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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
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Effects of BCAA Enteral Nutrition to the Change of Nutritional Status and Hepatic Encephalopathy Parameters in Liver Cirrhosis Patient with Hepatic Encephalopathy Achmad Fauzi; Unggul Budihusodo; Nurul Akbar; Pradana Suwondo; Suhardjono Suhardjono; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200956-62

Abstract

Background: This study was also conducted to determine the effects of high-branched chain amino acid (BCAA) enteral supplementation on altered nutritional status parameters (including plasma prealbumin) and hepatic encephalopathy parameters in liver cirrhosis patients with hepatic encephalopathy. Method: Our study was a randomized, single-blinded experimental study comparing between control group of liver cirrhosis patients with standard hospital liver diet (40 kcal/kgBW/day for male and 35 kcal/kgBW/day for female; protein 1.25 g/kgBW/day) and experimental group of liver cirrhosis patients with liver diet modification high in BCAA supplementation, which had similar protein and calorie calculation as the control group. Results: Subclinical hepatic encephalopathy prevalence was 32%. In the experimental group, prealbumin plasma, arm circumference, body weight and body mass index (BMI) increased; whereas in the control group, prealbumin plasma, arm circumference, body weight and BMI decreased (p 0.05). In experimental group, the ammonia level significantly decreased (p 0.01). Clinical hepatic encephalopathy, flapping tremor, the number connection test (NCT) did not show significant changes between the two groups. However, there was worsening trend in the control group. Level of albumin, bilirubin, AST, ALT did not show any significant difference between both groups. Conclusion: High-BCAA enteral supplementation which is administered to liver cirrhosis patients with hepatic encephalopathy for 14 days could improve plasma prealbumin level, arm circumference, body weight, BMI and could decrease the plasma ammonia level. However, it does not improve Fischer ratio, psychometric test and electroencephalography   Keywords: malnutrition, liver cirrhosis, BCAA, Fisher ratio
Mortality Risk Factors in Acute Upper Gastrointestinal Bleeding Marthino Robinson; Ari Fahrial Syam; Murdani Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (278.025 KB) | DOI: 10.24871/131201237-42

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is one of the emergency cases in gastroenterology. The mortality rate does not change in the last 4 decades, however, there is no precise data in Cipto Mangunkusumo Hospital. Identified risk factors are expected to increase early awareness and optimal planning in management of patients. This study was aimed to know the mortality risk factors in acute UGIB in Cipto Mangunkusumo Hospital. Method: Case control study was performed between August and December 2011 by collecting and studying medical records of acute UGIB patients who were admitted and hospitalized between January 2003 and June 2011 in Cipto Mangunkusumo Hospital. Cases were acute UGIB patients who passed away during hospitalization in that period of time. Controls were patients who did not pass away and hospitalize in same period (date/month/year index). Samples were taken randomly with the proportion of case and control 1 : 2. Bivariate analysis was perfomed by chi-square test and continued with multivariate analysis. Results: Study subjects consisted of 87 cases and 174 controls. Significant variables as risk factors were multiple co-morbidities (OR = 2.66; 95% CI = 1.21-5.85), recurrent bleeding (OR = 9.07; 95% CI = 3.87-21.26), decreased consciousness (OR = 7.60; 95% CI = 1.94-29.88), endoscopy not performed (OR = 11.95; 95% CI = 4.75-30.11), and sepsis (OR = 4.83; 95% CI = 2.03-11.48). Conclusion: Multiple co-morbidities, sepsis, decreased consciousness on hospital admission, and recurrent bleeding are mortality risk factors in acute UGIB. Mortality risk increases in patients, to whom endoscopy was not performed. Keywords: UGI bleeding, risk factors, mortality
Response Evaluation of Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatocellular Carcinoma with Respect to Tumour Size, Number of Lesion, and Alpha-Fetoprotein (AFP) Level Adaninggar PN; Ulfa Kholili; Ummi Maimunah; Poernomo B Setiawan; Iswan A Nusi; Herry Purbayu; Titong Sugihartono; Budi Widodo; Husin Thamrin; Amie Vidyani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 1 (2016): VOLUME 17, NUMBER 1, April 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (192.599 KB) | DOI: 10.24871/17120163-9

