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Abstrak :
The term "Inflammatory Bowel Disease" (IBD) is frequently used to denote two diseases, ulcerative colitis (UC) and Crohn's disease (CD). This condition is frequently recorded in the West, and along with development of diagnostic facilities, is beginning to be more commonly found in Indonesia. The etiology of this disease is still unclear, but it is suspected that environmental, geographic, and genetic factors are involved. Cytokines play a great role in the pathogenesis of IBD, where in IBD there is an unbalance of pro-inflammatory cytokines and inhibitor cytokines. In IBD, there is an increase in pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, IL-8, and alpha TNF in the intestinal mucosa. Such increase significantly correlates with the activity of ulcerative colitis through endoscopic examination, At this moment, forms of therapy for IBD associated with cytokines are being developed, such as ways to inhibit cytokine synthesis, cytokine release, cytokine activity and the cytokine signaling pathway in the target cell.

Abstrak :
Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials & Methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 [ig El/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 [ig El/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p > 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency (< 200 fig El/g stool) than in dyspepsia (control) (>_ 200 fj,g El/g stool, p < 0.001). The mean fecal elastase-1 result in chronic diarrhea and in dyspepsia were 316.29 ±_ 195.44 vs. 475.93 +. 65.33 fig El/g stool (p < 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea.

Abstrak :
Bile reflux: gastropathy is a disease caused by reflux of duodenal fluid to the gaster: This fluid contains pancreatic juices and duodenal secretion. The manifestations that occur depend on the frequency amount, and duration of reflux. This disorder is quite rarely recognized in daily clinical practice. Endoscopy of the upper gastrointestinal tract is required to establish the diagnosis of this disorder: This paper will give a brief view ofthe pathogenesis and diagnostic method for this disorder.

Abstrak :
Background: The prevalence of Helicobacter pylori (H. pylori) infection in the world is quite high, especially in developing countries. Usually the patient shows no specific symptoms and chronic gastritis therefore becomes chronically infected The complication of the injéction is the development of peptic ulcer; which is a predisposing factor for gastric carcinoma. Early diagnosis is an important step to avoid these complications by providing immediate accurate therapy. Methods: In this study the CLO, MIU (Motility Indole Urease) tests and culture were conducted on 131 biopsy samples of the stomach antrum mucous tissue taken from chronic dyspepsia patients from several hospitals in Jakarta. In the CLO test, biopsy tissue was put in a small well agar to be incubated at room temperature. In the MIU test the biopsy tissue sample was submerged in the small MlU tube agar with a depth of approximately 2/3 rds from the surface, and then incubated at room temperature. Another piece of biopsy tissue was cultured micro-aerophylicalty The CLO and MlU tests are considered positive if the color changes from yellow to red and are considered negative if there is no color change within 24 hours. Results: Compared to culture, the CLO test demonstrated 38% sensitivity; 96% specificity, 94% positive predictive value and 52% negative predictive value, whereas the results of the MIU test against culture method showed 76% sensitivity 89% specificity 88% positive predictive value, and 78% negative predictive value. Conclusion: The MIU test that showed high sensitivity and specyficity and thus could be further developed as an alternative diagnostic method for H. pylori infection.

Abstrak :
Latar Belakang. Diagnosis demam tifoid masih merupakan masalah kesehatan di Indonesia. Biakan S. typhi sebagai baku emas diagnosis hanya mampu positif pada 40-70% kasus. PCR sebagai alternatif diagnosis masih terhambat oleh harganya yang mahal dan fasilitas yang terbatas. Uji Widal yang saat ini banyak digunakan karena murah dan mudah dilakukan, dipengaruhi oleh banyak faktor sehingga sensitivitas dan spesifisitas hanya berkisar 60-80%. Oleh karena itu dibutuhkan uji serologi lain yang cepat dan mampu memberikan hasil yang baik ditinjau dari sensitivitas dan spesifisitas. Salah satu uji serologi yang memenuhi kriteria di atas adalah TUBEX TF yang telah diuji coba di beberapa negara tetapi belum pernah diuji coba di Indonesia. Tujuan. Mengetahui perbandingan nilai sensitivitas dan spesifisitas pemeriksaan TUBEX TF dengan uji Widal dalam mendiagnosis demam tifoid yang telah dikonfirmasi dengan PCR dan atau biakan S. typhi. Metodologi. Uji diagnostik yang dilakukan pada pasien dengan kecurigaan demam tifoid sesuai skor tifoid Nelwan>/=8 dan dirawat di RSCM, RSP dan RSUD Tangerang. Dilakukan anamnesis, pemeriksaan fisik, pemeriksaan laboratorium dasar, uji Widal, PCR dan biakan S. typhi serta uji TUBEX TF. Hasil pemeriksaan TUBEX TF dan uji Widal dibandingkan PCR dan atau biakan S. typhi sebagai baku emas. Data diolah dengan program SPSS13 dan dimasukkan ke tabel frekuensi dan tabel silang. Hasil. Selama periode Mei - Oktober 2006 terkumpul 52 pasien dengan kecurigaan demam tifoid, yang terdiri dari 27 laki-laki (52%) dan 25 perempuan (48%). Kelompok usia terbanyak 20-30 tahun (28 orang, 53,8%). Dari perhitungan tabel 2x2, uji TUBEX TF dibandingkan dengan uji Widal, didapatkan masing-masing sensitivitas 100% dan 53,1%, spesifisitas 90% dan 65%, NDP 94,1% dan 70,8%, NDN 100% dan 46,4%. Luas daerah dibawah kurva ROC adalah 0,950 untuk TUBEX TF dan 0,591 untuk uji Widal. Dibandingkan uji Widal, pemeriksaan TUBEX TF menunjukkan hasil bermakna (p<0,05) pada uji statistik Chi square.

