bluuebunny/crossref_metadata_2025 huggingface dataset:
Alpha-1 Acid Glycoprotein Cut-off Value as Diagnostic Biomarker in Hepatocelular Carcinoma with Liver Cirrhosis
Authors: Suryamin Maulana , Gani Rino A , Abdullah Murdani , Rumende C Martin
Published: August 2022

Background: Hepatocellular carcinoma (HCC) remains a major problem throughout the world, especially in diagnostic and therapeutic management. Previous studies stated that alpha-1 acid glycoprotein (AAG) was a potensial biomarker in diagnostic of HCC. This study assessed the best cut-off value of AAG as a diagnostic biomarker of HCC with liver cirrhosis.Method: This was a cross-sectional, diagnostic study, conducted from January to October 2013 in Cipto Mangunkusumo Hospital. The subjects were HCC with liver cirrhosis patients and as control were liver cirrhosis patients. Abdominal ultrasonography (USG), abdominal 3 phase contrast computerized tomography (CT) scan, and liver biopsy, if necessary, were done. All patients were having AAG examination, then the result was analyzed using receiver operating characteristic (ROC) curve and assessment of some cut-off values was done.Results: There were 25 HCC with liver cirrhosis patients and 37 liver cirrhosis patients as control included in this study. HCC with liver cirrhosis patients were 92% male and 8% were female, over 50 years old (72%). HBV infection was the most common etiology and most of the patients had multiple nodules in the liver (80%). ROC curve showed the area under the curve (AUC) was 81.44%.Conclusion: The best cut-off value of AAG to be aware of HCC with liver cirrhosis was 61 mg/dL and as a diagnostic was 136 mg/dL.                                                                            Keywords: hepatocelullar carcinoma, alpha-1 acid glycoprotein, cut-off
Imaging Modalities Role inRecurrent Acute Pancreatitis Diagnosis
Authors: Pekey Andreas , Zakaria Rio , Nainggolan Leonard , Syam Ari Fahrial , Makmun Dadang
Published: August 2022

Recurrent acute pancreatitis (RAP) is a potentially life-threatening pancreatic disorder. Itrequires a combination of medical and interventional skills to diagnose, determine the etiology, and treat the condition. Recurrencesoccur in 25-30% of all acute pancreatitis cases. The most common cause of RAP is gallstone (microlithiasis). Imaging modalities become an important aspect to evaluate multiple microlithiasis. In this case, we report a 52 years oldoverweight female with RAP and fatty liver ofunknown etiology.We suspected gallstone as the cause of RAP. Physical examination considered normal. Ultrasound and abdominal CT scan wasperformed in whichfatty liver were founded. Since the gallstone is not clearly found with radiologic imaging, we decide to undergoEndoscopic Retrograde Cholangiopancreatography(ERCP)procedure to evaluatea possibility of microlithiasis. ERCPresult showed a multiple microlithiasis, thus we evacuate the stones. Clinical outcome post ERCP and evacuationprocedure was good. We concluded that the best imaging modalities to evaluate microlithiasis in RAP with normal ultrasound and abdominal CT scan is ERCP.  Keywords:recurrent acute pancreatitis (RAP), microlithiasis, endoscopic retrograde cholangiopancreatography (ERCP).
Alcoholic Liver Cirrhosis in Young Female: Diagnostic and Therapeutic Challenge
Authors: Mustika Syifa , Arifah Nina Nur
Published: August 2022

Alcoholic liver cirrhosis is a disease due to excessive alcohol consumption that manifest as fatty liver, alcoholic hepatitis, and chronic hepatitis with fibrosis or liver cirrhosis. Alcohol consumption as much as 60-80 g per day for 20 years or more in male, or 20 g/day (approximately 25 mL/day) in female significantly increases the risk of hepatitis and fibrosis as much as 7-47%. The aim of this case report was to explore the diagnostic and therapeutic challenge of alcoholic liver disease in young aged female. A female, 24 years old, came with complaints of bloody vomiting, blacktarry stool, abdominal distention and history of alcohol consumption (canned beer 5%, equal to 56-70 g/day) for 9 years. Physical examination revealed anaemic conjunctiva (Hb 2.9 g/dL), ascites, hepatosplenomegaly, and bilateral legs oedema. Laboratory examinations showed thrombocytopenia (125000/uL) and hypalbuminaemia (2.65 gr/dL). AST and ALP were increased with the value of 175 U/L and 456 U/L, respectively. Albumin-globulin ratio was 0.93 g/dL with serum ascites albumin-gradient was 2.20 g/dL (ascites fluid albumin level was 0.45 gr/dL and serum albumin level was 2.65 gr/dL). Abdominal USG revealed hepatomegaly with coarse heterogenic ecoparenchyma, portal vein dilatation, and splenomegaly. Diagnosis of alcoholic liver cirrhosis was made based on clinical, laboratory, and radiologic findings, while biopsy result did not confirm the pathology. Patients condition improved with education of stop alcohol consumption and was given supportive therapy.
Symptoms and Diagnostic Yields of Colonoscopy in St Vincentius Hospital Singkawang West Borneo 2017-2018
Authors: Frandy Frandy , Mondrowinduro Prionggo
Published: August 2022

