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"ABSTRACTCoronary Heart Disease (CHD) morbidity and mortality rate is increasing dramatically in the last 15 years in Indonesia. Available data show that among the contribution factor changes in life style and demographic transition are prominent.A hypothetical risk factor for CHD is lipid peroxidation, a reaction between oxygen free radical and lipid parts of cell membranes and low density lipoprotein (LDL). Food habit is following a pattern of nutrient and non-nutrient intakes, including fatty acids and antioxidants. Fatty acid intakes determine the susceptibility of the lipid parts of eell membranes and LDL to peroxidation by free radicals. Theoretically, antioxidants will protect against oxidative damage caused by oxygen free radicals. Commercially available and advertised antioxidants such as vitamin E are widely used inspite of limited information on the interrelation between lipid peroxide levels in the Indonesian elderly with CHD risk factors such as food habits, dyslipidemia and obesity.A two-phase study on the elderly (55-85 years.) guided by the health centers was undertaken in Jakarta. Data for both phases were collected through interviews, anthropometric measurements, blood analysis and blood pressure measurements. Univariate, bivariate and multivariate analysis were done using SPSS and WorldFood 2 programs.The first phase was a cross-sectional study to see the association between lipid peroxides and fatty acids, vegetables, fruits, tempe intakes, obesity, smoking, dyslipidemia and hypertension. The samples were 394 elderly. The variables found correlated with lipid peroxides were LDL, intake of mono and poly-unsaturated fatty acids, tempe, and vitamin E. The study showed an increase level of lipid peroxides with age and ethnic differences with the highest level of lipid peroxides among the Minangkabau.The second phase is a randomized double-blind trial giving 600 mg/day vitamin E supplementation or placebo for 12 weeks to 152 elderly with the high level of lipid peroxides found in the cross-sectional study. The objective was to see if there was a change of lipid peroxide levels after the intervention. The results showed a significant decrease of lipid peroxides level in the vitamin E group compared to placebo after being adjusted with age, waist-hip ratio (WHR), plasma cholesterol, and saturated fatty acids (SAFA) intake. The high density lipoprotein (HDL) was also increased significantly in the vitamin E group compared to placebo group.Randomized controlled trial taking into account the confounding variables such as age, sex, ethnic, waist-hip ratio, saturated fat intake, carbohydrate intake and plasma cholesterol might be able to elucidate the specific beneficial effect of vitamin E supplementation. Health education and information concerning foods that have effect on lipid peroxidation, such as tempe should be endorsed. More studies should be undertaken to find other food or beverage that have protecting effects against lipid peroxides."

"Latar belakang: Morbiditas akibat duktus arteriosus paten (DAP) pada neonatus cukup bulan (NCB) cukup tinggi. Peran prostaglandin E2 (PGE2), trombosit (immature platelet fraction, IPF), dan vascular endothelial growth factor (VEGF) pada penutupan DA secara fungsional dan anatomis pada NCB belum banyak diteliti. Patofisiologi terjadinya DAP dapat memengaruhi tata laksana farmakologi dini yang belum terstandardisasi pada NCB. Penggunaan obat antiinflamasi nonsteroid seperti ibuprofen dimungkinkan dapat menghambat jalur sintesis prostaglandin dengan efek samping minimal.Tujuan: Mengkaji peran prostaglandin E2, VEGF, IPF, dan efek pemberian ibuprofen oral dalam proses penutupan DA pada NCB.Metode: Penelitian dilakukan di rumah sakit (RS) Sanglah Denpasar, RS Prima Medika Denpasar, dan RS Umum Daerah Wangaya Denpasar, dalam periode Maret sampai Agustus 2015. Penelitian terdiri dari 2 desain, pertama desain potong lintang pada pasien dengan DAP dan tanpa DAP secara consecutive sampling dan desain kedua uji klinis acak terkontrol ganda pada pasien DAP usia ≥ 48 jam. Pasien dengan DAP kemudian dimasukkan dalam uji klinis, dilakukan randomisasi untuk diberikan perlakuan ibuprofen oral dosis hari pertama 10 mg/kg, hari kedua dan ketiga 5 mg/kg atau plasebo. Pemantauan hemodinamik dan efek samping obat dilakukan selama pemberian perlakuan. Pemeriksaan ekokardiografi, PGE2, VEGF, IPF, dan kreatinin dilakukan pada hari pertama dan keempat pascapemberian perlakuan.Hasil: Terdapat 64 subjek yang diteliti pada desain pertama dan 32 subjek pada desain kedua. Rerata kadar PGE2 lebih tinggi pada kelompok dengan DAP dibanding tanpa DAP, sedangkan rerata kadar VEGF dan IPF tidak berbeda. Ibuprofen oral tidak terbukti menurunkan diameter DA pascaperlakuan, tidak terdapat perbedaan rerata diameter pada kedua kelompok. Terdapat hubungan positif sedang terhadap perubahan kadar PGE2 dengan perubahan diameter DAP pascaperlakuan. Tidak terdapat perubahan hemodinamik atau efek samping akibat pemberian ibuprofen oral atau plasebo pada NCB dengan DAP.Simpulan: Tingginya kadar PGE2 terbukti berperan dalam patensi DA pada NCB. Ibuprofen oral dosis 10 - 5 - 5 mg/kgBB tidak mengecilkan diameter DAP.

