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All Journal Acta Interna : The Journal of Internal Medicine The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Pendidikan Indonesia (Japendi)
Putut Bayupurnama
Division of Gastroentero-hepatology, Department of Internal Medicine Faculty of Medicine, University of Gadjah Mada/Sardjito General Hospital, Yogyakarta
Education Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology

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Reactivation and Flare of Chronic Hepatitis B: Natural History, Diagnosis, Therapy and Prevention Cahyono, Suharjo Broto; Neneng Rasari, Neneng Rasari; Bayupurnama, Putut; Maduseno, Sutanto; Nurdjanah, Siti
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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Abstract

ABSTRACTAlmost 30% of the world population has been exposed to hepatitis B virus (HBV) and 400 millionof these are chronically infected. 20–30% of HBsAg carriers may develop reactivation or fl are (acuteexacerbation) of chronic hepatitis B with elevation of biochemical levels, high serum HBV DNA level with orwithout sero-coversion to HBeAg. In countries with intermediate or high endemicity for HBV, compoundedin use cytotoxic or immunosuppressive therapy for the treatment of a wide variety of clinical disease,reactivation or fl are may be the fi rst presentation of HBV infection. Sometime it is diffi cult to differentiatebetween acute hepatitis B and reactivation (fl are). Accurate diagnosis in these cases is very important fordeciding whether to start treatment or not, because acute hepatitis B does not require treatment, whilereactivation or fl are may take benefi t from it. Effort to early detect, to treat and to prevent the reactivationor fl are of chronic hepatitis B is very crucial to reduce morbidity and mortality.Keywords: Reactivation, fl are (acute exacerbation) of chronic hepatitis B, acute hepatitis B, nucleos(t)ideanalogues
Relationship between plasma fi brinogen levels with model of end stage liver disease score in patients with liver cirrhosis Nasir, Moch. Abdul; Ratnasari, Neneng; Bayupurnama, Putut
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTIntroduction. One of the complications which often occur in the liver cirrhosis is bleeding. Closely associated with weighing of bleeding were disturbance haemostatic homeostasis disorders that commonly associated with impaired liver function. Therefore certain biomarkers are needed to objectively measure the severity of liver cirrhosis. Fibrinogen is one of the clotting factors that can be used to determine the severity of liver cirrhosis.The model of end-stage liver disease (MELD) score is most excellent alternative of the Child-Pugh score. It can be used in patients with liver cirrhosis spacious ranges severity of disease and etiology even in patients whose cirrhosis etiology are not clear. Currently, there was not any data showing the correlation between the level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis. Aims. This study aimed to determine the correlation between level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis.Method. This study was cross-sectionally conducted used consecutive sampling. Study population were eligible patients with liver cirrhosis who visited outpatient and inpatient clinic in the Division of Gastroentero-hepatology, Dr. Sardjito general hospital, between November 2011 to October 2012. Correlation between the level of plasmatic fibrinogen and MELD score was statistically assessed using correlation test with fi nal result stated as correlation coefficient (r).Result. There were 40 subjects that met criteria, 28 male and 12 female, with average age of 53 ± 12,51 years. Etiology of cirrhosis was viral hepatitis B in 16 (40,0%) subjects, hepatitis C in 11 (27,5%) subjects and non viral in 13 (32,5%) subjects. Subjects with ascites were 19 (47, 5%) and without ascites were 20 (52.5%). Bleeding was experienced by 30 (80.0%) subjects while 10 (20,0%) subjects did not present with bleeding. Mean of plasma fibrinogen was 198 ± 102, 89 mg/dl, and mean of the MELD score was 17,05 ± 8.79. Spearman correlation coefficients between fi brinogen and MELD score was r = -0,404 (p = 0,010).Conclusion. There was a negative correlation between plasma fi brinogen and the MELD score in liver cirrhosis patients visiting our local setting.Keywords: liver cirrhosis, fi brinogen, MELD score
Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score Gunadi, Heribertus; Bayupurnama, Putut; Nurdjanah, Siti
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground:    Cirrhosis patients  with renal failure  are  at   high   risk  for   death   and  reduced survival   as   compared   with   those   without   renal failure,  and have poor prognosis.  Some studies  have suggested   that  cystatin  C did  more  accurate   than creatinine /0  detect glomerulusfiltration    rate (GFR) in patients  with cirrhosis.  Model  of End Stage  Liver Disease  (MELD)  score  can be used in patients  with cirrhosis  with variously  Widely severity  disease  and etiologies.  Until nmv, there is no study about correlation  between  levels  of cystatin  C to disease severity  in cirrhosis based on MELD score.Objective:  This present  study  was to investigate  the correlation  between levels of cyst at ill C with disease severity  in cirrhosis  based on MELD score.Method:   Study  design  was cross sectional s t u d y,     This      study       was     conducted          at Gastoenterohepatology         outpatient     clinic    and Internal Medicine  ward of Dr Sardjito  General Hospital,     Yogyakarta.    Inclusion     criteria     were patients    with    cirrhosis    diagnosed     by   clinical criteria,  laboratory   and  USG.findillg,   age   >  18 years,   had  complete  medical  record  and  obtained informed consent. Exclusion criteria were chronic kidney  disease,  sepsis,  hepatocellutare   carcinoma, used high doses  of steroid,  had thyroid dysfunction. hypertension  and diabetes mellitus.Result:   The  mean  of cystatin   C based  on categorical    MELD    score   were   MELD    <10   = 0.93±0.19   mgll;   MELD    IO-19=1.08±0.26    mg/l; MELD  20-29   =  1.25±O.27 mgll;  MELD  30-39   = 2.49 mg/l and  MELD  >40  = 2.43 mgll;  0)=0.013; 95%   CI  0.000-0.061).     There   was   a  significant correlation   between  cystatin  C to MELD  score  as demonstrated   byp=O.OOOand r=0.485.Conclusion:     Our  data  suggested    a significant     correlation     with   medium    strength between cystatin  C to severity  disease  of cirrhosis based 011 MELD score. Keywords:  cirrhosis,  cystatin  C, MELD score  
Absolute Eosinophil Counts and Colonic Mucosal Eosinophils Based on Inflammatory Bowel Disease Severity Aulia, Nisma; Mulya, Deshinta Putri; Bayupurnama, Putut
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98159

