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"Penyakit gastroenterologi masih merupakan masalah kesehatan utama di Indonesia, dengan kolitis menempati urutan kelima dari sepuluh penyakit terbanyak pada pelayanan rawat jalan. Kesamaan gambaran klinis dan hasil pemeriksaan diagnostik kolitis TB dan Inflammatory Bowel Disease (IBD) menyebabkan kesulitan diagnosis. Studi ini bertujuan untuk mengetahui peran diagnostik Interferon-Gamma Release Assay (IGRA) metode Elispot pada pasien terduga kolitis tuberkulosis di Indonesia. Dilakukan studi potong lintang dan acak dengan penyajian data deskriptif analitik. Subjek penelitian merupakan 60 pasien terduga kolitis tuberkulosis yang mengunjungi poliklinik gastroenterologi di RSUPNCM bulan April-Oktober 2018. Sampel yang digunakan adalah darah vena. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi adalah sensitivitas 83,3%, spesifisitas 57,4%, NPP 17,3%, dan NPN 96,9%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi adalah sensitivitas 53,9%, spesifisitas 55,3%, NPP 25%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi dan histopatologi adalah sensitivitas 57,1%, spesifisitas 60,5%, NPP 28,6%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi, kolonoskopi, dan evaluasi klinis akhir adalah sensitivitas 100%, spesifisitas 59,3%, NPP 21,3%, dan NPN 100%. Tes IGRA Metode Elispot dapat digunakan sebagai pemeriksaan penapisan.

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Gastroenterology diseases are still a major health problem in Indonesia, with colitis ranks fifth among the top ten diseases in outpatient care. The similarity of clinical features and diagnostic results of TB and Inflammatory Bowel Disease causes difficulties in diagnosis. This study is aimed to determine the diagnostic value of Interferon-Gamma Release Assay (IGRA) with Elispot Method in patients with suspected tuberculous colitis in Indonesia. It is a cross sectional and randomized study, shown as an analytic descriptive report. There were 60 patients with suspected tuberculosis colitis, visiting gastroenterology polyclinic at RSCM from April-October 2018. The sample was venous blood.  Diagnostic results of IGRA with Elispot Method with histopathology test as the gold standard are sensitivity 83,3%, specificity 57,4%, PPV 17,3%, and NPV 96,9%. As with colonoscopy as the gold standard are sensitivity 53,9%, specificity 55,3%, PPV 25%, dan NPV 81,3%. Meanwhile, with colonoscopy and histopathology test as the gold standard are sensitivity 57,1%, specificity 60,5%, PPV 28,6%, dan NPV 81,3%. And, diagnostic results  of IGRA with Elispot Method with colonoscopy, histopathology test, and final clinical judgement as the gold standard are sensitivity 100%, specificity 59,3%, PPV 21,3%, dan NPV 100%. IGRA with Elispot Method can be used as screening test."

"The term "Inflammatory Bowel Disease" (IBD) is frequently used to denote two diseases, ulcerative colitis (UC) and Crohn's disease (CD). This condition is frequently recorded in the West, and along with development of diagnostic facilities, is beginning to be more commonly found in Indonesia.The etiology of this disease is still unclear, but it is suspected that environmental, geographic, and genetic factors are involved. Cytokines play a great role in the pathogenesis of IBD, where in IBD there is an unbalance of pro-inflammatory cytokines and inhibitor cytokines. In IBD, there is an increase in pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, IL-8, and alpha TNF in the intestinal mucosa. Such increase significantly correlates with the activity of ulcerative colitis through endoscopic examination,At this moment, forms of therapy for IBD associated with cytokines are being developed, such as ways to inhibit cytokine synthesis, cytokine release, cytokine activity and the cytokine signaling pathway in the target cell."

"Peptic ulcer is a clearly marginated ulceration in mucosal membran that can penetrate until muscularis layer and resulted from imbalance between aggressive factor (gastric acid and pepsin) and defensive factor (gastric mucous, bicarbonate and prostaglandin, mucosal blood flow, and cell replacement). Factors that can act as aggressive factor include H. pylori, NSAID, and smoking. Duodenal ulcer is frequently associated with H. pylori, in which Helicobacter pylori is found in 95 - 100% of duodenal ulcer patients..It was reported, a 39 years old female patient with cirrhosis hepatis who suffered from melena in which endoscopic examination revealed duodenal ulcer as a source of bleeding.The re was no H. pylori, based on serologic examination (IgG antiHP) and culture. The ulcer is suspected caused by NSAID based on history of using traditional medicine that may contain NSAID. Treatment with proton pump inhibitor and sucralfate can heal the ulcer after two week treatment."

