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All Journal journal of internal medicine Medical Journal of Indonesia The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Pangestu Adi
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Health Professions Medicine & Pharmacology

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A comparison of 5 or 7 days of rabeprazole triple therapy for eradication of Helicobacter pylori Syam, Ari F.; Abdullah, Murdani; Rani, Abdul A.; Nurdjanah, Siti; Adi, Pangestu; Djumhana, Ali; Tarigan, Pangarapen; Wibawa, I. D.N.
Medical Journal of Indonesia Vol 19, No 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (28.389 KB) | DOI: 10.13181/mji.v19i2.390

Abstract

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 efficacy 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 confirmed 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 treatment 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. (Med J Indones 2010; 19:113-7)Keywords: H. pylori, rabeprazole, triple therapy
The gastro-esophageal reflux disease questionnaire using Indonesian language: A language validation survey Simadibrata, Marcellus; Rani, Aziz; Adi, Pangestu; Djumhana, Ali; Abdullah, Murdani
Medical Journal of Indonesia Vol 20, No 2 (2011): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (38.269 KB) | DOI: 10.13181/mji.v20i2.442

Abstract

Background: The aims of this study were to test the usefulness of the Gastro-esophageal Reflux Disease Questionnaire (GERDQ) in the diagnosis of GERD, to validate the GERDQ written in Indonesian language, and to evaluate the reliability of the GERDQ for use in Indonesian-speaking GERD patients (Virginia study).Methods: This was a prospective survey of 40 patients diagnosed with GERD, based on an endoscopic examination, in 3 cities in Indonesia (Jakarta, Bandung, and Surabaya) from 15 January to 15 May 2009. Patients were asked to complete the GERDQ, and the validity and reliability of the questionnaire were assessed.Results: The percentages of respondents who reported symptoms lasting 4–7 days were as follows: 68% had a burning sensation behind the breastbone (heartburn); 65% had stomach content (fluid) move upwards to the throat or mouth (regurgitation); 70% had a pain in the centre of the upper abdomen; 58% had nausea; 63% had difficulty sleeping because of the heartburn and/or regurgitation; and 63% took additional medication for heartburn and/or regurgitation. Cronbach’s alpha was 0.83, indicating that all of the questions in the Indonesian-language GERDQ are valid and reliable for Indonesian GERD patients.Conclusions: This study achieved the primary objectives and showed that the GERDQ is valid and reliable for use with Indonesian-speaking GERD patients. The results were consistent with those of the DIAMOND study, which showed that the GERDQ can be used to diagnose GERD on the basis of the reported symptoms. (Med J Indones 2011; 20:125-30)Keyword: GERD, GERDQ, Reliability test, Validity test, Virginia study
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Purbayu, Herry; Setiawan, Poernomo Boedi; Nusi, Iswan A; Adi, Pangestu; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/83200776-79

Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Maimunah, Ummi; Rudyanto, Rudyanto; Setiawan, Poernomo Boedi; Adi, Pangestu; Nusi, Iswan Abbas; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/111201019-25

Abstract

Background: One of physician’s functions at primary health care center (PHC) is the ability to diagnose some diseases especially that contribute to high morbidity and mortality. Until now, hepatitis B virus infection has become a major health problem worldwide. The aim of this study was to identify the knowledge level of primary care physicians concerning hepatitis B in Surabaya. Method: The present study was a cross-sectional study that performed by investigators through interviews with primary care physicians in Surabaya to fill questionnaires for measuring their knowledge level. The questionnaires were modified from questionnaire survey in Tur Key performed by Peksen et al. It reflected the level of knowledge of the physicians including their comprehension, application and analysis. Validity and reliability test were performed on the Result of those questionnaires. The knowledge level was categorized as follows: > 75 (excellent), 70.0–74.9 (very high), 65.0–69.9 (high), 60.0–64.9 (medium), 55.0–59.9 (moderate), 47.5–54.9 (nearly moderate), 40.0-47.4 (less moderate), < 40 (low). Results: Based on validity test, we obtained 14 items of 17 question items with correlation coefficient 0.287–0.561 and alpha reliability index 0.639; therefore, the instrument can be used to measure the knowledge level. The results of mean score conversion included comprehension, which was 84.878 ± 16.499 (excellent category); application, which was 47.556 ± 31.870 (nearly moderate category) and analysis, which was 14.634 ± 35.562 (low category). Statistically, the mean value of the knowledge level scale, which was the combination of comprehension, application and analysis, was obtained at 49.023 ± 19.085 including the nearly moderate category. Conclusion: By using a valid and reliable instrument, the knowledge level of primary care physician in Surabaya concerning hepatitis B can be categorized as nearly moderate. Keywords: hepatitis B, liver cirrhosis, hepatoma
FAKTOR RISIKO TERKAIT PERDARAHAN VARISES ESOFAGUS BERULANG PADA PENDERITA SIROSIS HATI Vidyani, Amie; Vianto, Denny; W, Budi; Kholili, Ulfa; Maimunah, Ummi; Sugihartono, Titong; Purbayu, Herry; Boedi Setiawan, Poernomo; A Nusi, Iswan; Adi, Pangestu
journal of internal medicine Vol. 12, No. 3 September 2011
Publisher : journal of internal medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.384 KB)

