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All Journal journal of internal medicine Indonesian Journal of Tropical and Infectious Disease WMJ (Warmadewa Medical Journal) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Poernomo Boedi Setiawan
Division Of Gastroentero-hepatology, Departement Of Internal Medicine Faculty Of Medicine, Universitas Airlangga/Dr Soetomo General Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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)

Abstract

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.
RAGAMAN GENETIK GEN POLIMERASE VIRUS HEPATITIS B PADA PASIEN HEPATITIS B KRONIK DENGAN PENGOBATAN TELBIVUDIN Gondo Mastutik; Juniastuti Juniastuti; Ali Rohman; Mochamad Amin; Poernomo Boedi Setiawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1097

Abstract

Infection caused by hepatitis B virus (HBV) is still a major global health problem and can cause liver cirrhosis and hepatocellularcarcinoma as well. Telbivudine is one among the drugs used to treat the disease routinely. However, using this drug in a long term therapymight cause mutations in HBV polymerase gene that decreases the effectiveness of the therapy. Here with the researchers report the geneticvariations of the gene isolated from telbivudine-which is used treated chronic hepatitis B patients in Surabaya, Indonesia. The blood serawere collected at Dr. Soetomo hospital from 10 telbivudine-treated and 10 untreated chronic hepatitis B patients. The DNA viral wasisolated and purified from each serum. Sequence polymerase gene at nucleotides 455 to 796 was amplified by PCR, and then analyzedbio informatically to determine their mutation profile. This study revealed a point mutation in HBV25 sample at nucleotide A1525G thatgives rise to I509V modification. Such mutation is also observed in a sequence that is available in Gen Bank with an accession numberAY641562. Additionally, the researchers found point mutations A1554G, T1593C, and C1629T in HBV25 sample and a point mutationA1554G in HBV20 sample. However, these mutations are silent. To conclude, the mutation in HBV polymerase gene among telbivudinetreatedchronic hepatitis B patients in Surabaya is known as A1525G.
GENOTIPE DAN SUBTIPE VIRUS HEPATITIS B PENDERITA YANG TERINFEKSI KRONIK AKTIF Gondo Mastutik; Juniastuti Juniastuti; Ali Rohman; Mochamad Amin; Poernomo Boedi Setiawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i2.1077

Abstract

Chronic activivity of Hepatitis B Virus (HBV) infection can lead to liver cirrhosis or hepatocellular carcinoma. The objective of thisstudy was to know by analyzing the distribution of HBV genotypes and subtypes from hepatitis B patients suffering from chronic activehepatitis B infection in Surabaya. The HBV genotypes were determined by comparing the S gene sequences to those kept in the GeneBank. The phylogenetic tree was constructed by means of the unweighted-pair group method using arithmetic averages. Furthermore,the subtypes were deduced based on the prediction of amino acid residues 116 to 183 of HBsAg on multiple sequences alignment withClustalW2. This study involved 20 sera obtained from patients suffering chronic active hepatitis B infection. After PCR and sequencing,it was found that 13 samples could be used for sequence analysis. The results showed that all sequences were clustered into HBV genotypeB. The subtype adw2 was identified from 12 of 13 sequences, whereas one (1) belonged to ayw1. The subtype adw2 is most prevalent inIndonesia, namely in the islands of Sumatra, Java, South Kalimantan, Bali, Lombok, Ternate, and Morotai, while ayw1 is found in theislands of Nusa Tenggara and Moluccas. Based on this study, it was found that the patients with HBV subtype adw2 were from Surabaya, whereas with ayw1 was from Nusa Tenggara. It can be concluded that the HBV infected patients with chronic active hepatitis B inSurabaya have the genotype B with subtype adw2 which was originally from Surabaya, whereas, ayw1 was a patient originally fromNusa Tenggara.
CORRELATION BETWEEN HCV RNA VIRAL LOAD AND HOMA-IR IN CHRONIC HEPATITIS C PATIENTS Nadhya Allia; Poernomo Boedi Setiawan; Soebagijo Adi Soelistijo
Current Internal Medicine Research and Practice Surabaya Journal Vol. 2 No. 2 (2021): 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.v2i2.26537

