{"title":"M2BPGi for Liver Fibrosis Assessment in Chronic Liver Diseases in Indonesia","authors":"S. H. Nababan","doi":"10.24871/24120231","DOIUrl":"https://doi.org/10.24871/24120231","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90172123","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}
M. Simadibrata, Aditya Rachman, F. Budimutiar, Paulus Simadibrata, M. Abdullah, Raja Mangatur Haloho, A. Wijaya, Batara Bisuk, Shabrina Maharani, Dewi Mustikarani, D. M. Simadibrata, P. Sugita
Background: Inflammatory bowel disease (IBD) is idiopathic disease characterized by chronic inflammation of the gastrointestinal tract. Polysaccharide peptide of Ganoderma lucidum mycelium extract (PPGL) is considerably a good option for adjunctive therapy of IBD. This study aims to evaluate the benefit of PPGL in patients treated with 5-ASA.Method: A retrospective observational cohort study was conducted to examine the medical records of 124 ulcerative colitis patients. There were 80 patients in intervention group who were treated with a combination of 5-ASA and PPGL, and there were 44 patients in the control group who were treated with 5-ASA only. Clinical and laboratory endpoints were observed at the baseline and after 30, 60, and 90 days. Clinical endpoints included abdominal pain, bloody diarrhea, aphthous stomatitis, and polyarthritis; meanwhile, laboratory endpoints included hemoglobin level, ESR, CRP, fecal calprotectin, M2-pyruvate kinase (MP2K), fecal culture, C. difficile culture, and colonoscopy results. Clinical trials conducted after patient enrollment with registry number ClinicalTrials.gov NCT04029649.Results: On day-30 there was a significant difference between intervention group 45.6% and control group 2.3% in abdominal pain complaints (p 0.001). Moreover, laboratory parameters of fecal calprotectin (p 0.001), fecal MP2K (p = 0.015), and hemoglobin (p 0.001) were considerably better in intervention group on day-30. These differences were consistently found on day 60 and 90.Conclusion: The study implies potential correlation between PPGL administration and improvement of clinical and laboratory endpoints up to 90 days. A larger randomized, blinded, prospective study is required to confirm these effects in ulcerative colitis.
{"title":"Combination Treatment in Ulcerative Colitis using 5-Aminosalysilic Acid (5-ASA) and Polysaccharide Peptide of Indonesian Ganoderma lucidum Mycelium Extract","authors":"M. Simadibrata, Aditya Rachman, F. Budimutiar, Paulus Simadibrata, M. Abdullah, Raja Mangatur Haloho, A. Wijaya, Batara Bisuk, Shabrina Maharani, Dewi Mustikarani, D. M. Simadibrata, P. Sugita","doi":"10.24871/24120232-11","DOIUrl":"https://doi.org/10.24871/24120232-11","url":null,"abstract":"Background: Inflammatory bowel disease (IBD) is idiopathic disease characterized by chronic inflammation of the gastrointestinal tract. Polysaccharide peptide of Ganoderma lucidum mycelium extract (PPGL) is considerably a good option for adjunctive therapy of IBD. This study aims to evaluate the benefit of PPGL in patients treated with 5-ASA.Method: A retrospective observational cohort study was conducted to examine the medical records of 124 ulcerative colitis patients. There were 80 patients in intervention group who were treated with a combination of 5-ASA and PPGL, and there were 44 patients in the control group who were treated with 5-ASA only. Clinical and laboratory endpoints were observed at the baseline and after 30, 60, and 90 days. Clinical endpoints included abdominal pain, bloody diarrhea, aphthous stomatitis, and polyarthritis; meanwhile, laboratory endpoints included hemoglobin level, ESR, CRP, fecal calprotectin, M2-pyruvate kinase (MP2K), fecal culture, C. difficile culture, and colonoscopy results. Clinical trials conducted after patient enrollment with registry number ClinicalTrials.gov NCT04029649.Results: On day-30 there was a significant difference between intervention group 45.6% and control group 2.3% in abdominal pain complaints (p 0.001). Moreover, laboratory parameters of fecal calprotectin (p 0.001), fecal MP2K (p = 0.015), and hemoglobin (p 0.001) were considerably better in intervention group on day-30. These differences were consistently found on day 60 and 90.Conclusion: The study implies potential correlation between PPGL administration and improvement of clinical and laboratory endpoints up to 90 days. A larger randomized, blinded, prospective study is required to confirm these effects in ulcerative colitis.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89694679","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}
Diagnosing Crohn’s disease in systemic lupus erythematosus patients with gastrointestinal symptoms poses a great challenge, due to its rare occurrence and similarity of clinical characteristics between its differential diagnosis. We herein present a rare case of a patient diagnosed with systemic lupus erythematosus, complicated by renal involvement and conspicuous gastrointestinal manifestations. The non-specific gastrointestinal findings in this patient led to challenge in differentiating lupus enteritis from Crohn's disease, as they share many similar aspects in clinical manifestations, endoscopic findings, and histopathological findings. We herein provide the clinical judgement in reaching Crohn's disease in concurrence with systemic lupus erythematosus as the final working diagnosis through scrutinizing and comparing data from similar case studies in the past.
