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Murdani Abdullah
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Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia
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The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Published by The Indonesian Society for Digestive Endoscopy
ISSN : 14114801     EISSN : 23028181     DOI : -
Core Subject : Health,
Medicine & Pharmacology
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy is an academic journal which has been published since 2000 and owned by 3 Societies: The Indonesian Society of Gastroenterology; Indonesian Association for the Study of the Liver; The Indonesian Society for Digestive Endoscopy. The aim of our journal is to advance knowledge in Gastroenterology, Hepatology, and Digestive Endoscopy fields. We welcome authors for original articles, review articles, and case reports in the fields of Gastroenterology, Hepatology, and Digestive Endoscopy.
Arjuna Subject : Kedokteran - Ilmu Pencernaan
Articles 771 Documents
 28   29   30   31   32 
Comparison of Triiodothyronine (T3), Tetraiodothyronine (T4), Freethyoxine (FT4), Thyroid Stimulating Hormone (TSH) Levels in with Liver Cirrhosis Patients Based on Child-Pugh Score at H. Adam Malik Central General Hospital, Medan Beby Dewi Sartika; Leonardo Basa Dairi; Gontar Alamsyah Siregar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (163.462 KB) | DOI: 10.24871/1932018158-162

Abstract

Background: The liver is involved in thyroid hormone conjugation and excretion, as well as the synthesis of thyroid binding globulin. T4 and T3 regulate the basal metabolic rate of all cells.Method: The sample of this research was collected crosssectionally on 40 patients with liver cirrhosis based Child-Pugh score. Ultrasonography and Triiodothyronine (T3), Tetraiodothyronine (T4), Freethyoxine (FT4), thyroid stimulating hormone (TSH) levels examinations to know the difference between liver cirrhosis patients with Child-Pugh A, B, and C with ELISA method.Results: Statistical analysis showed there are not found significant differences in T3, T4, FT4, TSH levels in patients with of the liver cirrhosis based on the Child-Pugh score.Conclusion: Not found significant differences in thyroid hormone levels among patients with liver cirrhosis Child-Pugh A, B, and C. 
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Herry Purbayu; Poernomo Boedi Setiawan; Iswan A Nusi; Pangestu Adi; Hernomo Ontoseno Kusumobroto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200776-79

Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
The Role of Gastrointestinal Bacterial Ecology in Inflammatory Bowel Disease (IBD) Rémy Meier; Michael Steuerwald
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200348-53

Abstract

The pathogenesis of inflammatory bowel disease (IBD) is not yet fully understood. A genetic predisposition, some environmental factors and microbial flora of the gut are the key factors. The presence of bacteria in the intestinal lumen is a prerequisite for the development of IBD. In animal models, mice incapable of expressing IL2 or IL10 invariably develop a colitis- or Crohn-like inflammation. No inflammation occurs if they grow up in a pathogen-free environment or if they are fed with Lactobacillus sp when exposed to environmental bacteria. Thus, the absence of luminal bacteria or a different make-up there of prevents the development of inflammatory bowel disease in this model. Patients with IBD have been found to have a decreased stool excretion of Lactobacillus and/or Bifidobacteria. Furthermore, an increased number of bacteria adherents to the mucosa and within the epithelium has been demonstrated in quantitative studies. It appears that these bacteria trigger a strong abnormal mucosal immunological response, leading to intestinal epithelial cell injury mediated by activated T-cells, mononuclear cells and macrophages. If this response can not be down regulated by regulatory T-cells, numerous inflammatory cytokines are activated by stimulation of the intracellular transcription factor NF-kB. Recently it was shown that bacterial lipopolysaccharides can activate NF-kB by binding to two specific receptors on the cell membrane (Toll-like receptors [TLR’s]) or intracellular receptors (NOD’s). New insights of the role of bacteria in IBD became available by identifying susceptibility genes for IBD. Several IBD susceptibility loci were recently identified. The IBD-1 locus on chromosome 16 shows positive evidence for linkage in Crohn’s disease and IBD-2 locus on chromosome 12 for ulcerative colitis. The evidence for an association with Crohn’s disease at the IBD-1 locus have been shown to be attributed to mutations in the CARD15/NOD2 gene. This gene is expressed in peripheral blood monocytes and in intestinal epithelial cells and serves as a key factor of innate mucosal response to luminal bacteria as an antibacterial factor. The intact intercellular NOD2 protein binds LPS and activates NF-kB. This activation of the NF-kB signalling pathway in response to bacterial components plays a protective role in the mucosal epithelial cells for the host against inviting pathogens and an increased apoptosis of infected cells. There is evidence, that the defective NOD2 protein variants increase the susceptibility to pathogen invasion and a decrease in cellular apoptosis. NF-kB plays a dual role in IBD. On the mucosal epithelial cells, bacterial components bind on NOD2 proteins and protect bacterial invasion. If this barrier mechanism is not intact, the bacterial invasion stimulates via TLR- and NOD2 receptors in immune-active cells (macrophages, T-cells and monocytes) NF-kB and triggers an aberrant inflammatory response leading to tissue damage. These new insights in the pathogenesis in IBD have led to new treatment possibilities including pre- and probiotics. These therapies are aimed at directly modulating the host immune system to suppress intestinal inflammation. This has prompted considerable interest in manipulating the enteric microenvironment as a novel therapeutic strategy. Several clinical studies showed promising results using pre- and probiotics in patients with ulcerative colitis, pouchitis and Crohn’s disease. The introduction of genetically engineered probiotic organism to produce and deliver anti- inflammatory cytokines or other biological relevant molecules to the mucosa offers further new potential for the treatment of IBD. Keywords : Inflammatory Bowel Disease, inflammatory cytokines
Multimodality Treatment of Bile Duct Stone Arief Hakiki; Marcellus Simadibrata; Agi Satria Putranto; Nur Rasyid
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/101200918-22

