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"ABSTRAKLATAR BELAKANG: perawatan kandung kemih dan pencegahan retensio urin postpartum sangatlah penting, apabila tidak dikenali secara baik, maka dapat berkembang menjadi kerusakan kandung kemih yang permanen akibat distensi yang berlebihan yang mengakibatkan denervasi. Hal ini akan menyebabkan terjadinya peningkatan resiko infeksi saluran kemih dan kerusakan saluran kencing bagian atas. Tatalaksana retensio urin saat ini adalah dengan melakukan kateterisasi. Penggunaan kateterisasi sangat bervariasi pada beberapa panduan praktek klinik. Selain kateterisasi, saat ini prostaglandin telah terbukti mampu menyebabkan terjadinya kontraksi otot polos kandung kemih sehingga diharapkan dapat menjadi stimulator kontraksi kandung kemih pada pasien retensi urin pasca persalinan pervaginam. TUJUAN: menentukan efektifitas prostaglandin E1 dan kateterisasi atau kateterisasi saja sebagai terapi pilihan dan kelayakan melalui telaah kritis suatu panduan praktek klinik dalam tatalaksana retensio urin postpartum METODE: Evidence Based Case Report ini melakukan pencarian melalui PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library dan Google Scholar. Dengan menggunakan strategi pencarian ini, didapatkan 4 artikel pada PubMed, 101 artikel pada TRIP Database, 991 artikel pada EBM online, 687 artikel pada Clinical Evidence, 1 artikel pada Cochrane Library, dan 12600 artikel pada Google Scholar. Dari 21 artikel didapatkan 11 artikel yang berupa panduan praktek klinik dengan keseluruhan berupa naskah lengkap yang akan dilakukan telaah kritis dengan menggunakan AGREE II. HASIL: dari 11 panduan praktek klinik yang dilakukan telaah kritis, tidak ada satu panduan praktek klinik pun yang memperoleh penilaian pada setiap domain penilaian menurut AGREE II. Penilaian pada domain yang menjabarkan proses pengembangan panduan praktek klinik dengan pencarian evidence based, terapi alternatif, dan kebebasan editorial merupakan domain dengan penilaian terendah pada keseluruhan panduan praktek klinik. SIMPULAN: dari 11 panduan praktek klinik yang dilakukan telaah kritis, disimpulkan bahwa terapi untuk retensio urin postpartum yang digunakan saat ini adalah kateterisasi. Penggunaan terapi alternatif seperti prostaglandin tidak didapatkan pada keseluruhan panduan praktek klinik. Hanya saja keseluruhan panduan praktek klinik tidak didukung oleh evidence based yang sistematis sehingga kurang layak untuk dijadikan acuan untuk terapi. Dibutuhkan pencarian evidenced based secara sistematis terutama yang menggunakan desain randomized controlled trial RCT untuk dijadikan rujukan bagi terapi retensio urin postpartum.

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ABSTRACTBladder management and prevention of postpartum urinary retetntion are very important, and a failure in recognizing these conditions may lead to permanent bladder injury caused by overdistention which in turn lead to denervation. This may increase the risk of urinary tract infections and upper urinary tract damage. Current management of urinary retention is catherization. Besides catherization, prostaglandin have been proven to be effective in stimulating smooth muscle contraction of the bladder and is a promising alternative management in stimulating bladder contraction in vaginal postpartum urinary retention patients. GOALS to review several guidelines on postpartum urinary retention management METHOD The literature search for this Evidence Based Case Report conducted article from PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library and Google Scholar were used for article searching. Using this strategy, we obtained 4 articles from PubMed, 101 articles from TRIP Database, 991 articles from EBM online, 687 articles from Clinical Evidence,1 article from Cochrane Library, and 12600 articles from Google Scholar. From 21 articles we found 11 with attached guidelines on its full text, and these articles will be critically reviewedusing AGREE II. RESULTS From 11 guidelines that have been critically reviewed, not one guideline had an appropriate score in each assessment domain according to AGREE II. Guideline development using evidence based materials, alternative management and editorial freedom were the lowest scored domains in general. CONCLUSION From the 11 guidelines that have been critically reviewed, we concluded that the current management of postpartum urinary retention is catherization. Alternative managements such as prostaglandin usage are not present in current guidelines. In general, current guidelines are not supported by systematic evidence based materials, rendering them less reliable to be used as the basis for management. A systematic evidence based search, especially randomized controlled trial RCT , is needed for references of postpartum urinary retention management."

"Tujuan: Mengetahui hubungan antara rasio asam arakidonat (AA):asam eikosapentaenoat (EPA) eritrosit serta faktor-faktor lainnya dengan Sindroma Metabolik pada karyawan PT. Krakatau Steel, Cilegon. Tempat: RS Krakatau Medika, Cilegon. Metodologi: Penelitian desain potong Iintang pada 76 subyek yang dipilih secara acak dari karyawan PT. Krakatau Steel. Data yang dikumpulkan meliputi karalcteristik demografi, asupan asam lemak omega-3 dan omega-6 dengan metode tanya ulang 1 x 24 jam dan food frequency questionnaire (FFQ) semikuantitalif 3 bulan terakhir, kebiasaan merokok, aktivitas fisik, indeks massa tubuh (IMT), lingkar pinggang, tekanan darah, kadar gula darah puasa, kadar trigliserida, kadar kolesterol HDL, serta kadar AA dan EPA pada membran eritrosit. Hasil: Nilai tengah usia subyek adalah 46 (37-54) tahun, sebagian besar tergolong kelompok usia 41-50 tahun (80,3%), berpendidikan menengah (85,5%), perokok aktif (63,1%), gaya hidup kurang aktif (44,7%), dan semua subyek berpenghasilan di atas UMK Cilegon. Sebanyak 65,7% tergolong status gizi lebih. Prevalensi SM menurut kriteria ATP III yang dimodifikasi adalah 19,7%. Rerata kadar AA adalah 401,04 ng/mg (40,1-1213,0), kadar EPA 48,06 ng/mg (3,2-96,71), dan rasio AA:EPA adalah 12,8 (3,27-77,24). Hasil analisis bivariat menunjukkan adanya hubungan bermakna antara (1) rasio asupan AL∞6:AL∞3 (p=0,004), (2) asupan kalori total (p=002), (3) indeks massa tubuh/IMT (p=4,012), dan (6) rasio AA:EPA eritrosit (p=0,001) dengan sindroma metabolik. Asupan ikan (OR=0,013) dan kekerapan mengkonsumsi ikan (OR=0,063) merupakan faktor protektif terhadap tingginya rasio AA:EPA eritrosit, sedangkan asupan kalori total (OR=4,216) serta rasio ALw6:ALco3 (OR=4,208) merupakan faktor risiko tingginya rasio AA:EPA eritrosit. Terdapat perbedaan bermakna kadar EPA dan rasio AA:EPA eritrosit sejalan dengan peningkatan frekuensi konsumsi ikan. Kesimpulan: Terdapat hubungan yang bermakna antara rasio AA:EPA pada membran eritrosit dengan sindroma metabolik. Terdapat perbedaan bermakna kadar EPA clan rasio AA:EPA eritrosit sejalan dengan peningkatan frekuensi konsumsi ikan.

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Objective: To determine the relationship between ratio of arachidonic acid (AA):eicosapentaenoic acid (EPA) in erythrocyte membrane and other factors with metabolic syndrome (MS) at PT Krakatau Steel employees, Cilegon.

Location: Krakatau Medika Hospital, Cilegon.

Method: A cross sectional study has been carried out on 76 subjects using random sampling method among PT Krakatau Steel employees. Data collected consist of demography characteristics, omega-3 (m3FA) and omega-6 fatty acid (ea6FA) intake by dietary recall 1 x 24 hr and semiquantitative food frequency questionnaire (FFQ) in the last three months, smoking habit, physical activity, body mass index, waist circumference, blood pressure, fasting glucose, triglyceride, HDL-cholesterol, and fatty acid concentration (AA and EPA) in the erythrocyte membrane.

Result: Median age of subjects is 46 years (37-54), most of them are 41-50 years (80,3%), moderate educational background (85,5%), active smokers (63,1%), less physical activity (44,7%), overweight (65,7%), and all subjects have an income above minimum standard payment in Cilegon district. Mean of AA concentration is 401,04 ng/mg(40,1-1213,0), EPA is 48,06 rig/mg (3,2-96,71), and AA:EPA ratio is 12,8 (3,27-77,24). Bivariat analysis found significant relationship between (1) ratio of ∞6FA∞3FA intake (p=0,004), (2) total calorie intake (p=0,004), (3) BMI (p=0,012), and (4) AA:EPA ratio (p=0,001) with MS. Fish intake (OR=0,013) and fish consumption frequency (OR=0,063) are protective whereas total calorie (OR=4,216) and ratio of ∞6FA∞3FA intake are risk factors for the high AA:EPA ratio. There is a significant relationship between EPA concentration and AA:EPA ratio in accordance with fish consumption frequency.

Conclusion: There is a significant relationship between AA:EPA ratio in erythrocyte membrane and metabolic syndrome. There is a significant relationship between EPA concentration and AA:EPA ratio in accordance with fish consumption frequency."

"Hakim A. 2010. The diversity of secondary metabolites from Genus Artocarpus (Moraceae). Nusantara Bioscience 2:146-156.Several species of the Artocarpus genus (Moraceae) have been investigated their natural product. The secondary metabolitessuccessfully being isolatad from Artocarpus genus consist of terpenoid, flavonoids, stilbenoid, arylbenzofuran, neolignan, and adductDiels-Alder. Flavonoid group represent the compound which is the most found from Artocarpus plant. The flavonoids compound whichare successfully isolated from Artocarpus plant consist of the varied frameworks like chalcone, flavanone, flavan-3-ol, simple flavone,prenylflavone, oxepinoflavone, pyranoflavone, dihydrobenzoxanthone, furanodihydrobenzoxanthone, pyranodihydrobenzoxanthone,quinonoxanthone, cyclopentenoxanthone, xanthonolide, dihydroxanthone."

"Telah dilakukan uji sitotoksik metabolit sekunder kapang endofit 1.2.11 tanaman Bruce javanica (L) merr."

"Telah dilakukan uji sitotoksik metabolit sekunder kapang endofit 1.2.11 tanaman Brucea javanica (L. ) Merr. Sampel tanaman diambil dari Cianjur, bagian tanaman yang digunakan adalah buah. Uji sitotoksik dilakukan terhadap sel Ruji, NS-l, sel HeLa dan sel Vero. Pengamatan dilakukan selama 24 jam dan 48 jam dengan menghitung sel ludup menggunakan metode tripan biru. Penghitungan l CM dilakukan secara aritmatikal dengan rumus Ricd and Muench. Untuk melihat mekanisme kerja pada proses sitotoksik dilakukan teknik pengecatan DNA menggunakan etidium bromida dan acridine orange. Dari penelitian ini diperoleh lCft) terhadap sel Raji 58,35 fjg/ml, 88,39yg/ml; IC50sel NS-1 162,09 pg/ml, 66,24 p. g/ml; IC^ sel HeLa 361,21 pg/ml, 219,97 pg/ml. IC^sel Vero 1075.18 ug/ml, 656,82 ng/ml. Pengamatan dilakukan dalam waktu 24 jam dan 48 jam. Mekanisme kerja dari metabolit sekunder kapang endofit 1.2. 11 terhadap sel NS-1 cenderung melalui mekanisme apoptosis. (Med J Indones 2006; 15:137-44)

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Cytotoxic assay of secondary metabolite endophytic fungus 1.2.11 from Brucea javanica (L.) Merr has been carried out. Brucea Javanica fruit collected from Cianjur was used in this experiment. Cytotoxic assay was done on Raji, NS-1, HeLa and Vero cells. The observation was done for 24 hours and also for 48 hours. I CM was calculated using the Rich and Muench theory. To observe the working mechanism ofcytotoxic process, DNA staining with etidium bromide and acridine orange was conducted. The cytotoxic assay of endophytic fungi 1.2.11 showed an ICft) of 58.35p.g/ml, 88.39 pg/ml on Raji ceil; 162.09 pg/ml, 66.24 pg/ml on NS cell; 361.21 fjg/ml, 219.97 fjg/ml on HelM cell; and lastly 1075.18 fjg/ml, 656.82 /jg/ml on Vero cell after 24 and 48 hour incubation respectively. The results of this study showed that secondary metabolite of endophytic fungus 1.2.11 has selective cytotoxic effect towards cancer cell and also showed that it might cause apoptosis in NS-1 cell. (Med J Indones 2006; 15:137-44)"

"The aims of this study are to provide data regarding the taxonomic study of thermophilic Actinobacteria based on 16S rRNA gene sequences, description, and assessment for secondary metabolite biosynthetic gene clusters (BGCs) in the genome of novel taxa, and its antibacterial activity. Thirty-one isolates of thermophilic Actinobacteria were isolated from soil samples in Cisolok geothermal area, West Java. The 16S rRNA gene sequence-similarity search against all related species was performed using EzTaxon-e database. The sequences of 31 isolates showed similarity to member of family Micromonosporaceae, Nocardiaceae, Pseudonocardiaceae, Streptomycetaceae, Streptosporangiaceae, and Thermomonosporaceae. Six isolates displayed high similarity to genera in the family Pseudonocardiaceae, and most closely related to the genus Thermotunica, T. guangxiensis AG2-7T with similarity values from 94.6 to 95.2%. Phenotypic features and phylogenetic data differentiated strain SL3-2-4T from members of the family Pseudonocardiaceae. Therefore, the strain SL3-2-4T is proposed as a representative of a novel species in a novel genus, Gandjariella thermophila gen. nov., sp. nov. The genome of SL3-2-4T contained 21 antiSMASH-identified secondary metabolite regions harboring BGCs. These BGCs were for polyketide synthase, non-ribosomal peptide synthase, and ribosomally synthesized and post-translationally modified peptide family clusters. Thirteen and five regions displayed low (4–35%) and no similarity with known BGCs for secondary metabolites, respectively. Screening for antibacterial activity showed that strains SL3-2-4T and SL3-2-7 on MM 2 medium solidified with gellan gum at 45°C for 14 days demonstrated inhibitory activity against all Gram-positive, but not Gram-negative bacteria. Strain SL3-2-10 on ISP 3 gellan gum medium incubated for seven-days only active against K. rhizophila NBRC 12078. The results indicated that novel taxa have the potential for the discovery of active secondary metabolites."

"ABSTRAKStudi tentang uji kandungan metabolit sekunder dari ekstrak metanol daun surian (Toona sureni (Bl.) Merr) telahdilakukan dengan metode kromatografi lapis tipis (KLT). Hasilnya memperlihatkan bahwa ektrak metanol daun surianmengandung alkaloid, flavonoid, polifenol dan terpenoid. Semua metabolit tersebut memiliki kemampuan untukmeredam 2,2-diphenyl-1-picrylhydrazyl(DPPH). Untuk melihat kemampuan peredaman DPPH diukur secaraspektrophotometri dan memperlihatkan nilai IC50(4,80 ppm) yang relatif lebih kecil dibandingkan standar asam askorbat (IC50= 9,23 ppm).

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AbstractThe study of performed secondary metabolites from the methanol extract of Surian (Toona sureni (Bl.) Merr)leaves have been done by thin-layer chromatography (TLC) method. The result showed that methanol extract of Surianleaves consist of alkaloid, flavonoid, polyphenol and terpenoid. All of them positively have the ability to scavenge 2,2-diphenyl-1-picrylhydrazyl (DPPH). It has IC50(4.80) are smaller than the ascorbat acid standard (IC50= 9.23). "