Hasil Pencarian  ::  Simpan CSV :: Kembali

"We describe that often colonic tuberculosis remains unsuspected prior to surgery. We therefore draw attention to pitfalls in the diagnosis and review the literature on the diagnostic modalities available to diag-nose the disease. Today, the prompt diagnosis of an unknown gastroenteritis process invoives colonoscopy.

Using a fiberscope, a procedure with instantaneous return can be carried out. Patients with clinical presen-tation suggestive of coionic tuberculosis should have had either an aggressive diagnostic work out using high-yield tests or anti tubercuiosis therapy."

"Background: The diagnosis and treatment of chronic diarrhea is sometimes difficult. Orocaecal transit time may explained some pathogenesis mechanism in chronic diarrhea.Materials & Methods: Twenty six chronic diarrhea patients and 35 normal adult subjects were included in this study. After fasting for at least 10 hours, subjects were asked to drink 20 ml (13.3 g) lactulose, then performed the breath hydrogen test. If there were an increment of H2 concentration 10 ppm in '/2 -1 hour, the subject was considered as rapid transit time, ff an increment of H2 concentration 10 ppm in 1 - 2 hour, the subject was considered as normal transit time. If an increment of H2 concentration 10 ppm in 2 - 3 hour,the subject was considered as delayed transit timeResults: In the chronic diarrhea group, 10 (38.4%) had rapid OCTT, 15 (57.6%) had normal OCTT and only 1 (4%) had delayed OCTT. In the normal adults group, 2 (5.7%) had rapid OCTT, 22 (62.9%) had normal OCTT and 11 (31.4%) had delayed OCTT. The difference was statistically significant (p < 0.001). The mean value of OCTT in chronic diarrhea and normal adults were 84.23 ± 39.82 min vs. 114.00 ± 51.35 min (p = 0.027).Conclusions: The rapid OCTT was more likely to be found in the chronic diarrhea patients compare to normal adults significantly. The mean OCTT in chronic diarrhea was shorter than the mean OCTT in normal adults."

"Inflammatory bowel disease (IBD) in rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complain! of chronic diarrhea with or without hematochezia.We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy."

"Insidens diare kronik di Asia berkisar antara 0,8 ? 1,0%. Lokasi penyakit dan kelainan yang menimbulkan diare kronik dapat dibagi atas 3 kelompok yaitu usus halus, usus besar dan ekstra intestinal. Penyakit-penyakit pada usus halus terdiri dari infeksi dan non-infeksi. Penyakit-penyakit infeksi antara lain yaitu infeksi bakterial, infeksi parasit dll. Penyakit-penyakit non-infeksi yang menimbulkan diare kronik a.l. penyakit Crohn, ?Celiac sprue?, enteropati OAINS, intoleransi laktose, tumor jinak, tumor karsinoid, karsinoma, komplikasi pasca bedah, obat laksatif dll. Pendekatan diagnosis terdiri dari anamnesis riwayat penyakit yang baik, pemeriksaan fisik yang teliti, laboratorium penunjang, laboratorium penunjang yang lebih spesifik termasuk foto rontgen kolon, foto rontgen ?esofagogastroduodenum follow-through?, ?enteroclysis?, pemeriksaan ileo-kolonoskopi dan endoskopi saluran cerna atas termasuk usus halus dengan biopsi untuk pemeriksaan histopatologi. Pengobatan diare kronik dibagi atas pengobatan suportif dan kausal. (Med J Indones 2002; 11: 179-89)

---

The incidence of chronic diarrhea in Asia is between 0.8 ? 1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn?s disease, Celiac sprue, NSAID enteropathy, lactose intolerance, benign tumor, carcinoid tumor, carcinoma, post surgery complications, laxative etc. The approaches to diagnosis include good anamnesis, careful physical examination, supporting laboratory tests, more specialized supporting examinations including X-ray of the colon, esophagogastroduodenum follow-through, enteroclysis, ileo-colonoscopy and endoscopy on the upper portion of the digestive tract including the small intestine with biopsy for histopathology examinations. The treatment for chronic diarrhea is divided into supportive and causal therapy. (Med J Indones 2002; 11: 179-89)"

"Amyloidosis is a rare disease, when diagnosed it's incurable and mostly affect over 40 years old male. Diagnostic is confirmed if histopathologic stained positive with Congo red and evidence of monoclonal protein. Survivals for untreated patients are 13 months in primary amyloidosis but if secondary to other chronic disease and systemic, survival could be 3-4 years. It can not be prevented but when affected, control of the underlying illness can prevent progression of amyloidosis.

We report a rare case of a 67 year old male, who came with chronic diarrhea. The stool analysis, there were no negative gram microorganisme found, only food maldigestion and fungus infection. Stool analyze from parasitology department were found microspore, but the stool culture were sterile. The patient underwent colonoscopy which revealed hyperemis mucosa in rectum, sigmoid, descending & transverse colon. From the biopsy was concluded intestinal amyloidosis. We treated the patient symptomatically and couldn't find the underlying inflammatory disease which causes the problem."