Background: Colonoscopy is the gold standard procedure which is widely used in the diagnosis and treatment of colonic mucosal disorder. Colonoscopy examination which is included in the referral system of the social insurance administration organization has been available at St Vincentius Hospital Singkawang since March 2017 to support diagnosis of lower gastrointestinal diseases. Patients were from Singkawang City and 3 surrounding districts (Sambas, Bengkayang, and Mempawah) that close to the Malaysian border. The purpose of this study is to evaluate symptom and diagnosis yield of patient who underwent colonscopy at St. Vincentius Hospital, Singkawang from March 2017 to April 2018.Method: This was a retrospective descriptive study by using secondary data of patient’s medical records at St Vincentius Hospital Singkawang in March 2017 - April 2018. Every patient is included as a sample (total sampling).Results: Total numbers are consisted 78 colonoscopies, with 163 cases of lower gastrointestinal disease. Three major findings of colonoscopy were internal hemorrhoids (64%), colon mass (30%), and inflammatory bowel disease (IBD) (26%). Indications of patient to underwent colonoscopy were hematochezia 38%, chronic diarrhea 19%, chronic constipation 18%, anemia 12%, abdominal pain 6%, screening neoplasia 3% and unexplained weight lost 3%.Conclusion: Hematochezia is the most common indication of patients to underwent colonoscopy at Singkawang and its surrounding districts. The most common finding of colonoscopy was hemorrhoid.
Pancreatic Cancer: Alarm for Survival
Authors: Budimutiar Felix Aloysius , Simadibrata Marcellus
Published: August 2022

Pancreatic cancer is one of the deadliest and a highly aggressive cancer. Its incidence and mortality are highest in developed countries.  However, in Asia-Pacific region, the incidence and mortality rate of pancreatic cancer are also on increasing trend nowadays. Pancreatic cancer incidence rates increase with older age, the highest in the 7th and 8th decades. Clinical presentation of pancreatic cancer are usually non-specific, largely dependent on tumour size and location, with most patients experience symptoms already late in the disease. Computed tomography is considered the method of choice for diagnosis and staging of pancreatic cancer. Management for pancreatic cancer include surgical resection, radiotherapy, chemotherapy. Only surgical resection considered the potentially curative treatment for pancreatic cancer. Unfortunately, a lot of patients present with disease that is not surgically resectable. Prognosis for pancreatic cancer is very poor, despite surgery in resectable patients. The overall five-year survival rate is about less than 5%
Probiotics as Alternative Therapy for Psychometric Disorders in Hepatic Encephalopathy
Authors: Amin Bany Faris , Kresnadi Irfan , Karenina Vannessa , Prasetia A GM Yudi , Putri Trivani , Kurniawan Juferdy
Published: August 2022

Aim: To identify whether probiotics have the same effectiveness as lactulose in improving the results of psychometric testing in patients with hepatic encephalopathy.Method: Literature Searching were performed on Pubmed, EBSCOhost, Scopus, and Cochrane databases to obtain an randomized controlled trial (RCT) or a systematic review. Searches were made with the keywords "hepatic encephalopathy", "probiotic", "lactulose" and number connection test  ("NCT").  Search is continued by excluding the literature through abstract and full text.Results: Two studies were found to be relevant according to the criteria. The study by Mittal showed that probiotics were better than lactulose in improving NCT-B with a risk ratio (RR) of 0.88 (95% CI: 0.54-1.44; p = 0.62) but not better for improving NCT- A with RR 1.43 (95% CI: 0.62-3.24; p = 0.40). In the Sharma study, lactulose was better in improving NCT score with the mean difference (MD) 6.7 (95% CI: 0.58-12.82) and in the Li study, there was no significant significance between MD 3.93 (95% CI: -0,72-8,58)Conclusion: In conclusion, Probiotics cannot replace lactulose as a standard therapy for hepatic encephalopathy. There is not enough evidence that proves probiotics are better than lactulose.
Adult Ileocecal Intussusception: A Case Report and Review
Authors: Adiwinata Randy , Adiwinata Sheila , Simatupang Emerson Patulahon , Uwan Willy Brodus , Simadibrata Marcellus
Published: August 2022

Intussusception is a rare cause of bowel obstruction in adult patients, it represents for five percent of all age intussusception. Several different aspects were found between adult and pediatric intussusception. We report a case of 39-year-old male with bowel obstruction due to ileocecal intussusception, which firstly diagnosed as acute appendicitis. Unlike pediatric intussusception which usually manifest as classical triad signs, unspecific symptoms of adult intussusception may become diagnostic challenge. Imaging modalities such as plain abdominal radiograph and ultrasonography may aid the preoperative diagnosis in the rural hospital setting. Prompt management which involved surgical approach is warranted to prevent further complications.
The Diagnosis and Management of Acute Fatty Liver of Pregnancy
Authors: Zein Ahmad Fariz MZ , Anwar Irma Wahyuni , Sulaiman Andri Sanityoso
Published: August 2022

Acute fatty liver of pregnancy (AFLP) is a rare catastrophic illness constituting an obstetric emergency in third trimester of pregnancy and may have complications for both mother and fetus, including death. Yet it is still unclear, the pathogenesis of AFLP has been identified related to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty oxidation. Establishing the diagnosis of AFLP is challenging, further it may overlap with other liver diseases of pregnancy, such as preeclampsia and hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. The management of AFLP is a multidisciplinary progress providing the prompt intervention more than the termination of the pregnancy. The awareness of AFLP is highly needed to provide early diagnosis and management so that it can reduce the morbidity and mortality.
Endoscopic Variceal Ligation and ß-Blocker Combination Versus Ligation Monotherapy as Variceal Esophagus Bleeding Secondary Prevention
Authors: Marcevianto Kevin Varian , Simadibrata Marcellus
Published: August 2022

