Nafrialdi Nafrialdi
Department Of Pharmacology And Therapeutics, University Of Indonesia Medical School/ Dr. Cipto Mangunkusumo Hospital, Jakarta.

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Squamous cell carcinoma of the tongue in Sprague-Dawley rats using 4-nitroquinoline 1-oxide model Erfan, Erni; N., Nafrialdi; Ekawuyung, Puspita
Padjadjaran Journal of Dentistry Vol 28, No 1 (2016): March
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1371.838 KB) | DOI: 10.24198/pjd.vol28no1.13510

Abstract

Background. 4-nitroquinoline 1-oxide (4NQO) is a water soluble carcinogen which is often used to induce cancer in oral cavity. Objective. The purpose of this study was to know the incidence of histopathological lesions in the tongue of rats after administration of 4-nitroquinoline 1-oxide (4NQO) for a model of oral carcinogenesis in the animal experimental laboratory. Materials and Methods. This study was conducted in the Department of  Pathological Anatomy, Faculty of Medicine, University of Indonesia (FMUI). 4NQO (30 ppm) was administered by drinking water ad libitum to the Sprague Dawley (SD) rats during different time inductions (4-9 and 36-46 weeks). The present of tumor in oral cavity of the 4NQO-treated rats were observed macroscopically and microscopically. Tumor volume were measured based on the formula established by G. Carlsson. The degree of histological changes was determined according to observation towards their Hematoxylin and Eosin (HE) staining results. Results. Dysplasia and invasive squamous cell carcinoma (SCC) were respectively found in the tongue of the group given 4NQO for 4-9 and 36-46 weeks. The tongue from rats (4NQO for 36-46 weeks) exhibited whitish protuberant nodular lesions with the longest diameter was 17 mm. The histopathological lesion incidences for dysplasia and invasive SCC respectively were 25% (5/20) and 75% (15/20). The rats had tumor in their tongues with variation of degree alteration which proportional to the induction time. The extension of 4NQO induction time increasing the degree of change in the tumor. Conclusion. 4NQO represents a good model of carcinoma of tongue and gives consistence results with histological changes degree being related to duration of exposure.
Kurkumin sebagai Agen Kemopreventif - Benarkah Aman? -, Paramita; Louisa, Melva; -, Nafrialdi
Cermin Dunia Kedokteran Vol 43, No 5 (2016): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (147.015 KB) | DOI: 10.55175/cdk.v43i5.62

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Kanker adalah penyebab kematian dan kesakitan di seluruh dunia. Menurut data World Health Organization (WHO) ada sekitar 14 juta kanker kasus baru dan 8,2 juta kematian akibat kanker pada tahun 2012. Kemoprevensi adalah pendekatan anti-kanker yang menjanjikan dengan efek sekunder lebih rendah dibandingkan dengan kemoterapi klasik. Kurkumin (diferuloylmethane), suatu polifenol memiliki aktivitas anti-inflamasi, antioksidan, dan sifat kemopreventif yang poten dengan efek samping toksik minimal. Namun, beberapa bukti menunjukkan bahwa kurkumin dapat menyebabkan berbagai efek toksik seperti gangguan lambung, mual, diare, reaksi alergi kulit, dan pembekuan darah akibat gangguan aktivitas anti-trombosis. Bahkan beberapa bukti menunjukkan bahwa pemberian kurkumin dosis tinggi jangka panjang pada hewan pengerat dapat bersifat tumorigenik.
The Effect of Mangiferin Against Brain Damage Caused by Oxidative Stress and Inflammation Induced by Doxorubicin Soni Siswanto; Wawaimuli Arozal; Vetnizah Juniantito; Agatha Grace; Femmi Dwinda Agustini; . Nafrialdi
HAYATI Journal of Biosciences Vol. 23 No. 2 (2016): April 2016
Publisher : Bogor Agricultural University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (642.703 KB) | DOI: 10.4308/hjb.23.2.51

