Nugraha, Bayu Eka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Pengaruh Suplementasi Ekstrak Teh Hijau terhadap Kadar Malondialdehid Plasma pada Individu dengan Aktivitas Fisik Submaksimal, Double-Blind and Placebo-Controlled Trials Arsana, Putu Moda; Sasiarini, Laksmi; Nugraha, Bayu Eka
Jurnal Penyakit Dalam Indonesia Vol 6, No 1 (2019)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

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Abstract

 Pendahuluan. Ekstrak teh hijau (senyawa polifenol/katekin) terbukti secara in vitro memiliki kemampuan sebagai antioksidan. Aktivitas fisik submaksimal merupakan salah satu penyebab peningkatan radikal bebas. Peningkatan radikal bebas dapat dideteksi dengan peningkatan MDA yaitu produk akhir dari peroksidasi lemak. Penelitian ini dilakukan untuk mengetahui efek suplementasi antioksidan ekstrak teh hijau terhadap radikal bebas yang ditimbulkan oleh aktivitas fisik submaksimal dengan mengukur kadar MDA plasma.Metode. Uji double blind control trial dilakukan pada 20 orang mahasiswa Fakultas Ilmu Olahraga Universitas Negeri Malang dengan aktivitas fisik submaksimal yaitu lari 1.500 m dalam 12 menit menggunakan mesin treadmill. Subjek terbagi atas dua kelompok: kelompok ekstrak teh hijau (Tegreen 250 mg) dan kontrol (plasebo). Suplemen diberikan satu kapsul per hari selama 14 hari sebelum aktivitas fisik submaksimal. Kadar MDA plasma diambil sebelum aktivitas submaksimal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal.  Analisis hasil penelitian menggunakan uji ANOVA dan post hoc dengan Tukey. Penelitian telah dinilai layak secara etik oleh tim Komisi Etik Penelitian Kesehatan Fakultas Kedokteran Universitas Brawijaya.Hasil. Pada kelompok kontrol, rerata kadar MDA plasma kondisi basal, 2 jam dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 52,43 nmol/ml (simpang baku [SB] 12,52 nmol/ml), 55,57 nmol/ml (SB 13,84 nmol/ml), dan 63,86 nmol/ml (SB 12,17 nmol/ml). Namun demikian, peningkatan tersebut tidak bermakna secara statistik (p=0,158). Pada kelompok perlakuan, terdapat penurunan kadar MDA plasma yang bermakna saat 48 jam setelah aktivitas fisik submaksimal dari kondisi basal dengan rerata kadar MDA pada basal dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 36,14 nmol/ml (SB 5,88 nmol/ml) dan 19,86 nmol/ml (SB 8,92 nmol/ml) (p<0,001). Hasil analisis menunjukkan adanya perbedaan bermakna kadar MDA plasma antara kedua kelompok saat basal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal dengan nilai p secara berturut-turut yaitu 0,012; <0,001, dan <0,001.Simpulan. Ekstrak teh hijau dapat menurunkan kadar MDA plasma basal, 2 jam, dan 48 jam setelah aktivitas fisik submaksimal. Kata Kunci: Aktivitas fisik submaksimal, MDA, Suplementasi ekstrak teh hijauThe Effect of Green Tea Extract Supplementation on Plasma Malondialdehyde (MDA) in Human with Sub-Maximal Physical Activity, Double-Blind and Placebo-Controlled TrialsIntroduction. Green Tea extract has been proven in vitro to have the ability as an antioxidant. Submaximal physical activity causes an increase in free radicals. The increase of MDA can detect the increase of free radicals. This study aimed to determine the effects of green tea extract supplementation against free radicals in submaximal physical activity by measuring plasma MDA.Methods. This double-blind controlled trial study was performed in 20 students of faculty of sports science with submaximal physical activity in the form of 1,500 meters running in 12 minutes using a treadmill. Subjects were divided into two groups: green tea extract group (Tegreen 250 mg) and the control group (placebo). Supplement/placebo was given as one caps a day for fourteen days before submaximal physical activity. The plasma MDA was taken before, 2 hours after, and 48 hours after the submaximal physical activity. Analysis of the results used ANOVA and post hoc Tukey. The study has been assessed by Medical Research Ethical Committee at Medical Faculty of Universitas Brawijaya.Results. In the control group, the mean value of plasma MDA levels in basal conditions, 2 hours and 48 hours after submaximal physical activity