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"ABSTRAKBackground: a freshwater fish Ophiocephalus striatus or known locally to Indonesian as haruan,can potentially increases IGF-1 and albumin levels in elderly patients with hypoalbuminemia due to the contents of amino acids, fatty acids, vitamins, and minerals. This study was conducted to investigate the effect of Ophiocephalus striatus extract on the level of IGF-1 and albumin in elderly patients with hypoalbuminemia due to the contents of amino acids, fatty acids, vitamins, and minerals. This study was conducted to investigate the effect of Ophiocephalus striatus extract on the level of IGF-1 and albumin in elderly patients with hypoalbuminemia.Methods: the study is a double-blind randomized controlled trial involving malnourished elderly inpatients (≥60 years old) recovering from acute condition before hospital discharge, with Mini Nutritional Assessment score ≤23.5 and albumin level <3.5 g/dL. A total of 109 subjects were randomly divided into two groups: one group received 10 g Ophiocephalus striatus extract per day for 14 days and another group received placebo. Albumin and IGF-1 levels were obtained before and after intervention.Results: ninety subjects completed the study (extract group=45 subjects; placebo group =45 subjects) for 14 days. The median of age were 69 (64;75) years and the male to female ratio were 2 : 3. The changes of IGF-1 and albumin levels from before to after intervention between extract group compared to placebo group were 14.7 (0.30;31.5) ng/mL vs 1.0 (-6;13.15) ng/mL (p=0.002) and 0.5 (0.15;0.70) g/dL vs 0.10 (0.0;0.50) g/dL (p=0.003), respectively. There were significant differences in the improvement of IGF-1 and albumin levels between extract and placebo group.Conclusion: supplementation of Ophiocephalus striatus extract was associated with a significant increase in IGF-1 and albumin levels in elderly patients with hypoalbuminemia."

"ABSTRAK Latar Belakang.Ophiocephalus striatus berpotensi meningkatkan kadar IGF-1 dan albumin karena mengandung asam amino, asam lemak, vitamin, dan mineral. Belum ada penelitian menggunakan ekstrak Ophiocephalus striatus khusus pada pasien usia lanjut dengan malnutrisi.Tujuan. Mengetahui pengaruh pemberian ekstrak Ophiocephalus striatus terhadap kadar IGF-1 dan albumin pasien usia lanjut dengan malnutrisiMetode. Uji klinis acak tersamar ganda dilakukan pada pasien rawat inap yang telah melewati kondisi akut dan dibolehkan pulang, berusia ge; 60 tahun dengan skor Mini Nutritional Assessment le; 23,5 dan kadar albumin < 3,5 g/dL. Dilakukan randomisasi untuk mendapatkan ekstrak Ophiocephalus striatus 10 gram sehari atau plasebo selama 14 hari. Kadar IGF-1 dan albumin diperiksa sebelum dan sesudah perlakuan. Pengaruh pemberian ekstrak OS dianalisis menggunakan uji t tidak berpasangan atau uji Mann-Whitney. Hasil. Randomisasi dilakukan terhadap 109 subjek, sebanyak 90 subjek menyelesaikan penelitian hingga 14 hari masing-masing kelompok45 orang . Median usia 69 64;75 tahun dengan perbandingan laki-laki dan perempuan 2 : 3. Didapatkan perubahan kadar IGF-1 dan albumin sesudah perlakuan pada kelompok ekstrak OS vs plaseboberturut-turut 14,70 0,30;31,50 ng/mL vs 1,00 -6;13,15 ng/mL p = 0,002 dan 0,50 0,15;0,70 g/dL vs 0,10 0,0;0,50 g/dL p = 0,003 . Simpulan. Ekstrak Ophiocephalus striatus dapat meningkatkan kadar IGF-1 dan albumin pasien usia lanjut dengan malnutrisi

