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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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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.

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

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

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.

Studi Profil Histopatologi Pasien Kolitis Di Rsud Dr. Soetomo Surabaya Nadya Wulandari Alshanti; Ummi Maimunah; Etty Hary Kusumastuti
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Kolitis merupakan peradangan usus besar yang dapat terjadi secara akut maupun kronis dan prevalensinya terus meningkat di seluruh dunia. Kolitis kronis termasuk IBD, MC, kolitis radiasi, dan kolitis iskemik. Dalam mendiagnosis kolitis, diperlukan beberapa pemeriksaan antara lain kolonoskopi dan pemeriksaan histopatologi. Manifestasi yang muncul bervariasi tergantung pada jenis kolitis. Penelitian ini bertujuan untuk mempelajari gambaran histopatologi pada pasien kolitis. Metode yang digunakan yaitu penelitian deskriptif observasional dan retrospektif terhadap 113 pasien di RSUD Dr. Soetomo Surabaya. Sampel penelitian adalah seluruh pasien yang menjalani kolonoskopi dan pemeriksaan histopatologi dan didiagnosis sebagai kolitis kronis. Data dilakukan dengan menggunakan rekam medis dari Januari 2018 â€“ Desember 2019. Hasil yang didapat bahwa dari 113 pasien, penelitian ini menemukan pada pasien kolitis kronis menunjukkan gambaran histopatologi terbanyak yaitu infiltrasi sel inflamasi pada lamina propria (100%) serta gambaran erosi mukosa (57,5%) dengan gambaran sel infiltrat terbanyak yaitu sel limfosit (32,2%) dan makrofag (28,8%). Kesimpulan: Gambaran histopatologi berupa erosi mukosa dan infiltrasi limfosit pada lamina propria merupakan gambaran yang paling sering ditemukan pada pasien kolitis kronis dalam pemeriksaan histopaatologi.

Increased Levels of TNF-α, IL-6, and IL-10 are Associated with The Degree of Liver Fibrosis in Chronic Hepatitis B Patients with NUC Therapy Ummi Maimunah; Ulfa Kholili; Rheza Rahmadika Putra; Dio Brimantyo; Hendy Wirantara
The Indonesian Biomedical Journal Vol 16, No 1 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i1.2848

BACKGROUND: Liver fibrosis in chronic hepatitis B (CHB) involves the host immune responses mainly T-lymphocyte regulatory cells and cytokines production. Tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 have been reported to play a crucial role in the development of liver fibrosis. However, their association with liver fibrosis in treated CHB patients remains unclear. Therefore, this study was conducted to investigate the association between TNF-α, IL-6, and IL-10 with the degree of liver fibrosis in treated CHB patients.METHODS: This was a cross-sectional prospective study including 101 treated chronic hepatitis B subjects. TNF-α, IL-6, and IL-10 serum levels were measured with quantitative sandwich enzyme-linked immunosorbent assay (ELISA) kit. Transient elastography result was classified according to METAVIR score. Data was analyzed by the Spearman correlation test with a p<0.05 was considered statistically significant.RESULTS: From 101 subjects, there were significant differences were seen in TNF-α, IL-6, and IL-10 between patients with mild, significant and advance fibrosis. TNF-α (r=0.292; p<0.05), IL-6 (r=0.221; p<0.05), and IL-10 (r=0.208; p<0.05) were significantly correlated with the degree of fibrosis. After multivariate analysis, TNF-α was the only one cytokine parameter which significantly correlated with the degree of fibrosis.CONCLUSION: Levels of TNF-α, IL-6 and IL-10 are associated with the degree of liver fibrosis. These parameters may potentially be used to evaluate the development of liver fibrosis in treated CHB patients.KEYWORDS: chronic hepatitis B, liver fibrosis, cytokines, transient elastography

SERUM AFP (ALPHA FETO PROTEIN) LEVELS PROFILE OF HEPATOCELLULAR CARCINOMA PATIENTS IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA Putri, Dyeneka Rustanti Indreswara; Maimunah, Ummi; Retnowati, Endang
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

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 â‰¥ 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 â‰¤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.

DETECTION OF TUMOR NECROSIS FACTOR- (TNF- ) GENE PROMOTERS POLYMORPHISM AMONG LIVER CIRRHOSIS PATIENTS WITH CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IN SURABAYA, INDONESIA Wungu, Citrawati Dyah Kencono; Amin, Mochamad; Ruslan, S. Eriaty N.; Purwono, Priyo Budi; Kholili, Ulfa; Maimunah, Ummi; Setiawan, Poernomo Boedi; Lusida, Maria Inge; Soetjipto, Soetjipto; Handajani, Retno
Indonesian Journal of Tropical and Infectious Disease Vol. 7 No. 5 (2019)
Publisher : Institute of Topical Disease Universitas Airlangga

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.

HEPATITIS B VIRUS INFECTED INDIVIDUALS' QUALITY OF LIFE AND RELATED FACTORS Ummi Maimunah; Ulfa Kholili; Amie Vidyani; Annisa Zahra Mufida; Diah Rizki Rahma Dini; Isna Mahmudah; Titong Sugiharto; Muhammad Miftahussurur
Journal of Scientech Research and Development Vol 6 No 1 (2024): JSRD, June 2024
Publisher : Ikatan Dosen Menulis

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56670/jsrd.v6i1.422

Globally, hepatitis B is a public health issue, and Indonesia is not an exception. We investigated a number of factors related to chronic hepatitis B patients' quality of life. Patients with Hepatitis B provided information to us through the WHO Quality of Life questionnaire. Data analysis conducted in this study was a chi-square test and a multivariate logistic regression model was used to calculate the odds ratios (OR). This study involved 31 people with varying quality of life. The average age range for good quality of life was 33 years, with 61.9% of patients being Javanese and 38.1% being Madurese. 70% of very good quality of life patients were Javanese, while 30% were Madurese. High school education was the most common, with 52.4% of patients having a good quality of life. Most patients worked as housewives, with 90.5% and 9.5% as factory employees. Hepatitis B control history was also a significant factor, with 57.1% of patients having never had it. Pregnancy status was 81% of patients with good quality of life, while 90% had no other diseases. Housewives with hepatitis B had a better quality of life than the others (P = 0.043). However, we could not find any association between age, ethnicity, education background, treatment, current pregnancy, and have other disease with quality of life (P = 0.645, P = 0.218, P = 0.417, P = 0.339, P = 0.133 and P = 0.419, respectively). This study reveals a significant relationship between occupation and the quality of life of hepatitis B patients, highlighting the importance of health-related quality of life in evaluating treatment and prognosis.

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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