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"Latar Belakang : Bioelectric Impedance Analysis (BIA) mulai banyak digunakan dalam mengevaluasi status nutrisi. Belum ada data penelitian nutrisi di Indonesia yang menggunakan BIA. Tujuan : Penelitian ini dilakukan untuk mengetahui perbedaan rerata hasil pemeriksaan BIA antara status nutrisi baik dan malnutrisi pada penderita penyakit gastrointestinal dan liver yang dirawat inap. Metode : Penelitian potong lintang retrospektif terhadap penderita yang dirawat inap di ruang perawatan interna RSCM periode 1 Juni-31 Desember 2013, untuk mengetahui perbedaan rerata hasil pemeriksaan BIA penderita status nutrisi baik dan malnutrisi pada penyakit gastrointestinal dan liver yang dirawat inap. Hasil : Dari 28 penderita dengan status nutrisi baik, 71,57% laki-laki, dan 21,47% wanita. Dari 28 penderita malnutrisi, 53,60% laki-laki, dan 46,40% wanita. Perbedaan rerata hasil pemeriksaan BIA antara penderita nutrisi baik dan malnutrisi adalah : lean body mass, 49,5±8,59 vs 39,68±6,28kg, p<0,001; body cell mass, 32,19(20,49-40,95) vs 25,23(17,83-31,64) kg, p=0,003; total body water, 35,69±1,17 vs 28,58±0,85kg, p<0,001; dan phase angle 6,18◦(3,73-10,11)◦ vs 3,46◦(0,40-6,51)◦; , p<0,001. Kesimpulan : Pada penderita penyakit gastrointestinal dan liver yang dirawat inap dengan status nutrisi baik, memiliki nilai body mass, body cell mass,total body water dan phase angle hasil pemeriksaan BIA yang lebih tinggi dibandingkan dengan penderita malnutrisi.

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Background : Recently, Bioelectric Impedance Analysis (BIA) has been used to evaluate nutritional status. There has not been any nutrition study using BIA in Indonesia.

Objective : The objective of this study was to identify the differences of BIA examination between well nourished and malnourished gastrointestinal and liver diseases hospital inpatients.

Methods : A retrospective cross-sectional study of Cipto Mangunkusumo hospital inpatients during the period of 1 June to 31 December 2013 was conducted to identify differences of BIA examination means between well nourished and malnourished gastrointestinal and liver diseases inpatients.

Results : Of the 28 well nourished patients, 71.57% were male, 21.47% were female. Of the 28 malnourished patients 53.60% were male, 46.40% were female. The differences of BIA examination results in well nourished and malnourished were: lean body mass, 49.5±8.59 vs 39.68±6.28 kg, p<0.001; body cell mass, 32.19 (20.49-40.95) vs 25.23(17.83-31.64) kg, p=0.003; total body water, 35.69±1.17 vs 28.58±0.85 kg, p<0.001;and phase angle, 6.18◦(3.73-10.11)◦ vs 3.46◦(0.40-6.51), p<0,001.

Conclusion : BIA examinations revealed well nourished gastrointestinal and liver diseases inpatients had higher results of lean body mass, body cell mass, total body water and phase angle than malnutrition inpatients."

"Hati adalah organ terbesar dalam tubuh dan organ metabolisme yang sangat penting. Hepatocelullar Carcinoma (HCC) merupakan pertumbuhan abnormal dari hepatosit yang ditandai dengan peningkatan jumlah hepatosit yang mampu membelah dan menyertai perubahan sel hati yang menjadi ganas. Karsinoma hepatoselular berisiko terjadi retensi cairan karena rusaknya sel hepatosit yang mengakibatkan terganggunya aliran darah menuju ke hati sehingga menimbulkan distensi pembuluh darah dan terganggunya aliran tersebut juga mengakibatkan terganggunya produksi albumin untuk bisa mempertahankan tekanan onkotik. Asites, varises gastroesofagus yang tidak ditangani segera dapat menurunkan kualitas hidup bahkan kematian. Asites dan edema merupakan penyebab yang paling sering ditemukan pada pasien yang harus menjalani perawatan di rumah sakit. Penulisan karya ilmiah ini menggunakan metode studi kasus dengan menggunakan pemantauan cairan dan nutrisi dibuktikan bahwa pemantauan ini efektif untuk menangani kelebihan volume cairan dibuktikan dengan tidak bertambahnya komplikasi yang terjadi pada pasien.