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ABSTRACTBackgound.Supplementation with Ophiocephalus striatus is potential to increase IGF 1 and albumin levels in elderly malnourished patients beacause of the contents of amino acids, fatty acids, vitamins, and minerals.Objective.This study was conducted to confirm the effect of Ophiocephalus striatusextract on levels of IGF 1 and albumin in elderly malnourished patients. Method.The study design is a double blind randomized controlledtrial involving hospitalizedmalnourished ge 60 years old patientsin acute ward before discharged, with Mini Nutritional Assessment score le 23.5 and albumin level 3.5 g dL.A total of 109 subjects were randomly divided into two groups including one group received Ophiocephalus striatus extract 10 g per day and another group received plasebo for 14 days. Albumin and IGF 1 levelswere obtained before and after intervention. Results.Ninety subjects completed the study extract group 45 subjects plasebo goup 45 subjects for 14 days. Median of age was 69 64 75 years, with male to female ratio were 2 3. The delta differences of IGF 1 and albumin levels between extract group and placebo group were 14.7 0.30 31.5 ng mL vs 1.00 6 13.15 ng mL p 0.002 and 0.50 0.15 0.70 g dL vs 0.10 0,0 0.50 g dL p 0.003 , respectively. There were significant differences between extract and placebo group. Conclusions. Supplementation with Ophiocephalus striatus extract was associated with a significant increase in IGF 1 and albumin levels."

"Latar belakang. Pasien sakit kritis berada dalam kondisi katabolik yang menyebabkan ketidakseimbangan sintesis dan pemecahan protein sehingga dibutuhkan asupan protein yang adekuat untuk mempertahankan massa otot, meningkatkan kadar prealbumin, dan imbang nitrogen. Ophiocephalus striatus (OS) mempunyai potensi sebagai sumber protein karena mengandung asam amino, asam lemak, mineral, dan vitamin. Penelitian ini bertujuan untuk menilai efek dari pemberian suplementasi ekstrak OS terhadap luas penampang otot rektus femoris, bisep brakii, kadar prealbumin, dan imbang nitrogen pasien sakit kritis dengan ventilator.Metodologi. Penelitian ini merupakan uji klinis dengan desain uji acak terkontrol yang dilakukan terhadap pasien usia 18-65 tahun yang menggunakan ventilator di intensive care unit (ICU) RSUPN Dr. Cipto Mangunkusumo sejak bulan Juli sampai dengan Oktober 2019 ICU. Sebanyak 42 subjek dirandomisasi menjadi dua kelompok. Kelompok ekstrak (n=19) mendapatkan suplementasi ekstrak OS 15 g/hari, yang diberikan sejak hari kedua sampai dengan hari keenam. Kelompok kontrol (n=23) tidak mendapatkan suplementasi tersebut. Pengukuran luas penampang otot, pemeriksaan kadar prealbumin, dan imbang nitrogen dilakukan pada hari pertama dan hari ketujuh.Hasil. Terjadi peningkatan luas penampang otot rektus femoris pada kelompok ekstrak (p=0,038) dan penurunan pada kelompok kontrol (p=0,006) disertai perbedaan bermakna antara dua kelompok (p=0,001). Terjadi peningkatan luas penampang otot bisep brakii pada kelompok ekstrak (p=0,033) dan penurunan pada kelompok kontrol (p=0,001) disertai perbedaan bermakna antara kedua kelompok (p<0,001). Terjadi peningkatan kadar prealbumin pada kelompok ekstrak (p<0,001) maupun kelompok kontrol (p=0,023) disertai perbedaan peningkatan yang bermakna antara kedua kelompok (p<0,001). Terjadi peningkatan kadar imbang nitrogen pada kelompok ekstrak (p<0,001) maupun kelompok kontrol (p=0,001) disertai perbedaan peningkatan yang tidak bermakna antara kedua kelompok (p=0,685).Kesimpulan. Pemberian suplementasi ekstrak Ophiocephalus striatus secara signifikan dapat meningkatkan luas penampang otot rektus femoris, otot bisep brakii, dan kadar prealbumin pada pasien sakit kritis.