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Background: Serious morbidity impact due to patent ductus arteriosus (PDA) in full-term neonates remains high. The functional role of prostaglandin E2 (PGE2), platelet (immature platelet fraction, IPF), and vascular endothelial growth factor (VEGF) has not been studied in the closure mechanism of ductus arteriosus (DA). Understanding of pathophysiology of PDA may influence early pharmacological treatments, which have not been standardized in full-term neonates. The use of non-steroidal anti-inflammatory drugs such as ibuprofen can be beneficial as a pharmacological agent in enhancing the closure of PDA with minimal adverse effects.

Objectives: To evaluate the role of prostaglandin E2, VEGF, IPF, and the effect of oral ibuprofen in the process of DA closure in full-term neonates.

Methods: This study was conducted in Sanglah General Hospital, Prima Medika Hospital, and Wangaya Hospital Denpasar. The study consisted of two designs, the first was cross-sectional design in subjects with and without PDA using consecutive sampling and the second was double blind randomized controlled trial in full-term infant aged ≥ 48 hours. Subjects with PDA were randomized to oral ibuprofen and placebo administration, in which ibuprofen was given consecutively 10 - 5 - 5 mg/kg. All subjects underwent echocardiography, PGE2, VEGF, and IPF assays. Hemodynamics monitoring was evaluated during trial and adverse effect due to ibuprofen was recorded by measuring urine volume and plasma creatinine level.

Results: From March to August 2015, there were 64 subjects recruited for the first design and 32 subjects in the second design. The mean level of PGE2 was higher significantly in the group with PDA than non PDA group, while the mean levels of VEGF and IPF showed no difference. In the second design, oral ibuprofen showed no effect in reducing DA diameter after treatment. There were no differences in mean diameter of DA in both groups before and after treatments. There was moderate positive relationship between levels of PGE2 and the change of PDA diameter. There were neither hemodynamic changes nor adverse effect due to the administration of oral ibuprofen or placebo.

Conclusions: A high level of PGE2 appears to play a pivotal role in DA patency of full-term neonates. Administration of oral ibuprofen in 10 - 5 - 5 mg/kg schedule could not induce PDA closure in full-term neonates."

