The World Health Organization (WHO) has declared COVID-19 as global pandemic since there are tremendous growing numbers of confirmed cases for SARS-C0V-2 infection, the number of affected countries ...and high mortality rate. The global COVID-19 pandemic also will affect various aspects of health care including endoscopic service. The Indonesian Society for Digestive Endoscopy (ISDE), which provides a scope for doctors who perform endoscopic procedures, has developed a clinical and procedural guideline that may serve as a reference for doctors performing gastrointestinal endoscopy in Indonesia.
Chronic dyspepsia's symptoms are frequently seen in primary to tertiary healthcare in Indonesia. This study aimed to describe the potential usability of pepsinogen (PG) values in determining gastric ...mucosal conditions, including superficial gastritis and atrophic gastritis.
We recruited 646 adult dyspeptic patients and then analyzed PG values (including PGI, PGII, and PGI/II ratio) with endoscopic findings, gastric mucosal damages, and
infection. The gastric mucosal damage and
infection were evaluated using histological examination based on the updated Sydney system.
Among 646 enrolled patients, 308 (47.2%), 212 (32.8%), 91 (14.1%), 34 (5.2%), and 1 (0.2%) patient were diagnosed with normal mucosa, gastritis, reflux esophagitis, peptic ulcer disease, and gastric cancer, respectively. Significant differences in PGI, PGII, and PGI/II ratio values were observed among ethnic groups (all
< 0.01). The PGI and PGII levels were significantly higher and PGI/II was significantly lower in
-infected patients than in uninfected ones (all
< 0.001). The optimal cutoff value for PGII and PGI/II was 12.45 ng/mL with an area under the curve (AUC) value of 0.755 (0.702-0.811), sensitivity 59.3%, and specificity 77.1%; and 4.75 with AUC value of 0.821 (0.763-0.855), sensitivity 81.5%, and specificity 78.7%, respectively, to determine moderate-severe atrophy.
Serum PG levels, a useful biomarker, represent the endoscopic findings, especially for reflux esophagitis. In addition, the benefits of PG values detecting atrophic gastritis were limited to moderate-severe atrophic gastritis. This usefulness requires careful attention for several ethnic groups in Indonesia.
Background:
Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive epidemiologic study is necessary to explore infection ...susceptibility by demographic characteristics, especially between Indonesia's Eastern and Western regions.
Methods: We included our recent survey and data from our previous studies with 1,172 endoscopic examinations from 19 cities throughout Indonesia from January 2014 to March 2017.
H. pylori infection was diagnosed based on a combination of four different tests. Using a criterion of one positive result between four tests, we found that 190 subjects (190/1,158; 16.4%) were
H. pylori positive. A total of 939 subjects were analyzed for risk factors of sociodemographic characteristics of
H. pylori infection.
Results: Prevalence was slightly higher in the Eastern region compared with the Western region of Indonesia (79/277; 59.4%
vs. 54/529; 40.6%). Living in the Eastern region imposes a higher risk of infection (OR 5.33, 95%CI 1.17-24.26). Timor ethnicity had the highest prevalence (15/28; 53.6%), followed by Buginese ethnicity (21/74; 28.4%), and Papuan ethnicity (18/64; 28.1%) in the Eastern region. As an ethnicity with a high prevalence (37/109; 33.9%), Batak was an outlier among the low prevalence areas in the Western region. In general, age, living in the Eastern region, Batak ethnicity, Protestant, Catholic, and alcohol drinking were independent risk factors associated with
H. pylori infection in Indonesia (OR 1.03, 95%CI 1.02-1.05; OR 5.33, 95%CI 1.17-24.26; OR 5.89, 95%CI 1.58-21.94; OR 5.47, 95%CI 2.16-13.86; OR 5.05, 95%CI 1.43-17.80; OR 2.30, 95%CI 1.14-4.61, respectively).
Conclusions: Several ethnicities and habits were concluded to increase the risk of infection as the interaction of host, agent, and environment is inseparable in affecting disease susceptibility.
Pancreatic and peripancreatic tuberculosis is a rare abdominal tuberculosis. Diagnosis for pancreatic tuberculosis can be challenging. Conventional imaging tools may show mass or malignancy in the ...pancreas. Endoscopic ultrasound (EUS) is an excellent tools for evaluating pancreas and peri pancreas region. It also allows us to obtain tissue sample for cytology and histopathology. Here we present a case of peripancreatic tuberculosis lymphadenopathy that mimic pancreatic mass. His symptoms were also nonspecific (weight loss, epigastric pain, and irregular fever). From EUS evaluation we found that there was no mass but multiple lymphadenopathy around the pancreas and then performed FNA. The result of the cytology was granuloma inflammation and caseous necrosis which is compatible with tuberculosis infection. From this case illustration we conclude that EUS is an important diagnostic tool for pancreatic lesion to avoid unnecessary surgery.
to review the effectiveness of tranexamic acid therapy which has been proposed to reduce bleeding and in turn lower mortality rate.
following literature searching based on our clinical question on ...Cochrane Library, PubMed, Clinical Key, EBSCO, Science Direct and Proquest, one systematic review that includes seven randomized controlled trials is obtained. The article meets validity and relevance criteria.
the systematic review found that there is no any clear evidence between intervention and control groups in term of mortality.
the use of tranexamic acid to reduce mortality in patients with upper gastrointestinal bleeding is not recommended.
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 1980's, 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.
Coronavirus disease-19 (COVID-19) is a respiratory disease caused by novel SARS-CoV-2. The disease has become a global pandemic since March 2020. Transmission of the disease is rapid and contagious ...through droplets and contaminated environments. Meanwhile, gastrointestinal endoscopy is a procedure that has a high risk of transmitting COVID-19. Proper strategies are needed to prevent transmission of the virus in the endoscopic unit. Some literature has published the guidelines for prevent COVID-19 in endoscopic units such as guidelines by AGA, APSDE, ESGE and ESGENA. These guidelines state that strategies for prevent the COVID-19 transmission in endoscopy unit must be done from before the procedure, during the procedure until after the procedure. These strategies must be followed by all patients and health care providers who working in endoscopy units.
