International Journal of Human Capital Management (IJHCM)
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    Correlation of Aerobic Exercise and High Nitrate Diet with Population of Eschericia coli in the Digestive Tract of Liver Cirrhosis Individuals

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    Background: In liver cirrhosis, the population of E coli is increased. conditions such as reduced intestinal). Escherichia coli with 2 enzyme nitrate reductase (NRF and Nir) reduce nitrate to nitrite and subsequently converted to ammonia (99%) and nitric oxide (1%) in anaerobic condition. Regular aerobic exercise 2-3 times/week for 30 minutes resulted in increased 2,3-DPG which reduces the activity of E. coli to reduce nitrate to nitrite and ammonia, which only works on the anaerobic state. High Nitrate Diets lead to increased nitrate reducing bacteria such as E. coli resulting in the reduction of nitrate excess produce nitrite and ammonia in large quantities. Probiotic Lactobacillus spp. can suppress the growth of bacterial endotoxins and pathogens such as E. coli and other Enterobacteriaceae. This study aimed to determine the correlation of aerobic exercise and a high nitrate diet in gastrointestinal populations of Escherichia coli gastrointestinal tract in patient with liver cirrhosis.Method: This was a descriptive-experimental study in liver cirrhosis patients Child Pugh A/B in outpatient clinic Saiful Anwar Hospital in August 2015. Respondents were asked to fill out a questionnaire with information about the demographic data, the nitrate diet, aerobic exercise, other medical data and sanitation, and stool samples were taken for faecal culture. Eta Correlation statistical test was used to determine the correlation of aerobic exercise and a high nitrate diet high in population of E. coli. The significant difference are indicated by p < 0.005.Results: A total of 36 patients diagnosed with liver cirrhosis Child Pugh A/B, 14 (39%) underwent aerobic exercise 3x /week, as many as 25 (70%) consume a high nitrate diet. There was a strong relationship between aerobic exercise and high nitrate diet with population of E. coli (Ƞ = 0.725; p < 0.05).Conclusion: There was a strong relationship between aerobic exercise and high nitrate diet with a population of E. coli in liver cirrhosis. Giving probiotics in patients with liver cirrhosis suppressed the population of E. coli

    Chronic Pancreatitis

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    Chronic pancreatitis is a progressive inflammation in pancreas results in fibrosis and irreversible damage lead to loss of exocrine and endocrine function. Mortality and complication rate is high. Appropriate management of chronic pancreatitis begin from accurate diagnosis to adequate treatment. Diagnosis is still a challenge for clinician, mostly in early-stage disease. Several diagnostic modalities such computed tomography scan, magnetic resonance cholangiopancreaticography, endoscopic ultrasound, endoscopic retrograde cholangiopancreaticography, and direct-indirect pancreatic function test help diagnosis establishment. Endoscopic approach has an important role, both during diagnosis and treatment

    Red Cell Distribution Width to Platelet Ratio: in a Search of Non-Invasive Liver Fibrosis Biomarker

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    Primary Biliary Cirrhosis

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    Primary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome)

    First Year Gastrointestinal Endoscopy Profile in Singkawang West Borneo 2017 – 2018

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    Background: Gastrointestinal endoscopic examination which is included in the referral system of the Badan Penyelenggara Jaminan Sosial (BPJS) has been available at St Vincentius Hospital Singkawang and already been conducted by internist since March 2017 to diagnose upper and lower gastrointestinal diseases. The gastrointestinal endoscopic examination unit serves referrals from Singkawang and its 3 surrounding districts (Sambas, Bengkayang, and Mempawah) that close to the Malaysian border. The purpose of this study is to determine the patients’ profile from Singkawang, Sambas, Bengkayang and Mempawah Districs who underwent gastrointestinal endoscopic examination at St Vincentius Hospital from March 2017 to April 2018.Method: This is a retrospective descriptive study by using secondary data of patient’s  medical records at St Vincentius Hospital Singkawang in March 2017 - April 2018. Every patient is included as a sample (total sampling). Total numbers are consisted of 308 patients including 230 esophagogastroduodenoscopies and 78 colonoscopies.Result: The results of this study showed that majority of patients were more likely to undergo esophagogastroduodenoscopy (EGD) (75%) than colonoscopy (25%). Males, age group of 51-70 years old and Malay ethnic are the groups of patients who have the most upper and lower gastrointestinal disorders. The prominent finding of esophagogastroduodenoscopy was erosive gastritis (64%), whereas internal hemorrhoids was the most common finding in colonoscopy (67%); if internal hemorrhoids was excluded, colon mass became the most common finding disorder.Conclusion: Patient were mostly male, age group between 51 – 70 years old and Malay. The most common finding in colonoscopy (67%); if internal hemorrhoids was excluded, colon mass shifted forward  as the top finding disorder

