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"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: 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. "

"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."

"Data epidemiologi infeksi Helicobacter pylori (H. pylori) terus berubah dalam beberapa dekade terakhir. Indonesia dilaporkan memiliki prevalensi infeksi H. pylori yang rendah dibandingkan dengan negara lain di Asia. Beberapa penelitian di Indonesia melaporkan bahwa sanitasi yang buruk, usia, agama, etnis merupakan faktor risiko untuk infeksi H. pylori. Dibandingkan dengan tes diagnostik lainnya, tes urine merupakan tes yang dapat diandalkan untuk mendeteksi H. pylori di Indonesia karena tes tersebut bersifat non-invasif dengan harga yang cukup terjangkau dan memiliki akurasi yang tinggi. Meskipun banyak penelitian telah dilakukan mengenai prevalensi infeksi H. pylori pada beberapa etnis di Indonesia, peneliti masih memiliki beberapa pertanyaan yang belum terjawab mengenai infeksi H. pylori di Indonesia. Oleh karena itu, diperlukan untuk membangun pusat penelitian H. pylori yang menyediakan fasilitas untuk kultur, evaluasi resistensi antibiotik, dan memperoleh informasi genotipe yang dapat menjelaskan perbedaan dalam infeksi H. pylori di antara berbagai etnis di Indonesia."

"Dyspepsia is a common complain in clinical practice. Correlation between helicobacter pylori (H. pylori) and functional dyspepsia had been reported in many studies, but studies that analyzed the severity of dyspepsia and H. pylori were limited and the result were controversial. This study is about to know the correlation between the severity of dyspepsia and H. pylori infection. A retrospective descriptive analysis to patients with dyspepsia at Permata Bunda Hospital, Medan was done in 2010-2014. Simple random sampling was done to get 44 patient with dyspepsia, 22 are H. pylori positive and 22 patients are H. pylori negative. The severity of dyspepsia assessed with porto alegre dyspeptic symptoms questionnaire (PADYQ) scoring instrument. Univariate and bivariate analysis (Chi-square and spearman correlation) were done using SPSS version 22. Epigastric pain is teh most common symptom in dyspepsia patients. There is a correlation between ulcer type dyspepsia and H. pylori infection (p=0.030), while dysmotility type and mixed type were not correlated. The severity of epigastric pain has significant positive correlation with H. pylori (r=0.386;p=0.01), while the severity of other symptoms such as nausea, vomit, and abdominal bloating have negative correlation with H.pylori. Dyspepsia total scoring is significantly lower in H. pylori positive than in H.pylori negative (p=0.033). There is a positive correlation between the severity of nausea, vamit, and abdominal bloating and H.pylori infection, and correlation between lower dyspepsia total scoring and H.pylori pain."

"Tesis ini menggambarkan pola kuman pada kasus infeksi intra abdomen yang disebabkan perforasi saluran cerna atas dan bawah beserta kepekaan antibiotiknya di Rumah Sakit dr Cipto Mangunkusumo. Penelitian ini adalah penelitian cross sectional dengan desain deskriptif analitik. Kuman yang terdapat pada infeksi intra abdomen di tahun 2013 adalah E.coli, Stapylococcus sp dan Enterococcus, sama dengan studi sebelumnya. Sedangkan angka kepekaan kuman terhadap antibiotik terutama golongan aminoglikosida lebih rendah dari data yang sudah ada sebelumnya. Usulan penggunaan antibiotik Amikacin masih dapat diberikan untuk terapi empiris infeksi intra abdomen bersama dengan Metronidazol.

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Intra Abdominal Infection (IAI) is the second most commonly identified cause of severe sepsis. This study wants to identify pattern of bacteria in intra abdominal infections due to upper and lower gastro intestinal tract perforation. This is cross sectional study with analytic descriptive. Result of this study shows that mostly bacteria in intra abdominal infections are E.coli, Stapylococcus and Enterococcus. This is similar with the previous study but with antibiotic susceptibility rate are lower especially aminoglicoside, compare to prior data. Amikacin is still recommended for empiric therapy in intra abdominal infection but combine with Metronidazole."

"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"

"Helicobacter pylori adalah patogengastrointestinal yang penting yang berkaitan dengan gastritis,ulkus peptikum, dan peningkatan risiko kanker lambung. Studiini bertujuan mencari hubungan patogen ini dengan berbagaikelainan gastrointestinal."

"Helicobacter pylori (Hp) infection is the most common chronic bacterial infection in human. The role of Hp infection in various GI disorders had been widely accepted. However, further studies have found new extragastrointestinal involvement such as urticaria. Chronic urticaria is a common disorder that has complex pathophysiologic mechanism. As mater of fact, etiology remains unclear in most of the cases. This condition is called Idiopathic Chronic Urticaria. Several studies had shown high prevalence of Hp infection in patients with ICU and improved symptoms after eradication therapy of Hp. This observation had suggested that Hp has important role as etiologic factor in some cases of ICU. The presence of Hp infection and its role in ICU should be proven before initiating eradication therapy, so that irrational used of drugs and antibiotics resistance can be prevented."

"Although there has been a slow but steady decrease in incidence, gastric cancer remains the second leading cause of cancer death worldwide. Several aspects of the oncological and surgical management are still controversial and so gastric cancer represents a challenge for the surgeon. This book aims to delineate the state of the art in the surgical and oncological treatment of gastric cancer, describing the new TNM staging system, the extent of visceral resection and lymphadenectomy focusing on the different open and minimally invasive surgical techniques and discussing intraoperative chemohyperthermia and neoadjuvant and adjuvant treatment. Operative endoscopy and endoscopic ultrasonography are also discussed, as these now have an important role in both diagnostic work-up and palliative care of gastric cancer patients. Only a multidisciplinary approach involving the surgeon, gastroenterologist, and oncologist can produce the comprehensive and integrated overview that today constitutes a winning strategy for the optimization of results.What we hope we have achieved is a flexible, up-to-date, exhaustive publication, rich in illustrations and consistent with evidence-based medicine."