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"GERD is a condition that gastric content go back into the esophagus. This condition could came disturbances in the respiratory tract, heart and otolaryng. Those extra-esophageal clinical manifestation are common but often miss our attention. So it is important to explorate it further. The management of extra-esophageal GERD is similar with management of GERD. It is included life style modification and reducing refluxate with controlling pH with aggressiveness."

"Even though there are still no epidemiological data on the prevalence of Gastro Esophageal Reflux Disease (GERD) in Indonesia, data from The Division of Gastroenterology Department of Internal Medicine Cipto Mangunkusumo Hospital demonstrate signs of esophagitis in 22.8% of all patients with dyspepsia who underwent endoscopic examination. Western countries report a higher rate of GERD than Asian and African countries, possibly due to dietary factors and increased obesity. Besides adequate history and physical examination, there are many other supporting examinations that could be performed to establish the diagnosis of GERD, especiaily endoscopy of the upper gastrointestinal tract and 24-hour esophageal pH monitoring. Even though this condition is rarely fatal, GERD patients should still receive adequate management. Most patients demonstrate a satisfactory response towards therapy which inciudes Iife-style modification as well as medication. Currently the drugs of choice for GERD are proton-pump inhibitors. A combination of proton-pump inhibitors and prokinetics produces a better effect. Patients resistant to medical treatment or those with recurrent esophageal stricture should be considered for anti-reflux surgery."

"Proton pump inhibitors (PPls) are the most effective anti secretory drugs available for controlling gastricacid acidity and volume. They are the drug of choice in the treatment for gastro esophageal reflux disease(GERD), Helicobacter pylori eradication, peptic ulcer and non steroidal anti-inflammatory drug (NSAID)gastropathy. For acute cases, on intravenous PPI is needed, especially for hospitalized patient. Recently,intravenous pantoprazole represents an alternative to intravenous histamine-2 receptor antagonists. Weobserved 2 patients who were treated with pantoprazole for duodenal ulcer; where one case had acomplication of bleeding with a history of long term use of NSAID. After two weelrs of treatment withpantoprazole, significant lesion healing from endoscopy findings was achieved in both cases."

"Insulin resistance is the disturbance of glucose regulation characterized by higher insulin level. In clinical context, insulin resistance can manifest as abnormalities that are related with cardiovascular event risk, known as metabolic syndrome. Several studies had reported that insulin resistance was associated with erosive esophagitis in patients with gastroesophageal reflux disease (GERD).

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Resistensi insulin merupakan gangguan dalam regulasi glukosa yang ditandai dengan peningkatan kadar insulin. Dalam konteks klinik, resistensi insulin dapat bermanifestasi sebagai sindrom metabolik yang memiliki risiko kejadian kardivaskular yang tinggi. Beberapa studi telah melaporkan bahwa resistensi insulin berhubungan langsung terhadap adanya esofagitis erosif pada pasien dengan penyakit refluks gastroesofageal (GERD). Dalam tinjauan pustaka ini, kami akan menelaah pemahaman terbaru yang dapat menjelaskan adanya resistensi insulin pada pasien dengan penyakit refluks gastroesofageal."

