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All Journal E-Jurnal Medika Udayana Universa Medicina The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Dewi, Ni Luh Putu Yunia
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Efektivitas Suplementasi Zink Terhadap Lama Rawat Inap pada Pasien Pneumonia Anak: A Systematic Review of Randomized Controlled Trials Dewi, Ni Luh Putu Yunia; Mayangsari, Ayu Setyorini Mestika; Adnyana, I Gusti Agung Ngurah Sugitha
E-Jurnal Medika Udayana Vol 12 No 2 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i02.P02

Abstract

Zinc supplementation was reported increasing pneumonia in child outcomes, which one is the length of hospital stay, but still controversial. This review will discuss about effectivity of zinc supplementation for the length of hospital stay in children hospitalized with pneumonia in forms systematic review. Searching was performed at CENTRAL, PubMed, and ProQuest for journal published from 2015 to 2020 which evaluate the effectivity of zinc supplementation for the length of hospital stay in children hospitalized with pneumonia. This review based on writing guidelines by Cochrane Textbook of Systematic Review. There are four studies relevant to this review. All studies are blinded study. A total of 1.359 children hospitalized with pneumonia, percentage of a male around 59%. A total of 680 participants received zinc supplementation as addition for standard antibiotics. Participants were 1 to 60 months of age. All studies measure baseline serum zinc levels. Two studies reported significant results, while two other study conversely. Effectivity of zinc supplementation has not been concluded yet. Based on critical appraisal, the author attends to agree with two studies that conduct in Asia, in which the populations were similar to Indonesia. In that study found zinc supplementation effective to decreases the length of hospital stay in children hospitalized with pneumonia. There is no fatal adverse effect of zinc supplementation was reported.
Correlation of Simple Laboratory Result Parameters to CTP and MELD Scores, and the Diagnostic Role of Simple Laboratory Indexes to Cirrhosis Decompensation Dewi, Ni Nyoman Gita Kharisma; Dewi, Ni Luh Putu Yunia; Dewi, Putu Itta Sandi Lesmana; Pamungkas, Kadek Mercu Narapati; Sindhughosa, Dwijo Anargha; Mariadi, I Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202427-33

Abstract

BackgroundCirrhosis of the liver is a final condition of all chronic liver diseases. Liver cirrhosis is the leading cause of increasing morbidity and mortality in adults worldwide. Systemic inflammation has been suggested to play an important role in causing progressive liver damage and is one of the leading causes of compensated and decompensated liver cirrhosis.Aim of StudyEvaluate the correlation of neutrophil-lymphocyte ratio (NLR), albumin-bilirubin ratio (ABR), albumin-bilirubin score (ALBI), aspartate aminotransferase to platelet ratio (APRI), albumin-creatinine ratio (ACR), lymphocyte-monocyte ratio (LMR), de ritis ratio to the severity of liver cirrhosis as assessed by CTP score and MELD score. In addition, this study also evaluated the diagnostic ability of NLR, ABR, ALBI, APRI, ACR, LMR, de ritis ratio, and CTP and MELD scores in predicting decompensated liver cirrhosis.MethodWe conducted a cross-sectional study involving patients diagnosed with liver cirrhosis at Prof DR IGNG Ngoerah General Hospital. All patients were diagnosed based on clinical history, physical examination, and investigations. This study enrolled 96 cirrhotic patients regardless of etiology. Laboratory examination results recorded platelets, neutrophils, lymphocytes, monocytes, AST, ALT, albumin, and creatinine. Then NLR, ACR, APRI, LMR, de raitis, ALBI, and ABR are calculated. CTP and MELD scores were calculated by taking data from the patient's medical recordResultOf the 96 patients tested in our study, the majority were male (66). The study found a significant moderate to very strong relationship to the MELD score between ACR, APRI, ALBI, ABR, LMR, WBC, sodium, and albumin. Neutrophil to lymphocyte ratio, ACR, De ritis, APRI, LMR, ALBI, ABR, sodium levels, and albumin have a moderate to very strong significant relationship to CTP score. ACR, De ritis, APRI, LMR, ALBI, ABR, WBC, sodium, and albumin levels with respective cut-offs £ 3.6; ≥ 1.5; ≥ 0.3; £ 2.8; ≥ 0.7; £1.6; ≥ 6.7, £ 136.50, and £ 3.0 can be used to help predict decompensated cirrhosisConclusionIn addition to using the CTP score and MELD score as a tool to predict the severity of liver cirrhosis, data from laboratory examination results in the form of albumin and ABR levels can help establish the diagnosis of decompensated cirrhosis. The sensitivity and specificity of ABR were 96.8% and 75.4% with a cut-off of £  1.6, while albumin levels were 93.5% and 81.5% with an amount off of £  3.0.
Low albumin-to-creatinine ratio: a novel predictor of 90-day mortality in hepatocellular carcinoma with liver cirrhosis Pamungkas, Kadek Mercu Narapati; Dewi, Putu Itta Sandi Lesmana; Dewi, Ni Luh Putu Yunia; Dewi, Ni Nyoman Gita Kharisma; Sindhughosa, Dwijo Anargha; Mariadi, I Ketut
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.313-320

