EVALUASI PENGGUNAAN TERAPI ANTIHIPERTENSI TERHADAP TEKANAN DARAH PRA-DIALISIS PADA PASIEN RAWAT JALAN DENGAN END STAGE RENAL DISEASE (ESRD) YANG MENJALANI HEMODIALISIS RUTIN DI RS PKU MUHAMMADIYAH YOGYAKARTA

Hypertension and chronic kidney disease (CKD) are the two kinds of disease that are related each others. Hypertension is not only a major cause of kidney failure but also becomes a problem of dialysis patients. The prevalence of hypertension is estimated to occur in 80% of the hemodialysis population. Hypertension increases the risk of cardiovascular disease. Cardiovascular disease and complications are known as the major cause of morbidity and mortality among ESRD patients. In hemodialysis population, the target of pre-dialysis blood pressure is <140/90 mmHg and for the post-dialysis is <130/80 mmHg. This research aims to determine the relationship between the compliance levels of patients in antihypertensive medication towards the blood pressure control of predialysis outpatients with ESRD who undergo routine hemodialysis in RS PKU Muhammadiyah Yogyakarta. This research is conducted by using a descriptive observational study design with prospective data collection method. Data analysis was performed to determine the profile of antihypertensive therapy use, antihypertensive medication therapy outcomes profile of the pre-dialysis blood pressure, and the influence of the patients� compliance level in antihypertensive medication towards the blood pressure control of pre-dialysis outpatients with ESRD who undergo routine hemodialysis in RS PKU Muhammadiyah Yogyakarta. The patient compliance level in taking antihypertensive drugs is assessed by questionnaire of Modified Morisky Scale (MMS). Based on the research results, the antihypertensive profile used was CCBs system (32,91%), loop diuretics (23,42%), AIIRA (15,82%), central α agonists (12,66%), ACEI (12,03 %), and β blockers (3,16%). Antihypertensive therapies applied single and combination therapy. Mono-therapy applied ACEI group (1,85%), CCBs (3,70%), and loop diuretics (1,85%). The most used antihypertensive combination are 3 application, they are a combination of the class of CCBs, AIIRA, and loop diuretics (16,67%). The outcomes profile of antihypertensive medication therapy based on the measurement results of predialysis blood pressure is the target of pre-dialysis blood pressure (<140/90 mmHg) can only be achieved by 3 patients, 2 patients are the compliance patients with the right choice and appropriate dose of antihypertensive therapy and 1 patient is a non-adherent patient with incorrect type and inappropriate doses of antihypertensive therapy. Most of hemodialysis patients have isolated systolic hypertension (ISH). The influence of the patients� compliance level in antihypertensive medication towards the blood pressure control of pre-dialysis outpatients, there are 19 patients (35,19%) in the category of non-adherent patients with a mean blood pressure is 168,40/ 91,95 mmHg, and 35 patients (64,81%) in the category of adherence with a mean blood pressure is 165,60/ 87,77 mmHg

EVALUASI PENGGUNAAN TERAPI ANEMIA PADA PASIEN ASKES DENGAN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS RUTIN DI RS PKU MUHAMMADIYAH YOGYAK

Anemia is mostly associated with chronic kidney disease (CKD) patients. Anemia in CKD patients occurs due to the lack of erythropoietin. Low hemoglobin concentration relates to bad clinic outcome toward CKD patients. Epoetin therapy for CKD patients has been clinically confirmed to improve the quality of life and lower the morbidity and mortality rate. This research was intended to investigate the anemia profile therapy, adjuvant per-oral anemia therapy adherence profile and the effect of adjuvant per-oral anemia therapy adherence toward achievement target of anemia therapy using epoetin in CKD Askes patient receiving regular haemodialysis therapy at PKU Muhammadiyah Hospital Yogyakarta. The research was conducted using observational study design with prospective data collection, then the data were analyzed in order to know the success of anemia primary therapy via epoetin and adjuvant per-oral anemia therapy. The success of therapy were measured based on National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI), 2006, while adherence was measured via Modified Morisky Scale (MMS) questionaire. Based on the research, epoetin used in this research was epoetin alpha and beta, each 69.05% and 30.95%. Adjuvant per-oral anemia therapy used in this research was combined folic acid, iron and vitamin B-complex (82.05%

AKTIVITAS HESPERIDIN SEBAGAI AGEN KOKEMOTERAPI BERTARGET P-GLIKOPROTEIN DAN IKK UNTUK MENGATASI RESISTENSI PADA SEL MCF-7 RESISTEN DOKSORUBISIN

