International Journal of Human Capital Management (IJHCM)
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Survival of Pancreatic Cancer Patients in Dr Cipto Mangunkusumo National Referral Hospital Jakarta from November 2018 To December 2018
Full text linkBackground: Pancreatic cancer is a leading cause for cancer deaths worldwide and its survival rate remains low. The one year- and five year-survival rate remain as low as 21% and 6-8% consecutively. Little is known about the survival rate of pancreatic cancer in Indonesia. This study aims to evaluate the survival rate of pancreatic cancer patients at Gastrointestinal Endoscopy Center, National Referral Hospital Dr. Cipto Mangunkusumo, Jakarta, during November 2018 to December 2018.Method: This retrospective cohort study extracted the registry data of newly diagnosed pancreatic cancer patients between November 2018 to December 2018 from the Gastrointestinal Endoscopy Center, Cipto Mangunkusumo Hospital, Jakarta. All patients were followed since they were diagnosed to two months after diagnosis or 31st December 2018 or to their date of death, whichever came first. Results: We found 12 newly diagnosed pancreatic cancer cases between November 2018 to December 2018. The mean age at diagnosis was 55 years old, with 58% male, 50% sundanese, and 75% patient come from low educated level. About 58% cases presented with cholangitis, and the mean bilirubin concentration at diagnosis was 26 mg/dL. All patient came with an obstructive jaundice symptoms, and 91% had endoscopic biliary drainage procedure. After 2 months of observation, we found 16% patient died due to unresolved infection.Conclusion: There were 12 cases of pancreatic cancer, of which 16% pancreatic cancer patients died within 2 months of follow up. Infection is the main cause of morbidity and mortatlity in pancreatic cancer patients.
Probiotics as Alternative Therapy for Psychometric Disorders in Hepatic Encephalopathy
Full text linkAim: To identify whether probiotics have the same effectiveness as lactulose in improving the results of psychometric testing in patients with hepatic encephalopathy.Method: Literature Searching were performed on Pubmed, EBSCOhost, Scopus, and Cochrane databases to obtain an randomized controlled trial (RCT) or a systematic review. Searches were made with the keywords "hepatic encephalopathy", "probiotic", "lactulose" and number connection test ("NCT"). Search is continued by excluding the literature through abstract and full text.Results: Two studies were found to be relevant according to the criteria. The study by Mittal showed that probiotics were better than lactulose in improving NCT-B with a risk ratio (RR) of 0.88 (95% CI: 0.54-1.44; p = 0.62) but not better for improving NCT- A with RR 1.43 (95% CI: 0.62-3.24; p = 0.40). In the Sharma study, lactulose was better in improving NCT score with the mean difference (MD) 6.7 (95% CI: 0.58-12.82) and in the Li study, there was no significant significance between MD 3.93 (95% CI: -0,72-8,58)Conclusion: In conclusion, Probiotics cannot replace lactulose as a standard therapy for hepatic encephalopathy. There is not enough evidence that proves probiotics are better than lactulose
Decreased Liver Fibrosis in Patients with Hepatitis C Virus (HCV)/Human Immunodeficiency Virus (HIV) Coinfection After Treatment with Sofosbuvir/Daclatasvir
Full text linkBackground: Hepatitis C Virus (HCV)/Human Immunodeficiency Virus (HIV) co-infection increases the progression of liver fibrosis to advanced liver disease and death. The aim of this study is to determine whether the changes of liver fibrosis occur in HCV/HIV coinfection patients after therapy with Sofosbuvir/daclatasvir.Method: This study used a quasi-experimental study design without a control group. The study subjects were HCV / HIV coinfection patients who received Sofosbuvir / daclatasvir therapy in the Gastroentero-Hepatology Clinic of Dr. Hasan Sadikin Hospital. In this study measurement of liver fibrosis was carried out by using AST to Platelet Ratio Index (APRI) and Fibrosis-4 Index (FIB-4) before therapy and when SVR-24 was achieved.Results: The study involved 29 subjects. Most of the research subjects were men, with an average age of 40.38 years (SD 3.48). From the results of this study, we found a decrease in APRI scores and FIB-4 index when HCV / HIV coinfection patients, that were treated with Sofosbuvir / Daclatasvir, achieved SVR 24. The median of APRI scores before therapy and after SVR-24 was decreased from 0.41 to 0.28 (95% CI: 0.01 - 0.23, p-value 0,01) and the median of FIB-4 Index before therapy and after the SVR 24 was decreased from 0.94 to 0.81 (95% CI: -0, 04 - 0.35, p-value 0.28).Conclusion: This study concluded that therapy using Sofosbuvir / Daclatasvir in HCV / HIV coinfected patients has very good effectiveness and can reduce liver fibrosis
