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

Eka Surya Nugraha

Division Of Gastroenterology And Hepatology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung

Author-ID : 5436393

Medicine & Pharmacology

Published : 6 Documents Claim Missing Document

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Articles

Clinical Manifestations and Laboratory Examination Findings of Hepatocellular Carcinoma at a Tertiary Care Facility in Bandung: An Annual Observation Study Grace Amanda Maharani; Eka Surya Nugraha; Adhi Kristianto Sugianli
Althea Medical Journal Vol 8, No 3 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v8n3.2333

Background: Hepatocellular Carcinoma (HCC) is the most prevalent liver cancer with high mortality. Early detection is important for better patient outcomes. The aim of this study was to explore clinical manifestations and laboratory examinations among HCC patients in a tertiary care facility.Methods: This was a cross-sectional descriptive study with a total sampling method, reviewing the medical record of patients with HCC in the Outpatient Clinic of Dr. Hasan Sadikin General Hospital between January to December 2019. Clinical manifestations, laboratory findings, and imaging results data were collected.Results: Of the 112 HCC patients included in this study, the HCC findings among new patients at the outpatient clinic were 8.4%, with hepatitis B (80.8%) as the major etiology. Complaints of abdominal pain (65.2%) was frequent. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were increased in 89.8% and 67% of patients, as well as total bilirubin levels in 58.8% of patients. In contrast, hemoglobin and albumin levels decreased in 55.3% and 78.1% of patients, respectively. The characteristics of tumor were mainly multinodular, with a size of 3-10 cm.Conclusions: The annual proportion of HCC in Dr. Hasan Sadikin General Hospital in 2019 is 8.4% among all outpatient gastrointestinal and hepatology cases, with hepatitis B as the most common etiology. Abdominal pain is the predominantly prevalent clinical manifestation with increased ALT and AST levels.

Role of Radial Endoscopic-ultrasound (EUS) to Establish Diagnosis of Undetermined Causes of Obstructive Jaundice: A Case Series Eka Surya Nugraha; Dolvy Girawan; Nenny Agustanti; Yudi Wahyudi; Muhammad Begawan Bestari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Identification the causes of obstructive jaundice are challenging. Recent radiologic imaging techniques improve diagnostic yield to determine jaundice causes. However, small lesions particularly in pancreas or periampullary area that lead to jaundice, often unrecognize with conventional radiologic imaging. Radial endoscopic-ultrasound (EUS) is the most sensitive modality to identify the lesions-related obstructive jaundice, remarkably in the lack of high-resolution radiologic facilities. We presented four cases of obstructive jaundice, without obvious obstruction causes from conventional radiologic imaging or abdominal ultrasound. All patients underwent radial EUS, pancreatic head mass revealed in 2 patients, and distal stenosis of the common bile duct without evidence of mass was found in 2 other patients. The masses size were 16 mm and 39 mm in diameter. Due to linear EUS and EUS guided fine needle were unavailable in our center, confirmation biopsy was undone. Three patients were performed endoscopic retrograde cholangiopancreatography (ERCP) for dilatation and inserting stents, and one patient referred to the surgeon. In conclusion, radial EUS aided to diagnose the definite causes of jaundice despite in the less-equipped of high-resolution radiologic imaging.

The Efficacy of Generic Daclatasvir-Sofosbuvir as Pan-Genotypic Regiment for Hepatitis C Virus (HCV) Infected Patients in Bandung Indonesia Muhammad Begawan Bestari; Eka Surya Nugraha; Siti Aminah Abdurachman
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

Background: Direct-acting antivirals (DAAs) have altered the prognosis of hepatitis C virus (HCV) disease but its access is limited by socioeconomic factors. Generic DAAs with lower prices were available in Indonesia in 2016. The aim of this study was to determine the efficacy of generic daclatasvir-sofosbuvir.Method: We performed an observational study from January to December 2016 in a tertiary care center in Bandung, Indonesia. Data were obtained from medical registry. All study subjects received oral daclatasvir (60 mg, once daily) and sofosbuvir (400 mg, once daily) for 12 weeks for noncirrhotic chronic HCV patients and 24 weeks for cirrhotic chronic HCV patients. The main endpoint criterion was sustained virologic response at post-treatment week 12 (SVR12).Results: We enrolled 32 subjects (20 noncirrhotic, 12 cirrhotic). All noncirrhotic subjects (eighteen were previously untreated patients) and cirrhotic subjects (all were previously untreated patients) achieved SVR12 of 100%. These high rates of SVR12 were observed in all patients with HCV infection regardless of the genotype. ALT normalization was achieved in all patients 12 weeks after therapy. The most common adverse events were fatigue and nausea.Conclusion: Once-daily oral generic daclatasvir-sofosbuvir showed good efficacy and safety. Furthermore, it yielded a high rate of SVR among patients infected with HCV of all genotypes.

