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All Journal Medical Journal of Indonesia Abdimas Umtas : Jurnal Pengabdian kepada Masyarakat The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Hasan Maulahela
Division Of Gastroenterology, Department Of Internal Medicine, Faculty Of Medicine Universitas Indonesia/Dr. Cipto Mangukusumo General National Hospital, Jakarta
Religion Agriculture, Biological Sciences & Forestry Arts Education Health Professions Medicine & Pharmacology Public Health Social Sciences

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Diarrhea as a Prognostic Factor for Severe COVID-19 Dinda Nisrina; Hasan Maulahela
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (502.539 KB) | DOI: 10.24871/2322022266-271

Abstract

In March of 2020, the WHO has declared the state pandemic of COVID-19 that started in the city of Wuhan, China. The widespread of cases resulted in 2,877,476 cases and 73,582 death reported in Indonesia. It is commonly known that the respiratory system was the main problem in COVID-19, but it is recently reported that gastrointestinal involevment has a higher likelihood to develop into severe cases. Moreover, it is found that diarrhea is the most highly prevalent of the gastrointestinal signs and symptoms in COVID-19 patients. The aim of this evidence-based case report is to understand the association between diarrhea and severe cases of COVID-19. A search on Pubmed, Scopus and Cochrane result in five articles to be appraised using Centre for Evidence-Based Medicine (CEBM) critical appraisal tool. The most recent systematic review by Ghimere S et al (2020), found COVID-19 patients with diarrhea has higher likelihood of developin ginto a severe case (OR = 1.63, 95% CI: 1.11 – 2.38). While the cohort studies showed several prognostic factors that may potentially effect the outcome of severe COVID-19 cases. It is concluded that severe COVID-19 cases were more likely to be found in patients presenting with diarrhea. Thus, Confirmed COVID-19 patients with diarrhea should be carefully evaluated to anticipate worsening of symptoms.
The Role of Argon Plasma Coagulation in Radiation Proctitis: Obtaining Real Clinical Data Hasan Maulahela
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (240.914 KB) | DOI: 10.24871/222202193-94

Abstract

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Exhaled Breath Analysis for COVID-19 Investigation: Clinical instruments or Scientific Toys? Isna Mahmudah; Naufali Rizkiawan; Husin Thamrin; Brian Eka Rahman; Hasan Maulahela; Yudith Annisa Ayu Rezkitha; Yoshio Yamaoka; Muhammad Miftahussurur
ABDIMAS: Jurnal Pengabdian Masyarakat Vol. 6 No. 1 (2023): ABDIMAS UMTAS: Jurnal Pengabdian Kepada Masyarakat
Publisher : LPPM Universitas Muhammadiyah Tasikmalaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35568/abdimas.v6i1.2910

Abstract

The COVID-19 pandemic was crucial worldwide. Ongoing COVID-19 disease investigation methods were primarily based on molecular and serological detection. These instruments are invasive and necessarily require the use of trained personnel. Non-invasive COVID-19 investi-gation methods could help diagnose and monitor the outbreak. Because the SARS-CoV-2 virus is non-living, it lacks its metabolism. Different infectious diseases can release volatile organic compounds (VOCs), resulting in specific VOCs. All of these are metabolic products primarily produced locally in the respiratory system and systemically via blood circulation. We overview the clinical applications in the COVID-19 investigation and summarize the methodological is-sues. Numerous VOCs in the exhaled breath have the prospects to distinguish patients from healthy people and people infected with COVID-19. It is hard to define COVID-19 using VOCs from exhaled breath. Due to a lack of standardization in data collecting and processing proce-dures, their use in clinical practice is hampered. There are insufficient studies and external vali-dation to determine whether exhaled breath analysis adds value to the diagnostic and follow-up processes for COVID-19 infection. In conclusion, the use of VOCs in exhaled breath as a marker for COVID-19 infection has not been validated for clinical use.
Selective Serotonin Reuptake Inhibitors and Risk of Gastrointesinal Bleeding In Dyspepsia: An Evidence-Based Case Report Shatri, Hamzah; Zulkifly, Steven; Putranto, Rudi; Makmun, Dadang; Fauzi, Achmad; Maulahela, Hasan; Faisal, Edward; Irvianita, Vinandia; Ardani, Yanuar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023182-191

