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Gangguan pada pusat pengaturan nafsu makan dapat menyebabkan obesitas. Glucagon like Peptide -1 (GLP-1) dan Neuropeptide Y (NPY) merupakan dua peptida penting yang terlibat dalam pengendalian nafsu makan. Beberapa penelitian menunjukkan Hibiscus sabdariffa Linn. memiliki potensi dalam pengendalian obesitas dengan memodulasi kadar GLP-1 dan NPY di perifer. Penelitian ini bertujuan untuk mengetahui bagaimana potensi Hibiscus sabdariffa Linn.(HSL) dalam memodulasi kadar GLP-1 dan NPY di sentral khususnya di Nucleus Arcuatus. Penelitian ini merupakan penelitian lanjutan yang menggunakan jaringan otak tikus tersimpan yang berasal dari 24 ekor tikus Spraque Dawley jantan umur 6 -10 minggu, berat badan antara 90 -160 gram, yang dibagi dalam 4 kelompok yaitu: Normal(C); Obes(Ob); Obes-Hib200(Ob-Hib200); Obes-Hib400(Ob-Hib400). Ekstrak HSL diberikan secara oral satu kali per hari selama 5 minggu. Sampel diperoleh dari hasil isolasi ARC, kemudian dilakukan pengukuran kadar GLP-1 dan NPY menggunakan metode ELISA. Hasil penelitian menunjukkan ekstrak HSL dosis 400mg/KgBB/hari dapat meningkatkan kadar GLP-1 paling tinggi, dibandingkan dengan kelompok tikus lainnya, sekaligus dapat menurunkan kadar NPY dibandingkan dengan kelompok tikus Obes(Ob) dan Obes-Hib(200), meskipun secara analisis tidak terdapat perbedaan bermakna. Dosis ekstrak HSL berperan penting dalam efektifitasnya memodulasi kadar GLP-1 dan NPY di ARC untuk membantu mengendalikan nafsu makan sehingga dapat mengurangi resiko terjadinya obesitas.

BACKGROUND: Complex aerobic exercise is believed to induce positive effects on neuron structure and cognitive function. Long-term and continual cognitive stimulation increases neuroplasticity by stimulating the synthesis of neuronal growth proteins and the formation of new synapses. Exercise also increases the ability of neurons to survive and improves brain vascularization. Further investigations should be conducted to explore what types of aerobic exercise are beneficial for cognitive function. AIM: This study investigated the effects of hurdle aerobic exercise on developmentally regulated brain protein-A (Drebrin-A) as a neuroplasticity indicator, and on vascular endothelial growth factor (VEGF) as an angiogenesis marker in the hippocampus. METHODS: This study was an experimental study with post-test only control group design. Thirty-three adult mice were divided into control, hurdle aerobic runner (HAR), and plain aerobic runner (PAR) groups (n = 11 for each group). Fiberglass running wheels were originally designed and modified to assemble hurdles inside with adjustable speed. Speed adaptation was intended to achieve aerobic intensity. The experiment was performed 5 times a week for 8 weeks. The Morris water maze test (MWMT) was used to assess spatial memory ability. One day after the last running exercise and final MWMT, the mice were sacrificed and the right side of the hippocampus was obtained for Drebrin-A analysis by enzyme-linked immunosorbent assay (ELISA). The entire right side brain tissue after hippocampus was removed then used for the neuroglobin ELISA assay. To analyze VEGF expression and calculation of blood vessel, the left side of the brain was prepared for hematoxylin eosin and immunohistochemistry staining. To assess the effect of exercise on vascular widening, the analysis of the slides was performed by calculating the percentage of blood vessels with diameters more than 15 μm. One-way ANOVA and Fisher’s least significant difference test was used for statistical analysis. RESULTS: There was a significant difference in the levels of Drebrin-A between the HAR and PAR groups. Both exercise groups had higher levels of Drebrin-A than the control group. HAR and PAR groups exhibited significantly higher percentages of blood vessels expressing VEGF in hippocampus compared to control. HAR and PAR groups had the higher percentages of larger vessels compare to control. There was no significant difference of neuroglobin levels among the three groups. Both the HAR and PAR groups exhibited better spatial memory than the control group. CONCLUSION: Both aerobic exercises induced positive effects on brain angiogenesis, while the intensity of aerobic exercises did not result in high hypoxic stress in the brain.

