Ari Fahrial Syam
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia/Dr.Cipto Mangunkusumo General National Hospital, Jakarta

Published : 215 Documents
Articles

PCS-5 NITRIC OXIDE INDUCED BASAL CELL HYPERPLASIA AND LAMINA PROPRIA ELONGATION IN RAT GASTROESOPHAGEAL JUNCTION Djuartina, Tena; Priosoeryanto, Bambang Pontjo; Syam, Ari Fahrial; Aulia, Ahmad; Dewi, Tri Isyani Tungga
Hemera Zoa Proceedings of the 20th FAVA & the 15th KIVNAS PDHI 2018
Publisher : Hemera Zoa

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Abstract

NO (Nitric Oxide) is an inorganic compound composed of nitrogen and oxygen, NO is also produced in various places on various types of mammalian cells. NO as a radical compound is important in mediating physiological and pathological events in mammals including humans [1].GEJ (gastroesophageal junction) is a transition zone between the surface of esophagus which is covered by stratified squamous epithelium to the gastric mucosa which consists of simple columnar epithelium (z-line), where circular muscle of esophagus fuse with oblique muscle and lipid layer of the gaster. At the lower part of GEJ, there is the lower esophageal sphincter (LES) that not only allow food to move into stomach and works as an exit passage of the gas, but also inhibit reflux of any substances that potentially can cause harm to the esophagus [2].Petersson et al, found that chronic exposure to cytotoxic levels of NO can cause inflammation, intestinal metaplasia and neoplasia. Although it is known that gastric acid, pepsin and bile acids can cause adenocarcinoma of distal esophagus and GEJ, NO exposure and nitrosative stress role in this phenomenon is yet to be fully understood and further study is needed [3].The purpose of this was to identify and compare the histopathological changes occurring in GEJ in relation to administration of physiological concentration of nitrate dissolved in HCl and ascorbic acid. As such, the animal model used in this study can be used to study and represent the changes microscopically, because obtaining a full thickness biopsy from a human subject can be difficult to perform.
Conformity between Ileoscopy Appearance with Terminal Ileum Histopathology Appearance in Normal Colonoscopy Chronic Diarrhea Patients Marki, Indra; Syam, Ari Fahrial; Hasan, Irsan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 2 (2014): VOLUME 15, NUMBER 2, August 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/152201488-92

Abstract

Background: Chronic diarrhea is one of the most common problem in gastroenterology cases. Ileoscopy is one of the modalities to determine the etiology of chronic diarrhea by normal colonoscopy appearance. Recently, there is still controversy in the need of this examination in normal macroscopic appearance. The aim of this study is to study the conformity of histopathology abnormalities with ileoscopy appearance in chronic diarrhea patients with normal colonoscopy.Methods: This study uses cross sectional study design by collecting 60 medical record data in several hospitals in Jakarta in the period of 1 January 2005 to 31 December 2011. Diagnostic test between ileoscopy and histopathology is performed by histopathology examination as a gold standard.Results: Study results revealed conformity between both examinations for 93.33%. Sensitivity value of ileoscopy examination compared to histopathology as a gold standard was 94%, specificity 90%, positive predictive value 97.9%, and negative predictive value 75%.Conclusion: Ileoscopy examination in chronic diarrhea patients and normal colonoscopy showed similar results with histopathology examination. Keywords: Ileoscopy, histopathology, conformity, chronic diarrhea
Dyspepsia and Helicobacter pylori Infection Syam, Ari Fahrial
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/15120141-2

Abstract

No abstract available
Relationship Between Vascular Endothelial Growth Factor and Severity of Hepatocellular Carcinoma -, Arles -; Gani, Rino Alvani; Syam, Ari Fahrial; Shatri, Hamzah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (568.663 KB) | DOI: 10.24871/162201567-72

