Jeffry Beta Tenggara
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Non-invasive Markers for Diagnosis of Liver Cirrhosis in Chronic Hepatitis B Tenggara, Jeffry Beta; Hasan, Irsan; Sanityoso, Andri; Abdullah, Murdani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
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: 10.24871/1232011134-139

Abstract

Background: Indonesia is an endemic country for hepatitis B viral infection. Thus, early diagnosis of cirrhosis is important to be established with regard to prompt treatment and to determine the patients’ prognosis. Liver biopsy which is a gold standard in diagnosing liver cirrhosis has several limitations, such as expensive and invasive. The objective of this study was to identify the accuracy of non-invasive markers: aspartate/alanine transaminase ratio (AAR), age-platelet index (API), aspartate transaminase to platelet ratio index (APRI), spleen to platelet ratio index (SPRI), and age-spleen-platelet ratio index (ASPRI) in predicting cirrhosis in chronic hepatitis B patients. Methods: A diagnostic study was performed in Division of Hepatology and Hepatology Outpatient Clinic, Depatment of Internal Medicine, Cipto Mangunkusumo Hospital between January 2009 and July 2010, with the participation of 71 chronic hepatitis B patients who had undergone liver biopsy consecutively. Stage of fibrosis was determined based on the METAVIR scoring system. Five non-invasive markers: AAR, API, APRI, SPRI, and ASPRI were compared with liver biopsy Results. Statistical analysis was performed by using T-test and Spearman correlation test using SPSS version 13. Results: API, APRI, SPRI, and ASPRI had significant correlation with the incidence of liver cirrhosis in hepatitis B infection (p < 0.05). However, AAR had no correlation with the incidence of cirrhosis. Using the cut-off point of 1.19, APRI was the best marker with area under curve (AUC) 0.91, sensitivity 83.3%, and specificity 89.2%. Conclusion: Non-invasive markers were suitable in predicting cirrhosis and have the potential to decrease the number of liver biopsy in chronic hepatitis B patients. Keywords: non-invasive markers, chronic hepatitis B, liver cirrhosis
Complicated Benign Peptic Stricture of the Esophagus Mulia, Mulia; Tenggara, Jeffry Beta; Abdullah, Murdani; Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 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: 10.24871/1122010100-105

Abstract

Peptic esophageal stricture secondary to gastroesophageal reflux is an important cause of esophageal stenosis and dysphagia. Symptoms of peptic strictures are usually insidious but progressive beginning with dysphagia to solids followed by dysphagia to liquids. It was estimated to occur in up to 20% of untreated patients, which has decreased significantly since the era of proton pump inhibitor therapy. The presence of esophageal reflux stricture is typically diagnosed by means of a barium esophagogram, although endoscopy may have both diagnostic and therapeutic value. Treatment usually involves dilation combined with acid- suppressive therapy. We reported a 43-year-old patient with complicated benign peptic stricture of the esophagus that finally underwent esophageal resection, a rarely therapeutic option.   Keywords: gastroesophageal reflux disease, benign peptic esophageal stricture, dysphagia, esophageal dilatation, surgical treatment
Non-invasive Markers for Diagnosis of Liver Cirrhosis in Chronic Hepatitis B Jeffry Beta Tenggara; Irsan Hasan; Andri Sanityoso; Murdani Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (584.967 KB) | DOI: 10.24871/1232011134-139

Abstract

Background: Indonesia is an endemic country for hepatitis B viral infection. Thus, early diagnosis of cirrhosis is important to be established with regard to prompt treatment and to determine the patients’ prognosis. Liver biopsy which is a gold standard in diagnosing liver cirrhosis has several limitations, such as expensive and invasive. The objective of this study was to identify the accuracy of non-invasive markers: aspartate/alanine transaminase ratio (AAR), age-platelet index (API), aspartate transaminase to platelet ratio index (APRI), spleen to platelet ratio index (SPRI), and age-spleen-platelet ratio index (ASPRI) in predicting cirrhosis in chronic hepatitis B patients. Methods: A diagnostic study was performed in Division of Hepatology and Hepatology Outpatient Clinic, Depatment of Internal Medicine, Cipto Mangunkusumo Hospital between January 2009 and July 2010, with the participation of 71 chronic hepatitis B patients who had undergone liver biopsy consecutively. Stage of fibrosis was determined based on the METAVIR scoring system. Five non-invasive markers: AAR, API, APRI, SPRI, and ASPRI were compared with liver biopsy Results. Statistical analysis was performed by using T-test and Spearman correlation test using SPSS version 13. Results: API, APRI, SPRI, and ASPRI had significant correlation with the incidence of liver cirrhosis in hepatitis B infection (p 0.05). However, AAR had no correlation with the incidence of cirrhosis. Using the cut-off point of 1.19, APRI was the best marker with area under curve (AUC) 0.91, sensitivity 83.3%, and specificity 89.2%. Conclusion: Non-invasive markers were suitable in predicting cirrhosis and have the potential to decrease the number of liver biopsy in chronic hepatitis B patients. Keywords: non-invasive markers, chronic hepatitis B, liver cirrhosis
Complicated Benign Peptic Stricture of the Esophagus Mulia Mulia; Jeffry Beta Tenggara; Murdani Abdullah; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1122010100-105

Abstract

Peptic esophageal stricture secondary to gastroesophageal reflux is an important cause of esophageal stenosis and dysphagia. Symptoms of peptic strictures are usually insidious but progressive beginning with dysphagia to solids followed by dysphagia to liquids. It was estimated to occur in up to 20% of untreated patients, which has decreased significantly since the era of proton pump inhibitor therapy. The presence of esophageal reflux stricture is typically diagnosed by means of a barium esophagogram, although endoscopy may have both diagnostic and therapeutic value. Treatment usually involves dilation combined with acid- suppressive therapy. We reported a 43-year-old patient with complicated benign peptic stricture of the esophagus that finally underwent esophageal resection, a rarely therapeutic option.   Keywords: gastroesophageal reflux disease, benign peptic esophageal stricture, dysphagia, esophageal dilatation, surgical treatment