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"ABSTRAKGallstone is a crystal deposit which is formed in the gallbladder or bile duct. Gallstone is classified into cholesterol stone, pigment stone (black and brown), and mixed stone. Mechanism which underlies the formation of cholesterol or pigment gallstone is different. Information on chemical component of the stone will assist the management and prevention of its recurrence. Analysis of gallstone component can be performed by colorimetry method or even gas liquid chromatography (GLC). Chemical component analysis of gallstone by colorimetry includes examination of cholesterol, bilirubin, and calcium. Stone is classified as cholesterol stone if the cholesterol content is > 80%, pigment stone if cholesterol content is < 20%, and mixed stone if cholesterol content is 25-80%. Gallstone analysis by GLC method is conducted by separation of fatty acid chain and evaluation of fatty acid quantity in the methylester derivatives form, which is fatty acid methyl estered. Fatty acid content in cholesterol stone (310.09 + 49.7 mg/gram) is higher compared to pigment stone (55.59 +7.71 mg/gram). Saturated to unsaturated fatty acid (S/U) ration in cholesterol stone (8.6 + 3.1) is higher compared to pigment stone (4.8 + 1.5)."

"Penyakit gastroenterologi masih merupakan masalah kesehatan utama di Indonesia, dengan kolitis menempati urutan kelima dari sepuluh penyakit terbanyak pada pelayanan rawat jalan. Kesamaan gambaran klinis dan hasil pemeriksaan diagnostik kolitis TB dan Inflammatory Bowel Disease (IBD) menyebabkan kesulitan diagnosis. Studi ini bertujuan untuk mengetahui peran diagnostik Interferon-Gamma Release Assay (IGRA) metode Elispot pada pasien terduga kolitis tuberkulosis di Indonesia. Dilakukan studi potong lintang dan acak dengan penyajian data deskriptif analitik. Subjek penelitian merupakan 60 pasien terduga kolitis tuberkulosis yang mengunjungi poliklinik gastroenterologi di RSUPNCM bulan April-Oktober 2018. Sampel yang digunakan adalah darah vena. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi adalah sensitivitas 83,3%, spesifisitas 57,4%, NPP 17,3%, dan NPN 96,9%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi adalah sensitivitas 53,9%, spesifisitas 55,3%, NPP 25%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi dan histopatologi adalah sensitivitas 57,1%, spesifisitas 60,5%, NPP 28,6%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi, kolonoskopi, dan evaluasi klinis akhir adalah sensitivitas 100%, spesifisitas 59,3%, NPP 21,3%, dan NPN 100%. Tes IGRA Metode Elispot dapat digunakan sebagai pemeriksaan penapisan.

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Gastroenterology diseases are still a major health problem in Indonesia, with colitis ranks fifth among the top ten diseases in outpatient care. The similarity of clinical features and diagnostic results of TB and Inflammatory Bowel Disease causes difficulties in diagnosis. This study is aimed to determine the diagnostic value of Interferon-Gamma Release Assay (IGRA) with Elispot Method in patients with suspected tuberculous colitis in Indonesia. It is a cross sectional and randomized study, shown as an analytic descriptive report. There were 60 patients with suspected tuberculosis colitis, visiting gastroenterology polyclinic at RSCM from April-October 2018. The sample was venous blood.  Diagnostic results of IGRA with Elispot Method with histopathology test as the gold standard are sensitivity 83,3%, specificity 57,4%, PPV 17,3%, and NPV 96,9%. As with colonoscopy as the gold standard are sensitivity 53,9%, specificity 55,3%, PPV 25%, dan NPV 81,3%. Meanwhile, with colonoscopy and histopathology test as the gold standard are sensitivity 57,1%, specificity 60,5%, PPV 28,6%, dan NPV 81,3%. And, diagnostic results  of IGRA with Elispot Method with colonoscopy, histopathology test, and final clinical judgement as the gold standard are sensitivity 100%, specificity 59,3%, PPV 21,3%, dan NPV 100%. IGRA with Elispot Method can be used as screening test."

