R. Adiwinata, B. J. Waleleng, H. Haroen, Linda Rotty, Fandy Gosal, Luciana Rotty, Cecillia Hendratta, P. Lasut, Jeanne Winarta, Andrew Waleleng, M. Tendean
L-Asparaginase is one of the main chemotherapy regiments for acute lymphocytic leukemia (ALL) management. Acute pancreatitis is one of the serious side effects of l-asparaginase administration and may lead to interruption of chemotherapy cycle. Long term complications may be devastating for patients which include of pseudocyst pancreas and chronic pancreatitis. Asparaginase induced pancreatitis is rare among adult due to the nature of ALL which commonly occurred in children population. The pathophysiology of asparaginase induced pancreatitis is still unclear. Here we present 18-year-old male with ALL and asparaginase induced acute necrotizing pancreatitis which complicated to chronic pancreatitis and pseudocyst.
{"title":"Asparaginase-Induced Acute Necrotizing Pancreatitis Resulting in Chronic Pancreatitis and Pseudocyst in an Adult with Acute Lymphocytic Leukemia","authors":"R. Adiwinata, B. J. Waleleng, H. Haroen, Linda Rotty, Fandy Gosal, Luciana Rotty, Cecillia Hendratta, P. Lasut, Jeanne Winarta, Andrew Waleleng, M. Tendean","doi":"10.24871/241202398-101","DOIUrl":"https://doi.org/10.24871/241202398-101","url":null,"abstract":"L-Asparaginase is one of the main chemotherapy regiments for acute lymphocytic leukemia (ALL) management. Acute pancreatitis is one of the serious side effects of l-asparaginase administration and may lead to interruption of chemotherapy cycle. Long term complications may be devastating for patients which include of pseudocyst pancreas and chronic pancreatitis. Asparaginase induced pancreatitis is rare among adult due to the nature of ALL which commonly occurred in children population. The pathophysiology of asparaginase induced pancreatitis is still unclear. Here we present 18-year-old male with ALL and asparaginase induced acute necrotizing pancreatitis which complicated to chronic pancreatitis and pseudocyst. ","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74404194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Habiburrahman, Stefanus Sutopo, Nur Rahadiani
A deadly and debilitating disease, colorectal cancer (CRC), is rapidly becoming a significant threat to public health. However, current therapeutic approaches are still hampered by various side effects. Due to its benefits and remarkable apoptotic impact on cancer cells, plant-derived flavonoids now garner interest as candidates for cancer therapy. Isoquercitrin, a flavonoid commonly found in fruit plants, especially mangoes, is notable due to its ability to inhibit cancer development through various mechanisms. This review aims to highlight the use of isoquercitrin extracted from mango peels in inhibiting CRC carcinogenesis. A literature search was done on Pubmed, Proquest, and Google Scholar using inclusion and exclusion criteria, and a narrative review was synthesised using the evidence gathered. Validity assessment was done through the the Office of Health Assessment and Translation (OHAT) and Oxford Center for Evidence-Based Medicine (CEBM) critical assessment tools. Evidence suggested that isoquercitrin is promising as adjuvant therapy in CRC. It may inhibit overaccumulation of cytoplasmic β-catenin and its translocation into the nucleus, thus downregulating the expression of target proto-oncogenes leading to carcinogenesis of colon crypts. Isoquercitrin concentration in mango peel is abundant, 557.7 mg/kg in dried mango peel and 31.0 mg/kg in pure extracts. A pharmacology study approved that a daily intake of 5.4 mg/kgBW of isoquercitrin has an effective anticancer effect. This substance has good oral bioavailability and is well-tolerated but inhibits the metabolising enzymes CYP1A1 and CYP1B1. In conclusion, isoquercitrin is a potential adjuvant in inhibiting CRC growth with minimum costs and side effects.