Abstract

Aim: This evidence-based case report aims to provide the latest evidence about the risk of gastrointesinal (GI) bleeding in selective serotonin reuptake inhibitor (SSRI) users with dyspepsia.Method: The literature search was conducted in four major electronic databases (PubMed, Cochrane, Scopus, ProQuest). The selected articles were sorted through screening abstract based on the inclusion and exclusion criteria. Critical appraisal was performed by using validated critical appraisal tool.Results: Of 247 records from extensive literature searching, three eligible studies (one randomized clinical trial and two cohort studies) were obtained to answer the clinical question. All studies showed SSRIs did not increase the risk of GI bleeding in patients with functional dyspepsia and peptic ulcer. However, the adverse event of SSRIs might be under-reported.Conclusion: According to the evidence, the risk of GI bleeding in SSRIs users with dyspepsia is still unclear. Larger size of sample of controlled trial study is recommended to be conducted to calculate the precise risk of GI bleeding in SSRI users with dyspepsia.
Sarkopenia sebagai Faktor Risiko Varises Esofagus Risiko Tinggi berdasarkan Stratifikasi Child-Pugh Pasien Sirosis Hati Sepmeitutu, Iwandheny; Kurniawan, Juferdy; Maulahela, Hasan; Rinaldi, Ikhwan; Shatri, Hamzah; Pramana, Triyanta Yuli; Makmun, Dadang; Lesmana, Cosmas Rinaldi A; Hidayat, Rudy; Laksmi, Purwita Wijaya; Sunardi, Diana
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Background The high prevalence of sarcopenia in chronic liver disease negatively impacts the quality of life and increases the risk of various complications of cirrhosis, one of which is the development of esophageal varices. The aim of this study was to determine the prevalence of sarcopenia in cirrhosis patients based on the severity of liver cirrhosis and to explore the association of sarcopenia with high-risk esophageal varices stratified by Child-Pugh. Methods This observational cross-sectional study involved patients with liver cirrhosis at Cipto Mangunkusumo Hospital between January and September 2023. Sarcopenia was defined as a reduction in muscle mass accompanied by decreased grip strength or walking speed, according to the AWGS 2019 criteria (Asian Working Group for Sarcopenia). Multivariate logistic regression analysis was conducted to evaluate the association between sarcopenia and high-risk esophageal varices. Results A total of 155 patients with liver cirrhosis were included in this study. The majority of liver cirrhosis patients were males, with hepatitis B being the most commonly found etiology. The prevalence of sarcopenia was found in 40.0% of Child-Pugh A patients, 53.8% of Child-Pugh B patients, and 50.0% of Child-Pugh C patients with a p-value of 0.411. The high-risk of esophageal varices was found more frequently in Child-Pugh B (53.8%) and Child-Pugh C (50.0%) compared to Child-Pugh A (25.6%) with a p-value of 0.013. Bivariate analysis showed that the presence of sarcopenia in liver cirrhosis patients has a statistically significant association with an increased risk of high-risk esophageal varices, especially in the Child-Pugh B and C subgroups of liver cirrhosis patients (OR = 7.50 (95% CI: 1.48 – 37.91, p<0.030)). However, no association was found between sarcopenia and high-risk esophageal varices in the Child-Pugh A subgroup (OR = 1.46 (95% CI: 0.65 – 3.29, p<0.477)). Conclusion Sarcopenia significantly increases the risk of high-risk esophageal varices in liver cirrhosis, especially in those with Child-Pugh B and C classification.
Cardiopulmonary Complications During and After Endoscopy in Elderly Patients:a Prospective Study Yusuf, Sabrina Munggarani; Dwimartutie, Noto; Maulahela, Hasan; Harimurti, Kuntjoro; Rinaldi, Ikhwan; Yunihastuti, Evy; Fauzy, Achmad; Putranto, Rudi
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: 10.24871/2622025120-129