{"title":"Diagnostic Challenge in Distinguishing Crohn’s Disease from Lupus Enteritis in Systemic Lupus Erythematosus Patient: A Case Report","authors":"","doi":"10.24871/241202389-97","DOIUrl":"https://doi.org/10.24871/241202389-97","url":null,"abstract":"Diagnosing Crohn’s disease in systemic lupus erythematosus patients with gastrointestinal symptoms poses a great challenge, due to its rare occurrence and similarity of clinical characteristics between its differential diagnosis. We herein present a rare case of a patient diagnosed with systemic lupus erythematosus, complicated by renal involvement and conspicuous gastrointestinal manifestations. The non-specific gastrointestinal findings in this patient led to challenge in differentiating lupus enteritis from Crohn's disease, as they share many similar aspects in clinical manifestations, endoscopic findings, and histopathological findings. We herein provide the clinical judgement in reaching Crohn's disease in concurrence with systemic lupus erythematosus as the final working diagnosis through scrutinizing and comparing data from similar case studies in the past. ","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78778728","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: Annona muricata leaves are used as traditional tea drink that is currently being studied on the developing effort of treating some types of cancers because they are known as anti-cancer. Motivated by that usage, this study aims to analyse the potential of A. muricata leaves extract to be an anti-colon cancer by investigating the extract capability in reducing blood intercellular cell-adhesion molecule-1 (ICAM-1) and vascular cell-adhesion molecule-1 (VCAM-1).Method: The research was conducted in Faculty of Medicine Universitas Indonesia with an experimental design. A. muricata leaves extract was tested in vivo. In vivo test was conducted to Swiss Webster mice induced with 10 mg/kg azoxymethane (AOM) and dextran sodium sulfate 1% (DSS). Statistical analysis used was SPSS.Results: EIFAM reduce the serum level of ICAM-1 and VCAM-1. EIFAM significantly reduce serum level of VCAM compare to ESFAM.Conclusion: Ethanol insoluble fraction of Annona muricata leaves water extract of is potential to be an anti-colon cancer proven by the extract capability to reduce ICAM-1 and VCAM-1.
