International Journal of Human Capital Management (IJHCM)
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Hepatitis A Virus Infection in Guillain-Barré Syndrome
No full textProdromal factors of Guillain-Barré syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS. We report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM anti HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period
Bacterial Infection in Liver Cirrhosis
No full textPatients with liver cirrhosis frequently have infection which can deteriorate further the already impaired liver function. The most common form of infection in this particular patients are spontaneous bacterial peritonitis, urinary tract infection, and respiratory infection. Causative organism mostly Gram negative micro organism and originate from the gastrointestinal tract. The weaken of immune defense mechanism and also the altered gastrointestinal tract motility can explained most of these infection. This paper will review the bacterial infection in liver cirrhosis with some guidance in the management. Key words: Liver cirrhosis, spontaneous bacterial peritonitis, systemic antibiotic treatmen
Risk Factors for Spontaneous Bacterial Peritonitis in Patients with Liver Cirrhosis and Ascites
No full textSpontaneous bacterial peritonitis (SBP) is one of serious complication of liver cirrhosis. Most of the patient with SBP have severe reduced liver function that clasified as Child Plugh class C. There are other risk factors for SBP such as poor nutritional status, GI bleeding, intravascular catheter insertion, ascites fluid protein concentration of less than 1 g/L, large volume paracentesis, urinary tract infection and respiratory tract infection. The management of SBP is mainly the administration of proper antibiotics. The antibiotic of choice for the emperial treatment is cefotaxim. Keywords: sbp,liver cirrhosis, risk factor, ascite
Esophageal Varices Bleeding in Portal Hypertension due to Portal Vein and Splenic Vein Obstruction
No full textBased on its relation to the liver sinusoid, increased pressure of portal vein can occur at three levels: presinusoid, sinusoid ,and postsinusoid. Obstruction of the presinusoid veins can be caused by extra- hepatic condition such as venous thrombosis. We reported a case of portal hypertension with esophageal varices bleeding was a result of obstruction due to thrombosis of the splenic vein and portal vein under hypercoagulant conditions due to thrombocytosis. The management of esophageal varices was sclerotherapy while for overcome the thrombosis the patient was given hydroxy urea. Keywords: esophageal varices bleeding, portal hypertension, vein obstructio
Treatment of Chronic Hepatitis C with High Dose Interferon Therapy Experience from Pertamina Central Hospital Jakarta
No full textBackground: Until several years ago, interferon alfa was the only drug with proven benefit for the treatment of chronic Hepatitis C. Several therapy categories such as fixed-dose regimens, induction-dose regimens and escalation-dose regimens are already known. With standard dose interferon therapy of 3 MU, TIW for 6 months, a sustained response rate can ve achieved in only 10-20% of patients. This study reports the Results of treatment of chronic Hepatitis C with high dose interferon therapy of 6 MU, TIW for 6 months. Methods: From February 1996 to February 1998, 15 patients with Hepatitis C were treated with interferon alfa-2b 6 MU, TIW for 6 months. Ultrasound-guided liver-biopsy was performed using the Menghini-Technique (Hepafix). Virological and biochemical responses were assessed at the end of the treatment period at week 24 and at the end of follow-up period at week 48 and up to 2 years later. Virological and biochemical sustained responses were defined as the absence of HCV-RNA, and SGPT concentration within the normal range at both weeks 24 and 48. Histological response was assessed after the end of treatment. Side-effects were observed and noted. Results: Ten out of 15 patients (66.7%) were HCV-RNA negative and 11 out of 15 patients (73.3%) demonstrated ALT within the normal range at week 24. At the end of the follow-up, from week 48 until 2 years later, HCV-RNA negative and normal ALT were found in 6 patients (40%). Histological improvement was found in 4 out of 6 patients. Fever was the most common side-effect and was found in 13 patients, while fatigue was found in 12 patients, myalgia in 11, headache in 10, and anorexia in 11 patients. Conclusion: High dose interferon alfa-2b therapy for the treatment of chronic Hepatitis C can improve the rate of sustained response, but is associated with more side-effects. Key Words: Chronic hepatitis C, Interferon
The Quality of Life of Patients with Liver Cirrhosis Hospitalized at Dr. Sardjito Hospital, Yogyakarta