Background: Variceal esophagus' risk of re-bleeding in the first year is 60-70%. Mortality rate of acute bleeding is 20-35%. Latest guidelines of esophageal rupture suggest endoscopic ligation and Non-selective b-Blocker combination for re-bleeding prevention. However, monotherapy still can be chosen, depends on the clinical judgement and patient preference. The previous meta-analysis still gave inconclusive results on therapy combination effectivity. Moreover, there is no side effect discussion between both treatment choices. Hence, this evidence-based case report analyses the effectivity of combination treatment for esophageal bleeding secondary prevention.Method: Literature searching in Scopus, ProQuest, PubMed, ScienceDirect, and EBSCOhost used keywords and their synonyms. Three articles selected included two meta-analyses and one RCT. Critical appraisal on validity, importance, and applicability based on Oxford Center of EBM 2011 was conducted.Results: Two meta-analysis prove treatment combination is significantly effective decreasing variceal re-bleeding. Ravipati et al. results in RR 0.601 (95% CI 0.44 - 0.82). However, Kumar et al. shows non-significant result. On the other hand, three articles show that therapy combination failed to significantly lower the mortality rates RR 0,786 (95% IK 0,45 - 1,39). This is due to the limitation of treatment combination to prevent cirrhotic progression and other complications. Moreover, this also is due to contraindications and non-suitability of the patients toward non-selective b-Blocker in 30-40% cases.Conclusion: Endoscopic ligation and non-selective b-Blocker combination is recommended for variceal esophagus bleeding secondary prevention, but other treatments are needed to lower the mortality rate1.
The Role of Wisteria Floribunda (M2BPGi) Serum Level for Diagnosing Liver Fibrosis in Hepatitis B Patient: An Evidence Based Case Report
Authors: Prasetyadi Yosafat Lambang , Simbolon Agnes Elsha Maria , Permatasari Anggi Anggelina , Swaraghani Dela Ryana , Chairunisa Shafira , Kurniawan Juferdy
Published: August 2022

Aim: To assess M2BPGi serum performance compared to liver biopsy in diagnosisng liver fibrosisMethod: Literature search using Pubmed®, Ebsco®, ProQuest®, Scopus®, Clinical Key databases, and the Cochrane Library® yield four relevant and full-text articles. The four articles were critically appraised for its validity, importance, and applicability.Results: Sensitivity and specificity in all four studies showed that M2BPGi serum was inadequate to ruling in and ruling out the diagnosis of liver fibrosis in chronic hepatitis B patients. The difference in M2BPGi cut-off value to determine the stage of fibrosis in each study makes this value cannot be used as an accurate standard to determine the advanced stage (F≥3) of liver fibrosis. On the other hand, M2BPGi serum combined with other tests are known to improve the diagnostic accuracy.Conclusion: MBP2Gi serum cannot be used as a diagnostic modality for detecting liver fibrosis in chronic hepatitis B patients.
Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report
Authors: Lalisang Toar JM , Mazni Yarman , Moenadjad Yefta , Matondang Sahat
Published: August 2022

Background: There were only few publications related to pancreaticoduodenal resection (PDR) /Whipple procedure in Indonesia in the past decade.Method:  Retrospectively report of  the characteristics and outcomes of PDR performed by Cipto Mangunkusumo Hospital surgical team from 1993 to 2017 were collected.Results: PDR were performed in 213 patients, with a mean age of 50.6 years and 54.4% patients were females. Predominant preoperative clinical findings were jaundice (68.9%) and mild hypoalbuminemia (69.9%). Biliary decompression was performed in 112 (52.6%) subjects. Average surgical waiting time was 3.5 months. While PDR were performed in 84 (39.5%) subjects, pyloric preserving pancreaticoduodenal technique was predominated in 128 (59.8) and predominated,  especially during the latter years. Fifteen (9.0%) cases were benign. Thirty-one (14.6%) subjects underwent relaparotomy, 16 (51.6%) of whom died post-operatively. Overall operative mortality decreased from 16.9% to 5.5% in 2016, while resection rate generally increased over time, ranging from 2 - 21/year. Less than 10% of subjects survived for 5 years, while 20% survived for 24 months.  Overall morbidity was 65.1% in 177 survivors, with surgical site infection in 52.5%, pancreatic fistula in 24.2%, and post-pancreatectomy haemorrhage (PPH) as a fatal postoperative complication in 19 (8.9%) cases. Patients who died within 30 days postoperatively had significantly more relaparotomies and PPH (p 0.001).Conclusion: Prolonged jaundice and mild hypoalbuminemia are dominant characteristics in our Indonesian PDR subjects. Cipto Mangunkusumo Hospital is a high-volume PDR centre and world class hospital. Mortality rates decreased with the increasing resection rates. Relaparotomy and PPH are predictors of poor outcome.
Gastric Mucosa Plasma Cells is Unspecific for Diagnosing Helicobacter pylori Infection
Authors: Hartecia Gilda , Sandhika Willy , Maimunah Ummi , Miftahussurur Muhammad
Published: August 2022

