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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Virly Nanda Muzellina
Division Of Gastroenterology, Department Of Internal Medicine, Faculty Of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Medicine & Pharmacology

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Bowel Cleansing Protocol in Colonoscopy: Does It Affect Blood Thiamine Level? Rabbinu Rangga Pribadi; Virly Nanda Muzellina; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 1 (2020): VOLUME 21, NUMBER 1, April 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (123.647 KB) | DOI: 10.24871/211202022-25

Abstract

Background: The burden of vitamin B1 or thiamine deficiency in patients undergoing digestive surgery is quite enormous. In the field of gastroenterology, pre-colonoscopy preparation might affect thiamine level. However the burden is not well defined. This study was conducted to confirm whether there is significant decrease of blood thiamine level in post-colonoscopy compared to pre-colonoscopy group.Method: This cross-sectional study was carried out at gastrointestinal endoscopy center of Cipto Mangunkusumo National General Hospital, Jakarta from October 2018 to January 2019. The inclusion criteria were patients equal or more than 18-year-old who underwent colonoscopy. The exclusion criteria were malnutrition, history of post-gastrointestinal resection, definitive diagnosis of cancer, and chronic alcoholism.Results: The median value of blood thiamine level is 58 (20-78) for pre-colonoscopy group and 58 (25-79) for post colonoscopy group (p=0.31).Conclusion: There was no significant decrease of blood vitamin B1 level in post-colonoscopy compared to pre-colonoscopy group.
Gastric Outlet Obstruction sebagai Keluhan Awal Limfoma Gaster: Sebuah Laporan Kasus Chen, Lie Khie; Mohammad, Nurhidayat; Rumondor, Bayu B; Muzellina, Virly Nanda
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 4
Publisher : UI Scholars Hub

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Abstract

Gastric lymphoma often presents with non-specific symptoms, contributing to delayed diagnosis. Gastric Outlet Obstruction (GOO) is a potential complication that may occur in patients with gastric lymphoma. A 62-year-old male patient presented with persistent weakness, nausea, and vomiting. His symptoms began with long-standing abdominal discomfort, which had not been further evaluated. Esophagogastroduodenoscopy (EGD) revealed GOO secondary to a mass, which, after pathological and immunohistochemical evaluation, was diagnosed as diffuse large B-cell lymphoma (DLBCL). The patient was subsequently given a nasojejunal feeding tube and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and oral prednisone). The non-specific nature of gastric lymphoma symptoms often results in diagnostic delays, resulting in diagnoses at more advanced stages. Gastric lymphoma complicated by GOO poses distinct challenges, particularly in managing nutritional support, which can impair the patient’s performance status and, in turn, influence treatment response and overall survival. Due to the non-specific nature of initial symptoms, many patients with gastric lymphoma are diagnosed at later stages. Therefore, early screening for patients with atypical dyspepsia symptoms is essential to rule out malignancies, including gastric lymphoma.
Probiotics for Preventing Relapse in Ulcerative Colitis: A Systematic Review and Bayesian Network Meta-Analysis Alvianto, Steven; Muzellina, Virly Nanda; Widjanarko, Nicolas Daniel; Lee, Yeong Yeh; Wangidjaja, Olivia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, August, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025130-142