Abstrak :
Tujuan Pengobatan untuk eradikasi H pylori dengan kombinasi PPI dan Amoksisilin 1000 mg atau Clarithromycin 500 mg yang diberikan 2 kali sehari selama 2 minggu telah terbukti efektif. Kebanyakan penelitian menyebutkan bahwa pengobatan 7 dan 10 hari sama efektif. Tujuan dari penelitian ini adalah untuk membandingkan terapi eradikasi H pylori selama 5 dan 7 hari. Metode Penelitian ini dilakukan secara prospektif pada 60 pasien yang terinfeksi H pylori, pemeriksaan dilakukan dengan endoskopi dan biopsi saluran cerna bagian atas di 6 (enam) rumah sakit di Indonesia. Diagnosis H pylori ditegakkan berdasarkan pada 2 pemeriksaan rapid urea test (Pronto Dry) dan pemeriksaan histopatologi atau adanya urea breath test (UBT) yang positif. Kemudian secara terbuka pasien akan dibagi menjadi 2 kelompok, kelompok pertama mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 5 hari dan kelompok kedua mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 7 hari. Empat minggu kemudian, pasien dievaluasi dengan UBT untuk memastikan keberadaan H pylori. Hasil Pada penelitian ini didapatkan 60 pasien yang terdiri dari 42 laki-laki dan 18 perempuan dengan rata-rata (usia+SD) 47.63+13.93 tahun, rentang usia 21-74 tahun. Kelompok pengobatan 5 hari terdiri dari 25 (41,7%) pasien dan kelompok pengobatan 7 hari terdiri dari 35 (58.3%) pasien. Setelah kelompok pengobatan 5 hari didapatkan 18 (72%) pasien H Pylori negatif, dan setelah pengobatan 7 hari didapatkan 32 (91.4%) pasien H Pylori negatif. Kegagalan eradikasi ditemukan pada kelompok pengobatan 5 hari sebesar 7 (28%) pasien dan pada kelompok pengobatan 7 hari sebesar 3 (8.6%) (p=0,077). Kesimpulan Penelitian ini menunjukkan bahwa eradikasi H pylori dengan pengobatan tripel dengan rabeprazole pada kelompok 7 hari masih lebih baik daripada kelompok pengobatan 5 hari. Perbedaan yang tidak bermakna secara statistik ini mungkin karena jumlah sampel tidak mencukupi.

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Aim A combination of PPI and 1000 mg amoxicillin/500 mg clarithromycin twice daily for 2 weeks has been proven effective in the eradication of H. pylori. Most studies suggested that treatment for 7 and 10 days may be equally effective. Few data are available on the effi cacy of 5-day triple therapy. Aim of this study was to compare 5-day and 7-day rabeprazole triple therapy for eradication of H. pylori infection. Methods We prospectively studied 60 consecutive H. pylori-infected patients who came to hospitals in six centres in Indonesia and who underwent upper endoscopy and biopsy. H. pylori infection was confi rmed if two rapid urease tests (Pronto Dry) and histology or urea breath test were positive. Patients were assigned to either an open-labelled 5-day or 7-day course of oral amoxicillin 1000 mg b.i.d., clarithromycin 500 mg b.i.d., and rabeprazole 10 mg b.i.d. (RAC).Four weeks after therapy, all patients had a repeated UBT for evaluation of the presence of H. pylori. Results Of the 60 patients (42 males and 18 females) with mean age (± SD) 47.63 ± 13.93 years, range 21?74 years, 25 patients (41.7%) had 5-day treatment and 35 patients (58.3%) had 7-day treatment. With 5-day treatment, 18 patients (72%) and with 7-day treatment 32 patients (91.4%) became negative for H. pylori infection. The eradication failure was found on 7 patients (28.0%) in 5-day reatment and 3 patients (8.6%) in 7-day treatment. Conclusions The study showed that the eradication of H. pylori infection by triple rabeprazole-based treatment in 7-day is still better than in 5-day.