Abstract

Background: Severity of hepatocellular carcinoma (HCC) that is assessed using Barcelona Clinic Liver Cancer (BCLC) classification is a main prognostic factor of hepatocellular carcinoma. Assessment of the serum level of Vascular Endothelial Growth Factor (VEGF) is considered to reflect the severity of HCC. However, there is still no fundamental basis of the association of severity of HCC with the serum VEGF level. The objective of this study is to know the relationship between serum VEGF levels with the severity of HCC by assessing the average difference of serum VEGF level in various severity of HCC.Method: This study was a cross sectional study to identify the association between serum VEGF levels with the severity of HCC based on BCLC classification. This study was performed in Cipto Mangunkusumo Hospital between January and May 2015. Statistical tests used to evaluate the association between serum VEGF level with BCLC classification was one-way ANOVA analysis, and continued with post hoc Tukey Schaffe analysis.Results: A total of 61 subjects with HCC were included into this study. In this study, we did not find subjects with stage 0 BCLC. The average of serum VEGF level in stage A BCLC was 288.26 ± 156.6 pg/mL; stage B BCLC: 434 ± 164.8 pg/mL; stage C BCLC: 785.57 ± 194.25 pg/mL; stage D BCLC: 1537.97 ± 660.62 pg/mL. One-way ANOVA analysis showed significant difference (P < 0.001) between serum VEGF level and HCC severity based on BCLC classification. Post hoc Tukey Schaffe analysis showed the presence of significant difference between stage A and C BCLC (p < 0.05) and stage A and D BCLC (p < 0.001), stage B and D BCLC (p < 0.001), and stage C and D BCLC (p < 0.001). There was no significant difference between stage A and B BCLC, and between stage B and C BCLC.Conclusion: It was found that serum VEGF level increased in accordance to the HCC severity based on BCLC classification, particularly for stage B BCLC and above.
Upper Gastrointestinal Abnormalities in Esophagogastroduodenoscopy Examination: Descriptive Study in PSUPAU Endoscopic Unit Pribadi, Julwan; Sedijono, Sedijono; Suryantini, Suryantini; Simadibrata, Marcellus; Syam, Ari Fahrial; Abdullah, Murdani; Fauzi, Achmad; Makmun, Dadang; Manan, Chudahman; Daldiyono, Daldiyono; Rani, Abdul Aziz
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/93200882-85

Abstract

Background: The Endoscopy Unit of Indonesian Air Force Central Hospital Dr. Esnawan Antariksa, Jakarta, Indonesia, has just been established in late 2004 and it is still in developing process. This study was aim to depict the profile of patients who underwent esophagogastroduodenoscopy procedure in the unit. Method: This study was a retrospective study that analyzed data in endoscopic registry of patients who underwent esophagogastroduodenoscopy (EGD) examination from September 2004 to December 2007. Result: Total of 108 patients underwent EGD examination, comprised of 66 (61%) males and 42 (39%) females, with average age of 45.4 years old (range 16-77 years old). The most frequent indication for EGD was dyspepsia 63%, followed by hematemesis-melena 26% and dysphagia 5.5%. Among patients with dyspepsia, EGD revealed organic abnormalities in 71% patients, with descriptions of erosive gastritis 35%, gastritis 18%, bile reflux 7%, esophagitis 5% and gastric ulcer 3%. Among patients with hematemesis-melena, EGD revealed abnormalities, which were described as erosive gastritis 48%, esophageal varices bleeding 22%, gastric ulcer 18%, caustic injury 4%, and esophagitis 4%. Conclusions: EGD is an important procedure to ascertain the occurence of organic abnormalities in patient with gastrointestinal symptoms and signs e.g. dyspepsia and gastrointestinal bleeding. More than half of patients with dyspepsia showed organic abnormalities. Among patients with hematemesis-melena, erosive gastritis is more common than variceal bleeding. Keywords: esophagogastroduodenoscopy, dyspepsia, upper gastrointestinal bleeding, hematemesis melena
Diagnostic Problems in Crohnƒ's Disease: A Case Report Zakaria, Rio; Fauzi, Achmad; Abdullah, Murdani; Syam, Ari Fahrial
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1232011185-191