Abstract

Background: Insulin resistance (IR) is one of the extrahepatic complications of hepatitis C virus (HCV) infection that needs to be recognized early. HOMA-IR is an effective way to measure insulin resistancy. Core proteins, NS-3, and NS-5 are the main components of HCV RNA proteins which are involved in the incidence of IR. Seeing this, a hypothesis was developed that the level of HCV RNA viral load was related to the HOMA-IR. This study was designed to identify the correlation between HCV RNA viral load with HOMA-IR in chronic hepatitis C patients.Method: We conducted a cross-sectional approach from the medical record of chronic hepatitis C patients at the outpatient clinic dr. Soetomo Hospital, Surabaya. A total of 30 patients aged >19 years old with complete medical records were included. Clinical and laboratory (including HCV RNA viral load level and HOMA-IR) data were obtained from the availability of medical records.Result: A total of 30 chronic hepatitis C patients, 17 (56.7%) were women and 13 (43.3%) were men, with mean age was 50.90 ± 7.17 years. The median of HCV RNA viral load level was 3,14 x106 IU/ml and the median of HOMA-IR was 4.50. The result of the Spearman correlation test showed a moderate positive association between HCV RNA viral load and HOMA-IR (r=0.537 ; p=0.002).Conclusion: A positive moderate correlation was obtained between HCV RNA viral load with HOMA-IR in chronic hepatitis C patients.
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

Abstract

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
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Herry Purbayu; Poernomo Boedi Setiawan; Iswan A Nusi; Pangestu Adi; Hernomo Ontoseno Kusumobroto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200776-79

Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (482.519 KB) | DOI: 10.24871/2032019169-176

Abstract

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 CORRELATION BETWEEN THE SEVERITY OF LIVER CIRRHOSIS WITH ESOPHAGEAL VARICES IN RSUD DR SOETOMO SURABAYA Deva Medisika Hertiti; Poernomo Boedi Setiawan; Gwenny Ichsan Prabowo
Current Internal Medicine Research and Practice Surabaya Journal Vol. 3 No. 2 (2022): 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.v3i2.38065

Abstract

Introduction: Liver cirrhosis is the end stage of chronic liver disease. The morbidity and mortality associated with complications of liver cirrhosis are very high. In cases of death caused by cirrhosis of the liver, it tends to increase from around 676,000 in 1980 to more than one million in 2010, globally equivalent to 2% of all mortality in the world (Mokdad et al., 2014). The mortality rate increases if there are complications such as ascites, hepatic encephalopathy, esophageal varices, and liver cancer, with success rates of 20-60%, 50%, 70-90% (D'Amico, 2014). In liver cirrhosis with esophageal varices, it is reported that patients with mild and severe liver cirrhosis risk 40% and 85% for varicose veins. So, this research is to determine the correlation between the severity of liver cirrhosis with esophageal varices in Dr. Soetomo General Hospital Surabaya. Methods: This study was an analytic observational with a cross-sectional study design. The research subjects used in this study were patients diagnosed with liver cirrhosis with esophageal varices from January 2015 - December 2016. Data were collected from medical records and analyzed using the spearman correlation test. Sampling was carried out in total sampling. Results: Of 26 subjects, most of the subjects were men (69.32%), the highest severity of liver cirrhosis from the Child B group (53.85%), and the highest esophageal varices were grade II and III (46,15%). The most results from each group based on the severity of liver cirrhosis were Child A with grade II esophageal varices (66.7%), and Child B with grade II esophageal varices (64.3%), and Child C with esophageal varices grade III esophagus (88.9%). A correlation coefficient was obtained at 0.659 (p <0.005). Conclusion: This research concludes a significant correlation between the severity of liver cirrhosis and esophageal varices.
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

Abstract

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.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1302.693 KB) | DOI: 10.20473/ijtid.v7i5.7275

Abstract

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.
Co-Authors Ali Rohman Amie Vidyani Budi W Budi Widodo Chatarina Umbul Wahyuni Denny Vianto Deva Medisika Hertiti Fauziah Diayu Retnaningtyas Gondo Mastutik HERNOMO ONTOSENO KUSUMOBROTO Hernomo Ontoseno Kusumobroto Herry Purbayu Iswan A Nusi Iswan A Nusi Iswan Abbas Nusi Juniastuti Juniastuti Khairu Zein Maria Inge Lusida Mochamad Amin MOCHAMAD AMIN Muhammad Miftahussurur Nadhya Allia Pangestu Adi Prabowo, Gwenny Ichsan Priyo Budi Purwono Retno Handajani Rudyanto Rudyanto Ruslan, S. Eriaty N. Soelistijo, Soebagijo Adi SOETJIPTO . Soetjipto Soetjipto Thamrin, Husin Titong Sugihartono Ulfa Kholili Ummi Maimunah Wungu, Citrawati Dyah Kencono Zein, Khairu