Identifikasi Senyawa Aktif Pala (Myristica fragrans) sebagai Terapi Komplementer Antihipertensi melalui Penghambatan Reseptor ACE: Sebuah Studi Penambatan Molekuler: Identification of Acrive Compounds from Nutmeg (Myristica fragrans) as Complementary Antihypertensive Therapies Through ACE receptor Inhibition: A Molecular Docking Study

Hypertension is one of the biggest health problems which is the main cause of death worldwide. Angiotensin Converting Enzyme Inhibitor (ACE-I) as an antihypertensive drug that is commonly known has side effects that are often complained of. This study aims to identify potential compounds derived from nutmeg (Myristica fragrans) as antihypertensives using molecular docking studies. Twenty-three nutmeg compounds along with captopril were used in this study through a literature search and online screening. Compounds and comparative drugs were downloaded via PubChem while target receptors were on the RCSB. Swiss ADME, ProTox-II, and admetLab were used to evaluate drug-like compounds and predict toxicity. The compounds and comparative drugs, which is captopril, were conducted by molecular binding to the ACE target receptors using Autodock tools 1.5.6 and Autodock Vina and visualization of molecular interactions with the Discovery Studio v16 application. The results showed that all compounds met the criteria as drugs and had an affinity for ACE. Catechin, beta-caryophyllene, and alpha-bergamotene are not toxic and show strong molecular interactions in ACE compared to captopril and other compounds with binding energies of -8.2, -7.3, -7.2 kcal/mol, respectively. Catechin, beta-caryophyllene, and alpha-bergamotene have the potential to be developed as ACE-I. Further in vitro and in vivo studies are needed to allow for clinical trials. Keywords: Antihypertensive, Myristica fragrans, catechin, beta-caryophyllene, alpha-bergamotene Abstrak Hipertensi merupakan salah satu masalah kesehatan terbesar yang menjadi penyebab utama kematian di seluruh dunia. Angiotensin converting enzyme inhibitor (ACE-I) sebagai obat antihipertensi yang umum diketahui memiliki efek samping yang sering dikeluhkan. Penelitian ini bertujuan untuk mengidentifikasi senyawa potensial yang berasal dari pala (Myristica fragrans) sebagai antihipertensi dengan menggunakan studi penambatan molekular. Dua puluh tiga senyawa pala bersama dengan captopril digunakan dalam penelitian ini melalui pencarian literatur dan penyaringan daring. Senyawa dan obat pembanding diunduh melalui PubChem sementara reseptor target pada pada RCSB. Swiss ADME, ProTox-II, dan admetLab digunakan untuk mengevaluasi senyawa mirip obat dan memprediksi toksisitas senyawa. Senyawa dan captopril dilakukan penambatan molekular pada reseptor target ACE menggunakan Autodock tools 1.5.6 dan Autodock Vina serta visualisasi interaksi molekul dengan aplikasi Discovery Studio v16. Hasil penelitian menunjukkan seluruh senyawa memenuhi kriteria sebagai obat dan memiliki afinitas terhadap ACE. Catechin, beta-caryophyllene, dan alpha-bergamoten tidak toksik dan menunjukkan interaksi molekul yang kuat pada ACE dibanding dengan captopril dan senyawa lain dengan energi ikatan masing-masing -8,2, -7,3, -7,2 kkal/mol. Catechin, beta-caryophyllene, dan alpha-bergamoten berpotensi untuk dikembangkan sebagai ACE-I. Penelitian in vitro dan in vivo lebih lanjut diperlukan agar dapat dilakukan uji klinis. Kata Kunci: Antihipertensi, Myristica fragrans, catechin, beta-caryophyllene, alpha-bergamoten

Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang

Background: Impaired maternal and uteroplacental perfusion can occur in pregnancy with cardiac disease leading to maternal and perinatal mortality and morbidity due to increased cardiac load and ventricular dysfunction. This research aims to determine maternal and perinatal outcomes of pregnancies with cardiac disease. Method: This research was a descriptive observational study conducted by total sampling method and cross-sectional design. This research used medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Mohammad Hoesin Palembang in January 2018-December 2020 as study samples. Result: Among 68 pregnancies with cardiac disease, there were 6 cases (0.87%) found in 2018, 38 cases (2.47%) found in 2019, and 24 cases (1.48%) found in 2020. The highest distribution of pregnancies with cardiac disease was found at 64.7% in the range of 20-35 years old age group; 57.4% in the multiparity group; 38.2% in the range of ≥34 – <37 weeks gestational age group; 86.8% in the high school educational level group; 66.2% in the high-risk cardiac functional status group; 54.4% in the peripartum cardiomyopathy group; and 36.8% with preeclampsia/eclampsia as a comorbid. In this study, maternal outcomes found were maternal mortality at 11.8%; cardiac failure at 70.6%; arrhythmia at 1.5%; and stroke at 1.5%, while perinatal outcomes found were prematurity at 60.3%; low birth weight at 64.4%; IUGR at 37.0%; IUFD at 1.4%; stillbirth at 6.8%; neonatal death at 9.6%; and perinatal asphyxia at 42.5%. Conclusion: The prevalence rate of pregnancies with cardiac disease in RSUP Dr. Mohammad Hoesin Palembang was 0.87% in 2018, 2.47% in 2019, and 1.48% in 2020. The most common maternal outcome in this study was cardiac failure, with most in the peripartum cardiomyopathy group, while the most common perinatal outcome was low birth weight, with most in the hypertensive heart disease group