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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Irsan Hasan Irsan Hasan
Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia
Medicine & Pharmacology

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Acalculous Cholecystitis Prevalence on Abdominal Ultrasonography Examination of HIV/HCV Co-infection Patients in Cipto Mangunkusumo Hospital Bambang Sutopo; Unggul Budihusodo; Irsan Hasan; Rino Alvani Gani; Evy Yunihastuti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201032-34

Abstract

Background: Acalculous cholecystitis is commonly found in patients with human immunodeficiency virus (HIV) compared to general population. Surprisingly, the signs and symptoms are unremarkable. On the other hand, HIV/hepatitis C virus (HCV) co-infection is a common finding. The aim of this study was to evaluate whether HCV infection has any influence to HIV patients concerning acalculous cholecystitis prevalence. Method: A cross-sectional study was performed in HIV/HCV patients who visited AIDS study group clinic at Cipto Mangunkusumo hospital during September 2008 to February 2009. The patients who met the criteria were examined physically and underwent abdominal ultrasonography. Routine blood count, alanine aminotranferase, aspartate aminotransferase, cluster of differentiation 4 (CD4) and serum albumin were recorded. Results: Of 63 patients underwent ultrasonography examination, we found acalculous cholecystitis in 33 patients (52.3%), cholelithiasis and cholecystitis in 2 patients, and 28 patients were considered normal. Patients with CD4 less than 200 cells, tend to have acalculous cholecystitis more than those who had CD4 more than 200 cells. Conclusion: The prevalence of acalculous cholecystitis among HIV/HCV co-infection is higher compared to those with HIV infection alone. Keywords: acalculous cholecystitis, HIV/HCV co-infection, CD4
The Effect of Branched Chain Amino Acids and L-Ornithine L-Aspartate Combination as The Late Evening Snacks on Nutritional Status and Minimal Hepatic Encephalopathy in Liver Cirrhosis Eric Daniel Tenda; Irsan Hasan; Andri Sanityoso; Siti Setiati
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.89 KB) | DOI: 10.24871/1332012151-156

Abstract

ABSTRACTBackground:Minimal hepatic encephalopathy (MHE) in liver cirrhotic patients is critical manifestation of low grade hepatic encephalopaty (HE), is caused quality of life decrease and risk of deteriorating into distinct HE. The study was conducted to asses the effect of combination of branched-chain amino acids (BCAA) and L-ornithine L-aspartate (LOLA), which was given late evening, on nutritional status and degree of HE.Method: This single-blind randomized study was conducted on liver cirrhotic outpatients in hepatology clinic of Cipto Mangunkusumo Hospital period June 2011-June 2012. The study subjects were divided into two groups, group of late evening snack (LS) and day snack (DS). Each group was supplemented with combination of milk of BCAAs and LOLA (3.7 g/serving). Evaluation based on history, physical examination, laboratory tests and critical flicker frequency (CFF) was performed one month after the intervention. Data were statistically analyzed with SPSS 15.Results: Thirty-two patients whose the inclusion criteria were divided into 16 subjects for each group, LS and DS. After one month of the intervention, the average level of prealbumin for DS group was increased statistically significant (p 0.001), but not significant for LS group (p = 0.259). The increase of average body weight,mid-arm muscle circumference (MAMC) and CFF test result in both groups. There was no improvement on subject global assessment (SGA) score after one month intervention in both groups.Conclusion: This study proved that giving combination of BCAAs and LOLA may improve the condition of MHE, however for nutritional status can not be assessed. Keywords: minimal hepatic encephalopathy, BCAAs, LOLA, prealbumin, SGA score, nutritional status
Non-Surgical Biliary Drainage on Biliary Obstruction due to Malignancy Evy Yunihastuti; L A Lesmana; Ari Fahrial Syam; Irsan Hasan; Karmel Tambunan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 2, August 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2220018-20

