Comparison of endoscopic gastric mucosa features after administration of piroxicam to meloxicam and their correlation with dyspepsia symptoms in elderly patient with knee osteoarthritis.

AIM: to know the effect of piroxicam (COX-1 and COX-2 inhibitor NSAID) and meloxicam (selective COX-2 inhibitor NSAID) against the gastric mucosa. METHODS: a random, double-blind-parallel study and repeat measurement against 20 elderly-patients with knee-OA was conducted. Patients were divided into 2 equal groups, every group got piroxicam 20 mg/day or meloxicam 15 mg/day for 3 weeks. On the second group, sukralfat 2 x 1 g/day were given. To examine the difference before and after treatment, we used Wilcoxon signed rank test, to examine the difference within those groups we used Mann-whitney U test, to examine the correlation between endoscopic score and dyspepsia, we used the Spearman correlation test with significant correlation interpretation by Guilford rules. RESULTS: one of piroxicam group was resigned, so that there was 19 person left to complete this study. Piroxicam has caused elevation of endoscopic score in 78% subject compared to the beginning of study, and 22% of the subject has developed ulcers. Alteration of endoscopic feature after administration of this piroxicam was statistically significant (p< 0,05). Mild dyspepsia symptoms after piroxicam administration were positive on 67% subjects (p< 0,05). After administration of meloxicam, 40% subjects have elevated endoscopic score compared to beginning of the study (p< 0,05). Mild dyspepsia symptoms after meloxicam administration were positive on 40% subjects (p> 0,05). Meloxicam has less elevation of endoscopic score compared to the piroxicam (p< 0,05). By statistics, both of groups showed no difference in dyspepsia symptoms (p> 0,05). There was no significant correlation between elevation of endoscopic score and dyspepsia on both of groups. Nevertheless, it tends to have weak positive correlation (piroxicam group r= 0,306, p> 0,05, meloxicam group r= 0,330, p> 0,05). CONCLUSION: on this study, we conclude that the administration of either piroxicam or meloxicam in elderly-patient with knee-OA has caused the gastric mucosa impairment. The impairment after meloxicam administration is milder than piroxicam. There is no significant difference of dyspepsia symptoms in both of groups. There is correlation between endoscopic gastric mucosa features with the dyspepsia symptoms.

Correlation between anthropometrics measurements, prealbumin level and transferin serum with Child-Pugh classification in evaluating nutritional status of liver cirrhosis patient.

AIM: to evaluate nutritional status by using anthropometrics and biochemistry examination and to determine the correlation between albumin, prealbumin and transferin serum level with anthropometrics measures in liver cirrhosis patient according to Child-Pugh classification. METHODS: study was conducted on 30 patients with liver cirrhosis Child-Pugh A, B and C. There were 8 patient of Child-Pugh A, 18 Child-Pugh B and 4 Child-Pugh C. Every patient underwent anthropometrics and biochemistry examination including ideal body weight (IBW), body mass index (BMI), triceps skin-fold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), albumin, prealbumin and transferin serum. We used statistical analysis Spearman and Pearson correlation test. RESULTS: by IBW and BMI measurement, most of liver cirrhosis patients indicated normal results. By MAMC measurement, there was no liver cirrhosis patient with good nutritional status. Most of them have slight and moderate malnutrition. There was no significant correlation between anthropometrics measurement with Child-Pugh score, with [p > 0.01]. And also, there was no significant relationship between albumin, prealbumin and serum transferin with anthropometrics measures, but there was significant correlation between prealbumin and transferin level with Child-Pugh score, with [p < 0.01]. CONCLUSION: the conclusion of this study is prealbumin and transferin level may be used to evaluate nutritional status of liver cirrhosis patient, and on the contrary with anthropometrics measures. There was no correlation between anthropometrics measures with albumin, prealbumin and transferin level.

DHF with complication of acute pancreatitis related hyperglycemia: a case report.

DHF is endemic in Indonesia, with incidence of 9.72/100,000 population and CFR of 2.5%. Acute pancreatitis is a rare complication in DHF, usually without hyperglycemia. We report here 1 patient of DHF grade II with complication of acute pancreatitis, and hyperglycemia which occured as a result of pancreatitis. A 24 years old female was referred from Santa Jusuf Hospital, with 5 days of fever and hematemesis. On physical examination we found slight fever and hematoma on her left leg. Laboratory examination revealed Hb 13.4 g%, WBC 8,500/mm3, Ht 42%, platelets 22,500/mm3, amylase 317 U/l, lipase 1,198 U/l and blood glucose 397 mg%. CT scan result of pancreas was consistent with acute pancreatitis. Diagnosis of dengue infection was made after the finding of positive IgM and IgG for dengue virus. After 18 days clinical symptoms and signs and laboratory results returned to normal.