were 52.43 nmol/ml (standard deviation [SD] 12.52 nmol/ml), 55.57 nmol/ml (SD 13.84 nmol/ml), and 63.86 nmol/ml (SD 12.17 nmol/ml), respectively. However, this result was not statistically significant (p = 0.158). In the treatment group, the mean value of plasma MDA level at 48 hours after submaximal physical activity was significantly decreased compared to basal condition with mean value in basal and 48 hours after submaximal physical activity were 36.14 nmol/ml (SD 5.88 nmol/ml) and 19.86 nmol/ml (SD 8.92 nmol/ml), respectively (p <0.001). Further analysis showed a significant difference in plasma MDA levels between the two groups at basal, 2 hours, and 48 hours after submaximal physical activity (p values were 0.012; <0.001, and <0.001 respectively).Conclusion. Green tea extract can decrease the plasma level of MDA at basal, 2 hours, and 48 hours after submaximal physical activity.
Barrett’s Esophagus Mustika, Syifa; Nugraha, Bayu Eka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, AUGUST 2019
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Gastroesophageal reflux disease (GERD) is a condition commonly managed in the primary care setting. Patients with GERD may develop reflux esophagitis as the esophagus repeatedly is exposed to acidic gastric contents. Over time, untreated reflux esophagitis may lead to chronic complications such as esophageal stricture or the development of Barrett’s esophagus (BE). BE may progress to oesophageal adenocarcinoma. There is currently a rising incidence of BE. The pathogenesis of BE is not well-understood although genetic and environmental factors play significant roles. BE is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. As patients with BE can be entirely asymptomatic, it is difficult to screen this population group. BE is present in 10%–20% of patients with GERD and has also been detected in patients who deny classic GERD symptoms and are undergoing endoscopy for other indications.
Differences Between Alpha-Fetoprotein (AFP) and Prothrombine Induced by Vitamin K Absence or Antagonist II (PIVKA-II) Values as Early Detection Method for Hepatocellular Carcinoma (HCC) and Cirrhosis Nugraha, Bayu Eka; Setiawan, Nugraha; Susianti, Hani; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p > 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p > 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p < 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC.
Barrett’s Esophagus Mustika, Syifa; Nugraha, Bayu Eka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, AUGUST 2019
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar | Full PDF (824.84 KB)

Abstract

Gastroesophageal reflux disease (GERD) is a condition commonly managed in the primary care setting. Patients with GERD may develop reflux esophagitis as the esophagus repeatedly is exposed to acidic gastric contents. Over time, untreated reflux esophagitis may lead to chronic complications such as esophageal stricture or the development of Barrett’s esophagus (BE). BE may progress to oesophageal adenocarcinoma. There is currently a rising incidence of BE. The pathogenesis of BE is not well-understood although genetic and environmental factors play significant roles. BE is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. As patients with BE can be entirely asymptomatic, it is difficult to screen this population group. BE is present in 10%–20% of patients with GERD and has also been detected in patients who deny classic GERD symptoms and are undergoing endoscopy for other indications.
Differences Between Alpha-Fetoprotein (AFP) and Prothrombine Induced by Vitamin K Absence or Antagonist II (PIVKA-II) Values as Early Detection Method for Hepatocellular Carcinoma (HCC) and Cirrhosis Nugraha, Bayu Eka; Setiawan, Nugraha; Susianti, Hani; Pratomo, Bogi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar | Full PDF (412.214 KB)

Abstract

Background: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p > 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p > 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p < 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC.