Bogi Pratomo
Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, University of Brawijaya/Dr. Saiful Anwar General Hospital, Malang

Published : 22 Documents
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Journal : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Role of Phytopharmacy as Hepatoprotector in Chronic Hepatitis Herlianto, Budi; Mustika, Syifa; -, Supriono -; Pratomo, Bogi; Achmad, Harijono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Hepatitis is one of the health problems in Indonesia that require special treatment, in line with the increase of morbidity and mortality rate of this disease. Complications of hepatitis include liver cirrhosis and hepatocellular carcinoma. Indonesia, as a tropical country, has many medicinal plants that act as hepatoprotector, a substance that can protect liver from toxic agent. Use of medicinal plants is still considered as controversial treatment because there is still lack of studies. Medicinal plants with mix composition of phytopharmacy, such as: Curcuma xanthorrhiza, Arcangelesia flava, Nigella sativa, and Kleinhovia hospita show potency as hepatoprotector. The objective of this study is to analyse the function of phytopharmacy as hepatoprotector in chronic hepatitis.Method: This study is a clinical trial performed in the Gastroenterology Department and Outpatient Clinic in Saiful Anwar Hospital in May-June 2013. Chronic hepatitis B or C patients who have received antiviral therapy with > 3 fold increase of the threshold value of transaminase level, were included in this study. In this study, patients consumed phytopharmacy tablet 3 times per day. After 7 days of treatment, patients’ serum transaminase levels (ALT and AST) were re-assessed. Statistical analysis of before and after treatment data was performed using Wilcoxon test and the result was significant with p < 0.05.Results: From 10 patients, the average age was 50.3 years old. Sixty percent (60%) of them were male, with 50% suffered from chronic hepatitis B and the other 50% suffered from chronic hepatitis C. From this study, decrement of alanine transaminase (ALT) and aspartate transaminase (AST) after seven days of treatment were 45.06%, with p = 0.007 and 48.63%, with p = 0.007, respectivelyConclusion: Phytopharmacy supplementation in chronic hepatitis can decrease serum transaminase, however further study is needed. Keywords: chronic hepatitis, phytopharmacy, ALT, AST, hepatoprotector 
Overview of Serum Interleukin-18 (IL-18) Levels in Liver Cirrhosis Patients and Their Correlation to Hepatic Encephalopathy Komala, Anton; Mustika, Syifa; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: The inflammatory process has an important role in the pathophysiology of hepatic encephalopathy (HE) in liver cirrhosis. IL-18 is a key mediator who plays a role in neuroinflamation processes that can lead to symptoms of HE. This study aimed to determine serum IL-18 levels in liver cirrhosis patients and to assess the association of serum IL-18 levels with HE.Method: A total of 52 subjects (32 patients with liver cirrhosis and 20 healthy controls) were enrolled in this study. 32 patients with liver cirrhosis will be assessed for HE based on West-Haven criteria. All subjects were examined for serum IL-18 levels which is measured by ELISA method. We performed a comparative analysis between serum IL-18 levels of liver cirrhosis patients and healthy controls, a correlation analysis between serum IL-18 levels and HE, and a comparative analysis of serum IL-18 levels among degrees of HE.Results: Mean serum IL-18 levels in the liver cirrhosis group were 688.5 ± 674.3 pg/ml, and in the healthy controls group were 163.9 ± 100 pg/mL with p value = 0.01 (p < 0.05). There was a significant correlation between IL-18 and HE (r = 0.85, p = 0.00). Serum IL-18 levels in covert and overt HE groups were significantly higher than those without HE (p < 0.05).Conclusion: Serum IL-18 levels were significantly higher in liver cirrhosis patients than in healthy controls. There was a positive correlation between IL-18 and HE. Serum IL-18 levels in liver cirrhosis patients with HE were significantly higher than those without HE.
