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( Yudianti Pangestu ),( Ari Fahrial Syam ),( Ahmad Fauzi ),( Murdani Abdullah ),( Dadang Makmun ),( Marcellus Simadibrata ),( Chudahman Manan ),( Aziz Rani ),( H Daldiyono ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Obstructive jaundice may be caused by extrahepatic cholestatic (CBD stones, pancreas and ampula cancer, CBD stricture, cholangiocarcinoma) and intra hepatic cholestatic. The aim of this study was to know what was the cause of obstructive jaundice based on ERCP evaluation. Methods: We did the retrospective study based on data of ERCP in Cipto Mangunkusumo Hospital in October 2004 until Mei 2007 Results: We evaluated 95 patients which has be done ERCP examination. We got complete data in 76 patients. Male was more frequent than female (61.8% vs 38.2%), with age range was 20-80 years old (age mean was 48.47 years old). We found CBD stones in 33 (43.4%) patients, papilla vateri tumour in 10 (13.2%) patients, head of pancreatic cancer in 8 (10.5%) patients, CBD stricture in 3 (3.9%) patients, cholangiocarcinoma in 1 (1.3%) patient, Klatskin tumour in 1 (1.3%) patient and unknown etiology obstructive in 4 (5.3%) patients. Obstructive jaundice was the most indication in ERCP examination, in 47 (61.8%) patients, followed by cholelithiasis in 22 (28.9%) patients. Sphincterotomy and stones extraction has be done in 17 (22.4%) patients, ductal cleansing in 3 (3.9%) patients, CBD stenting was performed in 17 (22.4%) pasien. We sent to surgery in 13 (17.1%) patients. ERCP failed was reported in 15 (19.7%) patients, most in the of pancreatic cancer patients. Conclusions: We found CBD stones was the most cause of obstructive jaundice, based on ERCP evaluation. ERCP has done successfully in 80.3% patients and therapeutics has done in 48.7% patients.
Goto, Yasuyuki,Syam, Ari Fahrial,Darnindro, Nikko,Hapsari, Florentina Carolin Puspita Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.9
Indonesia is a developing country, in most of which the infection rates of Helicobacter pylori (H. pylori) have been reported to be high. However, the prevalence of H. pylori infection in Indonesia has been unexpectedly reported to be low. The purpose of our study was to confirm whether the prevalence of H. pylori infection is low among healthy inhabitants in Northern Jakarta by 13C-urea breath test (UBT), and to examine the association of their lifestyle/environmental factors with H. pylori infection and to identify potential routes of transmission. We recruited a total of 196 subjects from a low-income community in Northern Jakarta, Indonesia. Of them, 193 subjects who completed a questionnaire about their lifestyle/environment and had UBT were included in this study. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using logistic regression model. The overall H. pylori infection rate was 15.0%. There was difference in H. pylori infection rates among Buginese (40.0%), Betawi (9.1%), Sundanese (3.7%), and Batak (9.1%). After multivariate analysis, the ORs of intake of soybean milk, cucumber more than one time a week, infrequent hand washing before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10 (95%CI: 1.15-14.6), and 61.9 for former drinkers (95%CI: 1.67-2300.8), respectively. Buginese (OR=7.84; 95%CI: 1.82-33.8) and Batak ethnic groups (OR=20.1; 95%CI: 1.90-213.2) were infected more frequently, compared with Javanese. The H. pylori infection rate in this study was low, as reported previously. After we scrutinized the factors, Buginese and Batak ethnic groups eat food using fingers more frequently than Javanese, Betawi, and Sundanese. In addition, infrequent hand wash practice before meal increased the risk. Our study indicated that person-person transmission was possible in this low prevalence area. The low infection rates of H. pylori among those of Javanese, Betawi, and Sundanese ethnicity could be partly due to sanitary practice.