"Indonesia is one of the most populous developing countries in the world. Similar with other developing countries, Indonesia has been suffered from the high incidence of gastroenterology diseases that mainly due to infection. In the recent years, Indonesia had also increased number of non-infectious gastroenterology diseases cases such as inflammatory bowel disease, gastroesophageal reflux disease, and colorectal cancer. Nevertheless, the developments of diagnostic and therapeutic modality along with the cooperation between sectors have undergone rapid progress as an effort in improving digestive health in Indonesia."

"ABSTRAKLatar belakang: Sejak tahun 1980 Divisi Gastroenterologi Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto Mangunkusumo (IPD FKUI/RSCM) membuat kriteria derajat gastritis kronik berdasarkan gambaran esofagogastroduodenoskopi (EGD) adanya hiperemis dan erosi. Kriteria derajat gastritis kronik ini banyak digunakan di seluruh Indonesia namun kriteria tersebut belum pernah dilakukan uji diagnostik.Tujuan: Mendapatkan akurasi diagnostik derajat gastritis kronik berdasarkan pemeriksaan EGD dibandingkan dengan pemeriksaan histopatologi.Metode: Penelitian ini merupakan uji diagnostik derajat gastritis kronik berdasarkan hasil pemeriksaan EGD pada pasien yang memiliki indikasi, dibandingkan dengan gambaran histopatologi sebagai pemeriksaan baku emas yang dilakukan di Pusat Endoskopi Saluran Cerna (PESC) Divisi Gastroenterologi Departemen IPD FKUI/RSCM dari Oktober 2014 hingga Februari 2015. Uji diagnostik yang dilakukan ada 2 yaitu uji diagnostik gastritis sedang - ringan dan berat - sedang. Masing-masing uji diagnostik di atas, ditampilkan parameter-parameter uji diagnostik berupa sensitivitas (Se), spesifisitas (Sp), nilai duga positif (NDP), nilai duga negatif (NDN), serta rasio kemungkinan (RK) positif dan negatif. Seluruh parameter di atas menyertakan interval kepercayaan 95% (IK 95%).Hasil Penelitian: Dari 230 subjek didapatkan karateristik penelitian perempuan lebih banyak dari laki - laki dengan perbandingan 3:2, terdapat merata pada semua kelompok usia, DM 23%, hipertensi 36,5% dan infeksi H.pylori 2,6%. Hasil uji diagnostik gastritis ringan - sedang: Se 0.95 (IK 95% 0.87-0.98), Sp 0.96 (IK 95% 0.86-0.99), NDP 0.97 (IK 95% 0.89-0.99), NDN 0.94 (IK 95% 0.84-0.98), RK Positif 23.39 (IK 95% 6.09- 89.74) dan RK Negatif 0.05 (CI 95% 0.02-0.14). Hasil uji diagnostik gastritis sedang - berat: Sensitivitas 0.93 (IK 95% 0.82-0.98), Spesifisitas 0.94 (IK 95% 0.86-0.98), Nilai Duga Positif 0.91 (IK 95% 0.79-0.96), Nilai Duga Negatif 0.96 (IK 95% 0.88-0.99), Rasio Kemungkinan Positif 16.54 (IK 95% 6.32-43.28) dan Rasio Kemungkinan Negatif 0.05 (CI 95% 0.02-0.21).Kesimpulan: Pemeriksaan EGD memiliki akurasi yang baik untuk menegakkan diagnosis derajat gastritis kronik.

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ABSTRACT

Background: Since 1980, Division of Gastroenterology Department of Internal Medicine FKUI/RSCM had made a criteria for chronic gastritis grading based on hyperemic and erosion that are found in gastric?s mucosa based on esophagogastroduodenoscopy (EGD) examination. This criteria is used nationwide all over Indonesia but until now there is no diagnostic study for chronic gastritis grading based on EGD examination compare to histopathology examination as the gold standard.