Abstract

Background: Transarterial chemoembolization (TACE) is widely used as a palliative treatment for unresectable hepatocellular carcinoma (HCC). TACE is also used as bridging therapy before liver transplantation to avoid tumour progression and considered for downstaging to fulfill tumour resection or liver transplantation criterias. This study aimed to evaluate response of TACE in unresectable HCC according to changing of tumour size, number of lesion, and AFP level.Method: Retrospectively, we evaluate 69 HCC patients who underwent TACE in Dr. Soetomo General Hospital in January 2012-June 2015, including their age, sex, aetiologies, and Barcelona Clinic Liver Cancer/BCLC staging. Laboratory examinations such as complete blood count (hemoglobin/Hb, leucocyte, thrombocyte), liver function test (aspartate aminotransferase/AST, alanine aminotransferase/ALT, bilirubin, albumin, international normalized ratio/INR), alpha-fetoprotein/AFP level, and abdominal CT-scan were performed before and 1 month post-TACE. Data was analysed using paired t-test.Results: 69 patients with mean age of 51.81 ± 12.8 years old, predominantly 76.8% males, the most common aetiology was hepatitis B 68.1%, 92.8% BCLC B, 64.3% with stable disease, none achieved complete response, 97.1% had tumour size 5 cm, 69.6% had single tumour, and 55.7% had AFP level 1000 ng/mL. There was a significant increase in tumour size and number of lesions in 1 month post-TACE that were approximately 1.76 cm and 2.33, respectively, and there was no significant difference between AFP level before and 1 month post TACE.Conclusion: In 1 month post TACE evaluation, there was a significant increase of tumour size and number of lesion, but there was no significant alteration in AFP level. TACE might be performed repeatedly with shorter evaluation interval than 1 month to achieve better response.
Pancreatic Exocrine Insufficiency in Chronic Diarrhea Marcellus Simadibrata; Daldiyono Hardjodisastro; Abdul Aziz Rani
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: 10.24871/6120054-9

Abstract

Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 mg E1/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 mg E1/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency ( 200 mg E1/g stool) than in dyspepsia (control) ( 200 mg E1/g stool, p 0.001). The mean fecal elastase-1 Result in chronic diarrhea and in dyspepsia were 316.29 + 195.44 vs. 475.93 + 65.33 mg E1/g stool (p 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea Keywords: pancreatic exocrine insufficiency, chronic diarrhea, fecal pancreatic elastase-1
Current Role of Anti-Integrin Therapy in Inflammatory Bowel Disease Kevin Winston; Hasan Maulahela; Lusiani Lusiani; Raditya Dewangga; Lazuardi G Ilhami
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 2 (2020): VOLUME 21, NUMBER 2, August 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (476.163 KB) | DOI: 10.24871/2122020137-145

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory intestinal disorder with multifactorial etiology. Management of IBD is divided into conventional treatment and new treatment with biologic agents. The first biologic agents used for IBD was tumor necrosis factor (TNF)-inhibitor. However, TNF-inhibitor as a biologic agent has several limitations such as low rate of clinical response and systemic immunosuppressive side effects. Anti-integrin is a recently developed biologic agent which selectively inhibits leukocyte trafficking towards site of inflammation. The inhibition is caused by blocking the actions of integrin, a cell adhesion molecules (CAMs) that is necessary for leukocyte trafficking and leukocytes express specific integrin receptors for specific organs. Therefore, use of gut-specific anti-integrin agents in IBD can selectively prevent influx of leukocytes into the intestine to reduce inflammation without reducing immune function in other locations. As a result, gut-specific anti-integrin is hypothesized to have lower risk of infections and lower risk of malignancy than TNF-inhibitor while maintaining high therapeutic benefits, making anti-integrin a promising therapy for IBD in the future.
The Role of Fecal Occult Blood Test in Screening of Colorectal Cancer and Inflammatory Bowel Disease 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: 10.24871/111201035-39

Abstract

Colorectal cancer (CRC) and inflammatory bowel disease (IBD) are a quite common colon disease in the world. The World Gastroenterology Organization (WGO) recommends screening test to detect colorectal cancer, i.e. fecal occult blood test (FOBT) and colonoscopy. Diagnosis of CRC is established based on a good history taking, clinical manifestation, physical examination and laboratory examination. Other supporting laboratory tests include routine laboratory test of hemoglobin for detecting anemia, examination of bleeding stool either macroscopically or microscopically. Radiographic examination, either colon in loop or colonoscopy (if such modalities are available), shall be performed to confirm the occurrence of cancer mass in the colon. Moreover, biopsy examination is carried out to obtain the histopathological feature of tumor mass or the type of cancers. WGO has made a guideline for CRC screening, which consists of 6 cascades, which depend on the risk of colorectal cancer and local facilities available. There are several kinds of FOBT, but the most frequently used include three methods, i.e.: the FOBT guaiac base/traditional, the fecal immunochemical test (FIT) and the FOB + transferrin rapid test (OT 102c OT 103c). FIT and FOB + transferrin rapid test have a quite high sensitivity and specificity in detecting the lower gastrointestinal tract bleeding caused by colorectal cancer and IBD. Keywords: FOBT, colorectal cancer, IBD
Combination Therapy of Sorafenib and Transarterial Chemoembolization in Management of Hepatoma Bhanu S Kumar; Andri Sanityoso; Ari Fahrial Syam; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (835.542 KB) | DOI: 10.24871/142201390-96

