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"ABSTRAKAim: to know the effectiveness of probiotic in reducing hepatic inflammation among non-alcoholic fatty liver disease (NAFLD) patients. Methods: we performed literature searching regarding the potential role of probiotic in reducing hepatic inflammation among NAFLD patients. Results: six articles were finally critically appraised. All six studies had good validity and importance. These studies unanimously reported that probiotic is useful in reducing hepatic inflammation, and liver fat content. However, further evidence is needed to show whether or not probiotic is beneficial reducing cirrhosis progression and liver-related mortality. Conclusion: probiotic owns robust potential to treat NAFLD. Probiotic reduce hepatic inflammation, as shown by the reduction of liver aminotransferase, and inflammatory markers. Based on this evidence based report, probiotic is a promising adjunct therapy for NAFLD."

"AbstrakA 43-year old male presented with persistent discomfort and pain upper abdomen (epigastrium) more on left side associated with fever on and off, along with fatigue and loss of appetite for the last four months. Physical examination revealed mass on left hypochondrium extending to epigastrium with mild distension of the abdomen. Imaging studies of the patient showed dextrocardia on chest x-ray postero-anterior (PA) view, thoracic and abdominal CT scan showed situs inversus totalis with multiple SOL (space occupying lesion) in right lobe of liver with largest measuring 8x6 cm2 in the 4th segment. USG-guided FNAC of the mass showed features of hepatocellular carcinoma. Thereupon, hepatocellular carcinoma in situs inversus totalis was diagosed to this patient and was clinically staged as T3aN0M0. He was given sorafenib 400 mg orally twice daily with an advice to come for regular assessment every 4 week."

"ABSTRAKWe reported a male, 72 yo, Chinese ethnic with chief complaint black mushy defecation. Physical examination revealed pale on conjunctival palpebra which confirmed as anemia on complete blood count. Gastroduodenoscopy revealed a 3 mm ulcer at the antrum (Forrest stage III). H. pylori infection was positive based on five different test methods (urinary antibody tests, rapid urease test, culture, histology ad immunohistochemistry). Used polymerase chain reaction-based sequencing, we found the patient infected by CagA producing, East-Asian-type cagA and vacA s1m1-strain. Further analysis using 7 housekeeping genes confirmed that the strain categorized in to hspEAsia group. The patient was given continuous intravenous infusions of proton pump inhibitor and standard triple therapy regimens eradication of H. pylori."

"Pneumonia kemunitas adalah infeksi akut pada paru-paru yang tidak memilki riwayat rawat inap dalam waktu dekat atau tidak terpapar dengan perawatan medis secara teratur. Terdapat dua sistem skoring untuk menentukan prognosis pneumonia komnitas yaitu pneumonia severity index (PSI) and CURB-65. Pnemonia Serverity Index (PSI) lebih rumit dalam penghitungannya dibandingkan CURB-65 dimana PSI menilai 19 variabel sementara CURB-65 hanya 5 variabel. Tujuan menentukan apakah pneumonia serverity index (PSI) score lebih superior dibandingkan skor CURB-65.Metode pencarian literatur dilakukan menggunakan pubmed dan OVID Medline. Literatur dipilih bila tidak lebih lama dari 10 tahun, dan bukan review articel. Enam Literatur memenuhi kriteria dan dimasukan dalam analisis. Hasil lima literatur menyatakan bahwa PSI lebih akurat dalam menentukan dalam prognosis mortalitas 30 hari dan kebutuhan ICU pada pasien risiko tinggi (PSI kelas IV/V and skor CURB-65>3). satu literatur ( Luque et al ) menemukan bahwa CURB-65 sama akuratnya dalam menentukan prognosis mortalitas 30 hari pasien pnemonia komunitas secara keseluruhan. Kesimpulan skor PSI lebih dipilih dibandingkan skor CURB-65 dalam menentukan prognosis mortalitas 30 hari pasien secara keseluruhan pada pasien pneumonia kemunitas."

"ABSTRAKDuring 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO). There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE) were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents.The size of PDA ranged from 1.6 mm to 11.1 mm. Based on Kritchenko classification, the type of PDA were 15 type A1 and 3type A2. Flow ratio between pulmonary to systemic circulation was between 1.1 and 5.9. The procedure time ranged from 60-189 minutes and the fluoroscopic time 7.1-77.3 minutes. The PA pressure ranged from 22 to 63 mmHg. Immediate results after procedures as seen in angiography showed complete closure in 14 cases and smoky residual shunt or minimal residual shunts in 4 cases, which probably due to the temporary leaking through the devices. In 24 hours, complete closure was achieved in all cases (100%) and continued until 1months. At 6 month follow up, there was no residual shunts detected and also there was no significant complications, such as device embolization or recanalization. This case series suggest that transcatheter closure of PDA in adolescents and adults using Amplatzer duct occluder (ADO) is effective and has excellent resultswithout significant complication. However, long-term follow up is required to assess long term efficacy and safety."

"latar belakang : Esofagitis refluks merupakan kondisi yang cukup sering ditemukan pada pasien usia lanjut. kejadian kanker esofagus, dimana esofagitis merupakan faktor resiko penting masih dianggap jarang di kebanyakan negara Asia. banyak faktor risiko lain penyebab kejadian kanker esofagus masih banyak belum diketahui. studi ini ditujukan untuk mencari prevalensi esofagitis refluks pada pasien usia lanjut faktor-faktor yang berhubungan.metode: studi ini adalah studi potong lintang pada kelompok usia lanjut yang menjalani prosedur pemeriksaan endoskopi saluran cerna atas. pasien yang sudah mendapatkan terapi penghambat pompa proton jangka panjang pasien dengan kegemasan saluran cerna, pasien yang baru saja mendapatkan obat kemoterapi, pasien dengan kelainan otak dan pembuluh darah dan juga pasien yang terbukti terdapat infeksi kuman H. pylori dieksklusi analisis statistik dilakukan dengan menggunakan program SPSS versi 17 (Chicago, IIlinois, USA).hasil : dari 238 pasien usia lanjut didapatkan esophagitis refluks sebanyak 22 (9,2%) pasien, rerata usia pasien adalah 69.8± 6.8 tahun. beberpa komorbiditas yang ditemukan seperti, diabetes, hipertensi, penyakit jantung korner, penyakit ginjal kronik, dan sirosis hari. satu-satunya faktor yang berhubungan dengan kejadian esofagitis refulks adalah adanya hernia hiatus esofagus (p = 0,038), tetai, esofagitis refulks cenderung ditemukan lebih banyak pada pasien usia lanjut yang memilki riwayat konsumsi obat yang bisa ,encetuskan kondisi refulks tanpa adanya perlindungan anti asam.simpulan: esofagitis refluks masih merupakan masalah besar pada pasien usia lanjut. terdapatnya hernia hiatus bisa memberikan pertimbangan penting untuk dilakukanya pemeriksaan penyaring endoskopi saluran cerna atas. tetapi hal ini masih menjadi perbedaan dengan mempertimbangkan beban biaya dan rendahnya kejadian kanker esofagus di sebagian besar negara Asia."