In March of 2020, the WHO has declared the state pandemic of COVID-19 that started in the city of Wuhan, China. The widespread of cases resulted in 2,877,476 cases and 73,582 death reported in Indonesia. It is commonly known that the respiratory system was the main problem in COVID-19, but it is recently reported that gastrointestinal involevment has a higher likelihood to develop into severe cases. Moreover, it is found that diarrhea is the most highly prevalent of the gastrointestinal signs and symptoms in COVID-19 patients. The aim of this evidence-based case report is to understand the association between diarrhea and severe cases of COVID-19. A search on Pubmed, Scopus and Cochrane result in five articles to be appraised using Centre for Evidence-Based Medicine (CEBM) critical appraisal tool. The most recent systematic review by Ghimere S et al (2020), found COVID-19 patients with diarrhea has higher likelihood of developin ginto a severe case (OR = 1.63, 95% CI: 1.11 – 2.38). While the cohort studies showed several prognostic factors that may potentially effect the outcome of severe COVID-19 cases. It is concluded that severe COVID-19 cases were more likely to be found in patients presenting with diarrhea. Thus, Confirmed COVID-19 patients with diarrhea should be carefully evaluated to anticipate worsening of symptoms.
{"title":"Diarrhea as a Prognostic Factor for Severe COVID-19","authors":"Dinda Nisrina, H. Maulahela","doi":"10.24871/2322022266-271","DOIUrl":"https://doi.org/10.24871/2322022266-271","url":null,"abstract":"In March of 2020, the WHO has declared the state pandemic of COVID-19 that started in the city of Wuhan, China. The widespread of cases resulted in 2,877,476 cases and 73,582 death reported in Indonesia. It is commonly known that the respiratory system was the main problem in COVID-19, but it is recently reported that gastrointestinal involevment has a higher likelihood to develop into severe cases. Moreover, it is found that diarrhea is the most highly prevalent of the gastrointestinal signs and symptoms in COVID-19 patients. The aim of this evidence-based case report is to understand the association between diarrhea and severe cases of COVID-19. A search on Pubmed, Scopus and Cochrane result in five articles to be appraised using Centre for Evidence-Based Medicine (CEBM) critical appraisal tool. The most recent systematic review by Ghimere S et al (2020), found COVID-19 patients with diarrhea has higher likelihood of developin ginto a severe case (OR = 1.63, 95% CI: 1.11 – 2.38). While the cohort studies showed several prognostic factors that may potentially effect the outcome of severe COVID-19 cases. It is concluded that severe COVID-19 cases were more likely to be found in patients presenting with diarrhea. Thus, Confirmed COVID-19 patients with diarrhea should be carefully evaluated to anticipate worsening of symptoms.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72920562","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}
Inflammatory bowel disease (IBD) in the form of ulcerative colitis (UC) and Crohn's disease (CD) has multifactorial etiology and multiple inflammatory pathways. Newer treatments with biologic agents are used as an adjunct to conventional therapy. Biological agents such as anti-TNF, anti-integrin, and anti-interleukin are believed to be able to overcome the inflammation that underlies the occurrence of IBD. The “step up” approach in IBD therapy uses conventional drugs with low potency but fewer side effects as the first line, followed by biologic agents as second line therapy. However, the result is often a delay in the management of severe complications of IBD. A “top down” approach is currently being used to successfully prevent severe complications of IBD by using biologic agents early. Biological agent therapy can be initiated in moderate to severe IBD either in combination or sequentially. But in the end, various parameters must be considered before starting the use of biologic agents such as drug effectiveness, safety profile, drug availability, price, and patient preferences.
