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Mycophenolate mofetil versus cyclophosphamide for therapy of lupus nephritis: an evidence-based case report from systematic reviews and meta-analyses Pramono, Laurentius A.; Karim, Birry; Rajabto, Wulyo; Siregar, Parlindungan; Sukmana, Nanang; Setyohadi, Bambang
Medical Journal of Indonesia Vol 21, No 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.305 KB) | DOI: 10.13181/mji.v21i1.474

Abstract

Background: The aim of this case study is to compare the effectiveness between cyclophosphamide and mycophenolate mofetil to achieve remission of lupus nephritis in an evidence-based case report from meta-analyses.Methods: Method in this case study is evidence-based case report using meta-analyses. Clinical question used in this paper is; which immunosuppressant gives better result in achieving remission in lupus nephritis patient: cyclophosphamide or mycophenolate mofetil? To answer this question, we search the evidence from PubMed with the keywords: “lupus nephritis AND mycophenolate mofetil AND cyclophosphamide” with inclusion criteria of meta-analysis, written in English, and focused comparing cyclophosphamide and mycophenolate mofetil.Results: From the searching method, we found 11 articles which is relevant. One has been excluded since it written in Hebrew, 4 articles excluded since are not focus answering the clinical question. At the end, 6 studies were included to the critical appraisal step.Conclusion: Based on the evidences, mycophenolate mofetil is non-inferior to cyclophosphamide in achieving remission in lupus nephritis patients, but with the better safety profile. Patient in our case study get mycophenolate mofetil and shows better clinical condition towards remission as she are evaluated in the outpatient clinic. (Med J Indones 2012;21:44-51)Keywords: Cyclophosphamide, evidence-based case report, lupus nephritis, meta-analysis, mycophenolate mofetil, remission, systematic review
Proporsi Kejadian Depresi Pasien Kanker di Ruang Rawat Singkat Rumah Sakit Kanker “Dharmais” LUGITO, NATA; KARIM, BIRRY; KANSERA, DOLLY DOLVEN; KHORINAL, EKA WIDYA; YARUNTRADHANI, RIZKI; SUTANDYO, NOORWATI
Indonesian Journal of Cancer Vol 6, No 2 (2012): Apr - Jun 2012
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Tujuan: mendapatkan data  tentang proporsi  kejadian depresi  serta  faktor yang berhubungan pada  pasien  kanker di ruang rawat singkat Rumah Sakit Kanker “Dharmais”.Metode: studi potong lintang dilakukan terhadap 26 pasien dewasa ruang rawat singkat Rumah Sakit Kanker “Dharmais” (RSKD) untuk menentukan proporsi kejadian depresi dan faktor yang mungkin berhubungan. Data demografik meliputi nama,  usia, jenis kelamin, tempat tinggal, pekerjaan,  pendidikan, status pernikahan, dan pembiayaan. Data yang berhubungan dengan  kanker meliputi  jenis  kanker, lama  terdiagnosis kanker, kemoterapi, dan  terapi  lainnya (pembedahan dan radioterapi). Depresi dievaluasi menggunakan Beck Depression Inventory (BDI).Hasil: diperoleh 26 pasien kanker. Proporsi pasien yang mengalami depresi ambang, sedang, dan berat sebesar 13,1%; dan tidak ada pasien yang mengalami depresi sangat berat. Proporsi kejadian depresi lebih tinggi pada pasien dengan pembiayaan jaminan, sudah pensiun bekerja, dan menjalani pembedahan.Kesimpulan:  proporsi  kejadian depresi  di Rumah Sakit Kanker “Dharmais” sebanding dengan  berbagai  studi.  Perlu dilakukan penapisan gejala depresi  pada pasien  kanker sebagai  bagian penatalaksanaan kanker secara holistik serta rujukan untuk pasien  dengan  risiko tinggi menderita depresi  dalam usaha  menurunkan morbiditas, perbaikan  luaran penyakit, penghematan biaya kesehatan, dan peningkatan kualitas hidup pasien.Kata Kunci: Beck Depression Index (BDI), depresi, kanker
Proporsi Kejadian Depresi Pasien Kanker di Ruang Rawat Singkat Rumah Sakit Kanker Dharmais NATA LUGITO; BIRRY KARIM; DOLLY DOLVEN KANSERA; EKA WIDYA KHORINAL; RIZKI YARUNTRADHANI; NOORWATI SUTANDYO
Indonesian Journal of Cancer Vol 6, No 2 (2012): Apr - Jun 2012
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v6i2.183