No full textLiver cirrhosis is a chronic and irreversible disease. The patients quality of life (QOL) may be impaired because of long-standing burden of the disease. This research was a cross-sectional study conducted at Dr. Sardjito Hospital, Yogyakarta to determined the QOL of patients with liver cirrhosis who hospitalized in this institution. The parameter for the QOL was measured according to Spitzer index. Sixty-five patients with liver cirrhosis of various etiology were abled to be studied. The number of male and female patients were almost equal (30 and 35 respectively). There was a reduction in QOL in both male (21/30) and female (28/35) but no significant different between this variable. There was a significant positive correlation between Child criteria, and nutritional status with QOL (r=0.68, p<0.05 and r=0.37, p<0.05). It was concluded that Child criteria and nutritional status were positively correlated with QOL. Key words: Liver cirrhosis, quality of life, nutritional statu
Non Helicobacter pylori - Duodenal Ulcer in a Liver Cirrhosis Patient
No full textPeptic ulcer is an clearly marginated ulceration in mucosal membran that can penetrate until muscularis layer and resulted from imbalance between aggressive factor (gastric acid and pepsin) and defensive factor (gastric mucous, bicarbonate and prostaglandin, mucosal blood flow, and cell replacement). Factors that can act as aggressive factor include H. pylori, NSAID, and smoking. Duodenal ulcer is frequently associated with H. pylori, in which Helicobacter pylori is found in 95 - 100% of duodenal ulcer patients.. It was reported, a 39 years old female patient with cirrhosis hepatis who suffered from melena in which endoscopic examination revealed duodenal ulcer as a source of bleeding.There was no H. pylori, based on serologic examination (IgG antiHP) and culture. The ulcer is suspected caused by NSAID based on history of using traditional medicine that may contain NSAID. Treatment with proton pump inhibitor and sucralfate can heal the ulcer after two week treatment. Keywords: H. pylori, duodenal ulcer – liver cirrhosi
Orocecal Transit Time in Normal Adults at Cipto Mangunkusumo National General Hospital, Jakarta
No full textHelicobacter pylori has been known as a cause of chronic gastritis, a predisposition to gastric and duocenal ulcers, and a class I gastric carcinogen. Throughout the world, H. pylori infection is very common, reaching 40% -50% of the population in developed nations and 80% – 90% of the population in developing nations. Several techniques have been used to detect H. pylori infection, such as the urea breath test, rapid urease test, serological test, as well as biopsies of gastric or duodenal tissues for culture and histopathology. In this review article, we will discuss a relatively new method to detect H. pylori antigen in stools with enzyme immunoassay, and comparisons with other standard techniques. However, the H. pylori stool antigen test is not yet commercially available in Indonesia.Key words: Helicobacter pylori - stool antigen - enzyme immunoassa
Detection Of Helicobacter Pylori Infection With Stool Antigen: Comparison With Other Techniques
No full textHelicobacter pylori has been known as a cause of chronic gastritis, a predisposition to gastric and duocenal ulcers, and a class I gastric carcinogen. Throughout the world, H. pylori infection is very common, reaching 40% -50% of the population in developed nations and 80% – 90% of the population in developing nations. Several techniques have been used to detect H. pylori infection, such as the urea breath test, rapid urease test, serological test, as well as biopsies of gastric or duodenal tissues for culture and histopathology. In this review article, we will discuss a relatively new method to detect H. pylori antigen in stools with enzyme immunoassay, and comparisons with other standard techniques. However, the H. pylori stool antigen test is not yet commercially available in Indonesia. Key words: Helicobacter pylori - stool antigen - enzyme immunoassay
The Diagnostic and Management of Drug Induced Esophagitis
No full textThere are several factors that involve in drug induced esophagitis such as: drugs, esophagus, patients. The drug can cause direct effect to the esophageal mucosa. The drugs that often cause esphagitis: alendronate, tetracycline and its derivates and anti retroviral agents. Most of these drugs can cause esophageal damage due to corrosive nature of the drug. Esophageal factor that can cause the drug induced esophagitis: rheumatic heart disease, enlargement of the left atrium mass and aortal aneorysma. These conditions will disturb drug passage and prolongs drug contact with esophageal mucosa. The patients factor that influences this problem is the patients position when taking the drug, the patients age, the amount of water taken along with the drug, the time when drug was taken, and the amount of saliva. Endoscopy is a good procedure to evaluate the esophageal mucosa and establishing differential diagnosis through direct inspection, biopsy. In the management of esophagitis, PPIs are currently the most effectiveness agents available for treating esophagitis. Esomeprazole, an optical isomer of omeprazole is the first PPI to show greater efficacy than other PPI is in esophagitis healing. Keywords: Esophagitis, drug induced, proton pump inhibitor