Noto Dwimartutie
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Abdominal Tuberculosis: Diagnostic and Management Problems Dwimartutie, Noto; A, Iskandar; Simadibrata, Marcellus; Syam, Ari F; Pitoyo, Ceva W; Sulaiman, Andri; Loho, Tony
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 1, April 2006
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: 10.24871/71200621-27

Abstract

Abdominal tuberculosis, as one of the manifestations of extrapulmonary tuberculosis, may involve gastrointestinal tract, peritoneum, mesenteric lymph nodes, liver, and also spleen. Most patients have constitutional symptoms of fever, pain, diarrhea, constipation, alternating constipation and diarrhea, weight loss, anorexia and malaise. It also has an insidious course without any specific laboratory, radiological or clinical findings and makes it difficult to diagnosis. Anti tuberculosis treatments with initiation phase for 2 months and continue with continuation phase for 7 months is effective. Steroids may be used to reduce acute inflammation and limit delayed fibrotic complications. We report a male patient with abdominal tuberculosis involving peritoneum, liver, colon, paraaorta lymph nodes, and spleen, which at first suggested as a malignancy. Drug induced hepatitis due to anti tuberculosis drug during treatment was emerged and substituted with other regimen. After given anti tuberculosis treatment and steroid as adjunctive treatment, the clinical condition of patient was improved. Keywords: abdominal tuberculosis, anti tuberculosis treatment, drug induced hepatitis
Abdominal Tuberculosis: Diagnostic and Management Problems Noto Dwimartutie; Iskandar A; Marcellus Simadibrata; Ari F Syam; Ceva W Pitoyo; Andri Sulaiman; Tony Loho
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 1, April 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/71200621-27

Abstract

Abdominal tuberculosis, as one of the manifestations of extrapulmonary tuberculosis, may involve gastrointestinal tract, peritoneum, mesenteric lymph nodes, liver, and also spleen. Most patients have constitutional symptoms of fever, pain, diarrhea, constipation, alternating constipation and diarrhea, weight loss, anorexia and malaise. It also has an insidious course without any specific laboratory, radiological or clinical findings and makes it difficult to diagnosis. Anti tuberculosis treatments with initiation phase for 2 months and continue with continuation phase for 7 months is effective. Steroids may be used to reduce acute inflammation and limit delayed fibrotic complications. We report a male patient with abdominal tuberculosis involving peritoneum, liver, colon, paraaorta lymph nodes, and spleen, which at first suggested as a malignancy. Drug induced hepatitis due to anti tuberculosis drug during treatment was emerged and substituted with other regimen. After given anti tuberculosis treatment and steroid as adjunctive treatment, the clinical condition of patient was improved. Keywords: abdominal tuberculosis, anti tuberculosis treatment, drug induced hepatitis
Prediction Model of 30-Day Mortality in Elderly Patients Admitted to Geriatric Acute Ward Using Comprehensive Geriatric Assessment Domain Dwimartutie, Noto; Setiati, Slti; Wahyudi, Edy Rizal; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
Publisher : UI Scholars Hub

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Abstract

Elderly Mistreatment: Risk Factors and Therapy Madina, Ummi Ulfah; Dwimartutie, Noto
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Elderly mistreatment is a preventable serious health problem that lowering older adults quality of life. Elderly mistreatment can be done by the caregiver or even the patient himself, regardless the intention. Meanwhile, defining an elderly mistreatment is still a challenge due to varied risk factors and cultural differences in each country. Those conditions result in challenges in identifying and managing elderly mistreatment. This review will also discuss screening modalities to identify elderly who is at risk or currently abused to prevent and manage elderly mistreatment properly.
Prediction Model of 30-Days Postoperative Pneumonia in Elderly Patient Undergoing Abdominal Surgery Dwimartutie, Noto; Oktadiana, Harini; Singh, Gurmeet; Jeo, Wifanto Saditya; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Physiologic changes in respiratory tract in elderly increase incidence of post-operative pneumonia. Post-operative pneumonia in non-thoracic surgery was found higher in abdominal surgery. This study aimed to develop a prediction model of 30-day post-operative pneumonia in elderly patients undergoing abdominal surgery. Methods. A retrospective cohort study was conducted using elderly patient’s medical records who underwent abdominal surgery in Cipto Mangunkusumo General Hospital. Multivariate analysis using logistic regression was used to determine Odds Ratio (OR). Model’s calibration performance was determined by Hosmer-Lameshow test and its discrimination performance was determined by calculating area under the curve (AUC). Results. Of 753 subject who underwent abdominal surgery, postoperative pneumonia was found in 9.2% subjects. Independent predictors for 30-day postoperative pneumonia were functional status [ADL Barthel 0-11, odds ratio (OR) 6.908 (95% confidence interval (CI) 2.933-16.273); ADL Barthel 12-19, OR 3.191 (95%CI 1.53-6.657)], upper abdominal surgery [OR 4.869 (95%CI 1.805-13.132)], chronic obstructive pulmonary disease [OR 6.888 (95%CI 2.001-23.709)], and albumin level /dl [OR 2.54 (95%CI 1.404-4.596)]. Prediction model of pneumonia was stratified into lower risk (score 3; probabililty 60.42%). Hosmer-Lemeshow test revealed p-value 0.452 and the AUC value is 0.811 (95%CI 0.87-0.97). Conclusion. A simple prediction model of 30-day post-operative pneumonia for elderly patients undergoing abdominal surgery consisted of 4 predictors (functional status, upper abdominal surgery, COPD and albumin level /dl) has a good performance.