Murdani Abdullah
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

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Alpha-1 Acid Glycoprotein Cut-off Value as Diagnostic Biomarker in Hepatocelular Carcinoma with Liver Cirrhosis Maulana Suryamin; Rino A Gani; Murdani Abdullah; C Martin Rumende
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (145.055 KB) | DOI: 10.24871/1532014136-142

Abstract

Background: Hepatocellular carcinoma (HCC) remains a major problem throughout the world, especially in diagnostic and therapeutic management. Previous studies stated that alpha-1 acid glycoprotein (AAG) was a potensial biomarker in diagnostic of HCC. This study assessed the best cut-off value of AAG as a diagnostic biomarker of HCC with liver cirrhosis.Method: This was a cross-sectional, diagnostic study, conducted from January to October 2013 in Cipto Mangunkusumo Hospital. The subjects were HCC with liver cirrhosis patients and as control were liver cirrhosis patients. Abdominal ultrasonography (USG), abdominal 3 phase contrast computerized tomography (CT) scan, and liver biopsy, if necessary, were done. All patients were having AAG examination, then the result was analyzed using receiver operating characteristic (ROC) curve and assessment of some cut-off values was done.Results: There were 25 HCC with liver cirrhosis patients and 37 liver cirrhosis patients as control included in this study. HCC with liver cirrhosis patients were 92% male and 8% were female, over 50 years old (72%). HBV infection was the most common etiology and most of the patients had multiple nodules in the liver (80%). ROC curve showed the area under the curve (AUC) was 81.44%.Conclusion: The best cut-off value of AAG to be aware of HCC with liver cirrhosis was 61 mg/dL and as a diagnostic was 136 mg/dL.                                                                            Keywords: hepatocelullar carcinoma, alpha-1 acid glycoprotein, cut-off      
The Use of Immunochemical Fecal Occult Blood Test as Colorectal Cancer Screening Tool in Asymptomatic Population in Indonesia Murdani Abdullah; Hayatun Nufus; Ari Fahrial Syam; Dadang Makmun; Marcellus Simadibrata; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4677.787 KB) | DOI: 10.24871/151201415-9

Abstract

Background: Colorectal cancer is the fourth leading cause of cancer-related mortality worldwide. Earlydetection of colorectal cancer is necessary in term of increasing survival. Immunochemical fecal occult bloodtest (I-FOBT) is one of the simple and inexpensive screening modality that can be used widely. No data has been available yet regarding the usage of I-FOBT in Indonesia. This study is a prevalence study of I-FOBT in asymptomatic population in Indonesia. Method: A cross sectional study was conducted in asymptomatic population visiting five public health service centers in Depok district, West Java, Indonesia. This study was performed from January to March 2012. Casereport form and I-FOBT kit were used to assess and screen the patients. Statistic analysis was performed usingChi-square test. Results: The prevalence of positive I-FOBT was almost equally distributed among age group. Femaledominated whole patients 202 (72.7%). Most of them had middle to low education level 116 (41.7%). As manyas 50.7% patients had normal body mass index. We had 11 (4%) patients with positive result of I-FOBT. Conclusion: Prevalence of positive result of I-FOBT in asymptomatic population in Indonesia was 4%.Further studies were needed to confirm sensitivity and specifity of I-FOBT in Indonesia.Keywords: colorectal cancer, immunochemical fecal occult blood test (I-FOBT), early detection
Cost Effectiveness and Efficiency of Reusing Single-use Medical Devices Aan Santi; Risa Ismadewi; TR Fitriyani; Murdani Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5050.717 KB) | DOI: 10.24871/151201425-30

Abstract

Background: Reusing single-use medical devices is a very important and complicated process since theimplementation requires both operational and technical skills, even for professional users. The aim of our studywas to determine the cost effectiveness and efficiency of reusing single-use medical devices. Method: The study was a cross-sectional study conducted between July and December 2013. It compared twogroups of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) examination at the Digestive Endoscopy Center, Cipto Mangunkusumo Hospital, Jakarta. Patients in the first group received new single-use medical devices; while patients in the other group received the re-used single-use medical devices.Reprocessing for reusing single-used medical devices was conducted according to standard procedures ofdecontamination and sterilization. Results: Reusing medical devices were more commonly found (50.9%) in ERCP procedures than usingnew medical devices (49.1%). There was no significant difference on operator satisfaction between using there-used and new medical devices (p = 0.062). There was lower average cost for reusing medical devices thanusing new medical devices (IDR 198,818,250.00 vs. IDR 594,354,000.00; p = 0.000); percentage of successrate for reusing was lower than new medical devices (80% vs. 90,6%; p = 0.203). There was also no significantdifference regarding the negative impacts such as fever or infection of reusing medical devices compared tousing new medical devices (p = 0.676). Conclusion: This study has shown good effectiveness in terms of operator satisfaction, success rate andimpacts on patients. The cost for reusing medical devices is more efficient than using new medical devices.Keywords: effectiveness, efficiency, reusing medical devices, new, endoscopy ABSTRAKLatar belakang: Penggunaan alat medis sekali pakai (single-use) yang dipakai kembali (re-use) menjadi sangat penting dan kompleks dalam menerapkan kemampuan operasional dan teknik pada profesional penggunaalat tersebut. Tujuan penelitian ini adalah untuk menilai efektifitas biaya dan efisiensi penggunaan perangkatmedis single-use yang dijadikan re-use. Metode: Penelitian ini merupakan penelitian potong lintang dilakukan pada Juli hingga Desember2013. Penelitian membandingkan dua kelompok pasien yang menjalani pemeriksaan endoscopic retrogradecholangiopancreatography (ERCP) di Pusat Endoskopi Saluran Cerna (PESC), Rumah Sakit CiptoMangunkusumo, Jakarta. Pasien pada kelompok pertama menerima tindakan dengan alat medis baru; sedangkanpasien di grup lainnya menerima tindakan dengan alat medis re-use. Proses penggunaan alat medis re-use dilakukan sesuai dengan prosedur dekontaminasi dan sterilisasi yang berlaku. Hasil: Penggunaan alat medis dalam tindakan ERCP lebih banyak menggunakan alat re-use (50,9%) dibandingkan alat baru (49,1%); kepuasan operator pada alat re-use maupun alat baru tidak berbeda secarasignifikan (p = 0,062); rata-rata biaya pada penggunaan alat re-use lebih rendah dibandingkan pada alat baru (Rp 198.818.250,00 vs. Rp 594.354.000,00; p = 0.000); persentase keberhasilan penggunaan alat re-use lebihrendah dibandingkan pada alat baru (80% vs. 90,6%; p = 0,203); dampak berupa terjadi demam atau infeksipada penggunaan alat re-use dan alat baru tidak menunjukkan perbedaan yang signifikan (p = 0,676). Simpulan: Penggunaan alat re-use menunjukkan efektifitas yang baik pada kepuasan operator, keberhasilanalat, dan dampak pada pasien. Biaya penggunaan alat re-use lebih efisien dibanding dengan penggunaan alatbaru.Kata kunci: efektifitas, efisiensi, perangkat medis re-use, baru, endoskopi