Abstract

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of relapse and remission. Preventing relapse is critical to improving long-term outcomes. This study aimed to compare the efficacy of probiotics, 5-aminosalicylic acid (5-ASA), probiotics combined with 5-ASA, and placebo in preventing relapse in UC.Methods: A comprehensive search from PubMed, Cochrane Library, MEDLINE, ProQuest, ScienceDirect, Clinical Trials. gov and Google Scholar databases were conducted. The primary outcome was clinical relapse. A Bayesian random-effects model calculated pooled odds ratios (ORs) with 95% CIs and treatment ranks were assessed using the surface under the cumulative ranking curve (SUCRA).Results: Of total 552 initial papers, 37 extracted, and 26 were removed due to exclusion criteria. Eleven RCTs involving 1,099 participants were eventually included for analysis. Probiotics combined with 5-ASA had the highest efficacy (OR = 0.23, 95% CI: 0.027–1.09; SUCRA = 71.43), followed by 5-ASA alone (OR = 0.25, 95% CI: 0.035–0.95; SUCRA = 66.90) and probiotics alone (OR = 0.275, 95% CI: 0.059–0.724; SUCRA = 59.69). Placebo ranked lowest (SUCRA = 1.98). The most commonly used probiotics included E. coli Nissle 1917, Lactobacillus GG, and Bifidobacterium species. The most frequently used 5-ASA preparation was mesalazine. Interventions were generally well-tolerated, with no significant adverse events reported. Conclusion: With the Bayesian NMA, Probiotics plus 5-ASA demonstrates the highest efficacy in preventing relapses in UC. Further research is needed to standardize probiotic regimens and to assess long-term outcomes with the combination approach.
The Effectiveness of a High-Protein Liquid Dietary Supplementation in Improving Nutritional Status of Malnourished Patients in Hospital Care: a Preliminary Study Simadibrata, Marcellus; Abdullah, Murdani; Witjaksono, Fiastuti; Muzellina, Virly Nanda; Utari, Amanda Pitarini; Wulandari, Yohannessa; Wijayanti, Ari; Mustikarani, Dewi; Haloho, Raja Mangatur; Rachman, Aditya; Simadibrata, Daniel Martin; Mutiara, Rizka; Renaldi, Kaka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (671.108 KB) | DOI: 10.24871/231202243-51

Abstract

Background: Malnutrition is a very common problem in hospitalized patients. Based on studies conducted in various countries, the prevalence of hospital malnutrition ranges from 20-45%. Hospital malnutrition can occur as a result of insufficient nutrient intake, impaired absorption of nutrients in the gastrointestinal (GI) tract, loss of nutrients due to disease, or increased metabolic requirement during illness. Nutrition is the basis for the healing process as it requires good nutrients through various enzymatic reactions. Some studies have shown that hospital malnutrition increases morbidity, mortality, prolongs the duration of hospitalization, and delays recovery. To improve nutritional status, a high-protein diet can be given. Liquid diet is one of the alternative forms of nutrition because it is easier to swallow.Method: This study was a double-blind randomized controlled trial conducted to assess the effectiveness of high protein liquid dietary supplementation in malnourished hospitalized patients. The patients were assessed for their nutritional status based on ESPEN 2015 criteria. Patients who experienced malnutrition will be divided into 2 groups, namely the control group which was given normal protein liquid diet, while the intervention group was given high protein liquid diet supplementation as much as 2 bottles (200 mL) per day for 7-10 days. Furthermore, the nutritional status of the patient was assessed.Results: By administering high-protein liquid diet supplementation, there was a tendency to increase the strength of the right handgrip in 3 subjects (50%), the tendency to increase body mass index (BMI) in 3 subjects (50%), Subjective Global Assessment (SGA) score improved in 2 subjects with mild/moderate malnutrition (33.3%) and 1 subject with normal nutrition (16.7%), and the tendency to increase the fat-free mass in 3 subjects (50%).Conclusion: The administration of high protein liquid dietary supplementation tended to increase the strength of the right handgrip, BMI, SGA score, and body fat-free mass index.
Koeksistensi Spondiloartritis Perifer dan Fokal Segmental Glomerulosklerosis: Sebuah Laporan Kasus Jarang Zulaifah, Zakiya; Hapsari, Florentina Carolin Puspita; Muzellina, Virly Nanda
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
Publisher : UI Scholars Hub