To improve cardiovascular health, the WHO recommends 60 minutes of frequent moderate intensity physical activity in childhood. ACSM also recommends physical activity 30 minutes moderate activity or 30 minutes vigorous intensity, 3-4 times per week. However, limited data concerned in exercise starting from childhood effect to oxidative stress marker in vascular. Therefore the long-term effects of moderate intensity aerobic exercise training in early age on the cardiovascular, specifically on vascular stress oxidative marker needed to be studied. This study was conducted on male Wistar rats aged 3 weeks (60-70 grams), randomly allocated into 2 groups: 1) control group and 2) training group. Aerobic exercise training was conducted for 8 weeks on treadmill with age-dependent speeds. Training was intermittently 5 days each week for 20 minutes. Vascular oxidative stress marker was analyzed by measuring the level of malondialdehyde (MDA) and superoxide dismutase (SOD) activity on the abdominal aorta. Both the levels of MDA and SOD activity tended to increase in training group compared to the control group. The resuls of this study showed that long-term effects of moderate intensity aerobic exercise training in juvenile tended to increase the levels of MDA and specific SOD activity in the abdominal aorta tissues.

Objective: A pilot on duty at altitude can be exposed to hypoxia, both mild and severe. The incidence of hypoxia on a flight can be fatal, especially if hypoxia is experienced by a pilot on duty. One manifestation of hypoxia is decreased cognitive function. A pilot is required to carry out multitasking operations using cognitive functions, especially in an emergency. Therefore, decreased cognitive function due to hypoxia in a pilot can cause accidents in flight. This study aims to determine changes in cognitive function with hypoxia exposure at several altitude zones. Methods: This study used an experimental one-group pretest-posttest design. The subjects were 31 military pilots who participated in Indoctrination and Aerophysiology Training. Subjects filled 6 Cognitive Impairment Test (6 CIT) questionnaires at ground level, efficient physiological zone (10,000 ft), and physiological deficient zone (25,000 ft) in a hypobaric chamber. Results: There was a change of 6 CIT score at 10.000 ft compared to ground level (Friedman post-hoc Wilcoxon, P = 0.001). There was also a change of 6 CIT score at 25,000 ft compared to ground level (Friedman post-hoc Wilcoxon, P

BACKGROUND Exocrine pancreatic insufficiency (EPI) is one of the most challenging cases to be diagnosed accurately in Indonesia because of the unavailability of the fecal elastase-1 (FE-1) test, which is the primary indirect diagnostic tool till date. Stool analysis and steatocrit test are feasible alternatives as they can detect nutrient malabsorption, a consistent feature in EPI. Despite the common practice of using both tests, no study has ever been conducted in Indonesia to evaluate their accuracy. METHODS This cross-sectional diagnostic study was conducted in 182 children aged 6–60 months. Study subjects were divided into children with persistent diarrhea (PD), those with malnutrition, and healthy children. Children with PD and malnutrition were selected on the basis of clinical criteria and the WHO z-score. FE-1 test was used as the gold standard to detect EPI. Primary endpoints of this study were sensitivity and specificity of the stool analysis and the steatocrit test. The accuracy of both tests, represented by area under the curve (AUC) values, was also evaluated individually and in combination. RESULTS Each component of stool analysis and steatocrit test in each subgroup of patients generally had higher specificity than sensitivity. The specificity of both tests among healthy and malnourished children was good (≥70%), but among children with PD, the specificity of some components was