Abstract

Background. The inflammatory process in Inflammatory Bowel Disease (IBD) involves various types of inflammatory cells, including eosinophils. Eosinophils are not only associated with the severity of IBD but are also associated with clinical improvement. In contrast to the confirmed role of neutrophils, the role of eosinophils either in the blood or in the colonic mucosa of IBD patients have not been fully understood and confirmed.Objectives. To determine the difference in absolute eosinophil counts in the blood based on the severity of IBD and to determine the differences in the density of colonic mucosal eosinophil based on the severity of IBD.Methods. This is a cross-sectional study with consecutive sampling in the period August 2020 - July 2021. The research subjects were IBD inpatient or outpatient at Dr. Sardjito Hospital who met the inclusion and exclusion criteria. Researcher assessed data on absolute eosinophil counts in peripheral blood and eosinophil density in the colonic mucosa. The number of biopsies and the location of the biopsy were determined based on a colonoscopy performed by a Gastroentero-Hepatology Consultant. The calculation of eosinophils in the colonic mucosal tissue was carried out by an Anatomical Pathologist Specialist. IBD severity was assessed using the Truelove Witts score for Ulcerative Colitis (UC) and Crohn's Disease Activity Index (CDAI) for Crohn's Disease (CD) patients. Analysis using a computer program with a p value <0.05 was considered statistically significant.Results. There were 50 research subjects with a median age of 55 years (24-77 years). There was not a big difference between the number of male and female patients, namely 26 people (52%) vs 24 people (48%). The number of UC patients were dominant, namely 48 people (96%). The severity of IBD were divided into three groups with the number of patients with mild IBD were 22 (44%), moderate were 11 (20%), and severe IBD were 18 (36%). The number of patients with eosinophilia were 7 patients (14%) and colonic mucosal eosinophilia were 5 patients (10%). Kruskal Wallis test found that the mean absolute eosinophil blood in mild IBD was 21.45 cells/µL, moderate IBD was 25.50 cells/µL, and severe IBD was 30.44 cells/µL (p = 0.152). The mean of colonic mucosal eosinophils in mild IBD was 19.48 cells/hpf, in moderate IBD was 27.00 cells/hpf, in severe IBD was 32.03 cells/hpf (p = 0.023) and there was a statistically significant moderate correlation (r = 0.392; p = 0.005).Conclusion. There is no significant difference in absolute eosinophil counts in the blood based on the severity of IBD and there is a significant difference in the density of colonic mucosal eosinophil based on the severity of IBD.
Correlation between the Eosinophil Colonic Mucosa Density and Severity of Ulcerative Colitis Aulia, Nisma; Mulya, Deshinta Putri; Bayupurnama, Putut; Ratnasari, Neneng
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023132-136