"The abnormality or disease of ihe small intestine may cause chronic diarrhea. The tests required to investigate the abnormality of the small intestine are difficult and expensive. In this study we studied the small intestine in chronic diarrhea cases, to discover any abnormality.The chronic diarrhea patients presenting from 1996 to 2000(5 years) at Cipto Mangunkusumo General Central National Hospital were included in the study. Patients were excluded if unable to co-operate. All of the patients were given blood and stool lexis in addition to colonoscopy, ileoscopy and duodeno-jejunoscopy with biopsy.Small intestinal examination could only be performed on 78patients witii chronic diarrhea. The most frequent characteristic were: aged 30-39 or 50-59 years (25.6% of all canes in the study), male(57.7%), non-bloody non steatorrhoeic tvpe of diarrhea(74.4%), and 4 to 48 weeks-duration of diarrhea(68.0%). Small intestine abnormalities were endoscopically and/or histopathologically found in 65 cases(S2.6%), while the rest of the patients were found to have normal small intestine. The abnormalities were found to he infective non-tuberculosis ileitis (in 20 patients, or 26% of all cases), Infective non-tuberculosis duodenitis(20 or 26%), non-infective jejtinitixf 14, or 18.2%), villous aft phy of the jejunum(3, or 3.9%), lymphoid nodular/follii hyperplasia of the terminal Heutn(l2, or 15.6%) etc. LOT intestinal abnormalities were found in 67 or S3.7% of t chronic diarrhea cases.The frequent small intestinal abnormalities were infe tive ileitis, duodenitis and lymphoid nodular/follicle hype plasiaofthe terminal ileum. The small intestinal abnormal ties were found less than the large intestinal abnormalitie"

"Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia.Materials & Methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 [ig El/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 [ig El/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests.Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p > 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency (< 200 fig El/g stool) than in dyspepsia (control) (>_ 200 fj,g El/g stool, p < 0.001). The mean fecal elastase-1 result in chronic diarrhea and in dyspepsia were 316.29 ±_ 195.44 vs. 475.93 +. 65.33 fig El/g stool (p < 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency.Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea."

"Penyakit diare merupakan salah satu masalah utama kesehatan masyarakat di Indonesia. Diare termasuk dalam kelompok tiga penyebab utama kunjungan berobat ke Puskesmas/Balai Pengobatan. Angka kesakitan diare dalam setiap tahunnya sekitar 200-400 kejadian dari 1000 penduduk. Sebagian besar (70-80%) penderita adalah anak di bawah usia lima tahun dan mengalami lebih dari satu kejadian diare setiap tahunnya.Di Indonesia, angka kematian akibat diare selama 25 tahun terakhir telah menurun tajam, dari urutan pertama pada tahun 1972 menjadi urutan ke lima pada tahun 1996. Dibandingkan dengan penyebab kematian lainnya, kematian akibat diare pada tahun 1972, 1980, 1986, 1992 dan 1996 berturut-turut adalah 40%, 24,9%, 16%, 7,5% dan 7,4%. Menurut laporan Departemen Kesehatan, berdasarkan hasil Survey Kesehatan Rumah Tangga tahun 1983 dan 1986, di Indonesia seliap anak mengalami diare 1,6-2 kali setahun. Sebagian penderita (1-2%) jatuh ke dalam dehidrasi dan jika tidak segera ditolong, 50-60% di antaranya dapat meninggal.Di Medan, Metrizal dkk melaporkan jumlah kasus diare yang memerlukan perawatan di rumah sakit adalah sebanyak 45,4% dari seluruh kasus di bangsal perawatan dengan 51,3% di antaranya berusia kurang dart 2 tahun Ariyani melaporkan penelitian yang dilakukan di Departemen IKA FKUI/RSCM tahun 19964997, didapat kasus diare sebanyak 85 anak, 60% di antaranya laki-laki. Rentang umur pasien adalah 2-24 bulan dengan puncaknya pada usia 6-11 bulan (42,4%).Pada anak dengan diare berat, lebih dari 25% anak mengalami sindrom malabsorpsi. Beberapa penelitian yang dilakukan tentang kejadian intoleransi laktosa pada diare mendapatkan hasil sebagai berikut : Suharyono dkk mendapatkan angka sebesar 52,5% pada 838 penderita diare akut, Mustajab dkk di Manado mendapatkan angka intoleransi laktosa sebesar 63,2% pada anak dengan diare, Hegar dkk di Jakarta mendapatkan angka 23,1%, sedangkan Sunoto dkk mendapatkan angka intoleransi laktosa sebanyak 40% pada anak dengan diare melanjut. Dari beberapa penelitian pada bayi dan anak yang menderita diare yang dirawat di Bangsal Gastroenterologi Unit Anak RSCM/FKUI antara tahun 1971-1977 dan 1979-1980, Suharyono mendapatkan angka kejadian malabsorpsi lemak sebesar 57%, sedangkan Hegar dkk mendapatkan hasil 43,6%. Penelitian ini bertujuan untuk meneliti kembali kejadian intoleransi laktosa dan malabsorpsi lemak dengan jumlah sampel yang lebih besar dan diambil dari sampel selama 2 tahun terakhir."

