International Journal of Human Capital Management (IJHCM)
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Concomitant Case of Primary Biliary Cirrhosis and Autoimmune Hemolityc Anemia Responding to Corticosteroid and Ursodeoxycholic Acid in Young Woman
Get PDFPrimary biliary cirrhosis (PBC) is an autoimmune liver disease of unknown etiology and is characterized by chronic progressive cholestasis with destruction of the small intrahepatic bile ducts and associated most commonly with antimitochondrial antibodies. PBC is most common in women and is often associated with other autoimmune disease such as autoimmune hemolityc anemia (AIHA), rheumatoid arthritis, thyroiditis, and systemic lupus eritomatosus. We report one case, a 20 years old woman with AIHA have been treated by corticosteroid since last year and she came to the outpatient department (OPD) with fatique and jaundice. The result of laboratory were haemoglobin 8.7 mg/dL, white blood cell 8700 mg/dL, coomb test +2, total bilirubin 33.2 mg/dL, direct bilirubin 29.3 mg/dL, γGT: 297 mg/dL and alkalyphospatase: 158 mg/dL. The result of Abdominal CT scan showed the size of liver and spleen increased and normal common bile duct (CBD). The result of ANA test, anti-nuclear (ANA) and antimitochondrial M2 (AMA M2) antibodies were positive. From the physical examination, laboratory and CT scan Abdomen; the diagnose of this patient was AIHA with PBC. After treatment with corticosteroid (prednison 1mg/kg/day) and ursodeoxicholic acid (UDCA) for several weeks, the clinical manifestation of PBC such as jaundice getting better (the laboratory result: total bilirubin 2.7 mg/dL, direct bilirubin 1.5 mg/dL, gamma GT 80 mg/dL)
Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms
Get PDFGastroesophageal reflux disease (subsequently abbreviated as GERD) is a disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food
Expression of Hepcidin and Growth Differentiation Factor 15 (GDF-15) Levels in Thalassemia Patients with Iron Overload and Positive Anti Hepatitis C Virus
No full textBackground: Thalassemia patients who undergo life-long recurrent blood transfusion will experience iron overload in various organs including the liver and possibly suffer from chronic hepatitis C infection which may lead to liver impairment. The liver produces hepcidin, a hormone which plays role in the regulation of iron level in the blood. Various factors may influence hepcidin level in the blood. Chronic hepatitis C causes iron overload and liver impairment. Liver impairment and haemolytic anaemia due to haemoglobinopathy will suppress hepcidin production. Anaemia stimulates growth differentiation factor 15 (GDF-15) to increase erythropoiesis and suppress hepcidin production. Iron overload causes increase in hepcidin level. Presence of factors which decrease or increase hepcidin production will express various levels of hepcidin. This study aimed to identify the expression of hepcidin and GDF-15 levels in thalassemia patients with iron overload and positive anti-HCV. Information on hepcidin and GDF-15 levels are beneficial in the management of iron overload in thalassemia with positive anti-HCV.Method: This study was a descriptive analytic study in thalassemia patients who had received recurrent blood transfusion ≥ 12 times, suffered from iron overload (transferrin saturation > 55% and ferritin > 1,000 ng/mL), which consisted of 31 individuals with positive anti-HCV and 27 individuals with negative anti-HCV. This study was performed in Thalassemia Centre Department of Child Health and Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, in October 2011–January 2012. Serum hepcidin and GDF-15 examinations were performed using enzyme-linked immunosorbent assay (ELISA) method. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) examinations were performed using colorimetry method. Data on ferritin and transferrin saturation were obtained from medical records in the last 3 months. Data was analysed using SPSS Windows version 17 software.Results: Characteristics of subjects in this study included ferritin level, transferrin saturation, AST, and ALT were 5,289 (SD 2,492) ng/mL, 96.7 (SD 9.2)%, 41.8 (SD 26.7) U/L, and 50.6 (24.9) U/L, respectively. It was obtained that the hepcidin levels were within the normal limits with median of 51.5 (19-166) pg/mL, while GDF-15 levels were higher than the normal range with median of 1,936 (643-2,475) pg/mL. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV groups, with p value of 0.842 and 0.115, respectively.Conclusion: We obtained that the hepcidin levels were within normal limits and GDF-15 levels were higher than the normal range. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV group.