"Penelitian ini bertujuan untuk menganalisis manfaat vitamin E untuk menurunkan kadar F2a-isoprostan, mempertahankan fluiditas dan aktivitas enzim Na*-K? ATPase membran sel sinsitiotrofoblas jaringan plasenta penderita pre-eklampsia. Sampel plasenta diambil dari RSB Budikemuliaan, Tanah Abang Jakarta Pusat. Penelitian dilakukan pada bulan September 2003 - Maret 2005. Isolasi sel dan membran sel sinsitiotrofoblas dilakukan berdasarkan metode yang dikembangkan oleh Smith et ai. (1977), Rand (1997), dan Lodish (2000).F2a-isoprostan diisolasi dengan kromatografi dan diukur dengan kit F2a-isoprostan menggunakan ELISA Reader pada JL = 450 nm. Fluiditas dihitung dengan rasio molar kadar kolesterol:fosfolipid. Kolesterol diukur menggunakan Modular C800 dan fosfolipid diukur dengan spektrofluorometer Shimadzu RF5301PC dengan filter eksitasi 267 nm dan emisi 307 nm. Probe fosfolipid adalah 1,6-difenil-1,3,5-heksatrin (DPH) dan pelarut tetrahidrofuran. Aktivitas enzim Na*-K? ATPase diukur dengan spektrofotorneter pada it = 660 nm. Kadar protein diukur dengan spektrofotometer pada IL = 280 nm. Data dianalisis dengan Anava 1 Arah dan dilanjutkan dengan uji LSD (Least Significant Difference).Dari penelitian ini diperoleh hasil: (1) kadar F2a-isoprostan membran sel sinsitiotrofoblas plasenta fetalis pada penderita pre-eklampsia yang mendapat vitamin E lebih rendah secara sangat bermakna dibanding pada penderita pre-eklampsia yang tidak mendapat vitamin E (p < 0,01), (2) membran sel sinsitiotrofoblas plasenta fetalis pada penderita pre-eklampsia yang mendapat vitamin E lebih 'fluid' dibanding penderita pre-eklampsia yang tidak mendapat vitamin E secara bermakna (p < 0,05), (3) pemberian vitamin E tidak mempengaruhi aktivitas enzim Na'-K* ATPase membran sel sinsitiotrofoblas plasenta fetalis pada penderita pre-eklampsia (p > 0,05).Dari hasil penelitian ini disimpulkan bahwa vitamin E mampu:(1) menurunkan kadar F2a-isoprostan dan(2) mempertahankan fluiditas membran sel sinsitiotrofoblas plasenta fetalis pada penderita pre-eklampsia,(3) tidak berpengaruh terhadap aktivitas enzim Na*-K* ATPase membran sel sinsitiotrofoblas plasenta fetalis pada penderita pre-eklampsia."

"Akumulasi rantai globin-α berlebihan pada membran SDM thalassemia-β mayor menyebabkan hemolisis, eritropoiesis tidak efektif dan anemia kronik sehingga memerlukan transfusi sel darah merah (SDM) terus menerus. Transfusi rutin dan hemolisis mengakibatkan besi bebas sebagai radikal bebas dan membentuk radikal peroksil lipid di membran SDM sehingga memperberat hemolisis. Antioksidan α-tokoferol menghambat pembentukan radikal peroksil lipid tersebut.Penelitian ini bertujuan untuk menilai peran α-tokoferol terhadap hemolisis dan stres oksidatif. Penelitian ini merupakan uji klinis acak tersamar ganda pada thalassemia-β mayor usia 5–18 tahun yang mendapat transfusi dan kelasi besi rutin di Pusat Thalassemia RSUP dr.Ciptomangunkusumo Kiara. Intervensi plasebo dan α-tokoferol diberikan selama empat minggu. Suplementasi α-tokoferol berdasarkan rekomendasi Institute of Medicine (IOM), 4–8 tahun 200 mg/hari; 9–13 tahun 400 mg/hari; 14–18 tahun 600 mg/hari. Penilaian penanda hemolisis menggunakan haptogobin (Hp), hemopeksin (Hx) dan fragilitas osmotik SDM. Penanda stres oksidatif yaitu MDA, GSH, GSSG, rasio GSH/GSSG dan α-tokoferol. Pemeriksaan laboratorium dilakukan sebelum dan setelah diberikan plasebo/α-tokoferol, sesaat sebelum transfusi SDM. Analisis uji t-tidak berpasangan untuk melihat perbedaan antara kelompok studi dan uji korelasi untuk melihat hubungan antara variabel.Pada bulan Desember 2016 hingga Juli 2017, 40 subjek mampu menyelesaikan penelitian, 20 subjek kelompok plasebo dan 20 subjek kelompok α-tokoferol. Nilai rerata Hp lebih besar pada kelompok α-tokoferol (3,01 mg/dL) dibandingkan kelompok plasebo (1,08 mg/dL), secara statistik berbeda bermakna (p = 0,021). Nilai rerata kadar Hx dan persentase hemolisis SDM tidak berbeda bermakna pada kedua kelompok studi (p > 0,05). Tidak ada perbedaan bermakna pada kelompok α-tokoferol dan plasebo untuk kadar MDA (1,003 nmol/L dan 1,07 nmol/L), GSH (5,81 µM dan 6,15 µM), GSSG (1,77 µM dan 1,86 µM) dan rasio GSH/GSSG (1,29 dan 1,31), (P > 0,05).Antioksidan α-tokoferol dapat mengurangi hemolisis dan secara tidak langsung memperbaiki kadar Hp pada thalassemia-β mayor, akan tetapi tidak mampu memengaruhi stres oksidatif.