{"title":"The Effect of an Annona muricata Leaves Extract on Circulating Soluble Adhesion Molecules in Colon Carcinogenesis Model","authors":"Lili Indrawati, K. Kusmardi, Marwito Wiyanto","doi":"10.24871/241202330-34","DOIUrl":"https://doi.org/10.24871/241202330-34","url":null,"abstract":"Background: Annona muricata leaves are used as traditional tea drink that is currently being studied on the developing effort of treating some types of cancers because they are known as anti-cancer. Motivated by that usage, this study aims to analyse the potential of A. muricata leaves extract to be an anti-colon cancer by investigating the extract capability in reducing blood intercellular cell-adhesion molecule-1 (ICAM-1) and vascular cell-adhesion molecule-1 (VCAM-1).Method: The research was conducted in Faculty of Medicine Universitas Indonesia with an experimental design. A. muricata leaves extract was tested in vivo. In vivo test was conducted to Swiss Webster mice induced with 10 mg/kg azoxymethane (AOM) and dextran sodium sulfate 1% (DSS). Statistical analysis used was SPSS.Results: EIFAM reduce the serum level of ICAM-1 and VCAM-1. EIFAM significantly reduce serum level of VCAM compare to ESFAM.Conclusion: Ethanol insoluble fraction of Annona muricata leaves water extract of is potential to be an anti-colon cancer proven by the extract capability to reduce ICAM-1 and VCAM-1.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86130518","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}
The pancreas is a complex organ in which a suspicious lesion can appear which can be benign or malignant. Clinical manifestation can guide the clinician to choose the appropriate tests such as autoimmune tests, tumor markers, imaging with ultrasonography (USG), computerized tomography (CT), magnetic resonance imaging (MRI), or magnetic resonance cholangiopancreatography (MRCP), and endoscopic or surgical tissue biopsy. Pancreatic nodule therapy is tailored to the nature of the nodule, etiology-appropriate therapy for benign nodules or surgery, chemotherapy, and radiotherapy for cancerous nodules. Knowledge of the diagnostic approach of pancreatic solid mass is important for clinician to make prompt and accurate treatment for patients and to prevent unnecessary examination or intervention.
{"title":"Diagnostic Approach and Management of Solid Pancreatic Mass","authors":"Shafira Puspadina, M. Simadibrata","doi":"10.24871/2332022235-240","DOIUrl":"https://doi.org/10.24871/2332022235-240","url":null,"abstract":"The pancreas is a complex organ in which a suspicious lesion can appear which can be benign or malignant. Clinical manifestation can guide the clinician to choose the appropriate tests such as autoimmune tests, tumor markers, imaging with ultrasonography (USG), computerized tomography (CT), magnetic resonance imaging (MRI), or magnetic resonance cholangiopancreatography (MRCP), and endoscopic or surgical tissue biopsy. Pancreatic nodule therapy is tailored to the nature of the nodule, etiology-appropriate therapy for benign nodules or surgery, chemotherapy, and radiotherapy for cancerous nodules. Knowledge of the diagnostic approach of pancreatic solid mass is important for clinician to make prompt and accurate treatment for patients and to prevent unnecessary examination or intervention.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76685863","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}
{"title":"Tenofovir Alafenamide (TAF) as Long-Term Therapy for Chronic Hepatitis B: Is It the Best Choice?","authors":"I. Hasan","doi":"10.24871/2332022173","DOIUrl":"https://doi.org/10.24871/2332022173","url":null,"abstract":"","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85192483","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}
Occult hepatitis B infection (OBI) is still a topic of debate worldwide. It is defined as the presence of hepatitis B virus (HBV) DNA in serum and/or liver from HBsAg-negative subjects. OBI may lead to the development of cirrhosis and hepatocellular carcinoma. It continues to present several unique challenges in organ transplantation despite the availability of an effective vaccine to prevent HBV infection and the introduction of oral therapy to treat HBV infection. HBV reactivation following organ transplantation can occur even in recipients with absent hepatitis B surface antigen and remains an important cause of morbidity and mortality. Concerning OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for both recipients of organ transplant and organ transplant donors especially in highly endemic areas of HBV. In the era of potent antivirals and with evolving knowledge, HBsAg (+) renal transplant candidates and recipients can be monitored and successfully treated. Kidney organs from HBsAg-negative and anti-HBc–positive donors should be considered for transplant candidates after weighing the risk-benefit ratio. All transplant candidates should receive HBV vaccination if they are not immune to facilitate receipt of an organ from a donor with anti-HBc seropositivity.
