International Journal of Human Capital Management (IJHCM)
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Upper Gastrointestinal Symptoms and Climate Exchange in Indonesian Hajj Pilgrims: Community Based Study Islamic Year 1427
No full textBackground: Upper gastrointestinal symptoms rank among the three most common diseases for Indonesian hajj pilgrims in last 4 years. The prevalence was 22-34% per hajj season. Most of the cases were dyspepsia syndrome and Gastro Esophageal Reflux Disease (GERD). The internal risk factor of Upper gastrointestinal symptoms is largely known, but not for external factor such as environment and climate. Aim: To examine the association between climate exchange and upper gastrointestinal symptoms Methods: Dynamic population of 204,941 Indonesian Hajj Pilgrims in Islamic year 1427 were included for this study. Multiphase screening in Indonesia found the prevalence of upper gastrointestinal symptoms was 3.32%. Prospective follow up for upper gastrointestinal symptom-based on community health services (flight group/kloter and maktab policlinic/polimaktab) and hospital base (Sub Balai Pengobatan Haji Indonesia, Balai Pengobatan Haji Indonesia [BPHI] and Saudi Arabia hospital) was conducted in Saudi Arabia. Results: The incidence rate of the upper gastrointestinal symptoms was 2.4 per mile (95% CI = 1.8 -3.1). There was no significant difference among male and female p = 0.279 (95% CI = 0.18- 5.3) and there was significant difference among work area (Daker) p = 0.001 (95% CI = 50.4-182.5). There was no significant correlation between upper gastrointestinal symptoms and temperature or humidity in 3 work area (p = 0.155) Mecca, Medina and Jeddah. Conclusion: There was no significant correlation between climate exchanges to the upper gastrointestinal symptoms. Keywords: upper gastrointestinal symptoms, Indonesian Hajj Pilgrims, dyspepsia, GER
Upper Gastrointestinal Endoscopy and Histopathology Appearance in Indonesian Children with Recurrent Epigastric Pain
No full textBackground: Recurrent Epigastric Pain (REP) is a clinical symptom frequently found in children. Data of the correlation between duration of illness, frequency of illness, associated symptoms of REP and the abnormality of endoscopic and histopathologic appearance are still limited, especially in Indonesia. The role of Helicobacter pylori (H. pylori) infection in causing organic abnormalities of the gastrointestinal tract (GIT) is also still controversial. Aim:To know the endoscopic and histopathologic appearance and the prevalence of Helicobacter pylori infection, 169 children with REP was performed for endoscopic and histopathologic examination in Department of Pediatric, Cipto Mangunkusumo hospital. Result:Endoscopic and histopathologic abnormalities were found significantly in children who suffered from REP more than 9 months and more than 6 times during 3 months of period. Conclusion: Endoscopic and histopathologic examinations should be considered in children with REP. Keywords: recurrent abdominal pain, epigastric pain, Helicobacter pylori, endoscopy and histopatholog
Diagnosis and Management of Blastocystis Hominis Infection in Patient with HIV-AIDS
No full textThe incidence of AIDS/HIV infection has been increasing worldwide. Patients with AIDS/HIV infection is at high risk to get opportunistic infection which is often become life-threatening. Common infections associated with AIDS/HIV are tuberculosis (TB) infection and viral hepatitis. Commensal organism found in human body is actually not pathogenic. Blastocystis hominis is generally considered as commensal organism of intestinal tract and might cause opportunistic infection in patients with AIDS. We reported a case of young male patient with AIDS/HIV infection and evidence of opportunistic infection of Blastocystis hominis found in ascitic fluid along with concomitant lung TB and viral hepatitis. Patient was well-responded to treatment of B. Hominis. Keywords: AIDS/HIV infection, opportunistic infection, Blastocystis homini
The Clinical Significance of CYP450 in Gastrointestinal Tract
No full textCytochromes P450 (CYP450) is a super-family of multigenes bound to heme and also a catalysator enzyme. Cytochrome P450s (1, 2, and 3) are the most important enzymes for biotransformation of drugs administered through gastrointestinal tract. The gastrointestinal tract is the first part of immune system against all of oral xenobiotics. Drug interaction may be predicted but it is hardly prevented. Thus, it frequently becomes clinical problem. CYP450 polymorphism may influence effective drug metabolism, which consequently will affect drug response and good therapeutic effect. Poor metabolizers need only a small dose of drug to bring on drug response but extensive or ultra-rapid metabolizers will need a large dose of drug. The unexpressed CYP2E1, one of the CYP families, may influence cancer incidence. However, it is still controversial. Keywords: CYP450, xenobiotics, biotransformation of drugs, gastrointestinal trac
Correlation of CagA-Positive Strains of Helicobacter pylori with Topographic Distribution and Chronic Gastritis Grading
No full textBackground: CagA gene is a marker for the presence of Cag pathogenicity island. CagA-positive strains of Helicobacter pylori can identify individuals who have higher risk of developing gastrointestinal diseases. Aim: To discover the correlation of CagA status of Helicobacter pylori with topographic localization of Helicobacter pylori and chronic gastritis grading. Methods: Gastric biopsy specimens were taken from 104 patients. The specimens were obtained from gastric antrum, corpus and incisures for histological and polymerase chain reaction (PCR) studies. The histological chronic gastritis was assessed semi-quantitatively (grades 0-3). The PCR was used for detecting Helicobacter pylori genes and CagA strain. Topographic localization of Helicobacter pylori was classified as gastric antrum and corpus. Results: There were 33 (86.8%) CagA-positive strains of 38 patients with Helicobacter pylori-positive genes. There were no significant differences between topographic localization of Helicobacter pylori - either in the gastric antrum (rho = 0.14, p = 0.40) nor in the corpus (rho = 0.27, p =0.10) and the CagA status of Helicobacter pylori. Conclusion: CagA gene status of Helicobacter pylori does not determine chronic gastritis grading and gastric topographic localization. Keywords: chronic gastritis, cagA gene, Helicobacter pylori, gastric antrum, gastric corpus
