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All Journal Majalah Kedokteran Nusantara The Journal Of Medical School Indonesian Journal of Rheumatology
Faisal Parlindungan
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Health Professions Medicine & Pharmacology

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Korelasi antara skor Child-Pugh dengan gastropati hipertensi portal pada penderita sirosis hati Faisal Parlindungan; Mabel Sihombing
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction : Hypertensive portal gastropathy (PHG) is a pathologic appearance on the gastric mucosa which can cause acute or chronic bleeding in liver cirrhotic patients. The pathogenesis of PHG is controversial and there is no agreement on the effect of liver dysfunction to PHG. This study aims to evaluate correlation between liver dysfunction severity that is assessed by Child-Pugh score and PHG in liver cirrhotic patients.Methods : This is an analytic cross sectional study. The demographics and clinical data were recorded, laboratory tests were performed (albumin, INR and bilirubin) to calculate Child-Pugh score, and patients underwent esophagogastroduodenoscopy (EGD) to assess PHG. Correlation between Child-Pugh score and PHG were tested with Spearman correlation analysis. Cut-off value of Child-Pugh score was determined with receiver operating characteristics (ROC) analysis which is followed by diagnostic performance analysis.Results : From 41 subjects, there were 8, 18, 15 patients with Child-Pugh class A,B, and C respectively. On endoscopic examination, there were 10,19, and 12 patients without PHG, with mild PHG, and with severe PHG respectively. There is a positive correlation between Child-Pugh score and the severity of PHG (r = 0.556; P = 0.0001). Among Child-Pugh score components, ascites and bilirubin showed positive correlation with PHG. Using cut off point of • 7, Child Pugh score showed 87.1% sensitivity, 40% specificity, 81.8% PPV, 50% NPV, 1.45 LR(+), 0.32 LR(-), accuracy diagnostic was 75.6% and the AUROC was 0.65 (95% CI:0.437-0.860; P = 0.163)Conclusion: Child-Pugh score has a positive correlation with severity of PHG, in which higher Child-Pugh score is correlated with more severe PHG.Keywords : Child-Pugh Score; portal hypertensive gastropathy; liver cirrhotic; endoscopy
Characteristics of Patients with Autoimmune Rheumatic Disease in the Era of COVID-19 Pandemic in Indonesia Rudy Hidayat; Harry Isbagio; Anna Ariane; Faisal Parlindungan; Laniyati Hamijoyo; I Nyoman Suarjana; Dwi Budi Darmawati; Rakhma Yanti Hellmi; Gede Kambayana; IA Ratih Wulansari Manuaba; Awalia Awalia
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.159

Abstract

Background Coronavirus Disease 2019 (COVID-19) could be fatal in high-risk patient including autoimmune rheumatic patients. Nowadays, the management of these patients becomes dilemma because the use of steroids and disease-modifying anti-rheumatic drugs could suppress the immune system however, poor control of the underlying disease increases the infection risk. Understanding the characteristics of these patients in the COVID-19 pandemic is essentials to establish management guidelines and identify patients who are more susceptible to COVID-19. This study aimed to determine the characteristics of autoimmune rheumatic patients in the era of COVID-19 pandemic in Indonesia. MethodA descriptive study using national scale survey method was conducted. The subjects were autoimmune rheumatic patients in Indonesia and recruited using consecutive sampling. The variables evaluated in this study were demographic data, history of disease, current medications taken, daily activities in the COVID-19 pandemic, and also data related to COVID-19. The surveys distributed in online form to patients with autoimmune rheumatic disease in Indonesia. ResultTotal participants in this study were 570 patients, mostly women (93.9%), aged <60 years old (97.2%), and diagnosed with systemic lupus erythematosus (62.8%). Glucocorticoid (70.2%) especially low dose glucocorticoid (52.6%) is the most medication taken by patients. A 30.5% of patients is taking hydroxychloroquine/chloroquine and 88.1% of them have good compliance. During COVID-19 pandemic, 76.5% respondents still do normal activities/work and only 53.2% use personal protective equipment. Eleven of 541 respondents had positive PCR test and confirmed to COVID-19. The risk of COVID-19 infection based on British Society of Rheumatology (BSR) scoring system showed that 57.9%, 28.6%, and 13.5% patients in high, moderate and low risk, respectively. ConclusionPatients with autoimmune rheumatic diseases might be more susceptible to COVID-19 than the general population. Interplay of aging, therapies and disease-specific factors, comorbidities and the proper use of personal protective equipment seem to contribute. Keywords :autoimmune rheumatic disease, characteristic, COVID-19, Indonesia
Co-Authors Anna Ariane Awalia Awalia Dwi Budi Darmawati Gede Kambayana Harry Isbagio I Nyoman Suarjana IA Ratih Wulansari Manuaba Laniyati Hamijoyo Mabel Sihombing Rakhma Yanti Hellmi Rudy Hidayat