This study developed a formula for calculating the predicted VO2 max value using a prototype model of foot-based cardiorespiratory exercise. Forty sedentary workers (20 men and 20 women) were enrolled via consecutive sampling. They underwent direct measurement of VO2 max using spiroergometry as the gold standard; the predicted VO2 max value was calculated using a prototype model of foot-based cardiorespiratory exercise, which was performed on consecutive days. Multivariate linear regression analysis was used to formulate the equation for the predicted VO2 max value by including potential contributing variables: gender, body height, body weight and heart rate. Bland–Altman test was used for assessing the agreement level for the predicted VO2 max value. The equation for the predicted VO2 max value was formulated as 3.2 + 0.15 optimal exercise heart rate −5.5 sexes (0 for men, 1 for women). The agreement level for the formula was acceptable in all measurement result ranges. The formula developed in this study can be used to measure the predicted VO2 max value with an acceptable agreement level.

Background Hypertension and myocardial infarction account for the high rate of mortality globally. Hibiscus sabdariffa (HS) Linn. is rich in antioxidants and previous studies have demonstrated its anti-hypertensive effects. Several studies show that regular physical activity is an important component to reduce cardiovascular mortality. The objective of this study was to evaluate the effects of a combination of aerobic exercise and HS extract on nitric oxide (NO) and endothelin-1 (ET-1) in rats. MethodsAn experimental study was conducted on 36 male Wistar rats, aged 4 weeks and 60-70 g in weight. The interventions were aerobic exercises and HS at 400 mg/kg BW/day administered for 4, 8 and 12 weeks. The rats were randomized into 12 groups: 3 control groups (C4, C8, C12), 3 aerobic exercise groups (A4, A8, A12), 3 HS groups (H4, H8, H12), and 3 combination groups [aerobic exercise and HS] (HA4, HA8, HA12). After 4, 8, and 12 weeks, the rats were sacrificed and their abdominal aorta was collected for determination of nitric oxide and ET-1 concentrations. One way ANOVA was used to analyze the data. ResultsThere was a significant difference in NO levels between all groups, with the 4-week aerobic exercise group (A4) showing the highest NO levels compared to the other eleven groups (p

Background: To investigate the effect of fluid resuscitation on glycocalyx shedding, and extravascular lung water index (ELWI), mean arterial pressure (MAP) and oxygen delivery (DO2) changes.Methods: Male domestic piglets (Sus scrofa) 6-10 weeks old anesthetized and bled until mean arterial pressure drop to 20% of baseline and resuscitated with normal saline as much as blood drowned, followed with 40 mL/kg of normal saline after 30 minutes. Cardiac index (CI), ELWI, systemic vascular resistance index (SVRI), MAP, atrial natriuretic peptide (ANP) and syndecan-1 were measured before and after each fluid resuscitations. Results: Serum ANP was increased after normal volume fluid resuscitation (p= 0.043) and return its baseline value after hypervolemia fluid resuscitation. Serum Syndecan-1 levels did not increase. A small increase in ELWI only found 60 minutes after fluid resuscitation (p= 0.021). SVRI undergo a gradual decrease, until the lowest value at hypervolemia volume resuscitation. There was no difference between the MAP of the two groups (p= 0.105). Hemoglobin concentration significantly decreased from normal to hypervolemia volume resuscitation (p= 0.009). Oxygen delivery in hypervolemia resuscitation is higher than in normal volume resuscitation (p= 0.012), due to a significant increase in CI at hypervolemia volume resuscitation (pConclusions: Hypervolemia fluid resuscitation in the animal hemorrhage model is not induced glycocalyx shedding. Small increase ELWI was found in 60 minutes after fluid resuscitation. DO2 is maintained by increasing CI in spite of decreasing hemoglobin level due to hemodilution. Increasing CI is balanced by reducing SVRI to sustain stable MAP.