Background: A high density of Helicobacter pylori is believed to trigger an accumulation of plasma cells in the gastric mucosa. This accumulation stimulated the production of antibodies, causing high antibodies titer being circulated in the blood. The aims of this study is to identify the correlation between the number of plasma cells and H. pylori density in gastric mucosa.Method: This observational analytic study was performed with cross-sectional approach. The samples were the paraffin blocks which consisted of endoscopic gastric biopsy tissues of chronic gastritis patient in Anatomic Pathology Laboratory Dr. Soetomo General Hospital Surabaya in 2017 period. A total of 30 samples were purposively collected. Endoscopic gastric biopsy tissues were stained by two stains, Haematoxylin-Eosin and Modified Giemsa. The examination was performed by experienced pathologist. The correlation between total plasma cells and H. pylori density in gastric mucosa and the difference of total plasma cells between gastric mucosae with different density of H. pylori were determined.Results: There was no significant correlation between total plasma cells and H. pylori density in gastric mucosa. And there was no significant difference of the number of plasma cells found with different density of H. pylori.Conclusion: The number of plasma cells in the gastric mucosa is unspecific for diagnosing H. pylori infection. Other causes associated with plasma cells need to be assessed in further studies.
Clinical Characteristics and Outcome of Acute on Chronic Liver Failure Patients at Fatmawati General Hospital
Authors: Darnindro Nikko , Manurung Annela , Mulyana Edi , Harahap Arnold , Dewiastuti Marlina , Fedrizal Fenandri Fadillah , Prabhasworo Mohammad Sadhyo
Published: August 2022

Background: Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute liver decompensation with extrahepatic organ failure in patients with pre-existing liver disease causing high short-term mortality. A good knowledge about characteristics and diagnostic of ACLF will help us to give proper treatment. The aim of this study is to know the profile and characteristics of ACLF patientMethod: Retrospective study was conducted to find patient with ACLF between January 2017-January 2018 at Fatmawati General Hospital.Results: Ten patients were diagnosed with ACLF. Six patients admitted with a chief complaint: unconscious, 2 of them had hematemesis in the course-of-treatment. Three patients were admitted with abdominal pain, and 1 patient with hematemesis-melena. Seven patients had Hepatitis-B infection. Aspartate-transaminase to platelet-ratio index (APRI) values varied (median 8.1;minimum 2.81-maximum 34.67). Hepatic encephalopathy, ascites, and acute renal failure were found in 90% of patients. Jaundice can be found in all patients, with mean values of bilirubin levels in patients undergoing test for bilirubin level were 18.56 mg/dL (9/10). Coagulation disorders were found in 60% of patients undergoing haemostasis test. Four patients were diagnosed with grade 3 ACLF. All ACLF patients eventually died during treatment, including third-degree patients who all died within 7 days. Only 2 patients survived more than 7 days, and 4 patients died within 3 days of treatment. Conclusion: mortality rates of ACLF were very high, and are often found in patients with advanced liver disease characterized by high APRI values. The prognosis is related to the number of organ failures. Central nervous system, kidneys and liver are the organs that are often impaired. Because the current treatment method is still limited, further research is needed, especially on biomarkers for better prevention, diagnosis and treatment.
The Correlation Between Depression and GERD-Q Score Among Dyspepsia Patient in Atma Jaya Hospital
Authors: Hanjani Nadya , Steffanus Mario
Published: August 2022

Background: In adults, the symptoms of gastroesophageal reflux disease (GERD) are often complained of in daily life and their prevalence has increased. Symptoms of GERD are often found along with the occurrence of dyspepsia. One of the factors that affect the symptoms of GERD is depression. Due to the limited data available in Indonesia, this study was conducted to see the correlation between depression and gastroesophageal reflux disease questionnaire score (GERD-Q).Method: This study was conducted on dyspepsia patients at Atma Jaya Hospital (RSAJ) beginning at June to September 2018. The study was conducted using a cross-sectional design and using the GERD-Q and Depression questionnaire, Anxiety, Stress Scale 42 (DASS 42) which has been translated and validated by other researchers to measure GERD scores and depression scores.Results: The total respondents of this study were 53, with the percentage of men and women being 30.2% and 69.8% respectively. The average age of patients was 57.2, with those who were overweight / obese as many as 64.2%, and those who smoked as many as 9.4%. As many as 73.6% respondents had a GERD-Q score of ≥ 8. Moreover, 35.8% of respondents had mild depression, 15.1% had moderate depression, and 3.8% had severe depression. The results showed a significant correlation between depression and GERD-Q score in Atma Jaya Hospital dyspepsia patients (p = 0,000, r = 0,496).Conclusion: There is a correlation between depression and GERD-Q score of dyspepsia patients at Atma Jaya Hospital
Relationship between Gastroesophageal Reflux Disease Questionnaire (GERD-Q) Score and Reflux Oesophagitis in Gastroesophageal Reflux Disease (GERD) Suspected Patients in Bandung
Authors: Simarmata Dosmer Oloan , Wahyudi Yudi , Bestari Muhammad Begawan , Supriadi Rudi
Published: August 2022

