CURRICULUM VITAE RIWAYAT PENDIDIKAN PERGURUAN TINGGI. Perguruan Tinggi

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Buku 2 Penilaian Portofolio Sertifikasi Dosen Terintegrasi

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CURRICULUM VITAE

IDENTITAS DIRI

Nama : Prof.Dr. Subijanto Marto Sudarmo, dr.,Sp.A(K) Nomor Peserta : 08100400742

NIP/NIK : 19480610 197412 1 001 Tempat dan Tanggal Lahir : Magetan, 10 Juni 1948

Jenis Kelamin : □ Laki-laki □ Perempuan

Status Perkawinan : □ Kawin □ Belum Kawin □ Duda/Janda

Agama : Islam

Golongan / Pangkat : Pembina Utama Madya / IV-d Jabatan Akademik : Guru Besar

Perguruan Tinggi : Fakultas Kedokteran Universitas Airlangga Alamat : Mayjen. Prof. Dr. Moestopo 6-8 Surabaya

Telp./Faks. : (031-5501681)

Alamat Rumah : Dukuh Kupang Timur XX/38 Surabaya Telp./Faks. : (031-5678553)

Alamat e-mail : subijantoms@gmail.com

RIWAYAT PENDIDIKAN PERGURUAN TINGGI

Tahun

Lulus

Program Pendidikan(diploma,

sarjana, magister, spesialis, dan doktor)

Perguruan Tinggi Jurusan/ Program Studi

1973 S1 Universitas Airlangga Dokter

1977 S2 Universitas Airlangga Spesialis Anak

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2 PELATIHAN PROFESIONAL

Tahun Jenis Pelatihan( Dalam/ Luar Negeri) Penyelenggara Jangka waktu

PENGALAMAN MENGAJAR

Mata Kuliah Program

Pendidikan

Institusi/Jurusan/Program Studi Sem/Tahun Akademik. Ilmu Kesehatan

Anak

S1 Ilmu Kesehatan Anak 1976 s/d sekarang Ilmu Kesehatan

Anak

PPDS I Ilmu Kesehatan Anak 1978 s/d sekarang Ilmu Kesehatan

Anak

S1 Ilmu Kesehatan Anak 1979 s/d sekarang Immunology Mucosa S2 Pascasarjana 2005 s/d sekarang Ilmu Kesehatan Anak S2 FRMRS Farmasi 2005 s/d sekarang Ilmu Kedokteran Tropis S2 Pascasarjana 2009 s/d sekarang

Ilmu Kedokteran S3 Pascasarjana 2013 s/d

sekarang Imunologi Mukosa MKDU PPDS I 2015

PRODUK BAHAN AJAR

Mata Kuliah Program

Pendidikan

Jenis Bahan Ajar( cetak dan noncetak)

Sem/Tahun Akademik. Ilmu Penyakit Anak

(Sindroma Diare) S-1 Non Cetak

Ilmu Penyakit Anak (Pendekatan Klinik Anak dengan Diare)

S-1 Non Cetak

Ilmu Penyakit Anak Profesi Non Cetak Ilmu Kesehatan Anak

(Patofisiologi dan tatalaksana Anak dengan Diare)

S-2 Non Cetak

Imunologi S-2 Non Cetak

PENGALAMAN PENELITIAN

Tahun Judul Penelitian Ketua/anggota _Tim Sumber Dana 2010 Effect of probiotic in strengthening Anggota Swadana

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gut mucosa against pathogenic

bacteria (Experimental study on mus musculus balb/c (Oral)

2010 Effects of probiotic in enhancing innate mucosal immune response

against pathogenic bacteria Anggota Swadana 2010

The effects of probiotic administration on local humoral mucosal immune response (experimental study in animal models)

Anggota Swadana 2010 Diarrhea Associated with Bacteremia _{Due to Klebsiella Pneumonia} Anggota Swadana 2010 Clinical Signs and Symptoms of Children with Hirschprung’s Disease

in Dr. Soetomo Hospital Anggota Swadana 2010 Quality of Life of Colostomized

Children Anggota Swadana

2010 _{Recurrent Abdominal Pain} _Anggota _Swadana 2010 Clinical Assessment and Plasma Specific Gravity in the Diagnosis of