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The liver is the largest organ in the body and a very important metabolic organ. Hepatocellullar Carcinoma (HCC) is an abnormal growth of hepatocytes which is characterized by an increase in the number of hepatocytes capable of dividing and accompanying changes in liver cells that become malignant. Hepatocellular carcinoma is at risk of fluid retention due to damage to hepatocyte cells which results in disruption of blood flow to the liver, causing distension of blood vessels and disruption of this flow also results in disruption of albumin production to maintain oncotic pressure. Ascites, gastroesophageal varices that are not treated immediately can reduce the quality of life and even death. Ascites and edema are the most common causes in hospitalized patients. The writing of this scientific paper using a case study method using fluid and nutrition monitoring proved that this monitoring is effective for treating excess fluid volume as evidenced by not increasing complications that occur in patients."

"Latar belakang: Cedera gastrointestinal akut kerap terjadi pada pasien dengan sakit kritis. Fungsi saluran menjadi salah satu pertimbangan dalam pemberian nutrisi pasien. Komplikasi pada saluran cerna dapat menghambat pemberian nutrisi enteral yang lebih direkomendasikan. Oleh karena itu, penelitian ini bertujuan untuk melihat hubungan derajat cedera gastrointestinal akut dengan capaian nutrisi enteral pada pasien anak sakit kritis. Metode: Penelitian ini memiliki desain studi potong lintang menggunakan data sekunder dari rekam medis pasien anak sakit kritis yang dirawat di PICU RSCM dari September 2019 sampai Agustus 2020. Cedera gastrointestinal akut dikelompokkan berdasarkan klasifikasi WGAP ESICM. Asupan nutrisi diambil dari data rekam medis pasien. Data dianalisis menggunakan Uji Saphiro-Wilk dilanjutkan Uji Kruskal-Wallis untuk mengetahui hubungan derajat cedera gastrointestinal akut dengan capian nutrisi enteral pasien. Data diolah menggunakan aplikasi IBM SPSS for windows versi 20.Hasil: Sampel penelitian berjumlah 26 pasien. Median presentase capaian nutrisi enteral hari ketiga (% laju metabolik basal) setiap derajat yaitu derajat satu 40,08 (0-144,39); dua 0,00 (0-219); tiga 19,10 (0,00-38,20); dan empat 0,00 (0,00-130,30) dengan hasil uji Kruskal-Wallis (p=0,904). Tidak terdapat hubungan bermakna antara lama capaian 25% nutrisi enteral dengan derajat cedera gastrointestinal akut (Kruskal-Wallis, p=0,556). Pada penelitian, faktor lain seperti status gizi (p=0,952), penggunaan ventilator mekanik (p=0,408), dan riwayat pascaoperasi (p=0,423) tidak mempengaruhi presentase nutrisi enteral hari ketiga. Kesimpulan: Pada pasien anak kritis, tidak terdapat hubungan yang bermakna antara derajat cedera gastrointestinal akut dengan capaian nutrisi enteral.

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Background: Acute gastrointestinal injury (AGI) is usually found in critically ill patients. Gastrointestinal function can determine the route od nutritional therapy. Gastrointestinal abnormalities may delay enteral nutrition therapy in patients. Therefore, this study aims to determine the association between the association between acute gastrointestinal injury and enteral nutrition outcome in critically ill children.

Methods: This study had a cross-sectional study design using the medical records of critically ill children in PICU RSCM from September 2019 until August 2020. AGI patients was classified based on WGAP ESIM grading system. Nutritional outcomes were assessed using data from medical record. Data were analyzed the Kruskal-Wallis test to determine the association between acute gastrointestinal injury and enteral nutrition outcomes. The Data were analysed using SPSS for windows version 20.

Results: The study sample was 26 patients. The medians of day three enteral nutrition percentage were grade one 40,08 (0-144,39); grade two 0,00 (0-219); grade three 19,10 (0,00-38,20); dan grade four 0,00 (0,00-130,30) with Kruskall-walis test result (p=0,904). There was no significant association between AGI and the duration of 25% basal metabolic rate (Kruskal-Wallis, p=0,556). In this study, Other factors such as nutritional status (p=0,952), ventilator usage (p=0,408), and post-operative history (p=0,423) did not associate with day three enteral nutrition percentage.

Conclusion: In critically ill children, there was no significant association between the acute gastrointestinal injury and the outcome of enteral nutrition."