Comparing the Effects of Genistein, Silymarin, Lecithin on Improved Liver Necrosis Induced by Paracetamol Toxic Dose Administration in Rattus novergicus Wistar Strain Mustika, Syifa; Supriono, Supriono; Pratomo, Bogi; Achmad, Harijono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Paracetamol, a widely used antipyretic and analgesic drug has been known for its side effect of liver toxicity resulting from free radical formation leading to necrotic hepatocytes. Oral genistein may reduce lipid peroxidation and increase total antioxidant capacity in liver. The present study was aimed to compare the effects of administering genistein, silymarin and lecithin on improved necrotic hepatocytes in Wistar rats fed with toxic dose of paracetamol. Method: An experimental study was conducted at the Laboratory of Physiology and Anatomical Pathology, University of Brawijaya between May and September 2011. About 48 male rats were categorized into 4 groups. The first group was treated with 600 mg/kgBW of oral paracetamol. The other groups were treated with 600 mg/kgBW paracetamol and additional 2 mg/kgBW genistein, 50 mg/kgBW silymarin or 100 mg/kgBW lecithin. ALT, AST, bile acid, malondialdehyde (MDA) and glutation (GSH) levels were measured and centrilobular necrosis observed by histopathological examination. Data were analyzed statistically by ANOVA. Results: AST and ALT level were significantly lower in genistein group (p = 0.004 and p = 0.001). The lowest bile acid level was found in the lecithin group (p = 0.025); while lowest MDA level was found in silymarin group (p = 0.009). The highest GSH level was found in lecithin group (p = 0.001). The lowest percentage of centrilobular necrosis was found in genistein group (p = 0.001). Conclusion: Genistein, silymarin and lecithin supplementation improve liver necrosis induced by toxic dose of paracetamol. Among them, genistein is the most significant agent. Keywords: genistein, silymarin, lecithin, paracetamol, hepatotoxicity
Effects of Curcumin against Matrix Metalloproteinase-2 (MMP-2) and Tissue Inhibitor Metalloproteinase-2 (TIMP-2) Serum Level on Rat Model of Liver Fibrosis Resolution Process Supriono, Supriono; Pratomo, Bogi; Kriestian, Muhammad
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Liver fibrosis is an effect from continuous fibrogenesis and fibrolysis process. During fibrogenesis, MMP-2 and TIMP-2 that produced by hepatic stellate cell (HSC) have a role to regulate extracellular matrix (ECM) homeostastic. Otherwise, curcumin inhibits both MMP-2 and TIMP-2 expression and enhances HSC apoptosis, thus inhibit fibrogenesis. Role of curcumin, MMP-2, and TIMP-2 in a fibrolysis process has not been widely studied. This study aimed to determine the correlation between curcumin administration and the decline of MMP-2 and TIMP-2 on rat model of liver fibrosis.Method: This is an experimental study done in male Wistar rats. There are 8 groups consist of 4 rats each. Both control and intervention group were exposed to CCl4 1 cc/kgBW intraperitoneally 2 times per week for 9 consecutive weeks to form F3 fibrosis. Negative control group was injected with normal saline. After CCl4 injection, control group was given curcumin solvent as placebo while intervention groups were given curcumin 200 mg/kgBW for 2, 5, and 9 weeks. Statistical analysis then conducted in the end of study. Results: MMP-2 and TIMP-2 were remarkably increased in positive control group, but found decreased in control group 5 and 9. There are remarkable decrease of MMP-2 and TIMP-2 serum level in intervention group 2, 5, and 9, but MMP-2 and TIMP-2 level was significantly lower in intervention group 2 compared to the control group.Conclusion: MMP-2 and TIMP-2 serum level were decreased after giving of curcumin for 2 weeks. The duration of curcumin administration correlated with decrease of TIMP-2 serum level but not correlated with MMP-2 serum level in rat model of liver fibrosis.
Differences Between Alpha-Fetoprotein (AFP) and Prothrombine Induced by Vitamin K Absence or Antagonist II (PIVKA-II) Values as Early Detection Method for Hepatocellular Carcinoma (HCC) and Cirrhosis Nugraha, Bayu Eka; Setiawan, Nugraha; Susianti, Hani; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p > 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p > 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p < 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC.
