Guntur Darmawan
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Published : 12 Documents
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Acupuncture in the Management of Functional Dyspepsia Yoveline, Anastasia; Abdullah, Murdani; Darmawan, Guntur; Mihardja, Hasan; Sungkar, Saleha
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Dyspepsia is an uncomfortable sensation or pain in the upper abdomen which is persisting or recurring. Dyspepsia can be classified into functional and organic dyspepsia. Functional dyspepsia is more commonly found compared to the organic type, approximately 60%. Pharmacologic therapy in the management of functional dyspepsia has not shown optimal results, with the multifactorial etiology of functional dyspepsia as the main challenge. Therefore, the management of functional dyspepsia is widened and involves variety treatment modalities, acupuncture being one of them. Acupuncture is a way of treatment by puncturing needles to particular area on the skin to eliminate pain and treat particular diseases. Acupuncture affects stomach motility and gastric acid secretion in functional dyspepsia patients. Two acupuncture points commonly used in functional dyspepsia are ST 36 and PC 6. Acupuncture can restore gastric motility in patients with functional dyspepsia, who have gastric emptying disturbance. Besides, functional dyspepsia complaints, such as epigastric pain, nausea, vomiting, anorexia, burning sensation, and bloating were found to improve after acupuncture therapy. Side effects of acupuncture are not life threatening with low incidence rate. The effectiveness of acupuncture therapy compared to standard medication shows varies results. Further studies are needed to determine the characteristics of functional dyspepsia patients which could have optimal results through acupuncture therapy. Keywords: epigastric pain, gastric motility, ST 36, PC 6
Pancreatic Cancer: Review of Etiology, Clinical Features, Diagnostic Procedures, Treatment and Mesothelin Role Darmawan, Guntur; Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Pancreatic cancer is one with high mortality cancer in the world. Ninety percent of pancreatic cancer is pancreatic adenocarcinoma. Various factors is associated with an increased risk of pancreatic cancer including age, sex, race, genetic, history of chronic pancreatitis, diabetes mellitus, gallstone, obesity, Helicobacter pylori infection, smoking, diet, and polution exposure. A lot of cases were diagnosed in late stadium due to non-specific early clinical symptoms, and also, until now, there is no examination tool that may screen pancreatic cancer in the earliest stage. Total surgery resection is the therapy of choice in the early stadium of pancreatic cancer, and other therapy modalities are chemotherapy, radiotherapy. Combination of these modalities is frequently used in order to increase the effectiveness of therapy. Mesothelin, a surface glycoprotein on normal mesothelial cells, is overexpressed in pancreatic cancer; therefore, although it is not a cancer specific antigen, it can be used in diagnostic and treatment of pancreatic cancer. Several studies about mesothelin application in pancreatic cancer have been performed; however, more studies are needed to improve the application of mesothelin on pancreatic cancer. Keywords: pancreatic cancer, risk factor, therapy, mesothelin
Primary Biliary Cirrhosis Nugraha, Irvan; Darmawan, Guntur; Pranggono, Emmy Hermiyanti; Wahyudi, Yudi; Agustanti, Nenny; Girawan, Dolvy; Bestari, Begawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.295 KB) | DOI: 10.24871/1932018195-200

Abstract

Primary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome).
Left-Sided Portal Hypertension: A Case Series Darmawan, Guntur; Andini, Dinda; Agustanti, Nenny
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (269.546 KB) | DOI: 10.24871/1922018118-120

Abstract

Left-sided portal hypertension is rarely found, but this condition may cause gastrointestinal tract bleeding and can be life-threatening. The exact incidence of left-sided portal hypertension is unknown as it is rarely found, approximately 1-5%, and most cases were misdiagnosed. We reported 3 cases of left-sided portal hypertension in male patient aged 34 years old, female patient aged 29 years old, and female patient aged 35 years old. Most diagnosis was made based on the clinical findings by excluding the diagnosis of cirrhotic portal hypertension. Splenic vein angiography remains the gold standard in diagnosing left sided portal hypertension. Left-sided portal hypertension is difficult to differentiate from cirrhotic portal hypertension because in these both abnormalities, varices can be present. Left-sided portal hypertension can be considered as a diagnosis in patient with upper gastrointestinal tract bleeding due to oesophageal varices, gastric varices, or portal hypertension gastropathy, accompanied with hypersplenism without the presence of hepatic abnormality or cirrhosis.
Pancreatic Cancer: Review of Etiology, Clinical Features, Diagnostic Procedures, Treatment and Mesothelin Role Darmawan, Guntur; Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/121201144-49

Abstract

Pancreatic cancer is one with high mortality cancer in the world. Ninety percent of pancreatic cancer is pancreatic adenocarcinoma. Various factors is associated with an increased risk of pancreatic cancer including age, sex, race, genetic, history of chronic pancreatitis, diabetes mellitus, gallstone, obesity, Helicobacter pylori infection, smoking, diet, and polution exposure. A lot of cases were diagnosed in late stadium due to non-specific early clinical symptoms, and also, until now, there is no examination tool that may screen pancreatic cancer in the earliest stage. Total surgery resection is the therapy of choice in the early stadium of pancreatic cancer, and other therapy modalities are chemotherapy, radiotherapy. Combination of these modalities is frequently used in order to increase the effectiveness of therapy. Mesothelin, a surface glycoprotein on normal mesothelial cells, is overexpressed in pancreatic cancer; therefore, although it is not a cancer specific antigen, it can be used in diagnostic and treatment of pancreatic cancer. Several studies about mesothelin application in pancreatic cancer have been performed; however, more studies are needed to improve the application of mesothelin on pancreatic cancer. Keywords: pancreatic cancer, risk factor, therapy, mesothelin
Association between Helicobacter Pylori Infection and Graves’ Disease: A Meta-Analysis Darmawan, Guntur; Simadibrata, Marcellus; Widyahening, Indah Suci
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, August 2017
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/182201767-72