"Pendahuluan: Pengobatan Kolitis Ulseratif (KU) hingga saat ini masih dilakukan dengan cara pemberian obat-obatan antiinflamasi, seperti 5-aminosalicylic acid (5-ASA), hingga pembedahan. Selain pengobatan konvensional, dikembangkan pula pengobatan alternatif yang memanfaatkan bahan-bahan dari alam seperti elagitanin. Elagitanin danderivatnya, yakni asam elagat, dapat ditemukan dalam jumlah yang banyak pada kulit buah delima dan diduga memiliki efek antiinflamasi yang bermanfaat untuk terapi alternatif kolitis. Oleh karena itu, penelitian ini hendak menelusuri lebih lanjut pengaruh ekstrak etanol kulit buah delima terhadap ekspresi NF-kB sebagai penanda inflamasi. Metode: Desain penelitian yang digunakan dalam penelitian ini adalah eksperimental. Penelitian ini menggunakan organ kolon mencit yang telah diberikan perlakuan di penelitian dan dikelompokkan ke dalam 6 kelompok sebagai berikut: kelompok tanpa perlakuan (KTP), kontrol negatif (KN) yang diberikan DSS2%, kontrol positif 1 (KP1) yang diberikan DSS2% dan aspirin 43 mg/kgBB/hari, kontrol positif 2 (KP2) yang diberikan DSS2% dan asam elagat 26 mg/kgBB/hari, serta kelompok dosis 1 (KD1) dan 2 (KD2) yang diberikan DSS2% dan ekstrak kulit delima dalam dosis 240 mg/kgBB/hari dan 480 mg/kgBB/hari. Hasil dan Pembahasan: Rerata H Score untuk KTP adalah 129,0946; untuk KN adalah 200.3989; untuk KP1 adalah 165,5808; untuk KP2 adalah 159,0553; untuk KD1 adalah 186,1655; dan untuk KD2 adalah 141,0696. Uji One Way ANOVA menunjukkan hasil yang signifikan. Uji posthoc Tukey menunjukkan perbedaan yang bermakna antara KD2 dan KN. Kesimpulan: Pemberian ekstrak etanol kulit delima dengan dosis 480 mg/kgBB/hari dapat menurunkan ekspresi NF-kB pada epitel kolon mencit yang diinduksi DSS.

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Introduction: Up until now, Ulcerative Colitis (UC) treatment is mainly done conservatively by using antiinflammatory drugs, such as 5-aminosalicylic acid (5-ASA), or surgery. In addition to convensional treatment, alternative treatment that uses natural ingredient, such as elagitanin, is now under development. Elagitanin and its derivative, ellagic acid, can be found abundantly in pomegranate peel, and are expected to own an antiinflammatory property that can be considered to be an alternative choice for UC treatment. Therefore, this study is conducted with the intention of acknowledging the effect of pomegranate peel ethanol extract on NF-κB expression in mice’s colon tissue induced with DSS. Method: Study design used in this study is experimental. This study used the colonic tissue that was already prepared by the previous researcher and is divided into 6 groups: group without intervention (KTP), negative control (KN) with the administration of DSS 2%, positive control 1 (KP1) with the administration of DSS 2% and aspirin 43 mg/kgBW/day, positive control 2 (KP2) in which the mice are given DSS 2% and ellagic acid 26 mg/kgBW/day, and finally dose 1 and dose 2 group (KD1 and KD2) with the administration of DSS 2% and pomegranate peel extract with dose of 240 mg/kgBW/day and 480 mg/kgBW/day. Result and Discussion: Mean H Score for KTP is 129,0946; for KN is 200.3989; for KP1 is 165,5808; for KP2 is 159,0553; for KD1 is 186,1655; and for KD2 is 141,0696. Analysis using One Way ANOVA test shows a signicant result. Posthoc Tukey test shows a significant difference between KD2 and KN. Conclusion: pomegranate peel ethanol extract with dose of 480 mg/kgBW/day can decrease the NF-κB expression in mice’s colon epithelium induced with DSS."