Background: Chronic liver disease (CLD) often results in fatal complications. Child-Turcotte-Pugh (CTP) score is the earliest predictor of mortality but the Model for End-Stage Liver Disease (MELD) score is more objective. Studies showed platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) could become mortality predictors for chronic liver disease. We aimed to investigate NLR and PLR as early mortality predictors for CLD, in comparison with CTP and MELD scores. Method: This was a retrospective observational cohort study. We recruited patients with CLD (liver cirrhosis and hepatocellular carcinoma), from Saiful Anwar Hospital, Indonesia. Data regarding PLR, NLR, CTP, and MELD scores were obtained from the medical records. Participants were followed for 30 days to determine survival. Results: Ninety patients were recruited in the study. There were 31 deaths (34.4%) in 30 days. Mortality was higher in HCC patients than liver cirrhosis. Although NLR had similar sensitivity with CTP (51.6%), neither PLR (p 0.956) nor NLR (p 0.087) could significantly better predict mortality than CTP (p 0.001) or MELD scores (p 0.002). In opposite to PLR, NLR had a positive correlation with MELD and CTP scores. Conclusion: On the contrary to the PLR, the NLR positively correlated with the severity of the disease, NLR had the potential as a predictor of early mortality for patients with chronic liver disease as compared to CTP and MELD scores. But PLR could not substitute both CTP and MELD scores.
{"title":"Platelet-Lymphocyte Ratio and Neutrophil-Lymphocyte Ratio as Early Mortality Predictors for Patients with End-Stage Chronic Liver Disease","authors":"Syifa Mustika, Affa Kiysa Waafi","doi":"10.24871/2322022223-232","DOIUrl":"https://doi.org/10.24871/2322022223-232","url":null,"abstract":"Background: Chronic liver disease (CLD) often results in fatal complications. Child-Turcotte-Pugh (CTP) score is the earliest predictor of mortality but the Model for End-Stage Liver Disease (MELD) score is more objective. Studies showed platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) could become mortality predictors for chronic liver disease. We aimed to investigate NLR and PLR as early mortality predictors for CLD, in comparison with CTP and MELD scores. Method: This was a retrospective observational cohort study. We recruited patients with CLD (liver cirrhosis and hepatocellular carcinoma), from Saiful Anwar Hospital, Indonesia. Data regarding PLR, NLR, CTP, and MELD scores were obtained from the medical records. Participants were followed for 30 days to determine survival. Results: Ninety patients were recruited in the study. There were 31 deaths (34.4%) in 30 days. Mortality was higher in HCC patients than liver cirrhosis. Although NLR had similar sensitivity with CTP (51.6%), neither PLR (p 0.956) nor NLR (p 0.087) could significantly better predict mortality than CTP (p 0.001) or MELD scores (p 0.002). In opposite to PLR, NLR had a positive correlation with MELD and CTP scores. Conclusion: On the contrary to the PLR, the NLR positively correlated with the severity of the disease, NLR had the potential as a predictor of early mortality for patients with chronic liver disease as compared to CTP and MELD scores. But PLR could not substitute both CTP and MELD scores.","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":"85466677","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}
Athala Rania Insyira, I. G. B. S. Mahendra, Ni Komang Ayu Trisnayanti Yasa, Nimas Resti, Nofiana Ayu Risqiana Sari, Catarina Budyono
Achalasia is an esophageal motility disorder which is characterized by relaxation failure of the lower esophageal sphincter and absence of distal esophageal peristalsis. The prevalence rate of achalasia is 10 cases per 100,000 population with dysphagia, regurgitation, chest pain, and weight loss as the main clinical manifestations. Target of treatment for achalasia is a decreased resting pressure in the lower esophageal sphincter and this can be achieved using peroral endoscopic myotomy (POEM). POEM can be performed using two therapeutic approaches: anterior and posterior. Complication that often occurs after POEM is Gastroesophageal Reflux Disease (GERD). GERD leads to symptoms and/or structural damage that affects the patient’s quality of life. The GERD questionnaire (GERD-Q) is a sensitive and non-invasive screening tool for diagnosing GERD. Based on the result analysis of this research that was conducted to assess the outcome of anterior and posterior POEM with the GERD-Q score parameter, there was no significant difference in scores between the anterior and posterior approaches.
