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Carvedilol vs endoscopic variceal ligation for primary and secondary prevention of variceal bleeding: Systematic review and metaanalysis

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World Journal of Hepatology 2019年第5期11卷 464-476页

作者： Michael Dwinata David Dwi Putera Muhamad Fajri Adda’i Putra Nur Hidayat irsan hasan Department of Internal Medicine Depati Hamzah General HospitalPangkalpinang 33684Indonesia School of Medicine and Public Health University of SydneySydney 2006Australia Faculty of Medicine Public Healthand NursingUniversitas Gadjah MadaYogyakarta 55281Indonesia Hepatobiliary Division Department of Internal MedicineFaculty of Medicine Universitas IndonesiaCipto Mangunkusumo National General HospitalJakarta 10430Indonesia

BACKGROUND Variceal hemorrhage is associated with high mortality and is the cause of death for 20–30%of patients with ***βblockers(NSBBs)or endoscopic variceal ligation(EVL)are recommended for primary prevention of variceal bleeding in patients with medium to large esophageal ***,combination of EVL and NSBBs is the recommended approach for the secondary *** has greater efficacy than other NSBBs as it decreases intrahepatic *** hypothesized that there was no difference between carvedilol and EVL intervention for primary and secondary prevention of variceal bleeding in cirrhosis *** To evaluate the efficacy of carvedilol compared to EVL for primary and secondary prevention of variceal bleeding in cirrhotic patients METHODS We searched relevant literatures in major journal databases(CENTRAL,MEDLINE,and EMBASE)from March to August *** with cirrhosis and portal hypertension,regardless of aetiology and severity,with or without a history of variceal bleeding,and aged≥18 years old were included in this *** randomized controlled trials(RCTs)that compared the efficacy of carvedilol and that of EVL for primary and secondary prevention of variceal bleeding and mortality in patients with cirrhosis and portal hypertension were considered,irrespective of publication status,year of publication,and *** Seven RCTs were *** four trials assessing the primary prevention,no significant difference was found on the events of variceal bleeding(RR:0.74,95%CI:0.37-1.49),all-cause mortality(RR:1.10,95%CI:0.76-1.58),and bleedingrelated mortality(RR:1.02,95%CI:0.34-3.10)in patients who were treated with carvedilol compared to *** three trials assessing secondary prevention,there was no difference between two interventions for the incidence of rebleeding(RR:1.10,95%CI:0.75-1.61).The fixed-effect model showed that,compared to EVL,carvedilol decreased all-cause mortality by 49%(RR:0.51,95

关键词： Carvedilol Liver cirrhosis Variceal hemorrhage Portal hypertension Prophylaxis

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Hepatitis B virus subgenotypes and basal core promoter mutations in Indonesia

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World Journal of Gastroenterology 2009年第32期15卷 4028-4036页

作者： Andi Utama Sigit Purwantomo Marlinang Diarta Siburian Rama Dhenni Rino Alvani Gani irsan hasan Andri Sanityoso Upik Anderiani Miskad Fardah Akil Irawan Yusuf Wenny Astuti Achwan Soewignjo Soemohardjo Syafruddin AR Lelosutan Ruswhandi Martamala Benyamin Lukito Unggul Budihusodo Laurentius Adrianus Lesmana Ali Sulaiman Susan Tai Molecular Epidemiology Division Mochtar Riady Institute for NanotechnologyLippo KarawaciTangerangBanten 15810Indonesia Hepatology Division Department of Internal MedicineFaculty of MedicineUniversity of IndonesiaJakarta 10430Indonesia Center of Gastroentero-Hepatology Department of Internal MedicineFaculty of MedicineHasanuddin UniversityMakassar 90245Indonesia Department of Internal Medicine Mataram General HospitalMataram 83127Indonesia Gastroentero-Hepatology Division Department of Internal MedicineGatot Soebroto HospitalJakarta 10410Indonesia Department of Internal Medicine Siloam Hospital Lippo KarawaciTangerang Banten 15810Indonesia

