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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Abdul Aziz Rani

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Author-ID : 5435933

Medicine & Pharmacology

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Life Style Factors Influencing Serum Pepsinogen Levels in Healthy Japanese: A Prospective Study Murdani Abdullah; Fumiaki Kitahara; Tadashi Sato; Yuichiro Kojima; Abdul Aziz Rani; Masayuki A. Fujino
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, NUMBER 1, April 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/4120036-10

Background: Gastric cancer mass screening using serum pepsinogen has been recognized and several advantages of this methods over photofluorography have been shown by previous study. Aims: To determine the factors influence the serum pepsinogen levels in healthy subjects. Subjects Methods: One thousand and one hundred fourteen subjects who were screened for gastric cancer as part of a periodic health check. Blood samples were taken after fasting and stored below –20 ° C, until pepsinogen levels were assayed. Results: The subjects consist of 338 males (mean age 52.6+14.0) and 776 females (mean age 49.0+11.9). Age ranges from 19 to 81 years. The overall prevalence of chronic atrophic gastritis using a criterion PG I £ 70 hg/ml and PG I/II ratio £ 3.0 was 21.99 % in 1996 and 23.97 % in 2000. Bivariate analysis revealed a significant association between age, more salt consumption, fish favorable over meat and less than three time meal intake covariates with the lowering of PG I/II ratio. Smoking, drinking, BMI, weight and gender did not affect the changes of PG I/II ratio. Conclusion: Age and more salt consumption covariates have a strongest association with the decreased of PG I/II by multivariate analysis. Keywords: pepsinogen, dietary, drinking, smoking, atrophic gastritis

Obesity as a Risk Factor of Erosive Gastroesophageal Reflux Disease Hotmen Sijabat; Marcellus Simadibrata; Ari Fahrial Syam; Endang Susalit; Djulzasri Albar; Abdul Aziz Rani
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: 10.24871/112201061-65

Background: Gastroesophageal reflux disease (GERD) is a pathological condition of esophagus caused by reflux of gastric content or gastric juice with multifactorial etiologies. Some complications may occur such as: ulcer, bleeding, stricture, Barret’s esophagus and esophageal adenocarcinoma. One of risk factors that currently taken into concern is obesity. Our study aimed to identify obesity and abdominal obesity as the risk factor in the development of erosive GERD and to recognize that abdominal obesity is more important factor compared to obesity itself as the risk factor on the incidence of erosive GERD.. Method: Our study was a cross-sectional study. Data was obtained from eligible patients at Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia between June and September 2009 Results: Samples were 74 patients with mean age of 48.61 ± 8.64 years. The proportion of female patients was larger than male (60.81% vs. 39.19%). The endoscopic assessment of upper gastrointestinal tract based on Los Angeles Classification included: Grade A esophagitis: 27.03%, Grade B: 16.21%, Grade C: 4.05%, Grade D: 1.35%. Obesity (odds ratio (OR) 17.160; 95% confidence interval (CI) 5.219 – 56.418, p = 0.000) and abdominal obesity (OR 10.371, 95% CI 3.260 – 32.915; p = 0.000) has been proven as risk factors in the development of erosive GERD. Conclusion: There is a correlation between obesity and abdominal obesity as risk factors on the development of erosive GERD. Obesity becomes a more important factor compared to abdominal obesity as the risk factor on the development of erosive GERD. Keywords: erosive gastroesophageal reflux disease, obesity, abdominal obesity, risk factor

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

Protein Energy Malnutrition in Liver Cirrhosis Achmad Fauzi; Unggul Budihusodo; Marcellus Simadibrata; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 2, August 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/92200855-63

Protein-energy malnutrition is common in patients with liver cirrhosis, especially in advanced and severe stage. Liver cirrhosis patients with malnutrition have increasing risk to get post-operative complication and mortality. The etiology of malnutrition is multifactorial. Substrate metabolism in liver cirrhosis is characterized by insulin resistance, influencing the transport and elimination of nonoxidative glucose by muscle. Protein turnover occurs in normal rate or it may increase with the increasing of protein degradation. Oxidation and metabolic clearance of fat are normal in patients with liver cirrhosis. Most clinicians used to feed patients with liver disease with a common sense approach, otherwise many investigators suggest the use of nutritional supplements and specialized formulations aggressively, in older to correct pre-existing protein-calorie malnutrition and to stimulate hepatic regeneration. Keywords: malnutrition, liver cirrhosis, branched-chain amino acid

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.

