16 research outputs found
Perbandingan Penyekat Pompa Proton Rute Intravena Intermiten dan Intravena Drip Kontinu Pada Tatalaksana Perdarahan Saluran Cerna Atas Nonvariseal
Perdarahan Saluran Cerna Atas (PSCBA) non variseal merupakan keadaan darurat yang membutuhkan penanganan cepat serta diberikan terapi yang tepat. Salah satu terapi yang direkomendasikan adalah Penyekat Pompa Proton (Proton Pump Inhibitor/PPI). Studi ini akan membandingkan kedua rute pemberian PPI yaitu esomeprazole baik dengan rute intravena intermiten maupun intravena drip kontinu dengan parameter kejadian perdarahan dan lama rawat inap pasien. Penelitian ini menggunakan metode kohort retrospektif dengan pengambilan data melalui data rekam medis dari tahun 2019-2022. Hasil yang didapatkan terdapat 48 kasus pemberian esomeprazole, 31 kasus dengan intravena intermiten dan 17 kasus dengan intravena drip kontinu. Laki-laki memiliki persentase yang lebih tinggi dibandingkan perempuan pada kedua kelompok pemberian. Rentang usia 18-69 tahun memiliki persentase yang lebih tinggi pada kedua kelompok. Kejadian perdarahan intravena intermiten lebih rendah dibandingkan intravena drip (29% vs 58,8%, p=0,04). Namun, berbeda halnya dengan lama rawat inap dimana intravena drip kontinu memiliki rerata lama rawat inap yang lebih rendah dibandingkan intermiten (2,5 hari vs 4,7 hari, p=0,05). Perbandingan antara keduanya perlu dilakukan penelitian lebih lanjut dengan jumlah sampel yang lebih besar
Correlation Between the Severity of Liver Cirrhosis (Chil-Pugh Score) and QTc Interval Prolongation
Background:Liver cirrhosis causes changes in cardiovascular system. Electrographic (ECG) abnormality commonly found in cirrhosis patients is QT interval prolongation. It is part of cirrhotic cardiomyopathy. QTc interval prolongation is correlated to the incidence of life-threatening arrhythmias. The objective of this study was to recognize the correlation between the severity of liver cirrhosis and QTc interval prolongation in patients with liver cirrhosis at Sardjito General Hospital, Jogjakarta.Method: The design of this study was cross-sectional. The subjects were hospitalized patients with liver cirrhosis at the Department of Internal Medicine, Sardjito Hospital, Jogjakarta between January 2011 and March 2012. ECG was performed in all patients and QTc interval was measured. The severity of liver cirrhosis was determined by Child-Pugh score. Spearman correlation analysis was used to determine the correlation between variables of QTc interval prolongation and Child-Pugh score.Results: A total of 73 patients were enrolled, including 51 (69.9%) male and 22 (31.1%) female patients with mean age of 54.05 ± 12.55 years (range 20-80). Liver cirrhosis was caused by hepatitis B virus in 36 (49.3%) patients, hepatitis C virus in 20 (27.4%) patients and other causes in 19 (26%) patients. The Child-Pugh score for liver cirrhosis was found as follows: child A in 10 (13.6%) patients, child B in 27 (36.9%) patients and child C in 36 (49.3%) patients. The correlation between the severity of liver cirrhosis and QTc interval prolongation was weak (r = 0.255; p = 0.029).Conclusion:Severity of liver cirrhosis has a weak positive correlation with QTc interval prolongation
THE DIFFERENCE OF TRANSAMINASE LEVEL IN GALLSTONES LOCATION OF GALLSTONE PATIENTS IN RSUP DR SARDJITO
ABSTRACT
Background: Gallstone can occur anywhere within the
biliary tree, including the gallbladder and the common
bile duct. To identify a biliary etiology, several
biochemical investigations have been proposed including
bilirubin, ALT, AST, GGT, and alkaline phosphatase.
Objectives: To know the difference between the location
of gallstones and the level of transaminase.
Method: The data of cholelithiasis patient is collected
by analysing the medical records obtained from RSUP Dr.
Sardjito in 2010 to 2013. The medical record chosen is
cholelithiasis patients who were diagnosed by the
internist and undergo surgery to remove the stones and
classified into cholelithiasis, choledocholithiasis and
both cholelithiasis and choledocholithiasis. The data
is analysed by using computer.
Result: Shapiro-Wilk Test is used for normality test.
The difference of transaminase level based on
gallstones location was analysed using Kruskal-Wallis H
Test. In SGOT, there is statistically significant
difference between the gallstone location,
(H=18.84,p=0.000), with a mean rank of 52.69 for
cholelithiasis, 88.88 for choledocholithiasis, 87.21
for cholelithiasis and choledocholithiasis. In SGPT,
there is a statistically significant difference between
the three groups of gallstone location,
(H=13.52,p=0.001), with a mean rank of 55.61 for
cholelithiasis, 81.17 for choledocholithiasis, 86.29
for cholelithiasis and choledocholithiasis.
Conclusion: Based on the study, there is difference in
the value of SGOT and SGPT according to the gallstones
location
THE DIFFERENCE OF ALKALINE PHOSPHATASE, BILIRUBIN,AND GAMMA GLUTAMYL TRANSFERASE LEVEL IN DIFFERENT GALLSTONE LOCATION OF GALLSTONE PATIENT IN RSUP DR SARDJITO.
Background : In daily practice, it is difficult to
differentiate between cholelithiasis and choledocholithiasis
patients by clinical symptoms. Even though obstructive
jaundice usually happen in choledocholithiasis, but it can
also being absence. This problem can lead to underdiagnosis
and cause the stone to be remain in the bile duct even after
operation. The biochemical testing such as bilirubin,
alkaline phosphatase and gamma glutamyl transferase can
indicate biliary obstruction.