Purpose: To get diagnostic accuracy of chronic gastritis grading based on EGD compared to histopathology.

Methods: This research is a diagnostic study about chronic gastritis grading by EGD from patients that had indication for, compared to histophatology as a gold standard in gastrointestinal endoscopy room Division of Gastroenterology Department of Internal Medicine FKUI/RSCM from October 2014 to February 2015. There will be 2 diagnostic study, mild to moderate gastritis and severe to moderate gastritis diagnostic study. For every diagnostic study, the parameters that will be showed are Sensitivity (Se), Specificity (Sp), Possitive Predictive Value (PPV), Negative Predictive Value (NPV), Possitive Likelihood Ratio and Negative Likelihood Ratio (NLR). The 95% confidence interval will be included.

Results: Of 230 subjects, there were more women than men with ratio 3:2, age didn?t affect the grading of chronic gastritis, type 2 diabetes was found in 23% patients, hypertension was found in 36,5% patients and H.pylori infection in only 2.6% patients. The results for mild to moderate gastritis : Sensitivity 0.95 (CI 95% 0.87-0.98), Specificity 0.96 (CI 95% 0.86-0.99), Possitive Predictive Value 0.97 (CI 95% 0.89- 0.99), Negative Predictive Value 0.94 (CI 95% 0.84-0.98), Possitive Likelihood Ratio 23.39 (CI 95% 6.09-89.74), and Negative Likelihood Ratio 0.05 (CI 95% 0.02-0.14). The results for moderate to severe gastritis : Sensitivity 0.93 (CI 95% 0.82-0.98), Specificity 0.94 (CI 95% 0.86-0.98), Possitive Predictive Value 0.91 (CI 95% 0.79-0.96), Negative Predictive Value 0.96 (CI 95% 0.88-0.99), Possitive Likelihood Ratio 16.54 (CI 95% 6.32-43.28), and Negative Likelihood Ratio 0.05 (CI 95% 0.02-0.21).

Conclusion: Esophagogastroduodenoscopy feature has good accuracy to diagnose the grading of chronic gastritis."

"Successful cecal intubation is a primary quality indicator in colonoscopies and the most important factor in detecting abnormal lesion in the colon. There are many factors that influence cecal intubation rate during colonoscopy procedure. The aim of this study is to evaluate the factors that influence cecal intubation rate in unsedated patients during colonoscopy. A retrospective study of colonoscopy performed at Sardjito General Hospital, Jogjakarta, from January 2012 to August 2013. Age, sex, bowel preparation indication for colonoscopy, colonoscopist, and reasons of incomplete colonoscopy from 564 colonoscopy reports were recorded and analysed. Overall successful cecal intubation rate was 408 (72.34%). Causes of incomplete colonoscopy were patients discomfort or pain 41.66%, looping / redundant 28.85%, poor bowel preparation 18.59%, fixation / adhesion 6.41%, and bleeding risk 4.49%. Female was more unsuccessful in cecal intubation than male (31.50% vs 24.05%;p=0.048). the successful cecal intubation rates for gastroenterologist compared to gastroenterology (GI) fellows were 77.92% vs 49.55%; p<0.001). Multivariate logistic regression analysis demonstrated that female and poor bowel preparation were independently associate with lower cecal intubation rate and gastroenterologists were independently associated less unsuccessful to reach cecal. The overall successful cecal intubation rate was still below the set standard. Several identified factors that may predict lower of cecal intubation rate : the skill and experience of colonoscopists (GI fellows), poor bowel preparation and female."

"New technologies, softwares, and techniques, such as volumetric imaging, enhancement quantification, and fusion imaging, are increasing the diagnostic capabilities of US. The injection of microbubble contrast agents allows better tissue characterization with definitive differentiation between solid and cystic lesions. Contrast-enhanced US improves the characterization of pancreatic tumors, assists in local and liver staging, and can offer savings in both time and money. Acoustic radiation force impulse (ARFI) imaging is a promising new US method to test, without manual compression, the mechanical strain properties of deep tissues. Furthermore, the applications and indications for interventional, endoscopic, and intraoperative US have undergone significant improvement and refinement.This book provides a complete overview of all these technological developments and their impact on the assessment of pancreatic pathologies. Percutaneous, endoscopic, and intraoperative US of the pancreas are discussed in detail, with precise description of findings and with informative imaging (CT and MRI) and pathologic correlations."

