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"Ebola adalah virus penyebab fatal hemoragik pada manusia dan primata non-manusia. Virus ebola memiliki lima spesies dan yang paling mematikan ialah virus ebola Zaire. Genom virus ebola mengkodekan tujuh protein yang penting bagi siklus hidupnya dan penelitian ini dilakukan untuk menghambat VP24 virus ebola Zaire. VP24 memiliki potensi sebagai target obat karena memiliki peran penting dalam replikasi virus ebola dan penghambatan interferon sel inang. Dalam penelitian ini, senyawa terpenoid digunakan untuk menghambat VP24 Zaire secara komputasi dengan menggunakan fitur farmakofor. Terdapat 55.979 senyawa terpenoid diperoleh dari pangkalan data Pubchem kemudian ligan disaring berdasarkan sifat toksisitas melalui Osiris DataWarrior dan terdapat 3.353 ligan yang memiliki sifat toksisitas yang menguntungkan. Selanjutnya fitur farmakofor digunakan untuk menyaring ligan dan 1.375 ligan memiliki struktur yang sesuai dengan fitur farmakofor. Kemudian ligan dilakukan simulasi penambatan molekul dengan target protein dan terdapat 10 ligan terbaik berdasarkan sifat molekul dan interaksi molekuler. Selanjutnya, semua ligan dianalisa sifat farmakologisnya melalui Osiris DataWarrior, Toxtree, admetSAR, SwissADME, dan pkCSM. Akhirnya, terdapat tiga ligan terbaik yaitu Taxumairol V, Acrivastine, dan 3-O-acetyluncaric acid. Dalam penelitian ini, Taxumairol V adalah ligan terbaik untuk menghambat VP24 virus ebola Zaire karena ligan memiliki sifat molekul, interaksi molekuler, dan sifat farmakologis yang baik sebagai kandidat obat.

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Ebola is a pathogenic virus which causes fatal hemorrhagic fever in humans and non-human primates. Ebolavirus has five species, and there is the most pathogenic of ebolavirus namely Zaire ebolavirus. Ebola virus genome encodes seven protein which important for the ebolavirus life cycle and in this research was conducted to inhibit VP24 Zaire ebolavirus. VP24 has potential as a drug target because VP24 has an essential role in replication and interferon inhibition. In this research, 55,979 terpenoid compounds were obtained from PubChem database then the ligands were screened based on toxicity properties through Osiris DataWarrior, and there were 3,353 ligands which have beneficial toxicity properties. Afterward, the pharmacophore features were used to screen all ligands and 1,375 ligands have suitable structures according to the pharmacophore features. All ligands were docked with the protein target, and there were ten best ligands based on the molecular properties and interactions. Furthermore all ligands were investigated their pharmacological properties through Osiris DataWarrior, Toxtree, admetSAR, SwissADME, and pkCSM. Finally, there were three best ligands namely, Taxumairol V, Acrivastine, and 3-O-acetyluncaric acid. In this study, Taxumairol V was the best ligand to inhibit VP24 Zaire ebolavirus because the ligand has good molecular interactions, molecular and pharmacological properties."

"Latar Belakang: Penyakit periodontal terjadi karena adanya keterlibatan mikroorganisme oral salah satunya adalah Fusobacterium nucleatum. Perawatan suportif penyakit periodontal dapat berupa penggunaan antiseptik sintetik atau alami seperti tanaman obat. Salah satunya adalah rosela yang dilaporkan memiliki khasiat antibakteri secara in vitro. Dalam upaya pengembangan bentuk sediaan, ekstrak etanol kelopak bunga rosela dibuat dalam bentuk sediaan gel.Tujuan: Mengetahui potensi antibakteri gel ekstrak etanol kelopak bunga rosela terhadap Fusobacterium nucleatum. Metode:Uji zona hambat dilakukan dengan menghitung diameter zona hambat yang terbentuk pada kertas saring yang telah dipaparkan gel ekstrak etanol kelopak bunga rosela pada media MHA yang sudah diinokulasi Fusobacterium nucleatum. Uji Total Plate Countdilakukan dengan menghitung jumlah koloni Fusobacterium nucleatumyang bertahan hidup setelah dipaparkan gel ekstrak etanol kelopak bunga rosela.Hasil: Uji zona hambat, gel ekstrak etanol kelopak bunga rosela konsentrasi 15% memiliki zona hambat yang setara dengan gel klorheksidin. Pada uji Total Plate Count, adanya penurunan jumlah koloniFusobacterium nucleatumpada gel ekstrak etanol kelopak bunga rosela konsentrasi 10%, 15%, dan 25% yang setara dengan gel klorheksidin 0,2%.Kesimpulan: Gel ekstrak etanol kelopak bunga konsentrasi 10%, 15%,25% memiliki efek antibakteri terhadap Fusobacterium nucleatum.

