International Journal of Human Capital Management (IJHCM)
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Multiple Primary Malignancy of Esophageal and Gastric Synchronous and Colon Metachronous
Full text linkMultiple primary cancer is an incidence when a patient has multiple malignancy in two or more organs without possibility of metastatic lesion. There have been many reports on mutiple primary cancer since Billroth reported it for the first time in 1879. Patients who have been diagnosed with a cancer have higher risk for developing another cancer, thereby physician and the patients should raise more awareness toward possibility of developing a new metachronous or synchronous cancer. We report a patient who has three histologically distinct cancers. Resected primary colon adenocarcinoma and 3 years after came with hematemesis and diagnosed to have a metachronous squamous cell carcinoma of the oesophagus synchronous with gastric adenocarcinoma. This case is interesting due to the clustering of three primary cancers (synchronous and metachronous) which is a rare occurrence in a single patient.
Precancerous Lesions in Gastrointestinal Tract
Full text linkGastrointestinal cancer is one of the health problems which is frequently found in many people in the world until now. Studies in gastrointestinal cancer showed early detection can reduce morbidity and improve the survival of patients. The precancerous lesions of the gastrointestinal tract are highly potential turn into cancer. Precancerous lesions can be defined as a change or non-cancerous lesions that can become cancerous over time. Precancerous lesions can be found on the entire upper and lower gastrointestinal tract. Precancerous lesions of the upper digestive tract that can be found are Barrett's esophagus, chronic gastritis with or without Helicobacter pylori infection, atrophic gastritis, intestinal metaplasia of the gastric mucosa, epithelial dysplasia, and adenoma polyp. While precancerous lesions in the lower gastrointestinal tract are adenoma, inflammatory bowel disease, chronic infection and hereditary non-polyposis colon lesions. Precancerous lesions of the stomach in the form of chronic atrophic gastritis, intestinal metaplasia and dysplasia can be treated with anti-inflammatory and anti-free radical drugs such as rebamipide and superoxide dysmutase. Precancerous lesions in the colon in the form of chronic enterocolitis, dysplasia can be treated with anti-oxidants, anti-inflammatory and anti-free radical such as anti-oxidants, rebamipide, superoxide dismutase, anti-inflammatory drugs
Procalcitonin Level Differences in Patients with Liver Cirrhosis Without Bacterial Infection
No full textBackground: Procalcitonin level can increase in patients with liver cirrhosis without bacterial infection. The aim of this study is to identify the role of procalcitonin in patients with liver cirrhosis without bacterial infection.Methods: Cross-sectional study was performed to patients with liver cirrhosis without bacterial infection. In patients, we performed procalcitonin level examination and bacterial infection identification. Further, we analysed them to know the procalcitonin level difference in patients with compensated and decompensated liver cirrhosis without bacterial infection.Results: We obtained 39 patients with liver cirrhosis without bacterial infection, male 61.5% with compensated condition found in 17 patients and decompensated in 22 patients. We found significant difference in the average of procalcitonin level in decompensated patients (0.738ng/mL ± 1.185) compared to compensated (0.065ng/mL ± 0.022).Conclusion: Procalcitonin level increased in patients with liver cirrhosis without bacterial infection. The level in decompensated patients were higher compared to compensated patients
Screening and Management of Colon Polyp as Colorectal Cancer Prevention
Full text linkColon polyp is a term used for abnormality from bulging tissue above surrounding colonic mucosal layer. Adenoma polyp was the commonly found polyp that progress to colorectal cancer. Most of those patients was asymptomatic. Undetected and unmanaged polyp was a risk factors of colorectal cancer event.
Association Between Degree of Gastritis and Malondialdehyde Level of Gastritis Patients at Adam Malik General Hospital Medan
Full text linkBackground: The main pathogenesis of gastritis is inflammation which process can not be separated from the role of free radicals. Malondialdehyde (MDA) is a free radical biomarker and which increases in gastritis patients. However, studies on MDA were generally performed on experimental animals or examined MDA in gastric mucosa. The aim of this study is to determine the association of histopathological degrees of gastritis (the degree of lymphocyte infiltration, neutrophil activity, atrophy, and intestinal metaplasia) with plasma MDA level.Method: Cross-sectional study of 40 consecutive gastritis patients who came to endoscopic unit of Adam Malik General Hospital Medan, from January to May 2017. Assessment for the severity of chronic inflammation, neutrophil activity, atrophy, and intestinal metaplasia refers to Updated Sydney System. Plasma MDA levels were examined using an HPLC MDA kit. Univariate and bivariate (Chi-square and fisher exact test) analysis were performed with SPSS version 22.Results: A total of 26 patients (65%) were men with an average age of 49.25 years. Lymphocyte infiltration was observed in 100% of specimens, neutrophil infiltration in 37.5%, atrophy in 22.5%, and intestinal metaplasia in 22.5%. There was a significant association between degree of lymphocyte infiltration with MDA level (p = 0.014; PR = 8.667; 95% CI: 1.52-89.52). There was a significant association between degree of neutrophil activity with high MDA level (p = 0.002; PR = 11.33; 95% CI: 2.64-48.74). There was a significant association between degree of atrophy with high level of MDA (p < 0.001; PR = 14; 95% CI: 3.4–57.648). There was a significant association between degree of intestinal metaplasia with high MDA level (p = 0.001; PR = 12.5; 95% CI: 3.76-24).Conclusion: There were significant associations between degree of lymphocyte infiltration, neutrophil activity, atrophy, and intestinal metaplasia with high level of MDA
