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Abstrak :
Constipation is the most ignored complaint by doctors and unfortunately, it requires urgent management due to the decreased quality of life. Most cases are functional constipation but there is also a great number of constipation due to organic abnormalities. In an attempt to manage the patient properly, we should put our emphasis on excellent knowledge of pathophysiology of constipation.By using the colonic transit time test, we could determine the type of constipation, which would have an effect on therapy. In most cases, constipation has a good response to high fiber diet and additional laxative medication and surgical therapy is seldom required unless complications have occurred. There is also a suggestion for preventing constipation may be caused by opioid usage.

Abstrak :
Background: Minnesota Living with Heart Failure Questionnaire (MLHFQ) is the most commonly used questionnaire and it has a good EMPRO (Evaluating the Measurement of Patient-Reported Outcomes) score. The MLHFQ has been adapted and used by various countries worldwide. However, to be utilized in Indonesia, it needs validity and reliability studies. This study aimed to obtain a valid and reliable Indonesian version of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) so that it can be used in Indonesia. Methods: the present study was a cross sectional study with 85 subjects (mean age 58 (SD 11) years; 55% subjects were male) who had chronic heart failure and was treated at the outpatient clinic of cardiology in Dr. Cipto Mangunkusumo Hospital, Jakarta. Validity of the MLHFQ was assessed by evaluating the construct validity using multitrait-multimethod analysis and external validity was evaluated by compairing the MLHFQ with the SF-36 questionnaire. Reliability was assessed using Cronbachs and intraclass correlation coefficients (ICC). Results: the Indonesian version of the MLHFQ had moderate-to-strong correlation between domains and items in questionnaire (r: 0.571-0.748; p<0.01) and it had moderate negative correlation with SF-36 questionnaire (r -0.595; p<0.001). The Cronbach α of Indonesian version of MLHFQ was 0.887; while the ICCs was 0.918. Conclusion: the Indonesian version of MLHFQ has good validity and reliability to asses the quality of life of patients with chronic heart failure in Indonesia.

Abstrak :
Obstructive: jaundice represents the most common complication of biliary tract Malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer. Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6. Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%. Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure

Abstrak :
Tuberculosis remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tract. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to nonspecific sign and symptoms. In endemic areas, correct diagnoses were made only 50% of the time. Without a high index of suspicion of the disease, it has been rarely diagnosed correctly. We reported a case of colonic tuberculosis in 18 years old female patient with lung tuberculosis.Endoscopic examination showed ulcerative mucosa, 'halo lesion', and pseudopolyp while PPD skin test, sputum smear and histopathological examination of endoscopic biopsy revealed negative for tuberculosis infection. The presence of lung tuberculosis had made high index of suspicion of colonic tuberculosis. Standard regimen of antituberculosis therapy was given and the patient showed good clinical response.

Abstrak :
Tujuan Pengobatan untuk eradikasi H pylori dengan kombinasi PPI dan Amoksisilin 1000 mg atau Clarithromycin 500 mg yang diberikan 2 kali sehari selama 2 minggu telah terbukti efektif. Kebanyakan penelitian menyebutkan bahwa pengobatan 7 dan 10 hari sama efektif. Tujuan dari penelitian ini adalah untuk membandingkan terapi eradikasi H pylori selama 5 dan 7 hari. Metode Penelitian ini dilakukan secara prospektif pada 60 pasien yang terinfeksi H pylori, pemeriksaan dilakukan dengan endoskopi dan biopsi saluran cerna bagian atas di 6 (enam) rumah sakit di Indonesia. Diagnosis H pylori ditegakkan berdasarkan pada 2 pemeriksaan rapid urea test (Pronto Dry) dan pemeriksaan histopatologi atau adanya urea breath test (UBT) yang positif. Kemudian secara terbuka pasien akan dibagi menjadi 2 kelompok, kelompok pertama mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 5 hari dan kelompok kedua mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 7 hari. Empat minggu kemudian, pasien dievaluasi dengan UBT untuk memastikan keberadaan H pylori. Hasil Pada penelitian ini didapatkan 60 pasien yang terdiri dari 42 laki-laki dan 18 perempuan dengan rata-rata (usia+SD) 47.63+13.93 tahun, rentang usia 21-74 tahun. Kelompok pengobatan 5 hari terdiri dari 25 (41,7%) pasien dan kelompok pengobatan 7 hari terdiri dari 35 (58.3%) pasien. Setelah kelompok pengobatan 5 hari didapatkan 18 (72%) pasien H Pylori negatif, dan setelah pengobatan 7 hari didapatkan 32 (91.4%) pasien H Pylori negatif. Kegagalan eradikasi ditemukan pada kelompok pengobatan 5 hari sebesar 7 (28%) pasien dan pada kelompok pengobatan 7 hari sebesar 3 (8.6%) (p=0,077). Kesimpulan Penelitian ini menunjukkan bahwa eradikasi H pylori dengan pengobatan tripel dengan rabeprazole pada kelompok 7 hari masih lebih baik daripada kelompok pengobatan 5 hari. Perbedaan yang tidak bermakna secara statistik ini mungkin karena jumlah sampel tidak mencukupi.

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Aim A combination of PPI and 1000 mg amoxicillin/500 mg clarithromycin twice daily for 2 weeks has been proven effective in the eradication of H. pylori. Most studies suggested that treatment for 7 and 10 days may be equally effective. Few data are available on the effi cacy of 5-day triple therapy. Aim of this study was to compare 5-day and 7-day rabeprazole triple therapy for eradication of H. pylori infection. Methods We prospectively studied 60 consecutive H. pylori-infected patients who came to hospitals in six centres in Indonesia and who underwent upper endoscopy and biopsy. H. pylori infection was confi rmed if two rapid urease tests (Pronto Dry) and histology or urea breath test were positive. Patients were assigned to either an open-labelled 5-day or 7-day course of oral amoxicillin 1000 mg b.i.d., clarithromycin 500 mg b.i.d., and rabeprazole 10 mg b.i.d. (RAC).Four weeks after therapy, all patients had a repeated UBT for evaluation of the presence of H. pylori. Results Of the 60 patients (42 males and 18 females) with mean age (± SD) 47.63 ± 13.93 years, range 21?74 years, 25 patients (41.7%) had 5-day treatment and 35 patients (58.3%) had 7-day treatment. With 5-day treatment, 18 patients (72%) and with 7-day treatment 32 patients (91.4%) became negative for H. pylori infection. The eradication failure was found on 7 patients (28.0%) in 5-day reatment and 3 patients (8.6%) in 7-day treatment. Conclusions The study showed that the eradication of H. pylori infection by triple rabeprazole-based treatment in 7-day is still better than in 5-day.