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"Background: pathophysiology of functional dyspepsia remains poorly understood. Many factors such as gastric motility disorder, visceral hypersensitivity, Helicobacter pylori (Hp) infection, psychological stress and excessive gastric acid secretion play roles in this symptom. Psychological stress may promote peptic ulcer and has an effect on ulcers-associated Hp. This study aimed to determine Helicobacter pylori activity and expression of mucosal IL 6 and their association with psychological stress. Methods: a cross-sectional study was done among 40 outpatients with dyspeptic syndromes in M. Djamil General Hospital and two community health centers in Padang. The subjects were divided into two groups, with and without psychological stress, which were identified using DASS 42. Gastric biopsy specimens and peripheral blood samples were taken while performing esophagogastroduodenoscopy. Immunohistochemistry methods was used to determine the expression of IL 6 and Hp in gastric mucosa. The correlation of each variable in the group experiencing psychological stress and non stress was analyzed using Chi square test. Results: there were 40 patients with functional dyspepsia with average age of 37.58(SD 11.82) years old. The cortisol levels were significantly different between both groups (non stress vs. stress groups); moreover, morning cortisol level in psychological stress group was higher beyond normal limit. Interleukin 6 expression, as the evidence of inflammatory activity, seemed higher in non stress group than the group with psychological stress (8.25% vs. 7.25%). Helicobacter pylori activity was seemed to be increased in the stress group as characterized by higher numbers of invasion to the sub mucosa epithelium compared to the non stress group (11 vs. 7 subjects). Conclusion: psychological stress seems to have no correlation with IL-6 in gastric mucous of patients with functional dyspepsia; however, there is an evidence of increasing activity of Helicobacter pylori."

"Remaja merupakan populasi yang berisiko mengalami berbagai permasalahan kesehatan, salah satunya gejala dispepsia fungsional. Stres menjadi salah satu penyebab munculnya permasalahan kesehatan pada remaja seiring perubahan dalam perkembangannya. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara stres dan gejala dispepsia fungsional pada remaja SMA. Desain penelitian ini yaitu cross-sectional dengan 360 responden dipilih melalui metode purposive sampling dan stratified-cluster sampling dari SMA di Kota Bekasi. Instrumen penelitian ini yaitu the shortened version of the adolescent stress questionnaire dengan hasil r = 0.378-0.658 untuk uji validitasnya dan nilai cronbachs alpha sebesar 0.916 untuk reliabilitasnya, serta dyspepsia symptom severity index dengan hasil r = 0.368-0.750 untuk uji validitasnya dan nilai cronbachs alpha sebesar 0.931 untuk reliabilitasnya. Hasil penelitian menggunakan uji korelasi Spearman menunjukkan terdapat hubungan yang signifikan antara stres dan gejala dispepsia fungsional pada remaja (p=0.0001), dengan hubungan yang positif (searah) dan kuat (r = 0.588). Berdasarkan hasil tersebut, dapat disimpulkan bahwa semakin tinggi stres maka semakin tinggi gejala dispepsia fungsional pada remaja SMA. Pelaksanaan pendidikan keterampilan hidup sehat dan pelayanan kesehatan mental berbasis sekolah diperlukan sebagai upaya untuk mengurangi stres pada remaja. Selain itu, diperlukan upaya kesehatan sekolah terkait nutrisi pada remaja.

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The population of adolescent is at risk of experiencing various health problems, one of the problems is the functional dyspepsia symptom. One of the causes of this health problem is stress, which changes in their development. The research aims to identify the relationship between stress and functional dyspepsia symptoms in high school adolescents. The research design used is cross-sectional with 360 respondents selected through purposive sampling method and stratified-cluster sampling taken from A High School in Bekasi City. The research instruments used were the shortened version of the adolescent stress questionnaire with validity test values of 0.378-0.658 and Cronbachs alpha values of 0.916 for reliability, with dyspepsia severity index symptoms with validity test values of 0.368-0.750 and Cronbachs alpha value is 0.931 for reliability. The results of the study were analyzed using the Spearman correlation test showed that there was a significant relationship between stress and functional dyspepsia symptoms in adolescents (p value = 0.0001), with a positive (direct) and strong relationship (r = 0.588). Based on the results of the study, it can be concluded that the higher the stress, the higher the symptoms of functional dyspepsia in high school adolescents. The implementation of healthy life skills education and school-based mental health services are needed as an effort to reduce stress in adolescents. In addition, a school health program related to nutrition is needed in adolescents."