{"title":"Gerd-Q Score As Outcome Parameter Of Anterior vs. Posterior Peroral Endoscopical Myotomy in Acalasia Patient","authors":"Athala Rania Insyira, I. G. B. S. Mahendra, Ni Komang Ayu Trisnayanti Yasa, Nimas Resti, Nofiana Ayu Risqiana Sari, Catarina Budyono","doi":"10.24871/2322022244-249","DOIUrl":"https://doi.org/10.24871/2322022244-249","url":null,"abstract":"Achalasia is an esophageal motility disorder which is characterized by relaxation failure of the lower esophageal sphincter and absence of distal esophageal peristalsis. The prevalence rate of achalasia is 10 cases per 100,000 population with dysphagia, regurgitation, chest pain, and weight loss as the main clinical manifestations. Target of treatment for achalasia is a decreased resting pressure in the lower esophageal sphincter and this can be achieved using peroral endoscopic myotomy (POEM). POEM can be performed using two therapeutic approaches: anterior and posterior. Complication that often occurs after POEM is Gastroesophageal Reflux Disease (GERD). GERD leads to symptoms and/or structural damage that affects the patient’s quality of life. The GERD questionnaire (GERD-Q) is a sensitive and non-invasive screening tool for diagnosing GERD. Based on the result analysis of this research that was conducted to assess the outcome of anterior and posterior POEM with the GERD-Q score parameter, there was no significant difference in scores between the anterior and posterior approaches.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85952041","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. Miftahussurur, C. Savitri, R. I’tishom, P. S. Rejeki, Y. Rezkitha, Yoshio Yamaok
Microbiota was deemed essential as it involved in energy metabolism, nutrient absorption, intestinal immune system maturation, and pathogen protection. Gastrointestinal microbiome played essential roles in human body, such as immune response regulation, pathogen colonization, and few other diseases. The relation between gastric microbiota and host were difficult to explore for years due to unculturable microbes. Stomach with its acid production was presumed to be sterile and unfavorable for bacterial growth until the discovery of Helicobacter pylori. It dominates the stomach as it was estimated to colonize almost 50% global population. H. pylori infection was linked to the development of chronic gastritis and recognized as a definite carcinogen. There was a probability that the alteration of gastric microbiota likely influenced gastric immunobiology and possible gastric diseases. Recent studies showed that five phyla consist of Firmicutes, Bacteroidetes, Actinobacteria, Fusobacteria and Proteobacteria have been discovered in stomach mucosa which might contribute to the pathological process. In addition, genera such as Lactobacillus, Escherichia-Shigella, Lachnospiraceae, Burkholderia and Nitrospirae were considered to have a role on gastric carcinogenesis.