Goto, Yasuyuki,Syam, Ari Fahrial,Darnindro, Nikko,Hapsari, Florentina Carolin Puspita Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10
Background: The prevalence of Helicobacter pylori (H. pylori) infection in Indonesia has been reported to be exceedingly low. The purpose of our study was to confirm whether this is the case in Northern Jakarta using a sensitive 13C-urea breath test (UBT), and to examine any associations with lifestyle/environment factors and potential routes of transmission. Methods: We recruited a total of 196 subjects from a low-income community in Northern Jakarta, Indonesia, data from 193 who completed a questionnaire about their lifestyle/environment and had UBT being included as the final. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using a logistic regression model. Results: The overall H. pylori infection rate was 15.0% (95%CI, 10.3-20.9), with variation among Javanese (9.1%, total=77), Buginese (40.0%, 35), Betawi (9.1%, 33), Sundanese (3.7%, 27), and Batak (40.0%, 5). On multivariate analysis, the ORs for intake of soybean milk, cucumber more than once a week, infrequent hand washing practice before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10 (95%CI: 1.15-14.6), and 61.9 (95%CI: 1.67-2300.8), respectively. Rates for Buginese (OR=7.84; 95%CI: 1.82-33.8) and Batak (OR=20.1; 95%CI: 1.90-213.2) were significantly higher than for Javanese. Conclusions: The H. pylori infection rate in this study was relatively low, in line with previous studies. Regarding ethnicity factors, Buginese and Batak reported eating food using fingers more frequently than Javanese, Betawi, and Sundanese. Our study indicated that person-person transmission is possible in this low prevalence area. The low infection rates for H. pylori among Javanese, Betawi, and Sundanese ethnics could be partly due to their sanitary practices.
( Khaira Utia ),( Ari Fahrial Syam ),( Marcellus Simadibrata ),( Siti Setiati ),( Chudahman Manan ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: In most studies eradication of H. pylori has resolved the symptoms of dyspepsia in patient with or without peptic ulcer. But the symptomatic improvement of dyspepsia after eradication treatment remains unclear. The aim of this study was to find symptom characteristics of dyspepsia after eradication treatment of H. pylori and to see the association between symptom of dyspepsia and H. pylori findings. Methods: This was the cross sectional study in H. pylori patients with history of dyspepsia that had been administered eradication treatment of H. pylori for 1 week in 5 years period (2002-2007). Patients were invited to be interviewed about current symptoms of dyspepsia and then underwent urea breath test (UBT) examination to identify H. pylori. Global overall symptom of dyspepsia scale was used to assess the symptoms of dyspepsia. Results: There were 22 patients (13 male and 9 female) fulfilled the eligibility criteria for this study, 36.4% patients with eradication treatment history less than 1 year, and 63.6% patients more than 1 year. The symptoms of dyspepsia, the symptoms of dyspepsia were evaluated and as much as 77.3% (17/22) of patients, the symptoms of dyspepsia were subsided, and 22.7% (5/22) of patients with persistent symptoms after eradication. After eradication treatment, 72.7% (16/22) of patients appeared with negative Helicobacter pylori finding, and 27.3% (6/22) of patients remains positive. In negative group, 75% (12/16) of patients had relieved symptoms, and 25% (4/16) of patients with persistent symptom, and in positive group, as much as 83.8% (5/6) of patients the symptoms were relieved, and 16.7% (1/6) of patient remains persistent. We didn`t find any significant association between symptoms of dyspepsia and Helicobacter pylori status (p-0.581). Conclusions: In majority of patients, symptoms of dyspepsia after eradication treatment were resolved, but no significant association between symptoms of dyspepsia and Helicobacter pylori status.