{"title":"The Plausible Use of Mango (Mangifera indica) Peel Isoquercitrin as Adjuvant Therapy for Colorectal Cancer: Translating Research from Bench to Bedside","authors":"Muhammad Habiburrahman, Stefanus Sutopo, Nur Rahadiani","doi":"10.24871/241202354-62","DOIUrl":"https://doi.org/10.24871/241202354-62","url":null,"abstract":"A deadly and debilitating disease, colorectal cancer (CRC), is rapidly becoming a significant threat to public health. However, current therapeutic approaches are still hampered by various side effects. Due to its benefits and remarkable apoptotic impact on cancer cells, plant-derived flavonoids now garner interest as candidates for cancer therapy. Isoquercitrin, a flavonoid commonly found in fruit plants, especially mangoes, is notable due to its ability to inhibit cancer development through various mechanisms. This review aims to highlight the use of isoquercitrin extracted from mango peels in inhibiting CRC carcinogenesis. A literature search was done on Pubmed, Proquest, and Google Scholar using inclusion and exclusion criteria, and a narrative review was synthesised using the evidence gathered. Validity assessment was done through the the Office of Health Assessment and Translation (OHAT) and Oxford Center for Evidence-Based Medicine (CEBM) critical assessment tools. Evidence suggested that isoquercitrin is promising as adjuvant therapy in CRC. It may inhibit overaccumulation of cytoplasmic β-catenin and its translocation into the nucleus, thus downregulating the expression of target proto-oncogenes leading to carcinogenesis of colon crypts. Isoquercitrin concentration in mango peel is abundant, 557.7 mg/kg in dried mango peel and 31.0 mg/kg in pure extracts. A pharmacology study approved that a daily intake of 5.4 mg/kgBW of isoquercitrin has an effective anticancer effect. This substance has good oral bioavailability and is well-tolerated but inhibits the metabolising enzymes CYP1A1 and CYP1B1. In conclusion, isoquercitrin is a potential adjuvant in inhibiting CRC growth with minimum costs and side effects.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81980340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santi Sumihar Rumondang Parhusip, I. Rengganis, M. Simadibrata, M. Abdullah, H. Shatri, E. Yunihastuti, Heri Wibowo
Background: Inflammatory bowel disease (IBD) is an autoimmune disease that is influenced by food, an important factor in accelerating its clinical disease activity because of intestinal inflammation trough formation of antigen-antibody complex. Food-specific IgG examination can identify the types of person foods consumes that are maybe responsible for disease activity. It is useful in treating IBD without risking malnourishment as it is tailored to the individual immune profile.Method: This is a cross-sectional study involving 113 patients diagnosed with IBD by colonoscopy. Examination of serum IgG specific for 220 types of foods was performed using ELISA and immuno-array techniques. Disease clinical activity was assessed using the Mayo index and Crohn's disease activity index.Results: The highest proportion of dietary IgG in Crohn's disease was peas (100%), barley (97.9%), eggs (95.9%), milk (81.6%), and corn (75.5%); while in ulcerative colitis it was barley (98.4%), peas (96.8%), egg whites (92.2%), corn (82.8%), and prunes (78.1%). In ulcerative colitis, there was a weak negative correlation between cashew nuts IgG (r = -0.347; p = 0.041) and chickpeas IgG (r = -0.473; p = 0.017) with clinical disease activity; while in Crohn's disease, a weak positive correlation with disease activity was seen in barley (r = 0.261; p = 0.042).Conclusion: There was a weak negative correlation between cashew and chickpea-specific IgG antibodies with clinical activity of ulcerative colitis, and a weak positive correlation between barley-specific IgG antibodies and Crohn's disease clinical activity.