{"title":"New Paradigm of Gastric Pathogenesis: The Important Role of Gastric Microbiota","authors":"M. Miftahussurur, C. Savitri, R. I’tishom, P. S. Rejeki, Y. Rezkitha, Yoshio Yamaok","doi":"10.24871/231202262-66","DOIUrl":"https://doi.org/10.24871/231202262-66","url":null,"abstract":"Microbiota was deemed essential as it involved in energy metabolism, nutrient absorption, intestinal immune system maturation, and pathogen protection. Gastrointestinal microbiome played essential roles in human body, such as immune response regulation, pathogen colonization, and few other diseases. The relation between gastric microbiota and host were difficult to explore for years due to unculturable microbes. Stomach with its acid production was presumed to be sterile and unfavorable for bacterial growth until the discovery of Helicobacter pylori. It dominates the stomach as it was estimated to colonize almost 50% global population. H. pylori infection was linked to the development of chronic gastritis and recognized as a definite carcinogen. There was a probability that the alteration of gastric microbiota likely influenced gastric immunobiology and possible gastric diseases. Recent studies showed that five phyla consist of Firmicutes, Bacteroidetes, Actinobacteria, Fusobacteria and Proteobacteria have been discovered in stomach mucosa which might contribute to the pathological process. In addition, genera such as Lactobacillus, Escherichia-Shigella, Lachnospiraceae, Burkholderia and Nitrospirae were considered to have a role on gastric carcinogenesis.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74517772","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}
A. Syam, Armand Achmadsyah, Y. Mazni, C. Y. I. Sari
Novel Coronavirus 2019 (COVID-19) also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, non-segmented positive-sense RNA virus that belonging to the beta-coronaviridae family. Patients were said to had various symptoms of fever, cough, anosmia, and chest stuffiness in addition to other non-specific clinical manifestations, including diarrhea, vomiting, anorexia, abdominal pain, and so on. Although this gastrointestinal symptoms were present in COVID-19 case, there was not enough evidence about the involvement of gallbladder and biliary tract in literature to date. We report a rare case of Acute Cholecystitis on a COVID-19 patient in Jakarta, Indonesia. A case of 54-year-old female with COVID-19 confirmed by RT-PCR Test who had constant pain in the right upper quadrant of her abdomen during her arrival at the hospital that was finally diagnosed as Acute Cholecystitis. The Laboratory Findings revealed normal level of White Blood Cells(6.73 K/aeL). The Multidisciplinary team decided to treat COVID-19 infection with antiviral (Favipiravir, according to Indonesian COVID-19 Guideline) for 2 weeks until her RT-PCR was found to be negative then perform a laparoscopic cholecystectomy as the first treatment. During the administration of Favipiravir, there was a reduction of pain in the right upper quadrant abdomen and an overall clinical improvement.The precise mechanism of Acute Cholecystitis in COVID-19 Patients was still unclear. However, Acute Cholecystitis could be a possible complication of COVID-19 although there was not enough evidence whether the gallbladder might be vulnerable to COVID-19. In this case, the normal level of white blood cells could be a hint that Acute Cholecystitis was not caused by bacterial colonization and could be potentially triggered by COVID-19. Laparoscopic Cholecystectomy was chosen as the first management after RT-PCR COVID-19 was negative with 2-weeks of antiviral treatment. Although the lack of evidence and guidelines for Acute Cholecystitis management during The COVID-19 Pandemic, Laparoscopic Cholecystectomy remains the chosen treatment for Acute Cholecystitis Management on COVID-19 Patients. More research is needed to understand the possible relationship between Acute Cholecystitis and COVID-19.
{"title":"COVID-19 with Acute Cholecystitis: A Case Report","authors":"A. Syam, Armand Achmadsyah, Y. Mazni, C. Y. I. Sari","doi":"10.24871/231202282-86","DOIUrl":"https://doi.org/10.24871/231202282-86","url":null,"abstract":"Novel Coronavirus 2019 (COVID-19) also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, non-segmented positive-sense RNA virus that belonging to the beta-coronaviridae family. Patients were said to had various symptoms of fever, cough, anosmia, and chest stuffiness in addition to other non-specific clinical manifestations, including diarrhea, vomiting, anorexia, abdominal pain, and so on. Although this gastrointestinal symptoms were present in COVID-19 case, there was not enough evidence about the involvement of gallbladder and biliary tract in literature to date. We report a rare case of Acute Cholecystitis on a COVID-19 patient in Jakarta, Indonesia. A case of 54-year-old female with COVID-19 confirmed by RT-PCR Test who had constant pain in the right upper quadrant of her abdomen during her arrival at the hospital that was finally diagnosed as Acute Cholecystitis. The Laboratory