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All Journal journal of internal medicine Indonesian Journal of Tropical and Infectious Disease Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Ummi Maimunah
Division Of Gastroenterology And Hepatology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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FAKTOR RISIKO TERKAIT PERDARAHAN VARISES ESOFAGUS BERULANG PADA PENDERITA SIROSIS HATI Vidyani, Amie; Vianto, Denny; W, Budi; Kholili, Ulfa; Maimunah, Ummi; Sugihartono, Titong; Purbayu, Herry; Boedi Setiawan, Poernomo; A Nusi, Iswan; Adi, Pangestu
journal of internal medicine Vol. 12, No. 3 September 2011
Publisher : journal of internal medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.384 KB)

Abstract

Recurrent esophageal varices bleeding  in  liver cirrhosis  increase  the morbidity and mortality. 50 ! 60% patients with Esophageal Varricess (EV) will experience recurrent bleeding, 30% or one third of them will experience recurrent bleeding one year after diagnosis of EV. Mostly recurrent bleeding will be found at 6 weeks until 6 months after the Þ rst bleeding. Prevention of recurrent bleeding is important for survival. The aim of this research to know the risk factors of recurrent EV bleeding in liver cirrhotic patients and the onset of recurrent bleeding after the Þ rst endoscopy. This is a  cross sectional study. Thirty Þ ve decompensated liver cirrhosis patients that fulÞ ll the inclusion and exclusion criteria participated in this study. After the Þ rst endoscopy, the risk factors are written, consist of sex, age, ascites, degree of varices, history of LVE/STE the severity of liver disease, and history of consuming gastric iritating drugs. The patients followed for six months to evaluated  the occurence of  recurrent bleeding. We used Pearson Chi-Square  test  for statistic analysis  (signiÞ cant  if p < 0.05). SPSS 17 were used to statistic calculation. Statistic analytical showed signiÞ cant correlation (p = 0.006; OR = 8.889; CI: 1.803 ! 43.820). On  the other hand sex, age, degree of EV, history of STE/LVE showed non signiÞ cant correlation. The main risk factor of recurrent EV in liver cirrhosis is the severity of liver disease.
Profile Quantitative Hepatitis B Surface Antigen (qHBsAg) of Chronic Nai?ve Hepatitis B Patients in Dr. Soetomo Hospital, Surabaya, Indonesia Yessy Puspitasari; Puspa Wardhani; Munawaroh Fitriyah; Erik Hasudungan; Atika; Ummi Maimunah; Aryati
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14941

Abstract

This study aimed to evaluate the profile of qHBs Ag profile, and also to investigate the correlation betweenqHBs Ag and HBV DNA. Seventy samples of chronic-nai?ve hepatitis B patients in Dr. Soetomo Hospitalwere analyzed in a cross-sectional study. Patients were categorized according to the HBe Ag positive (n=30)and HBe Ag negative (n=18), also based on qHBs Ag 1000 IU/mL and qHBs Ag >1000 IU/mL. qHBs Agwas correlated with HBV DNA. qHBs Ag by CLEIA method from Sysmex, KOBE HISCL, HBV DNAwas measured by real-time Polymerase Chain method from Gene Xpert, Cepheid. 70 patients nai?ve CHBtreatment showed a median of ALT level 60.21±70.76 U/L. 30 patients showed a positive-HBeAg, 18 patientsshowed negative-HBeAg, 22 patients were not evaluated (N/A). Positive-HBeAg patients had 70% qHBsAg>2500 mg/dL and median HBV DNA 7.49×107IU/mL. Negative-HBeAg patients had 55.6% HBsAg ?1000mg/dL and median HBV DNA 9.66×102 IU/mL. qHBsAg correlated with HBV DNA (p <0.001). This datademonstrated that quantitative HBsAg was associated with a phase of HBV-infection, quantitative HBsAgshowed a moderate correlation with DNA HBV, quantitative HBsAg levels might be a predictor of initiationtherapy for CHB patients.
DETECTION OF TUMOR NECROSIS FACTOR- (TNF- ) GENE PROMOTERS POLYMORPHISM AMONG LIVER CIRRHOSIS PATIENTS WITH CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IN SURABAYA, INDONESIA Citrawati Dyah Kencono Wungu; Mochamad Amin; S. Eriaty N. Ruslan; Priyo Budi Purwono; Ulfa Kholili; Ummi Maimunah; Poernomo Boedi Setiawan; Maria Inge Lusida; Soetjipto Soetjipto; Retno Handajani
Indonesian Journal of Tropical and Infectious Disease Vol. 7 No. 5 (2019)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1302.693 KB) | DOI: 10.20473/ijtid.v7i5.7275