{"title":"Association between Food Specific IgG Antibodies with Clinical Activity of Disease in Patients with Inflammatory Bowel Disease: A Cross-Sectional Study","authors":"Santi Sumihar Rumondang Parhusip, I. Rengganis, M. Simadibrata, M. Abdullah, H. Shatri, E. Yunihastuti, Heri Wibowo","doi":"10.24871/241202341-48","DOIUrl":"https://doi.org/10.24871/241202341-48","url":null,"abstract":"Background: Inflammatory bowel disease (IBD) is an autoimmune disease that is influenced by food, an important factor in accelerating its clinical disease activity because of intestinal inflammation trough formation of antigen-antibody complex. Food-specific IgG examination can identify the types of person foods consumes that are maybe responsible for disease activity. It is useful in treating IBD without risking malnourishment as it is tailored to the individual immune profile.Method: This is a cross-sectional study involving 113 patients diagnosed with IBD by colonoscopy. Examination of serum IgG specific for 220 types of foods was performed using ELISA and immuno-array techniques. Disease clinical activity was assessed using the Mayo index and Crohn's disease activity index.Results: The highest proportion of dietary IgG in Crohn's disease was peas (100%), barley (97.9%), eggs (95.9%), milk (81.6%), and corn (75.5%); while in ulcerative colitis it was barley (98.4%), peas (96.8%), egg whites (92.2%), corn (82.8%), and prunes (78.1%). In ulcerative colitis, there was a weak negative correlation between cashew nuts IgG (r = -0.347; p = 0.041) and chickpeas IgG (r = -0.473; p = 0.017) with clinical disease activity; while in Crohn's disease, a weak positive correlation with disease activity was seen in barley (r = 0.261; p = 0.042).Conclusion: There was a weak negative correlation between cashew and chickpea-specific IgG antibodies with clinical activity of ulcerative colitis, and a weak positive correlation between barley-specific IgG antibodies and Crohn's disease clinical activity. ","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86488064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tamin, Sabda Ardiantara, Diar Riyanti Rudiatmoko
Background: Nonalcoholic fatty liver disease (NAFLD) is associated with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the first-line therapy for OSA. However, the effect of CPAP on NAFLD in patients with concomitant OSA is still unclear. This study aims to identify the use of CPAP on NAFLD in patients with OSA. Method: A systematic literature search was performed using particular keywords and medical subheadings in three journal databases: Cochrane, PubMed, and EBSCOhost. The results were screened and assessed using inclusion and exclusion criteria by three independent authors. The Randomized controlled trial (RCT) quality was evaluated with Jadad scale and the cohort studies quality was assessed with Newcastle-Ottawa quality assessment scale.Results: Two RCTs and three cohort studies were eligible to fulfil the inclusion criteria, consisting of 620 total patients. Two RCTs showed no statistically significant improvement after CPAP treatment in NAFLD based on intrahepatic triglyceride (measured by proton magnetic resonance spectroscopy), liver stiffness measurement, serum cytokeratin-18 fragment, and liver function blood test parameters. Meanwhile, 2 cohort studies in adults and 1 cohort study in children showed significant improvement in ALT, AST, and APRI. However, one cohort study showed no significant improvement in serum fibrosis markers and transient elastography measurement after CPAP treatment.Conclusion: CPAP might be beneficial in some patients with OSA to improve NAFLD, but further research that includes many subjects and longer duration of CPAP therapy is needed to confirm this result.
