeding, hematemesis melena
Serial Cases of Combining ESWL and ERCP Procedures in Management Chronic Pancreatitis and Difficult Bile Duct Stones Achmad Fauzi; Nur Rasyid; Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
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: 10.24871/1032009131-135

Abstract

Extracorporeal shock wave lithotripsy (ESWL) has an established role in the management of pancreaticductalcalculiandasfurthertreatmentmodalityforlargeordifficultcomplicatedcommon bile duct(CBD)stones. Combinedwithminimally invasive endoscopic procedure suchasendoscopic retrogradecholangio-pancreatography(ERCP),it has replaced open surgeryas theinitial form of therapy. ESWL has also proved to bean effective therapyin treating intrahepaticstones that are refractory toroutine endoscopic extraction.Inthese serialcaseswe presentthree caseswhichusing combinedESWLandERCP procedurestotreatchronicpancreatitispainandgiantCBDstonethat presentinggoodresultsonfollowupwithoutanycomplication.  Keywords:ESWL, ERCP,chronicpancreatitis, CBDstone
The Causes of Upper Gastrointestinal Bleeding in the National Referral Hospital: Evaluation on Upper Gastrointestinal Tract Endoscopic Result in Five Years Period Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Dharmika Djojoningrat; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 3, December 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/63200571-74

Abstract

Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding. Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005. Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade III in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), 60 years (305 cases; 36.2%), 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%). Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage III. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study. Keywords: upper gastrointestinal bleeding, endoscopy
Helicobacter pylori Infection in Superficial Gastritis, Erosive Gastritis and Gastric Ulcer Jacobus Albertus; Abdul Aziz Rani; Marcellus Simadibrata; Murdani Abdullah; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 2, August 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (687.24 KB) | DOI: 10.24871/132201274-79

Abstract

Background: Helicobacter pylori (H. pylori) infection leads to inflammation of the gastric mucosa. It damages the gastric epithelium and related to the risk of developing gastric cancer. Over time, it may develop into the development of glandular atrophy and intestinal metaplasia. This study was aimed to evaluate the histological features of gastric mucosa, including H. pylori infection in patients with endoscopically found superficial gastritis, erosive gastritis and gastric ulcer. Method: Subjects with abdominal complaints who underwent consecutive upper gastrointestinal endoscopy were prospectively selected at Tugurejo Hospital between November 2004 and December 2010. Eligible subjects were those with endoscopic diagnosis of superficial gastritis, erosive gastritis or gastric ulcer. The biopsy specimens were taken from the corpus, angulus and antrum of all the patients. Giemsa and hematoxylin-eosin staining were used for the histological diagnosis H. pylori and gastric mucosa inflammation. Results: The overall prevalence of H. pylori infection in superficial gastritis, erosive gastritis and gastric ulcer were 24.3%. There was significant difference between H. pylori infection rate in antrum of patients with superficial gastritis 19.4%, erosive gastritis 26.3%, and gastric ulcer 34.7%. The positivity rate of glandular atrophy and intestinal metaplasia of superficial gastritis with H. pylori- positivity was 12.5%, 14.0%; erosive gastritis 26.3%, 16.6%; and of gastric ulcer 38.9%, 29.3%; respectively. However, there was no significant difference. Conclusion: Patients with gastric ulcer have H. pylori infection, atrophic gastritis and metaplasia intestinal more than superficial gastritis and erosive gastritis. Progression of the gastric ulcer to atrophic gastritis and intestinal metaplasia is related to H. pylori infection. Keywords: Helicobacter pylori infection, superficial gastritis, erosion and ulcer
Upper Gastrointestinal Malignancy among Dyspepsia Patients in Cipto Mangunkusumo Hospital Jakarta Ali Imron Yusuf; Ari Fahrial Syam; Murdani Abdullah; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani
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: 10.24871/103200992-95

