International Journal of Human Capital Management (IJHCM)
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Successful Therapy in A 20 Years Old Male with Acute Pancreatitis
No full textAcute pancreatitis is an inflammation at pancreas that can be caused by biliary tract disease, alcohol and metabolic disorder. We presented a 20 years old male with acute pancreatitis, he was obese and had history of alcohol abuse came with severe abdominal pain. There is increasing amylase and lipase level, and his abdominal CT scan showed infiltrate peripancreatic, mesenteric, and left anterior pararenal space, hepatomegaly and mild ascites. Patient was given supportive treatment such as parenteral nutrition, analgetic, PPI, and also octreotide. With proper diagnosis and optimal treatment, patient was successfully treated without any complication
Performance of Fecal Leucocyte Test in Predicting Infection in the Gastrointestinal Tract of Children
Full text linkChanges in Tumor Nekrosis Factor Alpha and Interleukin 6 Levels in Patients with Obstructive Jaundice due to Pancreatobiliary Cancer Who Underwent Biliary Drainage
No full textBackground: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure.
Safety of Annona muricata Extract Supplementation for Colorectal Cancer Patients
Full text linkoai:ojs.ina-jghe.com:article/597Background: People have used Annona muricata leaves traditionally as tea drinks. Traditional use of A. muricata leaves is as an infusion which is closed to water extract. The potential health benefit of A. muricata tea leaves that is traditionally used for maintaining health which lately is being used by cancer patients. Therefore it is urgent to verify the safety of A. muricata leaves extract. Method: A randomized double blind placebo controlled trial was conducted on 30 colorectal cancer out patients who had undergone primary tumor resection. Twenty eight subjects completed the study, divided into two groups, namely ethanol-soluble fraction of A. muricata leaves water extract (ESFAM) (n = 14), and placebo (n = 14) for 8 weeks. Peripheral blood samples were withdrawn from subjects by venipuncture at baseline and at the end of the study period.Results: The effect on bone marrow can be considered to be safe. The measure in indices of organs function, i.e liver and kidney also showed similar results and within normal range after supplementation. The dose given to the subjects is safe and highly tolerable, as shown by very few (6.7%) of patients complained intolerable adverse effects. Conclusion: This study indicates the safety of ESFAM supplementation.
A Rare Complication of Acute Appendicitis: Superior Mesenteric Vein Thrombosis
Full text linkSuperior mesenteric vein (SMV) thrombosis caused by acute appendicitis is quite rare nowadays. These conditions occurs secondary to infection in the region drained by the portal venous system. In this case, we report a successfully treated case of SMV thrombosis and liver abscess associated with appendicitis with antibiotics and anticoagulant.Early diagnosis and prompt treatment are basic to a favorable clinical course
Correlation between Carcinoma Percentage (CP) and Lymphatic Microvessel Density (LMVD) Based on D2-30/Podoplanin as Metastatic Prognostic Factor to Lymph Nodes in not Otherwise Specified (NOS) Colorectal Adenocarcinoma
No full textBackground: In colorectal carcinoma (CRC), myofibroblast are the main component cells in tumour stroma which have an important role in the metastases process. The precentage between carcinoma and desmoplastic stroma known as carcinoma percentage (CP), can be used as an independent predictor metastases. D2-40/Podoplanin (PDPN) known as a spesific marker for lymphatic endothelial cell (LEC), which used to assess lymphatic microvessel density (LMVD) and lymphatic vessel invasion (LVI). This study aims to determine correlation and association between CP, LMVD and LVI with the metastases process to lymph node (LN).Method: CP assessment conducted on 44 samples of adenocarcinoma not otherwise specified (NOS) colorectal were divided into 22 cases with CP-High and 22 cases with CP-Low and examination D2-40/Podoplanin to assess LMVD and LVI. The statistical test is performed to find the correlation between CP and LMVD, as well as the relationship between CP, LVI and metastasis KGB.Results: There were a strong correlation between CP and LMVD intratumoral and peritumoral area with the negative correlation. There were a significant association (p=0,00) between LMVD (intratumoral and peritumoral area) with the LVI. There was a significant association between LVI and lymph node metastases (p = 0,03). Intratumoral area showed significant association with lymph node metastases (p = 0,04), whereas peritumoral area showed no significant association (p = 0,17).Conclusion: CP examination in histopathology specimen can be used to predict high/low rate of tumour cells metastases to the lymph node, based on a strong correlation between CP and LMVD