Abstract

Gallstone and bile duct stone is a common disease and affects people from every society, race, age and gender. Advance in medicine has led us to a new paradigm of bile duct stone treatment. Endoscopic procedures for bile duct stone by means of Endoscopy Retrograde Cholangio-pancreatography (ERCP), sphincterotomy, balloon dilation, basket extraction, and lithotripsy, and even using laser as well as the shockwave-has brought a lot of novel innovation with high success rate. Appropriate indication and the ability to recognize various risk factors of complication are the keys to successful treatment, in order to decrease morbidity and mortality rate. Multimodality treatment of bile duct stone includes endoscopy, surgery, and drugs are a treatment approach which has always to be carried out in bile duct stone management. Difficult bile duct stone cases such as large stone, impacted stone, biliary stone in pregnancy, and recurrent stone can be treated by endoscopy with excellent success rate particularly if it is accomplished using multimodality treatment.   Keywords: bile duct stone, endoscopy, ERCP, sphincterotomy, mechanical lithotripsy, laser lithotripsy, shockwave, cholecystectomy laparoscopy, precut sphincerotomy
Correlation between Branched Chain Amino Acids to Tyrosine Ratio and Child Pugh Score in Liver Cirrhosis Patients Irsan Hasan; Rino A Gani; Nurul Akbar; Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120051-3

Abstract

Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain amino acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay. Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio. Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 + 1.2; Child Pugh B 6.0 + 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin (r = 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test. Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio. Keywords: Branched chain amino acids, tyrosine, liver cirrhosis
Treatment for Intermediate-Stage Hepatocellular Carcinoma: Current Practice and Outcome in Real World Study Hasan, Irsan; Loho, Imelda Maria; Lesmana, Cosmas Rinaldi A.; Gani, Rino Alvani; Siregar, Lianda; Waspodo, Agus Sudiro; Lesmana, Laurentius A
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 (434.834 KB) | DOI: 10.24871/231202224-28

Abstract

Background: Intermediate-stage hepatocellular carcinoma (HCC) is a very heterogeneous disease. The first line treatment for this group is transarterial chemoembolization (TACE), however, in clinical practice, not all patients are suitable for TACE. We aim to evaluate current treatment practice and outcome of patients with intermediate-stage HCC.Methods: HCC patients database from 2013 to 2016 in Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital were retrospectively analyzed. Patients with intermediate-stage HCC were included in this study.Results: A total of 456 patients were diagnosed with HCC, but only 151 (33.1%) patients with intermediate-stage HCC were included. Men outnumbered women in a ratio of 3:1. The most common etiology for HCC was hepatitis B virus (HBV) infection, which accounted for 55% of patients. Fifty-two patients (34.4%) were treated with TACE as first-line treatment. Sixty-seven patients (44%) were given best supportive care due to ineligibility for TACE. Frequency of TACE varied from one to eleven times. Overall median survival was 617 days (1.7 years). One-year survival for patients undergoing TACE and liver resection was 47% and 60%, respectively. We did not compare the survival between any treatment groups because the number of patient in each group is not sufficient to be statistically analyzed.Conclusion: Only 34.4% of patients with intermediate-stage HCC was treated with TACE as first-line treatment. An improvement in the treatment strategy should be done for HCC patients in Indonesia.
Demographical Distribution on the Incidence of Helicobacter pylori Infection in Jakarta: Obtaining Samples from 5 Municipalities Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Marcellus Simadibrata; Dadang Makmun; Chudahman Manan; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 2 (2014): VOLUME 15, NUMBER 2, August 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (116.884 KB) | DOI: 10.24871/152201473-77