Abstract

Background & Aims: Helicobacter pylori (H. pylori) infection is proposed to be related with autoimmune diseases, such as Graves’ Disease (GD). This study aimed to assess the association between H. pylori infection and GD. Methods: A systematic literature review was conducted using Pubmed and Cochrane library. The quality of enrolled studies was assessed by the Critical Appraisal Skills Program Oxford. A fixed-effect model approach was used if there was no heterogeneity; otherwise, a random-effect model was used. Heterogeneity was assessed using I2. Publication bias was assessed by funnel plot. All data were analyzed using REVIEW MANAGER 5.3. Results: Six studies from Europe and Asia involving 983 patients were included. Overall H. pylori infection was significantly associated with GD (OR 2.7; 95% CI: 1.47-4.99; p < 0.001). In subgroup analysis of 3 studies using non-serological diagnostic method, the prevalence rate of H. pylori infection was higher in GD group (78.26% VS 42.42%) with significant relationship (OR 4.93; 95% CI: 3.16-7.69; p < 0.00001; I2 = 0%). The CagA antibody prevalence was significantly higher in GD group (46.57% VS 20.29%; OR 4.41; 95% CI: 2.65-7.33; p < 0.00001; I2 = 56%). No publication bias was observed. Conclusion: Our study showed association between H. pylori infection and GD. It might suggest the need of H. pylori examination in GD patients and the impact of H. pylori eradication in the treatment of GD.
Left-Sided Portal Hypertension: A Case Series Darmawan, Guntur; Andini, Dinda; Agustanti, Nenny
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1922018118-120

Abstract

Left-sided portal hypertension is rarely found, but this condition may cause gastrointestinal tract bleeding and can be life-threatening. The exact incidence of left-sided portal hypertension is unknown as it is rarely found, approximately 1-5%, and most cases were misdiagnosed. We reported 3 cases of left-sided portal hypertension in male patient aged 34 years old, female patient aged 29 years old, and female patient aged 35 years old. Most diagnosis was made based on the clinical findings by excluding the diagnosis of cirrhotic portal hypertension. Splenic vein angiography remains the gold standard in diagnosing left sided portal hypertension. Left-sided portal hypertension is difficult to differentiate from cirrhotic portal hypertension because in these both abnormalities, varices can be present. Left-sided portal hypertension can be considered as a diagnosis in patient with upper gastrointestinal tract bleeding due to oesophageal varices, gastric varices, or portal hypertension gastropathy, accompanied with hypersplenism without the presence of hepatic abnormality or cirrhosis.
Risk Factors Associated with in Hospital Complication Post Gastrointestinal, Pancreatic, Hepatic Cancer Surgery: A Retrospective Case Control Study (RAPHA Study) Subong, Nestor U; Darmawan, Guntur; Salvador, David Raymund K; Bernardo, Margrette Ruth L
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1932018141-147

Abstract

Background:This study aims todevelop a scoring system that will predict in-hospital morbidity post gastrointestinal (GI), pancreatic, hepatic cancer surgery in adult patients. This study took place in De La Salle University Medical Center.Method: Two hundred eighty five (285) adult patients 18 years old and above who underwent gastrointestinal, pancreatic and hepatic cancer surgery from 2010 to July 31, 2014 were included. Variables were evaluated in the univariate and multivariate analysis. Calculation of specific score from the resulting factors was performed by logistic regression analysis to develop the scoring system and to determine the best cut-off score in predicting in-hospital morbidity.Results: Out of 142 patients with post-operative complications, factors significantly associated with morbidity were as follows: age ≥ 75 years (p = 0.002), low serum albumin (p = 0.00), abnormal electrocardiogram (ECG) findings (p = 0.036) and emergency surgery (p = 0.000). Calculated best cut-off score was 1.4.Conclusion: The RAPHA scoring system may serve as a promising aid in predicting morbidity and mortality among patients who will undergo GI cancer surgery.
Primary Biliary Cirrhosis Nugraha, Irvan; Darmawan, Guntur; Pranggono, Emmy Hermiyanti; Wahyudi, Yudi; Agustanti, Nenny; Girawan, Dolvy; Bestari, Begawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1932018195-200

Abstract

Primary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome).
Gut Microbiota in Human Immunodeficiency Virus Infection Wisaksana, Rudi; Darmawan, Guntur; Agustanti, Nenny; Girawan, Dolvy
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, APRIL 2019
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/201201938-43

Abstract

Human microbiota, majority presents in human gastrointestinal tract, plays crucial role in body physiological functions, such as immune system. Human immunodeficiency virus (HIV) infection impairs gut barrier and alter the microbiota ecosystem, called dysbiosis. Several studies showed different composition of gut microbiota between healthy individual and HIV patient. Moreover, different phase of HIV infections had their own characteristic of gut microbiota. Antiretroviral treatment might improve the CD4 level, however, it inconsistently restore the gut ecosystem. Some studies in prebiotic and probiotic revealed the potential beneficial effect in gut microbiota. Probiotic might inhibit mucosal invasion, improve intestinal mechanical barrier integrity, reduce microbial translocation, restore mucosal immune function, counteract local inflammation and lower systemic inflammation.