Dehydration in Children Anggota Swadana 2010 _{Quantifying diarrheal stool by diapers} _Anggota _Swadana

2011

Probiotic Effect on Production of Immunoglobulin A and Relationship with Immune Response shift toward Th1, Treg and Th2 on the gut Mucosal

Ketua Swadana

2011 Incidence of Anemia in Children with H. Pylori Infection at Dr. Soetomo

Hospital Surabaya Anggota Swadana

2011 Pediatric Endoscopy in Surabaya Anggota Swadana 2011 Endoscopy Result in Children with _{Recurrent Abdominal Pain} Anggota Swadana 2011 Clinical Profile of Eosinophilic _{Gastroenteritis In Children} Anggota Swadana 2012 Proteksi Probiotik pada Mukosa Ileum Mencit yangTerpajan Lipo

Polisakarida Escherichia Coli Anggota Swadana 2012 Peran Pemeriksaan Endoskopi dalam Mendiagnosis Penyakit Penyakit

Gastrointestinal pada Anak Anggota Swadana 2013 Duration of diarrhea in HIV infection _{children with cryptosporidiosis} Anggota Swadana 2013 Incidence, clinical symptoms, and _{etiology of bloody diarrhe} Anggota Swadana 2013 Mortality risks of hirschsprung’s Anggota Swadana

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disease after surgical treatment

2013 Risk factors for enterocolitis following surgery in children with

Hirschsprung’s disease Anggota Swadana 2013 Risk factors for persistent diarrhea in _{children admitted to Soetomo hospital} Anggota Swadana 2013 Risk factors for preoperative enterocolitis in children with

Hirschsprung’s disease Anggota Swadana 2013 Zinc supplementation on prevention of damaged intestinal mucosal caused

by lipopolysaccharide Anggota Swadana

2013

Helicobacter pylori stool antigen (HPSA) as a diagnostic tool in children with Helicobacter pylori infection

Anggota Swadana

2013 Stool calprotectin in HIV-infected

children Anggota Swadana

2013 Early oral feeding in children following intestinal anastomosis

procedure Anggota Swadana

2013 Effect of oral supplementation of Lactobacillus plantarum IS-10506 on serum CD4+ T cell, CD4+ / CD8 T cell ratio and faecal secretory IgA in children with HIV infection that received antiretroviral therapy

Anggota Dana Penelitian Strategis Nasional Kluster Gizi dan Kesehatan DP2M Th. Anggaran 2009 2013 Lactobacillus plantarum IS-10506

reduced blood lipopolysaccharide level in HIV- infected children with antiretroviral therapy

Anggota Swadana

2013 Zinc supplementation on intestinal

mucosal morphology Anggota Swadana

2013 Effect of lactobacillus plantarus IS-10506 on gut inflammation in HIV infected children

Anggota Swadana 2013 Duration of diarrhea in HIV infection

children with cryptosporidiosis Anggota Swadana 2013 Incidence, clinical symptoms, and

etiology of bloody diarrhea Anggota Swadana 2014 Genotyping and Clinical Factors in

Pediatric Diarrhea Caused by Rotaviruses: One-Year Surveillance in Surabaya, Indonesia.

Ketua RKAT/POPA FakultasKedokt eran Unair 2014 Pengaruh Pemberian Probiotik Anggota LPPM Unair

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terhadap Keseimbangan Th1, Th2,

Treg dan Th17 pada Anak Penderita HIV

2014 Epidemiologi Klinis Infeksi Norovirus Diare akut pada Bayi dan Anak di RSUD Dr. Soetomo Surabaya

Anggota RKAT/POPA FakultasKedokt eran Unair 2014 Outbreak fatal cases: community

acquired sepsis associated with diarrhea syndrome at Dr.Soetomo Hospital Surabaya

Anggota Swadana

2014 Clinical profile of patients with amoebiasis

Anggota Swadana 2014 Coincidence of eosinophilic

gastroenteritis and Helicobacter pylori infection

Anggota Swadana 2014 Clinical profiles of

blastocystis-Entamoeba hystolitica coinfection and Entamoeba hystolitica infection