"Latar belakang: Prevalensi PRGE makin meningkat di Indonesia. Diagnosisnya sendiri masih sulit karena biasa dilakukan hanya berdasarkan gejala klinis yang sifatnya terlalu umum. Selain itu data mengenai gejala klinis PRGE anak di Indonesia masih minim, padahal akibat dari PRGE pada anak cukup mengganggu proses tumbuh kembangnya.Tujuan: Untuk mengetahui gejala klinis apa saja yang sering dan memiliki hubungan bermakna dengan usia dan status gizi pada anak dengan PRGE yang dilakukan endoskopi saluran cerna atas di Departemen IKA RSCM-FKUI.Metode: Penelitian ini menggunakan desain potong lintang (cross-sectional) untuk membandingkan prevalensi gejala klinis PRGE pada anak dan kaitannya dengan usia dan status gizi. Penelitian ini menganalisa 76 anak dengan diagnosis klinis PRGE yang dilakukan esofagogastroduodenoskopi, berusia 2-18 tahun, dan sesuai dengan kriteria inklusi dan eksklusi. Data dianalisa dari rekam medis tahun 2011-2015.Hasil: Anak dengan PRGE paling banyak berjenis kelamin laki-laki (53.9%), berusia sekolah (69.8%), dan berstatus gizi buruk/kurang (40.8%). Secara umum gejala klinis yang paling sering muncul pada anak dengan PRGE adalah muntah (76.3%), nyeri perut (72.4%), mual (63.2%), dan nyeri dada atau heartburn (51.3%). Terdapat hubungan bermakna antara kelompok usia dan gejala klinis berupa nyeri dada atau heartburn (p=0.04) yang lebih sering pada usia sekolah. Kelompok balita secara bermakna mengalami menolak makan (p=<0.0001), nafsu makan berkurang (p=0.002), dan gejala pernapasan (p=0.001). Gejala klinis PRGE berupa nyeri dada atau heartburn (p=0.011) secara bermakna lebih sering terjadi pada gizi lebih/obesitas; dan berat badan menurun lebih sering terjadi pada gizi kurang/buruk (p=0.044).Kesimpulan: Anak dengan PRGE lebih sering terjadi pada usia sekolah dan memiliki gizi buruk/kurang. Terdapat hubungan bermakna antara gejala klinis PRGE pada anak dengan kelompok usia maupun status nutrisi.

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Background: The prevalence of GERD tends to increase in Indonesia. Establishing the diagnosis itself is sometimes not easy since it is usually based only on clinical manifestations which are not specified to GERD only. Information about clinical manifestations of GERD in Indonesia children is still limited.

Objectives: To evaluate which clinical manifestations are frequent and have significant relation with age and nutritional status in Indonesian children with GERD who underwent upper-gastrointestinal endoscopy procedure in the Child Health Department of Cipto Mangunkusumo Hospital - Faculty of Medicine of Universitas Indonesia (RSCM-FKUI).

Methods: Cross-sectional design was used to compare the prevalence of clinical manifestations in children and their relationship with age and nutritional status. This study analyzed 76 children with GERD who underwent esophagogastroduodenos-copy procedure, aged from 2-to-18-years old, and fit the inclusion and exclusion criteria. The data analysed from medical record during the year of 2011-2015.

Results: Children with GERD were mostly male (53%), at school aged (69.8%), and had mild/moderate/severe undernutrition (40.8%). This study revealed that the most frequent clinical manifestations in children with GERD are vomiting (76.3%), stomachache (72.4%), nausea (63.2%), and chestpain or heartburn (51.3%). There was significant different between age groups and clinical manifestations of GERD symptoms such as chestpain or heartburn (p=0.04) which was more frequent in school-aged group. The under-five aged group was significantly had more feeding refusal (p=<0.0001), decreased appetite (p=0.002), and respiratory symptoms (p=0.001) compare to that of school-aged group. The GERD symptoms of chestpain or heartburn was statistically significant more frequent (p=0.011) in over-nutrition/obesity group; whereas losing weight was significantly more frequent (p=0.044) in mild/moderate/severe undernourished group.

Conclusion: Children with GERD are mostly in school-age group and had mild/moderate/severe undernutrition. There was statistically significant different of GERD symptoms between age groups and nutritional status groups."

"Gastroesophageal reflux disease (GERD) is a condi-tion of reflux of gastric content into the esophagus, whichcould create clinical symptoms. Reflux can occur under normal conditions, usually related to certain conditions, such as lying down after meals and during vomitting. If reflux occurs, the esophagus would immediately contract to cleanse the lumen from refluxate, preventing prolonged contact between the refluxate and the esophageal mucosa."

"Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain ammo acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay.Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio.Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 ± 1.2; Child Pugh B 6.0 ± 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin fr - 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test.Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio."

