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Abstrak :
Stroke memiliki insiden yang cenderung meningkat dari tahun ke tahun, dengan gejala sisa terutama berupa hemi/paraplegia. Obat konvensional yang dipakai untuk pengobatan stroke relatif mahal dan memiliki banyak efek samping. Ekstrak air akar dari tanaman akar kucing (Acalypha indica Linn.) dipercaya masyarakat dapat mengatasi gejala hemi/paraplegia. Akar kucing memiliki efek antiradang, diuretik, antibiotik, laksatif, hemostasis, antidiabetes, dan menurunkan asam urat. Sampai saat ini, belum ada uji mengenai efek ekstrak air akar dari tanaman akar kucing tersebut, baik in vitro, eks vivo, maupun in vivo (uji praklinik) sebagai neuroterapi. Oleh karena itu, akan dilakukan uji efek neuroterapi ekstrak akar air dari Acalypha indica Linn. secara eks vivo. Penelitian eksperimental ini menggunakan sampel otot gastroknemius katak Bufo melanostictus Schneider. Pertama-tama setiap sampel direndam dengan ringer selama 10 menit, dicatat kontraksinya, kemudian dibilas. Selanjutnya direndam dengan pankuronium bromida 2 mg selama 10 menit, dibilas, saraf dirangsang dan dicatat kontraksinya. Sampel kemudian direndam ekstrak air akar Acalypha indica Linn. dengan dosis 5 mg dan 10 mg selama 10 menit, saraf dirangsang dan dicatat kontraksinya. Parameter yang diukur dalam penelitian ini adalah aktivitas listrik otot katak seperti jumlah dan lama repolarisasi, depolarisasi, flat, dan amplitudo setelah distimulasi. Data yang diperoleh dianalisis secara statistik dengan uji Anova satu arah. Hasil penelitian menunjukkan adanya perbaikan pada lama depolarisasi pada kelompok dosis 5 mg dan 10 mg (p=0,941) dan lama repolarisasi pada kelompok dosis 10 mg (p=0,657), walaupun hasil ini secara statistik tidak signifikan. ......Stroke incidence is likely to increase over time, with hemi/paraplegia as the common symptoms after stroke. Conventional drugs use for treatment of stroke is relatively expensive and have many side effects. People believed that extract water from the root of Acalypha indica Linn. can overcome the symptoms of hemi/paraplegia. Acalypha indica Linn. have the effect anti-inflammation, diuretics, antibiotics, laxative, hemostatis, anti-diabetic, and anti-urosemic. Until now, there has been no test of the effect of water extract from the roots of Acalypha indica Linn. both in vitro, ex vivo or in vivo (preclinical trial) as neurotherapy. Therefore, a test will be conducted to test the neuro-therapy effect of water extract from the roots of Acalypha indica Linn. ex vivo. M. gastrocnemius of frog Bufo melanostictus Schneider used in this experimental study as a sample. First each sample soaked with the ringer for 10 minutes, and the contraction is recorded, then rinsed. Second sample soaked with pancuronium bromide 2 mg for 10 minutes, rinsed, nerve stimulated, contraction recorded then rinsed. Then sample soaked with extract with dose of 5 mg and 10 mg for 10 minutes, nerve stimulated and contraction recorded. Parameters measured in this study were electrical activities of frog muscle, such as amount and duration of repolarization, depolarization, flat (resting potential), and amplitude after stimulation. Data are analyzed statistically with the one way Anova test. Results of this study indicate the improvement in the long depolarization in the 5 mg and 10 mg dose group (p=0.941) and long repolarization in the 10 mg dose group (p=0,657), although these result is not statistically significant.

