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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Penyakit Dalam Indonesia
Neneng Ratnasari
Division of Gastroentero-hepatology, Department of Internal Medicine Faculty of Medicine, University of Gadjah Mada/Sardjito General Hospital, Yogyakarta
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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CORRELATION BETWEEN CHILD PUGH SCORE AND CYSTATIN C IN LIVER CIRRHOSIS PATIENTS Mulya, Deshinta Putri; Nurdjanah, Siti; Ratnasari, Neneng
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground. Renal dysfunction is a serious problem and it provides a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure. This condition is known as hepatorenal syndrome. Cystatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known. Objective. This study aimed is to verify correlation between the severity degree of the liver (Child Pugh/CP score) with levels of Cystatin C serum. Methods. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital - Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer; the analyzed of the CP score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed. Result. We found 48 research subjects during the month of October 2009 - March 2010. The subjects were 35 male (72.9%) and 13 female (27.1%) with average age 53.1 ± 11.9 years old. Subjects with CP-A were 9 patients (18.8%), CP-B were 14 patients (29.2%) and CP-C were 25 patients (52.1%). The range value of Cystatin C between CP class shows CP-A  0.7 - 0.97 mg/L, CP-B 0.7 - 0.49 mg/L, and CP-C 0.7 – 2.49 mg/L (statistically significant difference with p <0.05). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 patients (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p= 0.000; r= 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32). Conclusion. This study concluded that the Child score had a moderate positive correlation with Cystatin C serum level.  Key words: Liver Cirrhosis – Child Pugh score - Cystatin C 
Relationship between plasma fi brinogen levels with model of end stage liver disease score in patients with liver cirrhosis Nasir, Moch. Abdul; Ratnasari, Neneng; Bayupurnama, Putut
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTIntroduction. One of the complications which often occur in the liver cirrhosis is bleeding. Closely associated with weighing of bleeding were disturbance haemostatic homeostasis disorders that commonly associated with impaired liver function. Therefore certain biomarkers are needed to objectively measure the severity of liver cirrhosis. Fibrinogen is one of the clotting factors that can be used to determine the severity of liver cirrhosis.The model of end-stage liver disease (MELD) score is most excellent alternative of the Child-Pugh score. It can be used in patients with liver cirrhosis spacious ranges severity of disease and etiology even in patients whose cirrhosis etiology are not clear. Currently, there was not any data showing the correlation between the level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis. Aims. This study aimed to determine the correlation between level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis.Method. This study was cross-sectionally conducted used consecutive sampling. Study population were eligible patients with liver cirrhosis who visited outpatient and inpatient clinic in the Division of Gastroentero-hepatology, Dr. Sardjito general hospital, between November 2011 to October 2012. Correlation between the level of plasmatic fibrinogen and MELD score was statistically assessed using correlation test with fi nal result stated as correlation coefficient (r).Result. There were 40 subjects that met criteria, 28 male and 12 female, with average age of 53 ± 12,51 years. Etiology of cirrhosis was viral hepatitis B in 16 (40,0%) subjects, hepatitis C in 11 (27,5%) subjects and non viral in 13 (32,5%) subjects. Subjects with ascites were 19 (47, 5%) and without ascites were 20 (52.5%). Bleeding was experienced by 30 (80.0%) subjects while 10 (20,0%) subjects did not present with bleeding. Mean of plasma fibrinogen was 198 ± 102, 89 mg/dl, and mean of the MELD score was 17,05 ± 8.79. Spearman correlation coefficients between fi brinogen and MELD score was r = -0,404 (p = 0,010).Conclusion. There was a negative correlation between plasma fi brinogen and the MELD score in liver cirrhosis patients visiting our local setting.Keywords: liver cirrhosis, fi brinogen, MELD score
Correlation between leptin level with lipid profile and free fatty acid in liver cirrhosis patients Maryani, Siti; Ratnasari, Neneng; Nurdjanah, Siti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (123.354 KB) | DOI: 10.19106/JMedScie004603201404