Abstract

Background: The high incidence of gastrointestinal and pancreaticobiliary diseases among elderly has led to increased endoscopic procedures in this population. Previous studies indicate a higher risk of cardiopulmonary complications during and after endoscopy in elderly patients compared to younger individuals. This study investigated the incidence and contributing factors of endoscopy-related cardiopulmonary complications in elderly patients.Methods: A prospective cohort study was conducted on 194 patients aged ≥ 60 years undergoing endoscopy at the Gastrointestinal Endoscopy Center, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from August to October 2023. Consecutive sampling method was used. Multivariate analysis with logistic regression was conducted. Results: Among the 194 patients included, 49.52% experienced cardiopulmonary complications. The most common complications were tachycardia (23.20%), hypoxemia (15.03%), and hypotension (6.20%). Multivariate analysis identified the complexity of the procedure (ASGE level ≥ 3) as a significant risk factor (RR 1.505, 95% CI 1.039-2.179; p=0.03), while mild-moderate sedation was associated with a reduced risk of complications (RR 0.668, 95% CI 0.458-0.975; p=0,037). Conclusion: The incidence of cardiopulmonary complications during and after endoscopy is high among Indonesian elderly. Procedure complexity is an independent risk factor, whereas mild-moderate sedation mitigates the risk. In opposite, advanced age, multimorbidities, high ASA class, long duration of procedure, poor nutritional and functional status, and type of procedure did not affect outcomes
Detection of Small Lesion Insulinoma with 68Ga-DOTATATE PET/CT scan: A Case Report Irma Wahyuni; Tri Juli Edi Tarigan; Hendra Budiawan; Alvita Dewi; Rian Hidayatullah; Hasan Maulahela
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

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Abstract

Endogenous hyperinsulinism is a rare condition characterized by inappropriate insulin secretion, with insulinoma accounting for approximately 55% of cases. A 36-year-old woman presented with recurrent hypoglycemic episodes for 4.5 years, particularly in the morning, relieved by glucose intake. Laboratory findings during a supervised fasting test revealed a blood glucose of 44 mg/dL, elevated insulin (15 μIU/mL), C-peptide (2.27 ng/mL), proinsulin (53.1 pmol/L), and suppressed beta-hydroxybutyrate (0.1 mmol/L), indicating endogenous hyperinsulinemia. Initial imaging modalities including CT, MRI, and EUS failed to localize the lesion. The patient discontinued investigation but resumed a year later with nuclear imaging studies. A 99mTc-HYNIC-TOC scan was inconclusive, but subsequent ^68Ga-DOTATATE PET/CT at Hasan Sadikin Hospital revealed a somatostatin receptor-expressing nodule at the pancreatic head, consistent with insulinoma. Given the lesion's location and imaging findings, treatment options were discussed, including Whipple’s procedure versus radiofrequency ablation. Insulinomas are typically small, with 80% under 2 cm and 40% under 1 cm, often making localization challenging. While CT and MRI have detection rates of 70% and 86% respectively, the combination of CT and EUS may reach 100% sensitivity. In cases where conventional imaging is inconclusive, ^68Ga-DOTATATE PET/CT provides a valuable alternative, capable of detecting neuroendocrine tumors as small as 6 mm. This case highlights the critical role of nuclear medicine in localizing elusive insulinomas and guiding definitive treatment.
Effectivity of Extracorporeal Shock Wave Lithotripsy (ESWL) and Stenting vs. Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis Maulahela, Hasan; Rumagesan, Djahalia; Abdullah, Murdani; Makmun, Dadang; Renaldi, Kaka; Simadibrata, Marcellus; Shatri, Hamzah; Fauzi, Achmad; Tandan, Manu
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 1 (2023): VOLUME 24, NUMBER 1, April, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/241202323-29

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) alone may not be sufficient for treating difficult common bile duct stones. To address this challenge, several other modalities exist, including extracorporeal shock wave lithotripsy (ESWL) and biliary stent placement. This study aims to investigate the effectiveness of ESWL following biliary stent placement, in comparison to biliary stent placement alone , in the treatment of difficult common bile duct stones.Methods: A retrospective cohort study was conducted using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. This study evaluated 126 subjects with difficult bile stones, who were divided into two groups: one group received biliary stent placement alone, while the other underwent extracorporeal shock wave lithotripsy (ESWL) following biliary stent placement. The effectiveness of each treatment was assessed based on the rate of complete clearance of bile stones.Results: Of the total participants, 72 underwent ESWL following biliary stent placement, while 54 received biliary stent placement alone. The rate of complete stone clearance was 69.1% in the ESWL group and 64.8% in the stent-only group. However, the addition of ESWL as an adjuvant therapy did not result in a statistically significant improvement (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy following biliary stent placement has the same level of effectiveness as biliary stent placement alone.
Early Versus Delayed Laparoscopic Cholecystectomyafter Endoscopic Retrograde Cholangio-Pancreatography (ERCP) Removal of Choledocholithiasis: An Evidence-based Case Report Firman, Fauzan Hertrisno; Harianja, Gerald Abraham; Maulahela, Hasan
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: 10.24871/2332022258-262

