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All Journal Jurnal Kesehatan Andalas Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease The Indonesian Journal of Public Health Sari Pediatri Health Notions Journal Of Vocational Health Studies Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Smart Medical Journal Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research JURNAL ILKES (Jurnal Ilmu Kesehatan) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Jurnal MID-Z (Midwivery Zigot) Jurnal Ilmiah Kebidanan Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya Jurnal Abdi Insani JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology INDONESIAN MIDWIFERY HEALTH AND SCIENCES JOURNAL Bioscientia Medicina : Journal of Biomedicine and Translational Research Caring : Jurnal Pengabdian Masyarakat MEDICINUS Jurnal Kebidanan
Bagus Setyoboedi
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Airlangga - Rumah Sakit Akademik Dr Soetomo Surabaya, Indonesia
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Hepatocellular Carcinoma with Inferior Vena Cava Thrombus in a Child Pratiwi, Fauziah; Prihaningtyas, Rendi Aji; Setyoboedi, Bagus; Ontoseno, Teddy
Current Internal Medicine Research and Practice Surabaya Journal Vol. 5 No. 1 (2024): 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.v5i1.49091

Abstract

Hepatocellular carcinoma (HCC) in children is the second common malignant liver tumor after hepatoblastoma. Chronic hepatitis B virus (HBV) infection causes most hepatocellular cancer worldwide. Metastases to the inferior vena cava (IVC) and right atrium (RA) tumor thrombi are even less common. We reported a case of a 13-year-8-month-old girl with HCC and IVC involvement. Vascular invasion predicts poor overall survival in HCC patients. Patients with HCC involving the IVC had a higher risk of sudden mortality and a poor treatment outcome. It is difficult to treat, and no standard therapy has been established. This case report aimed to describe HCC with IVC involvement. This is a rare disease with a poor prognosis, therefore it is important to detect and manage early.
The Successful Administration of Steroid in Extrahepatic Cholestasis Winahyu, Anindya Kusuma; Prihaningtyas, Rendi Aji; Setyoboedi, Bagus; Arief, Sjamsul
Journal of Community Medicine and Public Health Research Vol. 4 No. 2 (2023): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v4i2.47751

Abstract

Biliary atresia is the most common cause of liver transplantation in children. Kasai surgery is still a bridging therapy for biliary atresia, but patients are often late for treatment. Based on the currently proposed theory, biliary atresia results from a progressive inflammatory process and progresses to fibrosis of the bile ducts. A case of a 1.5-month-old boy with prolonged jaundice followed by acholic stools and dark urine was presented. He had cholestasis, elevated GGT levels, and a liver biopsy suggesting extrahepatic cholestasis. He was treated with methylprednisolone, ursodeoxycholic acid, and vitamin supplementation was started orally. After steroid therapy, direct bilirubin levels decreased rapidly to 0.55 mg/dl on day 14. Jaundice, acholic stools, cholestasis, and liver function tests were improved. Therapeutic opportunities based on the pathogenesis of inflammation in biliary atresia using steroids may provide new opportunities for non-surgical management of biliary atresia in the early phase of the disease.
Primary Healthcare Providers' Knowledge on the Early Detection of Biliary Atresia Rendi Aji Prihaningtyas; Bagus Setyoboedi; Ni Nyoman Metriani Nesa; Melinda Masturina; Martono Tri Utomo; Sjamsul Arief
Folia Medica Indonesiana Vol. 60 No. 1 (2024): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i1.48446

