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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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Articles

Title

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.

The Management Problems of Patient with Chronic Hepatitis B Infection and Its Reactivation Tri Asih Imro'ati; Ummi Maimunah
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

Hepatitis B virus infection is a major global health problem in the world and particularly in Indonesia. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer. In this case, we will show about the problems that may occur while we manage a patient. A 55 years old man with chronic hepatitis B has been treated with Telbivudin 600 mg for 8 years and and then stop for 2 years (The HBsAg has been non reactive, HBeAg has been seroconversion from positive to negative, and HBV DNA has been not detected since 2014 until January 2016). In 2018, patients undergo surgery to remove nodules in the liver. After that, there were transaminase and bilirubin elevation, and then HBsAg become reactive again. After giving combination therapy of Telbivudin 600 mg with Entecavir 0.5 mg and metyl prednisolone 8 mg (per os, three times a day) for 1 months, the transaminase became decrease, but the bilirubine was still high. The patient was reported to have died in February 2019 after being hospitalized in a hospital outside Java, so we could not know or investigasted the cause of his mortality.

Response Evaluation of Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatocellular Carcinoma with Respect to Tumour Size, Number of Lesion, and Alpha-Fetoprotein (AFP) Level Adaninggar PN; Ulfa Kholili; Ummi Maimunah; Poernomo B Setiawan; Iswan A Nusi; Herry Purbayu; Titong Sugihartono; Budi Widodo; Husin Thamrin; Amie Vidyani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 1 (2016): VOLUME 17, NUMBER 1, April 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Transarterial chemoembolization (TACE) is widely used as a palliative treatment for unresectable hepatocellular carcinoma (HCC). TACE is also used as bridging therapy before liver transplantation to avoid tumour progression and considered for downstaging to fulfill tumour resection or liver transplantation criterias. This study aimed to evaluate response of TACE in unresectable HCC according to changing of tumour size, number of lesion, and AFP level.Method: Retrospectively, we evaluate 69 HCC patients who underwent TACE in Dr. Soetomo General Hospital in January 2012-June 2015, including their age, sex, aetiologies, and Barcelona Clinic Liver Cancer/BCLC staging. Laboratory examinations such as complete blood count (hemoglobin/Hb, leucocyte, thrombocyte), liver function test (aspartate aminotransferase/AST, alanine aminotransferase/ALT, bilirubin, albumin, international normalized ratio/INR), alpha-fetoprotein/AFP level, and abdominal CT-scan were performed before and 1 month post-TACE. Data was analysed using paired t-test.Results: 69 patients with mean age of 51.81 ± 12.8 years old, predominantly 76.8% males, the most common aetiology was hepatitis B 68.1%, 92.8% BCLC B, 64.3% with stable disease, none achieved complete response, 97.1% had tumour size 5 cm, 69.6% had single tumour, and 55.7% had AFP level 1000 ng/mL. There was a significant increase in tumour size and number of lesions in 1 month post-TACE that were approximately 1.76 cm and 2.33, respectively, and there was no significant difference between AFP level before and 1 month post TACE.Conclusion: In 1 month post TACE evaluation, there was a significant increase of tumour size and number of lesion, but there was no significant alteration in AFP level. TACE might be performed repeatedly with shorter evaluation interval than 1 month to achieve better response.

Severe Acute Pancreatitis Caused by Gallstones in a Young Adult Ummi Maimunah; Inne Tria Ramafita
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Acute pancreatitis is a pancreatic exocrine disorder consisting of various degrees of inflammation and is correlated with the parenchymal gland's damage due to auto-digestion of pancreatic enzymes. One of the causes of acute pancreatitis is gallstones. Acute pancreatitis has a typical clinical picture of abdominal pain with sedentary and blunt characteristics located in the epigastrium or periumbilical and often radiates to the back or chest, waist, and lower abdomen. Here presented a case of a 20-year-old male diagnosed with severe acute pancreatitis caused by gallstones who experienced various complications including acute necrotizing pancreatitis, colon perforation that caused generalized peritonitis and fistulation, as well as sepsis. The patient felt the main complaints, including intermittent abdominal pain, decreased appetite, nausea, and weakness. The treatment given is adequate conservative therapy and surgery for fluid and abscesses drainage, correction of fistulations, and perforation of hollow organs.

Gut Microbiota and Non-Alcoholic Fatty Liver Disease: Current Pathogenic Paradigm and Therapeutic Aspect Maimunah, Ummi; Soelistijo, Soebagijo Adi; Hadisuwarno, Wiharjo; Miftahussurur, Muhammad
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: 10.24871/2422023154-162

Changes in the gut microbiota are essential factors that cause non-alcoholic fatty liver disease (NAFLD), obesity, and diabetes. Small intestine bacteria overgrowth is discovered in NAFLD patients. Disruptions in the gut-liver axis include environmental factors that induce microbiota dysbiosis and/or increased intestinal permeability that causes liver inflammation. The most recommended therapy for NAFLD patients is still limited to lifestyle changes. This review will describe the role of the gut microbiota in the pathogenesis and therapeutic intervention of NAFLD. Recent evidence reveals that the gut microbiota is one of the main factors in the pathogenesis and progression of NAFLD through several mechanisms, particularly dysbiosis. This significant role makes the gut microbiota a non-invasive biomarker for NAFLD examination and a more effective therapeutic target.

Trends in Hepatocellular Carcinoma among Hepatitis C Patients Achieving Sustained Virological Response Following Direct-Acting Antivirals Treatment Maimunah, Ummi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/25320241-2

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 Brimantyo, Dio Budi W Budi Widodo Budi Widodo Budi Yuwono Chatarina Umbul Wahyuni Denny Vianto Diah Rizki Rahma Dini 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 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 Putra, Rheza Rahmadika Putri, Dyeneka Rustanti Indreswara Rahaju, Anny S. Retno Handajani 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 Wirantara, Hendy 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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