{"title":"Effects of Continuous Positive Airway Pressure on Nonalcoholic Fatty Liver Disease in Patients with Obstructive Sleep Apnea: A Systematic Review","authors":"S. Tamin, Sabda Ardiantara, Diar Riyanti Rudiatmoko","doi":"10.24871/241202349-53","DOIUrl":"https://doi.org/10.24871/241202349-53","url":null,"abstract":"Background: Nonalcoholic fatty liver disease (NAFLD) is associated with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the first-line therapy for OSA. However, the effect of CPAP on NAFLD in patients with concomitant OSA is still unclear. This study aims to identify the use of CPAP on NAFLD in patients with OSA. Method: A systematic literature search was performed using particular keywords and medical subheadings in three journal databases: Cochrane, PubMed, and EBSCOhost. The results were screened and assessed using inclusion and exclusion criteria by three independent authors. The Randomized controlled trial (RCT) quality was evaluated with Jadad scale and the cohort studies quality was assessed with Newcastle-Ottawa quality assessment scale.Results: Two RCTs and three cohort studies were eligible to fulfil the inclusion criteria, consisting of 620 total patients. Two RCTs showed no statistically significant improvement after CPAP treatment in NAFLD based on intrahepatic triglyceride (measured by proton magnetic resonance spectroscopy), liver stiffness measurement, serum cytokeratin-18 fragment, and liver function blood test parameters. Meanwhile, 2 cohort studies in adults and 1 cohort study in children showed significant improvement in ALT, AST, and APRI. However, one cohort study showed no significant improvement in serum fibrosis markers and transient elastography measurement after CPAP treatment.Conclusion: CPAP might be beneficial in some patients with OSA to improve NAFLD, but further research that includes many subjects and longer duration of CPAP therapy is needed to confirm this result.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90039253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cystic echinococcosis is a zoonotic disease that is caused by the larval stages of cestodes species and belongs to the genus Echinococcus. Echinococcus granulosus (E. granulosus) causes cystic echinococcosis which is global and wider in its distribution than alveolar echinococcosis. Endemic areas of E. granulosus are Russia, Eastern Europe, the Middle East, China, and South America based on data from the World Health Organization (WHO). Incidence rates are 50 per 100,000 person-years. The life cycle of E. granulosus requires both an intermediate host and a definitive host. A human accidentally becomes an intermediate host. Upon infection, cyst formation mostly occurs in the liver (70%). At the first, the infection is usually asymptomatic. Diagnosis of cystic echinococcosis can be done by imaging techniques (ultrasound or CT/MRI), serum serologic testing for antibodies against hydatid antigens, and immunologic testing. In general, there are four different management modalities for cystic echinococcosis, such as surgery, percutaneous therapy surgery, chemotherapy, and watchful waiting.
{"title":"Multimodal Treatment of Cystic Echinococcosis","authors":"Anak Agung Ketut Yunita Paramita, I. Wibawa","doi":"10.24871/241202372-82","DOIUrl":"https://doi.org/10.24871/241202372-82","url":null,"abstract":"Cystic echinococcosis is a zoonotic disease that is caused by the larval stages of cestodes species and belongs to the genus Echinococcus. Echinococcus granulosus (E. granulosus) causes cystic echinococcosis which is global and wider in its distribution than alveolar echinococcosis. Endemic areas of E. granulosus are Russia, Eastern Europe, the Middle East, China, and South America based on data from the World Health Organization (WHO). Incidence rates are 50 per 100,000 person-years. The life cycle of E. granulosus requires both an intermediate host and a definitive host. A human accidentally becomes an intermediate host. Upon infection, cyst formation mostly occurs in the liver (70%). At the first, the infection is usually asymptomatic. Diagnosis of cystic echinococcosis can be done by imaging techniques (ultrasound or CT/MRI), serum serologic testing for antibodies against hydatid antigens, and immunologic testing. In general, there are four different management modalities for cystic echinococcosis, such as surgery, percutaneous therapy surgery, chemotherapy, and watchful waiting.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84901488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Maulahela, D. Rumagesan, M. Abdullah, D. Makmun, Kaka Renaldi, M. Simadibrata, H. Shatri, A. Fauzi
Background: This study is conducted to investigate the effectiveness of extracorporeal shockwave lithotripsy (ESWL) after biliary stent placement compared to biliary stent placement alone in difficult common bile duct stones.Method: This is a retrospective cohort study using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. We retrospectively evaluated 126 subjects with difficult bile stones. The subjects were divided into two groups: subjects subjected to biliary stent placement only and subjects who underwent ESWL procedure after the biliary stent placement. The effectiveness of the procedures was measured in the form of total clearance of bile stones.Results: A total of 126 subjects were included in this study, including 72 subjects who underwent ESWL procedure after biliary stent placement and 54 subjects who underwent biliary stent placement only. The effectiveness of ESWL after biliary stent placement in achieving total clearance was 69.1%, and the effectiveness of biliary stent placement in achieving total clearance was 64.8%. The ESWL procedure as adjuvant therapy after biliary stent placement did not provide a statistically significant difference (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy after biliary stent placement has the same level of effectiveness as biliary stent placement alone.