Adult Ileocecal Intussusception: A Case Report and Review
Full text linkIntussusception is a rare cause of bowel obstruction in adult patients, it represents for five percent of all age intussusception. Several different aspects were found between adult and pediatric intussusception. We report a case of 39-year-old male with bowel obstruction due to ileocecal intussusception, which firstly diagnosed as acute appendicitis. Unlike pediatric intussusception which usually manifest as classical triad signs, unspecific symptoms of adult intussusception may become diagnostic challenge. Imaging modalities such as plain abdominal radiograph and ultrasonography may aid the preoperative diagnosis in the rural hospital setting. Prompt management which involved surgical approach is warranted to prevent further complications
Clinicomorphological Profile of Gastric Polyps in Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital (CMH): A Retrospective Study in Correlation of Long-Term Use of Proton-Pump Inhibitors
No full textBackground: Gastric polyps are mucosal elevation into the lumen, found incidentally during endoscopic examination and generally brings no specific symptoms. Long-term use of proton-pump inhibitors (PPIs) is related to the development of the fundic gland polyp (FGP). This retrospective study was conducted to determine the distribution of gastric polyps in CiptoMangunkusumo Hospital along with histomorphological features and their relation with long-term PPI use.Method: This retrospective review is a descriptive analytic study. Gastric polyp cases were taken consecutively from the archive of the Anatomical Pathology Department, Faculty of Medicine Universitas Indonesia/CiptoMangunkusumo Hospital the period of 2016-2017. Clinical data obtained from patient’s medical records. Statistical analysis was carried out with the IBM ® SPSS version 23 program.Results: Among 83 cases of gastric polyps, there were 66 cases of FGP, 11 cases of inflammatory polyps, 5 cases of hyperplastic polyps, and 1 case of Peutz-Jegher polyp. Long term PPI was used in 40 cases and was related with parietal cell hyperplasia.Conclusion: FGP is the most common type of gastric polyp in the Department of Anatomical Pathology CMH. Long term PPI use was found in half of gastric polyps and was related to parietal cell hyperplasia morphology
Pancreatic Cancer: Alarm for Survival
Full text linkPancreatic cancer is one of the deadliest and a highly aggressive cancer. Its incidence and mortality are highest in developed countries. However, in Asia-Pacific region, the incidence and mortality rate of pancreatic cancer are also on increasing trend nowadays. Pancreatic cancer incidence rates increase with older age, the highest in the 7th and 8th decades. Clinical presentation of pancreatic cancer are usually non-specific, largely dependent on tumour size and location, with most patients experience symptoms already late in the disease. Computed tomography is considered the method of choice for diagnosis and staging of pancreatic cancer. Management for pancreatic cancer include surgical resection, radiotherapy, chemotherapy. Only surgical resection considered the potentially curative treatment for pancreatic cancer. Unfortunately, a lot of patients present with disease that is not surgically resectable. Prognosis for pancreatic cancer is very poor, despite surgery in resectable patients. The overall five-year survival rate is about less than 5%
Case Report: A 31-year-old Post Cesarean Section Women with Intrahepatic Cholestasis of Pregnancy and Post Partum Bell’s Palsy