Anggota Swadana 2014 Clinical features of established

infantile hypertrophic pyloric stenosis in Dr.Soetomo Hospital: serial cases report

Anggota Swadana

2016 Pengaruh Probiotik Terhadap Kesigapan Respon Imun Innate Mukosa Dalam Menghadapi Pajanan Patogen

Ketua UPPM FK UNAIR Th. Anggaran 2016 2016 Penggunaan Imunoglobulin G Air

Ludah untuk Mendiagnosis Infeksi Helicobacter Pylori pada Anak

Anggota UPPM FK UNAIR Th. Anggaran 2016 2016 Perbandingan Metode

Imunokromatografi dengan RT-PCR dalam Diagnosis Diare Rotavirus dari Spesimen Feses pada Anak Usia 1-60 Bulan di RSUD Dr.Soetomo Surabaya

Anggota UPPM FK UNAIR Th. Anggaran 2016 2016 Pengaruh Pemberian Probiotik dan

Maturasi Epitel Ileum Setelah Kerusakan Mukosa Akibat Lipopolisakarida Escherichia Coli 055:B5 Anggota UPPM FK UNAIR Th. Anggaran 2016

KARYA ILMIAH*

A. Buku/Bab Buku/Jurnal

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2012 Proteksi Probiotik pada Mukosa Ileum Mencit yang Terpajan

Lipopolisakarida Escherichia Coli

Media Medika Indonesiana Vol.46 No.2, 69-146; Mei-Agustus 2012

2012 Peran Prosedur Endoskopi dalam Mendiagnosis Gangguan Pencernaan pada Anak

Journal NERS Vol.7 No.2, 103-207; Oktober 2012

2013

Protein Kinase C and

Calcium/Calmodulin-dependent Protein Kinase II signaling on hippocampal neurogenesis in Wistar rat after Docosahexanoic acid (DHA) supplementation

South Asian J Exp Biol; 3 (5): 226-231; 2013

2013 Frequency of Diarrheagenic Escherichia coli among Children in Surabaya, Indonesia

Jpn. J. Infect. Dis., 66, 00-00, 2013

2015

Genotyping and clinical factor in pediatric diarrhea caused by rotaviruses: one-year surveillance in Surabaya, Indonesia

Gut Pathogens (2015) 7:3

2015

Effect of Glutamine on Spectrin, Clathrin and STAT-3 signaling Protein in Repairing Ileum Intestine in Malnutrition Rats

Int.J. Pharm Tech Res. 2015,8(3),pp 325-329

2015

The Expression of TLR-2 and NOD-2 in Gingival Epithelium of Rat after Probiotic Lactobacillus reuteri Supplementation to Inhibit

Streptococcus mutans Grawth

Journal of Biological Researches Vol.21, No.1, December,2015

*termasuk karya ilmiah dalam bidang ilmu pengetahuan/teknologi/seni/desain/olahraga

B. Makalah/Poster

Tahun Judul Penyelenggara

2010

Effect of probiotic in strengthening gut mucosa against pathogenic bacteria (Experimental study on mus musculus balb/c (Oral)

PIT IKA IV IDAI

2010 Effects of probiotic in enhancing innate mucosal immune response against

pathogenic bacteria PIT IKA IV IDAI

2010 The effects of probiotic administration on local humoral mucosal immune response

(experimental study in animal models) PIT IKA IV IDAI 2010 Diarrhea Associated with Bacteremia Due to _{Klebsiella Pneumonia} PIT IKA IV IDAI 2010 Clinical Signs and Symptoms of Children with Hirschprung’s Disease in Dr. Soetomo

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2010 Quality of Life of Colostomized Children PIT IKA IV IDAI

2010 Recurrent Abdominal Pain PIT IKA IV IDAI 2010 Clinical Assessment and Plasma Specific Gravity in the Diagnosis of Dehydration in

Children PIT IKA IV IDAI

2010 Quantifying diarrheal stool by diapers PIT IKA IV IDAI 2011

Probiotic Effect on Production of

Immunoglobulin A and Relationship with Immune Response shift toward Th1, Treg and Th2 on the gut Mucosal

