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"Otak merupakan salah satu organ yang rentan hipoksia. Hipoksia menyebabkan kerusakan neuron terutama pada neuron korteks serebrum. Hingga saat ini belum ada agen neuroproteksi yang direkomendasikan untuk stroke iskemik sehingga terapi adjuvan sangatlah perlu diteliti. Ekstrak etanol Acalypha indica (AI) dan Centella asiatica (CA) telah banyak diketahui mampu mencegah kerusakan sel akibat hipoksia melalui aktivitas antioksidan. Penelitian ini bertujuan untuk melihat kemampuan neuroproteksi kedua herbal berdasarkan gambaran histopatologi neuron korteks serebrum. Sampel yang digunakan sebanyak 30 tikus jantan Spraque-Dawley yang diinduksi hipoksia selama 7 hari dan dilanjutkan dengan pemberian sediaan uji. Pemberian kombinasi AI dan CA menggunakan 2 dosis berbeda yaitu AI 200 mg/kgBB + CA 150 mg/kgBB dan AI 250 mg/kgBB + CA 100 mg/kgBB. Pemberian tunggal CA diberikan dengan dosis 100 mg/kgBB. Pemeriksaan histopatologi dilakukan dengan menghitung rerata persentase sel normalnya. Hasil uji one way ANOVA tidak menunjukkan perbedaan bermakna pada rerata persentase sel normal antar kelompok (p=0,575). Namun, terjadi peningkatan rerata persentase sel neuron normal dibanding kontrol negatif dengan urutan peningkatan terbanyak sebagai berikut: hipoksia+kombinasi 2 (15,43%), hipoksia+kombinasi 1 (11,46%) dan hipoksia+tunggal 2 (3,3%). Dapat disimpulkan bahwa pemberian kombinasi AI dan CA memiliki kecenderungan memperbaiki kerusakan sel neuron pascahipoksia.

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The Brain is an organ that is vulnerable to hypoxia. Hypoxia induces neuronal cell death especially in cerebral cortex neuron. Until now, there are no neuroprotective agents that are recommended for ischemic stroke. Among all potential therapies, Acalypha indica (AI) and Centella asiatica (CA), are examples of promising herbs for preventing cell damage from hypoxia through their antioxidant activity. The research purpose was to show the neuroprotective capabilities of these herbs by examining their histopathological features. Thirty hypoxia-induced male Spraque-Dawley rats were given treatment that contain the combination of AI and CA (AI 200 mg/kgBW + CA 150 mg/kgBW and AI 250 mg/kgBW + CA 100 mg/kgBW) and a single CA 100 mg/kgBW. Through the histopathological examination, percentages of the normal cells were counted and analyzed. One way ANOVA was conducted and the results did not show a statistically significant difference between all of the groups (p=0.575). The quantitative results depict an increase in the percentage of normal neuron cells in all of the exposed groups compared to the negative control group: combination 2 (15,43%), combination 1 (11,46%) and single CA (3,3%), respectively. Thus, the combination of AI and CA treatment have a trend toward restoring the neuron damage."

"Hipoksia merupakan kondisi inadekuat suplai oksigen menyebabkan peningkatan radikal bebas perusak organ, contohnya otak. Radikal bebas dinetralisir antioksidan endogen dan eksogen. Acalypha indica dan Centella asiatica memiliki efek antioksidan. Pewarnaan AgNOR mengukur derajat kerusakan sel. Penelitian bertujuan membuktikan efek pemberian kombinasi ekstrak etanol akar Acalypha indica dan Centella asiatica pada histopatologi neuron korteks serebrum tikus pascahipoksia pewarnaan AgNOR. Penelitian mendapat sediaan dari 26 ekor tikus Spraque-Dawley, terbagi dalam 6 kelompok: kontrol normal; kontrol negatif (hipoksia+aquades); hipoksia+kombinasi 1; hipoksia+kombinasi 2; hipoksia+tunggal 2; kontrol positif (hipoksia+vit C). Induksi hipoksia selama 7 hari dengan mengalirkan O2 10% dan N2 90% bertekanan 1 atm. Setelah 7 hari, dilakukan Analisis Gas Darah, reoksigenasi 1 jam, dilanjutkan pemberian perlakuan aquades; (AI200+CA150); (AI250+CA100); CA150 dan vitamin C selama 7 hari. Pada akhir studi dilakukan euthanasia, organ otak diambil untuk pemeriksaan histopatologi dengan pewarnaan AgNOR. Hasil: Pemberian esktrak kombinasi 2, tunggal 2, dan kombinasi 1 berbeda bermakna dibandingkan kontrol negatif (p=0,000; p=0,005; p=0,023). Kesimpulan: Kombinasi ekstrak etanol (AI250+CA100) memiliki efek terbaik untuk mengurangi kerusakan neuron korteks serebrum secara histopatologi.

