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"Proton pump inhibitors (PPls) are the most effective anti secretory drugs available for controlling gastricacid acidity and volume. They are the drug of choice in the treatment for gastro esophageal reflux disease(GERD), Helicobacter pylori eradication, peptic ulcer and non steroidal anti-inflammatory drug (NSAID)gastropathy. For acute cases, on intravenous PPI is needed, especially for hospitalized patient. Recently,intravenous pantoprazole represents an alternative to intravenous histamine-2 receptor antagonists. Weobserved 2 patients who were treated with pantoprazole for duodenal ulcer; where one case had acomplication of bleeding with a history of long term use of NSAID. After two weelrs of treatment withpantoprazole, significant lesion healing from endoscopy findings was achieved in both cases."

"Even though there are still no epidemiological data on the prevalence of Gastro Esophageal Reflux Disease (GERD) in Indonesia, data from The Division of Gastroenterology Department of Internal Medicine Cipto Mangunkusumo Hospital demonstrate signs of esophagitis in 22.8% of all patients with dyspepsia who underwent endoscopic examination. Western countries report a higher rate of GERD than Asian and African countries, possibly due to dietary factors and increased obesity. Besides adequate history and physical examination, there are many other supporting examinations that could be performed to establish the diagnosis of GERD, especiaily endoscopy of the upper gastrointestinal tract and 24-hour esophageal pH monitoring. Even though this condition is rarely fatal, GERD patients should still receive adequate management. Most patients demonstrate a satisfactory response towards therapy which inciudes Iife-style modification as well as medication. Currently the drugs of choice for GERD are proton-pump inhibitors. A combination of proton-pump inhibitors and prokinetics produces a better effect. Patients resistant to medical treatment or those with recurrent esophageal stricture should be considered for anti-reflux surgery."

"Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain ammo acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay.Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio.Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 ± 1.2; Child Pugh B 6.0 ± 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin fr - 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test.Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio."

"Tuntutan akademik seringkali membuat mahasiswa mengalami stres. Diyakini bahwa salah satu dampak dari stres akademik adalah GERD, sementara strategi koping merupakan cara mahasiswa mengatasi stres tersebut. Penelitian ini bertujuan untuk menganalisis pengaruh stres akademik terhadap Gastroesophageal Reflux Disease (GERD) dengan strategi koping sebagai moderator pada mahasiswa. Metode yang digunakan adalah pendekatan kuantitatif dengan teknik pengumpulan data melalui kuesioner. Partisipan yang terkumpul mencapai 202, namun yang dapat diolah hanya 183 partisipan. Data dianalisis dengan PROCESS Hayes. Hasil penelitian (p = 0.004) menunjukkan bahwa emotion-focused coping memoderasi pengaruh stres akademik terhadap GERD. Sementara itu, kedua jenis strategi koping lainnya tidak menunjukkan interaksi yang signifikan. Penelitian ini memberikan kontribusi untuk memahami penggunaan strategi koping yang efektif untuk meregulasi stres akademik, sehingga juga memperlemah pengaruhnya terhadap GERD. Saran untuk penelitian lanjutan adalah penggunaan teknik sampling yang lebih terkontrol, sehingga partisipan bisa lebih representatif.

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Academic demands often cause students to experience stress. It is believed that one of the impacts of academic stress is GERD, while coping strategies are the way students deal with that stress. This study aims to analyze the effect of academic stress on Gastroesophageal Reflux Disease (GERD) with coping strategies as a moderator among students. The method used is a quantitative approach with data collection techniques through questionnaires. The collected participants reached 202, but only 183 participants could be processed. The data were analyzed using PROCESS Hayes. The results of the study (p = 0.004) showed that emotion-focused coping moderates the effect of academic stress on GERD. Meanwhile, the other two types of coping strategies did not show significant interactions. This study contributes to understanding the effective use of coping strategies to regulate academic stress, thereby weakening its impact on GERD. Suggestions for further research include using more controlled sampling techniques so that participants can be more representative."

"Penelitian ini untuk mengevaluasi efek obat penghambat pompa proton (esomeprazol), penggunaan bronkodilator inhaler dan arus puncak ekspirasi (APE) pada pasien asma persisten sedang dengan penyakit refluks gastroesofagus (PRGE). Penelitian ini adalah uji klinis terbuka dengan kontrol di RS Persahabatan Jakarta dari Juli 2004 sampai Oktober 2005. Diagnosis PRGE ditegakkan jika ditemukan gejala PRGE dan gambaran esofagitis pada endoskopi dan atau pada pemeriksaan histopatologi hasil biopsi esofagus. Pada fase 1 (periode run in) selama 2 minggu, pasien mendapat pengobatan budesonid inhalasi dosis 2x200 ug/hari. Pada fase 2, pasien diacak menjadi 2 kelompok dan mendapat pengobatan budesonid inhalasi dosis 2 x 400 ug/hari dengan esomeprazol 40 mg/hari atau tanpa esomeprazol (kelompok kontrol) selama 8 minggu. Fase 3 (periode wash out) pasien mendapat pengobatan budesonid inhalasi dosis 2 x 200 ug/hari. Catatan harian dilakukan pada periode run in, setelah pengobatan 4 minggu, 8 minggu dan periode wash out. Sebanyak 32 pasien (23 perempuan dan 9 laki-laki) menyelesaikan penelitian ini. Rata-rata skor gejala asma total harian berkurang secara bermakna pada kelompok esomeprazol dibanding tanpa esomeprazol setelah pengobatan 8 minggu (-2,29 vs -0,90; p < 0,05). Rata-rata penggunaan bronkodilator inhaler berkurang secara bermakna pada kelompok esomeprazol dibanding tanpa esomeprazol setelah pengobatan 8 minggu (- 1,09 vs - 0,42; p < 0,05). Nilai APE pagi dan sore meningkat lebih besar pada kelompok esomeprazol dibanding tanpa esomeprazol tetapi tidak berbeda bermakna. Disimpulkan bahwa pemberian esomeprazol 40 mg perhari memperbaiki gejala asma dan penggunaan bronkodilator inhalasi pada asma persisten sedang dengan PRGE.