Abstract

Background: The inflammatory process of ulcerative colitis (UC) involves eosinophils. Eosinophils are not only related to the severity of UC but also to clinical improvement. The role of eosinophils in colonic mucosa has not been fully understood. This study aims to determine the correlation between the density of eosinophils in the colonic mucosa and the severity of ulcerative colitis.Method: This is a prospective cross-sectional study with consecutive sampling between August 2020 and July 2021. The subjects were UC inpatients/outpatients at Dr. Sardjito Hospital who met the inclusion and exclusion criteria. The number and location of the biopsies are determined based on a colonoscopy performed by a Gastroenterology-Hepatology Consultant. An Anatomic Pathology Specialist examined the eosinophil colonic tissue. The severity of UC was classified using the Truelove Witts score. Data analysis using a computer program with a p-value 0.05 was considered statistically significant.Results: There are 3 UC severity categories according to the Truelove Witts score: 22 mild (45.8%), 9 moderate (18.8%), and 17 severe (35.4%). Seven participants (14.6%) had eosinophilia, with a median eosinophilia score of 203.33 cells/microL (0–1470 cells/microL). Five participants (10.4%) with colonic mucosal eosinophilia, with a median value of 14.13 cells/HPF (0–172 cells/HPF). The density of colonic mucosal eosinophils and the severity of UC had a moderate connection (r = 0.396; p = 0.005).Conclusion: There is a significant correlation between the density of eosinophils in the colonic mucosa and the severity of UC.
Alpha-Fetoprotein : Its Diagnostic Role in Hepatocellular Carcinoma Bayupurnama, Putut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, August, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/262202599-100

Abstract

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Interaction between Internet Browsing Habit and Dyspepsia Syndrome in Adolescent Bayupurnama, Putut; Sofia, Noor Asyiqah; Cahyani, Angelin Utami
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (559.955 KB) | DOI: 10.24871/231202238-42