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Hypoxia is inadequate conditions of oxygen causes increasing free radicals destroying organs, e.g. brain. Free radicals neutralized by endogenous and exogenous antioxidants. Acalypha indica and Centella asiatica have antioxidant effects. AgNOR staining measures degree of damaged cell. The aim of this study was to prove the effect of the combination of ethanol extract on the roots of Acalypha indica and Centella asiatica on the histopathology of cortical neurons in cerebrum of rats after hypoxia in AgNOR staining. The study of 26 Spraque-Dawley rats, divided into 6 groups: normal control; negative control (hypoxia + aquades); hypoxia + combination 1; hypoxia + combination 2; hypoxia + single 2; positive control (hypoxia + vit C). Induction of hypoxia for 7 days by flowing 10% O2 and 90% N2 with 1 atm pressure. After 7 days, Blood Gas Analysis, 1 hour re-oxygenation, followed by treatments; distilled water; (AI200 + CA150); (AI250 + CA100); CA150 and vitamin C for 7 days. At the end of study, euthanasia was carried out, brain organs were taken for histopathology examination with AgNOR staining. The combination 2, single 2 and combination 1 extracts were significantly different compared to negative control (p = 0,000; p = 0.005; p = 0.023). The combination of ethanol extract (AI250 + CA100) has the best effect to reduce damage to cerebral cortical neurons histopathologically."

"In recent study of antioxidant effect of Acalypha indica Linn (AI) and Centella asiatica (CA) increased due to appearance more complication of various disease which often caused by ROS (Reactive Oxidative Stress) formation. The active content of both plants have several proved effect on tissue such as wound healing effect, anti-inflammatory effect, diuretic effect, antioxidant effect, etc. Many research of AI and CA are used to evaluate their scavenging effect towards free radical. Several research investigating the combination of both plants conducted in Faculty of Medicine Universitas Indonesia limited in liver, kidney and brain, this research aim to seek the efficacy of both plants to suppress oxidative stress in heart tissue. This study uses experimental in vivo method. Combination of AI and CA are administered to Sprague dawley rats with dose of 200mg.kgBW- and 150mg.kgBW-1 respectively for 3, 7 and 14 days in hypoxia condition. Then the effect of both plants are compared to placebo (aquades) and Piracetam at 50mg.kgBW-1 dose. The result showed that combination of AI and CA have antioxidant effect after 7 days administration. Those combinations of AI and CA can suppress those pathways and reduce the MDA level. Therefore, the usage duration of the combination of AI and CA determined the efficacy as antioxidant in the heart and longtime usage duration might replace the use of piracetam as antioxidant.

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Studi mengenai efek antioksidan pada Acalypha indica Linn (AI) dan Centella asiatica (CA) mulai diperdalam dikarenakan peningkatan komplikasi penyakit yang disebabkan oleh pembentukan stress oksidatif. Kandungan dari kedua tanaman ini telah diteliti pada jaringan dan memiliki efek yang bagus dalam penyembuhan luka, anti-inflamasi, diuretik, antioksidan dll. Telah banyak dilakukan penelitian tentang AI dan CA yang digunakan untuk mengevaulasi efek penurunan/eliminasi radikal bebas. Penelitian mengenai kombinasi AI dan CA masih sedikit dilakukan di Fakultas Kedokteran Universitas Indonesia, terbatas pada organ ginjal, hati dan otak, penelitian ini dilakukan untuk membuktikan khasiat kombinasi AI dan CA pada jaringan jantung dalam menanggulangi stres oksidatif.

