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All Journal e-CliniC JURNAL BIOMEDIK Heart Science Journal Narra J
Ira Posangi
Bagian Farmakologi Fakultas Kedokteran Universitas Sam Ratulangi Manado
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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EFEK EKSTRAK DAUN SIRSAK (ANNONA MURICATA L.) PADA KADAR KOLESTEROL TOTAL TIKUS WISTAR Posangi, Ira; Posangi, Jimmy; Wuisan, Jane
Jurnal Biomedik : JBM Vol 4, No 1 (2012): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.4.1.2012.750

Abstract

Abstract: Treatment using medicinal plants has already been applied before modern medicine. Soursop (Annona muricata L.) leaves have been used for the treatment of various diseases. The purpose of this study was to test whether the soursop leaf extract could lower the total cholesterol levels of wistar rats used as test animals. Prior to lowering the cholesterol levels, they first had to be raised, and to raise the level of total cholesterol, all test animals were induced by propyl thiouracyl (PTU). Rosuvastatin was used for positive control group F. Wistar rats were divided into six groups. Group A was the normal control group. Group B was given just PTU. Groups C, D, and E, after having been given PTU, were given respective doses of 50mg, 100mg, and 200mg/day of soursop leaf extract. Group F was given PTU and then rosuvastatin. The results showed that the total cholesterol levels in rats given soursop leaf extract or rosuvastatin were lower than rats that were not given soursop leaf extract or rosuvastatin. Conclusion: soursop leaf extract could lower the total cholesterol levels of wistar rats. Key words: soursop leaves, cholesterol Abstrak: Pengobatan menggunakan tanaman berkhasiat obat sudah lebih dulu diterapkan dari obat-obat modern. Daun sirsak telah digunakan untuk pengobatan bermacam penyakit. Tujuan penelitian ini untuk menguji apakah ekstrak daun sirsak dapat menurunkan kadar total kolesterol tikus wistar yang digunakan sebagai hewan uji. Untuk menaikkan kadar total kolesterol hewan uji diinduksi dengan PTU. Untuk kontrol positif digunakan rosuvastatin. Tikus wistar dibagi dalam 6 kelompok yang terdiri Kelompok A sebagai kontrol normal, Kelompok B diberikan PTU, Kelompok C, D, dan E diberikan PTU kemudian diberikan berturut-turut ekstrak daun sirsak dosis 50mg, 100mg, dan 200mg/hari, Kelompok F diberikan PTU kemudian rosuvastatin. Hasil penelitian menunjukkan kadar kolesterol total pada tikus yang diberikan ekstrak daun sirsak atau rosuvastatin lebih rendah daripada tikus yang tidak diberikan ekstrak daun sirsak atau rosuvastatin. Simpulan: ekstrak daun sirsak dapat menurunkan kadar total kolesterol tikus wistar.Kata kunci: daun sirsak, kolesterol
Pseudoaneurisma Arteri Brakialis Pasca Kateterisasi Laporan Kasus Polii, Natalia Ch.; Pangemanan, Janry A.; Panda, Agnes L.; Posangi, Ira
e-CliniC Vol 7, No 1 (2019): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v7i1.23109