The Role of Vitamin D in Inflammatory Bowel Disease Pathogenesis and Management
No full textVitamin D is widely recognized in maintaining bone metabolism and health. However, recent studies indicated that vitamin D also play important role in regulating immune system. Patients with inflammatory bowel disease (IBD) is commonly found to be vitamin D deficiency; whether it served as risk factor of IBD or as the consequence of disease activity are still debatable. Growing evidences showed that supplementation of vitamin D for IBD patients to achieve normal or optimal serum level may suppress the inflammatory process, reduce disease severity, maintaining remission status, and improving quality of life
Impact of Endoscopic Ultrasound (EUS) Procedure in Pancreatico-biliary Disorders in Indonesia
No full textPancreato-biliary disorders are the challenging disorders in gastroenterology practice. It is well-known that endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure in managing pancreato-biliary disorders. However, imaging modalities such as abdominal CT scan and MRI has been successfully reduced the unnecessary ERCP to avoid several potential complications. Recently, endoscopic ultrasound (EUS) procedure has become an important tool due to the limitation of imaging modalities in pancreato-biliary disorders. Its ability which is not only for diagnostic, but also for therapeutic purpose has given a new insight for most gastroenterologists in their daily practice. However, the investment, cost, and the proper training curriculum are still debatable in most developing countries, especially in Indonesia
Microscopic Examination of Fecal Leukocytes as a Simple Method to Detecting Infective Colitis in Children
Full text linkVarious pathogenic bacteria are reported as the cause of infectious colitis in children. Infectious colitis does not have a specific sign, therefore an accurate examination is required. The implementation of fecal cultures accompanied with drug resistance tests often have constraints, beside the relatively expensive costs, longer times are needed, and not all health care facilities have required instruments. On the other hand, this condition requires an immediate antibiotic therapy, so that the infection should not be continued. In daily practice, it is not uncommon to find diarrhea with the amount of fecal leukocyte 8. The sensitivity value was 83.3% and the specificity value was 45.1%. The antibiotic sensitivity test showed that one child infected by EPEC was sensitive to ciprofloxacin. Two children infected by Salmonella, were still sensitive to chloramphenicol, cotrimoxazole, cefixime, and ceftriaxone. Two children infected by C. Difficile were sensitive to ceftriaxone, and 1 child infected by Shigella was sensitive to cefixime, ceftriaxone and ciprofloksazine
Correlation Between Esophageal Varices and Lok Score as a Non-invasive Parameter in Liver Cirrhosis Patients
No full textBackground: Bleeding from gastro-esophageal varices is the most serious and life-threatening complication of cirrhosis. Endoscopic surveillance of esophageal varices in cirrhotic patients is expensive and uncomfortable for the patients. Therefore, there is a particular need for non-invasive predictors for esophageal varices. The aim of the present study was to evaluate association of esophageal varices and Lok Score as non-invasive parameter in liver cirrhosis patients.Method: This is a cross-sectional study of patients admitted at the Adam Malik hospital Medan between September to December 2014 with a diagnosis of cirrhosis based on clinical, biochemical, ultrasound, and gastroscopy. Lok Score was calculated for all patients, tabulated and analyzed.Results: Among 76 patients with esophageal varices, 55.3% was due to hepatitis B virus (HBV). The majority of patients were Child C with only 13,2% being Child Pugh class A. Majority of the population had F2 esophageal varices (42,1%), F1 (32,9%), and F3 (25%). There is significance difference between Lok Score and grading of esophageal varices, Lok score is higher in Large esophageal varices compared with small esophageal varises (0.92 ± 0.14 vs. 0.70 ± 0.29; p = 0.001). Lok Score cut-off value of > 0,9141 was highly predictive in the diagnosis large esophageal varices with a sensitivity of 74.5%, specificity of 72%, positive predictive value of 84%, negative predictive value 58%, and accuracy was 73.7%.Conclusion: Lok Score was significantly associated with esophageal varices. Lok score is a good non-invasive predictor of large esophageal varices in cirrhotic patients.