"Dyspepsia is one of numerous general complaints, which is commonly encountered by doctors of various disciplines. In daily practice, the complaint is not only limited for gastroenterologists. Knowledge on pathophysiology of dyspepsia have been developing continuously since a scientific investigation has been started in 1980s, which considers Helicobacter pylori as one of key factor in managing dyspepsia, either it is associated with ulcer or non-ulcer. The management of dyspepsia cannot be separated from the management of H. pylori and there is an additional new knowledge associated with definition, pathophysiology, diagnosis and treatment of both dyspepsia and H. pylori infection.

This consensus document on the management of dyspepsia and H. pylori infection in Indonesia has been developed using the evidence-based medicine principles; therefore, it can be used as a reference for doctors in dealing with dyspepsia and H. pylori infection cases in their daily practice. It is expected that with the new consensus, doctors can provide greater service to their patients who have dyspepsia and H. pylori infection."

"Latar belakang: Dispepsia merupakan gangguan kesehatan yang sering ditemuierologi dan urin (RAPIRUN) dibandingkan dengan UBT sebagai baku emas dalam mengetahui infeksi H. pylori. Penelitian dilakukan pada pasien rawat jalan Puskesmas Kecamatan Koja Kotamadya Jakarta Utara. Yang dinilai adalah sensitivitas, spesivisitas, positive predictive value (PPV), negative predictive value (NPV) tes tersebut. Tujuan: Mengetahui akurasi diagnostik pemeriksaan non-invasif (serologi dan urin) dibandingkan dengan UBT (urea breath test) sebagai baku emas untuk mendeteksi infeksi H. pylori pada pasien dengan sindroma dispepsia. Metode: Penelitian yang digunakan adalah studi potong lintang untuk mengetahui akurasi pemeriksaan non-invasif yaitu s H. pylori menunjukkan hasil positif pada 36,5% subyek, sedangkan pada pemeriksaan serologi (Mataram, Biomedika) didapatkan hasil positif sebanyak 32,4%. Pemeriksaan RAPIRUN (Rapid Urine Test, Otsuka) menunjukkan hasil positif pada 24,3% subyek. Pada serologi didapatkan sensitivitas 74%, spesifitas 91%, PPV 83%, NPV 86%. Sedangkan pada RAPIRUN didapatkan sensitivitas 63%, spesifitas 98%, PPV 94%, NPV 82%. Hasil: Selama kurun waktu April 2015 sampai Juni 2015, 74 subyek, dengan mayoritas perempuan (82,4%), dengan rerata umur 45,05 tahun menjalani pemeriksaan non-invasif. Pemeriksaan UBT sebagai baku emas diagnosis infeksi di pelayanan kesehatan. Infeksi Helicobacter pylori adalah salah satu penyebab dispepsia. Diagnosis infeksi H.pylori dapat dilakukan melalui pemeriksaan invasif dan non invasif. Pemeriksaan non invasif lebih mampu laksana, murah dan memiliki risiko yang lebih sedikit. Simpulan: RAPIRUN lebih unggul dalam hal spesifisitas dibanding serologi.

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Background: Dyspepsia is the common problem in the population. The main etiology of dyspepsia is Helicobacter pylori infection. The diagnosis of H. pylori infection is based on invasive examination and non-invasive examination. The non-invasive examination could be easier to do and have less risk than invasive examination.

Objective: To evaluate the diagnostic accuracy of the non-invasive test (serology and RAPIRUN) compared to UBT as gold standard examination to detect H. pylori infection in patients with dyspepsia syndrome.

Methods: A cross-sectional study for diagnostic H. pylori by using serology and Rapid Urine test (RAPIRUN) is conducted to evaluate the diagnostic accuracy of non-invasive test compared to UBT as gold standard examination in patients with dyspepsia syndrome. This study was conducted at outpatient Community Health Center in Koja District North Jakarta from middle April 2015 until Middle June 2015. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were used to evaluate the diagnostic accuracy.