Emergency Abdominal Surgery in Patient with Liver Cirrhosis
No full textThe number of patients with cirrhosis who require surgery is increasing. Therefore, it can be expected that a growing number of patients with cirrhosis will undergo surgery. Patients with cirrhosis are at particularly at high risk for morbidity and mortality due to the stress of surgery and the effects of general anesthesia. The risk for morbidity and mortality are influenced by the type of surgery and the extent of liver dysfunction. In patient with cirrhosis who undergo emergent abdominal surgery the mortality rate may reach 50%. The Child-Pugh score is used to predict perioperative morbidity and mortality rates for patients undergoing intra-abdominal surgery. The mortality rate patient with Child Classification A was 10%, Child Classification B was 31% and Child Classification C was 76%. So, an approach to perioperative risk assessment, evaluation, and management of the cirrhosis patients who is a surgical candidate is very crucial. We reported a case of an elderly male patient with liver cirrhosis who would undergo emergent abdominal surgery. Keywords: liver cirrhosis, emergency surgery, child pugh classificatio
Nutrition Management on Acute Pancreatitis
No full textPancreatitis is an inflammatory process in pancreas. Clinical manifestation of acute pancreatitis can be mild to severe. Mortality rate is high in severe acute pancreatitis. Etiology of acute pancreatitis generally remains obscured. Supportive management is important in acute pancreatitis. Nutrition is important part in acute pancreatitis. Patient should not be given enteral nutrition temporarily and meanwhile parenteral nutrition must provide sufficient amount of calories and nutritional requirements. Immune nutrition should also be considered. In mild acute pancreatitis, oral realimentation can be started in 3rd-7th day. In severe acute pancreatitis with prolonged fasting, gradual enteral nutrition via nasoenteral tube is recommended Keywords: nutrition, acute pancreatitis, enteral nutritio
Gastroesophageal Reflux Disease in Push Up and Sit Up Exercise
No full textBackground: Several factors involve in GERD are hypotension of Lower Esophageal Sphincter (LES), Transient Lower Esophageal Sphincter (TLES) relaxation, delayed gastric emptying and esophageal hiatal hernia. Bent over and supine position like push up and sit up exercise in this study, are known as trigger factors for GERD which can cause hypotension of the LES, TLES relaxation and transdiaphragmatic pressure resulted in increased diaphragmatic nerves activation. Aim: The purpose of this study was to investigate the occurrence of GERD in push up and sit up exercise. Materials and Methods: This is an experimental study; subjects were healthy male aged 18-21 years. Patients data were collected after fulfilling the selection criteria as described in the study protocol. χ2 analysis or Fischer’s exact test analysis was applied to determine the statistical significance of difference between push up and sit up. There were 30 subjects in the study, 15 subjects in push up group and 15 subjects in sit up group. Result: Three subjects (10%) were dropped out and 27 subjects (90%) were endoscopied. In the sit up group, 13 subjects (87%) were endoscopied, 9 subjects (70%) had normal endoscopy and 4 subjects (30%) had mucosal breaks. In push up group, 14 subjects (93%) were endoscopied, 6 subjects (43%) had normal endoscopy and 8 subjects (57%) had mucosal breaks. There was no significant difference between push up and sit up group with χ2 analysis or Fischer’s exact test (p = 0.322). Conclusion: There was more likely GERD in push up group than in sit up group, but the difference was not significant. Keywords: push up exercise; sit up exercise, gastroesophageal reflux disease (GERD
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya
No full textBackground: 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, diagnosi
Oxygen Hyperbaric Therapy in Patients with Radiation Proctitis
No full textBackground: Cervical cancer is the most common female malignancy in developing countries, including Indonesia. It usually occurs at the age of 20 years, reaches the peak incidence at the age of 35-55 years, and afterwards, the incidence declines. Radiotherapy is the most important treatment method in cervical cancer, especially for local advanced stage or stage IIb-IVa. It is also effective for the early stage. Oxygen hyperbaric therapy (OHBT) is defined as 100% oxygen (O2) administration of 2-3 ATA (Absolute Atmospheres) pressures in a high-pressure room. OHBT accelerates wound healing by improving oxygen perfusion around the wound and by increasing angiogenesis through Nitric Oxide Synthetase (NOS). Methods: The study was conducted at Cipto Mangunkusumo hospital, while OHBT was provided at Dr. Mintoharjo Navy Hospital. Block randomization was performed, Resulting 32 patients in OHBT group and 33 patients in control group; both groups were at normal distribution. The prevalence of radiation proctitis in OHBT and control group was determined using chi-square test. Results: By comparing the prevalence of radiation proctitis between OHBT and the control group, show that OHBT could decrease proctitis prevalence by p = 0.03. Conclusions: This study indicates that OHBT may reduce the prevalence of radiation proctitis. The OHBT is save and secure to the patients. Keywords: OHBT, cervical cancer, radiotherapy, radiation proctiti