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All Journal journal of internal medicine Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Syntax Literate: Jurnal Ilmiah Indonesia Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology Narra J Journal of Scientech Research and Development The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Ummi Maimunah

Division Of Gastroentero-hepatology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Airlangga/Dr Soetomo General Hospital, Surabaya

Author-ID : 312654

Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Earth & Planetary Sciences Education Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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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)

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

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.

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

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.

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

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

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.

Helicobacter pylori Antral Density More Valuable than Corporal Density in Chronic Gastritis Patients Bernadetta Jonan; Willy Sandhika; Ummi Maimunah; Muhammad Miftahussurur
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Helicobacter pylori has the capacity to colonize in stomach. In countries with a high prevalence of H. pylori, biopsy specimens must be obtained from corpus and antrum to elevate the accuracy. However, in a country with low prevalence of H. pylori such as Indonesia, the sensitivity of antrum specimen only is still questionable. We compared the density of H. pylori in the antrum and corpus of Indonesian gastric biopsy.Method: We conducted a prospective, cross-sectional, and observational study in thirty-two samples of corpus and antrum biopsy tissues from Pathology Anatomy Laboratory. The samples were stained by Modified Giemsa or Diff Quik. Updated Sydney System is utilized to classify the density of H. pylori.Results: Among 32 biopsy specimens from corpus and antrum, it has been statistically proven that H. pylori density in antrum and in corpus has a significant difference (65.5% vs. 15.6%, p 0.001). The density of H. pylori in antrum is mild predominant (43.8%), while the density in corpus is normal predominant (87.5%). Thus, the antral H. pylori infection was the predominant site. In 53.12% case, H. pylori was found in antrum but was not found in the corpus. In 6.24% case, H. pylori was found in both sites, but the density was higher in antrum. Importantly, no case with H. pylori infection in corpus only was found.Conclusion: H. pylori density in antrum is higher than in corpus. Only a small advantage to use additional biopsy from corpus to detect H. pylori in Indonesia.

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

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

Secondary Polycythemia in Hepatocellular Carcinoma: Treat or No Treat Poernomo Budi Setiawan; Ummi Maimunah; Nenci Siagian
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 1 (2020): VOLUME 21, NUMBER 1, April 2020
Publisher : The Indonesian Society for Digestive Endoscopy

A 45-year man with a chronic hepatitis B virus (HBV) infection, elevated alphafetoprotein (AFP) 628ng/dL and Abdominal CT-scan features of Hepatocellular Carcinoma was admitted with polycythemia condition (haemoglobin 20.4g/dL, haematocrit 65.4%). Elevated of erythropoietin (EPO) serum level confirmed the polycythemia was because of hepatocellular carcinoma (HCC) as a paraneoplastic syndrome. Based on diganosis criteria of HCC by Indonesian Association for the Study of the Liver 2017, the patient was diagnosed with HCC Barcelona clinic liver cancer (BCLC) B and was treated with trans arterial chemotherapy and embolization (TACE) with mixed doxorubicin. Aspirin 80mg once daily was given to patient to prevent thrombosis event. One month later after TACE, haemoglobin and haematocrite didn’t improve. Then 4 months later the patient died of cardiovascular event in the last admission at district hospital.

Gastric Mucosa Plasma Cells is Unspecific for Diagnosing Helicobacter pylori Infection Gilda Hartecia; Willy Sandhika; Ummi Maimunah; Muhammad Miftahussurur
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Background: A high density of Helicobacter pylori is believed to trigger an accumulation of plasma cells in the gastric mucosa. This accumulation stimulated the production of antibodies, causing high antibodies titer being circulated in the blood. The aims of this study is to identify the correlation between the number of plasma cells and H. pylori density in gastric mucosa.Method: This observational analytic study was performed with cross-sectional approach. The samples were the paraffin blocks which consisted of endoscopic gastric biopsy tissues of chronic gastritis patient in Anatomic Pathology Laboratory Dr. Soetomo General Hospital Surabaya in 2017 period. A total of 30 samples were purposively collected. Endoscopic gastric biopsy tissues were stained by two stains, Haematoxylin-Eosin and Modified Giemsa. The examination was performed by experienced pathologist. The correlation between total plasma cells and H. pylori density in gastric mucosa and the difference of total plasma cells between gastric mucosae with different density of H. pylori were determined.Results: There was no significant correlation between total plasma cells and H. pylori density in gastric mucosa. And there was no significant difference of the number of plasma cells found with different density of H. pylori.Conclusion: The number of plasma cells in the gastric mucosa is unspecific for diagnosing H. pylori infection. Other causes associated with plasma cells need to be assessed in further studies.