Background: As part of type 2 diabetes mellitus (T2DM) lifestyle management, exercise programs must be demonstrably effective and safe. Objectives: A randomized controlled trial (RCT) was used to evaluate the results of glycemic control and oxidative stress of a new T2DM management exercise program in a training facility setting. Methods: The study participants were randomly allocated into either an experimental (EXP) group who participated in the new training program or a control (CTR) group who participated in continuous cardiorespiratory exercise. Each participant’s glycemic control (glycated hemoglobin A, HbA1c), fitness level (maximum oxygen uptake, VO2max), and oxidative stress (malondialdehyde, MDA and superoxide dismutase, SOD) were measured before and after the training program. The 12-week training program combined high-intensity interval training (HIIT) three times a week with resistance training (RT) twice a week while gradually increasing the intensity. The HIIT element was comprised of one minute of high-intensity exercise and four minutes of low-intensity exercise. The RT element was comprised of nine exercises for the core, upper extremities, and lower extremities. Results: The 42 T2DM patients who participated in this RCT were 35 - 64 years old. The HbA1c level of the EXP group decreased (Δ = -0.43 ± 1.01%), although not significantly. The VO2max was higher in the EXP group (38.13 ± 5.93 mL/kg/min) than in the CTR group (32.09 ± 5.24 mL/kg/min, P = 0.004). The overall oxidative stress decreased in the EXP group (MDA level Δ = -0.14 ± 0.39 nm/mL) when compared to the CTR group (MDA level Δ = 0.18 ± 0.26 nm/mL, P = 0.011), and the SOD level significantly increased more in the EXP group [median Δ = 0.47 U/mL (interquartile range = 0.08 - 0.74 U/mL)] when compared to the CTR group (Δ = 0.14 ± 0.35 U/mL, P = 0.036). The EXP group’s composite effects score was significantly higher (8.72 ± 1.27) than the CTR group’s score (7.20 ± 1.08, P = 0.001). Conclusions: The combined HIIT and RT exercise program was not significantly improving glycemic control, however it lowered oxidative stress.

Latar belakang: Sindroma metabolik (MS) dapat menyebabkan kecacatan di antara pilot di Indonesia.Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor-faktor risiko MS antara pilot komersialjarak pendek di Indonesia.Metode: Penelitian potong lintang dengan sampling purposif yang dilakukan di antara pilot komersial yangmelakukan uji medik di Balai Kesehatan Penerbangan Sipil, Jakarta tanggal 27 Juli-30 Agustus 2014. Sindromametabolik dinilai menurutkriterian National Cholesterol Education Program Adult Treatment Panel III. Faktorrisiko diperoleh dengan menggunakan kuesioner self-reporting anonim. Data laboratorium diperoleh daricatatan medis. Regresi Cox digunakan untuk mengidentifikasi faktor-faktor risiko yang dominan dari MS.Hasil: Selama pengumpulan data, 2135 pilot melakukan uji medik. Jumlah pilot Asia laki-laki memenuhi kriteriainklusi adalah 864 pilot. Prevalensi MS adalah 18,28%. Dibandingkan dengan kelompok 20-35 tahun, yangberusia berusia 56-65 tahun memiliki risiko 88% lebih tinggi untuk MS [risiko relatif sesuaian (RRa) = 1,88;P = 0,019]. Jika ditinjau dari jumlah sektor dalam 24 jam terakhir, dibandingkan dengan 0-3 sektor, subyekyang memiliki 6-7 sektor mempunyai risiko 66% lebih tinggi untuk MS (RRa = 1,66; P = 0,033), sedangkanyang memiliki 8 atau lebih sektor dalam 24 jam memiliki 82% lebih berisiko untuk MS (RRa = 1,82; P = 0,072).Kesimpulan: Pilot berusia tahun-56-65, yang memiliki 6 atau lebih sektor dalam 24 jam terakhir, memilikirisiko lebih tinggi untuk sindroma metabolik antara jarak pendek pilot komersial di Indonesia. (HealthScience Journal of Indonesia 2015;6:81-6)Kata kunci: Sindroma metabolik, jumlah sektor, pilot, Indonesia Abstract Background: Metabolic syndrome (MS) could cause sudden incapacitation among pilots in Indonesia.The aim of this study was to identify risk factors of MS among short-haul commercial pilots in Indonesia.Methods: A cross-sectional study with purposive sampling was conducted among commercial pilotstaking medical examination at the Civil Aviation Medical Center, Jakarta from July 27-August 30th,2014. Metabolic syndrome was assessed according to the National Cholesterol Education Program AdultTreatment panel III criteria and criteria. Risk factors were collected using anonymous self-reportingquestionnaire. The laboratory data were extracted from medical records. Cox regression was used toidentify dominant risk factors of MS.Results: During data collection, 2135 pilots taking medical examination, Total male Asian pilots metthe inclusion criteria was 864 pilots. Prevalence of MS was 18.28%. Compared to 20-35 year-old group,subjects aged 56-65 years-old had 88% higher risk for MS [adjusted relative risk (RRa) = 1.88; P = 0.019].In term of number of sectors in the last 24 hours, compared to 0-3 sectors, subjects who had 6-7 sectors inthe last 24 hours had 66% higher risk for MS (RRa = 1.66; P = 0.033), while subjects who had 8 or moresectors in 24 hours had 82% more risk for MS (RRa = 1.82; P = 0.072).Conclusions: The pilot aged 56-65 years-old, who had 6 or more sectors in the last 24 hours, had higherrisk for metabolic syndrome among short-haul commercial pilots in Indonesia. (Health Science Journalof Indonesia 2015;6:81-6)Keyword: metabolic syndrome, number of sectors, pilots, Indonesia