    Serologic and Urine Diagnostic Tests to Detect Helicobacter pylori Infection in Functional Dyspepsia Patients

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    Background: Dyspepsia is a collection of symptoms in the forms of discomfort, pain, nausea, vomiting, bloating, and early satiety in the stomach. This condition can be caused by various problems; one of them is Helicobacter pylori infection. Dyspepsia without organic problem is known as functional dyspepsia. H. pylori examination is recommended in functional dyspepsia patients.Method: In this study, we performed a diagnostic test study in dyspepsia patients in Community Health Centre of Koja District, North Jakarta, from February to April 2015. Samples were obtained through consecutive sampling method; 74 patients were included. The data was gathered by distributing questionnaires to patients, performing urea breath test (UBT) examination, serologic test, and urine test using rapid urine test (RAPIRUN). Results: Prevalence of H. pylori infection by using UBT examination reached up to 36.5%; meanwhile serologic and RAPIRUN tests showed positive results in 32.4% and 24.3% patients, respectively. Serologic test has sensitivity of 74% (95% CI: 55-87%), specificity 91% (95% CI: 80-97%), positive predictive value (PPV) 83% (95% CI: 64-93%), and negative predictive value (NPV) 86% (95% CI: 74-93%). Meanwhile, RAPIRUN has sensitivity of 63% (95% CI: 44-78%), specificity 98% (95% CI: 89-100%), PPV 94% (95% CI: 74-99%), and NPV 82% (95% CI: 70-90%).Conclusion: Sensitivity of serologic and RAPIRUN tests are still inadequate to be alternative to UBT examination. However, they have high specificity. Further studies are required with larger sample size and consideration of factors which may influence the results of both tests

    Diagnostic and Therapeutic Approach in Intestinal Tuberculosis

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    Tuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them  is in abdominal organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and  absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care

    Melanosis Coli

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    Melanosis coli is a brownish discoloration of the colonic mucosa caused by the accumulation of pigment in macrophages of the lamina propria. We reported a 62 years old woman with prolonged constipation since 10 years ago. She underwent haemorhoidectomy when 17 years old. Since 4 years ago she regularly comsumted herbal laxative. On 27 january 2015 underwent colonoscopy at Sardjito hospital Yogyakarta. Colonoscopic examination revealed Melanosis coli

    Biliary Drainage and Inflammatory Environment in Patients with Malignant Obstructive Jaundice

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    A Case of Primary Ileocecal Lymphoma

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    Primary lymphoma in gastrointestinal tract is not very common. Ileocecal region is the commonest site for primary lymphoma and diffuse large B cell lymphoma (DLBCL) is the most prevalent subtype. The clinical presentation in this condition is pain in right lower quadrant region and this can very confusing since many diseases can also cause this problem like infection and inflammatory disease. In this paper, we report a case of primary lymphoma subtype DLBCL in ileocecal region that come to emergency department with ileus obstruction. Abdominal computerized tomography (CT) scan and colonoscopy revealed tumour in ileocecal region ascendens colon. Hemicolectomy was performed and the specimen was sent to pathology which revealed non-Hodgkin lymphoma with subtype DLBCL CD20 (+). The patient had undergone of Rituximab, Cyclophosphamide, Doxorubicine, Vincristin, and Prednison (RCHOP) chemotherapy regimen and had complete remission

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    International Journal of Human Capital Management (IJHCM)
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