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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Dolvy Girawan
Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung
Medicine & Pharmacology

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Role of Radial Endoscopic-ultrasound (EUS) to Establish Diagnosis of Undetermined Causes of Obstructive Jaundice: A Case Series Eka Surya Nugraha; Dolvy Girawan; Nenny Agustanti; Yudi Wahyudi; Muhammad Begawan Bestari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (184.057 KB) | DOI: 10.24871/2032019189-193

Abstract

Identification the causes of obstructive jaundice are challenging. Recent radiologic imaging techniques improve diagnostic yield to determine jaundice causes. However, small lesions particularly in pancreas or periampullary area that lead to jaundice, often unrecognize with conventional radiologic imaging. Radial endoscopic-ultrasound (EUS) is the most sensitive modality to identify the lesions-related obstructive jaundice, remarkably in the lack of high-resolution radiologic facilities. We presented four cases of obstructive jaundice, without obvious obstruction causes from conventional radiologic imaging or abdominal ultrasound. All patients underwent radial EUS, pancreatic head mass revealed in 2 patients, and distal stenosis of the common bile duct without evidence of mass was found in 2 other patients. The masses size were 16 mm and 39 mm in diameter. Due to linear EUS and EUS guided fine needle were unavailable in our center, confirmation biopsy was undone. Three patients were performed endoscopic retrograde cholangiopancreatography (ERCP) for dilatation and inserting stents, and one patient referred to the surgeon. In conclusion, radial EUS aided to diagnose the definite causes of jaundice despite in the less-equipped of high-resolution radiologic imaging.
Gut Microbiota in Human Immunodeficiency Virus Infection Rudi Wisaksana; Guntur Darmawan; Nenny Agustanti; Dolvy Girawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, April 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (534.325 KB) | DOI: 10.24871/201201938-43

Abstract

Human microbiota, majority presents in human gastrointestinal tract, plays crucial role in body physiological functions, such as immune system. Human immunodeficiency virus (HIV) infection impairs gut barrier and alter the microbiota ecosystem, called dysbiosis. Different phase of HIV infection demonstrates different composition of gut microbiota. Antiretroviral treatment might improve the CD4 level, however, it inconsistently restore the gut ecosystem. Some studies in prebiotic and probiotic revealed the potential effect in reducing inflammation and restoring gut microbiota.
Probiotics in Ankylosing Spondylitis: A Possible Potency Sumartini Dewi; Stefanie Yuliana Usman; Guntur Darmawan; Dolvy Girawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.025 KB) | DOI: 10.24871/2032019184-188

Abstract

Ankylosing Spondylitis (AS) is a common autoimmune arthritis which prevalence ranging from 0.1% up to 1.4% globally. Furthermore, in Asian population the prevalence of AS was increasing overtime. Up until now, there were several treatment options available in treating AS in Indonesia. However, there was still some limitations in complete remission achievement and some have limitation in potential adverse drug reaction. Eventually, these affect both patients’s daily activity and their quality of life.There were studies demonstrated the association between intestinal dysbiosis and inflammatory rheumatic disorders. Previous studies also presented there was an altered composition of gut microbiota in AS patients. Probiotic in the other hand, has been known previously for its efficacy in treating intestinal dysbiosis. Hence, this review aimed to identify potencies, efficacy and safety of probiotics as AS treatment options.
Co-Authors Eka Surya Nugraha Guntur Darmawan Muhammad Begawan Bestari Nenny Agustanti Rudi Wisaksana Stefanie Yuliana Usman Sumartini Dewi Yudi Wahyudi