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"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."

"Patients with liver cirrhosis frequently have infection which can deteriorate further the already impaired liver function. The most common form of infection in this particular patients are spontaneous bacterial peritonitis, urinary tract infection, and respiratory infection. Causative organism mostly Gram negative micro organism and originate from the gastrointestinal tract. The weaken of immune defense mechanism and also the altered gastrointestinal tract motility can explained most of these infection. This paper will review the bacterial infection in liver cirrhosis with some guidance in the management."

"Since the limulus test, a method for the evaluation of endotoxin levels using extract from horsehoc crabs (limulus, spp), was developed in the year 1969 by Levin and Bang, there have been reports on endotoxin from portal blood without negative gram bacterial infection, a condition known as endogenous endotoxemia."

"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."

"Sirosis hati merupakan penyakit hati kronis yang mempunyai komplikasi seperti varises esophagus, asites dan ensefalopati hepatikum. Karena bersifat kronis dan tidak bisa dipulihkan serta adanya komplikasi dari penyakit tersebut, maka secara substansial akan mengurangi kualitas hidup mereka. Oleh karena itu, diperlukan manajemen diri yang baik dalam mengelola penyakit sirosis demi menjaga agar tetap memiliki kualitas hidup yang baik pula. Penelitian deskriptif analitik dengan pendekatan cross-sectional ini bertujuan untuk melihat apakah ada hubungan antara self management dengan kualitas hidup pada pasien dengan sirosis hati di poliklinik RSUPN Dr.Cipto Mangunkusumo. Jumlah sampel pada penelitian ini adalah 102 yang ditentukan berdasarkan non probability sampling. Penelitian ini menggunakan 3 kuesioner yang terdiri dari kuesioner karakteristik demografi, Self Management dan Chronic Liver Desease Quationnare (CLDQ). Hasil penelitian menunjukkan adanya hubungan bermakna antara self management dengan kualitas hidup pada pasien dengan sirosis hati (p=0,002, α=0,05). Peneliti menyarankan perlunya upaya peningkatan self management pada pasien sirosis hati guna meningkatkan kualitas hidup mereka.

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Liver cirrhosis is a chronic liver disease that has complications such as esophageal varices, ascites and hepatic encephalopathy. It has been reported that this chronic disease affects quality of life. Self management is deemed to contribute the quality of life in patient with chronic disease. This analytic descriptive study with a cross-sectional approach aimed to investigate relationship between self management and quality of life in patients with outpatient cirrhosis. The number of samples in this study was 102 which were determined based on non probability sampling. This study used 3 questionnaires consisting of demographic characteristic questionnaires, Self Management and Chronic Liver DeseaseQuationnare (CLDQ). The results indicate the majority of respondents have good self management (57 people) and have a good quality of life (53 people). Analysis data also showed there was a significant relationship between self management and quality of life in patients with liver cirrhosis (p = 0.003, α = 0.05). Thus, it is recommended that the need to increase self-management in liver cirrhosis is important in patients with liver cirrhosis."

"Small intestinal bacterial overgrowth is a condition where the proximal small intestine harbours more than 10 organisms/ml intestinal fluid for a long period. Bacterial overgrowth could be found in patients with certain clinical conditions, such as intestinal anatomical disorders, intestinal motility disorders, and several diseases including liver cirrhosis. It was reported that the prevalence of bacterial overgrowth in patients with liver cirrhosis was around 30%-75%. Small intestinal bacterial overgrowth could induce various clinical conditions from mild to severe cases, therefore it is important to recognise its signs and symptoms, diagnosis, and management. This article will also review the clinical management of small intestinal bacterial overgrowth in liver cirrhosis."