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Abstrak :
Background: Dyspepsia is an important health problem from economic and quality of life point of view. However; to date, there has not been specific instrument of quality of life to evaluate patients with dyspepsia specially design in Indonesian language. The Nepean Dyspepsia Index (NDI) is a reliable and valid instrument regarding quality of life in patients with dyspepsia and had been validated in Australia, Germany, ltaly and Netherlands. Objective: To report translation of NDI in Indonesian language and validation in Indonesian patients with dyspepsia and also evaluate the possibility of its use in subjects who speak Indonesian language. Methods: NDI was translated into Indonesian language. The amount of 49 subjects with a clinical diagnosis of dyspepsia according to the inclusion and exclusion criteria were recruited. Collection of data included demographic data, physical and laboratory examination. All subjects were asked to complete translation of NDI. Reliability analysis was evaluated by a-Cronbach's and test-retest. Since dyspepsia has no gold standard, validity was evaluated rising factor analysis. Result: Reliability of the questionnaire was good, a-Cronbach's and interclass correlation coefficient were found to be > 0.70 respectively and Kaiser-Meyer-Olkin value was found to be > 0.64, suggesting that all items were appropriate to measure. Conclusion: translated NDI in Indonesian language can be used in dyspepsia, patients who understand Indonesian language.

Abstrak :
Oesofago-Gastro-Duodenoscopy (OGD) dilakukan pada pasien yang diterima melalui sistem "open acces " dan sistem biasa. Keluhan dapat berbeda pada pasien yang berumur < 45 tahun atau yang berumur > 45 tahun. Diagnosis rujukan, umur, gender dan faklor lingkungan dapat menimbulkan implikasi penting. Studi ini ditujukan untuk mempelajari profil pasien yang datang untuk OGD berdasarkan usia (< 45 tahun atau > 45 tahun) antara Januari 2004 - Desember 2004 yang dirujuk berdasarkan "open acces system" di wilayah sub-Himalaya, India Utara. Studi ini dilakukan di Indira Gandhi Medical College. Pasien dibagi dua kelompok: kelompok I usia < 45 tahun dan kelompok II usia > 45 tahun. Dari 1186 pasien, 451 (38%) adalah perempuan, 735 (62%) adalah laki-laki. Enam ratus enambelas pasien (52%) berusia < 45 tahun dan 570 (48%) berusia > 45 tahun. Dari kelompok /, 431 (70%) menunjukkan gambaran endoskopi yang normal dan 185 (30%) menunjukkan kelainan. Pada kelompok II 302 (53%) menunjukkan gambaran endoskopi yang normal, dan 268 (47%) memperlihatkan kelainan pada endoskopi. Ulkus gaster dan masa lebih sering terlihat pada kelompok > 45 tahun. "Gastro-esophageal reflex disease" (GERD) lebih sering pada usia muda. Gejala subjektif sama pada kedua kelompok. Disimpulkan bahwa untuk gejala yang sama, kelainan OGD lebih sering pada kelompok usia > 45 tahun. Hasil positif meningkat dari 30% menjadi 47% antara usia < 45 dan > 45 tahun. Disimpulkan bahwa semua pasien usia > 45 Tahun perlu dirujuk untuk endoskopi pada kali pertama kelainan gastrointestinal atau adanya alarm simtom. (MedJ Indones 2006; 15:90-3).

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The Oesophago-Gastro-Duodenoscopy (OGD) is done in patients received by either open access system or the conventional system. The presenting complaints and OGD findings may differ among patients with age < 45 yrs and those who are more than 45 yrs old. The referral diagnosis, age, sex, and environmental factors have important implications on the chances of finding and objective abnormality on endoscopy in a patient. This study was aimed to evaluate to evaluate the profile of ! 186 patients divided into younger (<45 yrs) and older age (45 or > 45 yrs) groups presenting for oesophago gastroduodenoscopy through open access referral system in sub-Himalayan region of North India. This is a retrospective study carried out on patients who underwent the OGD from Jan, 2004-Dec, 2004. The study was conducted in Indira Gandhi Medical College situated at a moderate altitude in North India. All patients presenting in Medical College during the study period for OGD were taken into study. The patients were divided into two groups based on age; less than 45 yrs and 45 yrs or more than 45 yrs. Their presenting complaint, age, sex, and OGD findings were recorded. The profile was compared between the two groups. A total of 7186 patients underwent OGD; the females were 451(38%) and males were 735(62%); 616(52%) were < 45 yrs old and 570(48%) of the patients were 45 yrs or older. In the group I 431(70%) had a normal endoscopy and 185(30%) showed abnormal endoscopic findings. In group II 302(53%) had a normal endoscopy, and 268(47%) had abnormal findings on endoscopy. Gastric ulcers, mass lesion/new growth were more common in elderly group, Gastro-esophageal reflux disease (GERD) was more common in younger group. The presenting complaints were similar in both groups. It is concluded that for the same presenting diagnosis the yield of OGD was more in patients > 45 yrs old. The positivity rate increased from 30% in < 45 yrs to 47% in the elderly cohort. So, all people >45 yrs should go for endoscopy at the first hint of upper Gl pathology, or appearance of alarm symptoms. (MedJ Indones 2006; 15:90-3).

