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"Gastroesophageal reflux disease (GERD) adalah suatu kondisi kembalinya cairan lambung ke esofagus. Terapi akupunktur tanam benang telah menjadi salah satu terapi yang digunakan untuk alternatif terapi. Penelitian ini bertujuan untuk mengetahui perubahan kadar Nitrit Oksida (NO) serum setelah terapi akupunktur tanam benang dan medikamentosa. Uji acak tersamar tunggal dilakukan pada 50 responden dengan GERD yang di bagi kepada kelompok akupunktur tanam benang dan medikamentosa dibandingkan dengan kelompok akupunktur sham dan medikamentosa. Pemeriksaan kadar NO menjadi parameter yang dinilai pada saat sebelum perlakuan dan 30 hari setelah 2 kali terapi dengan durasi 15 hari sekali.Hasil penelitian menunjukkan terjadi kenaikan kadar NO pada kelompok perlakuan dibandingkan kelompok sham namun tidak ada perbedaan bermakna antara kedua kelompok. Kesimpulan penelitian ini akupunktur tanam benang belum terbukti secara statistik mempengaruhi kadar NO pada pasien GERD.

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OksidaGastroesophageal reflux disease (GERD ) is a condition that causes the return of gastric fluid into the esophagus. Catgut embedding acupuncture has become one of the therapies used for alternative therapies. This study aimed to determine changes in serum Nitric Oxide (NO) levels after catgut embedding acupuncture therapy and conventional medicine. Single -blind randomized trials is used on 50 respondents with GERD were divided to group catgut embedding acupuncture therapy and conventional medicine compared with sham acupuncture group and medicine. The level of NO into the parameters assessed at the time before treatment and 30 days after treatment with 2 times the duration of 15 days.

The results showed increased levels of NO in catgut embedding acupuncture therapy and conventional medicine group compared with sham acupuncture group and medicine but there was no significant difference between the two groups. The conclusion of this study catgut embedding acupuncture has not been proven statistically in influencing the levels of NO in patients with GERD."

"Latar Belakang: Penyakit refluks gastroesofageal GERD adalah suatu kondisi patologis akibat refluks isi lambung ke dalam esofagus. GERD merupakan penyakit yang ditimbulkan oleh berbagai faktor dengan prevalensi yang semakin meningkat di seluruh dunia. Interleukin 6 IL-6 adalah sitokin pro inflamasi ditemukan pada mukosa esofagus pasien GERD dan berkaitan dengan gangguan motorik otot esofagus. Akupunktur tanam benang telah lama dikenal sebagai salah satu terapi tambahan dalam menangani GERD. Penelitian ini bertujuan untuk mengetahui pengaruh terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap kadar IL-6 serum pasien penyakit refluks gastroesofageal.Metode: Uji klinis acak tersamar tunggal dilakukan pada 40 pasien GERD yang dialokasikan ke dalam kelompok akupunktur tanam benang dan medikamentosa atau kelompok akupunktur sham dan medikamentosa. Akupunktur tanam benang dilakukan pada titik CV12 Zhongwan, ST36 Zusanli, BL21 Weishu sebanyak 2 kali dengan interval 15 hari. Kadar IL-6 dalam plasma darah secara ELISA digunakan untuk mengukur keluaran penelitian.Hasil penelitian: Tidak ada perbedaan signifikan pada kadar IL-6 sebelum terapi di kedua grup. Pada akhir terapi didapatkan penurunan kadar IL-6 pada kelompok akupunktur tanam benang dan penurunan kadar IL-6 pada kelompok sham, namun secara statistik tidak ada perbedaan bermakna antara kedua kelompok p = 0.14.Kesimpulan: Akupunktur tanam benang belum terbukti secara statistik mempengaruhi kadar IL-6 pada pasien GERD. Kata kunci : GERD, akupunktur tanam benang, IL-6.

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Backgrounds: Gastroesophageal reflux disease GERD is a pathological condition due to reflux of stomach contents into the esophagus. GERD is multifactorial disorder with increase in prevalence worldwide. Interleukin 6 IL 6 is a pro inflammatory cytokine that is commonly found in esophageal mucosa of GERD patients and associated with esophageal motor disorders. Acupoint catgut embedment has long been known as an adjunctive therapy for GERD. This study aimed to establish the effect of acupoint catgut embedment combined with medication on IL 6 serum levels of patients with GERD.