Ahmad Fariz Malvi Zamzam Zein,Rabbinu Rangga Pribadi,Uswatun Khasanah,Muhammad Begawan Bestari,Ari Fahrial Syam 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has necessitated modifications to allow the safe practice ofclinical gastroenterology and gastrointestinal endoscopy. This study aimed to investigate the characteristics of clinical gastroenterologyand gastrointestinal endoscopy practices during the COVID-19 pandemic in Indonesia. Methods: This cross-sectional study enrolled physician members of the Indonesian Society for Digestive Endoscopy. We used anonline self-administered questionnaire disseminated via social media. The 32-item survey determined the baseline characteristics ofthe participants, characteristics of clinical gastroenterology and gastrointestinal endoscopy practices, involvement of the physiciansin the management of COVID-19, and overall impact of the pandemic on practice. All collected data were analyzed using descriptivestatistics. Results: The 200 participants in this study had a median age of 50 (34–76) years. Modifications in clinical gastroenterology practice werefrequently reported in the outpatient (95.5%) and inpatient (100%) settings. All participants reported changes in the gastrointestinalendoscopy practice patterns. Of the participants, 86.0% were working in high-risk zones, and several of them reported inadequateprotective personal equipment (34.0%). The median overall impact score of the pandemic on practice was 9 (2–10). Conclusions: Physicians practicing clinical gastroenterology and gastrointestinal endoscopy in Indonesia work in high-risk settings. Modifications in clinical gastroenterology and gastrointestinal endoscopy practices are prevalent during the COVID-19 pandemic.
Role of interventional endoscopic ultrasound in a developing country
Hasan Maulahela,Nagita Gianty Annisa,Achmad Fauzi,Kaka Renaldi,Murdani Abdullah,Marcellus Simadibrata,Dadang Makmun,Ari Fahrial Syam 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.1
Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospitalas a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventionalEUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases ofEUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexusneurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100%for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1%for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverseevents, even in developing countries.
( Uday C Ghoshal ),( Kok Ann Gwee ),( Minhu Chen ),( Xiao R Gong ),( Nitesh Pratap ),( Xiao Hua Hou ),( Ari F Syam ),( Murdani Abdullah ),( Young Tae Bak ),( Myung Gyu Choi ),( Sutep Gonlachanvit ),( 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.1
Background/Aims The development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Rome III criteria. Methods After EAR3Q was developed by Asian experts by consensus, it was translated into Chinese, Hindi-Telugu, Indonesian, Korean, and Thai, following Rome Foundation guidelines; these were then validated on native subjects (healthy [n = 60], and patients with irritable bowel syndrome [n = 59], functional dyspepsia [n = 53] and functional constipation [n = 61]) diagnosed by clinicians using Rome III criteria, negative alarm features and investigations. Results Experts noted words for constipation, bloating, fullness and heartburn, posed difficulty. The English back-translated questionnaires demonstrated concordance with the original EAR3Q. Sensitivity and specificity of the questionnaires were high enough to diagnose respective functional gastrointestinal disorders (gold standard: clinical diagnoses) in most except Korean and Indonesian languages. Questionnaires often uncovered overlapping functional gastrointestinal disorders. Test-retest agreement (kappa) values of the translated questionnaires were high (0.700-1.000) except in Korean (0.300-0.500) and Indonesian (0.100-0.400) languages at the initial and 2-week follow-up visit. Conclusions Though Chinese, Hindi and Telugu translations were performed well, Korean and Indonesian versions were not. Questionnaires often uncovered overlapping FGIDs, which were quite common.
Second Asian Consensus on Irritable Bowel Syndrome
Kok-Ann Gwee,Sutep Gonlachanvit,Uday C Ghoshal,Andrew S B Chua,Hiroto Miwa,Justin Wu,Young-Tae Bak,Oh Young Lee,Ching-Liang Lu,Hyojin Park,Minhu Chen,Ari F Syam,Philip Abraham,Jose Sollano,Chi-Sen Cha 대한소화기 기능성질환∙운동학회 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.3
Background/AimsThere has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely toupdate the Asian IBS Consensus. MethodsKey opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology,pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process wascarried out by using a modified Delphi method. ResultsThirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-braininteraction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and uppergastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet,probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. ConclusionsOur consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view toholistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.