AIM： To identify the distribution of hepatitis B virus （HBV） subgenotype and basal core promoter （BCP） mutations among patients with HBV-associated liver disease in Indonesia.METHODS： Patients with chronic hepatitis （CH, n =61）, liver cirrhosis （LC, n = 62）, and hepatocellular carcinoma （HCC, n = 48） were included in this study. HBV subgenotype was identified based on S or preS gene sequence, and mutations in the HBx gene including the overlapping BCP region were examined by direct sequencing.RESULTS： HBV genotype B （subgenotypes B2, B3, B4, 85 and B7） the major genotype in the samples, accounted for 75.4%, 71.0% and 75.0% of CH, LC and HCC patients, respectively, while the genotype C （subgenotypes C1, C2 and C3） was detected in 24.6%, 29.0%, and 25.0% of CH, LC, and HCC patients, respectively. Subgenotypes B3 （84.9%） and C1 （82.2%） were the main subgenotype in HBV genotype B and C, respectively. Serotype adw2 （84.9%） and adrq＋（89.4%） were the most prevalent in HBV genotype B and C, respectively. Double mutation （A1762T/G1764A） in the BCP was significantly higher in LC （59.7%） and HCC （54.2%） than in CH （19.7%）, suggesting that this mutation was associated with severity of liver disease. The T1753V was also higher in LC （46.8%）, but lower in HCC （22.9%） and CH （18.0%）, suggesting that this mutation may be an indicator of cirrhosis.CONCLUSION： HBV genotype B/B3 and C/C1 are the major genotypes in Indonesia. Mutations in BCP, such as A1762T/G1764A and T1753V, might have an association with manifestations of liver disease.

关键词： Basal core promoter mutation Hepatitis Bvirus Indonesia Liver disease Subgenotype

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Impact of endoscopic ultrasound examination for deep esophageal collateral veins evaluation in liver cirrhosis patients prior to endoscopic treatment:A case series

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Portal Hypertension & Cirrhosis 2022年第1期1卷 76-81页

作者： Cosmas Rinaldi A.Lesmana Saut H.Nababan Kemal F.Kalista Juferdy Kurniawan Chyntia O.M.Jasirwan Andri S.Sulaiman irsan hasan Rino A.Gani Department of Internal Medicine Hepatobiliary DivisionDr.Cipto Mangunkusumo National General HospitalJakartaIndonesia Digestive Disease and GI Oncology Center Medistra HospitalJakartaIndonesia

Aim:The presence of esophageal collateral veins(ECV)has been reported to be associated with the recurrence of esophageal varices(EV)and bleeding in liver cirrhotic(LC)*** study aimed to see the potential clinical value of deep collateral veins assessment using endoscopic ultrasound(EUS)in liver cirrhotic patients with ***:During 6 months period,a prospective study is conducted,where we identified LC patients who were admitted for esophagogastroduodenoscopy(EGD)screening at the Department of Internal Medicine,*** Mangunkusumo National General Hospital,*** was examined using *** were excluded if they had(1)liver malignancy,(2)history of ligation or glue injection,or(3)portal or splenic vein *** collected demographic data,medical history,data pertaining to use of nonselective beta blocker(NSBB),and laboratory,imaging,and endoscopy *** was performed using a gastroscope(EG29‐i10,3.2 mm Pentax Medical)while EUS was performed using a linear array echoendoscope(EG‐3870UTK,3.8 mm,Pentax Medical)before band ligation or glue ***:There were 20 LC patients included in this study,where 15(75%)of patients were classified with Child-Pugh(CP)‐A and five(25%)of patients with CP‐*** most common aetiologies were hepatitis B in seven(35%)patients and hepatitis C in nine(45%)*** EV with peri‐or para‐esophageal veins(PEEV or PAEV)were detected in 65%of *** of the LC patients with no EV showed the presence of *** or PAEV were detected in grades 1-3 ***:EUS examination can give a better evaluation before managing gastroesophageal varices through deep ECV detection in LC patients.