Findings revealed normal level of White Blood Cells(6.73 K/aeL). The Multidisciplinary team decided to treat COVID-19 infection with antiviral (Favipiravir, according to Indonesian COVID-19 Guideline) for 2 weeks until her RT-PCR was found to be negative then perform a laparoscopic cholecystectomy as the first treatment. During the administration of Favipiravir, there was a reduction of pain in the right upper quadrant abdomen and an overall clinical improvement.The precise mechanism of Acute Cholecystitis in COVID-19 Patients was still unclear. However, Acute Cholecystitis could be a possible complication of COVID-19 although there was not enough evidence whether the gallbladder might be vulnerable to COVID-19. In this case, the normal level of white blood cells could be a hint that Acute Cholecystitis was not caused by bacterial colonization and could be potentially triggered by COVID-19. Laparoscopic Cholecystectomy was chosen as the first management after RT-PCR COVID-19 was negative with 2-weeks of antiviral treatment. Although the lack of evidence and guidelines for Acute Cholecystitis management during The COVID-19 Pandemic, Laparoscopic Cholecystectomy remains the chosen treatment for Acute Cholecystitis Management on COVID-19 Patients. More research is needed to understand the possible relationship between Acute Cholecystitis and COVID-19.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88825070","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. Koncoro, I. Hasan, C. Lesmana, Humala Prika Aditama, Thariqah Salamah, Aulia Rizka, E. Wahyudi, H. Shatri
Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. Sarcopenia can be assessed by using skeletal muscle index (SMI), measured on transverse CT images at the third lumbar vertebra (L3). HCC staging consists of liver function assessment and Eastern Cooperative Oncology Group performance status (ECOG-PS). ECOG-PS can reflect physical function. This study was aimed to describe the proportion of sarcopenia among adults, using Japan Society of Hepatology criteria and explore association between sarcopenia and poor performance status.Method: The study was conducted in a tertiary hospital during January – October 2021. SMI were evaluated using computed tomography images of L3 in 85 HCC patients. Clinical, laboratory and body composition data were analyzed using bivariate analysis. Logistic regression was performed to obtain an independent association between ECOG-PS and sarcopenic status of HCC patients.Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 49,4% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 4.169 (CI 95% = 1.504-11,555), p 0,006).Conclusion: Sarcopenia has high proportion in HCC patients. There were strong association between ECOG-PS and sarcopenia in HC.
{"title":"Sarcopenia are Associated with Poor Performance Status in Indonesian Patients with Hepatocellular Carcinoma","authors":"H. Koncoro, I. Hasan, C. Lesmana, Humala Prika Aditama, Thariqah Salamah, Aulia Rizka, E. Wahyudi, H. Shatri","doi":"10.24871/231202217-23","DOIUrl":"https://doi.org/10.24871/231202217-23","url":null,"abstract":"Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. Sarcopenia can be assessed by using skeletal muscle index (SMI), measured on transverse CT images at the third lumbar vertebra (L3). HCC staging consists of liver function assessment and Eastern Cooperative Oncology Group performance status (ECOG-PS). ECOG-PS can reflect physical function. This study was aimed to describe the proportion of sarcopenia among adults, using Japan Society of Hepatology criteria and explore association between sarcopenia and poor performance status.Method: The study was conducted in a tertiary hospital during January – October 2021. SMI were evaluated using computed tomography images of L3 in 85 HCC patients. Clinical, laboratory and body composition data were analyzed using bivariate analysis. Logistic regression was performed to obtain an independent association between ECOG-PS and sarcopenic status of HCC patients.Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 49,4% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 4.169 (CI 95% = 1.504-11,555), p 0,006).Conclusion: Sarcopenia has high proportion in HCC patients. There were strong association between ECOG-PS and sarcopenia in HC.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89747353","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}
N. Indrasari, Firensca Pattiasina, A. Fauzi, Y. Yusra, J. Kumalawati, Suzanna Immanuel
