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"ABSTRAKSecondary iron overload pada thalassemia mayor terjadi karena eritropoiesis inefektif dan tranfusi berkala. Besi melebihi transferin sehingga banyak non transferin bound iron NTBI yang mengkatalisasi terjadinya ion radikal bebas yang merusak jaringan. Pengendapan besi pada saluran cerna mengakibatkan perubahan fungsi, kerusakan organ, gangguan ketersediaan asam amino. Iron overload dikurangi dengan kelasi besi. Transferin merupakan kelator alami tubuh terdiri asam amino dominan alanin, leusin, glisin, asam aspartat. Berdasarkan penelitian, pasien iron overload memiliki transferin lebih rendah dibandingkan non iron overload. Penelitian bertujuan mengetahi perubahan status besi, profil asam amino dan hubungan iron overload dengan profil asam amino. Parameter yang diteliti : besi serum, unsaturated iron binding capacity UIBC , total iron binding capacity TIBC , feritin, saturasi transferin, indeks transferin, alanin, leusin, glisin, asam aspartat. Desain penelitian kohort dengan 21 subjek, yaitu 13 thalassemia beta mayor dan 8 thalassemia beta HbE. Hasil penelitian didapatkan perubahan status besi bermakna yaitu peningkatan feritin pasca transfusi, penurunan feritin pasca kelasi 1 bulan, peningkatan kadar besi pasca kelasi 3 bulan. Perubahan asam amino bermakna yaitu penurunan alanin, leusin, serta peningkatan glisin pasca kelasi 1 bulan Terdapat hubungan kuat, bermakna searah antara indeks transferin dan alanin pre transfusi. Terdapat hubungan kuat, bermakna, searah antara indeks transferin dengan alanin dan glisin pasca transfusi.

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ABSTRACTSecondary iron overload in thalassemia major occurs due to ineffective erythropoiesis and periodic transfusions. The excess of iron exceed transferrin so there are many non transferrin bound iron NTBI that induce tissue damaging free radical ion. Accumulation of iron in intestine can lead to changes in the function, organ damage, lack of amino acid availability. Iron overload can be reduced by iron chelation. Transferrin is the body 39 s natural chelator comprising of dominant amino acid alanine, leucine, glycine, aspartic acid. Research found that transferrin were lower in iron overload patients. This study aims to acquire the changes of iron status, amino acid profile, and correlation between iron overload and amino acid profile. Studied parameter were serum iron, unsaturated iron binding capacity UIBC , total iron binding capacity TIBC , ferritin, transferrin saturation, transferrin index, alanine, leucine, glycine, aspartic acid. The study design were cohort with 21 subjects consisted of 13 beta major thalassemia and 8 beta Hbe thalassemia. The result showed significant iron status changes ferritin increased post transfusion, ferritin decreased after 1 month chelation and serum iron increased after 3 months chelation. Significant amino acid profile changes decreased of alanine and leucine, and glycin increased after 1 month chelation. There rsquo s significant correlation between transferrin index and alanine pre transfusion. There rsquo s significant correlation between transferrin index and alanine, glycine after 3 month chelation. "

"Latar belakang: Indonesia dihadapkan pada masalah stunting yang cukup tinggi. Anak yang menderita stunting memiliki konsentrasi asam amino esensial yang lebih rendah. Mechanistic Target of Rapamycin Complex 1 (mTORC1) sebagai jalur utama regulasi pertumbuhan yang sensitif terhadap asam amino, mempromosikan sintesis protein melalui S6K1 dan 4EBP1. Penelitian ini bertujuan menganalisis keterlibatan asam amino esensial pada kadar mTORC1, S6K1, dan 4EBP1 dan korelasinya dengan kejadian stunting. Metode: Desain penelitian adalah kasus-kontrol. Anak berusia 6-24 bulan di Provinsi Sumatera Selatan diambil secara cluster random sampling berjumlah 137 orang. Pengumpulan data menggunakan kuesioner dan pengukuran antropometri. Pemeriksaan feses secara makroskopis dan mikroskopis, pemeriksaan darah dengan teknik LC-MS dan ELISA. Hasil: Terdapat perbedaan bermakna dalam hal usia anak, panjang badan lahir, BB/U, dan LK/U. Tidak ditemukan perbedaan makroskopis dan mikroskopis feses di antara kedua kelompok. Asam amino triptofan berbeda bermakna (p=0,004) dan berhubungan dengan kejadian stunting (p=0,045). Kadar mTORC1 dengan S6K1 dan 4EBP1 tidak berbeda pada kedua kelompok. Kadar mTORC1 tidak berhubungan dengan kejadian stunting. Kadar asam amino lisin berhubungan bermakna dengan kadar mTORC1 (p=0,003). Kadar mTORC1 berhubungan bermakna dengan kadar S6K1 dan 4EBP1 (masing-masing p<0,001). Simpulan: Asam amino esensial berimplikasi pada kejadian stunting dan kadar mTORC1, mTORC1 memengaruhi kadar S6K1 dan 4EBP1 anak.