Keytone Symposia on Molecular and Cellular Biology

2011 Incidence of Anemia in Children with H. Pylori Infection at Dr. Soetomo Hospital

Surabaya 15

th_{KONIKA IDAI}

2011 Pediatric Endoscopy in Surabaya 15th_{KONIKA IDAI} 2011 Endoscopy Result in Children with Recurrent _{Abdominal Pain} 15th_{KONIKA IDAI} 2011 Clinical Profile of Eosinophilic Gastroenteritis _{In Children} 15th_{KONIKA IDAI}

2013

Effect of oral supplementation of

Lactobacillus plantarum IS-10506 on serum CD4+ T cell, CD4+ / CD8 T cell ratio and faecal secretory IgA in children with HIV infection that received antiretroviral therapy

Third International Symposium on Probiotics and Prebiotics Microbiome (ISSPP)

2013 Lactobacillus plantarum IS-10506 reduced blood lipopolysaccharide level in HIV-

infected children with antiretroviral therapy PIT IKA VI IDAI 2013 Zinc supplementation on intestinal mucosal _morphology PIT IKA VI IDAI 2013 Effect of lactobacillus plantarus IS-10506 on _{gut inflammation in HIV infected children} PIT IKA VI IDAI 2013 Duration of diarrhea in HIV infection _{children with cryptosporidiosis} PIT IKA VI IDAI 2013 Incidence, clinical symptoms, and etiology _{of bloody diarrhe} PIT IKA VI IDAI 2013 Mortality risks of hirschsprung’s disease _{after surgical treatment} PIT IKA VI IDAI 2013 Risk factors for enterocolitis following surgery in children with Hirschsprung’s

disease PIT IKA VI IDAI

2013 Risk factors for persistent diarrhea in _{children admitted to Soetomo hospital} PIT IKA VI IDAI 2013 Risk factors for preoperative enterocolitis in _{children with Hirschsprung’s disease} PIT IKA VI IDAI 2013 Zinc supplementation on prevention of _{damaged intestinal mucosal caused by} PIT IKA VI IDAI

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lipopolysaccharide

2013 Helicobacter pylori stool antigen (HPSA) as a diagnostic tool in children with

Helicobacter pylori infection PIT IKA VI IDAI 2013 Stool calprotectin in HIV-infected children PIT IKA VI IDAI 2013 Early oral feeding in children following _{intestinal anastomosis procedure} PIT IKA VI IDAI 2014 Outbreak fatal cases: community acquired sepsis associated with diarrhea syndrome at

Dr.Soetomo Hospital Surabaya 16

th_{KONIKA IDAI}

2014 Clinical profile of patients with amoebiasis 16th_{KONIKA IDAI} 2014 Coincidence of eosinophilic gastroenteritis _{and Helicobacter pylori infection} 16th_{KONIKA IDAI} 2014 Clinical profiles of blastocystis-Entamoeba hystolitica coinfection and Entamoeba

hystolitica infection 16

th_{KONIKA IDAI}

2014 Clinical features of established infantile hypertrophic pyloric stenosis in Dr.Soetomo Hospital: serial cases report 16

th_{KONIKA IDAI}

2015

Immunoglobulin A-IgE levels between ileum and blood from musculus balb/c mice exposed to lipopolysaccharide Escherechia

coli after administration of probiotic

PIT Ke 7 IKA IDAI 2015 Pediatric endoscopy at Dr. Soetomo

hospital, Surabaya PIT Ke 7 IKA IDAI

2015 Characteristics of infants below 6 months of age with gastroesophageal reflux disease at

Dr.Soetomo hospital, Surabaya PIT Ke 7 IKA IDAI 2015 Pediatric logistic organ dysfunction score as a predictor of gastrointestinal bleeding in

critically-ill children PIT Ke 7 IKA IDAI 2015 Use of adjuvant drugs in diarrhea management: actual practice of

pediatricians PIT Ke 7 IKA IDAI

2015 Predictor of dehydration using Airlangga scoring system in children with acute

diarrhea at Dr.Soetomo PIT Ke 7 IKA IDAI 2015 Zinc Prescription for management of acute _{diarrhea among pediatrician} PIT Ke 7 IKA IDAI