Abstract

BackgroundDespite recent advances in the treatments of hepatocellular carcinoma (HCC), the prognosis of HCC patients remains controversial. Lowered serum albumin in hepatocellular carcinoma, an advanced stage of liver cirrhosis, indicates a worsening condition. Hepatorenal syndrome, marked by increased serum creatinine, is a key mortality indicator. The aim of this study was to determine the serum albumin-to-creatinine ratio (sACR) as a predictor of mortality in patients with HCC and liver cirrhosis. MethodsThis retrospective cohort study included 37 patients with HCC and liver cirrhosis. Patient characteristics, sACR, model of end-stage liver disease (MELD) score, and Child-Turcotte-Pugh (CTP) score were obtained from medical records. The optimal cut-off point for the sACR was determined using receiver operating characteristic (ROC) analysis to evaluate its predictive ability for 90-day mortality. Survival analysis was conducted using the Kaplan-Meier method with a log-rank test, and Cox regression was employed to obtain hazard ratios (HR) to estimate the patient’s prognosis. ResultsA low sACR cut-off of 2.32 was identified. Kaplan-Meier analysis confirmed that sACR met the proportional hazard assumption. sACR <2.32 was a significant predictor of 90-day mortality (HR 6.52; 95% CI 1.80-23.63; p=0.004), comparable to MELD 40 (HR 41.3; 95% CI 1.98-862.90; p=0.016) and CTP category (HR =2.19;95%CI: 0.79-6.06;p=0.131). Conclusion The sACR is a novel predictor of 90-day mortality in HCC patients with liver cirrhosis. Lower sACR is associated with overall survival and may help to design strategies to personalize management approaches among patients with HCC and liver cirrhosis.
Hepatic Encephalopathy Scoring Model in Hepatic Cirrhosis Based on Clinical and Laboratory Parameter Pamungkas, Kadek Mercu Narapati; Lesmana Dewi, Putu Itta Sandi; Dewi, Ni Luh Putu Yunia; Kharisma Dewi, Ni Nyoman Gita; Sindhughosa, Dwijo Anargha; Mariadi, Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202416-23

Abstract

Background: Hepatic Encephalopathy (HE) is a serious complication with a wide spectrum of clinical symptoms, from minimal changes to profound coma. HE is hard to diagnose without advanced laboratory parameters such as ammoni. This study aims to develop a scoring model to diagnose HE using clinical and laboratory parameters. Methods: An analytical cross-sectional study collected data from 96 hospitalized patients with liver cirrhosis from November 2021 to January 2022. Employing multivariate logistic regression analysis, the study aimed to identify autonomous factors associated with HE. Each significant variable was used to calculate patient probabilities. The score for each variable was computed utilizing the (B/SE)/lowest(B/SE) formula, demonstrating robust discriminatory capability. The scoring model was formulated and evaluated based on its sensitivity and specificity.Results: Nineteen point eight percent, equivalent to ninenteen patients, were admitted with HE. The scoring model was crafted based on nineteen variables. There were four significant variables in this model: Aspartate Aminotransferase (AST) (p=0.01), Total Bilirubin (p=0.007), Fibrosis-4-Index (FIB-4) (p=0.014), and Ascites (p=0.016). Each variable was scored as 1 for AST, -1 for total bilirubin, 1 for FIB-4-index, and 1 for Ascites. The probability was 2%, 14.2%, 57%, 91.4%, and 50%, following the total score of -1, 0, 1, 2, and 3, respectively. The sensitivity and specificity of the scoring model were 68.4% and 85.3%, respectively (AUC=84.7%).Conclusion: Daily laboratory and clinical manifestations related to hepatic cirrhosis could give a clue to diagnosing hepatic encephalopathy. 
Co-Authors Adnyana, I Gusti Agung Ngurah Sugitha Ayu Setyorini Mestika Mayangsari Dewi, Ni Nyoman Gita Kharisma Dewi, Putu Itta Sandi Lesmana Dwijo Anargha Sindhughosa, Dwijo Anargha I Ketut Mariadi Kharisma Dewi, Ni Nyoman Gita Lesmana Dewi, Putu Itta Sandi Mariadi, Ketut Pamungkas, Kadek Mercu Narapati