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Background. Critically ill patients are in catabolic conditions that have imbalances in protein synthesis and breakdown. Thus, they require adequate protein intake to maintain the muscle mass and to increase the prealbumin levels and nitrogen balance. Ophiocephalus striatus (OS) is a potential source of proteins since it contains high amount of amino acids, fatty acids, minerals, and vitamins. This study was aimed to measure the effect of OS extract supplementation on cross-sectional area (CSA) of rectus femoris and biceps brachii, prealbumin levels, and nitrogen balance in critically ill patients with ventilator.

Methods. This was a randomized controlled clinical trial study involving patients aged 18-65 years old with ventilator in intensive care unit (ICU) Dr. Cipto Mangunkusumo Hospital between July until October 2019. In total, 42 subjects were randomized into two groups. Extract group (n=19) recieved 15 g of OS extract supplementation daily, administered from the second day to the sixth day. Control group (n=23) did not receive the extract. Measurement of CSA of rectus femoris and biceps brachii, prealbumin levels, and nitrogen balance were done in the first and the seventh day.

Results. There was an increase of cross sectional area of rectus femoris in extract group (p=0.038) and a decrease in control group (p=0.006) with significant difference between the two groups (p=0.001). There was an increase of cross sectional area of biceps brachii in extract group (p=0.033) and a decrase in control group (p=0.001) with significant difference between the two groups (p<0.001). There was an increase of prealbumin levels in both groups, extract group (p<0.001) and control group (p=0.023), with a significant difference of increase between the two groups (p<0.001). There was an increase of nitrogen balance in both groups, extract group (p<0.001) and control group (p<0.001), with an insignificant difference of increase between the two groups (p<0.685)

Conclusion. Administration of Ophiocephalus striatus extract supplementation can significantly increase the cross-sectional area of rectus femoris and biceps brachii, and the prealbumin levels in critically ill patients."

"ABSTRACTBackground: the aging process causes decreasing in the function of various organs. Skletal muscle is one of the organs affected by aging process. It is known as sarcopenia. Sarcopenia is defined as a syndrome characterized by progressive loss of muscle mass and strength. The handgrip strength examination is often applied as a sarcopenia filtering technique. This study aimed to determine the relationship between age, nutritional status, and chronic diseases such as stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD), and chronic obstructive pulmonary disease (COPD) with handgrip strength. Methods: a cross-sectional study to determine factors related to the handgrip strength in elderly patients was conducted in Geriatric outpatient clinic of Cipto Mangunkusumo Hospital and Mohammad Hoesin Hospital from August to October 2015. There were 352 eligible subjects in this study recruited with consecutive sampling. The independent variables in the study consisted of age, sex, nutritional status, chronic disease (stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD)), waist circumference while the dependent variable was handgrip strength. Results: age of more than 75 years old and malnutriton were risk factors that affected hangrip strength. Age of >75 years increase the risk for having low handgrip strength by 2,3-fold. Malnutrition increased risk for low handgrip strength for 1,9-fold. Conclusion: ages of >75 years old and malnutrition will increase the risk of low handgrip strength in elderly patients."