Doxorubicin is a chemotherapeutic agent used to treat breast cancer, but it induces resistance in some cancers especially in breast cancer. One of the doxorubicin resistance mechanism was resulted from Pgp overexpression, which is an energy dependent pump effluxing xenobiotics out from cells. This study was aimed to overcome resistance of doxorubicin in MCF-7 resistant doxorubicin cells (MCF-7/Dox) with flavonoid active compound in citrus, hesperidin. The MCF-7 resistant doxorubicin (MCF-7/DOX) cells were maintained in 25 nM dox-contained medium for 5 weeks. The cytotoxic properties, 50% inhibition concentration (IC50) of hesperidin and its combination with doxo in MCF-7/DOX cells were determined using MTT assay. Apoptosis induction was examined by double staining assay using etidium bromide-acridine orange. Immunocytochemistry assay was performed to determine the level and localization of Pgp. For In silico study, docking PLANTS program was used to investigate the interaction of hesperidin on IKK and Pgp protein reseptor. Single treatment of hesperidin showed cytotoxic activity on MCF-7/DOX cells with IC50 value of 11 μM. The combination treatment of hesperidin and doxorubicin showed additive and antagonist effect (CI>1,0). Hesperidin did not increase the apoptotic induction, but decreased the Pgp expressions level when combined with doxorubicin in low concentration. The result of in silico study showed that hesperidin has high affinity to interact with IKK and Pgp reseptor. This research indicated that hesperidin is potential to be applied as a chemopreventive agent in resistant breast cancer therapy

Efektifitas Gastroprotektif Infusa Ramuan Kunyit (Curcuma domestica L.), Buah Kapulaga (Ammomum compactum S.) dan Daun Sembung (Blumea balsamifera DC.) pada Tikus Model Tukak Lambung

Gastric ulcer is gastrointestinal disorder that caused several factor, including by aspirin. Gastric ulcers induce inflammatory reaction that will increase the number of mast cells and eosinophils. Infuse of turmeric (Curcuma domestica), cardamom pods (Amomum compactum) and sembung leaf (Blumea balsamifera) has been used as gastroprotective agents. The purpose of this study was to assess the effectivity of the infuse in protecting gastric mucosa in rat model of aspirin-induced gastric ulcers. Thirty male Wistar rats weighing 150-200 g were divided into 6 groups. Four groups were given infuse that consisted of cardamom pods 36,6 mg/200 g BW and sembung leaf 91,5 mg/200 g BW. The infuse also consisted of turmeric in various ammount i.e. 10 mg/200 g BW in KA, 30 mg/200 g BW in KB & I, 50 mg/200 g BW in KC. One group S received sucralfat 72 mg /200 g BW. Ten minutes after received infuse or sucralfat, the rats were given aspirin 90 mg/200 g BW except group I. Another group A only received aspirin without any protective agent. All treatments were adsministered orally for seven days. Before termination, all rats were fasted for 24 hours. The number and area of the gastric ulcer were counted and measured macroscopically. Score of mucosal damage and the number of eosinophils as well as the number of mast cells were observed in paraffin sections stained with Hematoxylin Eosin and Toluidine Blue, respectively. The groups received herbal infuse showed less number and smaller area of gastric ulcer as well as smaller score of mucosal damage compared to aspirin group (p 0.05). No difference in gastroprotective effects between various doses of the herbal infuse of turmeric can be observed. In conclusion, the herbal infusion has gastroprotective effect

POTENSI KO-KEMOTERAPI Na PGV-0 DENGAN DOXORUBICIN TERHADAP BERBAGAI SEL KANKER DAN PENELUSURAN TARGET MOLEKULERNYA PADA JALUR MAP KINASE: PENDEKATAN IN VITRO DAN IN SILICO

Signal transduction disregulation, i.e. MAP kinase pathway leads to degenerative disease development, including cancer. Today, people are seeking for co-chemotherapeutic agent to increase chemotherapeutic agent�s effectiveness and decrease its side effect. Curcumin is a potential chemopreventive agent targeting kinase proteins on their ATP binding site. Thus, Faculty of Pharmacy UGM developed curcumin analogue, PGV-0. Due to its insolubility, Na PGV-0 was then synthesized. This research was done to study Na PGV-0 potential as cochemotherapeutic agent targeting proteins involved in MAP kinase pathway, especially EGFR and IKK, and its effector protein, Pgp and COX-2. Co-chemotherapeutic activity was determined by cytotoxicity single and in combination with doxorubicin on MCF-7 ori, MCF-7/DOX, HeLa, and WiDr cells using MTT assay. While the molecular mechanisms were explored in silico using PLANTS software. Na PGV-0 as ligand was prepared using Marvin Sketch, while protein targets were prepared using YASARA. Na PGV-0 exhibited cytotoxic property on MCF-7 ori, MCF-7/DOX, HeLa, and WiDr cells with IC50 values of 52.33 + 6.3