Background: Gastroesophageal reflux disease is a disease with heterogen symptoms, with no gold standard available to diagnose this condition. Questionnaire is a diagnostic tool that may enable an objective symptom assessment. GERD-Q questionnaire consist of 6 components of questions, formed from 4 various components of reflux symptoms (positive predictors of GERD) and 2 as negative predictors of GERD. This study aimed to observe the relationship between GERD-Q score and reflux oesophagitis in GERD suspected patients.Method: This study was an analytic cross-sectional study, conducted in March to July 2019. Study participants were patients visiting the Endoscopy Unit in Hasan Sadikin Hospital, Cibabat District General Hospital, and Al Islam General Hospital, who were then evaluated using GERD-Q and later underwent endoscopy examination. The severity of reflux oesophagitis observed through endoscopy was evaluated using the Los Angeles classification. Endoscopy readings was performed by one experienced doctor.Results: Thirty-six patients were examined; 17 (47.2%) patients suffered from reflux oesophagitis, including 13 cases with grade A (76.5%) and 4 cases with grade B (23.5%). There were no cases with grade C or grade D was found. Patients who suffered from reflux oesophagitis with GERD-Q score ≥ 8 were 15 patients (65.2%) and GERD-Q score 8 were 2 patients (15.4%). Chi Square test analysis with confidence interval of 95% revealed p = 0.004 (p 0.05). Biserial point correlation coefficient was 0.643 with p 0.001.Conclusion: There was a strong relationship between GERD-Q score and reflux oesophagitis. The higher the GERD-Q score, the higher the possibility to suffer from reflux oesophagitis.
A Systematic Review of the Frequency of Regulatory T Cells in Hepatitis B and Hepatitis C
Authors: Susilawati Tri Nugraha , Susianto Atik
Published: August 2022

Background: Regulatory T cells (Tregs) play an important role in sustaining the hepatitis B and C viruses (HBV and HCV) persistence and protecting the liver tissues from cytokine-associated detrimental effects through unclear mechanisms. This paper aims to review the frequency of Tregs during the course of HBV and HCV infection.Method: Electronic databases were searched to identify studies investigated the frequency of intrahepatic and peripheral Tregs of the patients infected with HBV and/ or HCV.Results: The majority of studies reported the increase of intrahepatic and peripheral Tregs in acute and chronic infection of HBV and HCV. The decrease of peripheral Tregs occurred in patients with chronic hepatitis B who respond to interferon α or nucleos(t)ide analogues treatment as well as those with chronic hepatitis C who were treated with interferon, ribavirin or liver transplantation.Conclusion: Infection with HBV and HCV appears to induce the production of Tregs in blood and hepatocytes whereas treatment may decrease Tregs levels. As the optimum balance between regulatory and effector T during HBV and HCV infection is crucial for preventing liver damage, further studies should be directed on the development of Tregs during HBV and HCV infection as well as their involvement in immunomodulatory strategies for combating HBV and HCV.
Clinical, Molecular, and Histopathological Aspect of Primary Biliary Cholangitis
Authors: Dameria Flora , Stephanie Marini , Kodariah Ria , Handjari Diah Rini , Krisnuhoni Ening , Rahadiani Nur
Published: August 2022

Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease which tends to be chronic and progressive in nature that is marked by the presence of cholangitis and small size biliary duct destruction which may cause cirrhosis or even liver failure. PBC incidence increases because PBC can now be diagnosed earlier and is due to the increasing survival rate of PBC patients. Diagnosis of PBC can be confirmed in asymptomatic state if in the indirect immunofluorescence (IIF) examination revealed AMA positive, and there is an abnormal liver function. Etiopathogenesis of PBC is multifactorial which involves genetic and environmental factors. Genetic factors which contribute to the incidence of PBC are HLA and non-HLA genes, while in the environmental factors, the triggering factors of PBC are bacterial infection and xenobiotic. Interaction of these factors causes the development of E2 subunit pyruvate dehydrogenase complex (PDC-E2) and antimitochondrial antibody (AMA) as the causing autoantigen of biliary duct desctruction in PBC, mediated by the immune system. PBC stage is divided into minimal, mild, moderate and severe. Ursodeoxycholic acid (UDCA) is the first line therapy for PBC, while obeticholic acid (OCA) and fibrate is used as the second line. Liver transplantation is the definitive therapy for PBC where disease progresses into the advanced stage, although the patients have received medical treatment.
Probiotics in Ankylosing Spondylitis: A Possible Potency
Authors: Dewi Sumartini , Usman Stefanie Yuliana , Darmawan Guntur , Girawan Dolvy
Published: August 2022

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.
A Two Generation of Familial Adenomatous Polyposis
Authors: Chandrawati Lily , Wibawa I Dewa Nyoman
Published: August 2022

Familial adenomatous polyposis (FAP) is a part of genetic polyposis syndrome which is caused by germline mutation in the adenomatous polyposis coli (APC) gene located in chromosome 5q21. The pathognomonic features is formation of hundreds to thousands of colorectal adenoma in late childhood and increase in size and number during adolescence. If left untreated, almost 100% patients will develop colorectal cancer by the age 50 years. We present a case of 26 year old male who complain of rectal bleeding, diarrhea, abdominal bloating, and has multiple polyps on colonoscopic finding. Two years ago, his father was diagnosed with polyposis coli and transverse colon adenocarcinoma. The patient was planned for preventive total colectomy. In conclussion, surgery remains the cornerstone treatment of FAP and surveillance program for early detection of cancer for all family member is very important to reduce colorectal cancer-related mortality.
The Management Problems of Patient with Chronic Hepatitis B Infection and Its Reactivation
Authors: Imro'ati Tri Asih , Maimunah Ummi
Published: August 2022