Abstract

Doxorubicin (DOX) is an anthracycline antibiotic used for anticancer therapy. However, this agent can cause various systemic side effects including cognitive impairments in chronic use. Brain damage due to DOX is caused by an increase of tumor necrosis factor-alpha (TNF-α) level in the brain. Increased TNF-α can further lead to chronic inflammation which can lead to neuronal deaths or neurodegenerative diseases. Mangiferin (MAG), a compound extracted from Mangifera indica, has been found neuroprotective activities, but its effect on DOX-induced brain damage is unknown. This study aims to determine the effect of MAG on brain damage induced by DOX. Male Sprague-Dawley rats were induced by DOX intraperitoneally. MAG was given orally at the doses of 30 and 60 mg/kg bw for 7 consecutive weeks. The parameters measured were inflammatory and oxidative stress markers in brain tissue. Coadministration of MAG with DOX reduced inflammation which was marked by the reduction of TNF-α mRNA expression, decreased TNF-α level and reduction of oxidative stress marked by increase of superoxide dismutase level and decrease of malondialdehyde level. In conclusion, MAG was shown to have a neuroprotective effect on brain damage induced by DOX, partly due to inhibition of inflammation and oxidative stress.
Plasma digoxin levels and ejection fraction in pediatric heart failure Nafrialdi Nafrialdi; Sake Juli Martina; Mulyadi Djer; Melva Louisa
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (107.029 KB) | DOI: 10.14238/pi55.6.2015.322-7

Abstract

Background Digoxin has long been prescribed in children with heart failure, but its efficacy has not been evaluated. A previous study at the Department of Child Health, Dr. Cipto Mangunkusumo Hospital revealed that plasma digoxin levels, following a maintenance dose of 15 μg/kg/d, were sub-therapeutic. Regarding its narrow margin of safety, the trend is to use digoxin in even lower dose. Thus, the drug’s impact on cardiac performance need to be evaluated. Objective To evaluate whether a lower maintenance dose of digoxin (10 μg/kg/d) is sufficient to achieve a therapeutic level and to assess for possible correlations between plasma digoxin level and left ventricular ejection fraction (LVEF) as well as fractional shortening (LVFS). Methods A cross-sectional study was conducted on 20 pediatric heart failure patients at the Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta, from January to May 2012. Plasma digoxin levels were measured by ELISA method after one month or more of treatment; LVEF and LVFS were measured by echocardiography. Correlations between plasma digoxin level and LVEF or LVFS were analyzed by Spearman’s correlation test. The LVEF before and after digoxin treatment were compared by paired T-test. Results Thirteen out of 20 patients had plasma digoxin levels within therapeutic range (0.5-1.5 ng/mL; 95%CI 0.599 to 0.898) and 7 had sub-therapeutic levels (<0.5 ng/ mL; 95%CI 0.252 to 0.417). No significant correlations were observed between plasma digoxin level and LVEF (r=-0.085; P=0.722) or LVFS (r=-0.105; P=0.659). There was a significant increase in LVEF before [42.18 (SD 14.15)%] and after digoxin treatment [57.52 (SD 11.09)%], (P < 0.0001). Conclusion Most patients in this study have plasma digoxin levels within therapeutic range. There are no significant correlations between plasma digoxin level at the time point of measurement and LVEF or LVFS. However, an increase of LVEF is observed in every individual patients following digoxin treatment.
Comparative efficacy, safety, and cost of iron chelation monotherapy vs. combination therapy in pediatric beta-thalassemia major: a single-center retrospective study Dewi Sharon Simorangkir; Nafrialdi Nafrialdi; Pustika Amalia Wahidiyat; Vivian Soetikno
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.91-7