UJI AKTIVITAS ANTIDIABETRES MELLITUS (DM) TIPE 2 AANDROGRAFOLID DAN EKSTRAK TERPURIFIKASI HERBA SAMBILOTO (Andrographis paniculata (Burm.f.) nees.) MELALUI PENINGKATAN TRANSLOKASI PROTEIN GLUT-4 PADA OTOT PAHA TIKUS RESISTEN INSULIN

The type 2 diabetes mellitus-insulin resistance disease is a condition characterized by obesity (hyperlipidemia) to cause a signal interference GLUT-4 protein translocation to the membrane of muscle cells and desensitization of muscle and fat tissue to insulin. These conditions stimulate hyperglycemia and hyperinsulinemia. Scientifically Andrographis paniculata (Burm. f.) Nees can treat some diseases such as influenza, cancer, inflammation, HIV and even AIDS. Andrographis paniculata (Burm. f.) Nees containing flavonoids and lactone compound. In the lactone, the main components are andrographolide. This study aims to look at the effect of andrographolide and purified extract of Andrographis paniculata (Burm. f.) Nees as a type 2 antidiabetes mellitus-insulin resistance. The main parameters are measured as a determinant of type 2 antidiabetic activity of insulin resistance such as blood glucose levels, lipid levels (triglycerides, LDL, and cholesterol), and translocation of GLUT-4 protein in muscle cells of the thigh (soleus muscle) rats. The research was conducted using a completely randomized design direction. Test preparations were divided into groups of andrographolide (doses 1.5 and 4.5 mg/ kg BW), purified extract (dose 434.6 and 1303 mg/ kg BW), fat-fructose group (Na CMC 1%), metformin group (metformin 45 mg/ kg BW) and normal group. Test animals are type 2 diabetes mellitus-insulin resistance is made through the imposition of fructose and fat-rich food for 50 days. Insulin resistance test carried out by comparing the parameter values of insulin resistance normal animals and fat-fructose animals. From the results of statistical analysis using the Independent Sample t-Test on all parameters of insulin resistance, showed significant differences (p<0.05) at day-30 and-50 between normal rats and fat-fructose rats. This indicates that the fatfructose diet affects all insulin resistance parameters were significantly, which the rat fat-fructose indicated that type 2 diabetes mellitus-insulin resistance. When the test animals had been insulin resistance, the animals were treated andrographolide and purified extract of Andrographis paniculata (Burm. f.) Nees for 5 days. Statistical tests were conducted using a Paired Sample t-Test for decreased levels of glucose, triglycerides, LDL, and translocation of GLUT-4 protein appeared to have a value of p<0.05 means that there are significant differences between days 50 and 55. This indicates that andrographolide and purified extract can significantly increase the translocation of GLUT-4 protein in rat thigh muscle cells, lowering blood glucose levels, triglycerides, and blood LDL levels, except lower blood cholesterol levels cannot be achieved. Percent of power reduction in blood glucose levels, triglycerides, LDL, and translocation of GLUT-4 protein of each group were statistically tested using the Oneway Analysis of Varian (Oneway ANOVA) with 95% confidence level

PENGARUH MARMIN, SENYAWA AKTIF Aegle marmelos Correa TERHADAP OTOT POLOS TRAKEA MARMUT TERISOLASI