"The purpose of this research was to develop anti-cytokine-based treatment using extract of Plectranthus amboinicusapplied to gout arthritis (GA) patients. The research was quasi experimental, with a pretest-posttest randomized controlgroup design. The samples were GA patients in the Outpatient Installation of Internal Medicine in General HospitalHaji, Surabaya. The sample was comprised of 30 respondents. The respondents were divided into a treatment group anda control group. The treatment group was asked to take medicine from the hospital, coupled with P. amboinicus extractcapsules, for 7 days, during which time patients’ joint inflammation was observed. The control group was provided withonly medication from the hospital, and their joint inflammation was likewise observed. Blood samples were takenbefore and after treatment, to measure the levels of blood urea nitrogen (BUN) and creatinine, as well as theconcentrations of TNF-α and IL-1β. There was a decrease in BUN and creatinine levels in the control group, but it wasnot significant, decreasing by 3% and 8%, respectively. The treatment group also showed elevated levels of BUN andcreatinine, which also was not significant at 3% and 7%, respectively. There was a decrease in the concentration ofTNF-α in the control group by 9% and 22%. The concentration of IL-1β in the control group increased by 18%,whereas,in the treatment group, it decreased by 3%; however, the decreases in both groups were not significant.Pengaruh Ekstrak Daun Jintan (Plectranthus amboinicus) terhadap Kadar BUN dan Kreatinin serta ResponSeluler Faktor Proinflamasi TNF-α dan IL-1β Pasien Gout Artritis. Pengobatan gout artritis (GA) saat inidikembangkan berbasis anti sitokin yaitu blokade kemokin, penghambatan pelepasan IL-1β dan TNF-α. Tujuanpenelitian ini adalah mengembangkan pengobatan berbasis anti sitokin dengan menggunakan ekstrak daun jintan yangdiaplikasikan pada penderita GA. Penelitian ini adalah penelitian eksperimental semu dengan desain penelitianrandomized pretest-posttest control group design. Pengambilan sampel pasien GA di Instalasi Rawat Jalan PoliPenyakit Dalam RSU Haji Surabaya yang memenuhi kriteria inklusi dan eksklusi. Jumlah sampel sebanyak 30responden terbagi menjadi kelompok perlakuan dan kelompok kontrol masing-masing 15 responden. Pada kelompokperlakuan diminta untuk minum obat dari Rumah Sakit ditambah dengan kapsul ekstrak daun jintan selama 7 hari,dengan dilakukan pengamatan keradangan sendi. Pada kelompok kontrol minum obat dari Rumah Sakit dan dilakukanpengamatan keradangan sendi. Sampel darah diambil sebelum dan sesudah perlakuan untuk mengukur kadar BUN,kreatinin, konsentrasi TNF-α dan IL-1β. Terdapat penurunan kadar BUN dan kreatinin pada kelompok kontrol namuntidak signifikan yaitu menurun sebesar 3% dan 8%. Sementara pada kelompok perlakuan terdapat peningkatan kadarBUN dan Kreatinin namun juga tidak signifikan sebesar 3% dan 7%. Terdapat penurunan konsentrasi TNF-α padakelompok kontrol sebesar 9% dan kelompok perlakuan sebesar 22%, keduanya tidak signifikan. Sementara konsentrasiIL-1β terjadi peningkatan pada kelompok kontrol sebesar 18%, sementara pada kelompok perlakuan terjadi penurunansebesar 3%, keduanya tidak signifikan."