Abstrak :
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.

Abstrak :
ABSTRAK
Latar belakang: Sindrom dispepsia fungsional merupakan gejala gastrointestinal yang bersifat kronis atau rekuren dan tidak dapat dijelaskan, karena abnormalitas biokimia atau struktural pada evaluasi menggunakan pemeriksaan diagnostik standar tidak menunjukkan adanya abnormalitas. Pada penelitian ini ingin diketahui apakah pekerja rumah sakit yang bekerja dengan sistem kerja gilir berhubungan dengan sindrom dispepsia fungsional dibandingkan dengan pekerja yang tidak bekerja secara gilir. Metode: Desain studi yang digunakan adalah komparatif potong lintang yang membandingkan antara pekerja dengan sistem kerja gilir dengan pekerja bukan dengan sistem gilir. Data yang digunakan adalah data primer (kuesioner dan wawancara), dan data sekunder (rekam medis serta data kepegawaian). Subjek terdiri dari 218 pekerja (109 pekerja gilir dan 109 pekerja bukan gilir). Hasil penelitian: Prevalensi dispepsia fungsional pada pekerja rumah sakit Jakarta adalah 42,2%. Pada analisis multivariat didapatkan bahwa kerja gilir (OR=2,22 (1,212-4,086) p=0,010), usia (OR=0,39 (0,209-0,752) p=0,005), pola makan (OR=1,90 (1,045-4,455) p=0,035), dan status perkawinan (OR=2,49 (1,097-5,651) p=0,029) mempunyai hubungan bermakna dengan dispepsia fungsional. Pembahasan: Kerja gilir, usia, pola makan, dan status perkawinan merupakan faktor risiko sindrom dispepsia fungsional. Usia dan jenis kelamin menjadi faktor protektif. Usia menjadi faktor protektif karena adanya mekanisme adaptasi dispepsia. Jenis kelamin sebagai faktor protektif mungkin disebabkan pada perempuan tingkat kesadaran terhadap kesehatan lebih tinggi yang menyebabkan angka mortalitas lebih kecil daripada laki-laki

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ABSTRACT
Background: Functional dyspepsia syndrome is a gastrointestinal symptoms that are chronic or recurrent and can not be explained, because the biochemical or structural abnormalities in the evaluation using standard diagnostic examination showed no abnormalities. In this study, we want to know whether the hospital workers who worked shift work system associated with the syndrome of functional dyspepsia compared with workers who do not work in shifts. Method: The study design used was a comparative cross-sectional comparing between workers with shift work system to workers who work not with the shift system. The data used are primary data using questionnaires and interviews, and secondary data through medical records and employment data. Subjects consisted of 218 employees (109 workers with shift work and 109 workers without shift work). Results: The prevalence of functional dyspepsia at Jakarta hospital workers was 42.2%. On multivariate analysis, it was found that shift work (Adj. OR=2.22 (1.212-4.086) p=0.010), age (Adj. OR=0.39 (0.209-0.752) p=0.005), diet (Adj. OR=1.90 (1,045-4.455) p=0.035) and marital status (Adj. OR=2.49 (1.097-5.651) p=0.029) had a significant relationship with functional dyspepsia. Discussion: Shift work, age, diet, and marital status are risk factors syndrome functional dyspepsia. Age and sex becomes a protective factor. Age becomes a protective factor for their adaptation mechanism of dyspepsia. Gender as a protective factor may be due to the level of awareness of women's health is higher that causes of mortality rate is smaller than the male

Abstrak :
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. ......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.