Methods: A single blind, randomized controlled trial involved 40 GERD patients randomly allocated to catgut embedding therapy plus medication or sham acupuncture with medication. Catgut embedding therapy was given two times at CV12 Zhongwan, ST36 Zusanli, BL21 Weishu every 15 days. Serum levels of IL 6 were measured by ELISA as research output.

Results: There were no significant differences in the baseline levels of pro inflammatory IL 6 mediators between groups. After one month treatment, the median levels of IL 6 were statistically insignificant decreased in catgut embedding therapy plus medication vs sham acupuncture and medication p 0.14.

Conclusion: The results suggest that catgut embedding therapy has not been proven statistically influencing the levels of IL 6 in patients with GERD. Keywords GERD, catgut embedding therapy, IL 6."

"ABSTRAK Gastroesophageal reflux disease (GERD) merupakan suatu kondisi patologis yang disebabkan oleh refluks kandungan lambung ke dalam esofagus. GERD memiliki dampak yang besar terhadap penderitanya baik secara fisik, psikologik, sosial maupun ekonomi. Penurunan kualitas hidup dan produktifitas kerja sering ditemukan pada penderita GERD. Berbagai terapi farmakologis telah dikembangkan, namun belum memberikan hasil yang optimal. Hal tersebut mendorong pengembangan modalitas terapi lain, salah satunya akupunktur tanam benang. Penelitian ini bertujuan untuk mengetahui efektifitas terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap gejala dan kualitas hidup penderita GERD. Uji klinis acak tersamar ganda dengan pembanding dilakukan terhadap 52 penderita GERD yang dialokasikan secara acak ke dalam kelompok kombinasi akupunktur tanam benang dan medikamentosa (kelompok perlakuan) atau kelompok akupunktur sham dan medikamentosa (kelompok kontrol). Akupunktur tanam benang dilakukan pada titik CV12 Zhongwan, ST36 Zusanli dan BL21 Weishu sebanyak 2 kali dengan interval 15 hari. Skor GERDQ, RQS dan SF-36 digunakan untuk mengukur keluaran terapi. Hasil penelitian menunjukkan bahwa penurunan skor GERDQ pada kelompok perlakan lebih besar dari kelompok kontrol (p<0,001) dan peningkatan skor RQS serta peningkatan skor seluruh komponen SF-36 pada kelompok perlakuan lebih besar dibanding kelompok kontrol (p<0,001). Kesimpulan penelitian adalah terapi kombinasi akupunktur tanam benang dan medikamentosa lebih efektif dalam mengurangi gejala dan meningkatkan kualitas hidup penderita GERD dibandingkan dengan terapi medikamentosa saja ABSTRACT Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients."

"Latar belakang: Pada saat puasa Ramadhan, terjadi penurunan rerata pH lambung dan memendeknya selisih waktu antara makan terakhir dan jam tidur sehingga memperberat keluhan Penyakit Refluks Gastroesofageal (Gastro-esophageal Reflux Disease, disingkat GERD). Sementara itu juga terjadi keteraturan jadwal makan, dan perubahan dalam kebiasaan merokok dan alkohol. Meski demikian, belum diketahui dengan pasti keluhan penyakit GERD selama berpuasa Ramadhan.Tujuan: Mengetahui pengaruh puasa Ramadhan terhadap keluhan GERD.Metode: Penelitian ini merupakan studi longitudinal yang mengevaluasi keluhan GERD pada pasien yang menjalani puasa Ramadhan. Penelitian dilakukan selama bulan Juli (Ramadhan) sampai bulan Oktober (tiga bulan setelah Ramadhan) 2015. Subjek penelitian yang didapatkan melalui metode consecutive sampling ini dikelompokkan menjadi kelompok berpuasa Ramadhan (n=66) dan kelompok tidak berpuasa Ramadhan (n=64). Evaluasi dilakukan antara kedua kelompok tesebut, dan antara bulan Ramadhan dengan di luar bulan Ramadhan pada kelompok berpuasa, dengan menggunakan kuesioner GERD (GERD-Q) yang telah diterjemahkan dalam bahasa Indonesia.Hasil: Pada kelompok yang berpuasa Ramadhan, terdapat perbedaan median nilai GERD-Q yang bermakna secara statistik (nilai p < 0,01) antara bulan Ramadhan dengan nilai median 0, dan di luar bulan Ramadhan dengan nilai median yang meningkat menjadi 4. Sementara itu, bila dilakukan analisis untuk membandingkan median nilai GERD-Q antara kelompok yang berpuasa Ramadhan dan tidak, juga didapatkan perbedaan yang bermakna (nilai p < 0,01).Simpulan: Pada subjek yang menjalani puasa Ramadhan, keluhan GERD dirasakan lebih ringan saat menjalani puasa Ramadhan dibandingkan di luar bulan Ramadhan. Di bulan Ramadhan, keluhan GERD lebih ringan dirasakan oleh subjek yang menjalani puasa Ramadhan dibandingkan subjek yang tidak menjalani puasa Ramadhan.