Abstract

Incidence of hepatocellular carcinoma (HCC) continues to increase in developing countries and rank 5th in male and 7th in female. Main cause being reported is chronic hepatitis B in Asian region. Treatment of choice for HCC is liver resection, however it is oftenly not possible to be performed as the disease has entered advanced stage. Due to the less choice of treatment in HCC, one of the several other alternatives has been considered is transarterial chemoembolization (TACE) which is applied in patients who cannot undergo resection or ablation therapy, failure of therapy. However limitation of TACE is very high recurrence rate of HCC. Sorafenib is ananti-angiogenic medicine approved as first systemic drug in HCC therapy. Several studies stated the benefits of combination therapy of TACE and Sorafenib administration to prevent HCC recurrence. Success rate of thiscombination therapy reaches control disease rate of 100% based on response evaluation criteria in solid tumors (RECIST) from European Association for the Study of the Liver (EASL).Keywords: TACE, sorafenib, liver cancer, HCC
Intralesion Triamcinolon Injection Therapy on Esophageal Stricture as Side Effect of Long Term Use Biphosphonate Arles Arles; Yoanda Silvia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.207 KB) | DOI: 10.24871/1832017202-205

Abstract

Systemic Lupus Erythematous (SLE) is a chronic inflammatory disease that affect almost any organ system. Patient with SLE is at risk of osteoporosis. Biphosphonate is one of osteoporosis treatments. However, esophageal stricture (ES) caused by continuous esophageal inflammation as a result of long-term use Biphosphonate can occur. Intralesion Triamcinolone Injection (ITI) becomes one of ES therapy by inhibiting inflammatory response to injury and decrease subsequent collagen formation. ITI inhibits transcription of matrix protein genes, including fibronectin and procollagen. It also reduces the synthesis of  α2-macroglobulin, an inhibitor of collagenase activity. A 43 year old woman was diagnosed with SLE. She was treated with Risedronic Acid (bisphosphonate class) 35 mg once a week. After 8 months, she started complaining difficulty to swallow. Symptom was getting worse 6 months later. One-third distal ES with inflammation process was found with endoscopy. ITI 150 mg was given in inflammation area. She was scheduled to follow up after 7 days for re-endoscopy.  Endoscopy showed that inflammation process had been improved. Six months later, she had again complained difficulty to swallow and we found that she still consumed Risedonic Acid. ITI 150 mg was given because inflammation and ES was found with endoscopy.  After 7 days, endoscopy showed that there was no ES and inflammation process had been improved. She was advised to stop Risedronic Acid consumption.
Comparison of Alpha-Fetoprotein Level in Varying Severity Degree of Hepatocellular Carcinoma Assesed with the Barcelona Clinic of Liver Cancer During 2015-2016 in Haji Adam Malik General Hospital Medan Gontar Alamsyah Siregar; Sri Ningsih Lubis
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1464.77 KB) | DOI: 10.24871/181201720-24

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide. Presently, the reference staging system to evaluate the prognosis of HCC is The Barcelona Clinic Liver Cancer (BCLC) system. The aim of the study was to identify the comparison of alpha-fetoprotein (AFP) level in varying severity degree of HCC patient assessed with BCLC.Method: This retrospective observational study used patients’ medical record hospitalized for HCC between January 1st 2015 until December 31st 2016 in Adam Malik Hospital. From 166 HCC patients with AFP, liver function test (LFT), home sleep test (HST), ultrasonography (USG), and computerized tomography (CT) scan liver 3 phase were included in this study. The comparison of AFP in severity of HCC based on BCLC system was analyzed.Results: About 77.7% HCC patients were male. The mean age was 52 ± 13.63 years. The most cause of HCC was hepatitis B infection. Median AFP was 574.97 ng/mL. According to the BCLC staging system, 12 patients were classified as stage A (7.2%), 54 patients stage B (32.5%), 76 patients stage C (45.8%) and 24 patients stage D (14.5%). There’s significance difference value of AFP in varying stage of BCLC for HCC, which the highest value in BCLC stage D, followed by C, B and A (p = 0,001)Conclusion: There’s significance difference value of AFP in varying stage of BCLC for HCC patients.
Immunocompetent Expression of CD4+ T Cell and CD8+ T Cell, TNF-alpha and INF-gamma in Patient with Chronic Hepatitis C Ellyza Nasrul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 2, August 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/72200633-37

Abstract

Aim: To investigate the expression CD4+ T cell and CD8+ T cell as well as TNF-a and INF-g level on chronic hepatitis C. Methods: This is a cross-sectional study. Forty patients with chronic hepatitis C based on laboratory examination, who were collected from blood transfusion centers at Dr. M. Djamil Hospital. The control group used forty healthy samples. Results: There were 40 chronic hepatitis C cases satisfying the inclusion criteria. We found that CD4+ T cells count 50.35 ± 3.18%; CD8+ T cells count 59.37 ± 3.52%; TNF-a level 22.03 ± 3.72 pg/ml and INF-g level 4.47 ± 1.47 pg/ml. Conclusion: The chronic infection hepatitis C virus have given the effects on the immunocompetent cells which increased of CD4+, CD8+, TNF-a level and INF-g level. Keywords: hepatitis C virus, CD4+ T cell, CD8+ T cell, cytokines TNF-a, INF-g

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