Abstrak :
Dyspepsia merupakan kumpulan gejala yang berasal dari daerah lambung atau usus 12 jari. Mekanisme spesifik dari kompleks gejala yang terjadi belum sepenuhnya diketahui, namun prevalensi keluhan dyspepsia diperkirakan mencapai 30%. Clinical pathway adalah alat untuk membantu proses pelayanan kesehatan berbasis bukti. Karakteristik dari clinical pathway adalah clinical pathway dibuat berdasarkan tatalaksana umum, menjelaskan langkah-langkah yang dilakukan untuk melakukan suatu tindakan, dan menstandarisasi alur tindakan untuk suatu masalah khusus. Karena itu, clinical pathway dyspepsia dapat bermanfaat sebagai pedoman dasar dalam pengobatan dyspepsia, terutama pada instalasi gawat darurat karena prevalensi yang cukup tinggi dan kemungkinan adanya keterbatasan waktu atau tenaga pada instalasi gawat darurat. Laporan ini membahas clinical pathway dyspepsia yang diharapkan dapat membantu IGD RSUI dalam penanggulangan kasus darurat dyspepsia di masa depan. ......Dyspepsia is a group of symptoms that comes from the stomach or duodenal area. The specific mechanism of the symptom complex is not fully known, but the prevalence of dyspepsia is approximated to reach 30%. Clinical pathway is a tool to help the process of healthcare based on proof. The characteristic of clinical pathway is that it is made based on a common procedure, explains the steps needed to do an action, and standardized the flow of actions on a specific problem. This makes clinical pathway of dyspepsia to be useful as a basic guide on dyspepsia treatment, especially on the emergency unit because of the high prevalence and the possibility of limited time or power on emergency units. This report discusses the clinical pathway of dyspepsia that is hoped to help the emergency unit of Universitas Indonesia Hospital on the management of emergency cases of dyspepsia in the future.

Abstrak :
In up to 80% of dyspepsia patients who consult a physician in the hospital, dyspepsia is considered to be functional dyspepsia. Although not associated with increased mortality, functional dyspepsia is a burden at both the community and national levels because it can cause physical, mental, and social ditress that can affect a patients quality of life. Health-related quality of life (HRQOL) is a multidimensional construct comprising at least three broad domains-physical, psychological, and social functioning-which can all be affected by a disease and its treatment. It is important to assess HRQOL in patients with functional dyspepsia to identify the effects of the disease and its treatment on patients. Both disease-specific and generic instruments can be used to assess HRQOL in patients with functional dyspepsia. Each instrument has it own advantages and limitations. The selection of instrument to assess HRQOL is determined by the study population, research questions, disease entities, and researcher preferences. The purpose of this article is to explain the concept of HRQOL and the use of HRQOL assessment in patients with functional dyspepsia.

Abstrak :
Latar belakang Dispepsia fungsional merupakan kumpulan gejala GIT dengan berbagai faktor penyebab. Depresi merupakan salah satu faktor yang berperan panting pada penderita dispepsia fungsional. Depresi sering dijumpai pada penderita dispepsia fungsional dalam menghadapi kehidupannya dan sering terabaikan dalam penatalaksanaannya. Anggota TNI AD merupakan populasi pilihan dan diharapkan mempunyai ketahanan mental dan frsik yang lebih baik. Dalam menghadapi tugas dan kehidupannya, bagaimana peranan depresi pada anggota TNI AD yang menderita dispepsia fungsional Metodologi Sampel didapatkan secara konsekutif sebanyak 95 anggota TNI AD yang menderita dispepsia fungsional di RSPAD Gatot Soebroto, periode Oktober 2005 sampai Juli 2006 dan dilakukan wawancara terstruktur dengan instrumen SLID I untuk diagnosis gangguan depresi berdasarkan DSM IV. Hasil Prevalensi depresi pada anggota TNI AD yang menderita dispepsia fungsional adalah sebesar 54,7 %. Faktor-faktor seperti umur (diatas 40 tahun), pangkat (Perwira), tempat tugas (di Staf, di daerah operasi militer, waktu tugas di daerah operasi militer), tempat tinggal (rumah sendiri) dan pemikahan menunjukkan kecenderungan mengalami depresi. Simpulan Kejadian depresi pada anggota TNI AD yang menderita dispepsia fungsional tidak jauh berbeda dengan populasi umum.

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Background Functional dyspepsia is a syndrome of GIT symptoms with multifactor etiologies. Depression is one of the important factors that influence on functional dyspepsia patient Depression is often found on functional Dyspepsia patient in facing their life event and is often ignored in the treatment. The Indonesian army forces were selected population and are expected to have better mental and physical endurance. In facing the military duty and life event, how is the relation of depression in the army patient with functional dyspepsia. Method 95 Samples were obtained consecutively from the army patient with functional dyspepsia in RSPAD Gatot Soebroto between October 2005 and July 2006 by using structured interview with SCID-1 instrument for the diagnosis of depression disorders according to DSM IV Result The prevalence of depression of Indonesian army with functional dyspepsia was 54.7%. Factor such as age (above 40 years), official rank, staff assignment, military operation and point of military operation time, living in own residence and the marriage are shown to have depression tendency. Conclusion The prevalence of depression of Indonesian army with functional dyspepsia was found to be almost equally comparable with general population.