C. Penyunting/Editor/Reviewer/Resensi

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9 KONFERENSI/SEMINAR/LOKAKARYA/SIMPOSIUM

Tahun Judul Kegiatan Penyelenggara

Peranan sbg Panitia/ peserta/pembicara 2010 Seminar Minggu Klinik IDAI Jatim – _{Surabaya II} Pembicara 2010 EBM Workshop IDAI – Nutricia _{Indonesia Fund} IDAI – Dep. IKA _{FK.Unair – NIF} Peserta 2010 Pertemuan Ilmiah Tahunan (PIT) _{IV Ilmu Kesehatan Anak} IDAI Medan Pembicara 2010 Scientific Meeting on Stem Cell Indonesian Stem Cell Association

Surabaya Moderator

2010 Seminar Ilmiah Stem Cell FK. Unair – Gramik Pembicara 2010 Continuing Education Ilmu _{Kesehatan Anak XXXIX} FK. UNAIR - RSU _{Dr. Soetomo} Pembicara 2010 Scientific Meeting IDAI Bali IDAI Bali – Dep. IKA FK.Udayana –

RSUP Sanglah Pembicara 2010 Scientific Meeting IDA JATIM IDAI JATIM Peserta 2010 The International Training Course IDI – IDAI – RSDS FK. Unair – UMCG

Groningen Peserta 2010 Indonesian Scientific Society for _{Probiotic and Prebiotics} IDAI – ISSPP Pembicara 2010 2nd Regional Symposium Nestle Nutrition _Institute Peserta 2010 IDAI – Nestle Nutrition Institute _{Scientific Meeting} IDAI JATIM Peserta 2010 2

nd_{Danone Asian Probiotic}

Convention The Japanese Society of Clinical

Nutrition Pembicara

2010 Kongres Nasional BKGAI IDAI – BKGAI Pembicara 2011 Semposium Nasional dan _Workshop PPIDAI – IDAI _ACEH Pembicara

2011 Seminar IDAI IDAI JATIM Pembicara

2011 Annual Meeting of Indonesian _Symposium ISPACC-IDI-IDSAI _{FK UNAIR-RSDS} Pembicara 2011 Seminar Ilmiah FK. Unair – Gramik Moderator 2011 15_{Kesehatan Anak (KONIKA)}th Konggres Nasional Ilmu IDAI Cabang _{Sulawesi Utara} Moderator 2011 Symposium Countinuing _{Education XL CPD – IKA} IDI-IDAI-FK UNAIR _RSDS Pembicara 2011 Symposium & KONAS I Forum Neuroscience to Nation Character

Building

FK.Unair-ASNS-

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2011 1

st_{Meeting Surabaya}

Regenerative Medicine and Stem Cell Centere

FK.Unair-SRMSC

IATB-RSDS Pembicara

2011 Workshop Penerapan Instrumen _{Evaluasi Peserta PPDS I IKA} IDI-IDAI-FK UNAIR _RSDS Peserta 2011 PKB LX Dep. Ilmu Kesehan Anak _FK.IU/RSCM FK.IU-RSCM-IDAI Pembicara 2011 Course and Workshop GCP Unair – APKESI Peserta 2012 Kuliah Penghargaan Keilmuan III FK. Unair – Gramik Peserta 2012 Continuing Education XLI FK UNAIR-RSUD _{Dr. Soetomo} Panitia 2012 Seminar Minggu Klinik IDAI JATIM Pembicara 2012 Scientific Meeting IDAI JATIM Pembicara 2012 International Seminar &

Workshop FK. Unair – RS.TID Moderator

2012 Kuliah Penghargaan Keilmuan III FK. Unair – Gramik Peserta 2012 Seminar Nasional & Workshop FK. Unair – RS.TID Pembicara 2013 Continuing Education XLII FK UNAIR-RSUD _{Dr. Soetomo} pembicara