Serial Case: Colorectal Malignancy in Young Age Sasmithae, Lia; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, August 2017
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Colorectal cancer was the third most common cancer found worldwide. In 2002, colorectal cancer was the 2nd most common cancer in men, while it ranked third among women. Based on Indonesian Ministry of Health data, its prevalence was 1.8 per 100.000 population. We report four cases of colorectal cancer in this case series, and all cases was occured among person aged 28-32 years old. Age was the main relevant risk factors for colorectal cancer in most population. Only 3% of colorectal cancer found in individual aged less than 40 years old. This case series also aimed to show that risk factors was various and changing by the time, but its determinant factors could not be explained yet.
Correlation Between Fibrosis-4 (FIB-4) Score and Metavir Score of Chronic Hepatitis C (CHC) Patients in Saiful Anwar Hospital Malang Irawati, Ekamaya Sofa; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, APRIL 2019
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Hepatitis C still remain a serious problem in Indonesia lead to increasing prevalence , major morbidity and mortality. Liver biopsy is gold standar, invasive procedure for liver fibrosis staging for treatment monitoring and fibrosis regression. Fibrosis-4 (FIB-4) score has been proposed as a non-invasive, easy, inexpensive as alternative indirect marker for the assessment of liver fibrosis in chronic hepatitis C (CHC).Method: Analytical cross sectional study was conducted among 54 patients with CHC from 2012 -2017 in Saiful Anwar Hospital Malang. Subjects were examined for complete blood count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), anti hepatitis C virus (anti HCV), hepatitis C virus ribonucleic acid (HCV RNA), genotype, and performed liver biopsy. Statistical analysis was performed using Spearman test and statistical significant was assumed when p < 0,05.Results: Fifty four (54) patients were fulfilled the selection criteria from total 67 patients. 29 (53%) males, and 25 (47%) were females. The characteristic were 33 (61%) genotype 1, 12 (22%) genotype 2, 5 (9%) genotype 3, and undetermined 3 (6%); with means of  HCV RNA titer 2,57 x 106, AST 79 ± 44 IU/L, ALT 77 ± 48 IU/L platelet 160.000/mm3. Distribution of Metavir F1 10 (19%) ,  Metavir F2 31(57%), Metavir F3  6(11%), and Metavir F4 7 (13%). Median of FIB-4 score as Metavir F1 1,88;Metavir F2 3,24; Metavir F3 5,36; Metavir F4 4,36. There was positive correlation between FIB-4 score and Metavir score (r = 0.38; p = 0,01).Conclusion: This study indicate that there was significant correlation between FIB-4 score and Metavir score in CHC patients.
Association Between Patient Characteristics and Diet Profile with Kirsten rat sarcoma (KRAS) and Neuroblastoma rat sarcoma (NRAS) Gene Mutation in Colorectal Cancer Praja, Dedy Indra; Helena, Helena; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, APRIL 2019
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Colorectal cancer is the third most common cancer according to American Cancer Society. It is also the third most common cause of death in men and women in US. Colorectal cancer encompasses 5% of all cancer and 29% of gastrointestinal cancer with men and women ratio is about 3:1. More than 1/3 of colorectal cancer occur below the age of 45 years. Mutation in Kirsten rat sarcoma (KRAS) gene was found in 30-50% of colorectal cancer in which it was suggested to associated with increase proliferation and decrease apoptosis. This study aimed to analyze the association between diet profile and KRAS gene mutation.Method: This study was a cross sectional study. Data was collected from medical records of colorectal cancer patient in Dr. Saiful Anwar General Hospital, which included KRAS gene mutation analysis.Results: There were 12 subjetcs included in this study. Four subjects (33.3%) had gene mutation with 3 subjects (75%) had positive KRAS mutation and 1 subjects (25%) had positive Neuroblastoma rat sarcoma (NRAS) mutation. In non-mutation group, it had been found a higher frequency of green leaf vegetables diet, in comparison with mutation group (p = 0.023). There was positive correlation between green leaf vegetables diet with gene mutation.Conclusion: Mutation of KRAS and NRAS mutation in colorectal carcinoma were found in 33.3% of subjects. Data analysis showed positive association between low green leaf vegetables diet with KRAS and NRAS mutation.