Abstrak :
Evaluasi Penggunaan Obat Dispepsia pada Pasien Dispepsia berdasarkan Metode ATC/DDD di Puskesmas Kecamatan Kembangan Jakarta Barat Tahun 2015-2016Prevalensi dispepsia yang tinggi di Indonesia menyebabkan banyaknya penggunaan obat dispepsia di fasilitas kesehatan. Penggunaan obat di fasilitas kesehatan harus mengacu pada Formularium Nasional. Penelitian ini bertujuan untuk mengevaluasi pola penggunaan obat dispepsia pada pasien dispepsia di Puskesmas Kecamatan Kembangan Jakarta Barat tahun 2015-2016. Desain penelitian ini adalah deskriptif dengan menggunakan metode ATC/DDD dan pengambilan data secara retrospektif dari resep pasien. Dispepsia diklasifikasikan berdasarkan kode ATC dan dihitung kuantitasnya dalam satuan DDD dan DDD/1000 pasien/hari. Sampel adalah resep pasien dengan obat dispepsia pada tahun 2015 hingga 2016. Berdasarkan hasil penelitian, diperoleh kuantitas penggunaan obat dispepsia yang dinyatakan dalam DDD dan DDD/1000 pasien/hari pada tahun 2015 adalah 45362,24 dan 1,396 sedangkan tahun 2016 adalah 40315,20 dan 1,169. Obat dispepsia yang paling banyak digunakan pada tahun 2015 dan 2016 adalah antasida. Obat dispepsia yang menyusun 90 penggunaan obat pada tahun 2015 dan 2016 adalah antasida, ranitidin dan omeprazol. Persentase kesesuaian penggunaan obat dispepsia dengan Formularium Nasional pada tahun 2015 dan 2016 adalah 62,50 dan 83,33 . Hasil evaluasi menunjukkan kuantitas penggunaan obat dispepsia tertinggi pada tahun 2015 dengan penggunaan obat terbanyak, yaitu antasida serta sesuai dengan Formularium Nasional. ......Evaluation of Dyspepsia Drug Utilization in Dyspepsia Patients with ATC DDD Methode at Puskesmas Kembangan West Jakarta 2015 2016 The high prevelance of dyspepsia in Indonesia leads to a large number of dyspepsia drug usage in healthcare facility. Drug usage in healthcare facility must obey the national formulary. This research aims to evaluate the dyspepsia drug usage pattern in dyspepsia patient at Puskesmas Kecamatan Kembangan West Jakarta in 2015 2016. This was a descriptive design research with ATC DDD method and the data was collected retrospectively from patient rsquo s prescription. Dyspepsia was classified based on ATC code and its quantity was calculated in DDD unit and DDD 1000 patient day. Sample was patient rsquo s prescription with dyspepsia drug in 2015 until 2016. The analysis rsquo results showed that the quantity of dyspepsia drug usage stated in DDD and DDD 1000 patient day in 2015 was 45362.24 and 1.396. The DDD and DDD 1000 patient day in 2016 was 40315.20 and 1.169. The most used dyspepsia drug in 2015 and 2016 was antacid. Dyspepsia drug which constructed 90 drug usage in 2015 and 2016 was antacid, ranitidine, and omeprazole. The percentage of conformity between dyspepsia drug usage with National Formularies in 2015 and 2016 was 62.50 and 83.33 . The result showed that in 2015 had a higher quantity of dyspepsia drug usage than 2016 and the most used drug was antacid and relevant with National Formularies.

Abstrak :
There are many determinant factors that may paly roles in pathophysiology of functional dyspepsia. One of them is psychological stress that cab increase plasma cortisol levels, alter inflammation process and affect helicobacter pylori activity. No study has been conducted to find out the dominant factor among them. This study aimed to find the dominant factor among plasma cortisol levels, IL-6 and IL-8 expressions and H.pylori activity, as the determinant factors in the pathophysiology of functional dyspepsia. Methos: a cross-sectional study was conducted in 80 patients with dyspepsia syndrome at M.Djamil General Hospital, Padang, West Sumatera, Indonesia. The patients were categorized into two groups, i.e. the stress and non-stress group, which were identified using DASS 42 questionairre criteris. The inflammatory expressions (IL-6 and IL-8 expressions) as well as H. pylori ativity were determined using immunohistochemistry of gastric biopsy specimens; while plasma cortisol levels was measured from peripheral blood samples. Data were analyzed using binary multivariate logistic regression. Resultss: there were 80 patients with functional dyspepsia with mean age of 38.9 years old. The morning cortisol level was found significantly higher in the stress group. Higher IL-6 and IL-8 expressions were found in patients of non stress group compared to those in the other group (IL-6; 73.28 (SD 16.60) vs. 72.95 (SD 19.49 and IL-8 18.45 (SD 17.32) vs. 14.80 (SD 12.71) ) although stastically not significant. There was greater helicobacter pylori activity in the group with psychological stress compared to those in the non-stress group since there was antigen-antibody reaction invading the submucosa. The dominant determinant factor was the afternoon plasma cortisol levels. Conclusion: many factors can become the determinant factors for gastric mucosal damage; however, our study has demonstrated that the dominant factor is afternoon plasma cortisol levels.