{"title":"Effectivity of Extracorporeal Shock Wave Lithotripsy and Stenting vs Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis","authors":"H. Maulahela, D. Rumagesan, M. Abdullah, D. Makmun, Kaka Renaldi, M. Simadibrata, H. Shatri, A. Fauzi","doi":"10.24871/241202323-29","DOIUrl":"https://doi.org/10.24871/241202323-29","url":null,"abstract":"Background: This study is conducted to investigate the effectiveness of extracorporeal shockwave lithotripsy (ESWL) after biliary stent placement compared to biliary stent placement alone in difficult common bile duct stones.Method: This is a retrospective cohort study using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. We retrospectively evaluated 126 subjects with difficult bile stones. The subjects were divided into two groups: subjects subjected to biliary stent placement only and subjects who underwent ESWL procedure after the biliary stent placement. The effectiveness of the procedures was measured in the form of total clearance of bile stones.Results: A total of 126 subjects were included in this study, including 72 subjects who underwent ESWL procedure after biliary stent placement and 54 subjects who underwent biliary stent placement only. The effectiveness of ESWL after biliary stent placement in achieving total clearance was 69.1%, and the effectiveness of biliary stent placement in achieving total clearance was 64.8%. The ESWL procedure as adjuvant therapy after biliary stent placement did not provide a statistically significant difference (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy after biliary stent placement has the same level of effectiveness as biliary stent placement alone.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73840534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haryono Haryono, M. B. Bestari, N. Agustanti, Dolvy Girawan, Yudi Wahyudi, S. Abdurachman, Anna Tjandrawati
Background: Hepatitis B virus (HBV) is a serious health problem in the world, including in Indonesia. Transient elastography (TE) is now regarded as a reliable surrogate marker for grading the severity of liver fibrosis in chronic hepatitis B (CHB) patients. The Mac-2 binding protein of glycosylation isomer (M2BPGi) is a novel non-invasive serum biomarker for liver fibrosis staging in various liver diseases including CHB. This study aims to evaluate the correlation of M2BPGi and liver stiffness (LS), measured through TE, in predicting liver fibrosis among CHB patients.Method: A cross-sectional study was conducted at Dr. Hasan Sadikinl General Hospital Bandung between September 2021–January 2022 on patients diagnosed with CHB based on clinical and biochemical examination. The subjects underwent TE examination using Fibroscan® and M2BPGi levels were determined with an automated immunoassay analyzer HISCL-800, Sysmex, Japan. Statistical analysis was conducted using the Spearman rank correlation method with a significance value of p 0.05.Results: A total of 119 CHB (M:F = 66:53, median age 43 years) patients were consecutively recruited. The median M2BPGi level was 1.04 COI (0.74–1.59) and the median of LS was 7.3 (5.6–12.5). M2BPGi had a moderate and significant correlation with LS (r = 0.525; p 0.001). Median M2BPGi values in each fibrosis stage were 0.89 COI in F0-F1, 0.88 in F2, 1.61 in F3, and 2.24 in F4 (p 0.001).Conclusion: This study revealed a moderate positive correlation between serum M2BPGi level and LS in CHB patients.
