Sheba, shiane Hanako
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Acute and Sub-chronic Toxicity Studies of Combination of Physalis angulata L. (Cecendet) Extract and Methylprednisolone on Animals Sukandar, Elin Yulinah; Sheba, Shiane Hanako
International Journal of Integrated Health Sciences Vol 7, No 1 (2019)
Publisher : International Journal of Integrated Health Sciences

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n1.1619

Abstract

Objective: To evaluate the safety of combination of Physalis angulata L. (Cecendet) extract and methylprednisolone through a single dose in mice (acute toxicity) and repeated doses within 90 days in rats (subchronic toxicity).Methods: Acute toxicity test was conducted to 2 groups of female mice by monitoring their behavior and death at 4 hours and 24 hours after cecendet adminstration. While subchronic toxicity test was conducted to 6 groups of rats as normal group, control group, and receive varoius cecendet dose. Each group was combined with methylprednisolone 5 mg/kg b.w. at first month and gradually taperred to 3.2 mg/kg b.w. at third month. Subchronic toxicity was evaluated by monitoring rats’ behavior, mortality, blood biochemistry, blood cell count, urinalysis, and organ macroscopic and histologic.Results: The study showed cecendet extracts did not affect mice behavior in single dose therapy up to 5 g/kg b.w. and had LD50 of more than 5 g/kg b.w., which was categorized as practically non-toxic. The sub-chronic toxicity study showed that up to 1 g/kg b.w. of cecendet extracts that was administered for 90 days did not cause death, was not organ toxic, did not affect blood biochemistries, blood cell count, and urinalysis.Conclusions: Cecendet extract and methylprednisolone combination was safe based on acute and sub-chronic toxicity data.Keywords: Acute toxicity, LD50, Lupus, Physalis angulata L, subchronic toxicity 
Kepatuhan Minum Obat Pada Pasien Lupus Eritematosus Sistemik di RSUP Dr. Hasan Sadikin Bandung Sheba, Shiane Hanako; Djuhaeni, Henni; Setiabudiawan, Budi; Sunjaya, Deni K.; Mutyara, Kuswandewi; Rinawan, Fedri Ruluwedrata
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (496.569 KB) | DOI: 10.15395/mkb.v50n1.1229