Abstract

Polymorphisms in TNF-α gene promoter region are known of its role in the production of TNF-α which may influences the pathogenesis of liver disease. SNPs in positions 238 and 308 of TNF-α gene promoters may affect the production of these cytokines. This study was aimed to detect Single Nucleotide Polymorphism (SNP) on -238 and -308 positions in the TNF-α gene promoter among liver cirrhosis patients with HBV infection in Surabaya, Indonesia. This was descriptive exploratory research with cross sectional study design using serum liver cirrhosis patients with HBV infection in Endoscopy Outpatient Clinic Dr. Soetomo General Hospital, Surabaya from April-May 2017. SNPs at -238 and -308 on TNF-α gene promoter (rs361525 and rs1800629 respectively) were detected using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) with primers specific for the TNF-α promoter region and restriction enzymes NcoI and MspI. The genotypes of TNF-α gene promoter were assessed according to the length of the fragments produced in RFLP. Serum TNF-α levels was measured by commercial ELISA. In this study, as much as 149 positive HBsAg patients was found in Endoscopy Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya. From those amount, as much as 30 liver cirrhosis patients with positive HBsAg were obtained. From 2/30 (6.7%) patients showed the GA heterozygote SNP either position -238 or -308. No patient had the AA genotype. Median blood TNF-α level in women (38 ng / L) was higher than in men (33 ng / L). TNF-α levels in patients with GA heterozygote genotype at -238 and -308 in this research was not different than wild-type (GG genotype). Among patients with liver cirrhosis due to chronic HBV infection in Surabaya, Indonesia, Surabaya, we found GA polymorphisms the TNF-α promoter gene at positions -238 and -308 in 6.7% patients, and did not find homozygous AA polymorphisms. Further studies including larger numbers of patients from various ethnic backgrounds in Indonesia are needed to provide robust data on TNF-α gene promoter polymorphisms and their role in the pathogenesis of liver cirrhosis with HBV infection in this country.
Quality of Life of Chronic Hepatitis B Patients Consuming Nucleoside Analog: A Case-Control Clinical Study in Indonesia Natasya Ariesta Selyardi Putri; R. Haryanto Aswin; Izzatul Fithriyah; Ummi Maimunah; Muhammad Miftahussurur; Yoshio Yamaoka
Biomolecular and Health Science Journal Vol. 5 No. 1 (2022): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v5i1.31409

Abstract

Introduction: Chronic hepatitis B raises serious concern due to its high morbidity, such as cirrhosis and hepatocellular carcinoma, and mortality from 267 per 100,000 person-years. Up to now, medical therapy that successfully eradicates the hepatitis B virus is not available. Therapy is given in the long term for suppressing viral replication and disease progression. Nucleoside analog (NA) is a medication that is consumed orally once a day for years. Previous studies showed that patients who were treated with NA had a different quality of life (QoL) compared to naïve patients. This research aimed to analyze the QoL of chronic hepatitis B patients who consumed NA by comparing it with naïve patients at Dr. Soetomo General Academic Hospital Surabaya. Methods: Subjects were recruited consecutively from chronic hepatitis B patients at Dr. Soetomo General Academic Hospital Surabaya during 9 February – 31 May 2021. Data about sociodemographic characteristics, hepatitis B therapy history, and QoL were gained by using the SF-36 questionnaire and medical records. Subjects were divided into NA and naïve groups which responses underwent an analytical comparison. Results: NA group had significantly higher QoL in a physical component score (PCS) and mental component score (MCS), with physical functioning (PF), role limitations due to physical health (RP), role limitations due to emotional problems (RM), energy/fatigue (VT), emotional well-being (MH), social functioning (SF), and general health perception (GH) subscales having p<0.05Conclusion: The QoL of patients who were treated with NA was significantly higher than that of naïve patients in terms of physical and mental components.
SERUM AFP (ALPHA FETO PROTEIN) LEVELS PROFILE OF HEPATOCELLULAR CARCINOMA PATIENTS IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA Dyeneka Rustanti Indreswara Putri; Ummi Maimunah; Endang Retnowati
Majalah Biomorfologi Vol. 32 No. 1 (2022): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v32i1.2022.6-12