Abstract

Background Iron chelation therapy is used to maintain iron balance in β-thalassemia major patients who undergo repeated blood transfusions. Objective To compare the efficacy, safety, and cost of iron chelation combination regimens [deferiprone (DFP) + deferoxamine (DFO) or DFP + deferasirox (DFX])] vs. high-dose DFP monotherapy (≥ 90 mg/kg/day) in pediatric β-thalassemia major patients. Methods This cross-sectional, retrospective study was done at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Retrospective data was obtained from electronic medical records of pediatric b-thalassemia major patients with serum ferritin of ≥ 2,500 ng/mL and/or transferrin saturation of ≥ 60%, who received either combination or monotherapy iron chelation agents. Outcome effectiveness was determined by the reduction of serum ferritin level of at least 80%. Safety was analyzed descriptively. A pharmacoeconomic analysis was performed based on clinical outcomes consisting of effectiveness and direct medical costs. Results At the end of the study, serum ferritin was reduced in 34.7% of the combination therapy group and 27.5% of the monotherapy group, however there was no significant difference between the two treatments (P=0.391). Nine (19.5%) patients on combination therapy and 17 (21.2%) patients on monotherapy had adverse drug reaction (ADR), with the most frequently reported ADR was elevated transaminase enzyme levels. Cost minimization analysis revealed that monotherapy for 6 months was IDR 13,556,592.64 less expensive than combination therapy (IDR 44,498,732.07); whereas monotherapy for 12 months was IDR 20,162,836.10 less expensive than combination therapy (IDR 78,877,661.12). Conclusion Combination regimens are as effective as monotherapy regimens in reducing serum ferritin in pediatric β-thalassemia major patients. There is no differences of ADR between combination or monotherapy. The average cost per patient is less expensive with monotherapy compared to combination therapy.
Choline-deficient High-fat Diet-induced Steatohepatitis in BALB/c Mice Saut Horas Hatoguan Nababan; Seruni Tyas Khairunissa; Erni Erfan; Nafrialdi Nafrialdi; Ening Krisnuhoni; Irsan Hasan; Rino Alvani Gani
Molecular and Cellular Biomedical Sciences Vol 5, No 2 (2021)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v5i2.193

Abstract

Background: Non-alcoholic steatohepatitis (NASH) is an expanding cause of chronic liver disease worldwide, including Indonesia, with higher risk progression to cirrhosis and hepatocellular carcinoma. Preclinical experiments using several mice models have been conducted to clarify its complex pathogenesis. This study was designed to investigate whether BALB/c mice on a choline-deficient high-fat diet can be used as a model for NASH. Materials and Methods: BALB/c male mice were fed choline-deficient L-amino acid-defined high-fat diet (CDAHFD) or a standard diet for six weeks. The body and liver weights, liver histology, and plasma biochemistry were analyzed. The relative expression levels of tumor necrosis factor (TNF)α, transforming growth factor (TGF)β1, collagen-1α1 (COL1α1), glutathione peroxidase 1 (GPx1), and uncoupling protein 2 (UCP2) genes in the livers were analyzed using a two-step real time-polymerase chain reaction. Liver fatty acids composition was analyzed using gas chromatography with flame ionization detector (GC-FID). Results: CDAHFD induced steatohepatitis in BALB/c mice with increased plasma levels of alanine aminotransferase. The liver of CDAHFD-fed BALB/c mice showed upregulated relative expression levels of TNFα, TGFβ1, COL1α1, GPx1, and UCP2 genes. The liver fatty acid analysis showed a significant accumulation of saturated fatty acids (SFAs) and an increased ratio of n-6/n-3 polyunsaturated fatty acids (PUFAs) in the livers of CDAHFD-fed BALB/c mice. Conclusion: This study suggests that CDAHFD can induce steatohepatitis in BALB/c mice and therefore may be used as NASH mice model.Keywords: steatohepatitis, fatty liver, choline-deficient high fat diet, BALB/c 
Cardioprotective Effect of Quercetin in 5/6-Nephrectomized Rats: Focus on Myocardial fibrosis and Oxidative Stress Tri Yuliani; Melva Louisa; Wawaimuli Arozal; Vivian Soetikno; Nafrialdi Nafrialdi; Indah D Dewijanti
Jurnal Jamu Indonesia Vol. 2 No. 3 (2017): Jurnal Jamu Indonesia
Publisher : Tropical Biopharmaca Research Center, IPB University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (994.684 KB) | DOI: 10.29244/jji.v2i3.37