"Latar belakang: Mortalitas pascaoperasi dan komplikasi respiratorik berat telah didokumentasikan pada pasien COVID-19 pada berbagai studi. Namun, belum terdapat penelitian yang secara khusus mengevaluasi luaran dari laparatomi gawat darurat dengan perforasi gastrointestinal selama pandemi COVID-19 tahun 2020.Metode: Studi dilakukan dengan desain observasional retrospektif sejak bulan Desember 2020-Februari 2021. Pasien perforasi gastrointestinal berusia lebih dari 15 tahun yang menjalani laparotomi gawat darurat diinklusi dalam penelitian. Luaran yang dievaluasi adalah mortalitas dan morbiditas, yang meliputi sindrom distres pernapasan akut (ARDS), reoperasi, durasi perawatan di rumah sakit, sepsis, admisi ke ruang perawatan intensif (ICU), dan infeksi daerah operasi (IDO).Hasil: Terdapat 117 pasien pascalaparotomi yang direkrut dalam penelitian ini, dengan 95 (81,2%) pasien tidak terinfeksi SARS-CoV-2. Median usia untuk kelompok non-COVID dan kelompok COVID secara berturut-turut sebesar 41 (14¬92) tahun dan 39 (15¬77) tahun. Mortalitas umum tercatat pada angka 23,9%. Pasien perforasi COVID-19 yang menjalani tindakan laparotomi memiliki risiko yang lebih tinggi untuk mengalami kematian, ARDS, dan sepsis, serta mendapatkan tindakan reoperasi dibandingkan pasien non-COVID, dengan risiko odds masing-masing sebesar 2,769 (95% IK; 1,032–7,434), 8,50 (95% IK; 2,939–24,583), 3,36 (95% IK; 1,292–8,735), dan 3,69 (95% IK; 1,049–13,030). Tidak terdapat perbedaan antara pasien perforasi gastrointestinal yang terkonfirmasi COVID-19 dan pasien non-COVID dalam hal risiko IDO, lama durasi perawatan, dan admisi ke ICU. Usia, sepsis, dan ARDS merupakan faktor prognostik bermakna untuk mortalitas COVID-19.Simpulan: Pasien perforasi gastrointestinal pascalaparotomi yang terkonfirmasi COVID-19 memiliki risiko mortalitas, ARDS, sepsis, dan menjalani tindakan reoperasi yang lebih tinggi dibandingkan pasien non-COVID.

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Background: Postoperative mortality and severe respiratory complications have been documented in COVID-19 patients in various studies. However, no studies specifically evaluate the outcome of emergency laparotomy with gastrointestinal perforation during the 2020 COVID-19 pandemic.Methods: The study was conducted with a retrospective observational design from December 2020-February 2021. Patients with gastrointestinal perforations aged more than 15 years who underwent emergency laparotomy were included in the study. The outcomes evaluated were mortality and morbidity, which included acute respiratory distress syndrome (ARDS), reoperation, duration of hospital stay, sepsis, admission to the intensive care room (ICU), and surgical site infections (SSI).Results: There were 117 post-laparotomy patients recruited, with 95 (81.2%) COVID-19 negative patients. The median ages for the non-COVID group and the COVID group were 41 (14¬92) years and 39 (15¬77) years. General mortality was recorded at 23.9%. Patients with perforated COVID-19 who underwent laparotomy had a higher risk of dying, ARDS, and sepsis, as well as receiving re-surgery than non-COVID-19 patients, with an odds risk of 2.769 each (95% CI; 1,032–7,434), 8,50 (95% CI; 2,939–24,583), 3.36 (95% CI; 1,292–8,735), and 3.69 (95% CI; 1,049¬ – 13,030). There was no difference between gastrointestinal perforated patients with confirmed COVID-19 and non-COVID-19 patients in terms of risk of SSI, length of stay, and admission to the ICU. Age, sepsis, and ARDS are significant prognostic factors for COVID-19 mortality.Conclusion: Post-laparotomy confirmed gastrointestinal perforation patients with COVID-19 have a higher risk of mortality, ARDS, sepsis, and undergoing reoperation than non-COVID-19 patients."

