Andi Zainal
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Riau-RSUD Arifin Ahmad Pekanbaru

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Multiple Liver Abscess Zainal, Andi; Alfina, Dona; Kurniawan, Heru
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
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: 10.24871/42200354-58

Abstract

Liver abscess is a public health problem in few countries in Asia, Africa, and South America.1 As time goes, there were only few cases of amebic liver abscess found in developed countries, on the contrary more pyogenic liver abscess are found in those countries.2 Liver abscess could be caused by bacteria, parasite, or fungus 2. The common symptoms among the liver abscess are fever, chill, fatigue, loss of appetite, weight loss, right upper abdominal pain,2,4 in a few cases have symptoms like coughing, hiccup, pain in low right chest, or pain on the shoulder. We reported a male patient 38 years batak ethnic was admitted with major symptoms such as high fever follow by chill, right upper abdominal pain, nausea, vomiting, appetite loss, fatigue and sometimes coughing. Based on clinical, laboratory data, and abdominal USG found this patient suspected suffered from pyogenic liver abscess. Treatment of this patient consist of antibiotic (cefotaxime 2x1 IV, metronidazol 3x500mg orally and aspiration of the liver abscess). Aspiration was done 2 times with the interval 1 week, extracted 260cc totally yellow greenish watery fluid with no smell. On the follow up abdominal USG was repeated on Janurary 8, 2003 found enlarge of the liver, 3 small abscesses on the right lobe liver and so recovery process and then patient left the hospital in good condition after 3 weeks hospitalized. Keywords: Multiple liver abscess, public health problem, pyogenic liver abscess
Distribusi Genotipe dan Subtipe Virus Hepatitis B pada Penderita Hepatitis B Kronik di Pekanbaru Arfianti, -; Zainal, Andi; Andrini, Fauzia; Endriani, Rita
Majalah Kedokteran Bandung Vol 43, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Variasi genetik virus hepatitis B (VHB) dapat mempengaruhi manifestasi klinis, risiko karsinoma hepatoselular (KH), dan respons terhadap terapi antiviral. Desain penelitian adalah analitik cross-sectional yang bertujuan untuk mengetahui apakah terdapat perbedaan distribusi genotipe dan subtipe VHB pada berbagai manifestasi klinis hepatitis B kronik di Pekanbaru. Sebanyak lima puluh dua serum penderita hepatitis B kronik di Pekanbaru diperoleh sejak bulan Maret sampai Agustus 2009 telah diperiksa pada penelitian ini. Analisis statistik menggunakan uji Fisher. Penentuan genotipe VHB dilakukan dengan membandingkan sikuens gen S pada penelitian ini dengan sikuens gen S yang telah dipublikasi pada GenBank. Hasil penelitian menunjukkan bahwa 31 (60%) penderita terinfeksi oleh genotipe C dan 21 (40%) oleh genotipe B. Berdasarkan manifestasi klinis, genotipe C merupakan genotipe yang paling banyak ditemukan pada donor darah (7/10 penderita) dan sirosis (7/10 penderita), sedangkan pada penderita hepatitis B kronik aktif dan KH ditemukan frekuensi genotipe B dan C yang hampir sama. Subtipe adr (60%) merupakan subtipe yang paling banyak ditemukan, diikuti oleh subtipe adw (38%) dan ayw (2%). Berdasarkan hasil uji stastitik tidak ditemukan perbedaan bermakna distribusi genotipe dan subtipe pada berbagai manifestasi klinis infeksi VHB. Namun, genotipe C (8/9 penderita) merupakan genotipe VHB yang paling banyak ditemukan pada penderita KH dengan sirosis, sedangkan genotipe B (8/11 penderita) merupakan genotipe VHB yang paling banyak menginfeksi penderita KH tanpa sirosis (p=0,01). Simpulan, genotipe VHB mungkin berhubungan dengan patogenesis karsinoma hepatoselular dengan sirosis dan tanpa sirosis. [MKB. 2011;43(3):105–11].Kata kunci: Genotipe, hepatitis B kronik, karsinoma hepatoselular, sirosis, subtipe Distribution of Hepatitis B Virus Genotypes and Subtypes Among Chronic Hepatitis B Patients in PekanbaruGenetic variance of hepatitis B virus (HBV) may influence the clinical manifestation, development of hepatocellular carcinoma (HCC), and response to antiviral treatment. This was analytic cross-sectional study which aimed to investigate the distribution of HBV genotypes and subtypes among different clinical status of chronic hepatitis B in Pekanbaru. A total of fifty-two of sera from chronic hepatitis B patients in Pekanbaru was collected from March to August 2009. Statistical analysis was performed by using Fisher test. HBV genotypes were examined based on homology