Nurul Akbar
Department of Internal Medicine, Universitas Indonesia Faculty of Medicine, Jakarta.

Published : 26 Documents
Articles

Found 26 Documents
Search

Hospital based cancer registry in Cipto Mangunkusumo hospital Jakarta Sibuea, Wilfried H.; Mangunkusumo, R. R.; Akbar, Nurul; Widjanarko, Abidin; Gatot, Djajadiman; Windiastuti, Endang; Hamzah, Mochtar; Panigoro, Sonar S.; Prihartono, Joedo; Krisnuhono, Ening; Lisnawati, Lisnawati; Utami, Sri M.S.; Ramli, Irwan; Roezin, Averdi; Pribadi, Sigit; Wilarso, Iik; Nasar, I Made; Cornain, Santoso
Medical Journal of Indonesia Vol 9, No 3 (2000): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (752.738 KB)

Abstract

[no abstract available]
The role of splanchnic vasoconstrictor in decreasing peripheral vasodilatation to reduce ascites formation of liver cirrhosis Akbar, Nurul; Soemarno, Soemarno; Sumarsono, Sumedi; Lesmana, Laurentius; Husodo, Unggul B.; Sulaiman, Ali; Sjaifoellah Noer, H. M.
Medical Journal of Indonesia Vol 6, No 4 (1997): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (583.239 KB)

Abstract

[no abstract available]
The prevalence of hepatitis C virus ribonucleic acid, the risk factors, and relation with aminotransferase levels in a general population of Jakarta, Indonesia Akbar, Nurul
Medical Journal of Indonesia Vol 6, No 3 (1997): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (771.893 KB)

Abstract

[no abstract available]
Genotyping of hepatitis B virus from dried and stored serum on filter paper Gani, Rino A.; Handayu, A. D.; Mulatsih, Reny; Lesmana, L. A.; Sulaiman, Ali; Akbar, Nurul
Medical Journal of Indonesia Vol 14, No 4 (2005): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (149.253 KB)

Abstract

HBV genotype has aclose association with prognosis and therapy as well as for epidemiology study. However, this examination can be done only in large cities that are not practical to send serum sample due to geographical burden and facilities. The aim of this study is to know whether HBV genotype can be determined from dried and stored serum on filter paper and compare the result with sera drawn directly from chronic hepatitis B (CHB) and hepatoma patients. Twenty-three serum samples were obtained from CHB patients. HBV DNA were quantitatively determined with Cobas Amplicor HBM (Roche Diagnostics GmBH, Germany) and dropped on to 3 x 1 cm filter papers. After allowed to dry in a plastic clip, it were put in a closed envelope then stored for 1 week in room condition (27 – 33 oC). DNA extraction were done from the filter papers after a short incubation period and HBV genotypes were determined with PCR and specific primers. For comparison, 20 CHB-Hbe(+) samples and 29 hepatoma samples were drawn directly and not dried. HBV genotype were detected in 18/23 (78.2%) from dried serum samples on filter paper while in sera that were not stored, from CHB-HBe(+) samples, 20/20 (100%) could be determined while from hepatoma patients, 24/29 (82.7%) samples. The proportion of genotype were in line with other reported HBV genotype examination for Indonesia. It is concluded that detection of HBV genotype can be done from dried serum in filter paper and stored for 1 week. (Med J Indones 2005; 14: 215-9)Keywords: Hepatitis B virus, genotype, filter paper
Risk of anti-hepatitis A virus in an urban population in Jakarta Akbar, Nurul; Basuki, Bastaman; Garabrant, David H.; Waspadji, Sarwono; Sjaifoellah Noer, H.M.
Medical Journal of Indonesia Vol 5, No 4 (1996): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (671.18 KB)