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The accumulation of excess unmatchedα-globin chains in the red blood cell membrane of β-thalassemia major leads to hemolysis, ineffective erythropoiesis and chronic anemia which needs multiple red blood cell transfusion. Routine transfusions may lead to iron overload as free radical in the red blood cell membrane, resulting clinically as severe hemolysis. Alpha-tocopherol as an antioxidant has been known as a potent scavenger of hydroxyl lipid radical.The aim of this study was to evaluate the effects of α-tocopherol in hemolysis and oxidative stress on the red cell membrane in β-thalassemia major. This randomized double-blind, placebo-controlled study was done in β-thalassemia major patients range aged 5–18 years old who regularly had transfusion and receiving iron chelating agents at Thalassemia centre, Kiara Ciptomangunkusumo Hospital. All subjects were randomized to receive either α-tocopherol or placebo orally for 4 weeks. Subjects in the experimental group received α-tocopherol, the doses based on the recommendation from Institute of Medicine (IOM) as follows: 200 mg/day for 4–8 years old; 400 mg/day for 9–13 years old; 600 mg/day for 14–18 years old. Laboratory analysis for hemolysis variables were haptoglobin, hemopexin, osmotic fragility test. Oxidative stress and antioxidant variables were MDA, GSH, GSSG, GSH/GSSG ratio, and α-tocopherol. All variable were evaluated before 4 weeks and after consuming α-tocopherol or placebo, just before they received a blood transfusion. The statistical analysis results using independent t-test and correlation test.During December 2016–July 2017, 40 subjects completed the study, they were 20 subjects in the placebo group and 20 subjects in the α-tocopherol group. There was significant enhancement of haptoglobin mean level in the α-tocopherol group (3.01 mg/dL) compared to placebo (1.08 mg/dL), (p = 0.021). The mean level of hemopexin and the percentage of RBC hemolysis did not significantly different in both groups, (p > 0.05). We also did not find any significantly different in mean level of MDA (1.003 nmol/L and 1.07 nmol/L), GSH (5.81 µM and 6.15 µM), GSSG (1.77 µM and 1.86 µM) and GSH/GSSG ratio (1.29 and 1.31), (p > 0.05) for the α-tocopherol and placebo groups.The effects of α-tocopherol may improve hemolysis and haptoglobin level indirectly in β-thalassemia major, but there was no significant role in oxidative stress."

"Intervensi koroner perkutan (IKP) terbukti mengurangi morbiditas dan mortalitas penyakit jantung koroner (PJK). Cedera pembuluh darah akibat IKP dapat menyebabkan timbulnya inflamasi dan stress oksidatif. Studi ini menunjukkan bahwa kurkumin memiliki efek menekan inflamasi dan antioksidan pada penderita PJK stabil pasca-IKP. Penelitian ini bertujuan untuk mengetahui efektivitas suplementasi kurkumin per oral dalam menurunkan kadar inflamasi dan stres oksidatif pasca-IKP pasien PJK stabil.Pasien dewasa PJK stabil dilakukan IKP, dirandomisasi secara acak tersamar ganda ke dalam kelompok kurkumin atau plasebo. Kurkumin (45 mg/hari) atau plasebo diberikan selama 7 hari sebelum IKP hingga 2 hari setelah IKP. Kadar marker inflamasi (hsCRP dan sCD40L) dan marker oksidatif (MDA dan GSH) dalam serum dinilai dalam 3 fase, 7 hari pra-IKP, 24 jam pasca-IKP, dan 48 jam pasca-IKP.Selama periode April–Juni 2015, terdapat 50 pasien yang direkrut (25 kurkumin dan 25 plasebo) di RSUP Cipto Mangunkusumo dan RS Jantung Jakarta. Konsentrasi hsCRP dan sCD40L pada kelompok kurkumin dalam 3 fase cendrung menurun (p < 0,05) dibanding kelompok plasebo, tetapi konsentrasi hsCRP dan sCD40L pada tiap fase tidak berbedaan bermakna, sedang kadar MDA dan GSH tidak berbeda bermakna setiap fase, namun menunjukkan kecenderungan penurunan kadar MDA (p = 0,6) dan GSH (p = 0,3).Pemberian kurkumin mempunyai kecenderungan menurunkan respons inflamasi pasca-IKP dan cenderung menghambat pembentukan stress oksidatif yaitu MDA serum melalui mekanisme peningkatan penggunaan antioksidan internal yaitu GSH serum.