Penelitian ini menggunakan metode eksperimental in vivo. Kombinasi AI dan CA yang digunakan mempunyai kadar dosis yang masing-masing berjumlah 200mg.kgBB-1 dan 150mg.kgBB-1. Lalu kombinasi tersebut dieksperimentalkan pada tikus Sprague dawley dengan berat antara 150-250 g selama 3, 7 dan 14 hari dalam keadaan hipoksia. Efek dari kedua tanaman tersebut dibandingkan dengan plasebo (aquades) dan Pirasetam dengan dosis 50mg.kgBW-1. Hasil penelitian ini menunjukan bahwa kombinasi AI dan CA mempunyai efek antioksidan setelah pemberian lebih dari 7 hari. Kombinasi AI dan CA dapat menekan/memotong jalur pembentukan stress oksidatif di jantung dan mengurangi kadar MDA. Oleh karena itu durasi penggunaan kombinasi AI dan CA menentukan khasiat antioksidan dalam jantung dan perlakuan jangka panjang mungkin dapat menggantikan obat Pirasetam sebagai antioksidan."

"The aim of this book is to provide insight into the principles of operation of the cerebral cortex. These principles are key to understanding how we, as humans, function. There have been few previous attempts to set out some of the important principles of operation of the cortex, and this book is pioneering. The book goes beyond separate connectional neuroanatomical, neurophysiological, neuroimaging, neuropsychiatric, and computational neuroscience approaches, by combining evidence from all these areas to formulate hypotheses about how and what the cerebral cortex computes. As clear hypotheses are needed in this most important area of 21st century science, how our brains work, I have formulated a set of hypotheses about the principles of cortical operation to guide thinking and future research. The book focusses on the principles of operation of the cerebral cortex, because at this time it is possible to propose and describe many principles, and many are likely to stand the test of time, and provide a foundation for further developments, even if some need to be changed. In this context, I have not attempted to produce an overall theory of operation of the cerebral cortex, because at this stage of our understanding, such a theory would be incorrect or incomplete. However, many of the principles described will provide the foundations for more complete theories of the operation of the cerebral cortex. This book is intended to provide a foundation for future understanding, and it is hoped that future work will develop and add to these principles of operation of the cerebral cortex. The book includes Appendices on the operation of many of the neuronal networks described in the book, together with simulation software written in Matlab."

"Otak merupakan organ yang memiliki kebutuhan oksigen dan glukosa tertinggi di tubuh. Rendahnya tekanan oksigen pada otak dapat memicu terjadinya kerusakan pada sel otak bahkan kematian sel. Hipoksia merupakan kondisi penurunan kadar oksigen pada organ, jaringan atau sel. Hipoksia yang diberikan pada kadar dan waktu tertentu dapat menimbulkan respons adaptasi tubuh sehingga kondisi hipoksia dapat ditanggulangi. Salah satu respons adaptasi yang dilakukan adalah autofagi. Autofagi adalah suatu proses degradasi dan daur ulang molekul sitoplasmik dan organel seperti mitokondria dengan bantuan lisosom yang berperan dalam menjaga homeostasis seluler. Penelitian ini dilakukan untuk mengetahui efek pemberian hipoksia hipobarik intermiten terhadap aktivitas autofagi sel melalui ekspresi protein LC3 dan mTOR pada jaringan otak tikus. Penelitian ini menggunakan sampel jaringan otak tikus jenis Sprague-Dawley. Tikus dibagi dalam lima kelompok, yaitu kelompok kontrol, kelompok hipoksia 1 kali (HHI 1), HHI 2, HHI 3 dan HHI 4. Setiap kelompok hipoksia akan dimasukan dalam hypobaric chamber dan dibawa sampai ketinggian 25.000 kaki selama 5 menit. Tikus kemudian dikorbankan dan dilakukan pengukuran ekspresi protein LC3 dan mTOR menggunakan metode ELISA. Ekspresi protein LC3 juga dianalisis dengan IHK. Hasil menunjukkan bahwa pemberian perlakuan hipoksia hipobarik intermiten mampu meningkatkan ekspresi protein LC3 dan mempertahankan ekspresi mTOR. Hasil pulasan IHK menunjukkan ekspresi protein LC3 lebih tinggi pada bagian cerebellum otak dibandingkan dengan bagian cerebrum pada setiap kelompok.