2013 Round Table Discussion PPIDAI Peserta

2013 Indonesian Scientific Society for _{Probiotic and Prebiotics (ISSPP)} ISSPP Peserta 2013 The 6

th_{Child Health Annual} Scientific Meeting of Indonesia

Pediatric Society IDAI Peserta

2013 Surabaya Regenerative Medicine and Stem Cell Centere & Dutch Foundation

FK.Unair-SRMSC

IATB-RSDS Moderator

2013 Seminar Minggu Klinik IDAI JATIM Peserta 2014 Pendidikan Profesi Berkelanjutan _{II – IDAI} IDAI JATIM Pembicara 2014 Kongres Nasional & Workshop PGHNAI PGHNAI-IDAI-FK.Unud-RSUP

Sanglah Peserta

2014 Seminar Ilmiah Perhimpunan _{Spesialis Penyakit Dalam} PAPDI - FK Unair- _{Gramik - IDI} Peserta 2014 16_Pediatricsth Indonesian Congres of IDAI Peserta 2015 Kongres Nasional PGHNAI PGHNAI Peserta 2015 Pagi Klinik Dep. IKA FK.Unair _{– RSDS} Pembicara 2015 Digestive Course UKK Gastrohepatologi –

IDAI Jatim Pembicara 2015 Web Seminar “Healthy Gut As A Basis of Human Health Focusing

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2015 Pertemuan Ilmiah Tahunan ke 7

Ilmu Kesehatan Anak PP IDAI Peserta

2015 RTD & Mini Workshop IDAI Jatim Pembicara

KEGIATAN PROFESIONAL/PENGABDIAN KEPADA MASYARAKAT

Tahun Jenis/Nama Kegiatan Tempat

1995 – skrg Panitia PKB IKA FK UNAIR-RSUD Dr. Soetomo Surabaya

JABATAN DALAM PENGELOLAAN INSTITUSI

Peran/Jabatan Institusi( Univ,Fak,Jurusan,Lab,studio,

Manajemen Sistem Informasi Akademik dll)

Tahun ... s.d. ... Ketua Ketua Departemen Ilmu Kesehatan Anak

FK. Unair

2008 s.d 2010 Anggota Anggota tetap Badan Pertimbangan

Fakultas Unair

2009 s.d 2016

PERAN DALAM KEGIATAN KEMAHASISWAAN

Tahun Jenis /Nama Kegiatan Peran Tempat

PENGHARGAAN/PIAGAM

Tahun Bentuk Penghargaan Pemberi

ORGANISASI PROFESI/ILMIAH

Tahun Jenis/ Nama Organisasi Jabatan/jenjang

keanggotaan 1974 s.d skrg Ikatan Dokter Indonesia (IDI) Anggota 1977 s.d skrg Ikatan Dokter Anak Indonesia (IDAI) Anggota 1977 s.d skrg Badan Koordinasi Gastroenterologi Anak

Indonesia (BKGAI) – (PGHNAI)

Anggota 1993 s.d skrg Perkumpulan Gastroenterologi Indonesia (PGI) Anggota 1993 s.d skrg Perkumpulan Endoskopi Gastroenterologi

Indonesia (PEGI)

Anggota 1993 s.d skrg Perkumpulan Peneliti Hati Indonesia (PPHI) Anggota

1996 Asian Pacific Society for Pediatric

Gastroenterology and Infant Nutrition (APSPGAN)

Anggota 1997 American Association for the Advancement of Anggota

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Science (AAAS)

1997 New York Academic of Science (NYAS) Anggota 2010 s.d skrg Indonesian Scientific Society for Probiotic and

Prebiotics (ISSPP)

Wakil Ketua

Saya menyatakan bahwa semua keterangan dalam Curriculum Vitae ini adalah benar dan apabila terdapat kesalahan, saya bersedia mempertanggung jawabkannya.

Surabaya, 01 Juli 2016

Mengetahui Yang menyatakan,

Ketua Departemen/SMF Ilmu Kesehatan Anak

( Muhammad Faizi, dr.,Sp.A(K) ) (Prof.Dr. Subijanto Marto Sudarmo,dr.,Sp.A(K)) NIP. 19560527 199002 1 003 NIP. 19480610 197412 1 001