"Latar belakang. Kombinasi spray lidokain dan anestetika intravena saat ini merupakan pilihan utama pada prosedur endoskopi saluran cerna, namun spray lidokain mempunyai kekurangan berupa iritasi lokal, mual, muntah dan rasa pahit. Gel lidokain merupakan alternatif pilihan anestetik lokal. Gel lidokain memiliki keuntungan karena dapat mengurangi gesekan mukosa dengan endoskop saat insersi serta memungkinkan pemberian lidokain yang tebal dan lengket sehingga menghasilkan anestesia lokal yang lebih baik pada rongga mulut dan orofaring dibandingkan spray lidokain. Pada penelitian ini kami ingin mengetahui perbandingan keefektifan gel lidokain dengan spray lidokain dalam mengurangi jumlah penggunaan propofol. Metode. Penelitian ini merupakan uji klinis acak tersamar ganda terhadap pasien endoskopi saluran cerna atas dengan sedasi di Rumah Sakit Cipto Mangunkusumo pada bulan Juli-September 2015. Sebanyak 52 subyek diambil dengan metode consecutive sampling dan dibagi ke dalam 2 kelompok (kelompok gel lidokain 2% dan spray lidokain 10%). Pasien secara acak diberikan gel lidokain 2% atau spray lidokain 10% sebagai anestetik lokal. Total dosis propofol, angka kejadian gag refleks, hipotensi, bradikardia, dan desaturasi dicatat pada masing-masing kelompok. Analisis data dilakukan dengan uji t-test tidak berpasangan. Hasil. Rerata dosis propofol berbeda bermakna diantara 2 kelompok, dimana rerata dosis propofol pada grup gel lidokain 2% adalah 186,92±43,52 mg, sedangkan rerata dosis propofol pada grup spray lidokain 10% adalah 218,85±61,01 mg (p=0.035, IK 95%=31,92). Simpulan. Gel lidokain 2% lebih efektif dibandingkan spray lidokain 10% dalam mengurangi dosis propofol pada pasien endoskopi saluran cerna atas.

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Background. A combination of lidocaine spray and intravenous anesthetics is currently the common choice in gastrointestinal endoscopy procedures, but lidocaine spray has some side efects like local irritation, nausea, vomiting and bitter taste. Lidocaine jelly is an alternative choice of local anesthetic. Lidocain jelly reduce friction of endoscope and enables to apply thick and sticky lidocaine resulting in better local anesthesia in the oral cavity and oropharynx compared to lidocaine spray. In this study, we want to compare the effectiveness between lidocaine jelly and lidocaine spray to reduce the propofol dose.

Methods. This study was a randomized double-blind control trial on upper gastrointestinal endoscopy patiens with sedation in Cipto Mangunkusumo Hospital in July to September 2015. A total of 52 subjects were taken with consecutive sampling method and divided into 2 groups (2 % lidocaine jelly group and 10% lidocaine spray group). Patients were randomly given 2% lidocaine jelly or 10% lidocaine spray as a local anesthetic. Total propofol dose, the incidence of gag reflex, hypotension, bradycardia and desaturation recorded in each group. Data analysis was performed by unpaired t-test.

Results. Mean propofol dose significantly different between 2 groups. The Mean propofol dose 2% lidocaine jelly was 186.92 ±43.52 mg, while the mean propofol dose in10% lidocaine spray group was 218.85 ± 61.01 mg (p = 0.035, CI 95% = 31.92).

Conclusion. 2% Lidocaine gel was more effective than 10% lidocaine spray in reducing the propofol dose in patients with upper gastrointestinal endoscopy."