Abstract

Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronik yang mengharuskan penyandangnya minum obat dalam waktu lama bahkan seumur hidupnya. Keadaan ini selain menimbulkan dampak fisik, psikis maupun sosial juga menyebabkab biaya tinggi sehingga LES digolongkan sebagai penyakit catastrophic. Ketidakpatuhan minum obat penyandang LES akan berpengaruh langsung terhadap memburuknya outcome penyakit lupus. Penelitian bertujuan mengeksplorasi pelaksanaan dan kepatuhan minum obat pada pasien LES dengan harapan terjadinya perbaikan penatalaksanaan LES yang berdampak pada peningkatan kualitas hidup serta penurunan angka kematian karena LES. Telah dilakukan penelitian kualitatif terhadap 6 informan pasien LES suku Sunda di klinik reumatologi RSUP Dr. Hasan Sadikin Bandung pada bulan Juli sampai September 2016 dengan menggunakan pedoman wawancara mendalam open question yang dikembangkan sesuai dengan jawaban informan. Paradigma penelitan adalah constructivism dengan triangulasi terhadap 2 orang keluarga pasien dan 3 dokter konsultan klinik reumatologi RSUP Dr. Hasan Sadikin Bandung. Data yang diperoleh dianalisis secara bertahap melalui proses transkripsi, reduksi, koding, kategorisasi, penyusunan tema, interprestasi data serta pembangunan konsep. Hasil penelitian menunjukkan ada 57 koding, 14 kategori, dan 3 tema yang mengarah kepada kepatuhan minum obat pasien LES. Ke-14 kategori kepatuhan tersebut terdiri dari: karakteristik individu, daya ingat, pengetahuan, eksperimen, dan manajemen konsumsi (faktor predisposing); karakteristik penyakit, karakteristik obat, biaya, kebijakan rumah sakit, akses ke rumah sakit, terapi alternatif dan enabler agent (faktor enabling); karakteristik tenaga kesehatan dan dukungan eksternal dari berbagai pihak (faktor reinforcing). Konsep dan konstruk yang ditemukan membangun konstruk lokal Jawa Barat berlatar belakang karakteristik masyarakat Sunda dan bersifat kontekstual terhadap penyakit lupus.Kata kunci: Kepatuhan minum obat, lupus eritematosus sistemik, odapusDrug Adherence Drug in Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin General Hospital BandungSystemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that requires prolonged treatment. SLE creates physical, psychological, social, and economic burden for the patients; therefore, it is categorized as a catastrophic illness. Non-adherence to medication in SLE patient isan important factor that directly leads to poor outcome. The aim of this study was to explore the management and adherence of patients with SLE to improve the quality of life and to reduce the mortality rate. A qualitative study was undertaken to 6 sundanese SLE patients at the Rheumatology clinic in Dr. Hasan Sadikin General Hospital Bandung in July-September 2016 by using open-ended questions in in-depth interviews with probing based on informant answers. The paradigm used was constructivism with triangulation to family members of 2 patients and 3 rheumatologist consultants in Dr. Hasan Sadikin General Hospital Bandung. Data collected were analyzed gradually through transcription, reduction, coding, categorizing, theme analysis, data interpretation, and theorizing. The results showed 57 codes, 14 categories, 3 themes that focused on the medication adherence of Lupus patients.The themes were categorized as predisposing (individual characteristics, memory, knowledge, experimentation, and consumption management), enabling (drug characteristic, cost, hospital policies, access to hospital, alternative therapy, and enabler agent), and reinforcing (characteristics of health care professionals and social support) according to the predetermined theory. This study has also identified the local concepts and constructs Sundanese people in West Java, which is contextual to the lupus disease.Key words: Adherence, systemic lupus erythematosus, odapus
Validitas dan Reliabilitas Instrumen Determinan Kepatuhan Minum Obat pada Pasien Lupus Eritematosus Sistemik Sheba, shiane Hanako
JURNAL TERAS KESEHATAN Vol 1 No 1 (2018): Jurnal Teras Kesehatan Vol.1 No.1 Juli 2018
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat (LPPM) Politeknik Al Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (649.034 KB)

Abstract

Lupus Eritematosus Sistemik (LES) adalah penyakit autoimun kronis yangbelum diketahui penyebabnya sehingga penyandangnya harus mengonsumsiobat jangka panjang untuk mengendalikan penyakitnya. Keadaan inimenimbulkan dampak fisik dan ekonomi karena efek samping serius danbiaya tinggi yang sering memengaruhi kepatuhan minum obat. Determinankepatuhan berbeda di setiap lokasi karena perbedaan sosial, politik danbudaya. Penelitian bertujuan mendapatkan instrumen determinan kepatuhanminum obat pasien LES yang valid dan reliabel. Telah dilakukan penelitian kuantitatif terhadap 30 pasien LES di klinikReumatologi RSUP Dr. Hasan Sadikin Bandung dengan teknik consecutivesampling. Analisis data menggunakan pemodelan Rasch. Uji validitas 103 butir pernyataan menunjukkan: 83 butir tergolong fitstatistic; seluruh butir terbukti unidimensi dan tidak ditemukan konflik antarbutir (dimensionality); 4 pilihan jawaban mampu dipahami perbedaannyaoleh responden (rating scale). Uji reliabilitas menunjukkan: reliabilitas danseparasi strata butir sangat baik; reliabilitas dan separasi strata respondenbaik; Alpha Cronbach sangat baik (0,88).Penelitian ini menghasilkan instrumen determinan kepatuhan minum obatpada pasien LES yang valid dan reliabel, mewakili 51 konstruk dan 13kategori: karakteristik individu, daya ingat, pengetahuan, eksperimen,manajemen konsumsi, karakteristik penyakit, karakteristik obat, biaya,kebijakan rumah sakit, akses ke rumah sakit, enabler agent, karakteristiktenaga kesehatan dan dukungan eksternal.  
Combination Effect of Cecendet (Physalisangulata L.) Extract and Methylprednisolone in Reducing Inflammation and Improving Renal Functions in Pristane-induced Lupus Rat Models Sheba, Shiane Hanako; Setiani, Nur Asni; Sutjiatmo, Afifah B.; Vikasari, Suci Nar; Sukandar, Elin Yulinah
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n1.1599