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The brain is an organ with the highest demand for oxygen and glucose in the body. Insufficient oxygen pressure in the brain can lead to damage to brain cells and even cell death. Hypoxia is a condition characterized by a decrease in the oxygen levels in organs, tissues, or cells. Hypoxia, when applied at specific levels and durations, can induce adaptive responses in the body, allowing it to cope with the hypoxic conditions. One such adaptive response is autophagy. Autophagy is a cellular process involving the degradation and recycling of cytoplasmic molecules and organelles, including mitochondria, facilitated by lysosomes. This process plays a crucial role in maintaining cellular homeostasis. This study aimed to investigate the effects of intermittent hypobaric hypoxia on autophagic activity in brain cells by assessing the expression of proteins LC3 and mTOR during hypoxic conditions. The experimental subjects were Sprague-Dawley rats, and they were divided into five groups: a control group, and four groups subjected to intermittent hypobaric hypoxia (IHH) for varying durations (IHH1, IHH2, IHH3, and IHH4). Each IHH group was exposed to a hypobaric chamber at an altitude of 25,000 feet for 5 minutes. Subsequently, the rats were sacrificed, and the expression of LC3 and mTOR proteins was measured using ELISA. The LC3 protein expression was also analyzed through immunohistochemistry (IHC). The results showed that intermittent hypobaric hypoxia treatment increased the expression of LC3 protein and maintained mTOR expression. Additionally, IHC feedback indicated higher LC3 protein expression in the cerebellum region compared to the cerebrum in each experimental group."

"Latar Belakang: Hipoksia adalah keadaan defisiensi suplai oksigen ke dalam sel atau jaringan akibat gagalnya sistem respirasi yang membawa oksigen sehingga mengakibatkan kerusakan jaringan. Hati merupakan organ yang sensitif terhadap hipoksia. Keadaan hipoksia dapat menyebabkan kerusakan hati yang mendasari beberapa kondisi patologis jaringan seperti ischemic hepatitis, cirrhosis hepatis. Tanaman Acalypha indica (AI) dan Centella asiatica (CA) telah terbukti memiliki efek antioksidan dan dapat melindungi banyak organ dari kondisi hipoksia. Pada penelitian ini menganalisis pengaruh pemberian kombinasi ekstrak etanol AI dan CA pada pascahipoksia sitemik terhadap fungsi hati, stres oksidatif dan aktivitas antioksidan organ hati. Metode: Dua puluh delapan tikus Spraque-Dawley dibagi secara acak menjadi 7 kelompok. Kelompok kontrol adalah perlakuan tanpa hipoksia, perlakuan enam kelompok lainnya pascahipoksia 7 hari diberikan zat uji sebagai berikut: air, kombinasi dosis 1 dan 2, dosis tunggal AI, dosis tunggal CA dan dosis tunggal vitamin C selama 7 hari. Aktivitas ALT dan AST, kadar MDA, rasio GSH/GSSG dan aktivitas SOD dianalisis dengan statistik menggunakan uji ANOVA yang dilanjutkan multiple comparisons Post Hoc dengan uji Least Significant Difference (LSD) untuk mengetahui kelompok mana yang berbeda, dimana perbedaan dianggap bermakna secara statistik bila p<0.05. Hasil: Tidak ada perbedaan aktivitas ALT dan AST yang bermakna pada semua kelompok. Kadar MDA meningkat pada kelompok pascahipoksia 7 hari dibanding kontrol. Kelompok kombinasi 1 memiliki MDA yang rendah, rasio GSH/GSSG dan aktivitas SOD yang meningkat dibanding dengan kelompok pascahipoksia 7 hari. Kesimpulan: Pemberian zat uji kombinasi 1 memiliki efek perlindungan pada hati tikus terhadap pascahipoksia 7 hari melalui mekanisme stres oksidatif dan antioksidan.

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Background: Hypoxia occurs due to the deficiency of oxygen supply to the cells or tissue caused by the failure of the respiratory system that carries oxygen result in cell or tissue damage. Liver is an organ that has sensitive reaction to hypoxia. Hypoxia may cause liver damage underlying the condition of several pathological tissues, such as; ischemic hepatic, cirrhosis hepatic. Acalypha indica (AI) and Centella asiatica (CA) have been proved to have antioxidant effects and may protect many organs from hypoxic conditions. This study analysed the effect of ethanol extract combination of AI and CA on post-hypoxia toward liver function, oxidative stress and antioxidant activity of the liver.

Methode: Twenty-eight Spraque-Dawley rats divided randomly into 7 groups. Controlled group was treated without hypoxia while the six other groups on 7 days-post-hypoxia were given with such substance test as follows: water, dose combination of 1 and 2, single dose of AI, single dose of CA, and single dose of vitamin C. Activities of ALT and AST, MDA, GSH / GSSG ratio and SOD activity were analyzed statistically using ANOVA test followed by Post Hoc multiple comparison by the Least Significant Difference (LSD) to determine which groups was different, where the difference was considered statistically significant at p <0:05.