Results: From mid-April 2015 to Mid-June 2015, 74 subjects, with the majority of patients was female (82.4%), and the mean of age was 45.05 years old, had undergone non-invasive test The UBT test as the gold standard examination for H. pylori infection showed positive result in 36.5% patients while the serology test resulting positive in 32.4%. The RAPIRUN test resulting positive in 32.4% patients. The sensitivity of serology test was 74%, specificity 91%, PPV 83%, NPV 86%, meanwhile the RAPIRUN test was resulting as sensitivity 63%, specificity 98%, PPV 94%, NPV 82%.

Conclusion: RAPIRUN has a high diagnostic value for H. pylori in specificity than serology."

"Latar Belakang: Diagnosis definitif Helicobacter pylori (H.pylori) hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung (34 antrum, 34 korpus), masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU (konsentrasi merah fenol, pH, urea dan suhu inkubasi). Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg/500 mL dan darah domba 7% belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001%; urea 4%; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29% (12/34), biakan 32,35%(11/34), PCR 32,35%(11/34) dan histopatologi 20,59% (7/34). Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7% bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first-line diagnostic test. Aim: to obtain optimal composition for culture medium and Motility-Indol-Urease (MIU) test for the detection of H. pylori in dyspeptic patient biopsy specimens. Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples (34 antrum, 34 corpus) were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test (phenol red and urea concentration, pH, and temperature). The optimal condition obtained was then applied to the specimens. Result: Columbia agar supplemented with vancomycin 5 mg / 500 mL and 7% sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition: phenol red 0,001%; urea 4%; pH 7; incubation temperature 35-37oC. Positive proportion of MIU was 35.29% (12/34), culture 32.35% (11/34), PCR 32,35% (11/34) and histopathology 20.59% (7/34). Conclusion: MIU test was able to improve the positivity rate by 14,7% compared to histopathology. "

"Latar Belakang: Prevalensi infeksi Helicobacter pylori yang masih tinggi di beberapa negara. Penelitian di Guang Zhou terjadi penurunan seroprevalensi infeksi Helicobacter pylori antara tahun 1993 2003 dari 62 5 menjadi 47. Studi prevalensi di salah satu RS swasta Jakarta menunjukkan penurunan prevalensi infeksi Helicobacter pylori dari 12 5 di tahun 1998 menjadi 2 9 di tahun 2005 Perlunya diketahui seroprevalensi dikomunitas saat ini apakah sesuai dengan penurunan yang terjadi pada penelitian berbasis rumah sakit dan faktor faktor yang mempengaruhi infeksi Helicobacter pylori di masyarakat. Tujuan: Mengetahui seroprevalensi dan faktor faktor sosiodemografis yang berhubungan dengan infeksi Helicobacter pylori. Metode: Studi potong lintang terhadap 111 pasien dispepsia yang berobat di Puskesmas Kelurahan Kalibaru Jakarta Utara Januari-Februari 2015. Dilakukan analisa bivariat untuk mengetahui hubungan faktor faktor dengan infeksi Helicobacter pylori menggunakan uji chi square dan uji T tidak berpasangan serta alternatifnya. Analisa multivariat menggunakan uji regresi logistik. Hasil dan Pembahasan: Pada 111 pasien dewasa dengan keluhan dispepsia yang berobat ke Puskesmas Kelurahan Kalibaru didapatkan seroprevalensi Helicobacter pylori sebesar 22 5 95 IK 14 8 30 2. Usia tidak berhubungan dengan infeksi Helicobacter pylori p 0 270. Semakin tinggi tingkat sosial ekonomi semakin rendah rasio odds infeksi Helicobacter pylori OR 0 2 95 IK 0 02-1 71. Semakin tinggi indeks kepadatan penduduk semakin tinggi rasio odds infeksi Helicobacter pylori OR 1 2 95 IK 0 37-4 49. Semakin rendah clean water index semakin tinggi rasio odds infeksi Helicobacter pylori OR 1 5 95 IK 0 57-4 04. Semakin rendah status sanitasi semakin tinggi rasio odds infeksi Helicobacter pylori OR 2 5 95 IK 1 01-6 19. Kesimpulan: Seroprevalensi Helicobacter pylori pada pasien dispepsia kelurahan Kalibaru sebesr 22 5 95 IK 14 8 30 2. Didapatkan hubungan antara sanitasi lingkungan dengan Helicobacter pylori.