Abstract

Background: Upper gastrointestinal (GI) malignancy was still a health problem in all over the world. The prevalence of the upper GI malignancy vary among Asian countries. Data from Indonesia was scarcely reported. The aim of this study is to determine the frequency of upper GI malignancy among dyspepsia patients who underwent esophagoduodenoscopy (EGD) procedure. Method: This is a retrospectives study from subject with dyspepsia that had underwent upper GI endoscopy at the Department of Internal Medicine Cipto Mangunkusumo hospital from January 2005 to December 2007. All complete data from medical report and histopathology appearance will be recorded. Results: Out of 2,116 subjects underwent endoscopy due to dyspepsia, 110 (5.19%) subjects was diagnosed as cancer. This upper GI malignancy consisted of gastric cancer in 63 (2.97%) cases, esophageal cancer 32 (1.51%) and duodenal cancer 15 (0.71%). The mean ages of the subjects was 53.36 ± 10.97 years, age less than 45 years was 20 (18.20%) subjects, more than 45 years was 90 (81.18%), male 71 (64.50%) subjects, female 39 (35.50%). Most of them had alarm signs 96 (87.30%). Histopathology finding showed adeno-carcinoma in 75 (68.20%) cases, signet ring cell carcinoma in 14 (12.70%), squamous cell carcinoma in 8 (7.30%), others in 13 (11.80%). Out of 59 gastric cancer, 48 (76.20%) cases was located at distal part while the rest 11 (17.50%) cases was located at the proximal gaster, and 4 (6.30%) in diffuse. By the ethnics founded Javanese 37 (33.60%) subjects, Betawinese 22 (20.00%), Sundanese 12 (10.90%) and Batak 13 (11.80%). Conclusions: Upper GI malignancy was found in five percent of subjects with dyspepsia who undergo colonoscopy. The three most frequent malignancies were gastric carcinoma, esophageal carcinoma, and duodenal carcinoma respectively. Most of gastric adenocarcinoma was located at distal stomach. Keywords: upper gastrointestinal malignancy, dyspepsia, endoscopy, alarm sign, histopathology
Clinical Effects of an Amino Acid and Glucose Solution in Non-surgical Gastrointestinal Patients of Internal Medicine Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani; Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.823 KB) | DOI: 10.24871/1232011155-159

Abstract

Background: This study was performed to assess the efficacy and safety of intravenous amino acid and glucose solution with electrolytes in non-surgical gastrointestinal patients. Method: This single, open, and pre-post study was conducted in the internal medicine ward at Cipto Mangunkusumo Hospital between June 2007 and March 2008. Patients were administered solution of amino acid, glucose, and electrolytes via peripheral vein at a dose of 1000 mL/day for one week period. Non-operative gastroenterology patients with age between 16 and 65 years were eligible in this study; patients were excluded if they had diabetes mellitus, severe hepatic or renal dysfunction, electrolyte disturbance, and obesity. The data were analyzed by paired t-test and McNemar test using SPSS version 16. Results: Fifteen patients consisted of 8 (53.5%) female, mean age was 38.47 ± 14.73 years. The body mass index (BMI) at screening was 14.50 ± 2.11 kg/m2. Patients’ BMI increased in day-1, day-3, and day- 7 into 14.5; 14.58; 14.80 kg/m2, respectively (p 0.05). The increasing of prealbumin, albumin, transferin, and total protein were 7.30 mg/dL vs 11.16 mg/dL; p = 0.018; 2.71 g/dL vs 3.12 g/dL; p = 0.024; 102.37 mg/dL vs 141.95 mg/dL; p = 0.016; 6.24 g/dL vs 6.85 g/dL; p = 0.019, respectively. The clinical symptoms of nausea and weakness in patients decreased from 53.3% to 6.7%; p = 0.016, and 66.7% to 6.7%; p = 0.004. Conclusion: This parenteral nutrition solution was effective to improve clinical nutrition parameters. Keywords: amino acid and glucose solution, non-surgical gastrointestinal patients, peripheral parenteral nutrition
The Pathogenesis and Diagnosis of Bile Reflux Gastropathy Ruswhandi Martamala; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/21200114-20

Abstract

Bile reflux gastropathy is a disease caused by reflux of duodenal fluid to the gaster. This fluid contains pancreatic juices and duodenal secretion. The manifestations that occur depend on the frequency, amount, and duration of reflux. This disorder is quite rarely recognized in daily clinical practice. Endoscopy of the upper gastrointestinal tract is required to establish the diagnosis of this disorder. This paper will give a brief view of the pathogenesis and diagnostic method for this disorder.    Keywords: gastropathy, bile reflux, motility
Dyspeptic Syndrome in Urban Population of Jakarta Marcellus Simadibrata; Murdani Abdullah; Ari Fahrial Syam; Achmad Fauzi; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani; Aan Santi; Ekowati Rahajeng
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201066-70