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Background: During Ramadan fasting, increasing gastric acid levels as a result of prolong fasting can precipitate symptoms of Gastroesophageal Reflux Disease (GERD). Meanwhile, lifestyle changes during Ramadan (such as smoking cessation) can relieve its symptoms. To the best of our knowledge, this is the first study to evaluate effect of Ramadan fasting on GERD.

Objective: The purpose of this study was to determine the effect of Ramadan fasting on GERD symptoms.

Method: This is a longitudinal study done in July (Ramadan) to October (three months after Ramadan) 2015. Using consecutive sampling method, a total of 130 GERD patients participated in this study. Patients were divided into two groups: patients who underwent Ramadan fasting (n=66), and patients who didn?t undergo fasting (n=64). The evaluation was done using Indonesian version of GERD questionnaire (GERD-Q) between the two groups, and between Ramadan month and non-Ramadan month of Ramadan fasting group.

Results: In Ramadan fasting group, there was a statistically significant difference (p < 0.01) in median of GERD-Q during Ramadan month and non-Ramadan month (median GERD-Q 0 and 4 respectively). Statistically significant difference (p < 0.01) was also found between Ramadan fasting group and non-fasting group.

Conclusion: In Ramadan fasting group, GERD symptoms were lighter during fasting month (Ramadan). During Ramadan month, GERD symptoms were also lighter in Ramadan fasting group than in non-fasting group."

"Gastroesophageal Reflux Disease (GERD) merupakan salah satu penyakit pada sistem pencernaan yang sering dijumpai di Indonesia. GERD adalah refluks isi lambung ke esophagus yang sudah berlangsung lama dan menimbulkan gejala yang dapat mengganggu atau menurunkan kualitas hidup. Salah satu penatalaksanaan yang dapat dilakukan yaitu dengan pemberian posisi head of bed elevation 30 derajat untuk mencegah terjadinya refluks isi lambung. Penelitian ini dilakukan untuk mengetahui keefektifan penerapan intervensi head of bed elevation 30 derajat pada pasien GERD untuk mengurangi gejala refluks. Intervensi ini dilakukan pada An. M selama 3 hari dan hasilnya menunjukan bahwa efektif untuk mengurangi gejala refluks dan menurunkan keinginan untuk muntah, terutama pada malam hari. Intervensi dilakukan selama 30 menit setelah makan. Intervensi juga dikombinasikan dengan pemberian medikasi dan edukasi kepada pasien dan keluarga. Pemberian posisi head of bed elevation 30 derajat direkomendasikan pada pasien GERD untuk mengurangi gejala refluks, mual, dan muntah karena mudah dilakukan saat perawatan di rumah dan tidak membutuhkan biaya.

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Gastroesophageal Reflux Disease (GERD) is a disease of the digestive system that is often found in Indonesia. GERD is reflux of gastric contents into the esophagus which can cause symptoms that can reduce quality of life. One of the treatments for GERD patients is by giving a head of bed elevation position of 30 degrees to prevent reflux of gastric contents. The purpose of this study was to determine whether the application of a 30-degree head of bed elevation intervention in GERD patients was effective in reducing the symptoms of nausea and vomiting. This intervention was performed on An. M for 3 days and has been shown to reduce nausea and reduce the urge to vomit, especially at night. The intervention was carried out for 30 minutes after eating. Interventions are also combined with providing medication and education to patients and families. Giving a head of bed elevation position of 30 degrees is recommended for GERD patients to reduce symptoms of nausea and vomiting because it is easy and safe to do."