Abstrak :
Kelumpuhan akibat miastenia gravis kini diobati dengan antikolinesterase sebagai obat lini pertama. Obat-obatan tersebut relatif mahal serta memiliki banyak efek samping sehingga dibutuhkan obat baru yang memiliki efektivitas tinggi tetapi aman digunakan dalam jangka panjang. Akar kucing (Acalypha indica Linn.) telah terbukti secara empiris untuk mengatasi gejala hemi/paraplegi. Namun, belum ada bukti ilmiah mengenai efeknya sebagai neuroterapi. Penelitian ini bertujuan untuk membuktikan efek neuroterapi ekstrak akar Acalypha indica Linn. secara eks vivo. Pada penelitian digunakan tiga kelompok percobaan, yaitu kelompok ekstrak dosis 10 dan 15 mg, serta kontrol. Tiap kelompok menggunakan empat sampel. Sediaan otot gastroknemius katak direndam dengan ringer, kemudian dengan pankuronium bromida 4 mg, masing-masing selama 10 menit. Setelah itu, perendaman dilanjutkan dengan ekstrak dosis tertentu selama 10 menit. Pada setiap perlakuan, dilakukan pengukuran lama depolarisasi, lama repolarisasi, lama flat, dan amplitudo kontraksi pada stimulasi 5 mV. Efek neuroterapi ditentukan dari kemampuan otot untuk memberikan respons elektrik setelah direndam dengan ekstrak. Dari hasil analisis ditemukan tidak ada perbedaan bermakna pada variabel lama depolarisasi (p=0,0852), lama repolarisasi (p=0,920), lama flat (p=0,803), dan amplitudo stimulasi (p=0,311). Namun, pada pengukuran lama depolarisasi kelompok ekstrak 10 mg dan amplitudo stimulasi kelompok ekstrak 15 mg, terlihat data kembali mendekati kondisi semula setelah mengalami perubahan saat perendaman dengan pankuronium. Disimpulkan bahwa ekstrak akar Acalypha indica Linn. dosis 10 dan 15 mg berefek neuroterapi secara eks vivo walaupun tidak bermakna secara statistik (p=0,0852 dan p=0,311) dan tidak didapatkan perbedaan antara efek neuroterapi pada dosis 10 dan 15 mg. ......Limb paralysis due to miastenia gravis is cured by anticholinesterase as a first line drug which is expensive and possesses many side effects. Hence, a new safe and highly effective drug is needed. Akar kucing (Acalypha indica Linn.) has been proved empirically but not scientifically to cure hemi/paraplegia. This study is aimed to prove neurotherapeutic effect of Acalypha indica Linn. extract ex vivo. Three experimental groups (extract group dose 10 and 15 mg, and control group) were used in the research, four samples each. Pancuronium bromide was used as a muscle relaxant. M. gastrocnemius was incubated for 10 minutes sequentially in ringer, pancuronium bromide 4 mg, and extract with dose of 10 and 15 mg. During each experiment, this study measured several parameters, consisting of depolarization time, repolarization time, flat time, and the height of the spike after 5 mV electrical stimulation. Neurotherapeutic effect was determined by muscle ability to give electric response after being incubated in the extract. Analysis test found no significant mean differences in every variable, such as depolarization time (p=0,0852), repolarization time (p=0,920), flat time (p=0,803), and spike amplitude (p=0,311). However, data showed that depolarization time of the extract group dosage 10 mg and spike amplitude of the extract group dosage 15 mg tended to alter into the original condition after alteration due to pancuronium incubation. To conclude, Acalypha indica Linn. root extract dose of 10 and 15 mg shows neurotherapeutic effect ex vivo despite statistically insignificant (p=0,0852 dan p=0,311) and there is no difference in neurotherapeutic effect between the extract group dosage 10 and 15 mg.