Abstract

Surgery is still the golden standard of curative therapy for malignant biliary obstruction, but only 10- 20% of cases considered resectable. Therefore, palliative therapy to relieve pain, cholestasis, and biliary obstruction, is the main treatment for most patients. The development of percutaneous transhepatic biliary drainage and endoscopic biliary drainage had brought about minimally invasive treatment for malignant biliary obstruction, which had lower morbidity and mortality than surgical drainage. The choice of drainage technique depends on type of tumor, site of obstruction, also the available expert and instrumentation.    Keywords: malignant  biliary  obstruction,  percutaneous  transhepatic  biliary  drainage, therapeutic endoscopic retrograde cholangiopancreatography
Idiopathic Portal Hypertension: A Rare Cause of Recurrent Hematemesis Melena Griskalia Christine; Irsan Hasan
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 (748.115 KB) | DOI: 10.24871/1232011179-184

Abstract

Idiopathic portal hypertension (IPH) known as non-cirrhotic portal fibrosis (NCPF) is a constellation of liver disorders, in which liver cirrhosis is not present and the main clinical and pathological findings are encountered in the portal venous system. Patients usually come to hospital with esophageal varices and upper gastrointestinal bleeding; however, it is often misdiagnosed as liver cirrhosis. Its etiology is still unknown, but some evidences and epidemiological studies suggest that it is a multifactorial disease with genetic basis. The laboratory evaluation in IPH reveals only mild and subtle abnormalities predominantly related to hypersplenism. The major complications of IPH are esophageal varices and hypersplenism. Endoscopic sclerotherapy or band ligation, shunt surgery, and transjugular intrahepatic portosystemic shunt (TIPS) are modalities to treat the complications of IPH. The case report reported about diagnosis and treatment of a 20-year-old male with idiopathic portal hypertension. Keywords: idiopathic portal hypertension, non-cirrhotic portal fibrosis, diagnosis, treatment
The Efficacy of L-Ornithine L-Aspartate Granules and Normal Protein Diet in Minimal Hepatic Encephalopathy with Malnutrition Suzanna Ndraha; Irsan Hasan; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201011-14

Abstract

Background: The dietary protein restriction that was commonly recommended to hepatic encephalopathy (HE) patients, often leads to malnutrition, whereas malnutrition can deteriorate cirrhosis prognosis. The aims of this study were to find out encephalopathy improvement that was measured by critical flicker frequency (CFF) test and nutritional status by measuring prealbumin level after L-Ornithine L-Aspartate (LOLA) treatment with adequate calories and protein intake in patients with HE. Method: Patients with liver cirrosis who visited Cipto Mangunkusumo hospital on June-October 2009 was evaluated by CFF test using HEPAtonormTM device. Encephalopathy was defined when CFF 39 Hz. Nutritional status was measured by the mid-arm muscle circumference (MAMC) and was stated as malnutrition when the MAMC was below the 15th percentile. Patients had been treated by 3 x 6 mg LOLA granules for 2 weeks, and adequate calories and protein intake with branched-chain amino acid (BCAAs) substitution. The change of encephalopaty was evaluated by the CFF test and the nutritional status by measuring prealbumin blood level. Results: There were 17 patients with liver cirrhosis who fulfilled the inclusion criteria. The mean CFF Result increased from 34.1 ± 2.5 Hz to 36.5 ± 2.9 Hz after LOLA treatment with the adequate calories and protein intake including BCAAs substitution, which was statistically significant (p 0.001) compared to before treatment. The prealbumin level also increased significantly compared before treatment, i.e. from 5.4 ± 2.1 mg/dL to 6.4 ± 2.6 mg/dL, p = 0.008. Conclusion: HE patients with malnutrition could be given adequate calorie and protein with BCAAs substitution  to  improve  their  nutritional  status,  and  LOLA  granules  for  the improvement of HE. Keywords: minimal hepatic encephalopathy, malnutrition, CFF, LOLA, prealbumin, BCAAs
Study of Transaminases in Heroin Addicts Rino A Gani; Agus Sudiro Waspodo; Unggul Budihusodo; Irsan Hasan; Muhammad Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2120011-4

