Marshell Tendean
Universitas Kristen Krida Wacana

Published : 10 Documents
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Gejala Klinik dan Pemeriksaan Laboratorium pada Pasien Diare di RSUD Koja Agustus-Oktober 2009

Jurnal Kedokteran Meditek vol. 16 no. 42 September-Desember 2009
Publisher : Jurnal Kedokteran Meditek

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Abstract

Problematika Diagnosis Karsinoma Hepatoseluler

Jurnal Kedokteran Meditek Vol. 16 No. 42A Januari - April 2010
Publisher : Jurnal Kedokteran Meditek

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Tes Critical Flicker Frequency pada Sirosis Hati di RSUD Koja

Jurnal Kedokteran Meditek Vol. 16 No. 42A Januari - April 2010
Publisher : Jurnal Kedokteran Meditek

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Abstract

AbstrakLatar belakang. Ensefalopati  hepatikum minimal (EHM) adalah keadaan dimana secara klinis tidak terdapat tanda gangguan mental namun pada tes psikometrik sudah ditemukan kelainan . EHM sulitDidiagnosis karena tes psikometrik tida mudah di lakukan, hasilnya di pengaruhi usia dan tingkatPendidikan, serta memakan banyak waktu. Belakangan ini tes critical flicker frenquency  (CFF) telahDikembangkan untuk diagnosis EHM. Tujuan penelitian  ini adalah mengevaluasi hasil tes critical flickerFrequency pada pasien sirosis hati di RSUD koja.Metoda. Semua pasien sirosis hati yang datang ke RSUD koja selama juni –agustus  2009 di evaluasi  tesCFF dilakukan dengan mengunakan alat HEP Atonorm TM analyzer. Pasien sirosis dengan ferkuensi kritis<39 Hz di golongkan kedalam ensefalopati .Hasil. Didapatkan 38 penderita sirosis hati yang datang berkunjung. Tigapuluh empat subjek (89,5%)Tergolong ensefalopati berdasarkan tes CFF.Kesimpulan :dari pemeriksaan CFF, didapatkan 89,5%dari penderita sirosishati tergolong EHM Kata kunci:sirosis hati , ensefalopati hepatikum minimal (EHM), critical flicker frequency (CFF)

Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HDis different from type 2 DM in clinical signs and management.A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient wasdiagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubinand liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound resultshowed liver cirrhosis with ascites.The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administrationof oral antidiabetic agent which could affect the liver function.Keywords: hepatogenous diabetes, liver cirrhosis, diabetes mellitus, chronic hepatitis B infection

Tatalaksana terkini Dislipidemia

Jurnal Kedokteran Meditek Vol. 20 No. 54 September-Desember 2014
Publisher : Jurnal Kedokteran Meditek

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Abstract

AbstrakLipid adalah komponen utama yang berfungsi membentuk beberapa bagian tubuh yang berfungsi sebagai sumber energi. Lipid memiliki kaitan erat dengan penyakit jantung koroner (PJK) apabila kadarnya melebihi normal. Disiplidemia merupakan kelaninan metabolisme lipoprotein yang bermanifestasi dengan meningkatnya total kolesterol, low density lipoprotein (LDL) dan penurunan high density lipoprotein (HDL). Dislipidemia berkaitan erat dengan penyakit aterosklerosis yang bermanifestasi menjadi PJK. Peningkatan kadar trigliserida dapat menyebabkan nyeri perut berulang dan pankreasitsis akut. Obat-obat terkini yang lazim digunakan meliputi: Statin sebagai penghambat kompetitif HMG-CoA reduktase yang efektif dalam menurunkan kadar LDL kolesterol plasma. Asam niktonat vitamin B-Kompleks yang merupakan hipolipidemik paling efektif untuk meningkatkan HDL. Asipimoks suatu analog sintetik asam nikotinat yang menghambat lipolisis dalam lemak. Fibrat berguna untuk menurunkan kadar kolesterol serum dengan menurunkan very low density lipoprotein (VLDL) dan trigliserida (TG).Kata kunci : dislipidemia, tatalaksana, lipid

Liver Disorders in Type 2 Diabetes Mellitus

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Patients with type 2 diabetes mellitus (T2DM) are frequently diagnosed with some abnormal liver features. These liver abnormalities are suggested to be correlated with insulin resistance. The aim of thisstudy was to evaluate liver abnormalities and fasting insulin levels in patients with T2DM.Method: This study was conducted in Koja Hospital from February to July 2013. Study design was analytical study. Data for sex, age, complication, body mass index (BMI), liver function, liver enzyme, and fasting insulinlevel were collected. Univariate and bivariate statistical analyses were done using SPSS 20.Results: Twenty eight patients were included in this study, 71.43% of them were female. The age group of 40-60 years was the highest among the patients (64.28%). Highest complication was neuropathy, BMI of mostpatients were obese. Liver abnormalities were documented in 35.8% patients, liver enzyme increased in 21.4% patients. Non alcoholic fatty liver disease (NAFLD) were noted in 46.6% patients, and one patient was positive for hepatitis B. Mean fasting insulin in T2DM with NAFLD were higher than in T2DM without NAFLD. However, it was not statistically significant (40.08 ± 36.8 μU/mL vs. 54.3 ± 37.1 μU/mL; p = 0.27).Conclusion: Liver abnormalities found in T2DM patients were elevated liver enzyme, decreased albumin and increased of bilirubin. Through ultrasound, NAFLD and liver cirrhosis were found. Fasting insulin levelwas higher in T2DM with NAFLD but it was not statistically significant.Keywords: type 2 diabetes mellitus, non alcoholic steato-hepatitis, fasting insulin