Abstract

Tujuan: mendapatkan data tentang proporsi kejadian depresi serta faktor yang berhubungan pada pasien kanker di ruang rawat singkat Rumah Sakit Kanker Dharmais.Metode: studi potong lintang dilakukan terhadap 26 pasien dewasa ruang rawat singkat Rumah Sakit Kanker Dharmais (RSKD) untuk menentukan proporsi kejadian depresi dan faktor yang mungkin berhubungan. Data demografik meliputi nama, usia, jenis kelamin, tempat tinggal, pekerjaan, pendidikan, status pernikahan, dan pembiayaan. Data yang berhubungan dengan kanker meliputi jenis kanker, lama terdiagnosis kanker, kemoterapi, dan terapi lainnya (pembedahan dan radioterapi). Depresi dievaluasi menggunakan Beck Depression Inventory (BDI).Hasil: diperoleh 26 pasien kanker. Proporsi pasien yang mengalami depresi ambang, sedang, dan berat sebesar 13,1%; dan tidak ada pasien yang mengalami depresi sangat berat. Proporsi kejadian depresi lebih tinggi pada pasien dengan pembiayaan jaminan, sudah pensiun bekerja, dan menjalani pembedahan.Kesimpulan: proporsi kejadian depresi di Rumah Sakit Kanker Dharmais sebanding dengan berbagai studi. Perlu dilakukan penapisan gejala depresi pada pasien kanker sebagai bagian penatalaksanaan kanker secara holistik serta rujukan untuk pasien dengan risiko tinggi menderita depresi dalam usaha menurunkan morbiditas, perbaikan luaran penyakit, penghematan biaya kesehatan, dan peningkatan kualitas hidup pasien.Kata Kunci: Beck Depression Index (BDI), depresi, kanker
Cardiac Tamponade Due to Liver Amebiasis Rupture Birry Karim; Afifah Is; Ikhwan Rinaldi; Dono Antono; Cleopas Martin Rumende; Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010150-155

Abstract

Amebiasis is common cases in Asia, Africa, and South Africa. Liver amebiasis has become a serious problem worldwide especially in health and social aspect. The protozoa named Entamoeba histolytica was easily found in area with poor sanitation, low socioeconomic status, and poor nutrition status. The incidence of amebiasis in several hospitals in Indonesia is 5-15% per year. Epidemiological observation showed the comparison of incidence among male and female population and it was approximately 3 : 1 until 22 : 1 with male predominance. The potential age suffered from amebiasis is around 20 - 50 years old. The route of infection spread to oral-fecal and oral-anal-fecal. The most common complication is abscess rupture (5-15.6%). Rupture may be located in pleural cavity, pericardial cavity, lung, bowel, intraperitoneal, and skin. Rupture of liver amebias spread to pleural and pericardial cavity is a rare case and frequently under reported. This case report illustrates a 40-year-old male with cardiac tamponade due to rupture of liver amebiasis. Patient’s was admitted with chief complaint of shortness of breath, positive Beck’s triad, hepatomegaly, pleural effusion, liver abscess on sonography and swinging of heart on echocardiography. This patient was treated with metronidazole as a drug of choice, and pericardiocentesis for the cardiac tamponade.Keywords: cardiac tamponade, Entamoeba histolytica, oral-anal-fecal, metronidazole, pericardiocentesis
Tuberculous Peritonitis Presenting Acute Recurrent Pancreatitis Birry Karim; Afifah Is; Ikhwan Rinaldi; Ari Fahrial Syam; Murdani Abdullah; Ceva Wicaksono Pitoyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009125-130

