International Journal of Human Capital Management (IJHCM)
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Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection
No full textBackground: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p > 0.05). Generally, the prevalence rate among males was slightly lower than females (p > 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad
Comparison of Endoscopic Ultrasound (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP) in Diagnosing Cholelithiasis in Acute Biliary Pancreatitis Patients
No full textAim: To determine how endoscopic ultrasound (EUS) is compared to magnetic resonance cholangiopancreatography (MRCP) in diagnosing cholelithiasis in acute biliary pancreatitis.Method: Five steps of evidence based medicine is conducted, they are: (1) Formulate the clinical question; (2) Search the evidence; (3) Appraise the study; (4) Apply the answer; (5) Assess the outcome. The search term in general is: (“cholelithiasis”) and (“EUS”) and (“MRCP”) and diagnosis.Results: We searched in Pubmed and Cochrane library. We excluded articles that do not focus on answering our clinical question. There is one systematic review that is capable of answering our clinical question.Conclusion: It can generally be concluded from this study that EUS and MRCP are useful techniques in the etiological diagnosis of acute pancreatitis of non-established cause. Endoscopic ultrasonography should be preferred for establishing a possible biliary etiology in patients who have not had a cholecystectomy
Liver Transplant in Hepatocellular Carcinoma: Indication and Prognostic Factors
Get PDFHepatocellular carcinoma (HCC) is the most common type of liver cancer. There are several treatment modalities according to Barcelona treatment algorithm. Liver transplant is one of the curative option treatments, with its indication and prognostic factors. Carefully selected patients for liver transplant in HCC case will result in the same or slightly inferior survival rate compare with liver transplant in non-malignancy case
Fecal Calprotectin Level as Diagnostic Marker for Intestinal Inflammation in Inflammatory Bowel Disease Patients
Get PDFBackground: Inflammatory bowel disease diagnosis was still based on invasive examination, such as endoscopy and histopathology. Fecal calprotectin was a non-invasive intestinal inflammation marker, but several study give a different result in its diagnostic value and correlation to inflammatory bowel disease. This research was aimed to prove that fecal calprotectin examination has a high diagnostic value in diagnosing inflammatory bowel disease, and also correlate to its clinical stages.Method: This is a cross sectional study to do a diagnostic test in several hospital in Jakarta, from September 2014 to February 2015. Receiver operating characteristic (ROC) curve was made to get fecal calprotectin diagnostic level and Krusskal Wallis test was performed to identify fecal calprotectin difference among each inflammatory bowel disease clinical stages.Results: A total of 71 patients with inflammatory bowel disease was invoved in this research, based on colonoscopic examination result. Among them, 57 patients was confirmed to have intestinal inflammation based on histopathology result. Fecal calprotectin level was found to be higher in patients with inflammatory bowel disease than patients without intestinal inflammation (553,8 µg/g vs. 76,95 µg/g, p < 0,001). A cut off point of 179,3 µg/g was gathered, with 96% sensitivity (95% CI: 0,88-0,99), 93% specificity (95% CI: 0,69-0,99), and 99,5% area under curve (AUC) 99,5% (95% CI: 0,98-1,00). A significant difference was found between fecal calprotectin in each inflammatory bowel disease clinical stages (p < 0,001).Conclusion: Fecal calprotectin has a high diagnostic value for inflammatory bowel disease (IBD) and strongly correlate to its disease clinical stages
Gastroesophageal Reflux Disease Questionnaire (GerdQ) is an Easy and Useful Tool for Assessing GERD
No full textConformity between Ileoscopy Appearance with Terminal Ileum Histopathology Appearance in Normal Colonoscopy Chronic Diarrhea Patients
No full textBackground: Chronic diarrhea is one of the most common problem in gastroenterology cases. Ileoscopy is one of the modalities to determine the etiology of chronic diarrhea by normal colonoscopy appearance. Recently, there is still controversy in the need of this examination in normal macroscopic appearance. The aim of this study is to study the conformity of histopathology abnormalities with ileoscopy appearance in chronic diarrhea patients with normal colonoscopy.Methods: This study uses cross sectional study design by collecting 60 medical record data in several hospitals in Jakarta in the period of 1 January 2005 to 31 December 2011. Diagnostic test between ileoscopy and histopathology is performed by histopathology examination as a gold standard.Results: Study results revealed conformity between both examinations for 93.33%. Sensitivity value of ileoscopy examination compared to histopathology as a gold standard was 94%, specificity 90%, positive predictive value 97.9%, and negative predictive value 75%.Conclusion: Ileoscopy examination in chronic diarrhea patients and normal colonoscopy showed similar results with histopathology examination. Keywords: Ileoscopy, histopathology, conformity, chronic diarrhe