关键词： endoscopic ultrasound esophageal collateral vein gastroesophageal varices liver cirrhosis portal hypertension

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Innovations in endoscopic ultrasound for portal hypertension and its role in managing complications in clinical practice:Lessons learned from a tertiary referral public hospital

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Portal Hypertension & Cirrhosis 2024年第1期3卷 31-35页

作者： Cosmas R.A.Lesmana Kemal F.Kalista Saut H.H.Nababan Juferdy Kurniawan Chyntia O.M.Jasirwan Andri S.Sulaiman irsan hasan Rino A.Gani Department of Internal Medicine Hepatobiliary DivisionDr.Cipto Mangunkusumo National General HospitalMedical Faculty Universitas IndonesiaJakartaIndonesia Digestive Disease&GI Oncology Center Medistra HospitalJakartaIndonesia Gastrointestinal Cancer Center MRCCC Siloam Semanggi HospitalJakartaIndonesia

Portal hypertension(PH)poses significant *** paper presents an innovative study on the utilization of endoscopic ultrasound(EUS)for both the diagnosis and management of *** at *** Mangunkusumo National General Hospital in Jakarta,this retrospective case series included patients diagnosed with PH through clinical examination,imaging evaluation,and *** criteria comprised a history of reduced blood consumption within the last 5 days,hepatocellular carcinoma,massive ascites,or elevated international normalized ratio(>1.4).EUS-guided portal pressure gradient(PPG)measurements were performed using an innovative standard *** study involved 15 patients,with 14 having liver cirrhosis and 1 diagnosed with Budd–Chiari *** them,nine patients experienced bleeding due to gastroesophageal *** and large esophageal varices were identified in four and eight patients,*** varices type 1 were observed in two patients,and type 2 in four *** gastric fundal varices type 1 were present in one *** on EUS-PPG measurements,14 patients exhibited clinically significant portal *** patients underwent endoscopic band ligation and three underwent EUS-guided cyanoacrylate injection during the same session as the EUS-PPG measurement ***,no adverse events,such as abdominal pain,perforation,or bleeding were observed during or after the *** emerges as a promising and accurate tool for both diagnosis and management.

关键词： cyanoacrylate injection endoscopic ultrasound liver cirrhosis portal hypertension portal pressure gradient

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A Framework for Driver DrowsinessMonitoring Using a Convolutional Neural Network and the Internet of Things

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Intelligent Automation & Soft Computing 2024年第2期39卷 157-174页

作者： Muhamad irsan Rosilah Hassan Anwar Hassan Ibrahim Mohamad Khatim hasan Meng Chun Lam Wan Mohd Hirwani Wan Hussain School of Computing Telkom UniversityBandung40257Indonesia Faculty of Information Science and Technology Universiti Kebangsaan MalaysiaBangi43600Malaysia Department of Electrical Engineering College of EngineeringQassim UniversityAl-Gassim51411Saudi Arabia Graduated School of Business Universiti Kebangsaan MalaysiaBangi43600Malaysia

One of the major causes of road accidents is sleepy *** accidents typically result in fatalities and financial losses and disadvantage other road *** studies have been conducted to identify the driver’s sleepiness and integrate it into a warning *** studies have examined how the mouth and eyelids ***,this limits the system’s ability to identify drowsiness ***,this study designed an Accident Detection Framework(RPK)that could be used to reduce road accidents due to sleepiness and detect the location of *** drowsiness detectionmodel used three facial parameters:Yawning,closed eyes(blinking),and an upright head *** model used a Convolutional Neural Network(CNN)consisting of two *** initial phase involves video processing and facial landmark coordinate *** second phase involves developing the extraction of frame-based features using normalization *** these phases used OpenCV and *** dataset contained 5017 images with 874 open eyes images,850 closed eyes images,723 open-mouth images,725 closed-mouth images,761 sleepy-head images,and 1084 non-sleepy head *** dataset of 5017 images was divided into the training set with 4505 images and the testing set with 512 images,with a ratio of 90:*** results showed that the RPK design could detect sleepiness by using deep learning techniques with high accuracy on all three parameters;namely 98%for eye blinking,96%for mouth yawning,and 97%for head ***,the test results have provided an overview of how the developed RPK prototype can accurately identify drowsy *** findings will have a significant impact on the improvement of road users’safety and mobility.

关键词： Drowsy drivers convolutional neural network openCV microprocessor face detection

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