High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors
Full text linkBackground: Patients receiving maintenance hemodialysis (HD) are at higher risk for Hepatitis B Virus (HBV) infections than in general population. Strict infection control is essential to prevent nosocomial transmission. We aimed to investigate the incidence of HBV infection in the HD population in Sanglah General Hospital as well as risk factors acquired HBV infection.Method: All adult patients receiving maintenance HD (n=267) in 3 dialysis units at Sanglah Hospital were studied between March to June 2016. In this study, medical record of patients on maintenance hemodialysis were reviewed and the patients were interviewed by the researchers to collect data regarding the serology status of these patients before and during HD, and potential risk factors which could be associated with HBV acquisition.Results: Participant mean age was 54.07 ± 0.80 years and 154 (57.7%) were male.We found 21 patients (7.8%) were sero-positive for HBV (HBsAg positive) with mean titer was 9.26±1.85. Of the sero-positive patients,1 patient (4.8%) were known to be infected before the initiation of HD and 20 patients (95.2%) were infected during HD. Incidence of HBV infection during HD was 7.5% (20/266). Sero-positive patients were younger with mean age was 51.81±2.76 years, had longer time on dialysis and had previous blood transfusions. Risk factors, which significant associated with hepatitis B infection were history of transfusion (p<0.01; OR: 2.49; 95%CI: 1.29-8.18) and duration of hemodialysis (p < 0.01; OR: 1.07; 95% CI: 1.03-3.74).Conclusion: Patients on maintenance HD in Sanglah General Hospital have a high incidence of HBV infection. The factors associated with HBV infection are highly suggestive of nosocomial transmission within HD units. History of transfusion and duration of hemodialysis were significant risk factors for HBV infection in patients receiving maintenance HD
The Association between Metaplasia and Gastric Malignancy with Helicobater pylori Infection
Full text linkBackground: Helicobacter pylori (H. pylori) infection is the main cause of peptic ulcer disease, gastric mucosa metaplasia, and gastric malignancy. The hypothesis of this study is whether there’s an association between metaplasia and gastric malignancy with H. pylori infection.Method: We conducted a retrospective study on 1.127 dyspepsia subjects who performed endoscopy between 2001 to 2011 at a hospital in North Jakarta. Data is obtained based on endoscopy and histopathology data. Investigation of H. pylori in this study using histopathology examination.Results: Of the 1.127 dyspepsia subjects who performed endoscopy and biopsy, there were 130 (11,54%) H. pylori-positive subjects. Gender proportion was composed of 55,37% men and 44,63% women, with median age was 47 years. On the histopathology examination, we obtained 45 metaplasia subjects with median age of 45 years and 7 malignancy subjects with median age of 64 years. Metaplasia was found in 33 of 997 (3,31%) H. pylori-negative subjects and 12 of 130 (9.23%) H. pylori-positive subjects. All gastric malignancy subjects had H. pylori-negative results.Conclusion: There was an association between metaplasia and H. pylori infection, but no association between gastric malignancy and H. pylori infection
Serial Case: Colorectal Malignancy in Young Age
Full text linkColorectal cancer was the third most common cancer found worldwide. In 2002, colorectal cancer was the 2nd most common cancer in men, while it ranked third among women. Based on Indonesian Ministry of Health data, its prevalence was 1.8 per 100.000 population. We report four cases of colorectal cancer in this case series, and all cases was occured among person aged 28-32 years old. Age was the main relevant risk factors for colorectal cancer in most population. Only 3% of colorectal cancer found in individual aged less than 40 years old. This case series also aimed to show that risk factors was various and changing by the time, but its determinant factors could not be explained yet
Prevention and Management of Refeeding Syndrome
Full text linkRefeeding Syndrome is a syndrome which occurs as a result of food administration in poorly nourished individuals. In this syndrome, there are wide range of biochemical alterations, clinical manifestations, and complications, starting from mild (asymptomatic) to severe (death). This syndrome was initially proposed in 1950s; however, there is still no agreement for its clear definition, causing clinicians to be less aware and tend to overlook this condition. Clinical manifestations which usually appear include electrolyte imbalances (hypophosphatemia, hypokalemia, hyponatremia, hypomagnesemia) and vitamin B1 deficiency. The main principle in management of refeeding syndrome is prevention, where clinicians need to identify this condition in the early stage in high risk individuals, supervision during refeeding, and administration of appropriate diet
Gallstone Analysis
Full text linkGallstone is a crystal deposit which is formed in the gallbladder or bile duct. Gallstone is classified into cholesterol stone, pigment stone (black and brown), and mixed stone. Mechanism which underlies the formation of cholesterol or pigment gallstone is different. Information on chemical component of the stone will assist the management and prevention of its recurrence. Analysis of gallstone component can be performed by colorimetry method or even gas liquid chromatography (GLC). Chemical component analysis of gallstone by colorimetry includes examination of cholesterol, bilirubin, and calcium. Stone is classified as cholesterol stone if the cholesterol content is > 80%, pigment stone if cholesterol content is < 20%, and mixed stone if cholesterol content is 25-80%. Gallstone analysis by GLC method is conducted by separation of fatty acid chain and evaluation of fatty acid quantity in the methylester derivatives form, which is fatty acid methyl estered. Fatty acid content in cholesterol stone (310.09 + 49.7 mg/gram) is higher compared to pigment stone (55.59 +7.71 mg/gram). Saturated to unsaturated fatty acid (S/U) ration in cholesterol stone (8.6 + 3.1) is higher compared to pigment stone (4.8 + 1.5)