Result: There is no significant difference in the activity of ALT and AST in all groups. MDA levels increased in the 7 days-posthypoxia group compared to the controlled one. The group combination 1 has lower MDA and increasing GSH/GSSG ratio and SOD activity compared with the 7 days-posthypoxia group.

Conclusion: The substance of combination 1 test has a protective effect on the rats? liver on 7 days-posthypoxia through oxidative stress and antioxidant mechanisms. "

"Antioksidan berperan penting dalam menanggulangi reaktif oksidatif spesies yang dipercaya mengambil peran pada kondisi hipobarik hipoksia. Oleh sebabnya, glutathione yang tereduksi (GSH) adalah antioksidan endogen non-enzimatik yang dapat mencegah kerusakan oksidatif. Secara teratur, riset ini dilaksanakan untuk menemukan efek dari pajanan intermiten hipobarik hipoksia yang dicerminkan dari level GSH, sebagai salah satu dari antioksidan penting pada jaringan ginjal. Sampel pada ginjal diambil dari tikus Sprague-Dawley yang berusia 6-8 minggu dengan berat 150-200g, yang sebelumnya telah terkena pajanan lingkungan normal (pada kontrol) atau pajanan intermittent hipobarik hipoksia selama beberapa hari. Setelah itu, level GSH dihitung dari ekstrak jaringan ginjal. Konsentrasi GSH naik pada pajanan hipoksia 1x dan hipoksia 2x jika dibandingkan dengan grup kontrol. Tapi, konsentrasinya menurun setelah pajanan 3x dan ditemukan hamper stabil pada pajanan 4x hipoksia. Level yang berbeda pada glutathione dalam kondisi intermiten hipobarik hipoksia disebabkan oleh jaringan ginjal yang sudah beradaptasi dengan kondisi hipobarik hipoksia.

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Antioxidants play important role for scavenging many reactive oxidative species, which believed are involved in hypobaric hypoxia condition. Hence, reduced-glutathione (GSH) is an endogenous non-enzymatic antioxidant could prevent oxidative damage. Consequently, this study attempted to find the effects of intermittent hypobaric hypoxia exposure as reflected by GSH level, as one of major antioxidant found in renal tissue. Renal samples were collected from 6-8 weeks old male Sprague-Dawley rats weighing 150- 200g, previously exposed to normoxic environment (control) or intermittent hypobaric hypoxia for certain days. Afterwards, GSH level was calculated from renal extracts. Concentration of GSH was increased on hypoxia 1x treatment and hypoxia 2x treatment compared to control group. But, the concentration was decreased after 3x treatment and found almost stabilized at 4x treatment of hypoxia. The various level of glutathione in intermittent hypobaric hypoxia was due to renal tissue adaptation toward hypobaric hypoxia treatment."

"Latar belakang: Seorang pilot yang bertugas di ketinggian dapat terpapar hipoksia, baik ringan maupun berat. Kejadian hipoksia di penerbangan dapat menjadi fatal, terutama jika hipoksia dialami seorang pilot saat bertugas. Salah satu manifestasi hipoksia adalah penurunan fungsi kognitif. Pilot dituntut untuk melakukan operasi multitasking dengan menggunakan fungsi kognitif, terutama saat darurat. Sehingga penurunan fungsi kognitif akibat hipoksia pada seorang pilot saat bertugas dapat menyebabkan kecelakaan dalam penerbangan. Tujuan dari penelitian ini adalah untuk mengetahui perubahan fungsi kognitif pada paparan hipoksia di beberapa zona ketinggian.Metode: Penelitian ini menggunakan uji eksperimental one group pretest-post test . Subjek penelitian adalah pilot militer yang mengikuti Indoktrinasi Latihan Aerofisiologi di Lakespra Saryanto, Jakarta. Subjek mengisi kuesioner 6 CIT pada ground level, physiological efficient zone (10.000 feet) dan physiological defficient zone (25.000feet) dalam hipobarik chamber.Hasil: Terdapat perubahan score 6 CIT di 10.000ft dibandingkan dengan ground level (Friedman post hoc Wilcoxon, P = 0.001). Terdapat juga perubahan score 6 CIT di 25.000ft dibandingkan dengan ground level (Friedman post hoc Wilcoxon, P < 0.001).Kesimpulan: Terdapat perubahan fungsi kognitif di physiological efficient zone dan physiological defficient zone jika dibandingkan dengan di ground level.

