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All Journal journal of internal medicine Jurnal Kesehatan Andalas Indonesian Journal of Tropical and Infectious Disease WMJ (Warmadewa Medical Journal) The Indonesian Biomedical Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Care : Jurnal Ilmiah Ilmu Kesehatan JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) 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 Scientica: Jurnal Ilmiah Sains dan Teknologi

Ulfa Kholili

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

Author-ID : 3297917

Religion Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Earth & Planetary Sciences Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Surgery in Liver Diseases: Perioperative Evaluation & Management Ulfa Kholili; Denada Aisyah Syalini
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

Many patients with liver disease would have to undergo surgery. Surgery and anesthesia in patients with liver disease are associated with extremely high perioperative complications and mortality. Identification of the type of liver disease, stratification of risk factors, and management of preoperative, intraoperative, and postoperative complications are essential to reduce the morbidity and mortality. Surgical risk is increased in patients with liver cirrhosis. Child turchote pugh (CTP) and the model for end stage liver disease (MELD) are two scoring systems which are often used nowadays to stratify risk factors in patients with liver cirrhosis who will undergo surgery. Elective surgery is well tolerated in cirrhosis patients with CTP class A and permissible in patient with CTP class B with preoperative preparation, except for extensive liver resection surgery and cardiac surgery. Elective surgery is contraindicated in patients with CTP class C, acute viral hepatitis, alcoholic hepatitis, fulminant liver failure, and liver disease with severe extrahepatic complication such as hypoxemia, cardiomyopathy, and acute renal failure. Intensive monitoring in the postoperative period and early intervention of complications are also essential to reduce the morbidity and mortality.

Profiles of Clinical and Liver Function Test of Hepatitis B and C Patients with Liver Cirrhosis Andreas Novaldi Watang; Aryati Aryati; Ulfa Kholili
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 14 No. 1 (2023): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V14I12023.30-35

Highlights:1. Liver cirrhosis due to viral hepatitis is still a big problem in developing countries.2. There were no significant differences in clinical and laboratory profile results between patients with liver cirrhosis caused by hepatitis B and C. AbstractIntroduction: Liver cirrhosis is a degenerative liver disease that ranks 14th as a global problem and has a high prevalence rate. This study aimed to determine the clinical and laboratory profile of inpatients with liver cirrhosis.Methods: Medical record data of liver cirrhosis patients at Dr. Soetomo General Academic Hospital, Surabaya, in 2018-2019, were used in this cross-sectional descriptive observational study. The results were analyzed statistically to determine the different profiles between patients with liver cirrhosis caused by hepatitis B and C.Results: 112 subjects in this study had liver cirrhosis caused by hepatitis B or C. The majority of cirrhotic patients were males over 40 years old. Melena was the most frequent complaint, and abdominal enlargement and hepatitis B virus (HBV) infection were the most common causes. Liver function tests in hepatitis B and C patients respectively showed albumin results of 2.73 g/dL (± 0.54); 2.75 g/dL (± 0.61), prothrombin time was 14.75 seconds (10.80-49.40); 14.9 seconds (11.1-19.1), direct bilirubin 1.17 mg/dL (0.9-17.05); 0.82 mg/dL (0.12-8.43), total bilirubin 2.18 mg/dL (0.28-24.9); 1.58 mg/dL (0.38-9.7), AST 50.5 U/L (16-826); 48.5 U/L (31-545), ALT 51.5 U/L (8-869); 38.5 (12-127). Subjects with hepatitis B and C had a median length of stay of 7.00 days, with an overall mean of 7.16 days. There was no significant difference in the results between patients with liver cirrhosis due to hepatitis B and C.Conclusion: There was no significant difference between patients with liver cirrhosis caused by hepatitis B and C.

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.