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Background:Periodontal disease occurs due to the involvement the presence of oral microorganisms, one of them is Fusobacterium nucleatum. Supportive treatment of periodontal disease can use synthetic or natural antiseptics such as medicinal plants. One of them is roselle which is reported to has antibacterial effect (in vitro). In developing the dosage form, roselle calyx ethanol extract is developed into gel form.

Objective: To determine the antibacterial effect of roselle calyx ethanol extract gel at 10%, 15%, and 25% concentration on Fusobacterium nucleatum.

Method: The inhibition zone test was carried out by counting the inhibition zone formed on paper disc that had been exposed to the roselle calyx ethanol extract gel on MHA media that had been inoculated by Fusobacterium nucleatum. Total Plate Count test was performed by counting the colonies of Fusobacterium nucleatumthat survived after being exposed to roselle calyx ethanol extract gel.

Result: In inhibition zone test, 15% concentration roselle calyx ethanol extract gel showed inhibition zone equivalent to chlorhexidine gel. Total plate count test showed that at 10%, 15%, and 25% concentration gel,Fusobacterium nucleatumcolonies have survived equivalent to chlorhexidine gel.

Conclusion: Roselle calyx ethanol extract gel at 10%, 15%, and 25% concentration have antibacterial effect to Fusobacterium nucleatum."

"Penyakit Graves (GD) merupakan penyakit autoimun yang menyerang kelenjar tiroid dan menjadi penyebab utama terjadinya hipertiroidisme. Manifestasi klinis ekstratiroid yang umum terjadi pada pasien GD ialah oftalmopati Graves (OG). Salah satu penentu genetik yang terkait dengan respon autoimunitas baik pada GD atau OG ialah gen CD40. Penelitian ini dilakukan untuk melihat hubungan variasi genetik CD40 (rs1883832 dan rs11086998) dan kadar sCD40 terhadap derajat keparahan oftalmopati pada penderita Graves. Studi potong lintang ini menggunakan 60 sampel DNA dan serum pasien Graves yang dikategorikan ke dalam tiga kelompok, yaitu kelompok OG kelas 0, kelas I-III, dan kelas IV-VI. Analisis variasi genetik dilakukan dengan metode PCR-RFLP dan pengukuran kadar sCD40 menggunakan metode ELISA. Derajat keparahan OG dinilai menggunakan klasifikasi NOSPECS yang mana data diperoleh dari rekam medik pasien. Hasil yang diperoleh menunjukkan bahwa variasi gen CD40 pada bagian 5’UTR rs1883832 tidak memiliki hubungan yang bermakna dengan kadar sCD40 dan derajat keparahan OG (p>0,05), sedangkan pada ekson 9 rs11086998 tidak ditemukan variasi genetik (hanya diperoleh genotip CC dan alel C). SNP gen CD40 pada rs1883832 menunjukkan genotip TT dan alel T memiliki rata-rata kadar sCD40 yang lebih tinggi dibandingkan kelompok variasi genetik lainnya pada penderita Graves. Disimpulkan, variasi genetik CD40 pada 5’UTR rs1883832 dan ekson 9 rs11086998 tidak berhubungan dengan derajat keparahan OG.

