S-Index and APRI Score to Predict Liver Fibrosis Chronic in Hepatitis B and C Patients

Background: A great interest has been dedicated to the development of non invasive predictive models in recent years to substitute liver biopsy for fibrosis assessment and follow-up. The aim of this study was to comparethe accuracy between S-index and aspartate aminotransferase to platelet ratio index (APRI) to FibroScan for predicting liver fibrosis in chronic hepatitis B and C patients.Method: A cross-sectional study was conducted in 40 patients with chronic hepatitis B and C between January 2010 - May 2011 at Division of Gastroentero-hepatology, Department of Internal Medicine, Adam Malik Hospital, Medan. Patients underwent laboratory examination and FibroScan, then used predictive values to assess the accuracy of S-index scores and APRI compared to FibroScan. The analysis was performed using SPSS 15.0.Results: S-index identified significant fibrosis in 87.5% patients with sensitivity (Se) 87.5% and specificity (Sp) 100%. About 67.5% of 40 patients could be identified correctly. S-index also could accurately predict the absence or presence of cirrhosis in 87.5% of the total 40 patients, with NPV 91.7% and PPV 81.25%, respectively. APRI for significant fibrosis has Se 85.7%, Sp 88%, PPV 88.8%, NPV 69.2%; while Se 53%, Sp 88%, PPV 72.7%, NPV 75.8% for liver cirrhosis. AUROC value for S-index was higher than APRI in predicting significant fibrosis and cirrhosis, i.e. 0.938 vs. 0.917 and 0.873 and 0.707, respectively.Conclusion: The S-index has a higher accuracy than APRI in predicting significant fibrosis and cirrhosis in patients with chronic hepatitis B virus and hepatitis C virus infection

Level of Gastrin Serum and Ulcer Size on Gastric Ulcer Correlated to Helicobacter Pylori Infection

Background: Previously has been defined that peptic ulcer has strongly correlated to Helicobacter pylori (H. pylori) infection. But it hasn\u27t determined about correlation of gastrin serum level to the ulcer severity on H. pylori infection. The aims of this study were to find the percentage of H. pylori infection on peptic ulcer cases and its correlation to the gastrin serum level. Method: This is analytic cross sectional study in 50 patients with gastric ulcer who came to Adam Malik hospital from February to October 2007. The correlation between gastrin serum level and the size of ulcer with positive and negative Urea Breath Test (UBT) group was analyzed by unpaired student t- test. The correlation between gastrin serum level and ulcer size were investigated with Pearson correlation test and linier regression. Result: Fifty eligible patients, 33 (66%) had positive UBT and 17 (34%) were negative. There were statistically significant difference on gastrin serum level in positive UBT and negative respectively (p = 0.017). There were also significant difference between mean of ulcer size in positive UBT and negative respectively (p = 0.025). There were correlation between gastrin serum level and ulcer size (r = 0.315; p = 0.026). It can predict the increasing ulcer size in 0.012 mm every 1 pg/mL of gastrin serum elevated. Conclusion: Patients with positive UBT has greater ulcer size and higher gastrin level as compared to the negative group. There were positive correlation between gastrin serum level to the size of ulcer in peptic ulcer patients and increase of ulcer size followed with elevated of gastrin serum level

Profile of Colorectal Cancer Patients in Endoscopic Unit at Dr. Pirngadi Hospital - Medan

Background: Colorectal cancer is the third most prevalent cancer and the second leading cause of cancer death worldwide every year. Rates of this Malignancy vary by country. In Indonesia, the prevalence is estimated to have an increased tendency. The objectives of this sudy was to examine the prevalence and profile of colorectal cancer, which are diagnosed by endoscopic examination. Method: The study was conducted retrospectively, by examining the Result of endoscopic findings of patients with rectal bleeding, altered bowel habit, chronic diarrhea, unexplain abdominal pain, and other signs and symptoms at The Endoscopic Unit Department of Internal Medicine, Dr. Pirngadi hospital from January 2004 to June 2008. Results: We found 197 patients with colorectal cancer (CRC) from 760 patients examined by colonoscopy (25.9%). One hundred and one patients (51.3%) out of 197 CRC patients were female. Most were in the group of age 51-60 years (28.9%). The most frequent ethnic of the patients were Bataknese (46.2%). The most common symptom was rectal bleeding (70.6%). The most common location of CRC was in the rectum (74.6%). Histopathologic Result was adenocarcinoma. Conclusion: The prevalence of colorectal cancer in this study were twenty six percents. Rectal bleeding appeared to be the most common sign in this study. Rectum was the most common site of the cancer. Most of patients were Bataknese. Patients were at advanced stage and most of them were having well-differentiated adenocarcinoma