Abstract

Higlight:1. The USG results of AFP level can be used for early detection and therapy of hepatocellular carcinoma that can prevent metastasis, progressivity, and recurrence. 2. The most common patients with high AFP levels are those with hepatitis B depending on etiology, younger age, male, gender, high SGOT level and BCLC B patients.Abstract:Background: Hepatocellular carcinoma (HCC) accounts for more than 90% of liver cancer which is the second most common cause of cancer-related death worldwide. The incidence of HCC was 626.000 cases every year worldwide. Early detection and therapy can prevent metastasis, progressivity, and recurrence. AFP level ≥ 400 ng/ml and USG results can be used as a diagnosis parameter of hepatocellular carcinoma. Objective: To analyze the AFP level’s profile in hepatocellular carcinoma. Materials and Methods: Descriptive methods used in this study with data collected from medical records on patients that fulfilled the inclusion criteria in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia during the periods of 1st January 2013- December 31st 2015. This study used various variables such as age, gender, etiology and size of the tumor, number of a nodule, hepatic function with child classification, staging BCLC, and AFP level. Results: This study found that the 98 patients with hepatocellular carcinoma with high AFP level or >400 ng/ml were dominated by younger patients with average age of 49.91 years, the most common etiology was hepatitis B (56.8%), poor results of laboratory tests (SGOT, SGPT), patients with all level of hepatic function based on Child-Pugh classification and staging B of the tumor (70.5%). Patients with normal AFP ≤20 ng/ml were dominated by female patients, with the most common etiology of fatty liver and others, and with BCLC A and C staging. Descriptively, there was no difference in AFP level based on the number of nodules and size of tumor. Conclusion: The most common patients with high AFP level are those who have hepatitis B as etiology, younger age, male gender, high SGOT level and BCLC B staging. Meanwhile, patients with normal AFP level dominated with female and non-hepatitis patients. In this research, we found no differences of AFP level based on number and size of tumor descriptively.
IMMATURE PLATELET FRACTION (IPF) DAN TROMBOPOIETIN DI SIROSIS HATI Esti Rohani; Yetti Hernaningsih; Suprapto Ma’at; Ummi Maimunah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i2.1066

Abstract

Liver cirrhosis remains a major clinical problem worldwide when associated with significant morbidity and mortality due toits complications. The presence of liver cirrhosis state affects the production of TPO influencing the process of thrombopoiesis. Thethrombopoiesis activity can be described by the Immature Platelet Fraction (IPF) value which is young platelets. The immature Plateletfraction value increases when platelet production enhances as well, on the contrary when the production declines, the IPF value is alsodecreased. This study was performed by cross-sectional method using 31 subject samples suffering from liver cirrhosis, consisting of ChildPugh score class A 2 samples (6.4%), Child Pugh score class B 9 samples (29%) and Child Pugh score class C 20 samples (64.6%). Theexamination of TPO levels was done by ELISA method using Humans TPO QuantikineR, the IPF value was examined using Sysmex XE-2100 Hematology Analyzer. The thrombopoietin serum levels in the samples ranged from 23.5 to 96.6 pg/mL with a mean of 45.1pg/mL.The immature Platelet Fraction values varied from 1.7% to 19.1% with a mean of 6.7%. From the statistical analysis, the levels of TPO andIPF at various degrees of the disease severity were not significantly different. There was no significant correlation between the TPO leveland IPF value, r = 0.038, p = 0.837. There was no significant difference between the TPO level and the IPF value in the splenomegaly andnonsplenomegaly state. In conclusion, based on this study no significant correlation was found between the IPF value with thrombopoietinserum levels, as well as the IPF and thrombopoietin levels, and there was no association with the disease severity.
The Association between The Degree of Liver Cirrhosis Severity and Zinc Serum Level Budi Yuwono; Ummi Maimunah; Budi Widodo
Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v1i1.16996