Clinical Utility of Quantitative Hbsag in Chronic Hepatitis B Infection Poernomo Boedi Setiawan; Ummi Maimunah; Khairu Zein
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

The prevalence of hepatitis B infection in Indonesia is still alarming, while its therapies cannot eradicate the virus and only aim for long term viral suppression. HBsAg quantification has become an emphasis on researches, regarding its capacity to identify the natural history of hepatitis B virus infection and predict the outcome of therapies. This review aims to determine the clinical role of HBsAg in chronic hepatitis B infection by reviewing textbooks, journal articles, and review articles without language restriction. This review finds that HBsAg is capable of predicting degrees of liver fibrosis severity in patients with chronic hepatitis B infection. Furthermore, HBsAg quantification can be used to distinguish inactive carriers from patients with HBeAg-negative chronic hepatitis B. The decrease of HBsAg is a good predictor of HBsAg loss, and it denotes discontinuation of nucleoside/nucleotide analog therapy. HBsAg quantification is also used in combined PEG-IFN and nucleoside/nucleotide analog therapy. Nevertheless, this role is still controversial. Additionally, HBsAg cannot replace the major roles of HBV DNA measurement in therapy management. Using either HBsAg or HBV DNA in therapy algorithm decreases its predictive value, hence recommendation to use both. In identifying patients with occult hepatitis B infection (OBI), HBV DNA still cannot be replaced by HBsAg quantification. Furthermore, HBsAg quantification may not be a good predictor of hepatocellular carcinoma in patients with OBI. Future studies are expected to demonstrate the role of HBsAg in current hepatitis B therapy and also future therapies.

Co-Authors Adaninggar PN Alphania Rahniayu Alshawsh, Mohammed A. Amie Vidyani Anggoro, Adhitri Annisa Zahra Mufida Ariani, Grace Arin Nurtya Artaria Tjempakasari, Artaria Aryati Aswin, R. Haryanto atika Bernadetta Jonan Bramantono Bramantono, Bramantono Budi W Budi Widodo Budi Widodo Budi Yuwono Denny Vianto Diah Rizki Rahma Dini Dio Brimantyo Djuanda, Stephanie N. DYAH FAUZIAH, DYAH Edi Suyanto Eko Budi Koendhori, Eko Budi Endang Retnowati Erik Hasudungan Esti Rohani Fauziah Diayu Retnaningtyas Gatot Soegiarto Gilda Hartecia Gunawan, Vania A. Hadisuwarno, Wiharjo Hartecia, Gilda Hendy Wirantara HERNOMO ONTOSENO KUSUMOBROTO Hernomo Ontoseno Kusumobroto Herry Purbayu I Made Subhawa Harsa Imelda Maria Loho, Imelda Maria Imro'ati, Tri Asih Inne Tria Ramafita Isna Mahmudah Iswan A Nusi Iswan A Nusi Iswan A Nusi Iswan Abbas Nusi Izzatul Fithriyah Jonan, Bernadetta Khairu Zein Kusumastuti, Etty H. KUSUMASTUTI, ETTY HARY Lefi, Achmad Lilihata, Jilientasia G. Maharani, Andi RK. Marhana, Isnin A. Maria Inge Lusida MOCHAMAD AMIN Muhammad Aafi Baharuddin Attamimi Muhammad Miftahussurur Munawaroh Fitriyah Nadya Wulandari Alshanti Natasya Ariesta Selyardi Putri Nenci Siagian Nila Kurniasari Nugraha, Ricardo A. Nugroho, Gilang MS. Pangestu Adi PN, Adaninggar Poernomo B Setiawan Poernomo Boedi Setiawan Poernomo Boedi Setiawan Poernomo Budi Setiawan Priyo Budi Purwono Puspa Wardhani Puspa Wardhani Puspitasari, Yessy Putri, Dyeneka Rustanti Indreswara Rahaju, Anny S. Retno Handajani Rheza Rahmadika Putra Rinjani, Lalu GP. Rosyid, Alfian N. Rudyanto Rudyanto Ruslan, S. Eriaty N. Savita, Lady Semedi, Bambang P. Setiawan, Poernomo B Setiawati, Rosy Shahnaz Azzahra Soelistijo, Soebagijo Adi SOETJIPTO . Sulistiawati Suprapto Ma’at Supriadi Supriadi Tanaya, Willa M. Thamrin, Husin Titong Sugiharto Titong Sugihartono Tjahjadi, Angela Kimberly Tri Asih Imro'ati Ulfa Kholili Wahyu, Dwi Wessels, Firda I. Widodo, Budi Willy Sandhika Wiratama, Priangga A. Wiwin Retnowati Wungu, Citrawati Dyah Kencono Yandi, I KR. Yetti Hernaningsih Yoshio Yamaoka Yoshio Yamaoka, Yoshio Yudith Annisa Ayu Rezkitha, Yudith Annisa Ayu Zein, Khairu

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