Abstract

Malnutrition is a common condition in liver cirrhotic patients. Leptin regulates body weightphysiologically by suppressing appetite and increasing energy expenditure. Leptin is higher in femalethan male. Studies have shown correlation between leptin with metabolic factors like body massindex (BMI) and lipid profile in cirrhotic patients. This study was conducted to investigate thecorrelation between serum leptin levels with lipid profile and free fatty acid in male patients with livercirrhosis. This was a cross sectional study that conducted at Gastroentero-Hepatology Clinic andInternal Ward at Dr. Sardjito General Hospital, Yogyakarta. The inclusion criteria were patients withliver cirrhosis > 18 years old, male, with Child-Pugh classification B and C, and provided informedconsent. The exclusion criteria were liver cirrhotic patients with comorbidity chronic kidney disease,chronic heart failure, diabetic, cancer, infection/septic, pregnancy, breast feeding, and steroid use.Data collecting was performed by anamnesis, physical examination, abdominal ultrasonographyexamination, and blood chemistry test. Pearson test was used to evaluate the correlation betweenthe serum leptin level with the lipid profile and free fatty acid. The results showed that no significantnegative correlation was observed between the serum leptin level with the total cholesterol (r= -0.052; p=0.766), high-density lipoprotein/HDL (r= -0.078; p=0.658) and triglyceride (r= -0.170; p=0.328) in male patients with liver cirrhosis. Furthermore, no significant positive correlationwas observed between the serum leptin levels with the low-density lipoprotein/LDL (r= -0.013; p=0.942) and free fatty acid/FFA (r= 0.007; p=0.968). In conclusion, there was no correlationbetween serum leptin levels with lipid profile and FFA in male patients with liver cirrhosis.
Sensitisasi Alergen Makanan pada Pasien Kolitis Eosinofilik: Laporan Kasus Zagoto, Agnes Dina Irene Dorithy; Mulya, Deshinta Putri; Ratnasari, Neneng
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
Publisher : UI Scholars Hub

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Eosinophilic colitis is a very rare disease that can occur in the bimodal population (neonates and young adults) with a prevalence was 2.1/100,000 in overall population and 2.3/100,000 in adults. However, only about 0.1% of cases were diagnosed from biopsy results obtained during colonoscopy. The lack of precise histological criteria for the quantity of eosinophils in the colon mucosa creates a distinct challenge in diagnosing eosinophilic colitis. Eosinophilia in the gastrointestinal tract can be mediated by IgE and non-IgE, but non-IgE tends to be dominant in adults. This report discusses about a case of a 64-year-old male with bloody diarrhea that has been occur for two years. The anamnesis revealed symptoms suggestive of eosinophilic colitis, including complaints of diarrhea with abdominal pain and weight loss. Laboratory tests revealed an increase in peripheral eosinophil count and elevated levels of IgE. A positive skin prick test supported the presence of food allergen sensitization. The endoscopy revealed signs of ulcerative colitis, but the biopsy showed evidence of eosinophilic colitis. Initially, the patient was treated for ulcerative colitis but did not show improvement. Following treatment for eosinophilic colitis, the patient’s clinical status showed improvement. Since eosinophilic colitis can be chronic and recur, an accurate diagnosis and proper management are crucial for achieving complete remission. Keywords: chronic diarrhea, eosinophilic colitis, food allergen sensitization, IgE, peripheral eosinophilia
Co-Authors Catharina Triwikatmani Deshinta Putri Mulya Dwijayanti, Hervina Fahmi Indrarti Farida, Yeni Fita Rahmawati Hakim, Suharno Hemi Senorita Jamhari Jamhari Moch. Abdul Nasir Mulyani, Tuty Nurdjanah S, Nurdjanah Probowati, Wiwiek Putut Bayupurnama Rachmad Aji Saksana Riska Humardewayani Adie SATRIYAS ILYAS SITI MARYANI Siti Nurdjanah Suharjo B Cahyono Suharjo Broto Cahyono Suryo Taroeno Susetyowati Susetyowati, Susetyowati Sutanto Maduseno Tri Murti Andayani Zagoto, Agnes Dina Irene Dorithy