{"title":"Use of Biologics in Inflammatory Bowel Disease: Combination and Sequential Therapy","authors":"Putra Nur Hidayat, M. Simadibrata","doi":"10.24871/2322022250-255","DOIUrl":"https://doi.org/10.24871/2322022250-255","url":null,"abstract":"Inflammatory bowel disease (IBD) in the form of ulcerative colitis (UC) and Crohn's disease (CD) has multifactorial etiology and multiple inflammatory pathways. Newer treatments with biologic agents are used as an adjunct to conventional therapy. Biological agents such as anti-TNF, anti-integrin, and anti-interleukin are believed to be able to overcome the inflammation that underlies the occurrence of IBD. The “step up” approach in IBD therapy uses conventional drugs with low potency but fewer side effects as the first line, followed by biologic agents as second line therapy. However, the result is often a delay in the management of severe complications of IBD. A “top down” approach is currently being used to successfully prevent severe complications of IBD by using biologic agents early. Biological agent therapy can be initiated in moderate to severe IBD either in combination or sequentially. But in the end, various parameters must be considered before starting the use of biologic agents such as drug effectiveness, safety profile, drug availability, price, and patient preferences.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88908914","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}
Jessica Cynthia Febryani, M. B. Bestari, H. ., Dolvy Girawan, N. Agustanti, Yudi Wahyudi, S. Abdurachman
Abstract BackgroundAmong non-invasive strategies available for liver fibrosis assessment, transient elastography is widely used, as it is non-invasive and can be repeated. Hepatus® (Mindray, China) is one novel instrument for measuring liver stiffness that is now available in the market with lower price than its precursor, FibroScan® (Echosens, Paris). MethodIn this cross sectional study, CHB patients in single center were recruited consecutively in October 2021-December 2021. The patients were examined for LSM with two transient elastography instruments in one visit. The first instrument was Hepatus® (Mindray, China) and the second one was FibroScan® (Echosens, Paris). Both measurements were done by the same operator. ResultsA total of 68 CHB patients were enrolled in this study. Median score of LSM by Hepatus® and FibroScan® were 7.6 (5.92-11.88) and 7.35 (5.63-11.80) respectively. Spearman rank analysis for correlation showed a significant correlation between the results of the two instruments ( r= 0.8, p 0.05). The number of patients with significant fibrosis (≥8 kPa) identified by Hepatus® and FibroScan® were 28 (41%) and 29 (43%) respectively. McNemar test yielded no significant difference of the results (p= 1.000), and Cohen’s kappa measure of agreement showed moderate agreement (κ = 0.789 and p 0.005). ConclusionHepatus® identified similar number of significant fibrosis patients with FibroScan®, with the results of liver stiffness measurement between the two instruments correlated significantly. Hepatus® has a potential as an alternative tool for measuring liver stiffness with a more economic price. KeywordsHepatus®, FibroScan®, transient elastography, liver fibrosis, CHB
在肝纤维化评估的非侵入性策略中，瞬态弹性成像因其无创性和可重复而被广泛使用。Hepatus®(迈瑞，中国)是一种用于测量肝脏硬度的新型仪器，目前在市场上的价格低于其前体FibroScan®(Echosens，巴黎)。方法在本横断面研究中，于2021年10月至2021年12月连续招募单中心CHB患者。在一次访问中使用两种瞬态弹性仪检查患者的LSM。第一台仪器为Hepatus®(迈瑞，中国)，第二台仪器为FibroScan®(Echosens，巴黎)。这两项测量都是由同一个操作者完成的。结果共纳入68例慢性乙型肝炎患者。Hepatus®和FibroScan®对LSM的中位评分分别为7.6(5.92-11.88)和7.35(5.63-11.80)。Spearman秩分析法显示两种仪器的结果有显著的相关性(r= 0.8, p 0.05)。Hepatus®和FibroScan®鉴定的显著纤维化(≥8 kPa)患者分别为28例(41%)和29例(43%)。McNemar检验结果无显著性差异(p= 1.000)， Cohen 's kappa一致性测量显示中度一致性(κ = 0.789, p 0.005)。结论hepatus®与FibroScan®鉴别出相似数量的显著纤维化患者，两种仪器的肝硬度测量结果具有显著相关性。Hepatus®有潜力以更经济的价格作为测量肝脏硬度的替代工具。关键词:shepatus®，FibroScan®，瞬态弹性成像，肝纤维化，CHB