Correlation between APRI, FIB-4 and GPR Indices to Fibroscan and HBeAg Status in Patients with Chronic Hepatitis B Rina Erlina; Puspa Wardhani; Yessy Puspitasari; Ulfa Kholili
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1718

Liver fibrosis is a complication of chronic hepatitis B. Early detection of liver fibrosis is important for therapy. The aspartate aminotransferase index (AST)-to-platelet ratio index (APRI) and the fibrosis index based on 4 factors (FIB-4) in chronic hepatitis B have been widely studied despite the inconsistent results. Research on other serum markers is extensively carried out, including Gamma-Glutamyl Transpeptidase (GGT)-to-platelet ratio (GPR). Previous studies have shown that the GPR index was more accurate than APRI and FIB-4. HBeAg status is an indication for therapy. There have not been many studies on the correlation of serum markers with HBeAg status. This study aimed to determine the correlation of APRI, FIB-4, and GPR with Fibroscan and HBeAg status in chronic hepatitis B patients. A cross-sectional study was carried out from June to September 2020 and found 50 chronic hepatitis B patients. Platelet count was measured using a Sysmex XN-1000 hematology device; AST, alanine aminotransferase (ALT), and GGT levels were measured using the Dimension RXL clinical chemistry device; and the degree of fibrosis was determined using transient elastography (Fibroscan). Spearman correlation test was used in this study for the correlation analysis. The results showed a significant correlation between APRI, FIB-4 and GPR indices with Fibroscan (r=0.454, p 0.001; r=0.610, p < 0.001; r=0.540, p < 0.001, respectively). A significant correlation was found between APRI, FIB-4 and GPR indices with negative (-) HBeAg (r=0.486, p 0.004; r=0.648, p < 0.001; r=0.595, p < 0.001, respectively). In addition, a significant correlation was found between FIB-4 and positive (+) HBeAg (r=0.499, p 0.049), but no correlation was found between APRI and GPR with positive (+) HBeAg (r=0.295, p 0,267; r=0.386, p 0.140, respectively).

A PATIENT DENGUE HEMORRHAGIC FEVER WITH SPASMS Kholili, Ulfa; Nasronudin, Nasronudin
Indonesian Journal of Tropical and Infectious Disease Vol. 5 No. 3 (2014)
Publisher : Institute of Topical Disease Universitas Airlangga

Indonesia is one of the countries with the high endemic of Dengue viral infection followed by Thailand, Myanmar, India and Srilanka. For more 10-15 years, Dengue Viral Infection/DHF has become a cause of patient who should be hospitalized and was the first cause of death children in south easthern Asia.1,2 Batavia was the first city of Indonesia found Dengue Viral infection which had been written in journal by David Bylon in the 1779. Encephalopathy of dengue (ED) is one unusually complication of dengue viral infection which had been characterized by aberration the arrangement of nerves central (CNS). This paper want to describe of a young teenage with suffer from DHF and seizure. Beside it, pleural effusion and cerebral edema had been found. Seizure most likely due to dengue encephalopathy associated with cerebral edema and was supported by positive IgG and IgM anti dengue. Corticosteroid was given toimprove cerebral edema. By good management as long as admission, she was discharged from hospital with a good condition.

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.

Association between COVID-19 severity with liver abnormalities: A retrospective study in a referral hospital in Indonesia Maimunah, Ummi; Kholili, Ulfa; Vidyani, Amie; Sugihartono, Titong; Tanaya, Willa M.; Wessels, Firda I.; Alshawsh, Mohammed A.; Miftahussurur, Muhammad
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.816

Coronavirus disease 2019 (COVID-19) is characterized by an acute respiratory infection with multisystem involvement and the association of its severity to liver function abnormalities is not well characterized. The aim of this study was to assess the association between the severity of COVID-19 patients and liver function abnormalities. This retrospective study included adult patients with confirmed COVID-19, which were classified as non-severe or severe according to World Health Organization guidelines. Liver function test results were compared between the severity groups. A total of 339 patients were included of which 150 (44.25%) were severe cases. The male-to-female ratio was 0.9:1 and 3:2 in the non-severe and severe groups, respectively (p=0.031). Aspartate aminotransferase (AST), alanine transaminase (ALT), and total bilirubin levels and acute liver injury (ALI) incidence were significantly higher in the severe group compared to non-severe group (p<0.001, p<0.001, p=0.025, p=0.014, respectively). In contrast, albumin levels were significantly lower (p=0.001). Multivariate analysis showed that ALI was significantly associated with human immunodeficiency virus (HIV) infection (odds ratio (OR): 5.275; 95% confidence interval (CI): 1.165–23.890, p=0.031), hemoglobin level (OR: 1.214; 95%CI: 1.083–1.361, p=0.001), and hypoalbuminemia (OR: 2.627; 95%CI: 1.283–5.379, p=0.008). Pre-existing liver diseases were present in 6.5% of patients. No significant differences were observed between the groups based on COVID-19 severity and ALI presence. Liver function test abnormalities, including ALI, are more prevalent in patients with severe COVID-19 infection. HIV infection, high hemoglobin levels, and hypoalbuminemia may be potential risk factors for ALI.