Abstract

Background: Impaired liver function in LC (Liver Cirrhosis) can cause Zinc deficiency (Zn). One of the causes of Zn deficiency in LC is decreased albumin synthesis, whereas albumin is required as the main Zn binding protein in plasma. However, some studies of the severity of LC with Zn serum levels still provide controversial results.Objective: To determine the association between the degree of LC severity and Zn serum level.Methods: The subjects of this study were LC patients in Gastroentero-Hepatology Unit and Internal medicine wards in of Dr. Soetomo General Hospital Surabaya for three months. Diagnosis of LC was based on clinical examination according to Soehardjno-Soebandiri criteria and other findings (ultrasound or endoscopy). The degree of LC severity was determined based on the CTP score (Child-Turcotte-Pugh). Serum Zn concentration was measured by atomic absorption spectrophotometry method. The research design used the cross-sectional method. The statistical test used was Spearman correlation.Results: Forty-three patients fulfilled the study criteria. The subjects consisted of 27 males (62.8%) and 16 females (37.2%) with the mean age of 53.81 ± 8.67 years. Based on the CTP scores, we obtained CTP A of 4 patients (9.3%), CTP B of 19 patients (44.2%) and CTP C of 20 patients (46.5%). The mean of Zn serum level in CTP A, CTP B, and CTP C score was 58.3 ± 19.6 μg/dl, 43.4 ± 14.5 μg/dl and 31.6 ± 10 μg/dl respectively. The result of the statistical test showed a significant correlation between LC severity and Zn serum level (p <0.05 and r = -0.583).Conclusion: The heavier the severity of LC, the lower Zn serum levels.
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Ummi Maimunah; Rudyanto Rudyanto; Poernomo Boedi Setiawan; Pangestu Adi; Iswan Abbas Nusi; Hernomo Ontoseno Kusumobroto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201019-25

Abstract

Background: One of physician’s functions at primary health care center (PHC) is the ability to diagnose some diseases especially that contribute to high morbidity and mortality. Until now, hepatitis B virus infection has become a major health problem worldwide. The aim of this study was to identify the knowledge level of primary care physicians concerning hepatitis B in Surabaya. Method: The present study was a cross-sectional study that performed by investigators through interviews with primary care physicians in Surabaya to fill questionnaires for measuring their knowledge level. The questionnaires were modified from questionnaire survey in Tur Key performed by Peksen et al. It reflected the level of knowledge of the physicians including their comprehension, application and analysis. Validity and reliability test were performed on the Result of those questionnaires. The knowledge level was categorized as follows: 75 (excellent), 70.0–74.9 (very high), 65.0–69.9 (high), 60.0–64.9 (medium), 55.0–59.9 (moderate), 47.5–54.9 (nearly moderate), 40.0-47.4 (less moderate), 40 (low). Results: Based on validity test, we obtained 14 items of 17 question items with correlation coefficient 0.287–0.561 and alpha reliability index 0.639; therefore, the instrument can be used to measure the knowledge level. The results of mean score conversion included comprehension, which was 84.878 ± 16.499 (excellent category); application, which was 47.556 ± 31.870 (nearly moderate category) and analysis, which was 14.634 ± 35.562 (low category). Statistically, the mean value of the knowledge level scale, which was the combination of comprehension, application and analysis, was obtained at 49.023 ± 19.085 including the nearly moderate category. Conclusion: By using a valid and reliable instrument, the knowledge level of primary care physician in Surabaya concerning hepatitis B can be categorized as nearly moderate. Keywords: hepatitis B, liver cirrhosis, hepatoma
Wilson’s Disease: A Review Amie Vidyani; Fauziah Diayu Retnaningtyas; Ulfa Kholili; Titong Sugihartono; Iswan Abbas Nusi; Poernomo Boedi Setiawan; Ummi Maimunah; Budi Widodo; Husin Thamrin; Muhammad Miftahussurur; Herry Purbayu
Current Internal Medicine Research and Practice Surabaya Journal Vol. 4 No. 1 (2023): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v4i1.36428