Candida Esophagitis: A Retrospective Study of Upper Gastrointestinal Endoscopic Grading and the Characteristic Profile Steven Sumantri; Marcellus Simadibrata; Moch Ikhsan Mokoagow; Deddy Gunawanjati; Seri Mei Maya Ulina; Bona Adhista; Novie Rahmawati Zirta; Riahdo Saragih; Daldiyono Daldiyono; Abdul Aziz Rani; Murdani Abdullah; Ari Fahrial Syam; Chudahman Manan; Dadang Makmun; Achmad Fauzi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Candida esophagitis is a common abnormality found on esophagogastroduodenoscopy (EGD) procedure in patients with recognizable risk factors. However, the finding is frequently incidental as most of them are asymptomatic. There has been no study on the characteristics of Candida esophagitis in Indonesia. The aim of this study was to describe the degree of Candida esophagitis and its characteristics in patients who underwent EGD procedure at Cipto Mangunkusumo Hospital. Method: A retrospective study was conducted on all EGD procedures at the Gastroenterology Procedure Room, Internal Medicine Department, Cipto Mangunkusumo Hospital, between January 2007 and December 2009 with a total of 2,311 samples. The study was carried out by visually examining all endoscopic procedures and grading them according to the Kodsi severity grading (1976), and evaluating medical records. Data analysis was performed using Microsoft Excel 2007. Results: During the study period, Candida esophagitis was found in 2.6% patients with predominant male (68.9%) and the average age was 49.8 ± 15 years. The chief complaints found were dyspepsia (34.4%), melena (21.3%) and dysphagia (4.9%) and 32.8% patients were asymptomatic. The most frequent risk factors were age ≥ 60 years old (28.3%), proton pump inhibitor or H2 receptor antagonist user (26.4%), and antibiotics (17.0%). Grade II Kodsi candidiasis was the most prevalent degree in this study (44.3%). Conclusion: Candida esophagitis was one frequent finding in endoscopy based on the complaint of dyspepsia in patients with certain risk factors. However, the results of this study still need further validation in prospective studies. Keywords: Candida esophagitis, esophagogastroduodenoscopy, risk factors, grading

A 17-Years Old Man of Colitis Tuberculosis with Fistula Perianal Paulus Kusnanto; Marcellus Simadibrata; Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Daldiyono Daldiyono; Abdul Aziz Rani; Ening Krisnuhoni
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: 10.24871/932008103-106

Tuberculosis (TB) remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tracts. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to its nonspecific signs and symptoms. Perianal granulomas or perianal fistula presents some degree of diagnostic difficulty. A spectrum of diseases can produce granulomas in perianal region and perineum. Most are infectious or inflammatory diseases. Standard histological diagnosis often less significant to clarify the etiology and treatment will vary from one to another disease entity. In this report, we present a case 17-years old man with colitis TB and fistula perianal, in which the initial diagnostic workup suggested Crohn’s disease. Mantoux test, Acid Fast Bacilli test on fecal examination and polymerase chain reaction analysis revealed negative result. The chest X-ray was normal; while the fistulography X-ray: revealed 2 orifices in rectosigmoid area. The colonoscopy revealed mucosa edema with ulceration in rectosigmoid and pedincular polyp in the caecum. Initial colonoscopy diagnosis was Crohn’s disease with differential diagnosis colitis ulcerative, colitis TB, colitis infection. results of direct or post homogenizes examination (Ziel–Nielsen staining) revealed that no acid-fast bacilli was found. Multiple biopsies were done, which indicated mucosa edema with ulceration in rectosigmoid area, pedincular polyp in the caecum, and surrounded by fistula perianal; while histopathological examination showed inflammatory-caseating-epithelioid-granulomas and giant cells (Langhans datia cell) caused by tuberculosis. It highlights the need for awareness of intestinal TB along with the differential diagnosis of chronic intestinal disease. Standard regimen of antituberculosis treatment was given and the patient showed good clinical response. Keywords: Crohn’s disease, caseating epithelioid granuloma, giant cell, colitis TB, perianal fistula

Colitis Tuberculosis Budi Tan Oto; Ahmad 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 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010143-149