Abstrak :
Myasthenia gravis adalah penyakit autoimun pada neuromuscular junction yang sampai saat ini pengobatannya hanya memberi perbaikan parsial. Oleh karenanya, dibutuhkan obat baru yang sebagai terapi alternatif. Tanaman akar kucing (Acalypha indica Linn.) adalah salah satu tanaman obat yang digunakan di masyarakat untuk mengatasi gejala kelumpuhan. Namun sayangnya, belum ada uji mengenai khasiat ekstrak tanaman ini sebagai neuroterapi. Oleh karena itu, akan dilakukan uji apakah ekstrak air akar Acalypha indica Linn. memberi efek neuroterapi pada dosis yang lebih rendah, yaitu 15 dan 20 mg dibandingkan dengan kontrol secara eks vivo. Penelitian ini dilakukan pada m. gastroknemius dan n. iskhiadikus Bufo melanostictus Schneider yang dibagi dalam 3 kelompok yaitu, kelompok kontrol, kelompok dosis 15 mg dan 20 mg, masing-masing 4 sampel. Sediaan saraf-otot tersebut dilumpuhkan dengan direndam dalam pankuronium bromida 4 mg selama 10 menit, kemudian direndam dalam ekstrak akar. Adanya efek neuroterapi ditentukan dengan membandingkan aktivitas listrik m. gastroknemius pada kontrol, setelah direndam dengan pankuronium bromida 0,2% dan setelah direndam dengan ekstrak Acalypha indica Linn. Aktivitas listrik yang diukur berupa lama depolarisasi, repolarisasi, flat (potensial istirahat), serta tinggi amplitudo saat pemberian stimulasi. Pada hasilnya kemudian dilakukan uji statistik Anova satu arah. Pada dosis 15 dan 20 mg, ekstrak air Acalypha indica Linn. menunjukkan adanya perbaikan pada lama depolarisasi (p=0,933), lama repolarisasi (p=0,965) dan amplitudo dari stimulasi (p=0,608), walaupun hasil ini secara statistik tidak signifikan.

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Myasthenia gravis is an autoimune-mediated disorders in neuromuscular junction, which therapy only produces partial improvement in most patients. Therefore, there is a need to develop new alternative drugs. Acalypha indica Linn. is one of the traditional herb that has generally been used to treat paralyze, hemi or paraplegia. Unfortunately, there has not been any study that proves its effect as neuro-therapy. Based on that fact, this study was proposed to prove the neurotherapy effects of the extract in dose of 15 and 20 mg compared to control, ex vivo on m. gastrocnemius of frog. This experimental study were done on m. gastrocnemius and n. ischiadicus of Bufo melanostictus Schneider, which divided into 3 groups: group of control, group of doses 15 and 20 mg; each had 4 samples. Sample of m. gasctrocnemius and n. ischiadicus was then paralyzed by incubatingthem in pancuronium bromide 4 mg for 10 minutes, then in water extract for the same duration afterwards. Neurotherapy effect was determined by comparing electrical activities of muscle shown in control, after incubating with pancuronium bromide 4 mg, and after incubating with extract of Acalypha indica Linn. The electrical activities was measured as duration of depolarization, repolarization, resting potential, dan the height of spike after stimulation at 5 mV. The data were analyzed using one way Analysis of Variant. In the dose of 15 and 20 mg, water extract of Acalypha indica Linn. has shown improvement in duration of depolarization (p=0,933), duration of repolarization (p=0,965) dan height of spike after stimulation (p=0,608), although this result is not statistically significant.

Abstrak :
The studies of neuro-protection and neuro-therapy effects of Acalypha indica Linn. water extract ex vivo on Musculus gastrocnemius frog have already done at three Departments in Faculty of Medicine, University of Indonesia. The experimental studies were done on 2 groups of frog for neuro-protection and neuro-therapy effects. Each group of frog was divided into 7 subgroups of application, 4 samples each. There were 5 subgroups of doses: 5; 10; 15; 20; 25 mg and 2 subgroups as control. Pancuronium bromide 0.2%, 4 mg, was used for a positive control as muscle relaxant. Neuroprotection study was done as follow: ringer - extract - pancuronium bromide, and neuro-therapy study was ringer - pancuronium bromide - extract, respectively. The parameters measured in these studies were the electrical activities such as amount and duration (second) of re-polarization; depolarization, resting potential, and the height of spike after electrical stimulation at 5 mV. Neuro-protection effect of extract was determined by the ability of muscle to show the electrical response after incubating with pancuronium bromide for 10 minutes, and after incubating with extract for 10 minutes for neuro-therapy effect. In the dose of 15 mg and 20 mg/mL of A. indica Linn. extract showed better activities than the dose of 25 mg of extract, both as neuro-protection and neuro-therapy effects, but statistically its have not a significant difference. This study should be followed by an in vivo experiment on frog and it would be done in pharmacokinetic and pharmacodynamic studies on other animal models.

