The gastro-esophageal reflux disease questionnaire using Indonesian language: A language validation survey.

Background: The aims of this study were to test the usefulness of the Gastro-esophageal Reflux Disease Questionnaire (GERDQ) in the diagnosis of GERD, to validate the GERDQ written in Indonesian language, and to evaluate the reliability of the GERDQ for use in Indonesian-speaking GERD patients (Virginia study). Methods: This was a prospective survey of 40 patients diagnosed with GERD, based on an endoscopic examination, in 3 cities in Indonesia (Jakarta, Bandung, and Surabaya) from 15 January to 15 May 2009. Patients were asked to complete the GERDQ, and the validity and reliability of the questionnaire were assessed. Results: The percentages of respondents who reported symptoms lasting 4–7 days were as follows: 68% had a burning sensation behind the breastbone (heartburn); 65% had stomach content (fluid) move upwards to the throat or mouth (regurgitation); 70% had a pain in the centre of the upper abdomen; 58% had nausea; 63% had difficulty sleeping because of the heartburn and/or regurgitation; and 63% took additional medication for heartburn and/or regurgitation. Cronbach’s alpha was 0.83, indicating that all of the questions in the Indonesian-language GERDQ are valid and reliable for Indonesian GERD patients. Conclusions: This study achieved the primary objectives and showed that the GERDQ is valid and reliable for use with Indonesian-speaking GERD patients. The results were consistent with those of the DIAMOND study, which showed that the GERDQ can be used to diagnose GERD on the basis of the reported symptoms.

A comparison of 5 or 7 days of rabeprazole triple therapy for eradication of Helicobacter pylori.

Aim A combination of PPI and 1000 mg amoxicillin/500 mg clarithromycin twice daily for 2 weeks has been proven effective in the eradication of H. pylori. Most studies suggested that treatment for 7 and 10 days may be equally effective. Few data are available on the effi cacy of 5-day triple therapy. Aim of this study was to compare 5-day and 7-day rabeprazole triple therapy for eradication of H. pylori infection. Methods We prospectively studied 60 consecutive H. pylori-infected patients who came to hospitals in six centres in Indonesia and who underwent upper endoscopy and biopsy. H. pylori infection was confi rmed if two rapid urease tests (Pronto Dry) and histology or urea breath test were positive. Patients were assigned to either an open-labelled 5-day or 7-day course of oral amoxicillin 1000 mg b.i.d., clarithromycin 500 mg b.i.d., and rabeprazole 10 mg b.i.d. (RAC). Four weeks after therapy, all patients had a repeated UBT for evaluation of the presence of H. pylori. Results Of the 60 patients (42 males and 18 females) with mean age (± SD) 47.63 ± 13.93 years, range 21–74 years, 25 patients (41.7%) had 5-day treatment and 35 patients (58.3%) had 7-day treatment. With 5-day treatment, 18 patients (72%) and with 7-day treatment 32 patients (91.4%) became negative for H. pylori infection. The eradication failure was found on 7 patients (28.0%) in 5-day treatment and 3 patients (8.6%) in 7-day treatment. Conclusions The study showed that the eradication of H. pylori infection by triple rabeprazole-based treatment in 7-day is still better than in 5-day.

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.