Abstract

Background:  Dyspeptic syndrome is experienced by many patients who visit general practitioners and gastroenterologist. In Indonesia, a small number of epidemiological data about dyspeptic syndrome are available. The aim of this study was to obtain data on prevalence, characteristics and factors/lifestyle associated with dyspeptic syndrome in urban population of Jakarta. Method: The study was conducted by interview to 1,645 respondents representing the population of Jakarta in the year 2007 using the Steps WHO version 1.4 instruments. The selection of respondents was performed by multistage cluster random sampling, i.e. each municipality is represented by one district and each was represented by a number of villages and respondents interviewed at random. Dyspeptic syndrome is defined whenever there is one or more complaints of nausea, vomiting, belching, epigastric pain, no appetite, early satiety, bloating. Scoring was performed for each category of questions using wstep1 method prior to the analysis. Data analysis was performed with Chi-square test or t-test. Results: Of the 1,645 respondents, the prevalence of dyspeptic syndrome was 58.1%. The most apparent clinical complaint ranges consecutively, i.e. nausea 30.1%, epigastric pain 28.7%, bloating 23.8%, etc. Dyspeptic syndrome is significantly more often experienced by female respondents (p 0.001). Dyspeptic syndrome were more common in respondents who have less/no fruit (p 0.001) and vegetables (p = 0.049) intake. Dyspeptic syndrome is more common in respondents with anxiety and depression (p 0.001) also in respondents who consume non-steroidal anti-inflammatory drugs (NSAIDs) (p 0.001). Conclusion: Prevalence of dyspeptic syndrome in Jakarta urban population is 58.1%. Dyspeptic syndrome was more common in female, respondents who have less / no fruit and vegetables intake, in respondents who experienced anxiety and depression and respondents who consume NSAIDs. Keywords: dyspeptic syndrome, Jakarta, urban population, prevalence
Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients Ralph Girson Gunarsa; Marcellus Simadibrata; Ari Fahrial Syam; Ina Susianti Timan; Siti Setiati; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (535.438 KB) | DOI: 10.24871/122201189-94

Abstract

Background: Nowadays, there are still many malnourished patients during hospitalization, which comprises around 45-50% patients. Malnutrition is related to increased mortality and morbidity rate; therefore, nutritional state should be assessed in hospitalized patients. Total lymphocyte count (TLC) is related to decreased body function in malnutrition and it is a means of nutritional assessment. Until now, there is no data showing association between malnutrition and TLC in hospitalized patients in Indonesia. The objective of this study was to identify the association between malnutrition and TLC 1,200 cell/mm3 in hospitalized patients. Method: This study was a cross-sectional study. Subjects were new patients hospitalized at internal medicine ward of Cipto Mangunkusumo Hospital. Patients were collected by consecutive sampling. We conducted the study between April and May 2008. Fifty four patients were assessed for malnutrition by the subjective global assessment (SGA) and they also had undergone complete blood count. TLC was numbered with routine complete blood count test. Patients were classified into malnutrition according to SGA. TLC was classified with cut-off point of 1,200 cell/mm3. Statistical analysis included Chi-square test, which was used to compare proportion. Results: There were 52% malnourished patients, 33% patients with TLC 1,200 cell/mm3, 57% patients with malnutrition and TLC 1,200 cell/mm3. This study showed that there was an association between malnutrition and TLC 1,200 cell/mm3 (p = 0.001). Moreover, there was also significant association between severe malnutrition (SGA C) with TLC 900 cell/mm3 (p = 0.02). Conclusion: There is an association between malnutrition and TLC 1,200 cell/mm3.   Keywords: malnutrition, total lymphocyte count, body mass index, subjective global assessment
Co-Authors Aan Santi ACHMAD FAUZI Ahmad Fauzi Ahmad Soefyani Ahmar Abyadh Ali Imron Yusuf Ari Fahrial Syam Bona Adhista Budi Tan Oto Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisastro Deddy Gunawanjati Dedy Gunawanjati Sudrajat Dharmika Djojoningrat Diah Rini Handjari Djulzasri Albar Dolly Dolven Kansera DWI SURYANTO Ekowati Rahajeng Ellen Susanti Elli Arsita Endang Susalit Ening Krisnuhoni Fajar Raditya Fransiska Hardi Fumiaki Kitahara Gunawanjati Sudrajat Hiroyuki Otsuka Hotmen Sijabat Ina Susianti Timan Indra Marki Irsan Hasan Jacobus Albertus Jane Estherina Jeffri Gunawan Joseph JY Sung Julwan Pribadi Kaka Renaldi Katharina Setyawati Lianda Siregar Marcellus Simadibrata Masayuki A Fujino Masayuki A. Fujino Moch Ikhsan Mokoagow Murdani Abdullah Nata Pratama Novie Rahmawati Zirta Nur Rasyid Nurul Akbar Pamela Abineno Pamela Abineno Damaledo Paulus Kusnanto Pradana Suwondo Raden Nur Ista Ralph Girson Gunarsa Riahdo Saragih Rizki Yaruntradhani Ruswhandi Martamala Salius Silih Sedijono Sedijono Seri Mei Maya Ulina Siti Setiati Steven Sumantri Suhardjono Suhardjono Sumaryono Sumaryono Suryantini Suryantini Suzana Ndraha Tadashi Sato Tjahjadi Robert Tedjasaputra Unggul Budihusodo Widyasari Kumala Yuichiro Kojima