Interstitial lung disease in mixed connective tissue disease

Indonesian Journal of Rheumatology Vol 9, No 1 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Interstitial lung diseases (ILD) are known as a debilitating pulmonary complications that may be occured in almost all systemic connective tissue diseases (CTD), including mixed connective tissue disease (MCTD). ILD is usually found in more than half of MCTD patients after 2-4years after the diagnosis made. A-47-years-old female initially diagnosed as systemic lupus erythematosus (SLE) developed a severe progressive dyspnea. She has recently diagnosed as MCTD with ILD after 9 months of initial symptoms. She was giving with Cyclophosphamide 500 mg IV pulse dose. However, after 1 months she developed severe pneumonia andpronounced demise due to intractable septic shock. The debilitating course of ILD is commonly seen in most systemic CTD. Therefore, it is important to perform initial screening and prevention. Systemic corticosteroid with or without immunosupressor agent(s) are indicated inILD-MCTD. Patients with progressive diseases will have poor prognosis.Keywords : ILD, MCTD, Corticosteroid

Interstitial lung disease in mixed connective tissue disease

Indonesian Journal of Rheumatology Vol 9 No 1 (2017)
Publisher : Indonesian Rheumatology Association

Show Abstract | Original Source | Check in Google Scholar | Full PDF (640.147 KB)

Abstract

Interstitial lung diseases (ILD) are known as a debilitating pulmonary complications that may be occured in almost all systemic connective tissue diseases (CTD), including mixed connective tissue disease (MCTD). ILD is usually found in more than half of MCTD patients after 2-4years after the diagnosis made. A-47-years-old female initially diagnosed as systemic lupus erythematosus (SLE) developed a severe progressive dyspnea. She has recently diagnosed as MCTD with ILD after 9 months of initial symptoms. She was giving with Cyclophosphamide 500 mg IV pulse dose. However, after 1 months she developed severe pneumonia andpronounced demise due to intractable septic shock. The debilitating course of ILD is commonly seen in most systemic CTD. Therefore, it is important to perform initial screening and prevention. Systemic corticosteroid with or without immunosupressor agent(s) are indicated inILD-MCTD. Patients with progressive diseases will have poor prognosis.Keywords : ILD, MCTD, Corticosteroid

Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar

Abstract

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HDis different from type 2 DM in clinical signs and management.A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient wasdiagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubinand liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound resultshowed liver cirrhosis with ascites.The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administrationof oral antidiabetic agent which could affect the liver function.Keywords: hepatogenous diabetes, liver cirrhosis, diabetes mellitus, chronic hepatitis B infection

Liver Disorders in Type 2 Diabetes Mellitus

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Patients with type 2 diabetes mellitus (T2DM) are frequently diagnosed with some abnormal liver features. These liver abnormalities are suggested to be correlated with insulin resistance. The aim of thisstudy was to evaluate liver abnormalities and fasting insulin levels in patients with T2DM.Method: This study was conducted in Koja Hospital from February to July 2013. Study design was analytical study. Data for sex, age, complication, body mass index (BMI), liver function, liver enzyme, and fasting insulinlevel were collected. Univariate and bivariate statistical analyses were done using SPSS 20.Results: Twenty eight patients were included in this study, 71.43% of them were female. The age group of 40-60 years was the highest among the patients (64.28%). Highest complication was neuropathy, BMI of mostpatients were obese. Liver abnormalities were documented in 35.8% patients, liver enzyme increased in 21.4% patients. Non alcoholic fatty liver disease (NAFLD) were noted in 46.6% patients, and one patient was positive for hepatitis B. Mean fasting insulin in T2DM with NAFLD were higher than in T2DM without NAFLD. However, it was not statistically significant (40.08 ± 36.8 μU/mL vs. 54.3 ± 37.1 μU/mL; p = 0.27).Conclusion: Liver abnormalities found in T2DM patients were elevated liver enzyme, decreased albumin and increased of bilirubin. Through ultrasound, NAFLD and liver cirrhosis were found. Fasting insulin levelwas higher in T2DM with NAFLD but it was not statistically significant.Keywords: type 2 diabetes mellitus, non alcoholic steato-hepatitis, fasting insulin