{"title":"Occult Hepatitis B Infection in Kidney Transplant Patients","authors":"Ida Ayu Pradnya Paramita, I. Wibawa","doi":"10.24871/2332022227-234","DOIUrl":"https://doi.org/10.24871/2332022227-234","url":null,"abstract":"Occult hepatitis B infection (OBI) is still a topic of debate worldwide. It is defined as the presence of hepatitis B virus (HBV) DNA in serum and/or liver from HBsAg-negative subjects. OBI may lead to the development of cirrhosis and hepatocellular carcinoma. It continues to present several unique challenges in organ transplantation despite the availability of an effective vaccine to prevent HBV infection and the introduction of oral therapy to treat HBV infection. HBV reactivation following organ transplantation can occur even in recipients with absent hepatitis B surface antigen and remains an important cause of morbidity and mortality. Concerning OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for both recipients of organ transplant and organ transplant donors especially in highly endemic areas of HBV. In the era of potent antivirals and with evolving knowledge, HBsAg (+) renal transplant candidates and recipients can be monitored and successfully treated. Kidney organs from HBsAg-negative and anti-HBc–positive donors should be considered for transplant candidates after weighing the risk-benefit ratio. All transplant candidates should receive HBV vaccination if they are not immune to facilitate receipt of an organ from a donor with anti-HBc seropositivity.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74636362","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: Liver cirrhosis (LC) is still being important public health concern, due to the rising of global incidence and mortality. There is risk progression in LC patients to acute-on-chronic liver failure (ACLF) patients with high incidence of complication and high short-term mortality rate. It needs rapid and simpler predictor to immediate and accurate triage of the patient. The aim of this study is to review systematically the role of PWR to predict the mortality in ACLF cirrhosis patient.Method: This systematic review study was identified by searching Pub-Med, Cochrane library, and EMBASE database (2016-2022). Only observational studies were included. ACLF patient was selected as the main subject in each study, and PWR was added as short-term mortality predictor. The Cochran seven step model was used to perform the review.Results: Six cohort retrospective studies met inclusion criteria, including total 1,348 patient ACLF. Half of studies included had high level of evidence. The non-survivor ACLF patient had significantly lower PWR values than survivor. The range of HR of PWR to predict mortality in ACLF was 0.665-0.995, with p value 0.0001. Whereas the cutoff range of PWR value to predict non survivor in ACLF patient was 7.83-14.2.Conclusion: PWR had a predictive efficacy, similar to CLIF-SOFA and MELD score in terms of predicting short-term mortality in ACLF patients. PWR showed significantly independent risk factor of short term mortality in ACLF cirrhotic patient.
{"title":"Platelet to White Blood Cell Ratio (PWR) to Predict Mortality in Acute on Chronic Liver Failure of Cirrhosis Patient: A Systematic Review","authors":"Roy Pandapotan, Burhan Gunawan","doi":"10.24871/2332022181-188","DOIUrl":"https://doi.org/10.24871/2332022181-188","url":null,"abstract":"Background: Liver cirrhosis (LC) is still being important public health concern, due to the rising of global incidence and mortality. There is risk progression in LC patients to acute-on-chronic liver failure (ACLF) patients with high incidence of complication and high short-term mortality rate. It needs rapid and simpler predictor to immediate and accurate triage of the patient. The aim of this study is to review systematically the role of PWR to predict the mortality in ACLF cirrhosis patient.Method: This systematic review study was identified by searching Pub-Med, Cochrane library, and EMBASE database (2016-2022). Only observational studies were included. ACLF patient was selected as the main subject in each study, and PWR was added as short-term mortality predictor. The Cochran seven step model was used to perform the review.Results: Six cohort retrospective studies met inclusion criteria, including total 1,348 patient ACLF. Half of studies included had high level of evidence. The non-survivor ACLF patient had significantly lower PWR values than survivor. The range of HR of PWR to predict mortality in ACLF was 0.665-0.995, with p value 0.0001. Whereas the cutoff range of PWR value to predict non survivor in ACLF patient was 7.83-14.2.Conclusion: PWR had a predictive efficacy, similar to CLIF-SOFA and MELD score in terms of predicting short-term mortality in ACLF patients. PWR showed significantly independent risk factor of short term mortality in ACLF cirrhotic patient.