Marmin has a good chance as an anti-allergic agent. Marmin can be used to diminish allergy symptoms, including contraction of the airways. Pharmacodynamics effects of marmin on various receptors of airways have not been studied yet. The purposes of this study were to evaluate the activities of marmin as H1 and Ach-M3- receptor antagonists, and β2-adrenergic receptor agonists. In addition, the study also investigated marmin molecular mechanisms in inhibiting smooth muscle contraction through preventing elevated-levels of isolated guinea-pig tracheal smooth muscle intracellular Ca2+. The study was performed using a guinea-pig tracheal smooth muscle in Krebs buffer solution (isolated organ method). Histamine and metacholine were used as agonists for H1 and Ach-M3 receptors respectively. Isoproterenol, a β2-adrenergic receptor agonist was also used to induce tracheal smooth muscle relaxation in Krebs buffer solution. Membrane depolarization and stimulating activation of voltagedependent Ca2+-channels were induced by KCl. The result showed that marmin (10 and 100 μM) has a reversible competitive antagonist to H1 receptor with pA2 value of 2.302. In contrast, marmin provides a reversible non-competitive antagonist on Ach-M3 receptors. Marmin did not affect isoproterenol-induced β2-adrenergic receptor. Furthermore, marmin inhibited extracellular Ca2+ influx and Ca2+ release from a calcium-store. Additionally, marmin inhibited intracellular Ca2+ elevation and decreased the ability of metacholine-induced tracheal smooth muscle contraction

AKTIVITAS INHIBISI α-AMILASE DAN α-GLUKOSIDASE OLEH EKSTRAK POLISAKARIDA DAN SENYAWA POLIFENOL DARI Eucheuma denticulatum DAN Sargassum hystrix

Alginate and polyphenol extract of Sargassum histrix and carrageenan and polyphenols extract of Eucheuma denticulatum were tested for their ability to inhibit carbohydrate hydrolysis enzymes (α-amylase and α-glucosidase) by in vitro methods. Extraction of alginate from Eucheuma denticulatum was using 0.5% KOH solution. Sodium alginate was extracted from Sargassum histrix by using 4% Na2CO3 solution. Polyphenols were extracted from both marine algae by using 50% (v/v). Identification of carrageenan and alginate was determined by Fourier Transform Infrared (FTIR) spectroscopy. Infrared spectra of polysaccharide standards (κ- carrageenan standard and sodium alginate standard) were obtained as comparison. Total polyphenols contents from the extracts were determined according to the Folin-Ciocalteu method. Carrageenan and polyphenols extracts from Eucheuma denticulatum showed the ability to inhibit the activity of α-amylase with an IC50 12.16 and 11.64 mg / mL and no inhibit the activity of α-glucosidase with an IC50. Alginate and polyphenols extracts from Sargassum hystrix showed the ability to inhibit the activity of α-amylase with an IC50 15.75 and 11.26 mg / mL and polyphenols inhibit the activity of α- glucosidase with an IC50 9.57 mg / mL. Polyphenols extract from Sargassum hystrix were more effective to inhibit α-amylase and α-glucosidase than extract alginate from Sargassum hystrix, and carrageenan and polyphenols extract from Eucheuma denticulatum

UJI AKTIVITAS ANTIHIPERLIPIDEMIA DAN ANTIATEROSKLEROSIS ISOLAT ANDROGRAFOLID DAN EKSTRAK TERPURIFIKASI HERBA SAMBILOTO (Andrographis paniculata (Burm.f) Ness) PADA TIKUS DIABETES MELLITUS TIPE 2 RESISTEN INSULIN

Diabetes mellitus (DM) is a degeneratif disorder that highly happens in Indonesia community due to increasing blood sugar level above normal level. Insulin resistance type 2 DM is one of type 2 DM that marked not only by hyperglicemia but also hyperlipidemia (LDL, triglyceride and cholesterol level increases in bloods). The main objective of this investigation is to antihyperlipidemia and antiatherosclerosis activity of andrographolide (1.5 and 4.5 mg/kg bw twice daily) and purified extract of bitter herb (434.6 and 1303.8 mg/kg bw) in insulin resitance type 2 DM rat and also influence of fructose 1,8 g/kg bw and food high fat (15% lard and 5% yolk) will made plaque in vein rat. First step was to isolation andrographolide and to make purified extract bitter herb. Insulin resistant type 2 rat was prepared by inducing with fructose 1.8 g/kg bw and high fat food for 50 days. Andrographolide and purified extract were given for 5 days after that treatment, and then measure lipid level in bloods (LDL, triglyceride and cholesterol), last take aorta organ for atherosclerosis test. By HPLC analysis the purity of andrographolide (88.29 ± 1.94)% was found. By HPTLC analysis the purity of purified extract (16.13 ± 0.50)% was found. On other hand, administration of fructose and high fat food for 50 days has brought about plaque fat in vein rat. Administration andrographolide and purified extract of bitter herb decreased blood LDL and triglyceride levels (p0.05). Andrographolide and purified extract did not appear to give antiatherosclerosis effect