Integrating FIB-4 and APRI into Clinical Practice Guidelines: A Literature Review Ghaniyya, Willandra Fitriyanri; Humairah , Ira; Kholili , Ulfa
Scientica: Jurnal Ilmiah Sains dan Teknologi Vol. 3 No. 2 (2024): Scientica: Jurnal Ilmiah Sains dan Teknologi
Publisher : Komunitas Menulis dan Meneliti (Kolibi)

Show Abstract | Download Original | Original Source | Check in Google Scholar

The FIB-4 and APRI indices have emerged as pivotal tools in the non-invasive assessment of liver fibrosis and cirrhosis, providing clinicians with accessible and cost-effective alternatives to liver biopsy. These scoring systems utilize routine laboratory parameters to stratify patients based on their risk of advanced fibrosis, making them especially valuable in managing chronic hepatitis B (HBV), hepatitis C (HCV), and non-alcoholic fatty liver disease (NAFLD). Their integration into clinical practice has significantly improved diagnostic accuracy and reduced the burden of invasive procedures, particularly in resource-constrained settings. Despite their advantages, the global adoption of FIB-4 and APRI faces several barriers. Variability in healthcare infrastructure, access to diagnostic resources, and differences in patient populations pose challenges to their consistent implementation. Furthermore, inequality in healthcare delivery systems and a lack of standardized protocols can lead to inconsistent utilization, particularly in low- to middle-income countries. Addressing these obstacles is critical to ensuring equitable and reliable liver disease assessment across diverse healthcare systems. Future research should focus on refining these indices, exploring their performance in diverse populations, and integrating them with emerging diagnostic technologies. Policymakers and healthcare stakeholders must work collaboratively to develop adaptable clinical guidelines that incorporate non-invasive liver tests into routine practice. By overcoming these challenges, the global integration of FIB-4 and APRI has the potential to transform liver disease management, improve patient outcomes, and promote health equity worldwide.

Co-Authors Adaninggar PN Agung Dwi Wahyu Widodo Alshawsh, Mohammed A. Alvin Hartanto Kurniawan Alvin Hartanto Kurniawan Amie Vidyani Andreas Novaldi Watang Annisa Zahra Mufida Annisya Dinda Paramitha Aryati Aryati Bagus Setyoboedi Benedictus Hanjaya Suwandi Brimantyo, Dio Budi W Budi Widodo Budi Widodo Denada Aisyah Syalini Denny Vianto Diah Rizki Rahma Dini Dwicahya, Fatrian Erlina, Rina Fardah Athiyyah, Alpha Fauziah Diayu Retnaningtyas Ghaniyya, Willandra Fitriyanri Hamzah, Arshq Mirza Herry Purbayu Humairah, Ira Isna Mahmudah Iswan A Nusi Iswan A Nusi Iswan A Nusi Iswan Abbas Nusi Maria Inge Lusida MOCHAMAD AMIN Mochamad Amin Muhammad Miftahussurur Muhammad Rivai Muhammad Vitanata Arfijanto, Muhammad Vitanata Nasronudin Nasronudin Novira Widajanti, Novira Nurhidayah, Meiwinda Rizky Pangestu Adi Paramitha, Annisya Dinda PN, Adaninggar Poernomo B Setiawan Poernomo Boedi Setiawan Poernomoboedi Setiawan Prabowo, Gwenny Ichsan Priyo Budi Purwono Puspa Wardhani Puspitasari, Yessy Putra, Rheza Rahmadika Retno Handajan Retno Handajani Rina Erlina Ruslan, S. Eriaty N. Setiawan, Poernomo B Setiawati, Rosy Shahnaz Azzahra SOETJIPTO SOETJIPTO . Soetjipto Soetjipto Sulistiawati, Sulistiwati Syalini, Denada Aisyah Tanaya, Willa M. Thamrin, Husin Titong Sugiharto Titong Sugihartono Tri Yanti Ummi Maimunah Vania Azalia Gunawan Wessels, Firda I. Widodo, Budi Wirantara, Hendy Wungu, Citrawati Dyah Kencono Yanti, Tri

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