Aim : The aim is to evaluate the difference in biochemical
marker which are bilirubin, alkaline phosphatase and gamma
glutamyl transferase at different gallstone locations in
cholelithiasis and choledocholithiasis patients.
Method : 88 patients from surgery department are selected for
this research. The subjects are divided into two groups which
are patients with choledocholithiasis (n=11) and
cholelithiasis (n=77). For total bilirubin, 75 cholelithiasis
and 11 choledocholithiasis are selected. While 28
cholelithiasis and 7 choledocholithiasis patients for
difference in alkaline phosphatase and 18 cholelithiasis and
7 choledocholithiasis patients for difference in Gamma
Glutamyl Transferase. The liver marker level were taken
maximum one week before the operation.
Results : Significant different was found in Bilirubin and
ALP P < 0.05 . Overall, the median shows that the level of
Bilirubin and ALP is higher in choledocholithiasis if compared
with cholelithiasis patients. While no significant different
in Gamma Glutamyl Transferase was found P > 0.05. Eventhough
overall median results shows that the level of GGT in
choledocholithiasis is higher than in cholelithiasis but some
low ranks and some high ranks will occur in each group, that
is the ranks will be distributed across the two group which
are cholelithiasis and choledocholithiasis more or less
evenly.
Conclusion : In a conclusion, only bilirubin and alkaline
phosphatase level have a significant difference in different
gallstone location
LEUKOCYTOSIS AND NEUTROPHILIA AS PREDICTIVE FACTORS OF ACUTE ON CHRONIC CHOLECYSTITIS A Graduating Paper
Background: Acute cholecystitis could progress into
chronic cholecystitis, and acute exacerbations of chronic
cholecystitis could occur (acute on chronic
cholecystitis). Neutrophilia is one of the systemic
features of acute inflammation. Typically, leukocytosis
in the range of 10,000-15,000 cells per microliter with a
left shift on differential count is found. Leukocytosis
and neutrophilia were chosen to be studied if they can be
predictive factors of acute on chronic cholecystitis.
Objectives: The objective of this research is to search
whether leukocytosis or neutrophilia can become the
predictive factors of acute on chronic cholecystitis.
Method: The study design of this research is a
retrospective cross-sectional study. The study was
conducted among acute cholecystitis and acute on chronic
cholecystitis patients with cholelithiasis from year
2010-2013. It was conducted using medical records and
laboratory reports of the patients in Sardjito Hospital,
Yogyakarta. The data was analysed using computerized
analysis.
Results: Leukocytosis is a predictive factor of acute on
chronic cholecystitis, however, it is not statistically
significant (PR=2.364, p=0.129). Neutrophilia is a
predictive factor of acute on chronic cholecystitis but
is not statistically significant (PR=2.250, p=0.174).
Conclusion: Leukocytosis and neutrophilia are not the
predictive factors of acute on chronic cholecystitis
Tuberculosis Peritonitis Patient with Septic Shock caused by Extended–Spectrum Beta Lactamases Producing Pseudomonas Aeruginosa
According to World Health Organization (WHO), tuberculosis (TB) is a worldwide pandemic. Up to 5% of patients with TB may have abdominal disease and 25-60% may have peritoneal involvement. Diagnosis of TB peritonitis is still challenging, and symptoms are usually insidious. The sensitivity of acid fast bacilli (AFB) is very low, ranging from 0-6%. Conventional mycobacterial culture takes up to 8 weeks to achieve results. Laparoscopic or laparotomy biopsy is uncomfortable for patient. The consequence of these problems is missing and delays in diagnosing TB peritonitis. In the end, it can results in significant morbidity and mortality. This case described a 20 year old female patient with TB peritonitis that suffered from septic shock caused by extended-spectrum beta lactamases (ESBL) producing Pseudomonas aeruginosa. In this case, TB peritonitis was diagnosed based on clinical features, high levels of adenosine deaminase (ADA) and a positive rapid DNA test with Xpert MTB/RIF.  Keywords: tuberculosis peritonitis, extended-spectrum beta lactamases producing bacilli, adenosine deaminase, XpertMTB/RIF assa
Endoscopic Sclerotherapy and Band Ligation in Secondary Prophylaxis of Esophageal Variceal Treatment
Background: Variceal bleeding is the most severe outcome of portal hypertension. Endoscopic sclerotherapy and band ligation are endoscopic treatment modalities for both active variceal bleeding and secondary prophylaxis. Endoscopic sclerotherapy has been carried out in Sardjito hospital since 1998, while band ligation has only been carried out since 2007 year. The aim of this study was to evaluate the long-term Result of endoscopic sclerotherapy and endoscopic band ligation in secondary prophylaxis of esophageal variceal eradication. Method: This is not a prospective study and is not randomized. The Results of patients who underwent endoscopic sclerotherapy and endoscopic band ligation from July 2003 to June 2009 were compared. Patients were evaluated for re-bleeding and recurrence rates. Results: Two hundred and seventy seven patients underwent endoscopic sclerotherapy and endoscopic band ligation during the period. One hundred and nine patients with varices eradication data; 49 patients who underwent sclerotherapy and 60 patients who underwent band ligation were followed for 1-119 (15.54 ± 20.70) months. The numbers of sessions for eradication were 4.33 ± 1.16 and 2.23 ± 0.59 for endoscopic sclerotherapy and endoscopic band ligation respectively (p 0.05). Conclusion: Endoscopic band ligation is more effective than sclerotherapy in the eradication of esophageal varices.  Keywords: esophageal varices, sclerotherapy, band ligation, secondary prophylaxi