Abstract

Background: Currently, the hospital-based studies on Helicobacter pylori (H. pylori) have demonstrated that the incidence of H. pylori infection tends to decline in Indonesia. On the other hand, no population-based study has ever been conducted. Therefore, our study was performed to evaluate the true incidence of H. pylori found among the population.Method: This study was a surveillance using cross-sectional design. The samples used in our study were randomly selected from 1,645 samples including those from five municapalities of Special Capital Region of Jakarta in 2006. Immunochromatographic test (ICT) was utilized to establish the diagnosis of H. pylori infection. The test has demonstrated high sensitivity and specificity for Indonesian populationResults: The seroprevalence of H. pylori infection among 310 patients was 52.3% (162 out of 310 patients) with mean age of 43.48 + 10.45 years. There was no difference regarding seroprevalence in both groups of 40 year and 40 years of age (52.3% and 52.2%). The highest prevalence of H. pylori infection was found in West Jakarta (66.1%); while the lowest prevalence was found in South Jakarta (41.0%). The incidence of H.pylori infection between those who were alcoholic was equal to those who were not alcoholic (46.2% vs. 52.5%).Similar result was also found between smokers and non-smokers (53.8% vs. 51.8%).Conclusion: In this study, we found that H. pylori seroprevalence remains high in the population. Various seroprevalence of H.pylori infection were found among five municipalities in Jakarta.Keywords: Helicobacter pylori, Jakarta, seroprevalence
Diagnosis and Management of Klatskin Tumor Dicky Levenus Tahapary; Rudy Hidayat; Achmad Fauzi; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201044-50

Abstract

Klatskin tumor is a cholangiocarcinoma in bifurcatio areas and related to poor prognosis. Surgery is the only curative method, but endoscopy also has a role in diagnostic as well as therapeutic measures. This report shall discuss a case of Klatskin tumor in which to establish diagnosis, multimodal imaging using ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography (ERCP), and tumor markers were used. For palliative therapeutic measures in this case, placement of plastic stents by ERCP was performed. The procedure ERCP with stents placement can be an option in the management of Klatskin tumor, in which surgery is not possible to be conducted. Keywords: Klatskin tumor, ERCP, stent, diagnosis, management
Clinical Characteristics and Outcome of Acute on Chronic Liver Failure Patients at Fatmawati General Hospital Nikko Darnindro; Annela Manurung; Edi Mulyana; Arnold Harahap; Marlina Dewiastuti; Fenandri Fadillah Fedrizal; Mohammad Sadhyo Prabhasworo
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (229.406 KB) | DOI: 10.24871/2032019140-145

Abstract

Background: Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute liver decompensation with extrahepatic organ failure in patients with pre-existing liver disease causing high short-term mortality. A good knowledge about characteristics and diagnostic of ACLF will help us to give proper treatment. The aim of this study is to know the profile and characteristics of ACLF patientMethod: Retrospective study was conducted to find patient with ACLF between January 2017-January 2018 at Fatmawati General Hospital.Results: Ten patients were diagnosed with ACLF. Six patients admitted with a chief complaint: unconscious, 2 of them had hematemesis in the course-of-treatment. Three patients were admitted with abdominal pain, and 1 patient with hematemesis-melena. Seven patients had Hepatitis-B infection. Aspartate-transaminase to platelet-ratio index (APRI) values varied (median 8.1;minimum 2.81-maximum 34.67). Hepatic encephalopathy, ascites, and acute renal failure were found in 90% of patients. Jaundice can be found in all patients, with mean values of bilirubin levels in patients undergoing test for bilirubin level were 18.56 mg/dL (9/10). Coagulation disorders were found in 60% of patients undergoing haemostasis test. Four patients were diagnosed with grade 3 ACLF. All ACLF patients eventually died during treatment, including third-degree patients who all died within 7 days. Only 2 patients survived more than 7 days, and 4 patients died within 3 days of treatment. Conclusion: mortality rates of ACLF were very high, and are often found in patients with advanced liver disease characterized by high APRI values. The prognosis is related to the number of organ failures. Central nervous system, kidneys and liver are the organs that are often impaired. Because the current treatment method is still limited, further research is needed, especially on biomarkers for better prevention, diagnosis and treatment.
Tuberculous Splenic Abscesses as an Etiology in Prolonged Fever Dolvy Girawan; S A Abdurachman; Iman Supandiman; Hadi Jusuf; Tan Siauw Koan; Warko Karnadihardja
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 3, December 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/63200588-90

Abstract

Extra-pulmonary tuberculosis covers all forms of tuberculosis in which the disease process occurs outside the lungs. Tuberculosis is one of the common infectious causes of splenic enlargement, but tuberculous splenic abscess is a rare presentation. We report the finding of tuberculous multiple splenic abscesses in a young male patient aged 33 years with prolonged fever. The main clinical feature was fever for 6 months prior to admission. Abdominal ultrasound revealed the spleen was normal in size but showed multiple abscesses. CT scan abdomen showed splenomegaly with multiple solid nodules. Patient underwent laparatomy and splenectomy, the spleen indeed showed multiple abscesses. Histopatology Result showed Langhan’s multi nucleated giant cells, caseous necrosis. The patients was diagnosed to have tuberculous multiple abscesses of the spleen. The patient was started  on  daily  short-course  antituberculosis  drugs  with  isoniazid,  rifampicin, pyrazinamide and ethambutol. He responded well to oral antituberculosis treatment.   Keywords: prolonged fever, abdominal ultrasound, CT scan abdomen, tuberculosis, multiple splenic abscesses, splenectomy

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