"Latar Belakang: Pemeriksaan impedans intraluminal multikanal dan pemantauan pH (MII-pH) baru diperkenalkan untuk mengevaluasi karakteristik refluksat pada pasien gastroesophageal reflux disease (GERD). Penggunaan MII-pH untuk prediksi hasil terapi empiris proton-pump inhibitor (PPI) belum dievaluasi.Tujuan: Mengevaluasi pola refluksat menggunakan MII-pH untuk memprediksi respons terapi empiris dengan PPI pasien GERD.Metode: Penelitianini merupakan studi prospektif dengan desain before-and-after treatment. Pasien direkrut dari Poliklinik Gastroenterologi, Departemen Ilmu Penyakit Dalam RS Cipto Mangunkusumo antara Desember 2015 dan Februari 2016. Diagnosis GERD ditegakkan menggunakan kuesioner GERD (GerdQ). Endoskopi saluran cerna atas dilakukan untuk membedakan erosive (ERD) dannon-erosive reflux disease (NERD). Semua pasien menjalani pemeriksaan MII-pH evaluasi yang terdiri dari bentuk refluksat (cair, gas atau campuran); jenis refluksat (asam atau non-asam); dan persentase acid exposure time (AET). Kemudian pasien mendapat terapi PPI oral, dua kali sehari selama 14 hari. Respons terapi dievaluasi dengan GerdQ. Prediktor respons terapi dianalisis menggunakan analisis multivariat.Hasil: Sejumlah 75 pasien dilibatkan dalam studi; 39 (52%) di antaranya adalah perempuan. Rerata usia adalah 40,4+10,20 tahun. Rerata skor GerdQ awal adalah 14 dan turun sampai 8 setelah terapi PPI empiris (p<0,001; uji t berpasangan). Sebanyak 41 (54,7%) pasien responsif terhadap terapi PPI. Respons terapi berhubungan dengan jenis GERD (OR: 3,763; IK95%: 1,381-10,253; p=0,008);jenis refluksat (OR: 10,636; IK95%: 2,179-51,926; p=0,001);dan AET (OR: 5,357; IK95%: 1,974-14,541; p=0,001). Analisis multivariat mendapatkan dua prediktor independen terhadap terapi PPI, yaitu jenis refluksat (ORadj:6,273; IK95%: 1,207-32,609; p=0,029) dan AET (ORadj: 3,363; IK95%: 1,134-9,974; p=0,029).Kesimpulan: Terdapat perbedaan respons terapi empiris PPI dimana ERD lebih responsif dari NERD, refluks asam lebih responsif dari non asam dan AET tinggi lebih responsif dari pada AET normal. Keberhasilan terapi empiris PPI dapat diprediksi dari jenis refluksat dan nilai AET.

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Background: Combinedmulti-channel intraluminal impedance and pH monitoring (MII-pH) has been recently introduced to characterize patients with gastroesophageal reflux disease (GERD). The use of MII-pH to predict initial treatment response with proton-pump inhibitor (PPI) has not been evaluated.

Objective: To evaluate refluxate patterns using MII-pH to predict initial treatment response using PPI for GERD patients.

Method: This was a prospective study using before-and-after treatment design. Patients were enrolled in the Gastroenterology Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital between December 2015 and February 2016. Diagnosis of GERD was established using GERD questionnaires (GerdQ).Upper endoscopy was done to distinguish erosive (ERD) and non-erosive reflux disease (NERD). All patients underwent MII-pH evaluation consisting of physical characteristics of the refluxate (liquid, gas or mixed); type of refluxate (acid or non-acid); and percent acid exposure time (AET). Then patients were given oral PPI treatment, twice a day, for 14 days. Treatment response was evaluated using GerdQ. Predictor of treatment response was analyzed using multivariate analysis.

Results: A total of 75 patients was enrolled; 39 (52%) of them were women. Mean age was 40.4+10.20 years. Initial mean GerdQ score was 14 and reduced to 8 after empirical PPI therapy (p<0.001; paired t test).Forty-one (54.7%) patients responded to PPI therapy.Treatment response was associated with type of GERD (OR: 3.763; 95%CI: 1.381-10.253; p=0,008;) type of refluxate (OR: 10.636; 95%CI: 2.179-51.926; p=0.001); and AET (OR: 5.357; 95%CI: 1.974-14.541; p=0.001). Multivariat analyses found two independent predictors of treatment response to PPI therapy, i.e. the type of refluxate(ORadj:6.273; 95%CI: 1.207-32.609; p=0.029) and AET (ORadj: 3.363; 95%CI: 1.134-9.974; p=0.029).