Background: Anaerobic physical exercise is a high intensity physical exercise performed in a short time. This exercise can stimulate apoptosis in left ventricular cardiomyocytes. The aim of this study is to analyze the apoptosis of cardiomyocytes after anaerobic exercise and detraining.Methods: Thirty two wistar rats Ratus Novergicus 250-350 grams (8-10 weeks old) were divided into the following groups (n = 4) and given naerobic physical exercise four and 12 weeks (group Exc-4, Exc-12) and anaerobic exercise followed by four weeks of detraining (Exc-4-D, Exc-12-D). The control groups were only observed in the same period (group CTL-4, CTL-12, CTL-4-D, CTL-12-D). At the end of observation, the rats were sacrificed and examination of the expression of caspase-3 as an indicator of apoptosis was done using immunohistochemical staining. Data were analyzed with ANOVA test.Results: An increase in expression of caspase-3 in the group Exc-4 (72.03%) compared to the CTL-4 (27.22%), (p < 0,001); and Exc-12 (79.30%) compared to the CTL-12 (30.53%) (p = 0.027). Detraining process showed a significant decline Capase-3 expression (31.12% in exc-4-D and 30.44% in the exc-12-D).Conclusion: Anaerobic physical exercise can increase apoptosis in rat left ventricle cardiomyocyte characterized by increased expression of caspase-3. Detraining can improve heart condition characterized by decreased expression of caspase-3.

Background: Chronic heart failure (CHF) is a slowly progressive disease with high morbidity and mortality; therefore, the management using pharmacological treatments frequently fails to improve outcome. Enhanced external counterpulsation (EECP), a non-invasive treatment, may serve as alternative treatment for heart failure. This study was aimed to evaluate the influence of EECP on myeloperoxidase (MPO) as inflammatory marker as well as cardiac events outcome.Methods: This was an open randomized controlled clinical trial on 66 CHF patients visiting several cardiovascular clinics in Manado between January-December 2012. The subjects were randomly divided into two groups, i.e. the group who receive EECP therapy and those who did not receive EECP therapy with 33 patients in each group. Myeloperoxidase (MPO) as inflammatory marker was examined at baseline and after 6 months of observation. Cardiovascular events were observed as well after 6 months of observation. Unpaired t-test was use to analyze the difference of MPO between the two groups, and chi-square followed by calculation of relative risk were used for estimation of cardiovascular event outcomes.Results: MPO measurement at baseline and after 6 months in EECP group were 643.16 ± 239.40 pM and 422.31 ± 156.26 pM, respectively (p < 0.001). Whereas in non EECP group, the MPO values were 584.69 ± 281.40 pM and 517.64 ± 189.68 pM, repectively (p = 0.792). MPO reduction was observed in all patients of EECP group and in 13 patients (48%) of non-EECP group (p < 0.001). Cardiovascular events were observed in 7 (21.21%) and 15 (45.45%) of patients in EECP and non-EECP groups, respectively (p = 0.037).Conclusion: EECP therapy significantly decreased the level of MPO as inflammatory marker and this decrease was correlated with the reduction of cardiovascular events in CHF patients. (Med J Indones. 2013;22:152-60. doi: 10.13181/mji.v22i3.584)Keywords: CHF, cardiovascular events, EECP, myeloperoxidase