Abstract

[no abstract available]
Correlation between Branched Chain Amino Acids to Tyrosine Ratio and Child Pugh Score in Liver Cirrhosis Patients Hasan, Irsan; Gani, Rino A; Akbar, Nurul; Noer, Sjaifoellah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain amino acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay. Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio. Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 + 1.2; Child Pugh B 6.0 + 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin (r = 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test. Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio. Keywords: Branched chain amino acids, tyrosine, liver cirrhosis
Do Hepatic Encephalopathy Patients Really Need a Low Protein in Their Diet Sudomo, Untung; Lelosutan, Syafruddin AR; Ruswhandi, Ruswhandi; Akbar, Nurul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8 ISSUE 2 August 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Hepatic encephalopathy (HE) is an extra hepatic complication of liver cirrhosis. The clinical manifestation of HE is a reflection of a low-grade cerebral edema due to astrocyte swelling as a consequence of hyperammonia. HE mostly is induced by precipitating factors. Correcting these identifiable precipitating factors can alleviate this complication. In the past, liver cirrhosis patients were recommended to lower their protein intake. It was assumed that by limiting protein intake, the ammonia production would lower, which can lead to HE recovery. This approach, on the other hand, had worsened the nutritional status that already present in most patients with HE. There are some ways to overcome these problems without restricting protein intake including balance diet, using Branch Chain Amino Acids (BCAA), and frequent small portion diet.   Keywords: hepatic encephalopathy, astrocytes swelling, ammonia, liver cirrhosis, BCAA
Efficacy and Safety of In-Asia-manufactured Interferon alpha-2b in Combination with Ribavirin for Therapy of Naïve Chronic Hepatitis C Patients: A Multicenter, Prospective, Open-Label Trial Akbar, Nurul; Sulaiman, Ali; Gani, Rino Alvani; Hasan, Irsan; Lesmana, Laurentius; Sanityoso, Andri; Noer, Sjaifoellah; Pridady, FX; Soemarno, Soemarno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Background: An open-label, multi center and non-comparative study was conducted to evaluate the efficacy and safety of a more affordable in-Asia-manufactured interferon á-2b product in combination with ribavirin to treat naïve chronic hepatitis C patients. Method: Thirty chronic naïve hepatitis C patients were treated with in-Asia-manufactured interferon   a-2b subcutaneously 3 MIU thrice weekly and ribavirin 800-1,200 mg daily for 48 weeks. Follow-up was done until 24 weeks after the end of treatment. Efficacy was assessed by examining serologic and biochemical parameters at pre and post-treatment. Safety was assessed by evaluating clinical symptoms and laboratory parameters. Results: The virological response and sustained virological response rates of all Hepatitis C Virus (HCV) genotypes were 83.3% and 76.7% respectively. Post-treatment, 80% patients had significant alanine transaminase (ALT) decreased into normal level and remained normal in 76.7% patients at 24th week follow up period. At that time, the ALT level and sustained virological response were lower in HCV genotypes 1 and 4 than in non-1 and non-4 genotypes. The most frequent adverse event was flu-like syndrome. Conclusion: The efficacy and safety study on combination therapy of in-Asia-manufactured interferon a-2b and ribavirin has shown a good result based on the current standard of interferon alpha and ribavirin combination therapy. Keywords: interferons, combination drug therapy, chronic hepatitis C, treatment efficacy, safety
Correlation between the Degree of Esophageal Varices and Liver Stiffness in Liver Cirrhosis Patients Akbar, Femmy Nurul; Tedjasaputra, Tjahjadi Robert; Makmun, Dadang; Akbar, Nurul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Background: Bleeding due to rupture of esophageal varices is one of main cause of death in liver cirrhosis, that endoscopy screening is recommended. However endoscopy is invasive and frequently cannot be performed due to contraindication, high-cost or uncomfortable effect to the patients, particularly on patients have not had any bleeding before. Consequently, it is necessary to find other assessment which can predict the presence of esophageal varices. Recent studies found liver stiffness measurement by the liver transient-elastography is one of non invasive measurement to evaluate liver fibrosis.This study was designed to know the correlation between degree of the esophageal varices and the degree of liver stiffness. Method: This was cross sectional study. Liver cirrhosis patients were consecutively enrolled in this study. They underwent endoscopy to determine esophageal varices and subsequently the liver transient- elastography by Fibroscan technique to determine liver stiffness. Degree of the esophageal varices based on OMED criteria. Liver stiffness are expressed in kilopascal (kPa). Correlation analysis was done to assess this study. Result: There were 13 subjects. Most subjectswere male, age > 50 years and Child-Pugh A or B. The mean value of liver stiffness was 35.55 ± 23.60 kPa and mean OMED was 5.61 ± 2.14. The coefficient correlation between degree esophageal varices and degree liver stiffnes was 0.492, p = 0.087. Conclusion: There is moderate correlation but not statistically significant between the degree of liver stiffness and the degree of esophageal varices. Larger sample size is necessary to find the correlation between the degree of liver stiffness and esophageal varices.   Keywords: liver cirrhosis, degree of esophageal varices, liver stiffness
The Role of Specific Cellular Immune System in Chronic Hepatitis C Husna, Ihsanil; Akbar, Nurul; Gani, Rino Alvani; Budihusodo, Unggul; Sukmana, Nanang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 1, April 2004
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Hepatitis C virus is a RNA virus with very high speed replication. The clinical course of chronic hepatitis C is frequently asymptomatic like other hepatitis viruses. Infection of hepatitis virus will activate the immune system specifically as well as non-specifically. Mechanism of the immune system regulation is controlled by tissues consisting of antibodies cells and cytokines. In the process, all of the immune systems integrate and coordinate with the main agent-lymphocytes. Lymphocytes recognize antigens through the specific-surface antigen receptors. Following exposure to viral chronic hepatitis virus, viremia takes place within 1-2 weeks. In immuno-competent hosts, viremia will be preceded with the increase in transaminase enzyme and delayed seroconversion of antibodies will occur. Unlike other immunologic processes, these established antibodies are not protective in nature but serve only as the sign that someone has been infected by hepatitis C. In most cases of hepatitis C virus infection, this virus cannot be eradicated in the acute phase. Approximately 80-90% of acute infection progresses to be chronic infection and in 50% of the cases, there is an increase in transaminase enzyme that reveals that there is still liver cell damage. The degree of liver tissue damage in hepatitis depends on the number of virus infecting and the activity of cytotoxic T cells. Keywords: hepatitis C virus, humoral immune response,cellular immune response