Hepatitis B virus infection is a major global health problem in the world  and particularly in Indonesia.    It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.  In this case, we will show about the  problems that may occur while we  manage a patient. A 55 years old man with chronic hepatitis B has been treated with  Telbivudin 600 mg for 8 years and and then stop for 2 years (The HBsAg has been non reactive, HBeAg has been seroconversion from positive to negative, and HBV DNA has been not detected  since 2014 until January 2016).  In 2018, patients undergo surgery to remove nodules in the liver.  After that, there were   transaminase and bilirubin elevation, and  then HBsAg become reactive again.  After giving combination therapy of Telbivudin 600 mg with Entecavir 0.5 mg and metyl prednisolone 8 mg (per os, three times a day) for 1 months, the transaminase became decrease, but the bilirubine was still high. The patient was reported to have died  in February 2019 after being hospitalized in a hospital outside Java, so we could not know or investigasted the cause of his mortality.
Does emergency surgery have impact on lymph node harvest in colorectal cancer surgery?
Authors: NİKOLOVSKİ Andrej , DERVİSHOV Kristijan , ULUSOY Cemal
Published: August 2022

Aim: Adequate oncologic surgery for colorectal cancer implies proper resection margin of the resected specimen and complete mesocolic excision in order to achieve objective postoperative pathologic staging. Current recommendations require a minimum of 12 lymph nodes retrieval. In emergency colon cancer surgery, questions are raised about its impact on the lymph node number harvest. Aim of this study is to determine the impact of emergency colorectal cancer surgery on the lymph node number retrieval.

Methods: Retrospective analysis of 102 patients operated for colorectal cancer in the period of 1 year was conducted. Two groups (emergency and elective) were formed. Six surgeons performed all of the operations (three high-volume and three low-volume surgeons).

Results: Twenty patients presented as surgical emergencies and the rest 66 were elective cases. Sixteen patients with stage IV were excluded. Mean number of lymph nodes retrieved in the emergency group was 11.1 [5 - 20], and 14.7 [4 – 34] in the elective one, respectively (p = 0.004). Sufficient number of lymph nodes (≥ 12) extraction was achieved in 7 patients in the emergency group and in 48 patients in the elective one (p = 0.003).

Conclusions: Emergency colon cancer surgery did have impact on the lymph node number harvest. Adequate colorectal training is expected to improve the surgical technique in order to achieve reliable TNM staging.
Faktor-Faktor Yang Mempengaruhi Kualitas Laporan Keuangan Pada Organisasi Perangkat Daerah Kabupaten Jember
Authors: Khoirunisa Nurulita , Ahmad Arisona
Published: August 2022

This study aims to analyze the effect of implementing Government Accounting Standards, human resource competence, internal control, and utilization of information technology on the financial reports quality in regional government organizations of Jember Regency. This study uses quantitative methods with research instruments in the form of questionnaires. The data analysis technique used is multiple linear regression analysis using SPSS. Tests were carried out on the variables of the Government Accounting Standards implementation (X1), human resource competence (X2), internal control (X3), information technology utilization (X4) and financial reports quality (Y). The results of this study indicate that government accounting standards implementation and information technology utilization have a significant positive effect on financial reports quality, while human resources competence and internal control have an insignificant effect on the quality of financial reports in regional government organizations in Jember Regency.
 
Penelitian ini bertujuan untuk menganalisis pengaruh penerapan Srandar Akuntansi Pemerintahan, kompetensi sumber daya manusia, sistem pengendalian intern, dan pemanfaatan teknologi informasi terhadap kualitas laporan keuangan pada Organisasi Perangkat Daerah Kabupaten Jember. Penelitian ini menggunakan metode kuantitatif dengan instrumen penelitian berupa kuisioner. Teknik analisis data yang digunakan adalah analisis regresi linear berganda dengan menggunakan SPSS. Pengujian dilakukan pada variabel penerapan Standar Akuntansi Pemerintahan (X1), kompetensi sumber daya manusia (X2), sistem pengendalian intern (X3), pemanfaatan teknologi informasi (X4) dan kualitas laporan keuangan (Y). Hasil dari penelitian ini menunjukkan bahwa penerapan standar akuntansi pemerintahan dan pemanfaatan teknologi informasi berpengaruh positif signifikan terhadap kualitas laporan keuangan, sedangkan kompetensi sumber daya manusia dan sistem pengendalian intern berpengaruh tidak signifikan terhadap kualitas laporan keuangan pada Organisasi Perangkat Daerah kabupaten Jember.
Analisis Pengaruh Kompetensi Perangkat Desa dan Peran Aplikasi Sistem Keuangan Desa Terhadap Kinerja Pengelolaan Keuangan Desa
Authors: Kusuma Doni , Ardhiarisca Oryza
Published: August 2022