Latar belakang: Hiperkolesterolemia merupakan penyebab penyakit kardiovaskular yang dapat menyebabkan inkapasitasi dalam penerbangan. Salah satu cara untuk mengontrol hiperkolesterolemia adalah dengan minum obat antikolesterol golongan statin, namun belum ada instrumen yang dapat digunakan untuk mengukur kepatuhan minum obat statin di kalangan penerbang militer di Indonesia. Tujuan penelitian ini adalah melakukan uji validitas dan reliabilitas kuesioner Morisky Medication Adherence Scale 8 (MMAS-8) versi bahasa Indonesia untuk mengukur kepatuhan konsumsi statin pada penerbang militer di Indonesia. Metode: MMAS 8 diterjemahkan secara sistematik ke dalam bahasa Indonesia. Uji validitas dan reliabilitas MMAS 8 pada 40 penerbang militer di Skadron Udara Halim Perdanakusuma dilaksanakan pada tanggal 6 April-15 Mei 2016. Validitas diuji dengan validitas kriteria. Reliabilitas diuji dengan konsistensi internal dan uji ulang (test-retest). Hasil: Sebagian besar penerbang (52,5%) memiliki kadar kolesterol tinggi (>200 mg/dL) dan tingkat kepatuhan minum statin yang rendah (74,4%). Didapatkan korelasi negatif lemah dan tidak ditemukan hubungan bermakna antara antara kadar kolesterol dan tingkat kepatuhan minum statin (koefisien Spearman -0,199; p=0,218). Konsistensi internal moderat (Cronbach’s α=0,759) dengan reliabilitas tes ulang yang baik (koefisien Spearman=0,860). Kesimpulan: Hasil uji validitas dan reliabilitas MMAS 8 versi bahasa Indonesia pada penerbang militer. (Health Science Journal of Indonesia 2016;7(2):129-133) Kata kunci: statin; kepatuhan; validitas; reliabilitas; penerbang; militer; Indonesia Abstract Background: Hypercholesterolemia is the cause of cardiovascular disease which lead to inflight incapacitation. One of the way to control hypercholesterolemia is using statin medication, however there has not been an instrument to measure statin adherence in military pilots in Indonesia. The aim of this study was to analyze the validity and reliability of MMAS 8 Bahasa version to measure statin adherence among military pilot in Indonesia. Methods: MMAS 8 sistematically translated into Bahasa. Validity and reliability test among 40 military pilots in Halim Perdanakusuma Air Force Base was held on April 06th - May 15th 2016. Validity was confirmed using crirerion-related validity. Reliability was tested for internal consistency and test-retest reliability. Results: Most of the pilots (52.5%) had high cholesterol level and 74.4% had low statin adherence. Negative weak correlation and no significant association between cholesterol and statin adherence level (Spearman coefficient -.199, p=0.218) was found. Moderate internal consistency and excellent test-retest reliability were found (Cronbach’s α=0.759; Spearman correlation=0.860). Conclusion: Validity and reliability of MMAS 8 Bahasa version has not been able to be used to measure statin adherence among military pilots in Indonesia. (Health Science Journal of Indonesia 2016;7(2):129-133) Keywords: statin; adherence; validity; reliability; pilots; military; Indonesia