{"title":"Reliability of Hepatus® for Evaluating Liver Fibrosis in Chronic Hepatitis B","authors":"Jessica Cynthia Febryani, M. B. Bestari, H. ., Dolvy Girawan, N. Agustanti, Yudi Wahyudi, S. Abdurachman","doi":"10.24871/2322022212-216","DOIUrl":"https://doi.org/10.24871/2322022212-216","url":null,"abstract":"Abstract BackgroundAmong non-invasive strategies available for liver fibrosis assessment, transient elastography is widely used, as it is non-invasive and can be repeated. Hepatus® (Mindray, China) is one novel instrument for measuring liver stiffness that is now available in the market with lower price than its precursor, FibroScan® (Echosens, Paris). MethodIn this cross sectional study, CHB patients in single center were recruited consecutively in October 2021-December 2021. The patients were examined for LSM with two transient elastography instruments in one visit. The first instrument was Hepatus® (Mindray, China) and the second one was FibroScan® (Echosens, Paris). Both measurements were done by the same operator. ResultsA total of 68 CHB patients were enrolled in this study. Median score of LSM by Hepatus® and FibroScan® were 7.6 (5.92-11.88) and 7.35 (5.63-11.80) respectively. Spearman rank analysis for correlation showed a significant correlation between the results of the two instruments ( r= 0.8, p 0.05). The number of patients with significant fibrosis (≥8 kPa) identified by Hepatus® and FibroScan® were 28 (41%) and 29 (43%) respectively. McNemar test yielded no significant difference of the results (p= 1.000), and Cohen’s kappa measure of agreement showed moderate agreement (κ = 0.789 and p 0.005). ConclusionHepatus® identified similar number of significant fibrosis patients with FibroScan®, with the results of liver stiffness measurement between the two instruments correlated significantly. Hepatus® has a potential as an alternative tool for measuring liver stiffness with a more economic price. KeywordsHepatus®, FibroScan®, transient elastography, liver fibrosis, CHB","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87090534","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}
E. S. Nugraha, Stefanie Hadi Supriami, Nur Atik, N. Agustanti, Yudi Wahyudi, Dolvy Girawan, M. B. Bestari, S. Abdurachman
Background: Hepatitis B Virus (HBV) is a health problem that has chronically infected 257 million globally. Appropriate therapy is immensely needed to prevent disease progression to cirrhosis and hepatocellular carcinoma (HCC). Moreover, routine monitoring is required to assess the efficacy of the given treatment. This study aims to describe the treatment and its follow-up outcomes among chronic HBV patients after one year of therapy in Bandung.Method: This was a cross-sectional descriptive study with a data sampling method obtained from assessing the medical records of treated chronic HBV outpatients at the Gastrohepatoenterology Clinic of Hasan Sadikin Hospital Bandung from 2018 to 2020. Laboratory findings before and after one year of therapy were further assessed.Results: Out of 107 patients treated, the proportion of tenofovir was 72.90%, telbivudine 16.80%, lamivudine 8.40%, and interferon group 1.90%. There were 52.30% of patients who did follow-up visits after one year of therapy. The therapeutic outcome rate was evaluated among total patients with the criteria of decreasing AST (91.18%) and ALT levels (93.10%) levels, reduction of HBV-DNA values (100%), and HBeAg seroconversion (14.29%).Conclusion: The most given therapy among chronic HBV outpatients was tenofovir. The follow-up rate of patients after one year of treatment was 52.30%. Overall, antiviral therapies produced decreases in liver laboratory parameters, HBV-DNA, and HBeAg.