"Obesitas merupakan masalah utama pada kesehatan masyarakat dunia yang diketahui juga sebagai salah satu faktor risiko penyakit perlemakan hati non alkoholik(NAFLD). Sistem penilaian untuk mendeteksi NAFLD telah dikembangkan dan divalidasi di Indonesia. Namun, pola makan orang obesitas yang mungkin memberikan pengaruh terhadap NAFLD masih belum diketahui. Penelitian ini mengevaluasi asupan sukrosa pada obesitas dewasa di Jakarta dan hubungannya dengan skor NAFLD. Ini adalah studi potong lintang berbasis komunitas di antara orang dewasa dengan indeks massa tubuh (BMI)>25 kg/m2 antara September dan Oktober 2018 di Jakarta, Indonesia. Asupan sukrosa dinilai menggunakan food recal l2x24 jam, dihitung berdasarkan tabel komposisi makanan Indonesia dan Amerika dengan menggunakan Nutrisurvey 2007.Skor NAFLD terdiri dari enam faktor risiko, yaitu BMI>25 kg/m2, jenis kelamin laki-laki, usia>35 tahun, trigliserida>150 mg/dL, kadar kolesterol lipoprotein kepadatan tinggi<40 mg/dL untuk pria atau <50 mg/dL untuk wanita, dan kadar alanin aminotrans feraseserum >35 U/L. Dari 102 subjek yang terdaftar, 75 orang(73,5%) adalah wanita. Median dari total skor NAFLD adalah 6,7 dengan rentang dari 3,6 hingga 10,2. Median asupan karbohidrat total adalah 179,6 (54,1-476,8) g/hari, dan median total asupan sukrosa adalah 47,0 (13,7-220,5) g/hari. Asupan sukrosa lebih tinggi signifikan pada responden dengan skor NAFLD >6,7 dibandingkan <6,7. (47,8 vs. 45,3 g; p=0,042; Mann-Whitney U test). Analisis multivariat mengonfirmasi adanya hubungan asupan sukrosa dan skor tinggi perlemakan hati non alkoholik.Kesimpulan: Asupan sukrosa tidak memiliki hubungan bermakna dengan skor NAFLD pada penyandang obesitas dewasa, namun bermakna jika dikaitkan dengan skor tinggi perlemakan hati non alkoholik. Dibutuhkan penelitian lebih lanjut untuk pengembangan variabel tambahan pada skor NAFLD.

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Obesity is a major problem in a world public health which is also known as one of the risk factors of non-alcoholic fatty liver disease (NAFLD). An assessment system for detecting NAFLD has been developed and validated in Indonesia. However, the diet pattern of obese people who might have an effect on NALFD is still unknown. This study evaluated sucrose intake among obese adults in Jakarta and ints association with NAFLD score. This was a community-based cross sectional study among adults with body mass index (BMI) >25 kg/m2 between September and Oktober 2018 in Jakarta, Indonesia. Sucrose intake was assessed using 2x24-hour food recall, calculated based on the Indonesian and American food composition tables using dietary software Nutrisurvey. The NAFLD score consists of six risk factors, i.e. BMI >25 kg/m2, male sex, age >35 years, triglycerides >150 mg/dL, high density lipoprotein cholesterol levels <40 mg/dL for men or <50 mg/dL for women, and serum alanine aminotransferase levels >35 U/L. A total of 102 subjects were recruited; 75 (73.5%) of them were women. The median of total NAFLD scores was 6.7, ranging from 3.6 to 10.2. Median total carbohydrate intake was 179.6 (54.1-476.8) g/day, while the median total sucrose intake was 47.0 (13.7-220.5) g/day. Sucrose intake was significantly higher in patients with NAFLD score >6.7 than <6.7 (47.8 vs. 45.3 g; p=0.042; Mann-Whitney U test). Multivariate analysis confirmed the association of sucrose intake and higher total NAFLD score.

Conclusions: Sucrose intake and NAFLD score have no significant association among obese adults. Further research is needed to develop additional variables on NAFLD score.

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"Multiple Liver AbscessLiver abscess is a public health problem in few countries in Asia, Africa, and South America. As time goes, there were only few cases of amebic liver abscess found in developed countries, on the contrary more pyogenic liver abscess are found in those countries. Liver abscess could be caused by bacteria, parasite, or fungus J. The common symptoms among the liver' abscess are fever; chill, fatigue, loss of appetite, weight loss, right upper' abdominal pain,? in a few cases have symptoms like coughing, hiccup, pain in low right chest, or' pain on the shoulder: We reported a male patient 38 years batak ethnic was admitted with major symptoms such as high lever follow by chill, right upper abdominal pain, nausea, vomiting, appetite loss, fatigue and sometimes coughing. Based on clinical, laboratory data, and abdominal USG found this patient suspected suffered from pyogenic liver abscess. Treatment of this pattern consist of antibiotic (cefotaxime 29x1 IV metronidazol 3x500mg orally and aspiration of the liver' abscess). Aspiration was done 2 times with the interval l week, extracted 260cc totally yellow greenish watery fluid with no smell. On the follow up abdominal USG was repeated on January 8, 2003 found enlarge of the liver; 3 small abscesses on the right lobe liver and so recovery process and then patient left the hospital in good condition after 3 weeks hospitalized."