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AbstractThis study aimed to evaluate effect of proton pump inhibitor (esomeprazole) on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR) in moderate persistent asthma with gastroesofageal refluks disease (GERD). This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group) for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male) completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05). Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05). Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD."

"Aim: to obtain a valid and reliable GERD-QOL questionnaire for Indonesian application.

Methods: at the initial stage, the GERD-QOL questionnaire was first translated into Indonesian language and the translated questionnaire was subsequently translated back into the original language (back-to-back translation). The results were evaluated by the researcher team and therefore, an Indonesian version of GERD-QOL questionnaire was developed. Ninety-one patients who had been clinically diagnosed with GERD based on the Montreal criteria were interviewed using the Indonesian version of GERD-QOL questionnaire and the SF 36 questionnaire. The validity was evaluated using a method of construct validity and external validity, and reliability can be tested by the method of internal consistency and test retest.

Results: the Indonesian version of GERD-QOL questionnaire had a good internal consistency reliability with a Cronbach Alpha of 0.687-0.842 and a good test retest reliability with an intra-class correlation coefficient of 0.756-0.936; p<0.05). The questionnaire had also been demonstrated to have a good validity with a proven high correlation to each question of SF-36 (p<0.05).

Conclusion: the Indonesian version of GERD-QOL questionnaire has been proven valid and reliable to evaluate the quality of life of GERD patients."

"Lingkungan perkuliahan yang memiliki berbagai tuntutan berdampak terhadap kualitas tidur mahasiswa dalam menghadapi tuntutan akademis. Berbagai negara telah merekam prevalensi kualitas tidur yang buruk pada mahasiswa di seluruh dunia. Beberapa penelitian telah menemukan bahwa stres akademik memiliki dampak negatif terhadap kualitas tidur. Tidak hanya kualitas tidur, jalur pencernaan dapat terdampak oleh stress akademik. Penyakit refluks gastroesofageal (GERD) ditemukan dapat memperburuk kualitas tidur. Selain itu, GERD dapat terdampak oleh stres sehingga gejala memburuk. Ditambah lagi, prevalensi GERD di Indonesia kian meningkat dari 14% hingga 24% dalam rentang waktu 3 tahun. Dengan demikian, penelitian ini bertujuan untuk melihat peran GERD sebagai mediator antara stres akademik dan kualitas tidur. Penelitian ini adalah penelitian kuantitatif dengan teknik analisis mediasi PROCESS Model 4. Jumlah partisipan keseluruhan adalah 201 mahasiswa perguruan tinggi di Indonesia (75,62% perempuan) dengan rentang usia 18-25 tahun. Ketiga variabel diukur menggunakan Perceived Academic Stress Scale (stres akademik), Pittsburgh Sleep Quality Index (kualitas tidur), dan GERD Questionnaire (GERD). Hasil analisis mediasi menunjukkan bahwa stress akademik memprediksi kualitas tidur secara signifikan tanpa perantara GERD sebagai mediator (β = 0,033, SE = 0,033, CI [LLCI = -0,0011 – ULCI = 0,0116]). Maka, dibutuhkan variabel lain sebagai mediator terhadap hubungan stres akademik terhadap kualitas tidur.

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The student environment, with its various demands, impacts sleep quality as an effort to deal with academic demands. Various countries have recorded the prevalence of poor sleep quality among students worldwide. Several studies have found that academic stress negatively affects sleep quality. Not only does it impact sleep quality, but the digestive tract can also be affected by academic stress. Gastroesophageal reflux disease (GERD) has been found to worsen sleep quality. Moreover, GERD can be exacerbated by stress, making its symptoms worse. Additionally, the prevalence of GERD in Indonesia has increased from 14% to 24% over a span of 3 years. Thus, this research aims to examine the role of GERD as a mediator between academic stress and sleep quality. This research uses a quantitative research type with the mediation analysis technique PROCESS Model 4. The total number of participants is 201 university students in Indonesia (75,62% women) with an age range of 18-25 years. The three variables were measured using the Perceived Academic Stress Scale (academic stress), the Pittsburgh Sleep Quality Index (sleep quality), and the GERD Questionnaire (GERD). The mediation analysis results show that academic stress significantly predicted sleep quality without GERD as a mediator (β = 0,033, SE = 0,033, CI [LLCI = -0,0011 – ULCI = 0,0116]). Therefore, another mediator variable is needed in the relationship between academic stress and quality of sleep."