Background: Colitis is a gastrointestinal disease that poses a major problem in Indonesia. Zinc (Zn) is an important trace element which plays role as antimicrobial in intestinal mucosa, increases gastrointestinal barrier, and immune function. Colitis can cause histologic changes in gastrointestinal tract epithelial which will disrupt the absorption and excretion of Zn causing zinc deficiency. This study aims to evaluate the difference of Zn level in colitis and healthy subjects, as well as the fecal analysis profile of colitis patients in Cipto Mangunkusumo General Hospital. Method: The design of this study was cross-sectional and was performed in colitis and healthy subjects. Colitis patients were recruited consecutively in patients in Gastroenterology Clinic and Gastrointestinal Endoscopy Centre in Cipto Mangunkusumo General Hospital. Zinc examination from blood sample was performed using spectrophotometry. Fecal analysis was performed manually. The level of zinc from colitis subjects was compared to healthy subjects. Fecal analysis examination consists of macroscopic, microscopic, and chemical examinations of the feces.Results: There were 40 colitis subjects and 16 healthy subjects in August 2019 - May 2020. There were significant differences in Zn levels between colitis and healthy subjects, which were 10.9 ± 1.9 mol/L and 12.3 ± 1 mol/L, respectively (p = 0.011). There were 45% (18/45) colitis subjects who were also suffering from Zn deficiency. The stool analysis in colitis subjects showed soft stool consistency in 90% subjects, slimy stools in 17.5%, increased in erythrocyte count in 60%, increased in leukocyte count in 5%, positive stool starch in 20%, positive stool fat in 7.5%, acid pH in 97.5%, positive stool occult blood in 37.5%, and fungi in stool in 7.5%.
{"title":"Blood Zinc Profile and Fecal Analysis of Colitis Patients in Cipto Mangunkusumo General Hospital","authors":"N. Indrasari, Firensca Pattiasina, A. Fauzi, Y. Yusra, J. Kumalawati, Suzanna Immanuel","doi":"10.24871/231202229-37","DOIUrl":"https://doi.org/10.24871/231202229-37","url":null,"abstract":"Background: Colitis is a gastrointestinal disease that poses a major problem in Indonesia. Zinc (Zn) is an important trace element which plays role as antimicrobial in intestinal mucosa, increases gastrointestinal barrier, and immune function. Colitis can cause histologic changes in gastrointestinal tract epithelial which will disrupt the absorption and excretion of Zn causing zinc deficiency. This study aims to evaluate the difference of Zn level in colitis and healthy subjects, as well as the fecal analysis profile of colitis patients in Cipto Mangunkusumo General Hospital. Method: The design of this study was cross-sectional and was performed in colitis and healthy subjects. Colitis patients were recruited consecutively in patients in Gastroenterology Clinic and Gastrointestinal Endoscopy Centre in Cipto Mangunkusumo General Hospital. Zinc examination from blood sample was performed using spectrophotometry. Fecal analysis was performed manually. The level of zinc from colitis subjects was compared to healthy subjects. Fecal analysis examination consists of macroscopic, microscopic, and chemical examinations of the feces.Results: There were 40 colitis subjects and 16 healthy subjects in August 2019 - May 2020. There were significant differences in Zn levels between colitis and healthy subjects, which were 10.9 ± 1.9 mol/L and 12.3 ± 1 mol/L, respectively (p = 0.011). There were 45% (18/45) colitis subjects who were also suffering from Zn deficiency. The stool analysis in colitis subjects showed soft stool consistency in 90% subjects, slimy stools in 17.5%, increased in erythrocyte count in 60%, increased in leukocyte count in 5%, positive stool starch in 20%, positive stool fat in 7.5%, acid pH in 97.5%, positive stool occult blood in 37.5%, and fungi in stool in 7.5%.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73568448","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: There were many patients, including adolescent, with dyspepsia symptoms in our daily clinical practice have been interacting with internet search engine to find medical information which induced or worsened their dyspeptic symptoms. Aim of the study is to know the pattern of internet browsing habit and dyspepsia syndrome in adolescentMethod: Grade 12 level students of senior high schools in Yogyakarta, Indonesia were included in the study with stratified random sampling method. Students with confirmed organic dyspepsia diagnosis were excluded. We use two simple questions to reveal the students internet browsing habit, question no 1 :“Did you ever browse information about diseases in the internet?” (answer choice: a.never;b.once;c.more than once); question no 2.: “Did you ever browse information about your medical complaint in the internet?” (answer choice: a.never;b.once;c.more than once). We used validated Gastrointestinal Symptom score (GIS) to reveal the students dyspepsia symptoms. Data were analyzed with chi-square test and anova.Results: There were 665 (477 girls and 188 boys) senior high school students (age range : 16-20 years old) included in this study. Based on question no 1, the result showed significantly different (p 0.001) between students with and without the dyspepsia syndrome, and the question no 2 also showed similar result (p=0.002). The anova between GIS and question no 1 showed significantly different ( p0.001) and the similar result was also found between GIS and question no 2 (p0.001). Conclusion:The internet browsing habit may influence the development of dyspepsia syndrome in adolescent and further study is needed to find the cause and effect relationship.