This study aims to determine and analyze the influence of village apparatus competence and the role of village financial system applications on village financial management performance in Sumenep City District, Sumenep Regency. The method used in this research is quantitative research with data collection procedures through questionnaires. This study uses data analysis, namely validity testing, reliability testing, classical assumption testing, multiple regression analysis, hypothesis testing, and the coefficient of determination. This study provides results that the competence of village officials and the role of village financial system applications have a significant partial or simultaneous effect on the performance of village financial management.
Penelitian ini memiliki tujuan agar dapat mengetahui serta melakukan analisis pengaruh kompetensi perangkat desa dan peran aplikasi sistem keuangan desa terhadap kinerja pengelolaan keuangan desa di Kecamatan Kota Sumenep, Kabupaten Sumenep. Metode yang digunakan di dalam penelitian ini adalah penelitian kuantitatif dengan prosedur pengumpulan data melalui penyebaran kuesioner. Penelitian ini menggunakan analisis data yakni pengujian validitas, pengujian reliabilitas, pengujian asumsi klasik, analisis regresi berganda, pengujian hipotesis, dan koefisien determinasi. Penelitian ini memberikan hasil bahwa kompetensi perangkat desa dan peran aplikasi sistem keuangan desa berpengaruh signifikan secara parsial maupun simultan terhadap kinerja pengelolaan keuangan desa.
Analisis Pengelolaan Dana Desa di Desa Klenang Lor Kecamatan Banyuanyar Kabupaten Probolinggo
Authors: Ummah Najmi Nurul , Wijayanti Rahma Rina
Published: August 2022

This study aims to analyze the management of village funds in Klenang Lor Village, Banyuanyar District, Probolinggo Regency. This research is included in qualitative research. The data used are primary data and secondary data. Primary data in the form of interviews and secondary data see the required documents. The data collection procedure used the method of observation, interviews, documentation. The data analysis technique used is the comparative analysis method. This research is guided by Permendagri Number 20 of 2018 and Perbup Number 63 of 2019. Based on Probolinggo Regent Regulation Number 63 of 2019 concerning guidelines and supervision of Village Fund Management, to provide adequate confidence in the process of fostering and supervising Village Fund management through the planning stages, implementation and reporting. The results of this study indicate that the Village Fund Management in Klenang Lor Village in the planning, implementation, reporting stages is in accordance with the Regulation of the Minister of Home Affairs (Permendagri) Number 20 of 2018.
Penelitian ini bertujuan untuk menganalisis pengelolaan dana desa di Desa Klenang Lor Kecamatan Banyuanyar Kabupaten Probolinggo. Peneltian ini termasuk dalam penelitian kualitatif. Teknik pengumpulan data diperoleh melalui observasi, wawancara, dokumentasi. Data yang digunakan yaitu data primer dan data sekunder. Teknik analisis data yang digunakan adalah metode analisis komparatif. Penelitian ini berpedoman pada Permendagri Nomor 20 tahun 2018 dan Perbup Nomor 63 tahun 2019. Berdasarkan Peraturan Bupati Probolinggo Nomor 63 tahun 2019 tentang pedoman dan pembinaan pengawasan Pengelolaan Dana Desa. Pedoman ini untuk memberikan keyakinan yang memadai terhadap proses pembinaan dan pengawasan pengelolaan Dana Desa melalui tahapan perencanaan, pelaksanaan serta pelaporan. Hasil penelitian ini menunjukkan bahwa Pengelolaan Dana Desa di Desa Klenang Lor dalam tahap perencanaan, pelaksanaan, pelaporan telah sesuai dengan Peraturan Menteri Dalam Negeri (Permendagri) Nomor 20 tahun 2018.
Hubungan Mutu Pelayanan dengan Kepuasan Pasien Poli Gigi Puskesmas di Kecamatan Guguk Panjang, Kota Bukittinggi
Authors: Zulmi Rezza Marietha , Symond Denas , Susi Susi
Published: August 2022

Background: Patient's perspective is one of the indicator that affect the health care quality. Best service of health provider is also important parameter to achieving the patient's satisfaction. Purpose: to determine the relationship of the dimensional service quality to dental patient satisfaction in Puskesmas Guguk Panjang, Bukittinggi. Method: This was a cross sectional study, participating of 106 respondents arround 25-65 years old. The patient who ever comes to the puskesmas Guguk Panjang were included to this study. The data were analyzed by Chi-Square test on a p-value of 0.05. Results: The most of respondents state the quality service of oral health care in Puskesmas Guguk Panjang Bukittinggi are good (80,2%). Statistically, there is significant relationship between quality service (tangibles, reliability, responsiveness, assurance, and empathy) to patient satisfaction. Thec cartesian diagram showed that there’s still some dimension haven’t meet the patients satisfaction and need to be fixed which consists of building and dental section’s appearance and sanitation, also lack of dental equipments. This research concluded that there is significant relationship between quality service to the dental patient satisfaction. Atributes in Quadrant I need to be evaluated and repaired.
Body Stalk Anomaly: Antenatal Sonographic Diagnosis
Authors: Yusrawati Yusrawati , Julio Azwan Reyhan , Indra Utama Bobby , Rifa Karmia Hudilla , Iqbal Muhammad , Serudji Joserizal
Published: August 2022

The abstract should summarize the content of the paper. Try to keep the abstract below 200 words. Do not make references nor display equations in the abstract. The journal will be printed from the same-sized copy prepared by you. Your manuscript should be printed on A4 paper (21.0 cm x 29.7 cm). It is imperative that the margins and style described below be adhered to carefully. This will enable us to keep uniformity in the final printed copies of the Journal. Please keep in mind that the manuscript you prepare will be photographed and printed as it is received. Readability of copy is of paramount importance.
Opinions of midwives regarding the introduction of breast ultrasound in mothers’ breast care
Authors: Kanazawa Yuki , Isoyama Akemi
Published: August 2022

