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All Journal JKKI : Jurnal Kedokteran dan Kesehatan Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Plexus Medical Journal
Darmayani, Aritantri
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Health Professions Medicine & Pharmacology Public Health

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Hubungan Tingkat Stres dan Kualitas Tidur dengan GERD pada Mahasiswa Kedokteran Universitas Sebelas Maret Ridho, Muhammad Ihsan; Agung, Ratih Arianita; Darmayani, Aritantri
Plexus Medical Journal Vol. 4 No. 2 (2025): April
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i2.798

Abstract

Pendahuluan: Gastroesophageal reflux disease (GERD) adalah penyakit gastrointestinal kronis yang secara signifikan mengurangi kualitas hidup dan pada beberapa pasien menyebabkan komplikasi yang serius. Mahasiswa kedokteran adalah sekelompok mahasiswa dengan tingkat stres yang sangat tinggi, dan kelelahan terkait pekerjaan yang menyebabkan gangguan tidur, termasuk kurang tidur, kualitas tidur yang buruk, dan kantuk di siang hari. Sampai sekarang belum banyak penelitian multivariat yang meneliti hubungan tingkat stress dan kualitas tidur dengan kejadian GERD. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat stres dan kualitas tidur dengan kejadian GERD pada mahasiswa kedokteran Universitas Sebelas Maret. Metode: Penelitian ini adalah penelitian observasional analitik dengan pendekatan cross sectional. Sampel penelitian berjumlah 90 orang responden yang telah memenuhi kriteria inklusi dan ekslusi. Pengambilan sampel dilakukan dengan teknik total sampling. Data yang diperoleh dianalisis secara bivariat dengan menggunakan uji koefesien kontingensi dan secara multivariat dengan menggunakan uji regresi logistik. Hasil: Hasil penelitian ini menunjukkan hubungan yang signifikan antara tingkat stres (p < 0,001) dan kualitas tidur (p = 0,042) dengan kejadian GERD. Berdasarkan hubungan dengan kejadian GERD (p<0,001). Kesimpulan: Tingkat stres dan kualitas tidur secara parsial dan simultan memiliki hubungan dengan kejadian GERD. Tingkat stres diketahui memiliki hubungan yang lebih bermakna dengan kejadian GERD jika dibandingkan dengan kualitas tidur.
Real-Life Situation Of Bile Duct Injury Management: Challenges And Lessons From A Tertiary Care Center Pramana, Triyanta Yuli; Adhyaksari, Apriliana; Lee, See Young; Ratanachu-ek, Thawee; Ranty, Stefanus Satrio; Prasetyo, Ari; Darmayani, Aritantri; Prasetyo, Didik; Notonugroho, Anung
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: 10.24871/2622025143-153

Abstract

Background: Bile duct injury (BDI) is a serious complication of cholecystectomy, particularly with the widespread adoption of laparoscopic cholecystectomy (LC). Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. This study evaluates reallife clinical experiences in managing post-cholecystectomy BDIs in Central Java, Indonesia. We aim to discuss the prevention of BDI further and find out the most effective management and timing of interventions for BDI based on these analyses.Methods: Twenty-seven cases with iatrogenic BDI following cholecystectomy were classified according to BDI Strasberg classification, repair procedures, mortality and success rate procedures, onset of BDI, and timing of repair procedures. The correlation analyses were performed using the Contingency Coefficient Correlation Test.Results: Of the 27 patients, BDIs were detected in 33.3% of patients within two weeks of surgery. Major BDIs (Strasberg E) often required biliodigestive surgery, with variable outcomes. The overall mortality rate was 29.6%, mainly due to biliary sepsis. ERCP success was significantly associated with less severe BDI (p=0.018). This study stated that the type of previous cholecystectomy, timing of BDI diagnosis, and duration of BDI to repair procedures did not statistically influence mortality (p=0.822, p=0.551, p=0.958, respectively).Conclusion: Prevention of BDI is paramount, emphasizing surgical training, careful patient selection, and the critical view of safety technique. Early detection, multidisciplinary management tailored to the injury’s severity improve outcomes. While minimally invasive approaches are preferred for minor BDIs, major injuries necessitate surgical intervention by experienced hepatobiliary surgeons.
A 57-year-old woman with chronic hepatitis B and left hepatic nodularity unmasking intrahepatic hilar adenocarcinoma: A diagnostic case report Pramana, Triyanta Yuli; Gunawan, Timotheus A.; Prasetyo, Didik; Darmayani, Aritantri; Jati, Agus; Wasita, Brian
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 2, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss2.art16

Abstract

Metastatic breast cancer involving the biliary tract is a rare case with an incidence rate of 1.49 per 100.000 persons. Chronic hepatitis B virus (HBV) infection is associated with tumor development and migration and promotes metastasis. While hepatocellular carcinoma is the most common primary liver cancer, cholangiocarcinoma is a rarer malignancy originating from epithelial cells in various parts of the bile ducts. Intraluminal adenocarcinoma of the common hepatic duct (CHD) is an exceptionally uncommon hepatic tumor. We reported that a 57-year-old female has been complaining of abdominal pain on the upper right side for 1 year, accompanied by nausea and icterus. The patient had a history of breast cancer in 1995 and chronic hepatitis B for 20 years on Tenovofir 1x300 mg. No abnormalities were found on physical examination. However, Magnetic Resonance Cholangiopancreatography (MRCP) revealed bilateral dilatation of the intrahepatic bile duct (IHBD), common hepatic duct (CHD), ductus cysticus, and common bile duct (CBD) distal to proximal, suggesting an intraluminal mass likely due to a tumor. A plastic stent was then placed, which reduced the lesion size. Immunohistochemistry (IHC) test confirmed adenocarcinoma, in which CK-7 and mammaglobin were positive, indicating metastatic breast cancer.. A thoracic MSCT revealed multiple lytic lesions in the T1, T7, T9–T12, and L2–L3 vertebral bodies. The patient was diagnosed with intraluminal adenocarcinoma of the CHD, representing metastatic Stage I triple-negative breast cancer with biliary, pulmonary, and osseous involvement, along with chronic hepatitis B. The chemotherapy regimen included carboplatin 370 mg and paclitaxel 260 mg, continued with Taceral 500 mg 2x3 in two weeks and Zometa every 6 weeks. Post-chemotherapy MRCP evaluation showed a solid intraluminal liver lobe lesion with partial obstruction. Metastatic adenocarcinoma of the CHD caused by breast cancer is a highly unusual clinical problem. In such cases, IHC plays a vital role in identifying the primary tumor site.
Co-Authors Adhyaksari, Apriliana Agung, Ratih Arianita Ari Prasetyo Brian Wasita Didik Prasetyo Gunawan, Timotheus A. Jati, Agus Lee, See Young Notonugroho, Anung Ranty, Stefanus Satrio Ratanachu-ek, Thawee Ridho, Muhammad Ihsan Triyanta Yuli Pramana