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Graves' Disease (GD) is an autoimmune disease which causes hyperthyroidism by attacking the thyroid gland. The most common extra thyroid manifestation in GD is Graves' ophthalmopathy (OG). One of the genetic determinants associated with the autoimmune response to GD and OG is the CD40 gene. The aim of this study is to determine the association between genetic variation of CD40 gene (rs1883832 and rs11086998) and the serum level of sCD40 to the degree of ophthalmopathy severity in patients with Graves' disease. In this cross- sectional study, 60 DNA and serum of Graves patients were categorized into three groups; namely OG class 0, class I-III, and class IV-VI. Analysis of genetic variations were carried out using the PCR-RFLP method and ELISA method for the measurement of sCD40 levels. The severity of OG was assessed using NOSPECS classification where the data was obtained from medical records. The results showed that the genetic variation of the CD40 gene at 5’UTR rs1883832 does not have a significant association with sCD40 levels and degree of OG severity (p> 0.05). There was no genetic variation found in exon 9 rs11086998 with only CC genotypes and alleles C were obtained. SNP rs1883832 of the CD40 gene indicates that the TT genotype and the T allele have higher average of sCD40 levels compare to the other group of genetic variation in patient with Graves' disease. In conclusion, genetic variation in 5’UTR rs1883832 and exon 9 rs11086998 of CD40 gene have no correlation with the severity degree of OG."

"Latar Belakang: Ensefalitis toksoplasma (ET) termasuk infeksi oportunistik yang paling banyak menyebabkan penyakit SSP pasien AIDS. Algoritma penatalaksanaan lesi fokal otak ET pasien AIDS di Rumah Sakit Cipto Mangunkusumo (RSCM) masih berdasarkan terapi empiris ET. Tujuan: Mengetahui proporsi pasien AIDS diduga ET yang menunjukkan perbaikan klinis dan atau radiologis setelah diberikan terapi empiris dan faktor-faktor yang mempengaruhi. Metode: Studi retrospektif potong lintang melalui data rekam medis pasien AIDS dewasa diduga klinis ET rawat inap pertama kali di RSCM dari tahun 2010-2012 dengan CD4 <200sel/mm3. Perbaikan klinis dan atau radiologis dinilai setelah 2 minggu terapi empiris. Hasil: Didapatkan 82 subyek, dengan perbaikan klinis pada 63 pasien (77%). Terdapat 20 subyek yang menjalani pencitraan evaluasi dan dapat dibandingkan.Enam belas di antaranya didapatkan perbaikan radiologis. Median usia subyek 30 tahun (23-51) dan nilai median CD4 21 sel/mm3 (3-152). Penyakit penyerta terbanyak adalah tuberkulosis (46.3%), pneumonia (40.2%), dan sepsis (22%). Subyek tanpa sepsis memberikan respons yang lebih baik secara nyata dibandingkan subyek dengan sepsis (p= 0,000). Kesimpulan: Pemberian terapi empiris pada pasien yang diduga ET secara klinis masih menghasilkan respons klinis dan atau radiologis yang baik. Sepsis menurunkan secara bermakna respons terhadap terapi empiris.

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Background: Toxoplasma encephalitis (TE) is one of opportunistic infections that most cause CNS disease in AIDS and leads to focal brain lesions. The algorithm management of focal brain lesions AIDS patients in Cipto Mangunkusumo Hospital (RSCM) was based on empirical therapy of TE.

Aim: To find out the proportion of AIDS patients in RSCM with clinical diagnosis of TE who showed clinical and or radiological improvement after administration of empirical therapy and the influencing factors.

Method: A retrospective, cross-sectional study using medical records of adult AIDS patients admitted in RSCM from year 2010–2012. The eligible subjects were those who were admitted with clinical diagnosis of TE for the first time and CD4 <200cells/mm3. Clinical and or radiological improvement was assessed after two weeks of empirical therapy.

Results: There were 82 eligible subjects. Clinical improvement was found in 63 subjects (77%). There were 20 subjects who undergone serial neuroimaging examination and have comparable result. Sixteen subjects showed radiological improvement. Median age of the subjects was 30 years old (23–51) and median CD4 was 21cells/mm3 (3–152). The most frequent comorbidities were tuberculosis (46.3%), pneumonia (40.2%), and sepsis(22%). Subjects without sepsis were more responsive to empirical therapy compared to subjects with sepsis (p= 0.00).

Conclusions: Administration of empirical therapy in patients clinically diagnosed with TE provided favourable clinical and or radiological responses. Sepsis was associated with poor response to empirical therapy."