Abstract

Abstract: Post-catheterization PSA occurs at the site of arterial puncture followed by incomplete hemostasis. We reported a 63-year-old male visited the emergency department of Prof Dr. R. D. Kandou Hospital with chief complaints of swelling and severe pain on the right arm, occured 6 days prior to the ER visit. His right arm looked darker and felt colder than the counterpart, felt numb, and was hard to move due to pain. Three months ago, the patient had a history of percutaneous transluminal coronary angiography through brachial artery access. Examination of the right upper extremity revealed hematoma at brachial artery puncture site, edema at 1/3 distal of the brachial region, cold acral areas, strong right brachial artery pulses, yet small radial ones. Vascular Doppler examination showed a superficial hematoma above the brachial artery and a PSA pouch of 1.23 x 1.67 cm with a small neck (<0.5 cm). Colour Doppler displayed a “yin and yang” flow at pouch, while pulsed-wave Doppler showed a “to and fro” wave through the neck. Patient was diagnosed as iatrogenic brachial artery pseudoaneurysm and managed with ultrasound-guided compression technique followed by continuous compression with elastic bandage. This technique was selected due to the PSA size less than 3 cm yet symptomatic, small neck size (<1 cm), and no size progression. Patient discharged after the PSA pouch and neck shrinked. On 6 months follow-up, neither neck nor pseudoaneurysm pouch were found.Keywords: pseudoaneurysm, ultrasound-guided compression Abstrak: PSA pasca kateterisasi terjadi pada arteri yang dipungsi tetapi tidak terjadi hemostasis sempurna. Kami melaporkan seorang laki-laki berusia 63 tahun datang di Instalasi Rawat Darurat Medik RSUP Prof. Dr. R. D. Kandou dengan keluhan utama bengkak dan nyeri hebat pada lengan kanan sejak 6 hari SMRS dan memberat pada satu hari terakhir. Tangan kanan tampak lebih gelap dibandingkan tangan kiri, teraba dingin, terasa kebas dan sulit digerakkan karena nyeri. Tiga bulan sebelumnya pasien dilakukan tindakan intervensi koroner perkutan. Pada pemeriksaan ekstremitas atas kanan tampak hematoma di daerah pungksi, edema setinggi 1/3 distal regio brachialis sampai ujung jari, akral teraba dingin, pulsasi arteri brakialis teraba kuat tetapi arteri radialis teraba kecil. Pemeriksaan Doppler vascular mendapatkan gambaran hematoma superfisial dari arteri brakialis dan tampak kantong PSA berukuran 1,23x1,67 cm dengan neck berukuran kecil (<0,5 cm) Pada colour Doppler didapatkan aliran pada kantong pseudoaneurisma seperti gambaran yin dan yang. Pada pulsed-wave Doppler di saluran PSA (neck) didapatkan gelombang “to and fro”. Berdasarkan anamnesis, pemeriksaan fisik dan penunjang pasien ini didiagnosis dengan PSA arteri brakialis iatrogenik (pasca kateterisasi). Penanganan dengan ultrasound-guided compression dan dilanjutkan dengan kompresi kontinu dengan bebat elastik. Pemilihan teknik kompresi ini berdasarkan pada ukuran kantong <3 cm namun bergejala, ukuran neck kecil <1cm serta tidak didapatkan pembesaran progresif. Pasien dipulangkan setelah kantong maupun neck PSA tampak mengecil, dan 6 bulan setelahnya tidak lagi terlihat neck maupun kantong PSA.Kata kunci: pseudoaneurisma, ultrasound-guided compression
Redefining treatment paradigms: Early use of dapagliflozin and empagliflozin in acute heart failure – a systematic review and meta-analysis of randomized controlled trials Immanuel, Surya S.; Yonatan, Eric R.; Tandecxi, Gabriel; Anthony, Clifford P.; Chan, Janice Z.; Sunardi, Andrew EP.; Posangi, Ira; Bandana, Victor
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1833