Abstract

Highlights:1. An evaluation is necessary to verify that the knowledge of healthcare providers is sufficient for the early detection of biliary atresia.2. It is crucial to promote education on prolonged jaundice to ensure early detection of biliary atresia in primary health facilities, as some primary healthcare providers have insufficient knowledge on the subject.   AbstractPrimary healthcare providers frequently fail to recognize biliary atresia because it closely mimics physiological jaundice. Early detection plays an important role in ensuring the optimal treatment of biliary atresia. Delays in referring to biliary atresia cases remain a problem around the world. The objective of this study was to analyze the knowledge of primary healthcare providers regarding prolonged jaundice as an early sign of biliary atresia. A cross-sectional study was conducted at primary healthcare centers using a self-administered questionnaire. The data were analyzed descriptively with the assistance of IBM SPSS Statistics for Windows, version 21.0 (IBM Corp., Armonk, N.Y., USA). A total of 271 respondents participated in this study, including midwives (63.8%), nurses (24.4%), and medical doctors (8.5%). This study found that 73.8% of the respondents agreed that infants with prolonged jaundice need to undergo a serum bilirubin level assessment. However, 40.2% of the respondents believed that pale stools and dark urine in yellow infants were symptoms of physiological jaundice. Concerning the definition of prolonged jaundice, 209 (77.1%) respondents provided a response indicating more than two weeks. A total of 137 (50.6%) respondents stated that biliary atresia is a disease that must be ruled out first in cases of prolonged jaundice. Nevertheless, 86 (31.7%) and 87 (32.1%) respondents also mentioned that breastfeeding jaundice and breast milk jaundice must be considered as potential causes to be investigated. These results indicated that primary healthcare providers still had limited knowledge regarding cholestasis. Education on prolonged jaundice in primary healthcare centers should be more improved to enhance the early detection of biliary atresia.  
Successful Steroid Treatment of Extrahepatic Cholestasis: A Case Report Bagus Setyoboedi; Rendi Aji Prihaningtyas; Muhammad Irawan; Syania Mega Octariyandra; Sjamsul Arief
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i4.963

Abstract

Background: Biliary atresia is the most common cause of cholestasis. However, not all healthcare facilities are capable of performing Kasai surgery and liver transplantation. The involvement of inflammatory processes in the bile ducts triggered by viral infections has been suggested in several theories of pathogenesis. This case report describes the successful steroid treatment of an infant with extrahepatic cholestasis. Case presentation: A girl aged 2 months and 20 days presented with complaints of jaundice since the age of 2 weeks, with no improvement and worsening of the jaundice, with the color of the stools becoming paler than before. The nutritional status is normal. The physical examination revealed icteric sclera, hepatomegaly, and splenomegaly. There was cholestasis (total bilirubin 7.30 mg/dL and direct bilirubin 5.75 mg/dL), as well as elevated levels of AST (249 U/L), ALT (251 U/L), GGT (995.7 U/L) and increased to 1529.6 U/L, CMV reactive IgG 28.9, and Rubella reactive IgG 6.90. A two-phase ultrasound of the abdomen showed a thickening of the gallbladder wall. A liver biopsy showed mild portal fibrosis (F1). Steroids at a dose of 2 mg/kg/day in combination with ursodeoxycholic acid were administered. At follow-up one month later, the jaundice had improved. Stools were yellow-brown, and liver function tests and bilirubin were normal. Conclusion: Adjunctive steroid therapy to suppress the inflammatory process in biliary obstruction may be beneficial in the early phase of the disease, especially in limited surgical and transplant settings.
Steroid therapy in extrahepatic cholestasis suggestive of biliary atresia: A case report Primadita Syahbani; Rendi Aji Prihaningtyas; Bagus Setyoboedi; Sjamsul Arief
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 9 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i9.1042

Abstract

Background: Biliary atresia is a fibroinflammatory disease obstructing the extrahepatic biliary system. Biliary atresia is the leading cause of cholestasis in infants and the cause of end-stage liver disease in the first two years of life. Surgical treatment with Kasai portoenterostomy has been performed but has not eliminated the need for liver transplantation. The consideration of adjuvant steroid therapy for suppressing the fibro-inflammatory process in the bile ducts may improve the outcome of extrahepatic cholestasis. Case Presentation: A case of a 2-month 7-day-old boy with a chief complaint of jaundice with suspicion of biliary atresia. Jaundice started 1 week after birth, followed by acholic stools, yellow-brown urine, distended abdomen, hepatomegaly, and visible abdominal veins. Laboratory examination revealed an elevated level of direct bilirubin (cholestasis) in combination with elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and Gamma-glutamyl transferase (GGT), hypoalbuminemia, and reactive of IgG and IgM CMV. A percutaneous liver biopsy was performed and showed extrahepatic cholestasis with mild fibrosis consistent with biliary atresia. The patient was treated with oral methylprednisolone and ursodeoxycholic acid (UDCA). After 12 weeks of therapy, the patient was free of jaundice and darkening of stool color, followed by a normal bilirubin level. Conclusion: In young infants with extrahepatic cholestasis suggestive of biliary atresia, steroid administration resulted in clinical and laboratory improvement. The involvement of the immune response in the pathogenesis of biliary atresia may suggest new therapeutic targets for biliary atresia, such as steroids for improving the outcome of biliary atresia in young infants.
PARENT COMMUNICATION PATTERNS AND RISK SEXUAL BEHAVIOR IN LATE ADOLESCENT Cindy Wahyu Agustina; Sulistiawati, Sulistiawati; Setyoboedi , Bagus
Indonesian Midwifery and Health Sciences Journal Vol. 8 No. 3 (2024): Indonesian Midwifery and Health Sciences Journal, July 2024
Publisher : UNIVERSITAS AIRLANGGA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/imhsj.v8i3.2024.211-219