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"239 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86159243","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: Tenofovir alafenamide (TAF) is phosphonamidate prodrug of tenofir that inhibits hepatitis B virus and HIV type-1 reverse transcription. TAF more stable form in plasma than tenofovir disoproxil fumarate (TDF) as choice treatment before. TAF in long-term treatment also significantly reduced bone mineral density (BMD) and raised serum creatinine, as well as improved markers of renal tubular function. This study aims to review the long-term therapy of TAF effect in body weight gain, BMD, renal function, lipids profile, ALT normalization, and HBeAg loss.Method: The data was taken from Pubmed, ScienceDirect, and Cochrane Library. We found 363 articles from databases. The articles related to long-term therapy in chronic hepatitis-B and adjusted according to restriction criteria. Articles selection using PRISMA flowchart and quality test using GRADE method into eligible articles.Results: We selected articles that eligible for systematic review with different GRADE recommendation which were 4 high-grade articles, 1 low-grade, and 1 very low-grade article. TAF in long-term therapy showed an increase in BMD (p 0.001), body weight gain (p 0.001), decreased renal dysfunction (CrCl; p 0.0001 and GFR; p = 0.027), and normalized ALT (p = 0.016). However, lipids profile level increase that could increase risk of atherosclerosis and dyslipidemia. There was no significant in HBeAg loss.Conclusion: TAF therapy is favourable therapy in long-term therapy of chronic hepatitis B patients by smaller reduce of BMD, and significant body weight gain, reduce renal dysfunction, good improvement in lipid profile and improving ALT enzymes.
{"title":"Evaluation Effect of Tenofovir Alafenamide (TAF) in Long-Term Therapy for Chronic Hepatitis B: A Systematic Review","authors":"Rada Citra Saputra, Nur Hidayat","doi":"10.24871/2332022217-226","DOIUrl":"https://doi.org/10.24871/2332022217-226","url":null,"abstract":"Background: Tenofovir alafenamide (TAF) is phosphonamidate prodrug of tenofir that inhibits hepatitis B virus and HIV type-1 reverse transcription. TAF more stable form in plasma than tenofovir disoproxil fumarate (TDF) as choice treatment before. TAF in long-term treatment also significantly reduced bone mineral density (BMD) and raised serum creatinine, as well as improved markers of renal tubular function. This study aims to review the long-term therapy of TAF effect in body weight gain, BMD, renal function, lipids profile, ALT normalization, and HBeAg loss.Method: The data was taken from Pubmed, ScienceDirect, and Cochrane Library. We found 363 articles from databases. The articles related to long-term therapy in chronic hepatitis-B and adjusted according to restriction criteria. Articles selection using PRISMA flowchart and quality test using GRADE method into eligible articles.Results: We selected articles that eligible for systematic review with different GRADE recommendation which were 4 high-grade articles, 1 low-grade, and 1 very low-grade article. TAF in long-term therapy showed an increase in BMD (p 0.001), body weight gain (p 0.001), decreased renal dysfunction (CrCl; p 0.0001 and GFR; p = 0.027), and normalized ALT (p = 0.016). However, lipids profile level increase that could increase risk of atherosclerosis and dyslipidemia. There was no significant in HBeAg loss.Conclusion: TAF therapy is favourable therapy in long-term therapy of chronic hepatitis B patients by smaller reduce of BMD, and significant body weight gain, reduce renal dysfunction, good improvement in lipid profile and improving ALT enzymes.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90733681","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}
Devi Novianto Rasdianto, E. S. Nugraha, H. Usman, N. Agustanti, Yudi Wahyudi, Dolvy Girawan, M. B. Bestari, S. Abdurachman
Background: Diagnosis and treating patients with chronic diarrhea are challenging due to broad differential diagnoses. An adequate examination leads to a specific diagnosis and appropriate management. Colonoscopy with biopsy is indicated to establish chronic diarrhea etiologies. No previous data demonstrated the colonoscopy and histology findings in patients with chronic diarrhea at Dr. Hasan Sadikin Bandung General Hospital, the main referral hospital in West Java. This study aims to determine the features of colonoscopy and histology in patients with chronic diarrhea.Method: This was a cross-sectional, descriptive study from secondary data of colonoscopy examinations at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. The inclusion criteria were patients with chronic diarrhea diagnosis, aged 18 years and over, and completed colonoscopy and biopsy results.Results: A total of 182 subjects with chronic diarrhea were included. Most subjects were women (52%) with an average age of 46 years. The clinical finding at admission was chronic diarrhea without hematochezia (75%). Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. Colonoscopy features mostly hyperemic or edematous lesions (58%). The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies (14%), and inflammatory bowel disease (12%).Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The hyperemic mucous lesion was mostly found. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD.