"LATAR BELAKANG: Prevalensi GERD di Indonesia semakin meningkat.GERD dapat memengaruhi kualitas hidup penderitanya. Kuesioner GERD Qualityof Life GERD-QOL telah diuji keandalan dan kesahihannya di Cina. Penelitianini bertujuan untuk menterjemahkan kuesioner GERD-QOL ke dalam bahasaIndonesia dan menguji keandalan dan kesahihannya. METODE: Sebagai tahap awal, kuesioner GERD-QOL terlebih dahuluditerjemahkan dengan metode forward backward translation ke dalam bahasaIndonesia, dan dievaluasi oleh tim peneliti sehingga dihasilkan kuesioner GERDQOLversi bahasa Indonesia. Sembilan puluh satu orang pasien yang telahdidiagnosis GERD secara klinis sebelumnya berdasarkan kriteria Montreal,diwawancarai dengan menggunakan kuesioner GERD-QOL versi Indonesia dankuesioner SF-36. Keandalan dinilai melalui metode konsistensi internal dan tesulang dengan mewawancarai pasien pada hari pertama dan hari ke-14. Kesahihan dinilai menggunakan kesahihan konstruksi dan kesahihan eksternal melaluiperbandingan dengan SF-36. HASIL: GERD-QOL berbahasa Indonesia memiliki keandalan konsistensiinternal kuesioner yang baik Cronbach alpha: 0,687 ndash;0,842 dengan keandalantes ulang yang baik intra class correlation coefficient: 0,756-0,936, P

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BACKGROUND: GERD prevalence in Indonesia has been increasing. GERDcan affect quality of life. GERD Quality of Life GERD QOL questionnaire hasbeen translated and validated in China. This study is aimed to translate GERDQOLquestionnaire into Indonesian version and to assess its validity andreliability.

METHODS: GERD QOL is translated into bahasa Indonesia using forwardbackward translation and compared by experts to original version. Total of 91patients have been diagnosed clinically with GERD based on Montreal consensus,were recruited to complete the questionnaire and validated Indonesian SF 36.Reliability was conducted by using internal consistency and test retest methodwith 14 days interval. Validity was conducted by using construct validity andexternal validity with SF 36 comparison method.

RESULT Indonesian version of GERD QOL was internally reliable withCronbach Alpha 0.822 and had good test and retest reliability intra classcorrelation coefficient 0.756 0.936, P"

"Tuntutan akademik seringkali membuat mahasiswa mengalami stres. Diyakini bahwa salah satu dampak dari stres akademik adalah GERD, sementara strategi koping merupakan cara mahasiswa mengatasi stres tersebut. Penelitian ini bertujuan untuk menganalisis pengaruh stres akademik terhadap Gastroesophageal Reflux Disease (GERD) dengan strategi koping sebagai moderator pada mahasiswa. Metode yang digunakan adalah pendekatan kuantitatif dengan teknik pengumpulan data melalui kuesioner. Partisipan yang terkumpul mencapai 202, namun yang dapat diolah hanya 183 partisipan. Data dianalisis dengan PROCESS Hayes. Hasil penelitian (p = 0.004) menunjukkan bahwa emotion-focused coping memoderasi pengaruh stres akademik terhadap GERD. Sementara itu, kedua jenis strategi koping lainnya tidak menunjukkan interaksi yang signifikan. Penelitian ini memberikan kontribusi untuk memahami penggunaan strategi koping yang efektif untuk meregulasi stres akademik, sehingga juga memperlemah pengaruhnya terhadap GERD. Saran untuk penelitian lanjutan adalah penggunaan teknik sampling yang lebih terkontrol, sehingga partisipan bisa lebih representatif.

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Academic demands often cause students to experience stress. It is believed that one of the impacts of academic stress is GERD, while coping strategies are the way students deal with that stress. This study aims to analyze the effect of academic stress on Gastroesophageal Reflux Disease (GERD) with coping strategies as a moderator among students. The method used is a quantitative approach with data collection techniques through questionnaires. The collected participants reached 202, but only 183 participants could be processed. The data were analyzed using PROCESS Hayes. The results of the study (p = 0.004) showed that emotion-focused coping moderates the effect of academic stress on GERD. Meanwhile, the other two types of coping strategies did not show significant interactions. This study contributes to understanding the effective use of coping strategies to regulate academic stress, thereby weakening its impact on GERD. Suggestions for further research include using more controlled sampling techniques so that participants can be more representative."