Abstract

Background: Risky sexual behaviour in adolescents can have a detrimental impact on adolescent development and health, such as exposure to sexually transmitted diseases including HIV/AIDS, unwanted pregnancy, and abortion. Many factors can cause risky sexual behaviour, family factors, especially parental communication patterns are one of the most important influences, because parents are the environment that has the strongest preventive efforts in keeping adolescents involved in promiscuous activities. This study aims to find the relationship between parental communication patterns and risky sexual behaviour in late adolescents. Method: Observational analytic with cross-sectional research design. The sample size was 300 respondents with consecutive sampling technique. The independent variable is communication pattern. The dependent variable was risky sexual behaviour in late adolescents. The research data used instruments in the form of questionnaires and analysed using the Spearman's rank test with a significance level of p < 0.05. Result: Parental communication patterns in late adolescents were dominated by authoritative communication patterns at 56% and 63% of respondents have low-risk sexual behaviour. Spearman's rank test results p value < α, p = 0.000 and r = -0.239. Conclusion : Parental communication patterns have a relationship with risky sexual behaviour in late adolescents.
Delayed Admission in Neonatal Cholestasis Setyoboedi, Bagus; Prihaningtyas, Rendi Aji; Winahyu, Anindya Kusuma; Arief, Sjamsul
Journal of Community Medicine and Public Health Research Vol. 5 No. 2 (2024): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v5i2.47315

Abstract

Delayed diagnosis of cholestasis in neonates remains a problem. Cholestatic jaundice is a pathological condition that requires immediate treatment, such as biliary atresia. This study aims to analyze the characteristics of infants with cholestasis who seek treatment at a tertiary hospital. This study was a cross-sectional study to determine the characteristics of infants with cholestasis treated at the tertiary hospital at Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. Subjects were collected using medical records using the consecutive method from 2019 to 2021. The inclusion criteria in this study were infants aged >2 weeks who suffered from cholestasis. The age of the 111 infants with cholestasis involved was 4.8 ± 2.9 months old. A total of 27 (24.3%) infants visited the hospital at the age of <2 months, 36 (32.4%) at the age of 2-4 months, but most of them, consisting of 48 (43.2%) infants, came to the hospital at the age of >4 months. Jaundice was present at birth in 23 infants (20.7%), and most infants had jaundice at 1 month of age in 75 infants (67.6%). Most of the infants (75 infants) had jaundice at the age of 1 month but visited the hospital at the age of >4 months. This showed that the late diagnosis of cholestasis in infants was still quite high. This study supports education for early detection of cholestasis in primary healthcare medical personnel, community health workers, and parents.
Socialization of stool color card for early detection of biliary atresia among healthcare professionals in Primary Healthcare facilities in Probolinggo Setyoboedi, Bagus; Prihaningtyas, Rendi Aji; Utomo, Martono Tri; Akbas, Ahmad Maulana Ifan; Octariyandra, Syania Mega; Arief, Sjamsul
Caring: Jurnal Pengabdian Masyarakat Vol 4, No 3 (2024): CARING Jurnal Pengabdian Masyarakat (Desember 2024)
Publisher : Caring: Jurnal Pengabdian Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.caringjpm.2024.004.03.4