日本の助産師のケアは、すべての母親の乳房問題を解決することはできません。この定性的、フォーカスグループインタビュー研究は、乳房ケアルーチンへの乳房超音波の導入に関する助産師の意見を明確にすることを目的としていました参加者は、5人と6人の助産師の2つのグループに分かれました。データは、フォーカスグループインタビューを実施することによって収集されました。インタビューデータは定性的に分析された。乳房ケアのための超音波の導入の3つの理由が助産師に明らかにされた。1つ目は、一定の助産能力の必要量を失い、母親の負担が増大する可能性であり、現状に不利な状況であった。2つ目は、助産師のスキルとケアの効率を向上させることによって母親の心理的安定性を高める可能性という肯定的なものでした。3つ目は、乳房超音波装置が簡単に操作できるように改良し、スキルを向上させるためのトレーニングを提供することです。助産師には、乳房ケアに乳房超音波を導入する利点が示されている。乳房超音波を乳房ケアに導入するためには、助産師が乳房超音波の操作方法を学ぶためのトレーニングコースを開発する必要があります。
Sirenomelia: A Case Report
Authors: Serudji Joserizal
Published: August 2022

Sirenomelia is an extremely rare anomaly, an incidence of 1 to 4.2 in 100,000 births, in which a newborn born with legs joined together featuring amermaid-like appearance (head and trunk like humans and tail like ﬁsh), and in most cases die shortly after birth. Gastrointestinal and urogenital anomalies and single umbilical artery are clinical outcome of this syndrome. There are two important hypotheses for pathogenesis of mermaidsyndrome: vitelline artery steal hypothesis and defective blastogenesis hypothesisThe cause of the sirenomelia is unknown, but there are some possible factors such as age younger than 20 years and older than 40 years in mother and exposure of fetus to teratogenics. Here, we introduced 39 year old mother’s ﬁrst neonate with  Sirenomelia syndrome. The mother had gestational diabetes mellitus and neonate was born with single lower limb, ambiguous genitalia, and thumb anomalies, and 4 days after birth, the neonate               dieddue to multiple anomalies and imperforated anus.
Analysis of Factors Affecting Breastfeeding Patterns During the 2021 Covid-19 Pandemic
Authors: Safaringga Miranie
Published: August 2022

Breast milk is the most ideal nutrition for babies because it contains nutrients that are most suitable for the baby's needs and contains antibodies that can protect babies from various diseases, especially during the Covid-19 period.This study aims to determine the factors that influence breastfeeding patterns during the COVID-19 pandemic in 2021.The research design used Correlative Analytical with Crosssectional approach. The sample of this research used purposive sampling. The number of samples is 97 breastfeeding mothers in the city of Padang in 2021. Collecting data using a structured questionnaire to determinethe level of knowledge, attitudes, work status and breastfeeding patterns during COVID-19. The data analysis used was univariate and bivariate usingChi-square statistical test (p < 0.05). Based on the results of the Kruskal Wallis test, of the 4 variables that are associated with breastfeeding patternsduring Covid-19, only the knowledge variable has an Assymp sig = 0.049 (< 0.05), it can be concluded that there is a difference between a person's level of knowledge on breastfeeding patterns. during Covid-19. While the education, work and attitude variables have an Assymp Sig value > 0.05 which means there is no difference between education, work and attitudes with breastfeeding patterns during Covid-19.
Factors Affecting the Preparedness of Pregnant Women Facing COVID-19 Vaccination
Authors: Mastryagung Gusti Ayu Dwina , Dewi Ni Nyoman Sri Artina , Diana Ni Putu Indah Putri
Published: August 2022

The COVID-19 disease also affects children and pregnant women. The latter can pose a risk to two humans, namely the mother herself and the fetus she is carrying. Therefore, the vaccination program for pregnant women at risk must be implemented immediately. However, this program of course still faces obstacles so that research on the concerns of pregnant women in dealing with COVID-19 vaccination must be determined. This quantitative study used a correlation analytic design with a cross sectional study approach. It took place at the Dauh Puri Sub-Public Health Center, Denpasar. The sample was pregnant women in TM I and TM II and had not received the COVID-19 vaccine as many as 70 pregnant women. The sampling technique was non-probability sampling. Data were collected through a questionnaire. Data analysis used non-parametric analysis, namely Spearman Rho Correlation. The results show that there was a relationship between the level of knowledge and the readiness of pregnant women but there was no relationship between education and the number of pregnancies and the readiness. Therefore, the level of knowledge becomes the only factor that affects the readiness of COVID-19 vaccination in pregnant women.
Pathophysiology of Preeclamsia
Authors: Karmia Hudila Rifa , Serudji Joserizal
Published: August 2022

The uncertainty of the etiology and underlying mechanisms of the pathophysiology of this disease makes causal structuring and primary prevention of preeclampsia impossible, making it difficult to control morbidity and mortality, both maternal and perinatal. From the many theories on preeclampsia, the disease can be classified into Placental preeclampsia, maternal preeclampsia, and Vascular Disorders of Pregnancy (VDP). Increased inflammatory response to placental factors, excessive inflammatory response to placental factors, and primary vascular disorders are the basis of distinction and also the basis of pathophysiology among the three forms of preeclampsia.