Abstract

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have proven to significantly reduce mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF). Supported by the 2023 European Society of Cardiology (ESC) guidelines and the safety, tolerability, and efficacy of rapid optimization of heart failure (STRONG-HF) trial, SGLT2i offer improved outcomes with a favorable safety profile, emphasizing their pivotal role in HFrEF management. The aim of this study was to evaluate early initiation with dapagliflozin and empagliflozin, focusing on their efficacy and safety in acute heart failure (AHF). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven databases for randomized controlled trials on SGLT2i in AHF (2019–2024). Outcomes included all-cause mortality, heart failure (HF)-related events, all-cause rehospitalization, length of hospital stay, diuretic response, serum electrolytes, and adverse events (AEs). The Cochrane Risk of Bias 2 tool was used. Data were analyzed using a random-effects model and presented as standardized mean differences and risk ratios with 95% confidence intervals. A subgroup analysis was conducted based on intervention. Nine studies encompassing 1,417 patients with a generally low risk of bias were included. Initiating SGLT2i within five days of admission significantly reduced in-hospital all-cause mortality risk by 42% and in-hospital worsening HF during rehospitalization by 39%. SGLT2i also significantly reduced serious AEs risk by 27%. No significant differences were found in other outcomes, including specific AEs (acute kidney injury, hepatic injury, symptomatic hypotension, hypoglycemia, urinary tract infections, and diabetic ketoacidosis). The analysis showed homogeneity, with no significant differences between SGLT2i. The study highlights that initiating SGLT2i within five days of admission significantly reduces all-cause mortality and worsening HF during rehospitalization, with a better safety profile than placebo.
Unmasking brugada syndrome: Baseline r′-wave triangle base duration and beta-angle in oral flecainide challenge positivity Raharjo, Sunu Budhi; Posangi, Ira; Hanafy, Dicky Armein; Hermanto, Dony Yugo; Waliyuddin, Ridwan Rasyid; Balqis, Indira Aura; Lin, Chin-Yu; Yuniadi, Yoga
Heart Science Journal Vol. 7 No. 4 (2026): Navigating High-Risk Cardiovascular Subsets: Premature Disease, Plaque Complexi
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.04.10

Abstract

Background: Electrocardiographic markers, including the r′-wave triangle base duration and beta-angle, have been proposed as adjunctive indicators of Brugada syndrome (BrS). As flecainide challenge testing (FCT) carries potential risks, baseline ECG predictors may refine pre-test risk stratification, although their relationship with oral flecainide challenge positivity remains uncertain.Objective: To evaluate whether baseline r′-wave triangle base duration and beta-angle were associated with FCT positivity.Methods:  This retrospective, single-center review included consecutive patients who underwent oral flecainide challenge within a historical institutional diagnostic pathway between September 2023 and September 2025. Baseline right-precordial ECG measurements, including r′-wave triangle base duration and beta-angle, were obtained from archived standard 12-lead tracings. The primary outcome was FCT positivity, defined as the emergence of a diagnostic type 1 Brugada patternResult: Among 40 included patients, 28 had a positive oral flecainide challenge result and 12 had a negative result.  In exploratory analyses, larger baseline β-angle and longer r′-wave triangle base duration were associated with oral flecainide challenge positivity. Mean β-angle was 36.07° ± 15.86° in positive versus 21.83° ± 10.72° in negative challenges (p=0.007); mean r′-wave triangle base duration was 161.6 ± 92.8 ms versus 81.6 ± 38.0 ms, respectively (p<0.001).  ROC analysis showed moderate discriminatory performance (AUC 0.756 for β-angle, 0.769 for r′-wave). Sample-derived thresholds of 27.5° and 2.625 mm (105 ms) yielded sensitivity of 71.4% and specificity of 83.3%. A combined model incorporating both parameters showed an AUC of 0.780 (95% CI, 0.635–0.924), with 75.0% sensitivity and 83.3% specificity at the Youden-optimal threshold. Conclusion: Baseline r′-wave triangle base duration and beta-angle were associated with FCT positivity. These findings support further prospective investigation using standardized ECG acquisition and contemporary provocation protocols.
Co-Authors Agnes L. Panda Anthony, Clifford P. Balqis, Indira Aura Bandana, Victor Chan, Janice Z. Dicky Armein Hanafy Hermanto, Dony Yugo Immanuel, Surya S. Jane Wuisan Janry A. Pangemanan Jimmy Posangi Lin, Chin-Yu Polii, Natalia Ch. Sunardi, Andrew EP. Sunu Budhi Raharjo Tandecxi, Gabriel Waliyuddin, Ridwan Rasyid Yoga Yuniadi Yonatan, Eric R.