Conclusion: There are differences in response to empiric PPI therapy where ERD is more responsive than NERD, acid reflux is more responsive than non- acid and high AET is more responsive than a normal AET . PPI empirical therapy success can be predicted from the type and value refluksat AET."

"Obesitas merupakan suatu keadaan dengan akumulasi lemak yang tidak normal atau berlebihan di jaringan adiposa sehingga dapat mengganggu kesehatan. Diperkirakan lebih dari 500 juta orang dewasa di seluruh dunia mengalami obesitas dan 1,5 miliar mengalami masalah kelebihan berat badan. Pada obesitas terdapat peningkatan jaringan adiposa dimana jaringan adiposa dapat mensintesis dan mensekresi sitokin pro-inflamasi seperti interleukin-6 (IL-6). Akupunktur telah lama dikenal sebagai salah satu terapi tambahan dalam menangani obesitas. Akupunktur dapat menurunkan respon inflamasi pada jaringan adiposa dengan menurunkan infiltrasi makrofag ke dalam jaringan adiposa pada obesitas sehingga jumlah makrofag yang merupakan sumber produksi adipokin pro-inflamasi menjadi lebih sedikit. Penelitian ini bertujuan untuk mengetahui pengaruh terapi akupunktur tanam benang catgut dan intervensi diet terhadap perubahan kadar IL-6 dan indeks massa tubuh pada pasien obesitas. Uji klinis acak tersamar ganda dilakukan pada 36 pasien obesitas yang dialokasikan ke dalam kelompok akupunktur tanam benang catgut dan intervensi diet atau kelompok akupunktur tanam benang sham dan intervensi diet. Akupunktur tanam benang dilakukan 2 kali pada titik CV12 Zhongwan, ST25 Tianshu, CV6 Qihai, dan SP6 Sanyinjiao setiap 2 minggu. Kadar IL-6 dalam plasma darah dan indeks massa tubuh digunakan untuk mengukur keluaran penelitian. Hasil penelitian menunjukkan perbedaan bermakna rerata kadar IL-6 awal dengan akhir dalam kelompok akupunktur tanam benang catgut (p = 0.01; 95% IK: 0.03 sampai 0.23) dan rerata selisih IMT lebih rendah 0.33 pada kelompok akupunktur tanam benang catgut dibandingkan dengan kelompok akupunktur tanam benang sham (p = 0.02; 95% IK: 0.05 sampai 0.61). Kesimpulan penelitian adalah terapi kombinasi akupunktur tanam benang catgut dan intervensi diet lebih efektif dalam menurunkan kadar IL-6 dan indeks massa tubuh pada pasien obesitas.

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Obesity is a condition with abnormal fat accumulation or excessive adipose tissue so it can disturb our health. It is estimated that over 500 million adults worldwide are obese and 1.5 billion are having problems with overweight. In obese there is an increased adipose tissue which can synthesize and secrete pro-inflammatory cytokines such as interleukine-6 (IL-6). Acupuncture has long been known as an adjunctive therapy for obesity. Acupuncture can reduce inflammatory responses in adipose tissue by reducing macrophage infiltration into adipose tissue in obesity so that the number of macrophages, which are the source of production of pro-inflammatory adipokines become fewer. A double blind randomized controlled trial involved 36 obesity patients randomly allocated into catgut embedding acupuncture group with diet intervention or sham embedding acupuncture group with diet intervention. Catgut embedding therapy was given two times at CV12 Zhongwan, ST25 Tianshu, CV6 Qihai, and SP6 Sanyinjiao every two weeks. Interleukine-6 level in blood plasma and body mass index (BMI) is used to measure research output. There was a statistically significant difference within catgut embedding group with levels of IL-6 (p = 0.01; 95% CI: 0.03 to 0.23) and lower mean BMI difference of 12.33 in catgut embedding group compared with sham embedding group (p = 0.02; 95% CI: 0.05 to 0.61). The result suggest that acupoint-catgut embedding therapy combined with diet intervention is more effective in reducing IL-6 levels and BMI in obese patients."