Diagnostic Findings of Sclerosing Mesenteritis and the Disease Correlations with Caecal Adenocarcinoma
Get PDFSclerosing mesenteritis (SM) is a rare disease with non-specific clinical manifestations and should be supported by radiological examination and confirmed by histopathological evaluation. Its relationship with cancer especially caecal adenocarcinoma is still unclear. This case report describes a young man who was diagnosed as having SM and poorly-differentiated caecal adenocarcinoma
Demographic Characteristic of Fundic Gland Polyp and Its Association with Gastritis in Pathology Anatomy Department, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital
No full textBackground: Fundic gland polyp (FGP) is the most common polyp found in the stomach with the incidence of 47% from all stomach polyps. FGP is more common to be found in female with the ratio of 5:1 and occurs in the average age of 53-year-old. Gastrin is a hormone produced by G cell, which function is to facilitate epithelial cell proliferation. Gastritis is a frequently found digestive tract disturbance. Torbenson et al showed the presence of chronic gastritis in FGP patients. The aim of this study is to observe the demographic characteristics of FGP and to identify the association between number of polyps with morphologic appearances of gastritis in Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital in year 2012-2014.Method: This retrospective study was a descriptive analytical study. This study was performed by reviewing the slides of FGP cases and evaluating the severity of gastritis based on visual analog scale from Sydney System (SS).Results: Study of FGP demographic obtained 44 cases with predominantly female aged 30 (68.2%), patients’ average age was 55.4 year old with dominant age group in age group 51-60 year old which accounted for 16 (36.4%). This study was performed in 38 cases. The frequency of single polyp was 18 and multiple polyp was 20. Most cases were chronic inflammation which accounted for 21 (55.3%) and mild atrophy 18 (47.4%). Mild intestinal metaplasia was found in 1 case. There was no case of neutrophil infiltration, H. pylori infection or dysplasia. Chi-square test revealed that there was no significant association between number of polyps with gastritis.Conclusion: Chi-square test which was performed in this study showed there is no significant association between number of polyps with gastritis
Diagnosis and Management of Gastroenteropathy Asssociated to Non-steroidal Anti-Inflammatory Drugs
Get PDFNon-steroidal anti-inflammatory drugs (NSAIDs) is a group of drugs used to treat pain, inflammation, and fever. High consumption of NSAIDs associated with high gastrointestinal side effects. Common complaint from patients, which ranging from mild heartburn to the onset of gastrointestinal bleeding, often complicates the adequate administration of NSAIDs. Various methods have been developed to reduce the likelihood of gastroenteropathy complication. Early diagnosis, appropriate prompt treatment, as well as adequate monitoring will reduce morbidity and mortality from complications due to NSAIDs. This paper will discuss the diagnosis and management of gastro-enteropathy NSAID through approaching the underlying pathophysiology
The Prevalence of Reflux Esophagitis in the Elderly and Its Associated Risk Factors
Get PDFBackground: Reflux esophagitis is a common problem in the elderly. Compare to the Western Countries, esophageal cancer where reflux esophagitis is the most predominant risk factor is considered rare in Asia. Many other risk factors have not been well studied especially in most Asian countries. The objective of this study is to evaluate the presence of reflux esophagitis in elderly patients and its associated risk factors.Method: This was a cross-sectional study in elderly patients who underwent upper gastrointestinal endoscopy. Patients who received long-term proton pump inhibitor (PPI) therapy, suffered from gastrointestinal malignancies, recently receiving chemotherapy agents, diagnosed with cerebrovascular disease or Helicobacter pylori infection were excluded. Statistical analyses were performed using the SPSS software version 17.00 (SPSS Inc., Chicago, Illinois, USA).Results: A total of 238 elderly patients were enrolled. Patients’ mean age was 69.8 ± 6.8 years old. Reflux esophagitis was found in 22 (9.2%) patients. Several comorbidities were found in these patients, such as diabetes, hypertension, coronary artery disease, chronic kidney disease, and liver cirrhosis. The only factor that associated with reflux esophagitis was the presence of hiatus hernia esophagus (p = 0.038). However, reflux esophagitis seemed to be more found in the elderly patients who have history of reflux inducing drugs consumption without any proton pump inhibitor (PPI) protection.Conclusion: Reflux esophagitis is still a major problem in the elderly. The presence of hiatus hernia might give an important consideration of upper gastrointestinal endoscopy screening. However, it would be a debate matter with regards to the cost burden and the low risk of esophageal cancer in Asian countries.