Tuberculosis (TB) is a significant public health problem worldwide. Indonesia is a country with the third highest prevalence of TB in the world after China and India. TB infection can attack all organs of the human body. TB in digestive system is one of the extrapulmonary TB manifestations and comprises of 3- 16% of all extrapulmonary TB cases. This type of TB may affect digestive system, peritoneum, mesentery lymphatic glands, liver, and spleen. Digestive system is affected in 66-75% of patients with abdominal TB. The ileocaecal region is most commonly affected. The manifestation of abdominal TB is not specific. Precise diagnostic approach and supporting results are needed to determine final diagnosis. However, there is no single examination adequate enough to diagnose abdominal TB. If the diagnosis can be established early, this disease could then be managed with conventional anti-TB drugs. Treatment for both 6-9 months period and 18-24 months period has been proven effective in management of extrapulmonary TB. In countries with high abdominal TB prevalence, initiation of anti-TB therapy is allowed if there are the clinical features present. Diagnosis can be determined when the patient has therapeutic response against the the anti-TB treatment. Keywords: tuberculosis, colitis, extrapulmonary, antituberculosis drugs

Through-the-scope Polyethylene Balloon Dilations in Benign Corrosive Esophageal Stricture Complicated with Temporomandibular Joint Dislocation Elli Arsita; Achmad Fauzi; Jeffri Gunawan; Kaka Renaldi; Ari Fahrial Syam; Murdani Abdullah; Marcellus Simadibrata; 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

Esophageal dilation is a non-surgical management for anatomic and functional abnormalities causing both benign and malignant esophageal stricture. The basic goals of stricture dilation include safe and efficacious lumenal enlargement plus prevention of restenosis. These could be achieved using through- the-scope (TTS) balloon dilations, ranged in diameter of 4 to 40 mm, they will allow dilation of previously inaccessible strictures in the esophagus, stomach, small bowel, and colon. There are 5,000–15,000 cases of stricture due to ingestion of corrosive substances in United States every year. The following case would demonstrate a 28-year-old male with depressive disorder who attempted a suicide by ingesting corrosive substances two months before admission. Subsequently he started having difficulty in swallowing even soft foods. The complaint was gradually increasing until a month before admission he went through endoscopic examination and a corrosive esophageal stricture found. Hence after, he underwent dilation using Savary bouginage with fluoroscopy and through-the-scope (TTS) balloon dilations. The patient underwent a series of dilation treatment and demonstrated vigorous improvement. Problems raised as the patient was complicated with temporomandibular joint (TMJ) dislocation due to traumatic injury after ingesting corrosive substances. The consideration in management of esophageal stricture with complications will be discussed further in this article. Keywords: esophageal stricture, corrosive substances, dysphagia, temporomandibular joint dislocation, through-the-scope polyethylene balloon dilation

The Cyclooxygenase-2 and Nuclear Factor-kappa B Expressions in Colorectal Polyps Ahmar Abyadh; Diah Rini Handjari; Murdani Abdullah; Pamela Abineno Damaledo; Abdul Aziz Rani
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: 10.24871/112201055-60

Background: Cyclooxygenase-2 (COX-2) is the rate-limiting enzyme in prostaglandin synthesis, while nuclear factor kappa B (NF-kB) is a family of transcription factors. Both play an important role in tumorigenesis. In the present study, we examined NF-kB and COX-2 expressions pattern, and their association in neoplastic and non-neoplastic colorectal polyps (CP). Method: Formalin-fixed and paraffin embedded tissue blocks from 77 patients with CP were immunostained with anti-NF-kB (p 65) and anti-COX-2. Expressions of NF-kB, and COX-2 were detected immunohistochemically. The relationship between these expressions and the two types of CP, and other clinicopathological findings were evaluated Results: The expressions of NF-kB and COX-2 in patients with neoplastic and non-neoplastic CP were high. The results of this study indicated that generally in CP, NF-kB was associated with COX-2 and the association was also seen in neoplastic and non-neoplastic polyps. There was no significant difference of NF-kB and COX-2 expressions in terms of patient’s age, sex, histologic type, and location of the CP. Neoplastic CPs were more common in the distal colon, female patients and older patients ( 60 years) compared with non-neoplastic CPs. Neoplastic CP were located more at the distal colon, more in female, and more in older ( 60 years) patients as compared with the non-neoplastic CP. Further studies are needed to elaborate the role of inflammation in sporadic colorectal carcinogenesis. Conclusion: The expressions of NF-kB and COX-2 in patients with CP were high, and strong correlated each other. There were no significant differences between expression of NF-kB and COX-2 in neoplastic and non-neoplastic polyps. Keywords: colorectal polyps (CP), NF- B, COX-2, inflammation

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

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