{"title":"Interaction between Internet Browsing Habit and Dyspepsia Syndrome in Adolescent","authors":"P. Bayupurnama, N. Sofia, Angelin Utami Cahyani","doi":"10.24871/231202238-42","DOIUrl":"https://doi.org/10.24871/231202238-42","url":null,"abstract":"Background: There were many patients, including adolescent, with dyspepsia symptoms in our daily clinical practice have been interacting with internet search engine to find medical information which induced or worsened their dyspeptic symptoms. Aim of the study is to know the pattern of internet browsing habit and dyspepsia syndrome in adolescentMethod: Grade 12 level students of senior high schools in Yogyakarta, Indonesia were included in the study with stratified random sampling method. Students with confirmed organic dyspepsia diagnosis were excluded. We use two simple questions to reveal the students internet browsing habit, question no 1 :“Did you ever browse information about diseases in the internet?” (answer choice: a.never;b.once;c.more than once); question no 2.: “Did you ever browse information about your medical complaint in the internet?” (answer choice: a.never;b.once;c.more than once). We used validated Gastrointestinal Symptom score (GIS) to reveal the students dyspepsia symptoms. Data were analyzed with chi-square test and anova.Results: There were 665 (477 girls and 188 boys) senior high school students (age range : 16-20 years old) included in this study. Based on question no 1, the result showed significantly different (p 0.001) between students with and without the dyspepsia syndrome, and the question no 2 also showed similar result (p=0.002). The anova between GIS and question no 1 showed significantly different ( p0.001) and the similar result was also found between GIS and question no 2 (p0.001). Conclusion:The internet browsing habit may influence the development of dyspepsia syndrome in adolescent and further study is needed to find the cause and effect relationship.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81656521","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. pylori is a common human pathogen and it is estimated that approximately 50% of the world's population are infected. Furthermore it's prevalence infection in Indonesia is 20% but much higher among several ethnic groups (Papuans 42.9%, Batak 40.0%, and Bugis 36.7%). H. pylori’s growth and survival has been shown to be sensitive to a variety of antimicrobial agents. The success of the treatment depends on susceptibility, dosage, formulation, dose frequency, the use of adjuvants such as anti-secretory drugs, antacids or probiotics, and duration of treatment. The treatment for H. pylori infection keep evolving and the triple therapy, levofloxacin, was replaced by CLR in triple therapy for 14-day with eradication rates over 90%. Sequential therapy, also achieved a higher cure rate against clarithromycin-resistant strains than a 7 and 10 day triple therapy. Triple bismuth therapy and quadruple bismuth therapy are used less frequently due to their inherent complexity, the large number of tablets four times a day, side effects, and lack of support from pharmaceutical companies. Inclusively, vonoprazan is also a good choice that is fully effective from day one. The role of the probiotics is unclear and is not recommended in consensus groups. Two mucolytic agents, erdosteine and N-acetylcysteine (NAC), were found to increase it's eradication efficiency clinical trials when administered in supplementation with triple therapy but are not commonly used because of the need for high doses, and increased medical costs. therefore, H. pylori resistant management should be adapted to the results of the the culture of resistance and the guidelines of existing resistance patterns.
