Poernomo Boedi Setiawan
Departemen Penyakit Dalam Fakultas Kedokteran Universitas Airlangga

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The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Maimunah, Ummi; Rudyanto, Rudyanto; Setiawan, Poernomo Boedi; Adi, Pangestu; Nusi, Iswan Abbas; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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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 Purbayu, Herry; Setiawan, Poernomo Boedi; Nusi, Iswan A; Adi, Pangestu; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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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
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Purbayu, Herry; Setiawan, Poernomo Boedi; Nusi, Iswan A; Adi, Pangestu; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and 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
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Maimunah, Ummi; Rudyanto, Rudyanto; Setiawan, Poernomo Boedi; Adi, Pangestu; Nusi, Iswan Abbas; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and 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
Distribution of Hepatitis B Virus Genotypes Among Patients at Internal Medicine Unit, Dr. Soetomo General Hospital, Surabaya Wungu, Citrawati Dyah Kencono; Amin, Mochamad; Kholili, Ulfa; Prabowo, Gwenny Ichsan; Setiawan, Poernomo Boedi; Soetjipto, Soetjipto; Handajani, Retno
WMJ (Warmadewa Medical Journal) Vol 4, No 1 (2019): MAY 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.1032.6-13

Abstract

Background: Hepatitis B virus (HBV) infection is a major health problem worldwide, especially in developing countries. The study of HBV genotypes is important to find out the diversity of HBV genotypes related to the severity of the disease, response to therapy, and clinical symptoms. Objective: This study was aimed to detect HBV genotypes in patients at Hepatology Outpatient Clinic, Dr. Soetomo Hospital Surabaya. Methods: This study was conducted on new patients at Hepatology Outpatient Clinic of Dr. Soetomo General Hospital, Surabaya in one month. Nested PCR was performed by targetting HBV surface genes. Samples with positive HBV DNA were sequenced and analysed further. Results: In this study, a total of 27 samples were obtained. The prevalence of HBV infection shown by positive HBsAg in patients with symptoms of liver disease was 55.55% (15/27 patients). Based on the results of electrophoresis from PCR products, positive HBV DNA was obtained in these 15 patients (100%). After sequencing samples with positive HBV DNA, genotype B of Indonesian strain was found to be predominant genotype (100%). Subgenotype analysis showed that 7/15 samples had B3 subgenotype (46.67%). Conclusion: In patients at Hepatology Outpatient Clinic of Dr. Soetomo General Hospital, Surabaya, the prevalence of HBV infection was high (55.55%) and genotype B was predominant. In Surabaya, HBV genotype infection still remained like the previous pattern, although in Indonesia there have been many inter-island and ethnic migration. Further similar studies are needed to obtain the diversity of other HBV genotypes.
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

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.
GENOTIPE DAN SUBTIPE VIRUS HEPATITIS B PENDERITA YANG TERINFEKSI KRONIK AKTIF Mastutik, Gondo; Juniastuti, Juniastuti; Rohman, Ali; Amin, Mochamad; Setiawan, Poernomo Boedi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

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.
RAGAMAN GENETIK GEN POLIMERASE VIRUS HEPATITIS B PADA PASIEN HEPATITIS B KRONIK DENGAN PENGOBATAN TELBIVUDIN Mastutik, Gondo; Juniastuti, Juniastuti; Rohman, Ali; Amin, Mochamad; Setiawan, Poernomo Boedi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

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.