"LATAR BELAKANG: Kualitas hidup telah menjadi salah satu komponen utama dalam penanganan Gastroesophageal Reflux Disease GERD . Penelitian ini bertujuan untuk menilai kesahihan eksternal kuesioner GERD-QOL berbahasa Indonesia.METODE:. Penelitian ini merupakan penelitian potong lintang dengan subyek penelitiannya adalah pasien yang mengalami gejala GERD dan berusia 18 tahun atau lebih yang berobat ke Rumah Sakit Umum Kecamatan RSUK Tebet. Total skor GERD-Q minimal adalah 8. Pasien kemudian diminta mengisi kuesioner GERD-QOL berbahasa Indonesia dan kuesioner SF-36. Kuesioner Short Form SF-36 digunakan sebagai baku emas kuesioner penilaian kualitas hidup. Uji kesahihan dilakukan dengan menggunakan kesahihan eksternal. Uji statistik yang digunakan adalah koefisien korelasi Spearman.HASIL: Penelitian ini melibatkan 91 subyek.Korelasi domain physical functioning : 0,488; role physical : 0,590; bodily pain : 0,474; general health : 0,482; vitality : 0,549; social functioning : 0,700; role emotional : 0,555; mental health : 0,373. Kuesioner GERD-QOL berbahasa Indonesia memiliki kesahihan eksternal yang baik ketika dilakukan korelasi dengan domain pada kuesioner SF-36 koefisien korelasi : 0,373-0,700, P

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Quality of life has become major concern in the management of Gastroesophageal Reflux Disease GERD . The aim of this study was to determine the external validity of the Indonesian Version of Gastroesophageal Reflux Disease Quality of Life GERD QOL questionnaire. METHODS This cross sectional study consisted of subjects who developed symptoms of GERD and aged 18 years or more. The subjects were recruited from district public hospital in Tebet. Total score for GERD Q was at least 8. These patients were invited to complete the Indonesian version of GERD QOL and validated Indonesian Short Form 36 SF 36 . External validity was then evaluated using Spearman rsquo s correlation coefficient.RESULT A total of 91 subjects completed the questionnaires. The coeeficient correlation of domain physical functioning 0,488 role physical 0,590 bodily pain 0,474 general health 0,482 vitality 0,549 social functioning 0,700 role emotional 0,555 mental health 0,373. The Indonesian version of GERD QOL questionnaire was externally valid compared to domain of SF 36 questionnaire correlation coefficient 0.373 0.700, P"

"Latar belakang: Prevalensi penyakit refluks gastroesofageal (PRGE) cenderung mengalami peningkatan di Indonesia. Kondisi PRGE dapat menimbulkan gangguan pertumbuhan dan perkembangan pada anak. Namun, untuk menentukan diagnosis PRGE masih sulit dilakukan karena gejala yang ditimbulkan tidak spesifik, alat diagnostik yang hanya tersedia di rumah sakit besar dan data epidemiologi di Indonesia masih kurang.Tujuan: Untuk mengetahui gambaran patologi anatomi anak dengan PRGE yang dilakukan pemeriksaan endoskopi saluran cerna atas di Departemen IKA RSCM-FKUI, serta hubungannya dengan kelompok usia dan status gizi.Metode: Penelitian ini menggunakan desain potong lintang (cross-sectional) dengan subjek 76 pasien anak usia 2-18 tahun dengan PRGE yang dilakukan pemeriksaan esofagogastroduodenoskopi yang memenuhi kriteria inklusi. Pengambilan data status rekam medis pasien di Departemen IKA RSCM-FKUI pada Januari 2011 hingga Oktober 2015.Hasil: Pada 76 pasien anak dengan PRGE yang dilakukan endoskopi didapatkan hasil anak lelaki dibandingkan perempuan adalah 4,1:3,5 dengan mayoritas kelompok usia sekolah (70%) dan status gizi malnutrisi (60%). Terdapat perbedaan bermakna pada hasil endoskopi berdasarkan kelompok usia yaitu ditemukannya infeksi H.Pylori pada 24% anak usia sekolah (p=0,013). Hasil endoskopi terkait status gizi secara bermakna (p=0,049) menunjukkan bahwa hiperemis pada lambung lebih banyak ditemukan pada pasien dengan status gizi malnutrisi (45/72 anak) dibandingkan dengan gizi baik (24/72 anak). Kelainan patologi anatomi anak dengan PRGE tidak berbeda antara kelompok usia maupun status gizi.Kesimpulan: Anak yang mengalami PRGE lebih banyak terjadi pada usia sekolah dengan status gizi malnutrisi. Terdapat perbedaan bermakna pada hasil endoskopi anak dengan PRGE berdasarkan kelompok usia dan status gizi. Kelainan patologi anak dengan PRGE tidak berbeda menurut kelompok usia maupun status gizi.