"ABSTRAKSaat ini terdapat perbaikan Angka Harapan Hidup (AHH) penduduk Indonesia dan penambahan populasi penduduk lanjut usia. Pada tahun 2017, AHH mencapai 71,06 tahun, dan jumlah lansia 23,4 juta orang (8,97% dari seluruh penduduk Indonesia). Hal ini berisiko meningkatkan kejadian penyakit degeneratif. Osteoartritis (OA) adalah penyakit yang sering dikaitkan dengan kondisi degeneratif dan mengakibatkan ketidakaktifan fisik. Pada Riskesdas 2013, penyakit Artritis berada di urutan kedua penyakit terbanyak diderita lansia dengan prevalensi 45% (55-64 tahun), 51,9% (65-74 tahun) dan 54,8% (usia >75 tahun). Pengobatan simtomatik dengan OAINS yang berkepanjangan dapat mengakibatkan efek samping yang fatal. Terdapat berbagai faktor risiko berkembangnya OA lutut, di antaranya konsentrasi serum Vitamin D (25(OH)D. Proporsi perempuan lansia dengan defisiensi 25(OH)D pada penelitian di Jakarta dan Bekasi mencapai 35,1%. Terdapat hubungan antara kadar Vitamin D (25(OH)D) yang rendah dengan nyeri lutut dan perubahan kartilago sendi lutut pada OA. Serum Cartilage Oligomeric Matrix Protein (COMP) merupakan produk degradasi penting dari kartilago sendi dan dapat menjadi marker diagnosis untuk OA lutut. Penelitian ini bertujuan mengetahui pengaruh pemberian suplemen Vitamin D (Alphacalcidol) selama 12 minggu terhadap derajat nyeri berdasarkan indikator WOMAC, dan kondisi obyektif kartilago sendi dengan perubahan marker serum COMP pada penderita OA lutut lansia. Disain penelitian uji klinis teracak, tersamar ganda, dan terkontrol plasebo. Subyek dengan OA lutut simtomatis direkruit secara consecutive sampling dan dilakukan anamnesis, diperiksa kondisi fisik, radiologi lutut, kadar serum Vitamin D (25(OH)D), serum Calcium dan marker COMP. Subyek dialokasikan secara acak (random allocation) pada kelompok perlakuan yang diberikan suplemen Vitamin D (Alphacalcidol) atau kelompok kontrol yang diberikan plasebo. Populasi sumber xviii Universitas Indonesia pada penelitian ini ialah pasien OA lutut lanjut usia yang berobat ke KPKM FKIK UIN Jakarta. Dari hasil pemeriksaan konsentrasi serum Vitamin D 25(OH)D sebelum dilakukan intervensi, 53,4% responden mengalami insufisiensi dan 12,3% responden mengalami defisiensi Vitamin D. Pemberian suplemen Vitamin D (Alphacalcidol) selama 12 minggu, mempengaruhi penurunan derajat nyeri berdasarkan indikator WOMAC pada penderita OA lutut lansia yang bermakna secara statistik dengan perbedaan perubahan skor pra dan pascaintervensi pada kelompok intervensi dibanding kontrol sebesar 2,174 (p=0,00). Pemberian suplemen Vitamin D (Alphacalcidol) selama 12 minggu, mempengaruhi penurunan konsentrasi serum COMP pada penderita OA lutut lansia, dengan perbedaan perubahan skor pra dan pascaintervensi pada kelompok intervensi dibandingkan kelompok kontrol sebesar 38,15 ng/ml namun tidak bermakna secara statistik (p=0,39)

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ABSTRACTAt present there are improvements in the Life Expectancy (AHH) of the Indonesian population and the addition of the elderly population. In 2017, AHH reached 71.06 yo and the number of elderly people reached 23.4 million people (8.97% of the total population of Indonesia). This has the potential to increase degenerative diseases. Osteoarthritis (OA) is a disease that is often associated with degenerative conditions and physical inactivity. Riskesdas in 2013 stated that Arthritis was the second most common disease suffered by the elderly with a prevalence of 45% (55-64 yo), 51.9% (65-74 yo) and 54.8% (>75 yo). Symptomatic treatment with prolonged NSAIDs can cause fatal side effects. There are various risk factors for developing knee OA, including serum Vitamin D (25(OH)D) concentrations. The proportion of elderly women with 25(OH)D deficiency in studies in Jakarta and Bekasi reaches 35.1%. It has been found an association between low Vitamin D levels (25(OH)D) with knee pain in OA and changes in the knee joint cartilage. Cartilage Oligomeric Matrix Protein (COMP) is an important degradation product of joint cartilage and can be act as a diagnostic marker of knee OA. This study aims to determine the effect of Vitamin D supplementation (Alphacalcidol) for 12 weeks on the degree of pain based on WOMAC indicators, and the objective conditions of joint cartilage with changes in COMP serum markers in patients with knee OA in the elderly. The research design is a randomized, double-blind, and placebo-controlled clinical trials. Subjects with symptomatic knee OA will be recruited by consecutive sampling and continued with history taking, physical conditions examinatons, knee radiology, and blood test for serum vitamin D (25(OH)D), serum calcium and marker COMP. Subjects were then randomly allocated to the treatment group given Vitamin D supplements (Alphacalcidol) or the control group given a placebo. The source population in this study was elderly with knee OA patients xx Universitas Indonesia who went to Primary Health Care Clinic (KPKM) of FKIK UIN Jakarta. We found that before intervention was done, 53.4% of respondents had Vitamin D insufficiency and 12.3% of respondents had Vitamin D deficiency. The administration of Vitamin D supplements (Alphacalcidol) for 12 weeks, influenced the decrease in the degree of pain based on the WOMAC indicator in knee OA of elderly patients significantly, with differences in changes in pre and post intervention scores of 2.174 compare with control (p=0.00). The administration of Vitamin D supplements (Alphacalcidol) for 12 weeks, affected the decrease in the serum concentration of COMP in knee OA of elderly patients, with differences in changes in pre and post intervention scores in the intervention group compared to the control group of 38.15 ng/ml but not statistically significant (p=0.39)."