"Latar Belakang: Major Adverse Cardiac Events (MACE) merupakan penyebab utama meningkatnya morbiditas dan mortalitas pada pasien sindrom koroner akut (SKA). Skor prediksi MACE merupakan model yang dapat memprediksi prognosis untuk terjadinya MACE berdasarkan faktor risiko yang dimiliki oleh pasien SKA. Tujuan: Untuk membuat skor prediksi sederhana, mudah dikalkulasi dan aplikatif, yang mampu mengidentifikasi pasien SKA dengan risiko terjadinya MACE. Metode: Dilakukan penelitian kohort retrospektif pada 1002 subyek pasien SKA yang dirawat di intensive coronary care unit RSCM dalam periode waktu Januari 2010 - Desember 2013. Dilakukan evaluasi terhadap faktor risiko jenis kelamin, usia, riwayat keluarga penyakit jantung koroner, diabetes, hemoglobin, leukosit, kreatinin, asam urat, enzim jantung, tekanan darah sistolik, denyut jantung, henti jantung, deviasi segmen ST dan kelas killip. Hasil: Major Adverse Cardiac Events didapatkan pada 112 subyek (9,21%), faktor prediktor jenis kelamin wanita, leukosit, kreatinin, asam urat, enzim jantung, tekanan darah sistolik, denyut jantung, henti jantung dan kelas killip pada analisis multivariat mempergunakan regresi logistik didapatkan berhubungan bermakna dengan MACE dengan RR (95% IK) masing-masing 2.66 (1.35-5.25), 2.06 (1.02-4.16), 2.84 (1.43-5.66), 3.79 (1.90-7.54), 3.26 (1.51-7.05), 3.48 (1.57-7.70), 2.46 (1.20-5.01), 42.04 (18.90-93.51), dan 6.31 (3.19-12.50) serta didapatkan akurasi prediksi yang baik dengan nilai area under curve 0,95, 95% IK, 0,93-0,97. Kesimpulan: Pada pasien SKA didapatkan probabilitas MACE sebesar 3,6% bagi yang memiliki skor total 0-6 dan 83,5% bagi yang memiliki skor > 6 berdasarkan faktor-faktor prediktor jenis kelamin wanita (skor 1), leukositosis (skor 1), peningkatan kreatinin (skor 1), hiperurisemia (skor 2), peningkatan enzim jantung (skor 1), hipotensi (skor 2), takikardi (skor 1), henti jantung (skor 5) dan kelas killip III-IV (skor 3).

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Background: Major Adverse Cardiac Events (MACE) have been known as the cause of increasing morbidity and mortality among acute coronary syndrome (ACS) patients. Prediction score have been used as prognostic to prediction MACE based on risk factor in ACS patients.

Aim: To develop a simple risk score, easily calculated and applicability that can identifies ACS patients with risk for MACE.

Methods: A cohort retrospective study involving 1002 ACS patients in intensive coronary care unit RSCM from January 2010 through December 2013. Sex, age, family history, diabetes, hemoglobin, leucocyte, creatinine, uric acid, cardiac enzyme, systolic blood pressure, heart rate, cardiac arrest, deviation ST segment and killip class as risk factor for MACE was assessed.

Results: Major Adverse Cardiac Events was found in 112 (9,21%) of ACS patients, predictor factor woman, leucocyte, creatinine, uric acid, cardiac enzyme, systolic blood pressure, heart rate, cardiac arrest and killip class in multivariate logistic regression analysis were associated with MACE in ACS patients with (RR 95% CI) 2.66 (1.35-5.25), 2.06 (1.02-4.16), 2.84 (1.43-5.66), 3.79 (1.90-7.54), 3.26 (1.51-7.05), 3.48 (1.57-7.70), 2.46 (1.20-5.01), 42.04 (18.90-93.51), and 6.31 (3.19-12.50) respectively, and the best predictive accuracy for MACE was obtained by area under curve 0,95, 95% CI, 0,93-0,97.

Conclusions: In ACS patients we found probability MACE was 3,6% in patients with total score 0-6 and 83,5% for who have total score > 6 based on predictor factor woman (score 1), leukocytosis (score 1), elevated creatinine level (score 1), hyperuricemia (score 2), elevated cardiac enzyme (score 1), hypotension (score 2), tachycardia (score 1), cardiac arrest (score 5) and killip class III-IV (score 3)."