"ABSTRAKLatar Belakang: Diare kronik meningkatkan risiko kematian serta morbiditas jangka panjang pada anak. Anak dengan infeksi HIV memiliki risiko lebih tinggi terjadi diare kronik. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran karakteristik, prevalensi, serta faktor risiko yang terkait dengan kejadian diare kronik pada pasien anak dengan infeksi HIV di Rumah Sakit Cipto Mangunkusumo. Faktor risiko yang diteliti ialah usia, status nutrisi, status dehidrasi, status pemberian ASI, fase infeksi HIV, penggunaan obat antiretroviral ARV , kultur tinja, serta sindrom malabsorbsi. Metode: Desain penelitian adalah potong lintang dengan sumber data dari rekam medis pasien departemen anak RSCM dengan infeksi HIV pada tahun 2014-2016. Seluruh data memenuhi kriteria dianalisis. Data dianalisis menggunakan analisis bivariat diikuti analisis multivariat. Hasil: Karena keterbatasan data rekam medis, variabel kultur tinja, sindrom malabsorbsi, serta status pemberian ASI dikeluarkan dari penelitian ini. Prevalensi diare kronik pada pasien anak HIV ialah 12,9 . Analisis multivariat atas 132 data menunjukkan hubungan bermakna antara gizi kurang dan buruk p=0,037, adjusted OR=5,737 dan dehidrasi p=0,026, adjusted OR=6,891 dengan kejadian diare kronik pada pasien anak dengan infeksi HIV. Diskusi: Hasil ini dapat dijelaskan dengan pengaruh imunosupresi dari status gizi yang rendah serta dehidrasi, selain bahwa diare pun dapat menyebabkan dehidrasi serta penurunan status gizi.

---

ABSTRACTIntroduction Chronic diarrhea increases mortality and other long term morbidities in children. Children with HIV infections are at higher risk of developing chronic diarrhea. Objective This study aims to investigate the characteristics, prevalence, and risk factors of chronic diarrhea in HIV children. Factors analyzed are age, nutritional status, dehydration status, breastfeeding, HIV infection phase, use of antiretroviral ARV drugs, stool culture, and malabsorbtive syndrome. Methods In this cross sectional study data are obtained from medical records of children with HIV infection in Cipto Mangunkusumo Hospital from 2014 until 2016. All data that satisfy the inclusion criteria and are not excluded are analyzed by bivariate followed by multivariate analysis. Results Due to insufficient data on stool culture, breastfeeding, and malabsorbtive syndrome, aforementioned variables are dropped from this study. Data shows that prevalence of chronic diarrhea in children with HIV in CMH is 12.9 . Analysis of 132 data shows that low nutritional status p 0.037, adjusted OR 5.737 and dehydration p 0.026, adjusted OR 6.891 are significantly associated with chronic diarrhea in HIV children. Discussions This finding may be due to the immunosupression caused by low nutritional status and dehydration, also by the fact that diarrhea can also cause a decrease in nutritional status and induce dehydration."

"ABSTRAKIndonesia merupakan negara berkembang yang mempunyai peluang besar terhadap mortalitas kejadian diare kronik dengan kultur tinja positif. Penelitian bertujuan untuk mengetahui faktor risiko pada pasien anak diare kronik non HIV dengan kultur tinja positif. Penelitian ini dilakukan dengan menggunakan desain potong lintang menggunakan data rekam medis. Penelitian ini menggunakan sampel sebanyak 45 yang dipilih berdasarkan kriteria inklusi dan eksklusi. Hubungan antar variabel dianalisis menggunakan uji bivariat Chi Square dan Fisher dan analisis multivariat uji Regresi Logistik. Dari hasil uji Chi Square didapatkan faktor risiko dehidrasi dan konsumsi antibiotik terhadap nilai hasil kultur tinja pasien diare kronik, bernilai p=0,027 dan p=0,058. Analisis multivariat uji Regresi Logistik tidak dapat dilakukan karena terdapat jumlah 0 pada data konsumsi antibiotik. Pada akhirnya, dapat disimpulkan bahwa dehidrasi dan pemberian antibiotik merupakan faktor yang berhubungan terhadap diare kronik dengan hasil kultur tinja positif berdasarkan analisis bivariat.

---

ABSTRACTIndonesia is developing country that has big risk of diarrhea mortality. The study aimed to know risk factors of pediatric chronic diarrhea non HIV with positive stool culture The study is conducted by using the analytical observational cross sectional study. The samples used in this study were 45 respondents selected by inclusion exclusion criteria. The relationship between variabels was analyzed by bivariate test Chi Square and multivariate analysis Logistic Regretion. Based on Chi Square test, relationship between stool culture with dehydration and antibiotics as risk factors, sequentiallly p 0.027 and p 0.058. Multivariate analysis Logistic Regretion can not be applied because there is quantity ldquo 0 rdquo in antibiotics use. In the end, the result is dehydration and antibiotics use are factors that correlate with chronic diarrhea with positive stool culture based on result of bivariate analysis."