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INTERLEUKIN 8 BERHUBUNGAN DENGAN DERAJAT GASTRITIS PADA PASIEN TERINFEKSI HELICOBACTER PYLORI Mariadi, IK; Kurniari, PK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Helicobacter pylori infection induces a local pro-inflammatory cytokine response. The secretion of IL-8 by epithelialcells is probably a key factor in host defenses at mucosal sites, permitting a rapid polymorph response against infectious agents.Interleukin-8 is an important chemotactic and activating factor for neutrophils. If defense mechanisms fail and chronic infectionresults, continued up regulation of IL-8 and neutrophil activation could lead to mucosal damage and increased free radicalformation. Mucosal IL-8 production in Helicobacter pylori infection may be an important factor in the immunopathogenesisof gastritis and peptic ulcer disease. This study aim to investigate correlation between IL-8 and severity of gastritis in ourpopulation. We performed a cross-sectional analytic study in Helicobacter pylori infected patients. Severity of gastritis wasdetermined base on The Updated Sydney System. IL-8 level was analyzed from gastric mucosa biopsy using ELISA method.We included 65 samples. 31 (47.7%) men and the rest was women. Base on Kruskalwallis test we found significant associationbetween IL-8 gastric mucosa and severity of gastritis (x2 = 12.8; p = 0.002). We also found significant association between IL-8gastric mucosa and density of H pylori infection (x2 = 10.6; p = 0.01), severity of atrophy (x2 = 9.4; p = 0.02) and neutrophilscount (x2 = 11.0; p = 0.01). But notmethaplasia (x2 = 3.3; p = 0.18). Base on this study we concluded that IL-8 was associatedwith severity of gastritis in Helicobacter pylori infected patients.
HUBUNGAN C-REACTIVE PROTEIN DENGAN PEMANJANGAN PROTHROMBIN TIME PADA PASIEN SIROSIS HATI YANG MENGALAMI PERDARAHAN SALURAN MAKANAN BAGIAN ATAS Mariadi, IK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Bacterial infections are common complications in cirrhosis, and cause the systemic in! ammation process. The natureof the relationship between gastrointestinal bleeding and infection in cirrhosis has not been clari" ed. Infection is associatedwith failure to control variceal bleeding and early variceal rebleeding in these patients. Bacterial infections, and particularlyendotoxemia, have been shown to activate the coagulation system and generally to interfere with hemostasis. We performedcross-sectional analytic study in cirrhosis patients with upper gastrointestinal bleeding to assess whether there are any associationbetween in! ammation process (CRP) with defect in haemostatic system (prolongation in prothrombin time). Forty-nine patientswere evaluated, 37 (75.5%) out of these were male and the rest were female. Ninteen out of this with in! ammation process and30 without in! ammation process. Fourteen out of 19 patients (73.7%) in in! ammation group have prolongation on prothrombintime and 12 out of 30 patients (40%) in non in! ammation group have prolongation on prothrombin time. The difference of thisproportion statistically signi" cant (Chi-square test X2: 5.29; p = 0.021). The CRP also have positive correlation with prolongationin prothrombin time (Spearman correlation R = 0.390; p = 0.006). In conclusion there is signi" cant association between CRP andprothrombin time in cirrhosis patients with upper gastrointestinal bleeding.
Age and Alarm Symptoms Predict Upper Gastrointestinal Malignancy among Patients with Dyspepsia Hendra Koncoro; I Ketut Mariadi; Gde Somayana; IGA Suryadarma; Nyoman Purwadi; IDN Wibawa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

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Abstract

Background: Upper gastrointestinal (UGI) malignancy is one of the major causes of cancer related death. Endoscopy in dyspeptic patients above 45 years, or those with alarm symptoms may detect this condition. There were only limited data in Indonesia about age and alarm symptoms to predict UGI malignancy. This study was aimed to determine the prevalence of UGI malignancy among dyspepsia patients and to develop a simple clinical prediction model.Method: A cross-sectional study to 390 patients with dyspepsia underwent endoscopy in Endoscopy Unit of Sanglah Hospital Denpasar between July 2012 and June 2013 was conducted. Demography and alarm symptoms were documented. Chi-square and logistic regression test analysis were conducted to analyze variables associated with UGI malignancy.Results: Twenty (5.13%) of 390 patients with dyspepsia had UGI malignancy. Of the 20 patients, 65% were gastric cancer and 30% were esophageal cancer. The mean age was 59 ± 12 years. Variables associated with UGI malignancy were weight loss (OR = 8.2), dysphagia (OR = 6.2), age 45 years old (OR = 5.6), gastrointestinal bleeding (OR = 5.5), persistent vomiting (OR = 5.4), and anemia (OR = 4.9). Using a simplified rule of age 45 years and the presence of any alarm symptom, sensitivity was 85% and specificity was 67.57%.Conclusions: UGI malignancy was found in 5.13% of patients with dyspepsia who underwent endoscopy. Simple clinical prediction model states that age above 45 years and alarm symptoms may be used as a screening tool to predict UGI malignancy.Keywords: dyspepsia, alarm symptoms, upper GI malignancy, clinical prediction model
Effect of Omeprazole to Dyspeptic Symptom on Ramadan Fasting Patient based on Dyspepsia Symptoms Severity Index Scores Eddy Chandra; Suzanna Ndraha; IDN Wibawa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.225 KB) | DOI: 10.24871/142201369-72

Abstract

Background: Dyspepsia is a symptoms collection of discomfort at the upper abdomen. Ramadan Fasting is a worship that must be run by all Moslems that do not eat and drink for ± 12 hours. Proton pump inhibitors are drugs commonly given to patients with dyspepsia with mechanism controlling gastric acid secretion. The aim of this study is to find the effect of omeprazole to the patient with dyspepsia and undergo Ramadan fasting.Method: Using analytic study design, conducted in outpatient in Koja Hospital Jakarta from June - July 2013, for patients with dyspepsia who will undergo Ramadan fasting. Subjects are divided into 2 groups; one group was given omeprazole while others were given a placebo. Before and after 2 weeks of fasting, dyspepsia symptoms severity index scores (DSSI) was taken which assessed changes in both groups and compared using student T-test.Results: DSSI scores on average before the intervention of both groups (n = 30) was not significant (p = 0.9). In the placebo group obtained increasing of DSSI score from 27.7 ± 14 to 36 ± 14.8 (p = 0.001), whereas in the omeprazole group obtained increasing of score only from 27.2 ± 9.4 to 30 ± 9.9 (p = 0.08). In the placebo group score worsened by 8.3 ± 7.2 but in the omeprazole group with only 2.7 ± 5.7 (p = 0.02).Conclusion: There was a significant decrease of DSSI scores in fasting patient with omeprazole. Therapy with omeprazole 20 mg twice daily during the month of fasting can reduce the abdominal complain in patient with dyspepsia.Keywords: dyspepsia, DSSI, fasting, Ramadan