Abstract

Recurrent esophageal varices bleeding  in  liver cirrhosis  increase  the morbidity and mortality. 50 ! 60% patients with Esophageal Varricess (EV) will experience recurrent bleeding, 30% or one third of them will experience recurrent bleeding one year after diagnosis of EV. Mostly recurrent bleeding will be found at 6 weeks until 6 months after the Þ rst bleeding. Prevention of recurrent bleeding is important for survival. The aim of this research to know the risk factors of recurrent EV bleeding in liver cirrhotic patients and the onset of recurrent bleeding after the Þ rst endoscopy. This is a  cross sectional study. Thirty Þ ve decompensated liver cirrhosis patients that fulÞ ll the inclusion and exclusion criteria participated in this study. After the Þ rst endoscopy, the risk factors are written, consist of sex, age, ascites, degree of varices, history of LVE/STE the severity of liver disease, and history of consuming gastric iritating drugs. The patients followed for six months to evaluated  the occurence of  recurrent bleeding. We used Pearson Chi-Square  test  for statistic analysis  (signiÞ cant  if p < 0.05). SPSS 17 were used to statistic calculation. Statistic analytical showed signiÞ cant correlation (p = 0.006; OR = 8.889; CI: 1.803 ! 43.820). On  the other hand sex, age, degree of EV, history of STE/LVE showed non signiÞ cant correlation. The main risk factor of recurrent EV in liver cirrhosis is the severity of liver disease.
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Ummi Maimunah; Rudyanto Rudyanto; Poernomo Boedi Setiawan; Pangestu Adi; Iswan Abbas Nusi; Hernomo Ontoseno Kusumobroto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201019-25

Abstract

Background: One of physician’s functions at primary health care center (PHC) is the ability to diagnose some diseases especially that contribute to high morbidity and mortality. Until now, hepatitis B virus infection has become a major health problem worldwide. The aim of this study was to identify the knowledge level of primary care physicians concerning hepatitis B in Surabaya. Method: The present study was a cross-sectional study that performed by investigators through interviews with primary care physicians in Surabaya to fill questionnaires for measuring their knowledge level. The questionnaires were modified from questionnaire survey in Tur Key performed by Peksen et al. It reflected the level of knowledge of the physicians including their comprehension, application and analysis. Validity and reliability test were performed on the Result of those questionnaires. The knowledge level was categorized as follows: 75 (excellent), 70.0–74.9 (very high), 65.0–69.9 (high), 60.0–64.9 (medium), 55.0–59.9 (moderate), 47.5–54.9 (nearly moderate), 40.0-47.4 (less moderate), 40 (low). Results: Based on validity test, we obtained 14 items of 17 question items with correlation coefficient 0.287–0.561 and alpha reliability index 0.639; therefore, the instrument can be used to measure the knowledge level. The results of mean score conversion included comprehension, which was 84.878 ± 16.499 (excellent category); application, which was 47.556 ± 31.870 (nearly moderate category) and analysis, which was 14.634 ± 35.562 (low category). Statistically, the mean value of the knowledge level scale, which was the combination of comprehension, application and analysis, was obtained at 49.023 ± 19.085 including the nearly moderate category. Conclusion: By using a valid and reliable instrument, the knowledge level of primary care physician in Surabaya concerning hepatitis B can be categorized as nearly moderate. Keywords: hepatitis B, liver cirrhosis, hepatoma
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Herry Purbayu; Poernomo Boedi Setiawan; Iswan A Nusi; Pangestu Adi; Hernomo Ontoseno Kusumobroto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200776-79

Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
Co-Authors Abdul A. Rani Ali Djumhana Amie Vidyani Ari F. Syam Aziz Rani Budi W Denny Vianto HERNOMO ONTOSENO KUSUMOBROTO Hernomo Ontoseno Kusumobroto Herry Purbayu Herry Purbayu I. D.N. Wibawa Iswan A Nusi Iswan A Nusi Iswan Abbas Nusi Jamhari Jamhari Marcellus Simadibrata Muhammad Miftahussurur Murdani Abdullah Pangarapen Tarigan Poernomo Boedi Setiawan Poernomo Boedi Setiawan Rudyanto Rudyanto Titong Sugihartono Ulfa Kholili Ummi Maimunah Yoshio Yamaoka, Yoshio Yudith Annisa Ayu Rezkitha, Yudith Annisa Ayu