Prevalence of Gastroesophageal Reflux Disease and Its Risk Factors In Rural Area
No full textBackground: Prevalence of gastroesophageal reflux disease (GERD) is escalating in Asia. The present study aimed toinvestigate the prevalence of GERD symptoms as well as potential risk factors associated with GERD in residents in a rural area in Jakarta. Method: The study population consisted of subjects who aged 20 years or more and lived in rural area Kebon Bawang-Tanjung Priok, Jakarta. A self-administered questionnaire based on earlier validated questionnaire (GERDQ) was given. The questionnaire consisted of demographic characteristic, self and environment sanitary, social and past illness history, and the symptoms score for GERD. Total score for GERD’s symptoms score was 18, with a score of at least 8 was considered to have symptomatic GERD.Results: The questionnaire was completed in 90 subjects. Of the 90 subjects, 12 (13.3%) had GERDQ score ≥ 8 which was the cut-off for definingpresence of GERD. On both univariate and multivariate analysis, age > 50 years old (OR = 6.33; 95% CI 1.1-35.6), handwashing habit before eating (OR = 6.93; 95% CI 1.1-43.8), and raw/tap water (OR = 10.28; 95% CI 0.8-130) were significantly associated with the presence of GERD.Conclusion: Prevalence of GERD was high (13.3%) in rural area in Jakarta. Age > 50 years old, handwashing habit before eating, and raw/tap waterwere risk factors for GERD in this population
Association between Helicobacter Pylori Infection and Graves’ Disease: A Meta-Analysis
Get PDFBackground & Aims: Helicobacter pylori (H. pylori) infection is proposed to be related with autoimmune diseases, such as Graves’ Disease (GD). This study aimed to assess the association between H. pylori infection and GD. Methods: A systematic literature review was conducted using Pubmed and Cochrane library. The quality of enrolled studies was assessed by the Critical Appraisal Skills Program Oxford. A fixed-effect model approach was used if there was no heterogeneity; otherwise, a random-effect model was used. Heterogeneity was assessed using I2. Publication bias was assessed by funnel plot. All data were analyzed using REVIEW MANAGER 5.3. Results: Six studies from Europe and Asia involving 983 patients were included. Overall H. pylori infection was significantly associated with GD (OR 2.7; 95% CI: 1.47-4.99; p < 0.001). In subgroup analysis of 3 studies using non-serological diagnostic method, the prevalence rate of H. pylori infection was higher in GD group (78.26% VS 42.42%) with significant relationship (OR 4.93; 95% CI: 3.16-7.69; p < 0.00001; I2 = 0%). The CagA antibody prevalence was significantly higher in GD group (46.57% VS 20.29%; OR 4.41; 95% CI: 2.65-7.33; p < 0.00001; I2 = 56%). No publication bias was observed. Conclusion: Our study showed association between H. pylori infection and GD. It might suggest the need of H. pylori examination in GD patients and the impact of H. pylori eradication in the treatment of GD