Clinical Efficacy and Side Effects of Nabumeton Compared to Meloxicam in Osteoarthritis Pain
No full textBackground: Most patients who use non steroid anti-inflammatory drug (NSAID) in long-term or high-dose will experience NSAID gastropathy that appears as dyspepsia complaints. The aim of this study is to assessthe efficacy of nabumeton and incidence of dyspepsia as side effect of treatment using nabumeton compared to meloxicam in patients with pain due to osteoarthritis. Methods: Sixty patients with pain due to osteoarthritis at internal medicine clinic in Koja Hospital were included in this study and were given meloxicam or nabumeton within February 29th to March 25 in double-blind manner. Primary disease pain degree and heartburn pain degree were evaluated three days after administration of the drug and a week was added if necessary. The statistical analysis used were student t-test to compare changes in pain scores between the 2 groups, and Chi-square test to assess differences in the number of dyspepsia in both groups.Results: Pain scale reduction in meloxicam group was 0.57 ± 0.67 points, which is less than 1.27 ± 0.74 points in nabumeton group. In addition, the average recurrence of heartburn in the meloxicam was 18 out of 30 (60%) patients in total, while the average recurrence of heartburn in nabumeton was 2 out of 30 (60%) patients.Conclusion: The use of nabumeton pain medication is better in terms of efficacy and side effects of heartburn compared to meloxicam.Keywords: osteoarthritis, joint pain, meloxicam, nabumeto
Quantification Hepatitis B Surface Antigen: Does It Really Matter in Clinical Practice?
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Reactivation of Hepatitis B Infection During the Cause of Non Hodgkin's Lymphoma Chemotherapy
No full textHepatitis due to hepatitis B virus (HBV) reactivation after cytotoxic or immunosuppressive therapy is a serious cause of liver-related morbidity and mortality. Frequently used combination regimens in Non-Hodgkin’s lymphoma are cyclophosphamide, hydroxydaunomycin (adriamycin), vincristine (oncovin), and prednison (CHOP). The use of rituximab, a monoclonal antibody targeting CD20 antigen present in benign and malignant B-cells, in combination with systemic chemotherapy has resulted in an improved duration of remission and survival for this patients. Rituximab is a HBV reactivation risk factor even greater than corticosteroids in a series of patients with lymphoma treated with combined-modality treatment (CMT).A 43 years old female patient who already diagnosed with Non-Hodgkin’s lymphoma, came with chief complain nausea and vomiting for three weeks. The patient recently got hospitalized with icteric and known have positive HBsAg. She received chemotherapy rituximab CHOP (R-CHOP) for four times and got rituximab in the last chemotherapy. Previously she had icteric and increased liver function test. After exclude other possibility causes this symptom and sign, it was concluded this is HBV reactivation. The chemotherapy was postponed until this reactivation of hepatitis B resolved and start giving lamivudine two weeks before reintroduce chemotherapy.Keywords: antiviral treatment, chemotherapy, hepatitis B virus, reactivatio
Tuberculosis Peritonitis Patient with Septic Shock caused by Extended–Spectrum Beta Lactamases Producing Pseudomonas Aeruginosa
No full textAccording to World Health Organization (WHO), tuberculosis (TB) is a worldwide pandemic. Up to 5% of patients with TB may have abdominal disease and 25-60% may have peritoneal involvement. Diagnosis of TB peritonitis is still challenging, and symptoms are usually insidious. The sensitivity of acid fast bacilli (AFB) is very low, ranging from 0-6%. Conventional mycobacterial culture takes up to 8 weeks to achieve results. Laparoscopic or laparotomy biopsy is uncomfortable for patient. The consequence of these problems is missing and delays in diagnosing TB peritonitis. In the end, it can results in significant morbidity and mortality. This case described a 20 year old female patient with TB peritonitis that suffered from septic shock caused by extended-spectrum beta lactamases (ESBL) producing Pseudomonas aeruginosa. In this case, TB peritonitis was diagnosed based on clinical features, high levels of adenosine deaminase (ADA) and a positive rapid DNA test with Xpert MTB/RIF. Keywords: tuberculosis peritonitis, extended-spectrum beta lactamases producing bacilli, adenosine deaminase, XpertMTB/RIF assa