"Latar belakang. Penyakit Ginjal Kronik (PGK) stadium 3 merupakan faktor risiko tinggi terjadi Nefropati Akibat Kontras (NAK) setelah Percutaneous Coronary Intervention (PCI). Hidrasi merupakan salah satu modalitas mencegah NAK, demikian juga N-Acetyl Cysteine (NAC) walaupun efek proteksinya terhadap NAK masih kontroversial.Tujuan. Mengetahui apakah kombinasi hidrasi dan NAC dapat menurunkan risiko NAK pada pasien PGK stadium 3 setelah PCI pada pasien Pelayanan Jantung Terpadu (PJT) RSCM.Methoda penelitian. Studi kohort prospektif mengukur kreatinin plasma sebelum dan 48 jam sesudah PCI, sambil mencatat ada atau tidaknya perlakuan pemberian kombinasi hidrasi dan NAC pada pasien PGK stadium 3 tersebut.Hasil. Terdapat 38 pasien yang memenuhi kriteria penerimaan dan tidak mencakup kriteria penolakan serta menuntaskan penelitian dalam kurun waktu Agustus 2013 ? Januari 2014. Dua puluh tiga (43,4%) dari total 53 pasien PGK stadium 3 yang awalnya masuk studi ini diberikan perlakuan hidrasi dan NAC dan sisanya tidak mendapat perlakuan tersebut. Insidens kejadian NAK terdapat pada 2 dari 38 pasien yang menuntaskan studi (5.26%) yaitu pada kelompok yang tidak mendapat hidrasi dan NAC. Attributable Risk% sebesar 100%, kejadian NAK dapat dihilangkan 100% apabila diberikan hidrasi dan NAC.Simpulan. Kombinasi hidrasi dan NAC cenderung memproteksi kejadian NAKpada populasi PGK stadium 3 yang menjalani PCI

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Background. Stage 3 Chronic Kidney Disease (CKD) is known as a high risk factor for Contrast Induced Nephropathy (CIN) after Percutaneous Coronary Intervention (PCI). Hydration is a modality which is widely used to prevent CIN, and so is N-Acetyl Cysteine (NAC) eventhough there are controversial issues regarding their effectiveness to prevent CIN.

Aim. To know whether hydration and NAC combined has an effect of lowering CIN incidence in stage 3 CKD patients after PCI in Integrated Cardiac Services (ICS) in Cipto Mangunkusumo Hospital.

Methods. A prospective cohort is conducted examining plasma creatinine before and 48 hours after PCI in stage 3 CKD patients, meanwhile recording which patients are given combined hydration and NAC and which are not.

Results. Total 38 patients were collected whom fulfill the inclusion criteria and not meet the exclusion criteria and finished the study, from August 2013 until January 2014. Twenty-three (43,4%) of total 53 patients with stage 3 CKD whom enter the study at first were given hydration and NAC, and the did not received the combination. Incidence of CIN occurred in 2 of 38 patients whom finished this study (5.26%), all belonging to the non-hydration and NAC group. Attributable Risk% is 100%, means CIN can be 100% prevented if hydration and NAC is given.

Conclusion. Combination of Hydration and NAC is indicated to be protective against the risk of CIN in stage 3 CKD patients undergoing PCI."