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Background: The prevalence of Helicobacter pylori infection in some countries remains high. Study in Guang Zhou showed a decrease in seroprevalence of Helicobacter pylori from 62 5 in 1993 to 47 in 2003. Prevalence studies in one of the private hospitals in Jakarta showed a decrease in the prevalence of Helicobacter pylori infection from 12 5 in 1998 to 2 9 in 2005. It is important to know the seroprevalence in community nowadays and its related factors in society.

Objective: To identify seroprevalence of Helicobacter pylori infection and its socio demogrphic related factors.

Method: A cross sectional study in 111 patients with dyspepsia who got treatment in Kalibaru Primary Health Care in North Jakarta from January to February 2015. A bivariate analysis was done to know relationship between Helicobacter pylori infection and its related factors using chi square unpaired t test and their alternatives. Multivariate analysis was done using logistic regression test.

Result: Seroprevalence of Helicobacter pylori of 111 dyspepsia patients who get treatment in Kalibaru Primary Helath Care in this study was 22 5 95 CI 14 8 30 2. There is no relationship between age and Helicobacter pylori infection p 0 270 Higher socio economic class was related to lower risk Helicobacter pylori infection OR 0 2 95 IK 0 02-1 71. Higher crowding index was related to higher risk Helicobacter pylori infection OR 1 2 95 IK 0 37-4 49. Lower clean water index was related to higher risk Helicobacter pylori infection OR 1 5 95 IK 0 57-4 04. Lower sanitation status was related to higher risk Helicobacter pylori infection OR 2 5 95 IK 1 01-6 19.

Conclusion: Seroprevalence of Helicobacter pylori infection in patient with dyspepsia in Kalibaru village was 22 5 95 CI 14 8 30 2. There is a relation between sanitation and Helicobacter pylori infection. "

"Dispepsia merupakan sindrom penyakit pada regio gastroduodenal yang berpengaruh besar terhadap kualitas hidup penderitanya baik secara fisik maupun mental. Berbagai terapi farmakologis telah dikembangkan, namun efektivitasnya masih belum maksimal. Akupunktur merupakan salah satu modalitas terapi yang telah terbukti efektif dalam mengatasi gejala-gejala dispepsia. Elektroakupunktur (EA) pada titik ST 36 Zusanli merupakan metode perangsangan dan titik akupunktur yang paling sering digunakan dalam penelitian untuk mengatasi masalah lambung melalui mekanisme yang melibatkan nitrit oksida (NO). Penelitian ini bertujuan untuk mengetahui efektivitas metode terapi elektroakupunktur dibandingkan dengan akupunktur manual pada ST 36 Zusanli terhadap peningkatan kadar NO serum pada penderita dispepsia. Uji klinis acak tersamar ganda dengan pembanding dilakukan terhadap 40 pasien dispepsia yang dibagi ke dalam kelompok elektroakupunktur (EA) dan kelompok akupunktur manual (AM). Hasil penelitian menunjukkan terdapat perbedaan bermakna rerata peningkatan kadar NO serum pada kelompok elektroakupunktur dibandingkan dengan kelompok akupunktur manual (p = 0,026). Kesimpulan penelitian ini yaitu tindakan elektroakupunktur pada ST 36 Zusanli lebihefektif meningkatkan kadar NO serum dibandingkan tindakan akupunktur manual pada pasien dispepsia (p < 0,05).

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Dyspepsia is a syndrome in gastroduodenal region which affect the quality of life ofpatients both physically and mentally Various pharmacological therapies have beendeveloped but its effectiveness is unsatisfying Acupuncture is a modality that hasbeen proven effective in addressing the symptoms of dyspepsia Electroacupuncture EA at ST 36 Zusanli is the method of stimulation and acupuncture points whichmost frequently used in research to overcome the problem of the stomach through amechanism involving nitric oxide NO

The aim of this study was to determine theeffectiveness of electroacupuncture treatment method compared to manualacupuncture at ST 36 Zusanli to increase serum levels of NO in patients withdyspepsia A double blind randomized controlled trial involved 40 patients withdyspepsia randomly allocated into groups of electroacupuncture EA and manualacupuncture MA

The results showed there were significant differences in themean serum levels of NO in the EA group compared to the MA group p 0 026 The results suggested that electroacupuncture at ST 36 Zusanli is more effectivethan manual acupuncture in increasing the serum levels of NO in patients withdyspepsia p 0 05"