Abstract

Crohn’s disease is marked by transmural inflammation of the digestive tract and is categorized into inflammatory bowel disease (IBD). In Indonesia, Simadibrata et al, reported 20% from 107 patients who experienced non-infective chronic diarrhea, actually suffered from IBD. A 33-year old male patient complained of watery stool since 3 months before hospital admission. He experienced stabbing stomachache and loss of body weight. Physical and laboratory examination results were within normal limits. Faecal analysis revealed intestinal infection caused by gram-negative bacteria and intestinal maldigestion. Colonoscopy examination exhibited the presence of hyperemic mucosa, edematous, and positive cobblestone appearance in the terminal ileum. Additionally, the histological evaluation showed the impression of chronic ileitis usually found in IBD. Meanwhile, moderate pangastritis was obtained in the esophagoduodenoscopy examination. results of histological biopsy of the antrum showed absence of Helicobacter pylori infection. An active lesion in chronic ileitis was found in immunohistochemistry examination. Acid fast bacterial culture was also performed to the ileum tissue and revealed negative results in clinical microbiology examination. From the examinations conducted, patient was diagnosed as Crohn’s disease and treated with budesonide capsule 3 mg and mesalazine tablet 1,000 mg twice daily. Later, he felt improvement of the complains. This case illustrated Crohn’s disease which is rarely found in Indonesia. This is because diagnosis requires supporting examinations which could only be done in tertiary health care facilities. However, possibility of other diagnosis should be considered, particularly intestinal tuberculosis and infective colitis. Early diagnosis and prompt treatment may improve patient’s prognosis and quality of life. Keywords: IBD, Crohn’s disease, positive cobblestone
Risk Factors for the Occurrence of Erosive Esophageal in Patients with Dyspepsia Setyawati, Katharina; Abdullah, Murdani; Syam, Ari Fahrial
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: The prevalence of erosive esophagitis tends to increase recently. It induces higher medical expense, loss of working time, and decreases quality of life. However the study on risk factors of erosive esophagitis scarcely reported in Indonesia. This study aimed to find the association between age, sex, smoking, alcohol drinking, body mass index, hiatal hernia, the use of non steroidal anti-inflammatory drugs (NSAID), and drugs that decrease lower esophageal sphincter (LES) tone with the occurrence of erosive esophagitis in dyspeptic patients. Method: A case-control study was conducted on patients with dyspepsia who underwent upper gastrointestinal endoscopy procedure and had been interviewed to determine risk factors for erosive esophagitis in July - September 2008. The association between risk factors and the occurrence of erosive esophagitis were analyzed using Chi-square, which subsequently revealed p &lt; 0.25, this variable included in multivariate analysis. Result: There were 135 patients fulfilled criteria; 45 patients as cases and 90 patients as controls. The association was found between the occurrence of erosive esophagitis in dyspeptic patients and smoking more than 15 cigarette/day (OR 15.43; p = 0.00; CI 95% 4.77-49.88), the use of NSAID (OR 9.49; p = 0.00; CI 95% 2.77-32.53) and the consumption of drugs that decrease LES tone (OR 3.56; p = 0.02; CI 95% 1.26-10.02). Conclusion: Smoking more than 15 cigarettes/day, use of NSAID and drugs that decrease LES tone is a risk factors for the occurrence of erosive esophagitis. Keywords: erosive esophagitis, NSAID, smoking, drugs that decrease LES tone
Through-the-scope Polyethylene Balloon Dilations in Benign Corrosive Esophageal Stricture Complicated with Temporomandibular Joint Dislocation Arsita, Elli; Fauzi, Achmad; Gunawan, Jeffri; Renaldi, Kaka; Syam, Ari Fahrial; Abdullah, Murdani; Simadibrata, Marcellus; Makmun, Dadang; Manan, Chudahman; Rani, Abdul Aziz; Daldiyono, Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Esophageal dilation is a non-surgical management for anatomic and functional abnormalities causing both benign and malignant esophageal stricture. The basic goals of stricture dilation include safe and efficacious lumenal enlargement plus prevention of restenosis. These could be achieved using through- the-scope (TTS) balloon dilations, ranged in diameter of 4 to 40 mm, they will allow dilation of previously inaccessible strictures in the esophagus, stomach, small bowel, and colon. There are 5,000–15,000 cases of stricture due to ingestion of corrosive substances in United States every year. The following case would demonstrate a 28-year-old male with depressive disorder who attempted a suicide by ingesting corrosive substances two months before admission. Subsequently he started having difficulty in swallowing even soft foods. The complaint was gradually increasing until a month before admission he went through endoscopic examination and a corrosive esophageal stricture found. Hence after, he underwent dilation using Savary bouginage with fluoroscopy and through-the-scope (TTS) balloon dilations. The patient underwent a series of dilation treatment and demonstrated vigorous improvement. Problems raised as the patient was complicated with temporomandibular joint (TMJ) dislocation due to traumatic injury after ingesting corrosive substances. The consideration in management of esophageal stricture with complications will be discussed further in this article. Keywords: esophageal stricture, corrosive substances, dysphagia, temporomandibular joint dislocation, through-the-scope polyethylene balloon dilation
Management of Constipation Toruan, Toman L; Syam, Ari Fahrial; Simadibrata, Marcellus; Abdullah, Murdani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