{"title":"Antiviral Treatment and One-Year Follow-Up of Chronic Hepatitis B Patients in Bandung: An Observational Study","authors":"E. S. Nugraha, Stefanie Hadi Supriami, Nur Atik, N. Agustanti, Yudi Wahyudi, Dolvy Girawan, M. B. Bestari, S. Abdurachman","doi":"10.24871/2322022217-222","DOIUrl":"https://doi.org/10.24871/2322022217-222","url":null,"abstract":"Background: Hepatitis B Virus (HBV) is a health problem that has chronically infected 257 million globally. Appropriate therapy is immensely needed to prevent disease progression to cirrhosis and hepatocellular carcinoma (HCC). Moreover, routine monitoring is required to assess the efficacy of the given treatment. This study aims to describe the treatment and its follow-up outcomes among chronic HBV patients after one year of therapy in Bandung.Method: This was a cross-sectional descriptive study with a data sampling method obtained from assessing the medical records of treated chronic HBV outpatients at the Gastrohepatoenterology Clinic of Hasan Sadikin Hospital Bandung from 2018 to 2020. Laboratory findings before and after one year of therapy were further assessed.Results: Out of 107 patients treated, the proportion of tenofovir was 72.90%, telbivudine 16.80%, lamivudine 8.40%, and interferon group 1.90%. There were 52.30% of patients who did follow-up visits after one year of therapy. The therapeutic outcome rate was evaluated among total patients with the criteria of decreasing AST (91.18%) and ALT levels (93.10%) levels, reduction of HBV-DNA values (100%), and HBeAg seroconversion (14.29%).Conclusion: The most given therapy among chronic HBV outpatients was tenofovir. The follow-up rate of patients after one year of treatment was 52.30%. Overall, antiviral therapies produced decreases in liver laboratory parameters, HBV-DNA, and HBeAg. ","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78782053","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: Hepatorenal syndrome is a part of the prerenal acute kidney injury (AKI) characterized by kidney dysfunction which is secondary to the decreased renal blood flow that occurs in liver cirrhosis with portal hypertension and is a fatal complication. Hepatorenal syndrome (HRS) occurs in about 20% of liver cirrhosis patients with refractory ascites.Method: This study was conducted on 24 liver cirrhosis patients with ascites who visited Gastroenterohepatology Outpatient Ward and Internal Medicine Inpatient Unit, Dr. M. Djamil Padang. Samples were collected and data analyses were conducted in December 2019 to March 2020.Results: In this study, the model for end-stage liver disease (MELD)-Na score was used to determine the risk of HRS in liver cirrhosis patients with ascites, in which patients with a MELD-Na score 22 belonged to the group at risk of developing HRS. From 24 patients, the mean MELD-Na score was 24.58 ± 3.5. The lowest MELD-Na score was 22 in 8 patients (33.3%), while 1 patient (4.2%) had the highest MELD-Na score of 35. In this study, serum CysC levels were measured in patients with normal creatinine, and the mean serum CysC level was 2.69 ± 0.46 mg/L. The minimum value of CysC was 2.03 mg/L, while the maximum value was 3.9 mg/L. Serum CysC levels in all 24 patients were increased compared to the normal values.Conclusion: Liver cirrhosis patients who were at risk to develop HRS based on the MELD-Na score have increased serum Cystatin C levels, although serum creatinine levels were still normal.
{"title":"Serum Cystatin C Level in Liver Cirrhosis Patients with MELD-Na > 22","authors":"Arnelis Arnelis, Vesri Yoga, Nasrul Zubir, Saptino Miro, Andry Kurniawan","doi":"10.24871/2322022233-236","DOIUrl":"https://doi.org/10.24871/2322022233-236","url":null,"abstract":"Background: Hepatorenal syndrome is a part of the prerenal acute kidney injury (AKI) characterized by kidney dysfunction which is secondary to the decreased renal blood flow that occurs in liver cirrhosis with portal hypertension and is a fatal complication. Hepatorenal syndrome (HRS) occurs in about 20% of liver cirrhosis patients with refractory ascites.Method: This study was conducted on 24 liver cirrhosis patients with ascites who visited Gastroenterohepatology Outpatient Ward and Internal Medicine Inpatient Unit, Dr. M. Djamil Padang. Samples were collected and data analyses were conducted in December 2019 to March 2020.Results: In this study, the model for end-stage liver disease (MELD)-Na score was used to determine the risk of HRS in liver cirrhosis patients with ascites, in which patients with a MELD-Na score 22 belonged to the group at risk of developing HRS. From 24 patients, the mean MELD-Na score was 24.58 ± 3.5. The lowest MELD-Na score was 22 in 8 patients (33.3%), while 1 patient (4.2%) had the highest MELD-Na score of 35. In this study, serum CysC levels were measured in patients with normal creatinine, and the mean serum CysC level was 2.69 ± 0.46 mg/L. The minimum value of CysC was 2.03 mg/L, while the maximum value was 3.9 mg/L. Serum CysC levels in all 24 patients were increased compared to the normal values.Conclusion: Liver cirrhosis patients who were at risk to develop HRS based on the MELD-Na score have increased serum Cystatin C levels, although serum creatinine levels were still normal.