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Background: A pilot on duty at altitude can be exposed to hypoxia, both mild and severe hypoxia. The incidence of hypoxia on flight can be fatal, especially if hypoxia is experienced by pilot on duty. One manifestation of hypoxia is decreased cognitive function. Pilot is required to carry out multitasking operations using cognitive functions, especially at emergency. Therefore, decreased cognitive function due to hypoxia on pilot can cause accidents in flight. The aim of this study was to determine changes in cognitive function in hypoxia exposure at several altitude zones.

Methods: This study used an experimental one group pretest-post test design. The subjects were 31 military pilots who participated in Indoctrination and Aerophysiology Training. Subjects filled 6 CIT questionnaire at ground level, physiological efficient zone (10,000 feet) and physiological defficient zone (25,000 feet) in a hypobaric chamber.

Result: There was change of 6 CIT score at 10.000ft compared to ground level (Friedman post hoc Wilcoxon, P = 0.001). There was also change of 6 CIT score at 25,000 ft compared to ground level (Friedman post hoc Wilcoxon P <0.001).

Conclusion: There was change in cognitive function in physiological efficient zone and physiological defficient zone, compared to ground level."

"Latar Belakang: Salah satu aspek dalam fungsi fisiologis manusia yang berperan penting dalam penerbangan adalah fungsi visuospasial. Fungsi visuospasial merupakan kemampuan persepsi visual tingkat tinggi yang dibutuhkan untuk identifikasi, integrasi informasi, menganalisa bentuk visual dan spasial, detail, struktur, dan hubungan spasial antara bentuk dua dengan tiga dimensi. Paparan hipoksia merupakan hazard spesifik yang terdapat dalam dunia penerbangan dan dampaknya terhadap fungsi visuospasial dapat meningkatkan risiko terjadinya kecelakaan dalam penerbangan. Tujuan dari penelitian ini adalah untuk mengetahui perubahan fungsi visuospasial terhadap paparan hipoksia di zona ketinggian yang berbeda.Metode: Penelitian ini menggunakan uji eksprimen one-group pretest-postest. Subjek penelitian adalah awak terbang militer yang mengikuti Indoktrinasi Latihan Aerofisiologi (ILA) di Lakespra Saryanto, Jakarta. Subjek mengerjakan tes Clock Drawing Test (CDT) pada ground level, physiological efficient zone (10.000 ft) dan physiological deficient zone (25.000 ft.) di dalam hypobaric chamber.Hasil: Terdapat peningkatan angka kejadian gangguan fungsi visuospasial di 10.000 kaki dibandingkan dengan ground level (McNmear = 0.031), 10.000 kaki dengan 25.000 kaki (McNemar = 0.0001) dan ground level dengan 25.000 kaki (McNemar = 0.0001).Kesimpulan: terdapat peningkatan angka kejadian gangguan fungsi visuospasial yang signifikan antara ketinggian ground level, 10.000 kaki dan 25.000 kaki.

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Background: One of many aspects of human physiological function that has an important role in aviation is visuospatial function. Visuospatial function is a high-level visual perception that is required for identification, information integration, analyzing visual and spatial form, detail, structure and spatial relation between two-dimensional and three-dimensional form. Hypoxia exposure is considered to be a specific hazard in the aviation environment and its impact against visuospatial function can potentially increase the risk of aviation-related accident. The purpose of this study was to investigate changes in visuospatial function on hypoxia exposure in different altitude zones.

Metode: This study used an experimental one-group pretest-posttest design. The subjects were 42 military aircrews who participated in Indoctrination and Aerophysiology Training. Subjects completed The Clock Drawing Test (CDT) at ground level, physiological efficient zone (10.000 ft) and physiological deficient zone (25.000 ft) in a hypobaric chamber.

Hasil: There was an increase of the number of impaired visuospatial function at 10.000 ft compared to ground level (McNemar = 0.031), 10.000 to 25.000 ft (McNemar = 0.0001) and ground level to 25.000 ft (McNemar = 0.0001).

Kesimpulan: There was a significant change in the number of impaired visuospatial function between ground level, 10.000 ft, and 25.000 ft."