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. Keywords: Constipation, colonic transit time test, high fiber diet, laxatives
Upper Gastrointestinal Abnormalities in Esophagogastroduodenoscopy Examination: Descriptive Study in PSUPAU Endoscopic Unit Pribadi, Julwan; Sedijono, Sedijono; Suryantini, Suryantini; Simadibrata, Marcellus; Syam, Ari Fahrial; Abdullah, Murdani; Fauzi, Achmad; Makmun, Dadang; Manan, Chudahman; Daldiyono, Daldiyono; Rani, Abdul Aziz
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: The Endoscopy Unit of Indonesian Air Force Central Hospital Dr. Esnawan Antariksa, Jakarta, Indonesia, has just been established in late 2004 and it is still in developing process. This study was aim to depict the profile of patients who underwent esophagogastroduodenoscopy procedure in the unit. Method: This study was a retrospective study that analyzed data in endoscopic registry of patients who underwent esophagogastroduodenoscopy (EGD) examination from September 2004 to December 2007. Result: Total of 108 patients underwent EGD examination, comprised of 66 (61%) males and 42 (39%) females, with average age of 45.4 years old (range 16-77 years old). The most frequent indication for EGD was dyspepsia 63%, followed by hematemesis-melena 26% and dysphagia 5.5%. Among patients with dyspepsia, EGD revealed organic abnormalities in 71% patients, with descriptions of erosive gastritis 35%, gastritis 18%, bile reflux 7%, esophagitis 5% and gastric ulcer 3%. Among patients with hematemesis-melena, EGD revealed abnormalities, which were described as erosive gastritis 48%, esophageal varices bleeding 22%, gastric ulcer 18%, caustic injury 4%, and esophagitis 4%. Conclusions: EGD is an important procedure to ascertain the occurence of organic abnormalities in patient with gastrointestinal symptoms and signs e.g. dyspepsia and gastrointestinal bleeding. More than half of patients with dyspepsia showed organic abnormalities. Among patients with hematemesis-melena, erosive gastritis is more common than variceal bleeding. Keywords: esophagogastroduodenoscopy, dyspepsia, upper gastrointestinal bleeding, hematemesis melena
Co-Authors -, Arles - -, Suhendro - -, Suhendro - Aan Santi Abdul Aziz Rani Achmad Fauzi Adiwinata, Sheila Adjeg Tarius Afifah Is Agnes Kurniawan Ahimsa, Titos Ahimsa, Titos Ahmad Aulia Ahmad Fauzi Ali Imron Yusuf Alkindi Bahar Amanda Pitarini Utari ANDI KRISTANTO Andreas Pekey, Andreas Andree Kurniawan Andri Sanityoso Anggilia Stephanie, Anggilia Ari, Franciscus Armen Muchtar Arya Govinda Aryanto Basuki Awang, Iqbal I Aziz Rani BAMBANG PONTJO PRIOSOERYANTO Bambang Setyohadi Bhanu S Kumar Birry Karim Bona Adhista Bradley Jimmy Waleleng Budi Tan Oto C Rinaldi A. Lesmana, C Rinaldi A. C Rinaldi