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88790756","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":"Understanding of Functional Constipation in Clinical Settings","authors":"H. Maulahela","doi":"10.24871/2322022193","DOIUrl":"https://doi.org/10.24871/2322022193","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86000156","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: Hepatitis B is a health issue that become major problem worldwide with high morbidity. Hepatitis B is a liver infection that caused by Hepatitis B Virus. Chronic hepatitis B is a liver inflammation that lasted more than 6 months and it has the potential to progress to liver cirrhosis and hepatocellular cancer. The disease is influenced by Gene X and viral genotype. Mutations in the Gene X are suspected to having a role in disease progression. The aim of this study was to detect Gene X polymorphism and the phylogeny of HBV from Padang local clinical samples of chronic hepatitis B (CHB), West Sumatera, Indonesia.Method: The entire chronically HBV-infected patients were enrolled in this study: 38 CHB. The research samples were the entire Hepatitis B serum from Indonesian Red Cross Blood Bank than Gene X was amplified using nested PCR, which produced two fragments and aligned with X sequence database continued with mutation analysis. Results: In this study we found all the samples were having nucleotide variation. Of various mutations, we observed the presence of known liver cirrhosis and HCC-related HBx protein mutant i.e double mutations (HBx130 and HBx131) and two triple mutations (HBx5/HBx130/HBx131) and (HBx127/HBx130/HBx131) were high. The analysis also showed that patients were infected mainly by genotype C at 72,2% and followed by B at 27,8%.Conclusion: We conclude that all the samples have nucleotide variation and the mutation implying that molecular progression between the virus and the host at chronically infected patients.
{"title":"Gene X Two Triple Mutations Predominance on Chronic Hepatitis B Virus in Padang, West Sumatra Indonesia","authors":"Afida Razuna Ave, A. Putra, Saptino Miro","doi":"10.24871/2322022206-211","DOIUrl":"https://doi.org/10.24871/2322022206-211","url":null,"abstract":"Background: Hepatitis B is a health issue that become major problem worldwide with high morbidity. Hepatitis B is a liver infection that caused by Hepatitis B Virus. Chronic hepatitis B is a liver inflammation that lasted more than 6 months and it has the potential to progress to liver cirrhosis and hepatocellular cancer. The disease is influenced by Gene X and viral genotype. Mutations in the Gene X are suspected to having a role in disease progression. The aim of this study was to detect Gene X polymorphism and the phylogeny of HBV from Padang local clinical samples of chronic hepatitis B (CHB), West Sumatera, Indonesia.Method: The entire chronically HBV-infected patients were enrolled in this study: 38 CHB. The research samples were the entire Hepatitis B serum from Indonesian Red Cross Blood Bank than Gene X was amplified using nested PCR, which produced two fragments and aligned with X sequence database continued with mutation analysis. Results: In this study we found all the samples were having nucleotide variation. Of various mutations, we observed the presence of known liver cirrhosis and HCC-related HBx protein mutant i.e double mutations (HBx130 and HBx131) and two triple mutations (HBx5/HBx130/HBx131) and (HBx127/HBx130/HBx131) were high. The analysis also showed that patients were infected mainly by genotype C at 72,2% and followed by B at 27,8%.Conclusion: We conclude that all the samples have nucleotide variation and the mutation implying that molecular progression between the virus and the host at chronically infected patients.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"1106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76752807","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}
Abhishek Mohata, Mrinmoy Adhikary, Ranajit Bari, Shubho Chowdhuri, P. Jana, V. Chellaiyan
Background: Gallstone disease (GSD) is one of the most common surgical problems throughout the world. The rise in gallstone disease burden and its wide spectrum of non-specific presentation makes the disease more challenging. Gall bladder cancer (GBC) is a common cancer in the northern and North-eastern States of India. The six cancer registries of the Indian Council of Medical Research (ICMR) (1990-1996) show a 10 times lower incidence of GBC per 1 00 000 in South India compared with the North. The objective of present study was to assess the epidemiological and pathological profile of GSD and GBC patients of Eastern India visiting tertiary care hospital of Kolkata.Method: This cross-sectional observational study was conducted, over a period of 18 months, at a tertiary referral hospital of Kolkata. In this study, 66 gallstone disease patients and 24 gallbladder cancer patients who undergone surgery were included in the study after their written informed consent. Data on their demographic and pathological profile, type of gallstones, their number and staging and type gallbladder cancer were collected. Results: GSD GBC were found to afflict females, Male to female ratio was 1:2 1:3 for GSD and GBC respectively. We found that nearly half (45.4%) GSD patients were in the age group of 21-40 years and more than half (58.6%) GBC patients were in age group of 41-60 years. Majority of GSD patients had multiple stones (57.6%) and cholesterol stones were most common (59.1%). Out of 24 GBC patients, nearly one-third (33.3%) had stage II cancer and only 12.5% patients had stage IV cancer. More than one-fourth (29.2%) GBC patients had poorly differentiated carcinoma.Conclusion: The results of this study reaffirm that female gender is a strong predisposing factor for GSD and GBC and patients in their fourth decade, are more at risk. Large population based multicentric analytical study is necessary to strengthen this study findings.