of S gene from this study with those of GenBank database. Of these subjects, 31 (60%) and 21 (40%) were infected by genotype C and B, respectively. Based on clinical manifestation, genotype C was predominantly found among HBsAg-positive blood donors (7/10 patients) and liver cirrhosis (7/10 patients), whereas genotype B and C were comparable among chronic hepatitis B active and hepatocellular carcinoma patients. Subtype adr (60%) was the most prevalent, followed by subtype adw (38%) and subtype ayw (2%). There were no significant difference in the distribution of HBV genotypes and subtypes among diverse clinical manifestation of HBV infection. However, genotype C was predominantly detected among cirrhotic-HCC (8/9 patients) , while genotype B was mostly identified among non cirrhotic-HCC (8/11 patients) (p=0.01). In conclusion, HBV genotype may be associated with the pathogenesis of cirrhotic and noncirrhotic-HCC. [MKB. 2011;43(3):105–11].Key words: Chronic hepatitis B, genotype, hepatocellular carcinoma, liver cirrhosis, subtype DOI: http://dx.doi.org/10.15395/mkb.v43n3.54
FAKTOR RISIKO HEPATITIS B PADA TENAGA KESEHATAN KOTA PEKANBARU Amtarina, Rina; Arfianti, A; Zainal, Andi; Chandra, Fifia
Majalah Kedokteran Bandung Vol 41, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penyakit hepatitis B tergolong penyakit yang menjadi masalah kesehatan serius di Indonesia. Penularan virus hepatitis B melalui kontak dengan produk darah. Data mengenai pembawa HBsAg dan faktor risiko penularan VHB di Kota Pekanbaru belum ada sehingga perlu diadakan penelitian mengenai hal tersebut. Penelitian dilakukan secara retrospektif terhadap hasil pemeriksaan HBsAg dan anti-HBs responden dengan cara menganalisis hasil jawaban kuesioner. Responden dibagi 2 kriteria yaitu kriteria pernah/sedang terpapar hepatitis B dengan hasil pemeriksaan anti-HBs positif HBsAg negatif atau HBsAg positif Anti-HBs negatif dan kriteria tidak pernah terpapar VHB dengan hasil pemeriksaan HBsAg dan anti-HBs negatif. Dari 110 responden, 32 orang (29,1%) hasil anti-HBs positif, HBsAg negatif, 1 orang (0,9%) hasil HBsAg positif, anti-HBs negatif. Dari analisis kuesioner, faktor risiko penularan dari 32 orang anti-HBs positif terbanyak melalui pernah cabut gigi yaitu sebanyak 29 orang (90,6%) diikuti dengan pernah tertusuk jarum bekas/tidak steril sebanyak 18 orang (56,2%). Hanya 3 (9,3%) dari 32 orang pernah menderita hepatitis B sebelumnya. Pada 1 orang dengan HBsAg positif, faktor risiko penularan melalui tertusuk jarum bekas/tidak steril, pengobatan akupuntur, cabut gigi, dan ada anggota keluarga serumah yang pernah menderita hepatitis B. Faktor risiko penularan terbanyak pada tenaga kesehatan di Pekanbaru adalah melalui cabut gigi dan tertusuk jarum bekas/tidak steril.Kata kunci: Hepatitis B virus, anti-HBs, HBsAg, tenaga kesehatan, faktor risikoRISK FACTORS FOR TRANSMISSION OF HEPATITIS B VIRUS INFECTION IN HEALTH CARE WORKER OF PEKANBARU CITYHepatitis B is still the one of serious public health problem in the world including Indonesia. Transmission of hepatitis B virus (HBV) is strongly associated with use of contaminated blood products. For many people infected with HBV, risk factors of transmission are unknown. We examined risk factors for acquiring HBV in health care worker. This research was done by retrospective to blood participants who tested positive for HBs antibody or HBs antigen, using a questionnaire.participants divided into 2 groups. Had/having exposed to VHB with ati-HBs Positive HBsag negative or HBsag positive, anti-HBs negative and never had exposed to VHB with HBsag and anti-HBs negative. Positive anti- HBs were identified in 32 (29.1%) of 110 participants. Positive HBs antigen anti-HBs negative was identified in 1 (0.9%) of 110 participants. In questionnaire analysis, significant risk factors for HBV infection among HBs antibody - positive participants were tooth extraction in 29 (90.6%), and needle stick injuries in 18 (56.2%) of 32 participants. Only 3 (9.3%) of 32 participants with HBs antibody - positive had history of post infected HBV for several years ago. In 1 participant with HBs antigen - positive, significant risk factors were needle stick injuries, acupuncture, tooth extraction, and contact infected person. The most significant risk factors for transmission of hepatitis B in health care worker in Pekanbaru city are tooth extraction and needle stick injuries.Key words: Hepatitis B virus (HBV), HBs antibody, HBs antigen, health care worker, risk factor DOI: http://dx.doi.org/10.15395/mkb.v41n3.245