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Background: Percutaneous coronary intervention (PCI) has been proven to improve morbidities and mortalities in stable coronary heart disease (CHD). However, ischemia-reperfusion injury resulted from PCI might induce inflammation and oxidative stress. Several studies suggested that curcumin exerts anti-inflammatory and antioxidant properties that may be beneficial in post-PCI stable CHD patients.

Objectives: To determine the efficacy of orally administered curcumin in reducing inflammatory response and oxidative stress in post-PCI of stable CHD patients.

Methods: A double-blind randomized controlled trial consisting of 50 adult patients of both sexes with stable CHD who underwent PCI were treated with curcumin or placebo. Either curcumin (45 mg/day) or placebo was given 7 days prior to PCI until 2 days after PCI. Inflammatory markers (hsCRP and sCD40L) and oxidative stress assessment (MDA and GSH) were measured in 3 phases (7 days pre-PCI, 24 hours post-PCI, and 48 hours post-PCI).

Results: During April–June 2015, 50 patients were recruited (25 curcumin and 25 placebo) from Cipto Mangunkusumo General Hospital and Jakarta Heart Center. The serum concentrations of hsCRP and sCD40L in curcumin group (p < 0.05) in all observation phases were significantly lower compared with placebo group; however, there were no significant differences between groups. No significant difference was observed among phases in MDA and GSH, but there was a trend of decreasing MDA and GSH levels (p = 0.6 and p = 0.3, respectively) in curcumin group.

Conclusion: Curcumin tends to reduce inflammatory response following PCI by decreasing oxidative stress (MDA) through the increase of internal antioxidant utilization (GSH)."

"Penelitian ini bertujuan untuk mengetahui kandungan zat dalam kuda laut (Hippocampus comes L.) dan pengaruhnya terhadap kualitas sperma, kadar hormon testosteron, apoptosis sel germinal, profil hematologi dan kimia darah, serta berat badan tikus yang diinduksi Depo Medroksiprogesteron Asetat (DMPA). Kuda laut (Hippocampus comes L.) yang berasal dari hasil budidaya dan dari alam dilakukan karakterisasi menggunakan pelarut etanol dan air untuk mengetahui nilai rendemen, kadar proksimat, golongan senyawa, asam amino dan golongan steroid. Hasil ekstrak yang paling optimal kemudian dilanjutkan uji ke hewan coba. Tikus jantan (Rattus norvegicus L.) galur Sprague-Dawley (SD) diinduksi 1,25 mg/kgBB DMPA pada minggu ke-0 dan ke-12, dan dibagi secara acak menjadi 5 kelompok perlakuan yang dicekok dengan akuades (K1), CMC 1% (K2), ekstrak kuda laut dosis 150 mg/kgBB (K3), dosis 225 mg/kgBB (K4) dan dosis 300 mg/kgBB (K5). Semua tikus dicekok setiap hari mulai minggu ke-7 hingga ke-18. Pada minggu ke-18 semua tikus diterminasi dan dilakukan pengukuran terhadap parameter penelitian. Kuda laut (Hippocampus comes L.) dari alam dengan pelarut air memberikan rendemen ekstrak optimal dan dapat meningkatkan kualitas sperma dan kadar hormon testosteron, serta mampu menurunkan apoptosis sel germinal dan tidak memengaruhi profil hematologi, kimia darah dan berat badan tikus.

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This study aims to determine the content of substances in seahorse (Hippocampus comes L.) and its effect on sperm quality, testosterone hormone levels, germ cell apoptosis, hematological and blood chemistry profiles, and body weight of rats induced by Depo Medroxyprogesterone Acetate (DMPA). Seahorse (Hippocampus comes L.) originating from cultivation and from nature was characterized using ethanol and water solvents to determine the yield value, proximate content, compound groups, amino acids and steroid groups. The most optimal extract results were then continued by testing on experimental animals. Male rats (Rattus norvegicus L.) Sprague-Dawley strain (SD) were induced by 1.25 mg/kg DMPA at week 0 and 12, and were randomly divided into 5 treatment groups which were gavage with distilled water (K1), CMC 1% (K2), seahorse extract dose of 150 mg/kgbw (K3), dose of 225 mg/kgbw (K4) and dose of 300 mg/kgbw (K5). All rats were force-fed every day from week 7 to 18. At the end the weeks 18, all rats were terminated and the parameters of the study were measured. Seahorse (Hippocampus comes L.) from nature with water solvent provides optimal extract yield and ameliorate sperm quality and testosterone hormone levels, and reducing germ cell apoptosis and no affect the hematology profile, blood chemistry and body weight of rats."