{"title":"Clinical and pathological profile of Gallbladder Cancer (GBC) and Gallstone disease GSD) among the patients admitted in tertiary care institute in Kolkata","authors":"Abhishek Mohata, Mrinmoy Adhikary, Ranajit Bari, Shubho Chowdhuri, P. Jana, V. Chellaiyan","doi":"10.24871/2322022194-198","DOIUrl":"https://doi.org/10.24871/2322022194-198","url":null,"abstract":"Background: Gallstone disease (GSD) is one of the most common surgical problems throughout the world. The rise in gallstone disease burden and its wide spectrum of non-specific presentation makes the disease more challenging. Gall bladder cancer (GBC) is a common cancer in the northern and North-eastern States of India. The six cancer registries of the Indian Council of Medical Research (ICMR) (1990-1996) show a 10 times lower incidence of GBC per 1 00 000 in South India compared with the North. The objective of present study was to assess the epidemiological and pathological profile of GSD and GBC patients of Eastern India visiting tertiary care hospital of Kolkata.Method: This cross-sectional observational study was conducted, over a period of 18 months, at a tertiary referral hospital of Kolkata. In this study, 66 gallstone disease patients and 24 gallbladder cancer patients who undergone surgery were included in the study after their written informed consent. Data on their demographic and pathological profile, type of gallstones, their number and staging and type gallbladder cancer were collected. Results: GSD GBC were found to afflict females, Male to female ratio was 1:2 1:3 for GSD and GBC respectively. We found that nearly half (45.4%) GSD patients were in the age group of 21-40 years and more than half (58.6%) GBC patients were in age group of 41-60 years. Majority of GSD patients had multiple stones (57.6%) and cholesterol stones were most common (59.1%). Out of 24 GBC patients, nearly one-third (33.3%) had stage II cancer and only 12.5% patients had stage IV cancer. More than one-fourth (29.2%) GBC patients had poorly differentiated carcinoma.Conclusion: The results of this study reaffirm that female gender is a strong predisposing factor for GSD and GBC and patients in their fourth decade, are more at risk. Large population based multicentric analytical study is necessary to strengthen this study findings.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91191871","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}
B. A. Wicaksono, F. B. H. Jonathan, A. T. Sridevi, Dewi Friska, B. Hegar
Background: Functional constipation is one of the most common functional gastrointestinal disorders in children under 4 years of age. The Rome IV Criteria have standardized diagnostic criteria for functional constipation. The purpose of the study was to determine the knowledge and therapeutic approach of Indonesian pediatricians to functional constipation.Method: A cross-sectional analytic observational study with the target of 101 pediatricians practicing in the DKI Jakarta area. This study provides an electronic questionnaire which was validated with facial and construct validity and the reliability was determined by Alpha-Cronbach value.Results: The average duration of experience practicing as pediatricians was 6.83 ± 3.96 years, with a range of 5-15 years (66.3%) with the majority working in non-teaching institutions (83.2%). Pediatricians’ knowledge of functional constipation did not show a significant difference in score based on length of experience practicing as a pediatrician (p = 0.738) and place of daily practice (p = 0.690). A Significant difference was seen based on the use of Rome Criteria as a source of information on functional constipation (p = 0.047). Five to fifteen years of experience practicing and teaching hospital as place of daily practice showed a higher therapeutic approach score, although this was not statistically significant. It turned out that using Rome Criteria as a source of information does not give higher therapeutic approach scores.Conclusion: Periodic evaluation of pediatrician's knowledge and therapeutic approach is needed to maintain the quality of functional constipation care.