Abstract

Cecendet (Physalis angulata L.) is a herbal plant commonly used for traditional remedies in Indonesia to prevent inflammation in rheumatic disease. Several studies have determined that cecendet has an immunosuppressant activity towards pristane-induced lupus animal model. A preliminary study has proven that its use is safe in animals based on acute and sub-chronic toxicity tests. In management of lupus, methylprednisolone is used for primary immunosuppressant agent. This study aimed to investigate the effect of cecendet ethanolic extract in combination with methylprednisolone on inflammation, urinalysis, and serum creatinine level of rats as pristane-induced lupus animal models. This study was conducted at the Pharmacology Laboratory of Pharmacy Faculty of Jenderal Ahmad Yani University in January 2016. Four groups of female rats were used i.e. normal group, control group, 62.5 mg/kg body weight (BW) cecendet ethanolic extract group, and group receiving 62.5 mg/kg bw cecendet ethanolic extract combined with 0.36 mg/kg body weight methylprednisolone for six weeks, followed by thirty days of 0.5 mL pristine-induced. Examinations on anti-inflammation effect, urinalysis, and serum creatinine level  were performed in week 3 and 6 during the intervention. The results showed that the administration of cecendet ethanolic extract alone and in combination with methylprednisolone could inhibit inflammation and reduce proteinuria and serum creatinine level when compared to the control group.Key words: Anti-inflammation, cecendet, creatinine, methylprednisolone, Physalis angulata L. Pengaruh Pemberian Kombinasi Ekstrak Cecendet (Physalisangulata L.) dan Metilprednisolon terhadap Penurunan Radang dan Perbaikan Fungsi Ginjal Pada Model Tikus Lupus yang Diinduksi PristanaTanaman cecendet (Physalis angulata L.) sering digunakan sebagai obat tradisional di Indonesia, antara lain sebagai antiradang untuk mengobati reumatik. Penelitian terdahulu menunjukkan bahwa cecendet memiliki aktivitas imunosupresan pada hewan model lupus yang diinduksi pristana dan aman berdasar s ata uji toksisitas akut dan subkronis. Pada penanganan lupus, metilprednisolon digunakan sebagai obat utama imunosupresan. Penelitian ini bertujuan menguji khasiat ekstrak etanol herba cecendet dalam penggunaan tunggal dan kombinasi dengan metilprednisolon terhadap radang, urinalisis, dan kadar kreatinin serum pada tikus yang diinduksi pristana sebagai model hewan lupus. Penelitian dilaksanakan di Laboratorium Farmakologi Fakultas Farmasi Universitas Jenderal Ahmad Yani pada bulan Januari 2016.  Tikus betina sebagai hewan uji dibagi menjadi 4 grup, yaitu: grup normal, grupkontrol, grup diberi sediaan ekstrak etanol herba cecendet 62,5 mg/kg BB tunggal, dan grup hewan uji diberi sediaan ekstrak etanol herba cecendet 62,5 mg/kg BB kombinasi dengan metilprednisolon 0,36 mg/kg BB selama enam minggu, setelah tiga puluh hari diinduksi 0,5mL pristana. Tiga dan enam minggu setelah pemberian sediaan uji, dilakukan uji efek antiradang, pemeriksaan urin, dan pengukuran kadar kreatinin serum. Hasil penelitian menunjukkan bahwa pemberian ekstrak etanol herba cecendet tunggal maupun sebagai komplemen dengan metilprednisolon selama enam minggu memperlihatkan pengaruh penghambatan pembentukan radang, menurunkan proteinuria dan menurunkan kadar kreatinin serum jika dibanding dengan kelompok kontrol.Kata kunci: Anti-radang, Cecendet, kreatinin, metilprednisolon, Physalis angulata L.