Abstract

Wilson’s disease is a disease that results from a genetic disorder that causes copper accumulation. Wilson’s disease has presented challenges for physicians during the last century, but it can be diagnosed and treated over time. Diagnosing Wilson’s disease is challenging for doctors because of its wide range of clinical manifestations and complexity. Studies that can help diagnose Wilson’s disease include a 24-hour copper urine examination and neurological tests, such as a CT scan or MRI, and liver function tests. There is also a scoring system to help medical personnel diagnose this disease. Correct diagnosis and adequate therapy can be provided, such as penicillamine, trientine, zinc, and, most rarely, liver transplantation. It is also necessary to monitor the side effects of treatment and its effectiveness of treatment. When receiving therapy, Wilson’s disease has a better prognosis than if it is not treated.
Profile of Patients of Hepatocellular Carcinoma in The Internal Medicine Inpatient Room at Dr. Soetomo General Academic Hospital Shahnaz Azzahra; Ulfa Kholili; Rosy Setiawati; Ummi Maimunah
Current Internal Medicine Research and Practice Surabaya Journal Vol. 4 No. 1 (2023): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v4i1.42287

Abstract

Introduction: Primary liver cancer is the sixth most frequently diagnosed cancer and the third leading cause of cancer death worldwide in 2020, with approximately 906,000 new cases and 830,000 deaths. Primary liver cancer includes hepatocellular carcinoma (HCC), with a percentage of 75%-85% of cases. The poor prognosis of HCC is mainly related to late diagnosis.Methods: This research is a descriptive study with a cross-sectional study. Data retrieval is taken from secondary data in the form of medical record data. The sampling technique used was the total sampling technique.Results: The number of HCC patients in the Internal Medicine Inpatient Room at Dr. Soetomo General Academic Hospital for 1 January 2017–31 December 2019 who met the inclusion and exclusion criteria was 60. The male sex had the highest number of 43 patients (71.7%), with the highest age group being 50-59 years old.Conclusion: Profile of HCC patients in the Internal Medicine Inpatient Room at Dr. Soetomo General Academic Hospital for the 2017-2019 period, the largest age group was 50-59 years, dominated by male sex, the most risk factors were HBsAg positive, high liver function tests, high tumor markers, and had BCLC stage C. The patient had a live clinical outcome.
Co-Authors Amie Vidyani Aryati atika Budi W Budi Widodo Budi Widodo Budi Yuwono Citrawati Dyah Kencono Wungu Denny Vianto Dyeneka Rustanti Indreswara Putri Endang Retnowati Erik Hasudungan Esti Rohani Fauziah Diayu Retnaningtyas Hartecia, Gilda HERNOMO ONTOSENO KUSUMOBROTO Hernomo Ontoseno Kusumobroto Herry Purbayu Herry Purbayu Husin Thamrin Imro'ati, Tri Asih Iswan A Nusi Iswan A Nusi Iswan Abbas Nusi Izzatul Fithriyah Jonan, Bernadetta Maria Inge Lusida Mochamad Amin Muhammad Miftahussurur Munawaroh Fitriyah Natasya Ariesta Selyardi Putri Pangestu Adi PN, Adaninggar Poernomo Boedi Setiawan Poernomo Boedi Setiawan Poernomo Boedi Setiawan PRIYO BUDI PURWONO Puspa Wardhani Puspa Wardhani Puspitasari, Yessy R.Haryanto Aswin Retno Handajani Rosy Setiawati Rudyanto Rudyanto S. Eriaty N. Ruslan Setiawan, Poernomo B Shahnaz Azzahra Soetjipto Soetjipto Suprapto Ma’at Thamrin, Husin Titong Sugihartono Ulfa Kholili Widodo, Budi Willy Sandhika Yetti Hernaningsih Yoshio Yamaoka Yoshio Yamaoka, Yoshio Yudith Annisa Ayu Rezkitha, Yudith Annisa Ayu Zein, Khairu