{"title":"Updates on Management of Helicobacter pylori Infection and Antibiotic Resistant Helicobacter Infection Management","authors":"S. A. Nursyirwan, M. Simadibrata","doi":"10.24871/231202267-73","DOIUrl":"https://doi.org/10.24871/231202267-73","url":null,"abstract":"H. pylori is a common human pathogen and it is estimated that approximately 50% of the world's population are infected. Furthermore it's prevalence infection in Indonesia is 20% but much higher among several ethnic groups (Papuans 42.9%, Batak 40.0%, and Bugis 36.7%). H. pylori’s growth and survival has been shown to be sensitive to a variety of antimicrobial agents. The success of the treatment depends on susceptibility, dosage, formulation, dose frequency, the use of adjuvants such as anti-secretory drugs, antacids or probiotics, and duration of treatment. The treatment for H. pylori infection keep evolving and the triple therapy, levofloxacin, was replaced by CLR in triple therapy for 14-day with eradication rates over 90%. Sequential therapy, also achieved a higher cure rate against clarithromycin-resistant strains than a 7 and 10 day triple therapy. Triple bismuth therapy and quadruple bismuth therapy are used less frequently due to their inherent complexity, the large number of tablets four times a day, side effects, and lack of support from pharmaceutical companies. Inclusively, vonoprazan is also a good choice that is fully effective from day one. The role of the probiotics is unclear and is not recommended in consensus groups. Two mucolytic agents, erdosteine and N-acetylcysteine (NAC), were found to increase it's eradication efficiency clinical trials when administered in supplementation with triple therapy but are not commonly used because of the need for high doses, and increased medical costs. therefore, H. pylori resistant management should be adapted to the results of the the culture of resistance and the guidelines of existing resistance patterns.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86778987","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) patients have an increased rate of some vaccine-preventable infection during their course of disease. However, the coverage of vaccination is still low. Many physicians often do not feel comfortable or confidence offering vaccination to IBD patients. Vaccine effectiveness can be altered by the immune dysregulation condition and immunosuppressive therapy that IBD patients use. There are also some concerns about IBD flare after vaccination and potential adverse events related to live vaccines. Nonetheless, offering vaccines and obtaining vaccination history is necessary for health care maintenance of IBD patients, especially those using immunosuppressive therapy.
{"title":"Vaccination for Inflammatory Bowel Disease Patients","authors":"E. Yunihastuti","doi":"10.24871/231202252-61","DOIUrl":"https://doi.org/10.24871/231202252-61","url":null,"abstract":"Inflammatory bowel disease (IBD) patients have an increased rate of some vaccine-preventable infection during their course of disease. However, the coverage of vaccination is still low. Many physicians often do not feel comfortable or confidence offering vaccination to IBD patients. Vaccine effectiveness can be altered by the immune dysregulation condition and immunosuppressive therapy that IBD patients use. There are also some concerns about IBD flare after vaccination and potential adverse events related to live vaccines. Nonetheless, offering vaccines and obtaining vaccination history is necessary for health care maintenance of IBD patients, especially those using immunosuppressive therapy.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"31 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86488267","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: Ulcerative colitis (UC), a chronic inflammatory disease that can cause bloody diarrhea, remains a major global disease burden. While Helicobacter pylori infection is postulated to be able to reduce the occurrence of UC, its role in the disease itself remains contentious. Hence, this meta-analysis aims to examine whether H. pylori infection can lower the chance of developing UC.Method: A systematic search was conducted through three electronic databases, namely Cochrane, PubMed, and Embase, with the addition of individual hand searching to analyze the association between ulcerative colitis and H. pylori infection in the adult population. Relevant articles selected through eligibility criteria were assessed for quality by using the Newcastle-Ottawa Scale. Furthermore, a random-effects meta-analysis was conducted to estimate the pooled odd ratios (ORs) along with their 95% confidence intervals (CIs). Higgins test and funnel plots were also conducted.Results: A total of 11,498 patients with UC and 356,130 controls from 22 studies were included in the meta-analysis. Included studies showed fair or good quality. Good quality was achieved with the minimum score of 3 stars for selection, 1 star for comparability, and 2 stars for outcome/exposure, while fair quality was achieved with the minimum score of 2 stars for domain, 1 star for comparability, and 2 stars for outcome/exposure. Our findings indicated that H. pylori infection was associated with lower odds of UC [pooled ORs 0.51 (95% CI: 0.46-0.56)]), albeit moderate heterogeneity (I2= 54%, p = 0.002). Furthermore, publication bias was not found.Conclusion: The present study adds to the growing body of evidence supporting the potential protective effects of H. pylori infection on the occurrence of UC. However, further primary research with prospective study design needs to be conducted to confirm our findings.