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Background: The prevalence of gastroesophageal reflux disease (GERD) has increased recently in Indonesia. The condition of GERD can impaired growth and development in children. However, to determine diagnosis of GERD is difficult because the symptoms are non-spesific, diagnostic tools are only available in large hospitals, and epidemiological data Indonesia still less.

Aim: To evaluate the anatomical pathology of GERD in children and the correlation according to age group and nutritional status.

Methods: This was a cross-sectional study comparing GERD anatomic pathology findings and its relation to age group and nutritional status. The data were evaluated from 76 subjects aged 2-to-18-years old who underwent esophagogastroduodenos-copy (EGD) that fullfiled inclusion criteria. The data based on the medical record of endoscopic procedure at Child Health Department of Cipto Mangun-kusumo Hospital – Faculty of Medicine of Universitas Indonesia (RSCM-FKUI) from January 2011 to October 2015.

Results: Among 76 children with GERD whom underwent EGD, the boy compare to girl was 4.1:3.5 and most of them (70%) were school-aged chidren with malnutrition (60%). The prevalence of H. pylori infection was 24% and it was significantly higher in school-aged group than under-five group (p=0,013). The macroscopic appearance of endoscopy in relation to nutritional status was significantly (p=0.049) more hyperemic stomach wall in malnutrition group (45/72 children) compare to that of good nutritional status group (24/72 children). The abnormality of upper gastrointestinal pathology was not statistically different (p>0.05) in both aged groups and nutritional status groups.

Conclusion: Children suffered from GERD were more often at school age and had malnutrition condition. There were significant different of endoscopic findings of children with GERD in regards to age groups and nutritional status groups. The abnormality of pathologic findings of GERD in children were not significantly different between age-groups and nutritional status groups."

"Latar belakang. Refluks gastroesofagus (RGE) dengan gejala klinis regurgitasimerupakan manifestasi gastrointestinal yang sering dijumpai pada bayi. Penelitianmenunjukkan bahwa prevalens regurgitasi menurun setelah usia 6 bulan sedangkan gejalaklinis penyakit refluks gastroesofagus (PRGE) didapatkan pada anak di atas 1 tahun yangmemiliki riwayat regurgitasi sering pada usia di atas 6 bulan. Infant gastroesophagealreflux questionnaire (I-GERQ) merupakan sarana diagnosis PRGE yang tidak invasif danmemiliki nilai prediktif positif yang baik.Tujuan. Penelitian ini bertujuan untuk mengetahui insidens PRGE, karakteristik bayiyang mengalami regurgitasi, skor I-GERQ dan gejala yang berkaitan dengan PRGE,faktor-faktor risiko yang berkaitan dengan gejala regurgitasi yang menetap hingga akhirpemantauan, dampak regurgitasi terhadap peningkatan berat badan dan pola makanMetode. Penelitian longitudinal prospektif pada subjek dengan regurgitasi minimal1x/hari setidak-tidaknya 4x/minggu. Kriteria eksklusi adalah bayi atopi, mengi berulang,dicurigai alergi susu sapi, kelainan neurologis, terdiagnosis tuberkulosis, riwayat operasisaluran cerna sebelumnya, pernah mencapat terapi antogonis reseptor H2 ataupenghambat pompa proton. Subjek sesuai PRGE jika skor I-GERQ >7, dan dirujuk keRumah Sakit Cipto Mangunkusumo. Pemantauan dilakukan setiap bulan pada subjekdengan I-GERQ ≤ 7, dengan menilai skor I-GERQ dan pengukuran antropometris.Hasil. Sebanyak 131 dari 352 subjek yang memenuhi kriteria penelitian. Subjek sebagianbesar berusia 6 bulan (51,1%), status antropometris sesuai (85,5%), dan mendapat asupandengan median frekuensi 14 (5-15) x/hari. Median skor I-GERQ saat awal pemantauanadalah 4 (3-7). Sebanyak 81,9% subjek mencapai skor I-GERQ nol saat akhirpemantauan. PRGE didapatkan pada 1 subjek saat pemantauan pertama dengan gejalaberat badan sulit naik, regurgitasi 3-5x/hari, volume regurgitasi >15 mL. Variabelpemberian ASI eksklusif, paparan rokok, keluarga dengan alergi, keluarga dengan RGE,dan terapi non-farmakologis tidak berkaitan dengan gejala regurgitasi yang menetaphingga akhir pemantauan. Gejala regurgitasi hingga akhir pemantauan didapatkan pada13,7% subjek yang mengikuti saran terapi non-farmakologis dibandingkan dengan 86,4%yang tidak mendapat dan tidak mengikuti edukasi (p = 0,14). Perbedaan rerata z-scoreberat badan berdasarkan usia pada subjek yang masih mengalami gejala regurgitasihingga akhir pemantauan adalah -0,006 ± 0,357 (IK 95% -0,164; 0,152), p = 0,939.Kesulitan makan didapatkan pada 19 subjek dan 17 diantaranya tidak lagi mengalamiregurgitasi saat akhir pemantauan.Simpulan. Insidens PRGE adalah 0,7%. Sebagian besar subjek mencapai skor I-GERQsaat akhir pemantauan. Terapi non-farmakologis walaupun tidak bermakna secarastatistik dengan gejala regurgitasi yang menetap hingga akhir pemantauan namundidapatkan perbedaan proporsi. Gangguan peningkatan berat badan dan kesulitan makantidak berhubungan dengan gejala regurgitasi yang menetap hingga akhir pemantauan.Kata kunci: bayi, refluks gastroesofagus, penyakit refluks gastroeosfagus, infantgastroesophageal reflux questionnaire