"Latar Belakang: Penyakit periodontal berkaitan dengan peradangan kronis yang mempengaruhi jaringan pendukung gigi, termasuk jaringan gingiva, ligamen periodontal, dan tulang alveolar dalam bentuk penyakit yang lebih parah. Etiologi dari periodontitis adalah karena adanya perubahan jumlah relative takson spesifik pada yang memicu penyakit ini. Salah satu patogen kunci dalam perubahan lingkungan mikroba ini adalah Aggregatibacter actinomycetemcomitans dan Porphyromonas gingivalis. Asupan obat-obatan konvensional terkadang menyebabkan resistensi antibiotik, sehingga obat herbal digunakan bertahap sebagai alternatif. Salah satu herbal yang potensial ialah Cyperus rotundus L. atau rumput teki yang dikenal sebagai obat herbal yang umum digunakan untuk mengobati beberapa gangguan klinis. C. rotundus dilaporkan memiliki banyak aktivitas farmakologis, khususnya aktivitas antimicrobial. Studi in vivo dan in vitro membuktikan keefektifannya terhadap beberapa penyakit. Tujuan: Mengetahui dan menganalisis efektivitas ekstrak etanol rimpang rumput teki (Cyperus rotundus L.) dalam menghambat pertumbuhan dan membunuh koloni bakteri Aggregatibacter actinomycetemcomitans dan Porphyromonas gingivalis serta membandingkan efektivitas ekstrak etanol rimpang rumput teki dengan chlorhexidine (kontrol positif). Metode: Efektivitas ekstrak etanol rimpang rumput teki terhadap bakteri Aggregatibacter actinomycetemcomitans dan Porphyromonas gingivalis dilihat dari uji Kadar Hambat Minimum (KHM) dan uji Kadar Bunuh Minimum (KBM) dengan konsentrasi ekstrak etanol rimpang rumput teki yang digunakan adalah 50%, 25%, 12,5%, 6,25%, dan 3,125%. Selanjutnya hasil tersebut dianalisis dengan uji statistik One Way Anova. Hasil: Ekstrak etanol rimpang rumput teki (Cyperus rotundus L.) dapat menghambat pertumbuhan, namun tidak dapat membunuh koloni bakteri Aggregatibacter actinomycetemcomitans dengan nilai KHM 3,125% dan Porphyromonas gingivalis dengan nilai KHM 6,25%. Nilai KBM pada kedua bakteri tidak dapat ditetapkan. Melalui uji statistik One Way Anova didapatkan hasil bahwa terdapat perbedaan bermakna pada efektivitas ekstrak etanol rimpang rumput teki dengan Chlorhexidine 0,2% (p < 0,05). Kesimpulan: Ekstrak etanol rimpang rumput teki (Cyperus rotundus L.) dapat menghambat pertumbuhan bakteri, namun tidak dapat membunuh koloni bakteri Aggregatibacter actinomycetemcomitans dan Porphyromonas gingivalis sehingga dapat dipertimbangkan untuk menjadi agen antibakteri terhadap periodontitis.

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Background: Periodontal disease is associated with chronic inflammation that affects the supporting tissues of the teeth, including the gingival tissues, periodontal ligament, and alveolar bone in more severe forms of the disease. The etiology of periodontitis is due to changes in the relative number of specific taxa that trigger this disease. One of the key pathogens in this changing microbial environment is Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Intake of conventional medicines sometimes causes antibiotic resistance, so herbal medicines are used gradually as an alternative. One of the potential herbs is Cyperus rotundus L. or nut grass which is known as a herbal medicine that is commonly used to treat several clinical disorders. C. rotundus is reported to have many pharmacological activities, especially antimicrobial activity. In vivo and in vitro studies prove its effectiveness against several diseases. Objectives: To determine and analyze the effectiveness of ethanol extract of nutgrass rhizome (Cyperus rotundus L.) in inhibiting growth and killing bacterial colonies Aggregatibacter actinomycetemcomitans andPorphyromonas gingivalis and to compare the efficacy of ethanol extract of nutgrass rhizome with chlorhexidine (positive control). Methods: The effectiveness of the ethanol extract of nutgrass rhizome against the bacteria Aggregatibacter actinomycetemcomitans and Porphyromonas gingivaliswas seen from the Minimum Inhibitory Concentration (MIC) test, and Minimum Bactericidal Concentration (MBC) test with the concentration of ethanol extract of the nutgrass rhizome used was 50%, 25%, 12.5%, 6.25 %, and 3.125%. Furthermore, these results were analyzed with the One Way ANOVA statistical test. Results: The ethanol extract of nutgrass (Cyperus rotundus L.) rhizome could inhibit growth but not kill the bacterial colonies Aggregatibacter actinomycetemcomitans with a MIC value of 3.125% and Porphyromonas gingivalis with a MIC value of 6.25%. MBC values for both bacteria could not be determined. Through the One Way ANOVA statistical test, it was found that there was a significant difference in the effectiveness of the ethanol extract of nutgrass rhizome and Chlorhexidine 0.2% (p < 0.05). Conclusion: The ethanol extract of nutgrass (Cyperus rotundus L.) rhizome can inhibit bacterial growth but cannot kill the bacterial colonies Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis so that they can be considered antibacterial agents against periodontitis."