背景:诊断和治疗慢性腹泻患者是具有挑战性的，由于广泛的鉴别诊断。充分的检查可导致具体的诊断和适当的处理。结肠镜活检用于确定慢性腹泻的病因。在西爪哇的主要转诊医院Hasan Sadikin万隆总医院，以前没有数据证明慢性腹泻患者的结肠镜检查和组织学发现。本研究旨在了解慢性腹泻患者的结肠镜检查和组织学特征。方法:这是一项横断面描述性研究，来自2016年至2019年Dr. Hasan Sadikin医院总医院结肠镜检查的二次资料。纳入标准为诊断为慢性腹泻的患者，年龄在18岁及以上，完成结肠镜检查和活检结果。结果:共纳入182例慢性腹泻患者。大多数受试者为女性(52%)，平均年龄为46岁。入院时临床表现为慢性腹泻无便血(75%)。同时，52%的结肠镜病变为多发病变，其中以肛肠段(15%)受累最多。结肠镜检查主要表现为充血或水肿病变(58%)。本研究的组织病理学结果显示59%为非特异性慢性结肠炎(NSCC)。特定的组织病理学特征主要见于恶性肿瘤(14%)和炎症性肠病(12%)。结论:无便血的慢性腹泻是转介结肠镜检查患者最常见的目的。以充血性黏液病变多见。此外，在组织病理学评估中，鳞状细胞癌是常见的，其次是恶性肿瘤和IBD。
{"title":"Colonoscopy and Histopathologic Features in Chronic Diarrhea Patients at Dr. Hasan Sadikin General Hospital Bandung","authors":"Devi Novianto Rasdianto, E. S. Nugraha, H. Usman, N. Agustanti, Yudi Wahyudi, Dolvy Girawan, M. B. Bestari, S. Abdurachman","doi":"10.24871/2332022188-192","DOIUrl":"https://doi.org/10.24871/2332022188-192","url":null,"abstract":"Background: Diagnosis and treating patients with chronic diarrhea are challenging due to broad differential diagnoses. An adequate examination leads to a specific diagnosis and appropriate management. Colonoscopy with biopsy is indicated to establish chronic diarrhea etiologies. No previous data demonstrated the colonoscopy and histology findings in patients with chronic diarrhea at Dr. Hasan Sadikin Bandung General Hospital, the main referral hospital in West Java. This study aims to determine the features of colonoscopy and histology in patients with chronic diarrhea.Method: This was a cross-sectional, descriptive study from secondary data of colonoscopy examinations at Dr. Hasan Sadikin Hospital General Hospital from 2016 to 2019. The inclusion criteria were patients with chronic diarrhea diagnosis, aged 18 years and over, and completed colonoscopy and biopsy results.Results: A total of 182 subjects with chronic diarrhea were included. Most subjects were women (52%) with an average age of 46 years. The clinical finding at admission was chronic diarrhea without hematochezia (75%). Meanwhile, 52% of colonoscopy lesions were multiple, with the anal-rectum segment (15%) being the most involved. Colonoscopy features mostly hyperemic or edematous lesions (58%). The histopathological result from this study revealed that 59% were non-specific chronic colitis (NSCC). Specific histopathological features were primarily found in malignancies (14%), and inflammatory bowel disease (12%).Conclusion: Chronic diarrhea without hematochezia was the most common objective for referring patients to colonoscopy. The hyperemic mucous lesion was mostly found. Moreover, the NSCC was frequent in histopathological evaluation, followed by malignancies and IBD.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72757496","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}
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