Abstract

Uremic cardiomyopathy is the leading cause of death in patients with chronic kidney disease. Fluid overload and oxidative stress play important roles in its pathogenesis. This study aims to determine the effect of quercetin on uremic cardiomyopathy in 5/6-nephrectomized rats. To our knowledge, its cardioprotective effect on uremic cardiomyopathy induced in rats by 5/6 nephrectomy has not been investigated yet. Uremia was induced surgically in male Sprague-Dawley rats via 5/6 nephrectomy. Quercetin was administered per orally at a dose of 100 mg/kg/day for 8 weeks prior to sacrifice. Meanwhile, captopril was administered at a dose of 10 mg/kg/day. Lipid peroxidation was assessed using TBARS reaction, while GPX activity was determined to explore the endogen antioxidant mechanism. Myocardial fibrosis was analyzed using Massons’ Trichrome staining and the level of NT-proBNP in plasma was measured as a marker of cardiac dysfunction. Nephrectomy 5/6 had no effects on plasma NT– proBNP levels, cardiac and plasma MDA levels, but induced mild myocardial fibrosis and significant increase in cardiac GPX activity in comparison with normal rat (p<0.05). However, administration of quercetin or captopril did not ameleriote those mild myocardial fibrosis and increased GPX activity. Uremic cardiomyopathy induced by 5/6 nephrectomy demonstrated mild myocardial fibrosis but preservation of cardiac function demonstrated by NT-proBNP levels. Increased of GPX activity in the nephrectomized-rats compared to the control rats (p<0.05) suggests induction of antioxidant defense mechanisms that might not be exhausted yet. This condition highlighted a compensatory phase which was unchanged following chronic administration of either quercetin or captopril.
Differential Effects of Albumin Infusion between ICU and Non-ICU Hypoalbuminemia Patients Mariana, Nina; Wijaya, Surya Oto; Setyawati, Rumaisah; Maemun, Siti; Nafrialdi, Nafrialdi
Pharmaceutical Journal of Indonesia Vol. 7 No. 1 (2021)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2021.007.01.3

Abstract

Background: Hypoalbuminemia is frequent among hospitalized patients and is associated with poor outcomes. ICU patients are widely associated with more severe condition making albumin correction seems to be less effective. This study was aimed to compare the results of albumin correction in ICU and non-ICU patients at Sulianti Saroso Hospital, Jakarta. Methods: A cross sectional study was conducted on adult patients in ICU and non-ICU wards who received intravenous albumin infusion at Sulianti Saroso hospital, between January 2013 to March 2018. Paired t-test was used to analyze the changes of albumin level before and after albumin infusion. Results: 123 ICU patients (41 sepsis, 82 non-sepsis) and 206 non-ICU patients (34 sepsis, 172 non-sepsis) who received 20% or 25% albumin infusions were included. Significant increase in albumin levels were observed in sepsis patients both in ICU and non-ICU, while in non-sepsis patients, the significant increase only observed in non-sepsis patients. Overall, mean increase in albumin levels in ICU-and non-ICU patients were 0.13 (0.63) g/dL vs 0.35(0.54) g/dL, respectively (P= < 0,001). Conclusion: Non-ICU patients show better response to albumin infusion compared to ICU patients. This difference is presumably due to different degree of inflammation. It is suggested that the quantity needed for albumin infusion is calculated differently according to clinical condition of the patients   
Andrographis paniculata Ethanolic Extract Improved Doxorubicin-induced Cardiac Inflammation, Alterations in Liver Function Parameters and Anemia Eziefule, Oluebube Magnificient; Arozal, Wawaimuli; Wanandi, Septelia Inawati; Louisa, Melva; Wuyung, Puspita Eka; Dewi, Syarifah; Nafrialdi, Nafrialdi; Dewi, Yulia Ratna; Nabillah, Deya Adiby
Molecular and Cellular Biomedical Sciences Vol 8, No 2 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i2.444