{"title":"The Knowledge and Therapeutic Approach of Paediatrician on Functional Constipation","authors":"B. A. Wicaksono, F. B. H. Jonathan, A. T. Sridevi, Dewi Friska, B. Hegar","doi":"10.24871/2322022199-205","DOIUrl":"https://doi.org/10.24871/2322022199-205","url":null,"abstract":"Background: Functional constipation is one of the most common functional gastrointestinal disorders in children under 4 years of age. The Rome IV Criteria have standardized diagnostic criteria for functional constipation. The purpose of the study was to determine the knowledge and therapeutic approach of Indonesian pediatricians to functional constipation.Method: A cross-sectional analytic observational study with the target of 101 pediatricians practicing in the DKI Jakarta area. This study provides an electronic questionnaire which was validated with facial and construct validity and the reliability was determined by Alpha-Cronbach value.Results: The average duration of experience practicing as pediatricians was 6.83 ± 3.96 years, with a range of 5-15 years (66.3%) with the majority working in non-teaching institutions (83.2%). Pediatricians’ knowledge of functional constipation did not show a significant difference in score based on length of experience practicing as a pediatrician (p = 0.738) and place of daily practice (p = 0.690). A Significant difference was seen based on the use of Rome Criteria as a source of information on functional constipation (p = 0.047). Five to fifteen years of experience practicing and teaching hospital as place of daily practice showed a higher therapeutic approach score, although this was not statistically significant. It turned out that using Rome Criteria as a source of information does not give higher therapeutic approach scores.Conclusion: Periodic evaluation of pediatrician's knowledge and therapeutic approach is needed to maintain the quality of functional constipation care.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85191192","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}
Nicholas Wijayanto, Y. Kandarini, I. Wibawa, N. Winarti
Glomerulonephritis is an inflammatory condition on renal glomerulus. These entities can manifest as nephrotic syndrome. One of causes of secondary glomerulonephritis is hepatitis B infection. Glomerulonephritis due to hepatitis B only happens in 0.1 – 25% cases, with the focal segmental glomerulosclerosis (FSGS) is rarely reported. We reported 20 years old male with nephrotic syndrome. He was homosexual with history of unprotected sex and multiple partners. From kidney biopsy, we found focal segmental glomerulosclerosis lesion. Blood examination showed he had both hepatitis B (HBV-DNA 1.7x108 IU/mL) and HIV infection (HIV-RNA 820 copies/mL, CD4 839 cell/uL). We treated this patient with combination of anti-viral drugs which consist of tenofovir, lamivudine and efavirenz. After three weeks of treatment, he showed improvement in the clinical symptoms and urinalysis.
{"title":"Focal Segmental Glomerulosclerosis caused by Hepatitis B Infection Comorbid with HIV Infection","authors":"Nicholas Wijayanto, Y. Kandarini, I. Wibawa, N. Winarti","doi":"10.24871/2322022256-260","DOIUrl":"https://doi.org/10.24871/2322022256-260","url":null,"abstract":"Glomerulonephritis is an inflammatory condition on renal glomerulus. These entities can manifest as nephrotic syndrome. One of causes of secondary glomerulonephritis is hepatitis B infection. Glomerulonephritis due to hepatitis B only happens in 0.1 – 25% cases, with the focal segmental glomerulosclerosis (FSGS) is rarely reported. We reported 20 years old male with nephrotic syndrome. He was homosexual with history of unprotected sex and multiple partners. From kidney biopsy, we found focal segmental glomerulosclerosis lesion. Blood examination showed he had both hepatitis B (HBV-DNA 1.7x108 IU/mL) and HIV infection (HIV-RNA 820 copies/mL, CD4 839 cell/uL). We treated this patient with combination of anti-viral drugs which consist of tenofovir, lamivudine and efavirenz. After three weeks of treatment, he showed improvement in the clinical symptoms and urinalysis.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74550120","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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