The COVID-19 with Gastrointestinal Symptoms: A Case Report Eka Surya Nugraha; Davin Takaryanto; Susantina Prodjosoewojo; Nenny Agustanti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 2 (2020): VOLUME 21, NUMBER 2, August 2020
Publisher : The Indonesian Society for Digestive Endoscopy

The COVID-19 mostly manifested as fever and pulmonary symptoms, but recent evidence demonstrated the frequent gastrointestinal symptoms in particular moderate to severe disease. Here, we present a case of a 51-years old man with confirmed COVID-19 diagnosis who was admitted with profuse acute diarrhea and nausea. He previously had a mild fever, cough, and shortness of breath. Administration of oseltamivir, levofloxacin, and chloroquine sulfate exaggerated vomiting, nausea, and increased serum level transaminase. After withdrawal, the gastrointestinal symptoms were relieved gradually. Adequate supportive treatment and fluid therapy ceased diarrhea and led to the negative result of the nasal swab RT-PCR COVID-19 after seven days.

Antiviral Treatment and One-Year Follow-Up of Chronic Hepatitis B Patients in Bandung: An Observational Study Eka Surya Nugraha; Stefanie Hadi Supriami; Nur Atik; Nenny Agustanti; Yudi Wahyudi; Dolvy Girawan; M Begawan Bestari; Siti Aminah Abdurachman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 2 (2022): VOLUME 23, NUMBER 2, August 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Hepatitis B Virus (HBV) is a health problem that has chronically infected 257 million globally. Appropriate therapy is immensely needed to prevent disease progression to cirrhosis and hepatocellular carcinoma (HCC). Moreover, routine monitoring is required to assess the efficacy of the given treatment. This study aims to describe the treatment and its follow-up outcomes among chronic HBV patients after one year of therapy in Bandung.Method: This was a cross-sectional descriptive study with a data sampling method obtained from assessing the medical records of treated chronic HBV outpatients at the Gastrohepatoenterology Clinic of Hasan Sadikin Hospital Bandung from 2018 to 2020. Laboratory findings before and after one year of therapy were further assessed.Results: Out of 107 patients treated, the proportion of tenofovir was 72.90%, telbivudine 16.80%, lamivudine 8.40%, and interferon group 1.90%. There were 52.30% of patients who did follow-up visits after one year of therapy. The therapeutic outcome rate was evaluated among total patients with the criteria of decreasing AST (91.18%) and ALT levels (93.10%) levels, reduction of HBV-DNA values (100%), and HBeAg seroconversion (14.29%).Conclusion: The most given therapy among chronic HBV outpatients was tenofovir. The follow-up rate of patients after one year of treatment was 52.30%. Overall, antiviral therapies produced decreases in liver laboratory parameters, HBV-DNA, and HBeAg.

Colonoscopy and Histopathologic Features in Chronic Diarrhea Patients at Dr. Hasan Sadikin General Hospital, Bandung Rasdianto, Devi Novianto; Nugraha, Eka Surya; Usman, Hermin Aminah; Agustanti, Nenny; Wahyudi, Yudi; Girawan, Dolvy; Bestari, Muhammad Begawan; Abdurachman, Siti Aminah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 3 (2022): VOLUME 23, NUMBER 3, December 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2332022188-192

Background: Diagnosing and managing patients with chronic diarrhea remains a clinical challenge due to its broad differential diagnoses. Colonoscopy with biopsy is often indicated to establish chronic diarrhea etiologies. However, to date, no data have been published describing the colonoscopic and histological findings in patients with chronic diarrhea at Dr. Hasan Sadikin General Hospital in Bandung. This study aimed to determine the features of colonoscopy and histology in patients with chronic diarrhea.Methods: This study employed a cross-sectional-descriptive design, utilizing secondary data from colonoscopy examinations conducted at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. Participants included adults aged 18 and above who had been diagnosed with chronic diarrhea and had completed both colonoscopy and biopsy procedures.Results: A total of 182 subjects with chronic diarrhea were included in the study. The majority were women (52%), with mean age of 46 years. Upon admission, the predominant clinical presentation was chronic diarrhea without hematochezia, observed in 75% of cases. Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. The most frequent colonoscopic features were hyperemic or edematous lesions, seen in 58% of subjects. The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies and inflammatory bowel disease (IBD) that is 14% 12%, respectively.Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The most frequently observed lesion was hyperemic mucosa. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD .

Co-Authors Adhi Kristianto Sugianli Agustanty, Nenny Davin Takaryanto Dolvy Girawan Grace Amanda Maharani Hermin Aminah Usman M Begawan Bestari Muhammad Begawan Bestari Nenny Agustanti Nur Atik Rasdianto, Devi Novianto Siti Aminah Abdurachman Siti Aminah Abdurachman Siti Aminah Abdurachman Stefanie Hadi Supriami Susantina Prodjosoewojo Yudi Wahyudi Yudi Wahyudi Yudi Wahyudi

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