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Background. Regurgitation as symptom of gastroesophageal reflux (GER) is a common

gastrointestinal manifestation in infant. Publications showed that regurgitation will

decrease after 6 month old; whereas symptoms of gastroesophageal reflux disease

(GERD) is more prevalent in children with history of frequent regurgitation after 6 month

old. Infant gastroesophageal reflux questionnaire (I-GERQ) is a non-invasive diagnostic

tool for GERD with high positive predictive value.

Aim. To investigate the incidence of GERD, characteristics of infants with regurgitation,

I-GERQ score and manifestation of GERD, risk factors that related with regurgitation

symptom that persists at the end of follow-up, correlation of regurgitation with weight

gain and feeding problems.

Method. A Longitudinal prospective study in subjects with regurgitation at least 1

time/day; 4 times/week. We excluded infants with atopy, recurrent wheezing, probable

cow milk allergy, diagnosed as tuberculosis, neurologic disorder, history of

gastrointestinal surgery, history of H2 receptor antagonist or proton pump inhibitor

treatment. I-GERQ score and anthropometric status were measured at enrollment.

Subjects with GERD (I-GERQ >7) were referred to Cipto Mangunkusumo Hospital.

Follow-up of I-GERQ, body weight, and body length in every month were performed in

subjects with I-GERQ ≤7.

Results. 131 of 352 subjects fulfilled the criteria. Subject mostly were 6 month old

(51.1%), normal anthropometric status (85.5%), and have frequent intake with median 14

(5 – 15) times/day. Median of I-GERQ at enrollment were 4 (3 – 7), and at the end of

follow-up 81.9% subjects reached I-GERQ score 0. GERD were found in 1 subject at first

month follow-up with poor weight gain, regurgitation 3-5 times/day, regurgitation>15

mL. Exclusively breastfeeding, smoke exposure, family history of allergy and GER, and

non-pharmacotherapy were not related with regurgitation that persists until 3 months

follow-up. Regurgitation at the end of follow-up were found in 13.7% subjects who

complied with non-pharmacotherapy; compared to 86.4% who have not complied nor had

educated (p = 0.14). Mean difference of weight for age z-score in subjects with

regurgitation at the end of follow-up were -0.006 ± 0.357 (95%CI -0.164; 0.152), p =

0.939. Feeding problems were found in 19 subjects while 17 of them no longer have

regurgitation symptom at the end of follow-up

Conclusion. Incidence of GERD is 0.7%. Most of subjects reached I-GERQ 0 at the end

of follow up. Non-pharmacotherapy showed no statistically significant with regurgitation

symptom at the end of follow up, but we found proportion difference. Weight gain and

feeding problems are not related with regurgitation symptom that persists at the end of

follow up"