{"title":"Correlation of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) with Liver Transient Elastography Results in Evaluating Liver Fibrosis in Chronic Hepatitis B Patients","authors":"Haryono Haryono, M. B. Bestari, N. Agustanti, Dolvy Girawan, Yudi Wahyudi, S. Abdurachman, Anna Tjandrawati","doi":"10.24871/241202312-22","DOIUrl":"https://doi.org/10.24871/241202312-22","url":null,"abstract":"Background: Hepatitis B virus (HBV) is a serious health problem in the world, including in Indonesia. Transient elastography (TE) is now regarded as a reliable surrogate marker for grading the severity of liver fibrosis in chronic hepatitis B (CHB) patients. The Mac-2 binding protein of glycosylation isomer (M2BPGi) is a novel non-invasive serum biomarker for liver fibrosis staging in various liver diseases including CHB. This study aims to evaluate the correlation of M2BPGi and liver stiffness (LS), measured through TE, in predicting liver fibrosis among CHB patients.Method: A cross-sectional study was conducted at Dr. Hasan Sadikinl General Hospital Bandung between September 2021–January 2022 on patients diagnosed with CHB based on clinical and biochemical examination. The subjects underwent TE examination using Fibroscan® and M2BPGi levels were determined with an automated immunoassay analyzer HISCL-800, Sysmex, Japan. Statistical analysis was conducted using the Spearman rank correlation method with a significance value of p 0.05.Results: A total of 119 CHB (M:F = 66:53, median age 43 years) patients were consecutively recruited. The median M2BPGi level was 1.04 COI (0.74–1.59) and the median of LS was 7.3 (5.6–12.5). M2BPGi had a moderate and significant correlation with LS (r = 0.525; p 0.001). Median M2BPGi values in each fibrosis stage were 0.89 COI in F0-F1, 0.88 in F2, 1.61 in F3, and 2.24 in F4 (p 0.001).Conclusion: This study revealed a moderate positive correlation between serum M2BPGi level and LS in CHB patients.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83148419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries. The diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of 200 mg/dL. The management consists of identifying and treating the underlying disease process, dietary modification, and diuretics. Treatment with nutritional optimization and management of the underlying etiology are the cornerstones of therapy. When conservative measures fail, other interventions such as octreotide/somatostatin analogues, surgical ligation, embolization and transjugular intrahepatic portosystemic shunt in patients with cirrhosis can be considered.
{"title":"Diagnosis and Management of Chylous Ascites","authors":"","doi":"10.24871/241202363-71","DOIUrl":"https://doi.org/10.24871/241202363-71","url":null,"abstract":"Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries. The diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of 200 mg/dL. The management consists of identifying and treating the underlying disease process, dietary modification, and diuretics. Treatment with nutritional optimization and management of the underlying etiology are the cornerstones of therapy. When conservative measures fail, other interventions such as octreotide/somatostatin analogues, surgical ligation, embolization and transjugular intrahepatic portosystemic shunt in patients with cirrhosis can be considered.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"45 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72432261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gastric polyps are usually asymptomatic; they are often incidentally discovered during an esophagogastroduodenoscopy (EGD) for other indication. Most of gastric polyps are benign, however, some have malignant potential. Therefore, identifying gastric polyp risk factors are crucial. This article aims to determine the prevalence and risk factor of gastric polyp in Endoscopy Unit at Prof. Dr. R.D. Kandou Hospital between April 2021-2022.Method: The retrospective study was using medical record data of all patients who underwent EGD between April 2021-2022. Data regarding patient’s characteristic, endoscopic finding, and risk factors were collected. Data was analyzed using SPSSv25.0 with Mann-Whitney, Chi-square-test, and logistic-regression.Results: There were 241 patients included, 56.4% were males. The median age was 53 years old. The most common symptom was epigastric pain (69.3%). The main indication of EGD was dyspepsia with alarm symptoms (79.25%). We found 24.1% of patients had gastric polyps. Most polyps were found in corpus (93.1%) and 70.7% were fundic gland polyp. We found that older age (p=0.001), female (p=0.003), gastritis (p=0.037), active-smoker (p=0.000), and one-year-PPI-usage (p=0.000) were significantly associated with gastric polyp. Logistic-regression analysis showed active smoking was the most significant risk factor (OR=9.3), followed by female gender (OR=6.4), and PPI-usage (OR=3.4). We found no significant association between esophagitis, bile-reflux, gastric ulcer, H. pylori infection, NSAID use, and alcohol abuse with gastric polyp.Conclusions: We found 24.1% gastric polyp prevalence with significant risk factors such as older age, female gender, gastritis, smoking, and long-term-PPI-usage.