"Pengaruh Ekstrak Daun Jintan (Plectranthus amboinicus) terhadap Kadar BUN dan Kreatinin serta Respon Seluler Faktor Proinflamasi TNF-α dan IL-1β Pasien Gout Artritis. Pengobatan gout artritis (GA) saat ini dikembangkan berbasis anti sitokin yaitu blokade kemokin, penghambatan pelepasan IL-1β dan TNF-α. Tujuan penelitian ini adalah mengembangkan pengobatan berbasis anti sitokin dengan menggunakan ekstrak daun jintan yang diaplikasikan pada penderita GA. Penelitian ini adalah penelitian eksperimental semu dengan desain penelitian randomized pretest-posttest control group design. Pengambilan sampel pasien GA di Instalasi Rawat Jalan Poli Penyakit Dalam RSU Haji Surabaya yang memenuhi kriteria inklusi dan eksklusi. Jumlah sampel sebanyak 30 responden terbagi menjadi kelompok perlakuan dan kelompok kontrol masing-masing 15 responden. Pada kelompok perlakuan diminta untuk minum obat dari Rumah Sakit ditambah dengan kapsul ekstrak daun jintan selama 7 hari, dengan dilakukan pengamatan keradangan sendi. Pada kelompok kontrol minum obat dari Rumah Sakit dan dilakukan pengamatan keradangan sendi. Sampel darah diambil sebelum dan sesudah perlakuan untuk mengukur kadar BUN, kreatinin, konsentrasi TNF-α dan IL-1β. Terdapat penurunan kadar BUN dan kreatinin pada kelompok kontrol namun tidak signifikan yaitu menurun sebesar 3% dan 8%. Sementara pada kelompok perlakuan terdapat peningkatan kadar BUN dan Kreatinin namun juga tidak signifikan sebesar 3% dan 7%. Terdapat penurunan konsentrasi TNF-α pada kelompok kontrol sebesar 9% dan kelompok perlakuan sebesar 22%, keduanya tidak signifikan. Sementara konsentrasi IL-1β terjadi peningkatan pada kelompok kontrol sebesar 18%, sementara pada kelompok perlakuan terjadi penurunan sebesar 3%, keduanya tidak signifikan.

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The purpose of this research was to develop anti-cytokine-based treatment using extract of Plectranthus amboinicus applied to gout arthritis (GA) patients. The research was quasi experimental, with a pretest-posttest randomized control group design. The samples were GA patients in the Outpatient Installation of Internal Medicine in General Hospital Haji, Surabaya. The sample was comprised of 30 respondents. The respondents were divided into a treatment group and a control group. The treatment group was asked to take medicine from the hospital, coupled with P. amboinicus extract capsules, for 7 days, during which time patients? joint inflammation was observed. The control group was provided with only medication from the hospital, and their joint inflammation was likewise observed. Blood samples were taken before and after treatment, to measure the levels of blood urea nitrogen (BUN) and creatinine, as well as the concentrations of TNF-α and IL-1β. There was a decrease in BUN and creatinine levels in the control group, but it was not significant, decreasing by 3% and 8%, respectively. The treatment group also showed elevated levels of BUN and creatinine, which also was not significant at 3% and 7%, respectively. There was a decrease in the concentration of TNF-α in the control group by 9% and 22%. The concentration of IL-1β in the control group increased by 18%, whereas,in the treatment group, it decreased by 3%; however, the decreases in both groups were not significant."