Aim: to investigate the efficacy of enhanced external counterpulsation (EECP) therapy to improve functional capacity in patients with chronic heart failure (CHF). Methods: a double-blind random clinical trial was performed in 99 patients with CHF who had received EECP therapy at Jade Cardiovascular Clinic, Manado, North Sulawesi, Indonesia between January 2014 and June 2015. Subjects were categorized into 2 groups, i.e. 49 subjects had sham EECP therapy and 50 subjects had EECP therapy. All subjects performed six-minute walking test (6MWT) before and after receiving EECP therapy. Results: there was no significant difference between both groups regarding the basic characteristics of patients with CHF. The 6MWT result before EECP therapy showed that there were 30 patients (61.2%) with walk distance of

Background: To investigate the association between aircraft noise and blood pressure.Methods: A nested case-control study was conducted on Indonesian Air Force pilots doing annual medical check-ups at the Saryanto Institute for Aviation and Aerospace Health (LAKESPRA) from 2003 – 2008. The data extracted from medical records were age, total flight hours, type of aircraft, fasting blood glucose and cholesterol levels, waist circumference, height and weight (Body Mass Index), and blood pressure.Results: There were 549 pilots, 49 were found to be hypertensive, with SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Helicopters pilots were at an almost 2 fold risk of hypertension compared to pilots of the fixed wing aircrafts. Pilots with more than 1400 hours of flight had more than 2 fold risk of being hypertensive compared to those with 1400 flight hours or less.Conclusion: The type of aircraft, which is related to the noise generated, may be a risk factor for developing hypertension in pilots. Increased total flight hours also increased the risk of hypertension. (Med J Indones 2012;21:38-43)Keywords: Aircraft noise, hypertension, pilots

To determine whether the renal sympathetic--nerve ablation method is more effective compared to multiple anti--hypertensive drug among patients with resistant hypertension.a search was conducted on PubMed. The selection of title and abstract was conducted using inclusion and exclusion criteria, which led to five relevant articles. The selected studies were critically appraised for its validity, importance and applicability.one of studies showed that renal denervation is not effectively reduced blood pressure in patients with resistant hypertension; nevertheless other studies showed significant results.literature with strongest evidence showed that there is no relationship between renal sympathetic-nerve ablation procedure and reduction of blood pressure. However, as there is still some methodological flaw on the literature, we recommend doing another study that may find the appropriate results.

Since the last five years, Faculty of Dentistry Universitas Indonesia has implemented an integrated curriculum as a process of change from teacher centered to student centered learning, as well as problem based learning, community based and praciticing in a small group discussion. The dental curriculum is divided separately into seven semesters for academic and followed by three semesters for clinical years. The aim of this study is to evaluare the implementation of the integrated curriculum. Evaluation of this five year program showed less than 10% of the 5th year students were able to finish their study on time. Most of the students needed more than three semesters to complete the clinical requirements; therefore, the recent curriculum should be revised.DOI: 10.14693/jdi.v16i2.93

Background: Osteoporosis occurred in 64% of Indonesian women aged 60-64 years. The risk of osteoporosis can be reduced by achieving optimal peak bone mass in ages 25-32 years. However, 33.4% women had low peak bone mass (LPBM).Objective: We aimed to develop a tool to identify women at risk of developing LPBM in order to ameliorate this situation. Some risk/protective factors were explored in a case-control study.Method: We recruited 25 cases, those with LPBM (T-score

Aim: To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP) in Indonesian Air Force pilots.Methods: A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA) in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ≥ 90 mmHg were compared with contral group with DBP < 79 mmHG. One case matched to 12 controls.Results: Out of 567 pilots, 544 (95.9%) had complete medical records. For this analysis there were 40 cases of high DBP and 480 controls for DBP. Pilots exposed to aircraft noise 90-95 dB rather than 70-80 dB had a 2.7-fold increase for high DBP [adjusted odds ratio (ORa) = 2.70; 95% confi dence interval (CI ) = 1.05-6.97]. Pilots with resting pulse rates of ≥ 81/minute rather than ≤ 80/minute had a 2.7-fold increase for high DBP (ORa = 2.66; 95% CI = 1.26-5.61). In terms of total fl ight hours, pilots who had 1401-11125 hours rather than 147-1400 hours had a 3.2-fold increase for high DBP (ORa = 3.18; 95% CI = 1.01-10.03).Conclusion: High interior aircraft noise, high total flight hours, and high resting pulse rate, increased risk for high DBP. Self assessment of resting pulse rate can be used to control the risk of high DBP. (Med J Indones 2009; 276: 276-82)Keywords: diastolic blood pressure, aircraft noise, resting pulse rate, military pilots

