Muzellina, Virly Nanda
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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
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, AGUSTUS, 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.