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"Inflammatory bowel disease (IBD) in rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complain! of chronic diarrhea with or without hematochezia.We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy."

"In up to 80% of dyspepsia patients who consult a physician in the hospital, dyspepsia is considered to be functional dyspepsia. Although not associated with increased mortality, functional dyspepsia is a burden at both the community and national levels because it can cause physical, mental, and social ditress that can affect a patients quality of life. Health-related quality of life (HRQOL) is a multidimensional construct comprising at least three broad domains-physical, psychological, and social functioning-which can all be affected by a disease and its treatment. It is important to assess HRQOL in patients with functional dyspepsia to identify the effects of the disease and its treatment on patients. Both disease-specific and generic instruments can be used to assess HRQOL in patients with functional dyspepsia. Each instrument has it own advantages and limitations. The selection of instrument to assess HRQOL is determined by the study population, research questions, disease entities, and researcher preferences. The purpose of this article is to explain the concept of HRQOL and the use of HRQOL assessment in patients with functional dyspepsia."

"Cardiomyopathy is a primary disease of the myocardium, unrelated to hypertension, congenital defect, or disorders of the valves, coronary blood flow, arteries, or pericardium.

In developing nations, Cardiomyopathy makes up 30% of all deaths due to heart disease, while in developed nations, Cardiomyopathy is not the main cause of heart disease.

Cardiomyopathy is classified according to etiology and clinical findings. From the etiology, Cardiomyopathy is classified into two types, the primary tipe, where the myocardiac disease is unknown/idiopathic, and the secondary type, with a clear cause, or is related with a disease of other organ systems. Based on clinical findings, Cardiomyopathy is classified into dilatation cardiomyopa-thy or congestive, restrictive, and hypertrophic Cardiomyopathy."

"Upper gastrointestinal bleeding is one of the emergency conditions in the field of gastroenterology and variceal blending is the. most common cause of it. Gastric varices accounts only 5% to 10% of all causes of upper gastrointestinal bleeding respectively, but it could be fatal and difficult to control despite provision of adequate therapy. Early diagnosis and appropriate management may decrease the morbidity and mortality of gastric variceal bleeding."

"Constipation is the most ignored complaint by doctors and unfortunately, it requires urgent management due to the decreased quality of life. Most cases are functional constipation but there is also a great number of constipation due to organic abnormalities. In an attempt to manage the patient properly, we should put our emphasis on excellent knowledge of pathophysiology of constipation.By using the colonic transit time test, we could determine the type of constipation, which would have an effect on therapy. In most cases, constipation has a good response to high fiber diet and additional laxative medication and surgical therapy is seldom required unless complications have occurred. There is also a suggestion for preventing constipation may be caused by opioid usage."

"Helicobacter pylori (Hp) infection is the most common chronic bacterial infection in human. The role of Hp infection in various GI disorders had been widely accepted. However, further studies have found new extragastrointestinal involvement such as urticaria. Chronic urticaria is a common disorder that has complex pathophysiologic mechanism. As mater of fact, etiology remains unclear in most of the cases. This condition is called Idiopathic Chronic Urticaria. Several studies had shown high prevalence of Hp infection in patients with ICU and improved symptoms after eradication therapy of Hp. This observation had suggested that Hp has important role as etiologic factor in some cases of ICU. The presence of Hp infection and its role in ICU should be proven before initiating eradication therapy, so that irrational used of drugs and antibiotics resistance can be prevented."

"Systemic lupus erythematosus (SLE) as a chronic autoimmune disease with multi-organ involvement often occurs in women of childbearing age. We report a case of active SLE in a-23 year old woman who presented with multi-organ involvement, including pericardia! effusion, severe anemia that caused congestive heart failure, and kidney involvement. ANA and ami ds DNA were positive. The patient was treated with intravenous digoxin followed by a daily dose of oral digoxin, ROmg/day of furosemide, 600 ml packed red cell transfusion, and !.5 mg/kg bodyweight/day of prednisan. The patient was discharged in good condition on the I5'h day of hospitalization."

"We describe that often colonic tuberculosis remains unsuspected prior to surgery. We therefore draw attention to pitfalls in the diagnosis and review the literature on the diagnostic modalities available to diag-nose the disease. Today, the prompt diagnosis of an unknown gastroenteritis process invoives colonoscopy.

Using a fiberscope, a procedure with instantaneous return can be carried out. Patients with clinical presen-tation suggestive of coionic tuberculosis should have had either an aggressive diagnostic work out using high-yield tests or anti tubercuiosis therapy."

"Crolm's disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower Gi bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease.

We reported a case of Crohn's disease in young male who suffered from severe lower Gi bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn's disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved."

"Pembedahan masih menjadi standar emas terapi kuratif untuk obstruksi saluran empedu maligna, namun hanya 10-20% kasus yang dianggap dapat dioperasi. Oleh karena itu, terapi paliatif untuk menghilangkan rasa sakit, kolestasis, dan obstruksi saluran empedu, merupakan pengobatan utama bagi sebagian besar pasien. Perkembangan drainase bilier transhepatik perkutan dan drainase bilier endoskopi telah menghasilkan pengobatan invasif minimal untuk obstruksi bilier ganas, yang memiliki morbiditas dan mortalitas lebih rendah dibandingkan drainase bedah. Pilihan teknik drainase tergantung pada jenis tumor, lokasi obstruksi, serta ketersediaan tenaga ahli dan instrumentasi.

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Surgery is still the golden standard of curative therapy for malignant biliary obstruction, but only 10-20% of cases considered resectable. Therefore, palliative therapy to relieve pain, cholestasis, and biliary obstruction, is the main treatment for most patients. The development of percutaneous transhepatic biliary drainage and endoscopic biliary drainage had brought about minimally invasive treatment for malignant biliary obstruction, which had lower morbidity and mortality than surgical drainage. The choice of drainage technique depends on type of tumor , site of obstruction, also the available expert and instrumentation."