The steady state pharmacokinetics and pharmacodynamics of metoprolol controlled release tablets 100 mg CR/ZOK, was compared with those of metoprolol conventional tablets 100 mg (CT) and atenolol 50 mg (ATL) in ten healthy Oriental men. The study was of double-blind, cross-over placebo controlled design. The three study drugs and placebo were given in a random order once daily for 4 consecutive days with 1-week wash-out between each period. Treadmill exercise tests were performed and blood samples were obtained at fixed intervals after the fourth dose of each treatment. There was less fluctuation in the plasma level-time profile after CR/ZOK than CT and ATL. Plasma concentrations were significantly higher on CR/ZOK than CT at 24 hours after dosing. The relative bioavailability of CR/ZOK to CT was 69.0%. CR/ZOK achieved relatively more uniform beta-blocking effect over the dose interval. Compared to CT and ATL, the peak effect after CR/ZOK was less pronounced and the beta-blockade after 24 hours more effective.

Numerous factors, such as VEGF and intra-placental oxygenation, can influence placental angiogenic activity. Early in the normal gestation period, β-hCG enhance VEGF activity to induce angiogenesis. The aims of this study were to identify the correlation between β-hCG concentration in placental culture and placental angiogenic activity in pre-eclampsia. Ten placenta samples from women with pre-eclampsia and l0 from controls (normal pregnancy) were collected. All subjects agreed to participate in this study and signed an informed consent form. β-hCG concentration in supernatant of placental culture was measured by Microparticle Enzyme Immunoassay (MEIA) and placental angiogenic activity was measured by endothelial cell migration toward placental explant (score 0-4). The results showed that the median score of placental angiogenic activity in pre-eclampsia was significantly higher than in normal pregnancy (p

Some hypertensive subjects in Indonesia consume traditional herbal medicines in addition to the usual pharmacological drugs. This paper studied the relationship between several traditional herbal medicines, such as morinda, star fruit, garlic, or jamu, believed to control hypertension and the risk of current pharmacological antihypertensive drug users in subjects with stage 1 and 2 hypertension in a rural community West Java, Indonesia. The data were obtained from 3 field studies by the second year medical students of the Faculty of Medicine, University of Indonesia conducted in 2001, 2002, and 2003 in a subdistrict of the Bogor regency. The subjects were selected randomly from neighborhood clusters. Interviews and blood pressure measurements were conducted at the houses of the subjects by specially trained second year medical students supervised by faculty members. There were 496 subjects with stage 1 or 2 hypertension, with 11.5% under current antihypertensive drugs. Compared with the hypertension stage 1 subjects, hypertension stage 2 subjects were 5.4 times more likely to be currently taking pharmacological antihypertensive medication (adjusted odds ratio = 5.44; 95% confidence interval = 2.64-11.27). The combined of current antihypertensive medication with traditional medicines were cucumber which being the most dominant followed by star fruit and morinda. Reasons for this were probably the strong influence of culture, the limited medical facilities, and high cost of the antihypertensive drugs. It was concluded that in a rural Indonesia, it was common for hypertensive subjects to take pharmacological drugs as well as traditional medicine for antihypertensive therapy. (Med J Indones 2004; 13: 246-51) Keywords: hypertension, pharmacological drugs, traditional medicine, Indonesia

Endothelial cells play an i,nportant role in various physiologic and pathologic processes. Their function in biologic eyents can be better understood if these endothelial cells can be isolated and cultured in vitro. The success of endothelial cell cultire in the tropics depends was nade to isolate and culture endothelial cellsfrom hu)nan untbilica a out of 50 umbilical corcl vein satuples cultured, 35 produced confluen of further siudies on the funciions of endothelial cells in physiologic and pathologic processes.