Abstract

AbstractBackground: Biliary Atresia (BA) is an idiopathic progressive fibro obliterative disease affecting the extrahepatic biliary duct with clinical manifestations of biliary obstruction in the neonatal period. Infants with BA are characterized with acholic stools which are frequently unidentified due to daily variations in stool color. Early detection is essential to reduce morbidity and mortality rates in infants with BA. Objective: This project aimed to improve the knowledge of health workers in primary health facilities in Probolinggo about BA through socialization of stool color cards as an early detection tool. Methods: Socialization was conducted to midwives in primary health facilities in Probolinggo with pre-test and post-test methods. Results: A total of 35 midwives participated in this activity. The evaluation showed a significant increase in health workers' understanding of biliary atresia. The average pre-test score was 83.82 and increased to 92.18 in the post-test with a p-value=0.00, indicating the effectiveness of counseling in improving health workers' knowledge. In addition, the implementation of the stool color card as an early detection tool received a positive response from the participants, who stated that the tool is easy to use and helps in identifying infants at risk of biliary atresia more accurately. Conclusion: The level of knowledge of health workers in primary health facilities regarding BA is still varied. Socialization of stool color cards may improve the understanding of health workers to accelerate early detection of cholestasis and improve the prognosis of infants with BA.
Perbedaan Profil Abses Hati Pyogenic dengan Amoebic pada Pasien Abses Hati Rawat Inap di RSUD Dr Soetomo Tahun 2016-2019 Paramitha, Annisya Dinda; Kholili, Ulfa; Setyoboedi, Bagus
Jurnal Kesehatan Andalas Vol. 9 No. 3 (2020): Online September 2020
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i3.1391

Abstract

Abses hati dibagi menjadi dua berdasarkan penyebab, yaitu bakteri pyogenik dan amoebik. Abses hati yang terjadi pada Dr. Soetomo masih belum diketahui, tetapi protozoa atau bakteri yang menyebabkan abses hati ditemukan banyak di Indonesia. Tujuan: Menentukan perbedaan profil klinis pasien dengan abses hati amoebik dan pyogenik di RSUD Dr. Soetomo pada periode 2016 sampai 2019.  Metode: Studi ini adalah analitik observasional menggunakan pendekatan cross-sectional pada rekam medis, dengan kriteria inklusi tes seroamoeba dan USG. Data dianalisis menggunakan uji Chi-square untuk skala nominal, t-test dan Man-Whitney untuk skala interval. Hasil: Ada 58 pasien dengan abses hati, masing-masing terdiri dari 29 pasien pada kedua jenis abses hati. Abses hati terjadi lebih dari 85% pada pria dengan usia rata- rata 42 hingga 45 tahun. Manifestasi klinis yang paling umum adalah nyeri RUQ (Kuadran Kanan Atas) (93,1%), hepatomegali (70%), dan demam (69%). Hasil pemeriksaan USG adalah abses tunggal di lobus kanan. Tinjauan terapi menggunakan drainase perkutan lebih dari operasi. Komplikasi yang paling umum adalah efusi pleura (37,9%) dan sepsis (34,5%). Kematian hanya terjadi pada abses hati pyogenik sebesar 13,8%, sedangkan pada amoebik 0%. Dan rata-rata lama durasi abses hati (LOS) adalah 15 (sekitar 7 hari). Simpulan: Terdapat perbedaan karakteristik, gambaran klinis, dan angka kematian antara pasien abses hati amoebik dan pyogenik, dan terbukti secara statistika pada mortalitas.Kata kunci: abses hati amoebic, abses hati pyogenic, rawat inap
Challenges in Managing Portal Hypertension and Fibrosis in a Case of Biliary Atresia Post-Kasai Procedure—Implications for Early Detection and Long-Term Care Jasin, Yayu Dwinita; Prihaningtyas, Rendi Aji; Octariyandra, Syania Mega; Setyoboedi, Bagus; Arief, Sjamsul
Current Internal Medicine Research and Practice Surabaya Journal Vol. 6 No. 1 (2025): 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.v6i1.54321