Abstract

Tuberculosis (TB), one of the oldest diseases known to affect humans, is a major cause of death worldwide. TB is still a major problem in Indonesia. This disease, which is caused by bacteria of the Mycobacterium tuberculosis, usually affects the lungs, although other organs are involved in up to one- third of cases. Approximately 95% cases of TB and 98% death because of TB occur in developing country. Gastrointestinal tuberculosis is uncommon, making up 3.5% of extrapulmonary cases in the United States. This kind of TB may involve gastrointestinal tract, peritoneal, lymph nodes, or solid intraabdominal organs (viscera). A 17 years old male admitted to hospital with TB peritonitis presenting unusual clinical manifestation. At the first admission patients was diagnosed with acute pancreatitis based on elevation of amylase and lipase level up to 285 and 2,046 U/L and after finishing further examination, patients suffered from tuberculous peritonitis which based on literature manifested some gastrointestinal disorders. Diagnostic confirmation was accomplished by conducting serum-ascites albumin gradient (SAAG) of 1.1 g/dL, peritoneal thickening and the presence of ascites with fine mobile septations on ultrasound, positive polymerase chain reaction (PCR) TB from ascitic fluid. Patients received conventional antitubercular therapy for 12 months of rifampicin, isoniazid, pyrazinamide, and ethambutol. The addition of corticosteroids for the first two or three months of treatment may reduce the incidence of late complications arising from adhesive disease, such as small bowel obstruction. Keywords: mycobacterium tuberculosis, tuberculous peritonitis, PCR, serum-ascites albumin gradient
Selecting Treatment Modality for Small Hepatocellular Carcinoma: Radiofrequency Ablation, Percutaneous Alcohol and Acetic Acid Injection Birry Karim; Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (491.297 KB) | DOI: 10.24871/1222011116-122

Abstract

Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy worldwide and is the leading cause of death in patients with cirrhosis. In early-stage tumors, potential curative therapies have been used including ablative therapies using percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI) or radiofrequency ablation (RFA); surgical resection and liver transplantation. RFA is more effective and safer than other local ablative therapy modalities. RFA should be considered as the first-line treatment for patients with small HCC, i.e. sized less than 5 cm; preferably less than or equal to 3 cm since they are not suitable for liver resection or liver transplantation. RFA should also be compared with transarterial embolization, which currently has been considered as the standard HCC therapy in some countries. It has been reported that the combination of RFA and embolization treatment may reduce the early and late recurrence rate. Keywords: hepatocellular carcinoma, percutaneous ethanol injection, acetic acid injection, radiofrequency ablation
Diagnosis dan Tata Laksana Paroksismal Nokturnal Hemoglobinuria Pramono, Laurentius A; Karim, Birry; Iskandar, Marha; Yanto, Asnawi
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 2
Publisher : UI Scholars Hub

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Abstract

Paroksismal nokturnal hemoglobinuria (PNH) merupakan kelainan darah yang sangat jarang. Penegakan diagnosis PNH cukup panjang, mulai darianamnesis, pemeriksaan fisik, serta pemeriksaan laboratorium (darah dan urin) dimulai dari yang sederhana sampai lanjutan. Penyelidikan ini tidak saja memerlukan perencanaan klinis yang matang, melainkan juga waktu dan tenaga yang banyak, serta biaya yang mahal. Selain itu, sampai saat ini, pilihan pengobatan untuk PNH masih sangat terbatas, dengan keberhasilan yang belum memuaskan sepenuhnya. Berikut kami laporkan sebuah kasus PNH pada seorang perempuan 18 tahun.