Abstract

Background: Doxorubicin (DOX), an efficacious chemotherapy drug is compromised by cardiotoxicity, myelosuppression, and hepatotoxicity. Due to the limited success of current treatments for DOX toxicity, there is a pressing need to explore alternative medical interventions, particularly from plant sources. This study was conducted to investigate the potential protective effect of ethanolic extract of Andrographis paniculata leaves (EEAP) against DOX-induced cardiac inflammation, liver toxicity, and anemia.Materials and methods: Sprague-Dawley rats were intraperitoneally injected with DOX at a total dose of 16 mg/kgBW. EEAP was administered orally for 4 weeks at doses of 125, 250, and 500 mg/kgBW/day according to the assigned treatment groups. The mRNA expression levels of interleukin-1β (IL-1β) and nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) in the heart tissue, along with the concentrations of nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) and calcium level were examined. Additionally, the hematological parameters (including hematocrit, hemoglobin and red blood cells (RBCs)), aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and malondialdehyde (MDA) levels in blood were also analyzed.Results: EEAP dose-dependently decreased the mRNA expressions of IL-1β (p<0.05), tended to decrease mRNA expression of NLRP3 and the concentrations of NFκB and calcium in heart tissue compared with the DOX-only group. Additionally, EEAP dose-dependently decreased ALP values (p<0.0001) and tended to improve hematological parameters, as well as AST and MDA levels in serum.Conclusion: This extract may prevent DOX-induced cardiac inflammation, anemia, and hepatotoxicity. However, further studies are needed to confirm these findings, including the efficacy profile of the extract in cancer rats treated with DOX.Keywords: doxorubicin, Andrographis paniculata, inflammation, anemia, hepatotoxicity, herbal medicine
Analisis Efektivitas Insulin Analog dan Human yang Digunakan pada Penderita Diabetes Melitus Tipe-2 dengan Biaya BPJS di RS. Islam Sukapura 2018 Zaim, Muhammad; Purwantyastuti, Purwantyastuti; Nafrialdi, Nafrialdi
Muhammadiyah Journal of Geriatric Vol 2, No 1 (2021): Muhammadiyah Journal of Geriatric
Publisher : Faculty of Medicine and Health Universitas Muhammadiyah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1713.384 KB) | DOI: 10.24853/mujg.2.1.17-26

Abstract

Latar Belakang: Insulin merupakan obat diabetes melitus tipe-2 terutama digunakan pada pasien yang sudah tidak responsif dengan obat oral. Dikenal 2 kelompok insulin yaitu insulin analog dan insulin human. Strategi pengobatan optimal  untuk pasien diberikan antidiabetik oral. Apabila kadar HbA1c 7%, dapat diberikan insulin atau antidiabetik oral monoterapi Tujuan: Tujuan penelitian ini adalah membandingkan efektifitas pengobatan menggunakan obat insulin analog dan insulin human di RS. Islam Sukapura dalam periode Januari– Desember 2018. Metode: Studi retrospektif ini dilakukan berdasarkan rekam medis pasien diabetes melitus tipe-2 yang berobat di poliklinik penyakit dalam RS.Islam Sukapura dalam periode Januari–Desember 2018. Uji statistic yang digunakan yaitu uji beda mann-whitney dan uji chi-square. Hasil: Dari 200 pasien terdapat 82 orang yang mendapatkan insulin human dan rata-rata selisih HbA1c awal dan akhir sebesar 1,40 %. Pada 118 pasien yang mendapatkan insulin analog, rata-rata selisih HbA1c awal dan akhir sebesar 1,34 %. Secara statistik tidak terdapat perbedaan bermakna antara rerata selisih HbA1c awal dan akhir pasien yang mendapatkan insulin human dan insulin analog (P=0,785). Efek samping insulin yang ditemukan seperti hipoglikemia sebesar 3,5% yang dapat terjadi pada pemberian Insulin dalam jangka waktu lama dan pada dosis yang besar. Simpulan: Tidak ada perbedaan yang bermakna secara statistik maupun klinik efektifitas insulin human dibandingkan insulin analog.