Abstract

Background: There were many patients, including adolescent, with dyspepsia symptoms in our daily clinical practice have been interacting with internet search engine to find medical information which induced or worsened their dyspeptic symptoms. Aim of the study is to know  the pattern of   internet browsing habit and dyspepsia syndrome in adolescentMethod: Grade 12 level students of senior high schools in Yogyakarta, Indonesia were included in the study with stratified random sampling method. Students with confirmed organic dyspepsia diagnosis were excluded. We use two simple questions to reveal the students internet browsing habit, question no 1 :“Did you ever browse information about diseases in the internet?” (answer choice: a.never;b.once;c.more than once); question no 2.: “Did you ever browse information about your medical complaint in the internet?” (answer choice: a.never;b.once;c.more than once). We used validated Gastrointestinal Symptom score (GIS) to reveal the students dyspepsia symptoms. Data were analyzed with chi-square test and anova.Results: There were 665 (477 girls and 188 boys) senior high school students (age range : 16-20 years old) included in this study. Based on question no 1, the result  showed significantly different (p 0.001) between students with  and without the dyspepsia syndrome, and the question no 2 also showed similar result (p=0.002). The anova between GIS and question no 1 showed significantly different ( p0.001) and the similar result was also found between GIS and question no 2 (p0.001). Conclusion:The internet browsing habit may influence the development of dyspepsia syndrome in adolescent and further study is needed to find the cause and effect relationship.
Efikasi Zingiber Officinale (Ekstrak Jahe) + Ranitidin Vs Ranitidin + Plasebo Terhadap Simtom Gastrointestinal Pada Dispepsia Fungsional Retnaningrum, Yuliana Rahmah; Ratnasari, Neneng; Bayupurnama, Putut
Jurnal Pendidikan Indonesia Vol. 6 No. 12 (2025): Jurnal Pendidikan Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/japendi.v6i12.8835

Abstract

Ekstrak jahe telah lama digunakan sebagai terapi tradisional dan tercantum dalam monograf WHO untuk mengatasi dispepsia, flatulen, spasme, kolik, diare, muntah, serta keluhan gastrointestinal lainnya. Penelitian in vivo menunjukkan efektivitas jahe mencapai 68–77%. Studi ini bertujuan menilai pengaruh kombinasi ekstrak jahe dan ranitidin dibandingkan ranitidin dengan plasebo pada pasien dispepsia fungsional. Metode yang digunakan adalah quasi experimental dengan 26 subjek penelitian pada periode Desember 2014 hingga Juni 2015. Analisis data meliputi paired t-test, independent t-test, Mann–Whitney, Wilcoxon, serta Pearson’s Chi-Square, dengan tingkat signifikansi p < 0,05. Setelah dua minggu terapi, kelompok ekstrak jahe + ranitidin menunjukkan penurunan skor GIS sebesar 68%, dari 16 ± 4,48 menjadi 5 ± 3,54 (p < 0,001). Kelompok ranitidin + plasebo mengalami penurunan 28%, dari 14 ± 4,05 menjadi 10 ± 3,59 (p = 0,004). Penggunaan berbagai uji statistik ini memperkuat validitas temuan penelitian dengan memastikan bahwa metode analisis sesuai dengan distribusi dan karakteristik data yang diperoleh. Perbandingan penurunan skor GIS dari baseline hingga minggu kedua menunjukkan hasil signifikan, yaitu 10,85 ± 2,115 pada kelompok perlakuan dibandingkan 4 ± 3,341 pada kelompok kontrol (p = 0,018). Gejala yang berbeda bermakna antara kedua kelompok meliputi mual, kembung, perut penuh, ketidaknyamanan pagi hari, ulu hati tidak nyaman, dan nyeri perut. Penelitian menyimpulkan bahwa penambahan ekstrak jahe memberikan perbaikan gejala gastrointestinal lebih baik dibandingkan ranitidin saja.
Co-Authors Aulia, Nisma Cahyani, Angelin Utami Catharina Triwikatmani Deshinta Putri Mulya Fahmi Indrarti Hakim, Suharno Haryanto Rahardjo Hemi Senorita Heribertus Gunadi Jamhari Jamhari Moch. Abdul Nasir Neneng Rasari Neneng Rasari Neneng Ratnasari Noor Asyiqah Sofia Nurdjanah S, Nurdjanah Probowati, Wiwiek Rachmad Aji Saksana Retnaningrum, Yuliana Rahmah Riska Humardewayani Adie SATRIYAS ILYAS Siti Nurdjanah Suharjo B Cahyono Suharjo Broto Cahyono Suryo Taroeno Sutanto Maduseno