Abstract

A recent increase in the number of drug users particularly of heroin has been noted in the community. A cross-sectional study on the level of transaminases as a representation of liver damage in drug users was done in privated hospital in Jakarta. Exclusion criteria were fever, serious illness or the multiple use of addictive drugs based on a urinary test. The hepatitis B surface antigen (HBsAg) was examined using reverse passive hemaglutination assay (RPHA) and the antibody of hepatitis C virus core-protein (anti- HCV) with dipstick anti-HCV.  AST and ALT levels were determined using an automatic chemical analyzer. Of 132 patients who fulfill the criteria, 83.5 % were injection drug users (IDU). Means AST and ALT were significantly higher in IDU. Anti-HCV positive patients with increased AST and ALT were significantly higher compared to anti-HCV negative. The increase of transaminase was also consistent in injection drug users although no viral marker could be detected. In conclusion, the examination of transaminases in drug users especially IDU is important besides tests for hepatitis viral markers because there is often an increase with or without viral infection and this can be associated with hepatocellular damage.     Key words: Transaminase, heroin addicts, hepatitis
Abdominal Disturbances among Dengue Fever Patients Arnold Hasahatan Harahap; Marcellus Simadibrata; Dadang Makmun; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200970-74

Abstract

Background: Abdominal disturbances are common symptoms found in approximately 40% of patients with dengue fever, which frequently cause significant morbidity. This study was developed as an attempt to understand the effect of plasma leakage in dengue hemorrhagic fever; particularly on ab dominal problems. Method: The study was conducted in hospitalized patients who were diagnosed with dengue fever and dengue hemorrhagic fever (based on the 1997 WHO criteria for DHF) at Fatmawati hospital, Jakarta, Indonesia. Abdominal ultrasonography (USG) was done on the fourth to sixth day in every patient and when necessary, endoscopy was done. Data were analyzed by Chi-square test. Results: Fifty-three (54.6%) patients had abdominal pain,  81 (83.5%) patients had nausea, 45 (46.4%) patients had excessive vomiting and 28 (28.9%) patients had diarrhea. Forty-seven (48.4%) patients had their aspartate aminotransferase (AST) elevated more than two fold of the Upper Normal Limit (UNL) level; 19 (20%) patients had their alanine aminotransferase (ALT) level elevated two fold higher than the UNL. Amylase was found to be two fold higher than the UNL only in 2 (2%) patients. Lipase level elevated two fold higher than the UNL in 11 (11.3%) patients. USG imaging showed that thickening of the gallbladder wall (over 3 mm) were observed in 83 (85.6%) patients. Endoscopic procedures showed erosive features particularly in the antrum, including edema of the gastric mucosa and widening of the gastric mucosa folding in four patients, while 4 (4.12%) patients had melena. Conclusion: Abdominal disturbances such as abdominal pain, vomiting, melena, liver enlargement and abnormal liver function as well as thickening of the gallbladder wall more than five mm are significantly high in patients with dengue hemorrhagic fever.   Keywords: abdominal disturbances, plasma leakage, dengue hemorrhagic fever
Co-Authors Abdul Aziz Rani Agus Sudiro Waspodo Ali Sulaiman Alvin Nursalim Andi Utama Andri Sanityoso Andri Sanityoso Sulaiman Ari Fahrial Syam Arnold Hasahatan Harahap Bambang Sutopo Dadang Makmun Eric Daniel Tenda Evy Yunihastuti FX Pridady Griscalia Christine Griskalia Christine Idrus Alwi Iman Firmansyah Jeffry Beta Tenggara Karmel Tambunan L A Lesmana Laurentius Lesmana Marcellus Simadibrata Martha Iskandar Muhammad Sjaifoellah Noer Murdani Abdullah Nurul Akbar Paulus Kusnanto Pudji Rahardjo Rino A Gani Rino Alvani Gani Salius Silih Siti Setiati Sjaifoellah Noer Soemarno Soemarno Susan Tai Suzanna Ndraha Unggul Budihusodo