Abstrak :
Sepsis memiliki angka kematian yang cukup tinggi di seluruh dunia. Hal ini disebabkan sebagian besar oleh karena penegakan diagnostik, pemantauan, dan tatalaksana yang tidak adekuat. Mortalitas dan morbiditas sepsis masih dalam banyak penelitian di seluruh dunia. Penyebab terbanyak adalah keadaan imunoparalisis pada sepsis. Penelitian ini bertujuan untuk melihat kejadian, gambaran klinis imunoparalisis pada sepsis klinis anak.Penelitian ini dengan desain deskriptif, dimana subjek di IGD, PICU, dan ruang rawat anak RSCM usia 1 bulan ndash; 18 tahun dengan diagnosis sepsis klinis yang memilki 2/lebih dari 4 kriteria: 1 takikardia; 2 takipnu; 3 hipo/hipertermia; 4 leukositosis/leukopenia, dengan bukti infeksi berupa prokalstionin 0,5 ng/mL dan/atau dijumpai pertumbuhan kuman pada kultur. Setelah orangtua subjek mengisi informed consent, pasien dilakukan pemeriksaan darah rutin, analisa gas darah, prokalsitonin, kultur darah, dan darah diambil untuk pemeriksaan TNF alfa ex vivo. Pemeriksaan TNF alfa ex vivo dilakukan dengan menstimulasi darah segar dengan lipopolisakarida salmonella serotipe abortus equii 500 pg/mL yang kemudian akan dilakukan inkubasi pada suhu 370C selama 4 jam dan disentrifugasi 1000XG selama 5 menit, dilakukan pemeriksaan TNF alfa dengan metode ELISA. Subjek dikatakan imunoparalisis jika didapati hasil TNF alfa ex vivo < 200 pg/mL.Hasil penelitian menunjukkan angka kejadian imunoparalisis 12 17,1 dari 70 subjek terdiagnosa sepsis klinis. Proporsi laki:perempuan 1,4:1. Status gizi kurang n=8/66,7 lebih banyak didapati pada imunoparalisis sepsis klinis. Fokus infeksi tersering adalah infeksi pada sistem hematologi, nefrologi dan respirasi. Subjek demam 5 41,7 , takikardia 3 25 , takipnu 3 25 dari 12 subjek imunoparalisis pada sepsis klinis anak Untuk pemeriksaan laboratorium, prokalsitonin >2,0 ng/mL dan jumlah leukosit > 11.000/mm3 lebih sering dijumpai.Simpulan: angka kejadian imunoparalisis pada sepsis klinis anak di RSCM 17,1 . Gambaran pasien imnoparalisis pada sepsis klinis yang memiliki persentase besar adalah gizi kurang; pasien dengan fokus infeksi hematologi, nefrologi, dan respirasi; prokalsitonin ge; 2 ng/mL; dan leukosit ge; 11.000/mm3

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Mortality in sepsis is high worldwide. It is caused by the diagnostic, monitoring, and inadequate therapeutic. Mortality and morbidity in sepsis is still in research. Immunoparalysis is a leading cause of mortality and morbidity of sepsis. The objectives of this study were investigating incidence, clinical characteristics immunoparalysis in clinically sepsis.Design of study was descriptive. The subjets were children age 1 month-18 years from emergency room, PICU, and pediatric ward with clinically sepsis following ge; 2 of 4 criterias: 1 tachycardia; 2 tachypnea; 3 hypo/hyperthermia; 4 leucocytosis/leucopenia, with proven infection such as procalcitonin 0.5 ng/mL with/without positive culture. After informed consent was filled, subjects were examined blood sample, procalcitonin, blood culture, and TNF alpha ex vivo. Whole blood was stimulated with lipopolysaccharides salmonella serotype abotrtus equii, incubated in 37 0C for 4 hours, centrifugated 1000XG for 5 minutes, and examined for TNF alpha with ELISA. Subjects was defined imunoparalysis with TNF alpha ex vivo < 200 pg/mL.We found the incidence of immunoparalysis was 12 17.1 of 70 clinically sepsis subjects. Malnourished status n=8/66.7 was higher frequency. The large numbers for focus of infection were hematologic, nephrologic, and respiratory system. Subjects had fever 5 41,7 , tachycardia 3 25 , and tachypnea 3 25 from 12 imunoparalysis clinically sepsis subject. Laboratorium findings showed procalcitonin > 2.0 pg/mL 8 66,7 subjects and leucocyte > 11.000/mm3 6 50 subjects.Conclusion: The incidence of imunnoparalysed sepsis was 17.1 . Profile of pediatric clinically sepsis had a big number in malnourished status, focus infectious on hematology, nephrology, and respitarory with laboratorium findings showed procalcitonin > 2.0 ng/mL and leococyte > 11.000/mm3 had a high numbers in immunoparalysed clinically sepsis.