Full text linkIntrahepatic cholestasis of pregnancy (ICP) is cholestasis condition characterized by pruritus, elevated serum aminotransferase and bile acid levels with onset in the second or third trimester of pregnancy. Estimated of ICP prevalence only 0.001% to 0.3%. Bell's Palsy is a neurological disorder that causes facial muscles on one side of the face to suddenly weaken or become paralyzed. Bell's Palsy is more common in young adults, older people, diabetics and pregnant women. A 31-year-old women with major complaint is yellow eyes. She got itching in all over the body. Patient was in second pregnancy with gestational age was 39-40 weeks. She suffered from unable to close her eyelid or blink. Patient was diagnosed with cholestasis intrahepatal in pregnancy and Bell’s palsy post partum. Diagnosis was established concluded from anamnesis, physical examination and hepar biopsy. The result of a liver biopsy showed intrahepatic cholestasis. From Fibroscan examination was visible with F2 category or Moderate Fibrosis. The main management of this patient is cesarean section with UDCA and corticosteroid therapy. Patient was administrated with antiviral therapy for her Bell’s Palsy condition. After 1 week hospitalization, patient was discharged with improvement of her major complaint
Differences Between Alpha-Fetoprotein (AFP) and Prothrombine Induced by Vitamin K Absence or Antagonist II (PIVKA-II) Values as Early Detection Method for Hepatocellular Carcinoma (HCC) and Cirrhosis
Full text linkBackground: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p > 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p > 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p < 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC
Incidence of Colorectal Cancer in Saiful Anwar Hospital, Malang January 2010- April 2015
No full textBackground: Colorectal carcinoma is the third most common malignancy worldwide and the second most frequently found cause of mortality in the United States. In Indonesia, the number of colorectal cancer patients ranks 10th (2.75%) after other cancers (cervical, breast, lymph nodes, skin, nasopharyngeal, ovarium, soft tissue, and thyroid). The main key to success in managing this carcinoma is by detecting the cancer in early stage to enable curative treatment to be performed. But, unfortunately most patients in Indonesia seek for treatment in the advanced stage, causing low survival rate. Colorectal carcinoma requires multimodalities management and there is no uniformity of management approach in the national level. This study was aimed to identify the incidence, epidemiology, and risk factors which influence the occurrence of colon and rectal cancer in Saiful Anwar Hospital (SAH), Malang based on colonoscopy examination from January 2010-April 2015.Method: Descriptive study, with total sampling method. Samples were colon and rectal cancer patients in SAH, Malang who underwent colonoscopy within January 2010 – April 2015.Results: We found 472 eligible samples, which comprised of 50 individuals (11%) with the age of less than 36 years old, 326 individuals (69%) in middle aged group with the age of 36-65 years old, 96 individuals (20%) in older aged group with the age of more than 65 years old. Patients were predominantly male with 248 individuals (53%), while female patients were 224 individuals (47%). The most common location of the tumour was in the rectum, which was found in 380 individuals (74.15%). The most common clinical symptoms was bloody stool with mucus. From patients in this study, 87 individuals (18.43%) had history of smoking, 11 individuals (2.3%) had family history of cancer, and 58 individuals (12.28%) consumed traditional herbal drinks (jamu). Patients’ characteristics of colon cancer based on anatomical pathology results showed that the most common was moderately differentiated adenocarcinoma in 33 patients (61.11%), followed by well-differentiated adenocarcinoma in 14 patients (25.93%), and the least common was those with anatomical pathology results revealing unspecific adenocarcinoma in 7 patients (12.96%). Characteristics of patients with rectal cancer based on anatomical pathology results showed that the most commonly found was moderately differentiated adenocarcinoma in 72 patients (54.15%), well-differentiated adenocarcinoma in 34 patients (25.56%), unspecific adenocarcinoma in 24 patients (18.04%) and the least common was those with anatomical pathology results of mucinous adenocarcinoma found in 3 patients (2.25%).Conclusion: The conclusion of this study was colon and rectal cancer were frequently found in middle aged group. The most common location was rectum. Mainly found in male compared to female.