Lesmana, C Rinaldi Caputra, Hadyanto Catarina Budyono, Catarina Ceva Wicaksono Pitoyo Christy Efiyanti Chudahman Manan Chyntia Olivia MJ Cleopas Martin Rumende Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dante Saksono Harbuwono, Dante Saksono Dante Saksono, Dante Deddy Gunawanjati Dedy Gunawanjati Sudrajat Dewi, Tri Isyani Tungga Dharmika Djojoningrat Diah Rini Handjari Diany N Taher Didi Kurniadhi Djulzasri Albar Dwi Suseno E Mudjaddid, E Eka Ginanjar Ekowati Rahajeng Elizabeth Merry Wintery Ellen Susanti Elli Arsita Elza Febria Sari Endang Susalit Ening Krisnuhoni Esthika Dewiasty, Esthika Euphemia Seto, Euphemia Evita H Effendi Evy Yunihastuti Fajar Raditya Feriadi Suwarna FJW Ten Kate Gerie Amarendra Ginova Nainggolan GNJ Tytgat Grace Nami Sianturi Gunawanjati Sudrajat Hamzah Shatri Hantoro, Ibnu Fajariyadi Haris Widita Haryanto Rahardjo Hasan Maulahela, Hasan Hayatun Nufus Helsi Helsi Herardi, Ryan Heru Sundaru Hery Djagat Purnomo Hotmen Sijabat Ikhwan Rinaldi Ilham Ahmadi Ilum Anam, Ilum Imam Subekti Ina Susianti Timan Indra Marki Indra, Suwito Irsan Hasan Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jeffri Gunawan Joseph JY Sung Julwan Pribadi Jumhana Atmakusuma Kaka Renaldi Karmel Tambunan Katharina Setyawati Khaira Utia Yusrie Kharia Utia Khie Chen L A Lesmana Laurentika, Ira Laurentius A Pramono, Laurentius A Laurentius Aswin Pramono Laurentius Lesmana Leonard Nainggolan Listya, Luh Putu Luciana Budiati Sutanto Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Marcellus S Kolopaking Marcellus S. Kolopaking Marcellus Simadibrata Marcellus Simadibrata K Marcellus Simadibrata Kolopaking Marthino Robinson Moch Ikhsan Mokoagow Murdani Abdulah Murdani Abdullah Nata Pratama Nikko Darnindro Novie Rahmawati Zirta Nugroho, Prionggodigdo Nunung Ainur Rahmah Nur Rasyid Nurul Akbar Oktaramdani, Tessa Paulus Kusnanto Phang, Beatrice Belinda Purwita W Laksmi, Purwita W Puspita, Florentina Caroline Putri, Leonita Ariesti Rabbinu Rangga Pribadi Radhiyatam Mardhiyah, Radhiyatam Rahardja, Cindy Ralph Girson Ralph Girson Gunarsa Randy Adiwinata, Randy Ranty, Stefanus Satrio Rasidi, Josephine Resti Mulya Sari Riadi Wirawan Riahdo Saragih Rino A Gani Rino Alvani Gani Rio Zakaria Rolan Sitompul Ryan Ranitya Sayid Ridho Sedijono Sedijono Seri Mei Maya Ulina Simon Salim Siti Setiati Stella Evangeline Bela Stephanie Dewi, Stephanie Steven Sumantri Suhendro Suhendro Suhendro Suwarto, Suhendro Sumaryono Sumaryono Suryantini Suryantini Suzana Ndraha Taufiq Taufiq Teguh Hardjono Tena Djuartina, Tena Timoteus Richard, Timoteus Tito Ardi Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Vera D Yoewono Vera Yoewono Vera Yuwono Wardhana, Agasjtya Wisjnu Willy Brodus Uwan, Willy Brodus Wina Sinaga Wirasmi Marwoto Wulyo Rajabto