Abstrak :
Stroke menimbulkan gangguan neurologis menetap. Obat-obatan konvensional yang ada selain relatif mahal dan banyak efek samping, belum dapat menyembuhkan gejala sisa tersebut. Melihat penggunaan rebusan akar Acalypha indica Linn. di masyarakat dalam mengatasi gejala paresis pasca stroke, dilakukan uji efek neuroterapi ekstrak akar Acalypha indica Linn. secara eks vivo pada saraf otot gastroknemius katak, untuk membuktikan adanya efek terapi dari ekstrak. Studi eksperimental ini dilakukan dengan model neuromuscular junction katak. Dikarenakan kemiripan studi dengan patofisiologi miastenia gravis, bila penelitian ini menunjukkan hasil yang baik, kemungkinan dapat diterapkan pula untuk mengobati miastenia gravis. Penelitian dilakukan dengan lima kelompok dosis (ekstrak 5; 10; 15; 20; 25 mg/ml) dan satu kelompok kontrol (ringer), dengan empat sampel setiap kelompok. Pada pembahasan hanya akan dibandingkan antara kelompok kontrol, ekstrak 20 mg, dan 25 mg. Pankuronium bromida 2 mg digunakan sebagai pelumpuh otot. Penelitian dilakukan sebagai berikut: perendaman dengan Ringer – Pankuronium bromida – Ekstrak. Parameter yang digunakan berupa aktivitas listrik seperti jumlah dan durasi (dalam detik) dari repolarisasi, depolarisasi, potensial istirahat, dan tinggi spike setelah pemberian stimulasi listrik pada 5 mV. Adanya efek neuroterapi ditentukan oleh kemampuan otot untuk menunjukkan respons listrik setelah perendaman dengan pankuronium bromida dan ekstrak selama 10 menit. Ekstrak air akar Acalypha indica Linn. menunjukkan efek neuroterapi terbaik pada dosis 20 mg dan 25 mg, dengan perbaikan nilai rata-rata depolarisasi (p= 0,197), repolarisasi (p= 0,475), dan flat (p= 0,558), walaupun secara statistik tidak berbeda bermakna. ......Stroke has caused persistent neurologic symptoms. The conventional drugs used today cannot cure these symptoms, besides they are more adverse reactions and expensive. The extract of Acalypha indica Linn. has been used for long time to treat patient with paralyze. To prove the extract’s therapy effect, a study of neuro-therapy effects of Acalypha indica Linn. extract ex vivo on m.gastrocnemius of frog has been done. The experimental study was done on neuromuscular junction of frog. Because of the similarity with pathophysiology of myasthenia gravis, if the extract has been proved to have therapy effect, this can also be used to treat myasthenia gravis. The study was done on five groups of doses: 5; 10; 15; 20; 25 mg and one group as control (ringer), with four samples each group. On the results discussion, only control group, the extract of 20 mg and 25 mg were compared. Pancuronium bromide 2 mg, is used for muscle relaxant. The study was done as follow: Ringer – Pancuronium bromide – Extract. The parameters used to measure in this study were the electrical activities such as amount and duration (second) of repolarization, depolarization, resting potential, and the height of spike after electrical stimulation at 5 mV. The neuro-therapy effect of extract was determined by the ability of muscle to show the electrical response after incubating with pancuronium bromide and extract within 10 minutes. The extract of Acalypha indica Linn. showed best effects on doses of 20 mg and 25 mg, with improved depolarization (p= 0,197), repolarization (p= 0,475), and flat (p= 0,558), but statistically there were no significant difference.