Abstract

Aim: To determine the preferred method of treatment in patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography (ERCP) by evaluating efficacy of early laparascopic cholecystectomy compared to delayed laparoscopic cholecystectomy.Method: Literature searching was carried out on two databases, PubMed and Cochrane, according to the inclusion and exclusion criteria. Two randomized clinical trial (RCT) studies were appraised critically for validity, importance, and applicability.Results: Early laparascopic cholecystectomy after ERCP shows lower outcomes in incidence of recurrent choledocholithiasis, acute cholecystitis, duration of hospitalization, and treatment costs (p 0.05). Meanwhile, there was no significant difference (p 0.05) between the two groups regarding the incidence of biliary adhesions, bleeding during cholecystectomy, and laboratory parameters such as total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT).Conclusion: Early cholecystectomy, within three days after ERCP, is recommended for the treatment of choledocholithiasis after ERCP removal.
Validity and reliability of the Indonesian version of the 9-item Inflammatory Bowel Disease Questionnaire (IBDQ-9) Esa, Dekta Filantropi; Shatri, Hamzah; Rumende, Cleopas Martin; Susilo, Adityo; Maulahela, Hasan; Fauzi, Achmad; Simadibrata, Marcellus
Medical Journal of Indonesia Vol. 32 No. 3 (2023): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236848

Abstract

BACKGROUND Decreasing the quality of life (QoL) of patients with inflammatory bowel disease (IBD) will increase morbidity and mortality. A valid and reliable instrument is needed to assess the QoL of patients with IBD. This study aimed to analyze the validity and reliability of the Indonesian version of the 9-item Inflammatory Bowel Disease Questionnaire (IBDQ-9). METHODS This cross-sectional study was conducted using the Indonesian version of the IBDQ-9 in adult patients with IBD at the Gastroenterology Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, in November 2022. Patients aged 18 to 59 years who had experienced IBD for at least 2 weeks and provided informed consents were included. The total score of the IBDQ-9 Indonesian version was compared with the 36-item Short-Form Health Survey (SF-36) using the Spearman's correlation test. Reliability tests were examined using Cronbach’s alpha and the intraclass correlation coefficient (ICC). RESULTS A total of 124 participants were included in this study. The Spearman's test showed a high and significant result for the IBDQ-9 Indonesian version and the SF-36 (r = 0.769 and p<0.001). Cronbach’s alpha and ICC coefficient were equal to 0.883. CONCLUSIONS This study provided evidence of the good validity and reliability of the IBDQ-9 Indonesian version for assessing the QoL of patients with IBD in Indonesia.
Co-Authors Achmad Fauzi Achmad Fauzi ACHMAD FAUZI Achmad Fauzy, Achmad Adityo Susilo, Adityo Alvita Dewi Amanda P Utari, Amanda P Anjar Raraswati Ardani, Yanuar Ari F Syam Ari F Syam Ari Fahrial Syam Brian Eka Rahman C Rinaldi A Lesmana Cleopas Martin Rumende Dadang Makmun Dedy G Sudrajat Diana Sunardi Dinda Nisrina E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Esa, Dekta Filantropi Evy Yunihastuti Faisal, Edward Firman, Fauzan Hertrisno Gurmeet Singh Harianja, Gerald Abraham Hendra Budiawan Hilda Nurmalihah Ikhwan Rinaldi Irma Wahyuni Irvianita, Vinandia Isabela Andhika Paramita Isna Mahmudah Jaffray DP Rambak Juferdy Kurniawan Kaka Renaldi Kevin Winston Kuntjoro Harimurti Lazuardi G Ilhami Lusiani Lusiani Marcellus Simadibrata Marcellus Simadibrata Maureen Irawati Koesnadi Muhammad Miftahussurur Murdani Abdullah Murdani Abdullah Murdani Abdullah Naufali Rizkiawan Noto Dwimartutie Nur Atikah Paramita, Isabela Andhika Purwita Wijaya Laksmi Raditya Dewangga Rahmat Cahyanur Rian Hidayatullah Roy Soetikno Rudi Putranto Rudy Hidayat Rumagesan, Djahalia Sabrina Munggarani Yusuf Samudra Andi Yusuf Sepmeitutu, Iwandheny Tandan, Manu Thamrin, Husin Tri Juli Edi Tarigan Triyanta Yuli Pramana Winston, Kevin Yoshio Yamaoka Yudith Annisa Ayu Rezkitha Zulkifly, Steven