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Abstract

Spondyloarthritis is a group of inflammatory rheumatic diseases characterized by shared clinical features, genetic predispositions, and pathogenic mechanisms. Without appropriate management, it carries a risk of various complications. We report the case of a young male patient with a one-year history of nephrotic syndrome prior to admission, presenting with chronic polyarthritis. Initially, systemic lupus erythematosus (SLE) with renal and musculoskeletal involvement was suspected, although SLE is relatively uncommon in young males. However, based on the clinical presentation of arthritis, imaging findings of sacroiliitis, and the absence of diagnostic criteria supporting SLE, the patient was subsequently diagnosed with peripheral spondyloarthritis and nephrotic syndrome secondary to focal segmental glomerulosclerosis (FSGS). Patients with spondyloarthritis have approximately a twofold increased risk of renal complications compared with the general population, with IgA nephropathy being the most common abnormality. Although rare, cases of spondyloarthritis occurring in patients with FSGS have been reported. The relationship between these two conditions remains unclear—whether causal or coincidental—and warrants further investigation. A careful diagnostic approach is essential in patients with chronic polyarthritis, particularly when differential diagnoses do not align with demographic characteristics or clinical presentation. This is crucial to improve diagnostic accuracy, guide appropriate therapy, enable earlier prevention of disease progression, and reduce the risk of complications.
Etiology of Upper Gastrointestinal Bleeding: A Five-Year Study at a Tertiary Hospital Virly Nanda Muzellina; Liovicinie Andarini; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/27120263-9

Abstract

Background: Upper Gastrointestinal bleeding is a common medical condition requiring prompt treatment and endoscopic evaluation. Identifying the causes is crucial for enhancing patient outcomes and guiding clinical decisions. This study aims to evaluate the etiologies of hematemesis and melena over the past five years.Methods: This study analyzed patient records retrospectively who underwent upper gastrointestinal endoscopy at the Gastrointestinal Endoscopy Center in Cipto Mangunkusumo Hospital, Jakarta, Indonesia between 2019 and 2023. Statistical analysis was performed using SPSS version 26.0.Results: Between 2019 and 2023, 5,721 patients underwent upper gastrointestinal endoscopy, with 1,090 (19.1%) due to upper gastrointestinal bleeding. Among these, 593 were male (54.4%) and 497 were female (45.6%), with a mean age of 54.4 ± 15.12 years. The largest age group affected was 40-59 years, comprising 451 cases (41.4%). Of the 1,090 patients, 262 (24%) presented with hematemesis, 654 (60%) with melena, and 174 (16%) with both symptoms. Non-variceal bleeding was identified in 913 cases (83.8%), while variceal causes accounted for 177 cases (16.2%). Erosive gastritis was the leading cause of upper GI bleeding (408 cases, 37.4%), followed by peptic ulcers (270 cases, 24.8%). Among peptic ulcer cases, 136 (50.4%) were located in the stomach. Additionally, cancer was a cause in 104 cases (9.5%), with duodenal cancer being the most common (48 cases, 46.2%).Conclusion: This study identified erosive gastritis as the leading cause of upper gastrointestinal bleeding, followed by peptic ulcers and varices.
Association of HER2 Expression with Clinical, Endoscopic, and Histopathological Features in Gastric Adenocarcinoma dr. Virly Nanda Muzellina, SpPD, K-GEH
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2722026107-110

Abstract

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Co-Authors Aditya Rachman, Aditya Alvianto, Steven Amanda Pitarini Utari Ari Fahrial Syam Ari Wijayanti Fiastuti Witjaksono Haloho, Raja Mangatur Hapsari, Florentina Carolin Puspita Kaka Renaldi Khie Chen Lee, Yeong Yeh Liovicinie Andarini Marcellus Simadibrata K Mohammad, Nurhidayat Murdani Abdullah Mustikarani, Dewi Mutiara, Rizka Rabbinu Rangga Pribadi Rumondor, Bayu B Simadibrata, Daniel Martin Wangidjaja, Olivia Widjanarko, Nicolas Daniel Yohannessa Wulandari Zulaifah, Zakiya