Abstract

Biliary atresia frequently causes portal hypertension, resulting in significant morbidity and mortality. Elevated portal pressure can be detected as early as during a Kasai procedure. Pediatric portal hypertension is the primary cause of various complications, including variceal hemorrhage, ascites, and extra-hepatic processes. This paper aims to draw attention to the complications and limitations of the Kasai procedure by presenting a case of portal hypertension and fibrosis in an 8-month-old male infant with biliary atresia who underwent the procedure at 3 months. The patient was never completely free of jaundice post-surgery. The jaundice worsened, and the pale-colored stool reappeared two months later. The abdomen was distended, accompanied by ascites, hepatomegaly, splenomegaly, and dilated veins. Edema was present on the lower extremities and the scrotum. The patient was diagnosed with biliary atresia and portal hypertension. Supportive therapy was recommended as a preparatory measure before a liver transplant. However, the parents declined the procedure due to financial constraints. This case suggests that the Kasai procedure may not always be effective. Despite the timely execution of the procedure, liver fibrosis may persist and be associated with portal hypertension. Most patients develop significant fibrosis that progresses to cirrhosis, requiring a liver transplant. To date, biliary atresia remains the primary indication for liver transplant in children, with no alternative medical treatment recognized. This case report highlights the progression of portal hypertension and liver fibrosis following the Kasai procedure for biliary atresia, emphasizing the challenges in early detection, complications management, and the exploration of alternative therapeutic strategies.   Highlights: 1. This study critically reviews the limitations and complications of the Kasai procedure in treating biliary atresia, with particular focus on portal hypertension issues, for which case reports are limited. 2. This study highlights the important need for accessible and effective long-term treatment alternatives by presenting a pediatric case where financial constraints prevented a liver transplant. 3. The data from this study are anticipated to contribute to the advancement of healthcare equity and pediatric liver disease management.
Co-Authors Akbas, Ahmad Maulana Ifan Amilia krisdiantini Anggi Sepfana Zizilia Anindya Kusuma Winahyu Anisa Yuniar Fadilla Annisya Dinda Paramitha Arvelina Novia Damayanti Budiono Budiono Budiono Budiono Cindy Wahyu Agustina Eighty Mardiyan K, Eighty Enny Karyani, Enny Evi Rokhayati Farahdina Farahdina Farida Triani Firyal Nadiah Rahmah Gina Noor Djalilah Gondo Mastutik Henry Wicaksono, Henry IDG Ugrasena Ilya Krisnana, Ilya Irwanto Irwanto Irwanto, Irwanto Jasin, Yayu Dwinita Karina Pharamita Dewi Kuntoro Kuntoro Kuntoro Kuntoro Lasmauli Situmorang Linda Dewanti Mahrus A Rahman, Mahrus A Manika Putri Kunigara Maretha Sukmawardani, Maretha Martono Tri Utomo Maytasya Dwinaqifah Melantika Nur Fitria Syahri Melinda Masturina Muhammad Irawan Muhammad Irawan Muhammad Rais Fathurrachman Mukarromah, Nur Nabilah Khansa Nastiti, Prima Hari Ni Nyoman Metriani Nesa Ningrum, Astika Gita Nisak Luvi Mega Irawati Nur Mukarromah Octariyandra, Syania Mega Paramitha, Annisya Dinda Pratiwi, Fauziah Prihaningtyas, Rendi Aji Primadita Syahbani Puspa Wardhani Qurrota Ayuni Novia Putri Rachmat Hargono Rani Sidaryanti Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Rendi Aji Prihaningtyas Reny Widayanti Samisatun Maulina, Siti Samsriyaningsih Handayani Situmorang, Lasmauli Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief Sjamsul Arief, Sjamsul Sri Umijati Sulistiawati Sulistiawati Sulistiawati Sulistiawati Syania Mega Octariyandra Teddy Ontoseno Tiyas Kusumaningrum Ulfa Kholili Utamayasa, I Ketut Alit Viky Nafi&#039;ah Rahma Maulidia Viky Nafi'ah Rahma Maulidia Widati Fatmaningrum Winahyu, Anindya Kusuma Woro Setia Ningtyas Zizilia, Anggi Sepfana