{"title":"The Prevalence and Risk Factors of Gastric Polyp in Endoscopy Unit at Prof. Dr. R.D. Kandou Hospital","authors":"","doi":"10.24871/241202335-40","DOIUrl":"https://doi.org/10.24871/241202335-40","url":null,"abstract":"Background: Gastric polyps are usually asymptomatic; they are often incidentally discovered during an esophagogastroduodenoscopy (EGD) for other indication. Most of gastric polyps are benign, however, some have malignant potential. Therefore, identifying gastric polyp risk factors are crucial. This article aims to determine the prevalence and risk factor of gastric polyp in Endoscopy Unit at Prof. Dr. R.D. Kandou Hospital between April 2021-2022.Method: The retrospective study was using medical record data of all patients who underwent EGD between April 2021-2022. Data regarding patient’s characteristic, endoscopic finding, and risk factors were collected. Data was analyzed using SPSSv25.0 with Mann-Whitney, Chi-square-test, and logistic-regression.Results: There were 241 patients included, 56.4% were males. The median age was 53 years old. The most common symptom was epigastric pain (69.3%). The main indication of EGD was dyspepsia with alarm symptoms (79.25%). We found 24.1% of patients had gastric polyps. Most polyps were found in corpus (93.1%) and 70.7% were fundic gland polyp. We found that older age (p=0.001), female (p=0.003), gastritis (p=0.037), active-smoker (p=0.000), and one-year-PPI-usage (p=0.000) were significantly associated with gastric polyp. Logistic-regression analysis showed active smoking was the most significant risk factor (OR=9.3), followed by female gender (OR=6.4), and PPI-usage (OR=3.4). We found no significant association between esophagitis, bile-reflux, gastric ulcer, H. pylori infection, NSAID use, and alcohol abuse with gastric polyp.Conclusions: We found 24.1% gastric polyp prevalence with significant risk factors such as older age, female gender, gastritis, smoking, and long-term-PPI-usage.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"292 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73633935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esophageal stricture is a disorder that limiting patients’ capability to get adequate intake. Dysphagia and regurgitation are main problem that makes patient admit to the hospital. There are several causes that narrowing esophageal lumen; those could be intraluminal or extraluminal. Esophageal diverticulum is one of a kind. It is not easy to establish the diagnosis of diverticulum in esophagus segment since supporting examination needed were complex. Esophageal stricture treatment should be interdisciplinary approach because inappropriate management would increase risk of complication and lowering patient’s quality of life. The management of esophageal diverticulum could be challenging and its prognosis depends on the patient’s characteristic and comorbidity.
{"title":"Recurrent Esophageal Stricture as a Result of Esophageal Diverticulum: Case Report","authors":"","doi":"10.24871/241202383-88","DOIUrl":"https://doi.org/10.24871/241202383-88","url":null,"abstract":"Esophageal stricture is a disorder that limiting patients’ capability to get adequate intake. Dysphagia and regurgitation are main problem that makes patient admit to the hospital. There are several causes that narrowing esophageal lumen; those could be intraluminal or extraluminal. Esophageal diverticulum is one of a kind. It is not easy to establish the diagnosis of diverticulum in esophagus segment since supporting examination needed were complex. Esophageal stricture treatment should be interdisciplinary approach because inappropriate management would increase risk of complication and lowering patient’s quality of life. The management of esophageal diverticulum could be challenging and its prognosis depends on the patient’s characteristic and comorbidity.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77321859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}