Internal Medicine

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori po...

Background: Transarterial chemoembolization (TACE) is widely used as a palliative treatment for unresectable hepatocellular carcinoma (HCC). TACE is also used as bridging therapy before liver transplantation to avoid tumour progression and considered for downstaging to fulfill tumour resection or liver transplantation criterias. This study aimed to evaluate response of TACE in unresectable HCC according to changing of tumour size, number of lesion, and AFP level.Method: Retrospectively, we evaluate 69 HCC patients who underwent TACE in Dr. Soetomo General Hospital in January 2012-June 2015, including their age, sex, aetiologies, and Barcelona Clinic Liver Cancer/BCLC staging. Laboratory examinations such as complete blood count (hemoglobin/Hb, leucocyte, thrombocyte), liver function test (aspartate aminotransferase/AST, alanine aminotransferase/ALT, bilirubin, albumin, international normalized ratio/INR), alpha-fetoprotein/AFP level, and abdominal CT-scan were performed before and 1...

Background: The quality of life of Gastro Esophageal Reflux Disease (GERD) patients will consistently decline both physically and psychologically compared to the general population. WHOQOL-BREF is a questionnaire to evaluate the quality of life with high validity and reliability. One of GERD therapy is a proton pump inhibitor (PPI). There are studies on PPI administration in GERD patients worldwide, however in Indonesia there is limited research evaluating how PPI especially Omeprazole influences the quality of life in GERD. We determined the effect of omeprazole to the quality of life of patients with GERD. Methods: GERD questionnaires (GERDQ) was used to determine life quality of GERD patients and interpretation was performed based on score obtained. The comparison between the perception of the quality of life and perception of health satisfaction in GERD patients before and after Omeprazole administration was analyzed using Wilcoxon signed rank test. While, the comparison of the ...

Background: The density of the H. pylori colonies is associated with more severe clinical manifestations, chronic infections, ineffective therapy responses and malignant events. Interleukin-8 (IL-8) is one of cytokines that plays a role in the inflammatory process that results in gastric mucosal damage. We determined the association between H. pylori density and gastric mucosal IL-8 expression in dyspeptic patients. Methods: H. pylori density was determined using histopathology based on Updated Sydney System. IL-8 levels were measured using immunohistochemistry from the gastric biopsy. Results: There was significant difference between gastric mucosal IL-8 expression obtained in gastric mucosal gland epithelium (p = 0.028) at mild and high density of H. pylori (p = 0.013). There was a correlation between H. pylori density with gastric mucosal IL-8 expression of glandular epithelium (r = 0.622; p = 0.004), surface epithelium (r = 0.510; p = 0.026), and inflammatory cells (r = 0.054; =...

Until now liver biopsy is still gold standard to asses liver fibrosis. Fibroscan within superiority and little limitation can be an alternative as non-invasive procedure to asses liver fibrosis. In this pioneer study among “various chronic liver disease patients at Dr Soetomo hospital resulted higher Fibroscan score of liver stiffness, whereas the highest score of liver stiffness revealed among respectively hepatoma, liver cirrhosis, chronic hepatitis C, chronic hepatitis B, and NAFLD. For future, It is important to enrollment similar study that involved bigger sample size to determine liver fibrosis among any various liver diseases and conjuncted to detect its clinical complication earlier.

Crohn’s disease (CD) is a chronic debilitating inflammatory disease which mostly affect gastrointestinal tract, but due to its unique features, CD enables to affect extraintestinal organs. Pathophysiology of extraintestinal manifestations is still debatable as many experts propose immune-related hypotheses. It is still unpredictable which manifestation precedes another as studies ongoing. Diagnosing CD is difficult since no gold standards available, therefore clinicians must combine history taking, diagnostic modalities, and a good clinical judgement to diagnose CD. Treatment for CD is not only to treat disease activity, but also to prevent complications to preserve patients’ quality of life.   

Background Gastrointestinal manifestations of coronavirus disease 2019 (COVID-19) appear to be substantial. Fecal calprotectin is a promising biomarker in COVID-19 associated gastrointestinal inflammation; however, its role in the severity of COVID-19 remains limited. We conducted a study to analyze the relationship between the severity of COVID-19 and hypoxic intestinal damage. Methods We assessed the severity of 44 hospitalized COVID-19 pneumonia patients based on the PaO2/FiO2 (P/F) ratio. Inflammatory markers were measured from blood samples, and fecal calprotectin was obtained from stool samples. Results Median levels of fecal calprotectin in COVID-19 patients involved in this study (n = 44) were found to be markedly elevated along with the severity of hypoxemia, as seen in the non-acute respiratory distress syndrome (ARDS) group 21.4 µg/g (5.2–120.9), mild ARDS 54.30 µg/g (5.2–1393.7), moderate ARDS 169.6 µg/g (43.4–640.5), and severe ARDS 451.6 µg/g (364.5–538.6). We also fou...

Inflammatory bowel disease (IBD) with a poor prognosis may be due to persistent colitis. According to the latest guidelines, monitoring has become a part of the treatment process for colitis. Adequate monitoring of the patient's condition is necessary to determine the course of the disease to prevent the worsening of the condition and suppress the subclinical inflammatory process. This analytical study with a cross-sectional design was conducted to evaluate the activity of colitis using the results of C-reactive protein (CRP) and fecal calprotectin (FC) assays. FC levels were analyzed by ELISA, while CRP levels were analyzed using Siemens Flex particle-enhanced turbidimetric immunoassay. In 30 subjects with endoscopy and biopsy of colitis, 16 men and 14 women had a median age of 52.5 (18–70) years. The median FC value increased by 67 (7.3–722 g/g) and was positive (≥50 g/g) in 20 subjects (66.7%), and the mean CRP value was 13.64 mg/L, positive (10–15 mg/L) in 13 subjects (43.33...