背景:溃疡性结肠炎(UC)是一种慢性炎症性疾病，可导致出血性腹泻，仍然是全球主要的疾病负担。虽然幽门螺杆菌感染被认为能够减少UC的发生，但它在疾病本身的作用仍然存在争议。因此，本荟萃分析旨在研究幽门螺旋杆菌感染是否可以降低UC的发生机会。方法:通过Cochrane、PubMed、Embase三个电子数据库进行系统检索，并辅以个体手检索，分析成人溃疡性结肠炎与幽门螺杆菌感染的相关性。通过资格标准选择的相关文章通过使用纽卡斯尔-渥太华量表进行质量评估。此外，进行了随机效应荟萃分析，以估计合并奇数比(ORs)及其95%置信区间(ci)。并进行Higgins检验和漏斗图分析。结果:meta分析共纳入了来自22项研究的11498例UC患者和356130例对照。纳入的研究显示质量一般或良好。质量好，选择3星，可比性1星，结果/曝光2星;质量一般，领域2星，可比性1星，结果/曝光2星。我们的研究结果表明，幽门螺杆菌感染与较低的UC发生率相关[合并or为0.51 (95% CI: 0.46-0.56)]，尽管存在中等异质性(I2= 54%， p = 0.002)。此外，未发现发表偏倚。结论:本研究增加了越来越多的证据支持幽门螺旋杆菌感染对UC发生的潜在保护作用。然而，需要进一步进行前瞻性研究设计的初步研究来证实我们的发现。
{"title":"Association Between Helicobacter pylori Infection and Ulcerative Colitis: A Meta-Analysis Study","authors":"Alesia Prillya Mauna, M. Simadibrata","doi":"10.24871/23120223-10","DOIUrl":"https://doi.org/10.24871/23120223-10","url":null,"abstract":"Background: Ulcerative colitis (UC), a chronic inflammatory disease that can cause bloody diarrhea, remains a major global disease burden. While Helicobacter pylori infection is postulated to be able to reduce the occurrence of UC, its role in the disease itself remains contentious. Hence, this meta-analysis aims to examine whether H. pylori infection can lower the chance of developing UC.Method: A systematic search was conducted through three electronic databases, namely Cochrane, PubMed, and Embase, with the addition of individual hand searching to analyze the association between ulcerative colitis and H. pylori infection in the adult population. Relevant articles selected through eligibility criteria were assessed for quality by using the Newcastle-Ottawa Scale. Furthermore, a random-effects meta-analysis was conducted to estimate the pooled odd ratios (ORs) along with their 95% confidence intervals (CIs). Higgins test and funnel plots were also conducted.Results: A total of 11,498 patients with UC and 356,130 controls from 22 studies were included in the meta-analysis. Included studies showed fair or good quality. Good quality was achieved with the minimum score of 3 stars for selection, 1 star for comparability, and 2 stars for outcome/exposure, while fair quality was achieved with the minimum score of 2 stars for domain, 1 star for comparability, and 2 stars for outcome/exposure. Our findings indicated that H. pylori infection was associated with lower odds of UC [pooled ORs 0.51 (95% CI: 0.46-0.56)]), albeit moderate heterogeneity (I2= 54%, p = 0.002). Furthermore, publication bias was not found.Conclusion: The present study adds to the growing body of evidence supporting the potential protective effects of H. pylori infection on the occurrence of UC. However, further primary research with prospective study design needs to be conducted to confirm our findings.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"330 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79723216","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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