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Background: Indonesia is faced with a fairly high stunting problem. Children who suffer from stunting have lower concentrations of essential amino acids. The Mechanistic Target of Rapamycin Complex 1 (mTORC1) as the main pathway of growth regulation that is sensitive to amino acids, promotes protein synthesis through S6K1 and 4EBP1. This study aims to analyze the involvement of essential amino acids in mTORC1, S6K1, and 4EBP1 levels and their correlation with stunting. Methods: The study design was a case-control study. Children aged 6-24 months in South Sumatra Province were taken using cluster random sampling totaling 137 people. Data collection used questionnaires and anthropometric measurements. Macroscopic and microscopic examination of feces, and blood examination using LC-MS and ELISA techniques. Results: Significant differences were in child age, birth length, BB/A, and LK/A. There were no macroscopic and microscopic differences in feces between the two groups. Tryptophan amino acids were significantly different (p=0.004) and associated with stunting (p=0.045). mTORC1 levels with S6K1 and 4EBP1 were not different in both groups. mTORC1 levels were not associated with stunting. Lysine amino acid levels were significantly associated with mTORC1 levels (p=0.003). mTORC1 levels were significantly associated with S6K1 and 4EBP1 levels (each p<0.001). Conclusion: Essential amino acids are implicated in stunting and mTORC1 levels, and mTORC1 affects children's S6K1 and 4EBP1 levels."

"ABSTRAKPada lanjut usia terjadi penurunan massa dan kekuatan otot yang memengaruhikapasitas fungsional sehingga meningkatkan risiko sarkopenia. Salah satu faktor yang dinilai dapat memengaruhi penurunan massa dan kekuatan otot pada lansia adalah menurunnya asupan protein dan asam amino rantai cabang (AARC) sehingga akan memengaruhi status protein viseral terutama prealbumin. Tujuan penelitian ini adalah untuk menilai hubungan antara asupan protein, AARC dan kadar prealbumin dengan kekuatan otot pada lansia. Metode penelitian ini adalah studi potong lintang pada 52 lansia dari bulan April-Mei 2016. Data asupan makanan yang meliputi asupan energi, kalori non protein, protein dan AARC didapatkan dari food record 2x24 jam. Pengambilan darah dilakukan setelah subjek berpuasa ± 8 jam dan pengukuran kekuatan otot dengan handgrip dynamometer merk Jamar. Hasil penelitian menunjukan tidak terdapat korelasi yang signifikan antara kekuatan genggam tangan dengan asupan protein (r=0,21 dan p=0,11), asupan AARC (r=0,18 dan p=0,19), dan kadar prealbumin serum (r=-0,05 dan p=0,69). Kesimpulan dari penelitian ini didapatkan bahwa asupan protein yang rendah tetapi disertai dengan asupan energi dan AARC yang cukup akan memengaruhi kadar prealbumin serum dan kekuatan otot tetap berada pada nilai normal, walaupun tidak ditemukan hubungan yang bermakna secara statistik.

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ABSTRACTThe decrease of muscle mass and strength in elderly people will affect thefunctional capacity and increase the risk of sarcopenia. One factor that can affect the loss of mass and muscle strength in elderly is the decrease in protein and branched chain amino acids (BCAA) intakes. This will affect the visceral protein status, especially prealbumin. The purpose of this study is to assess the association between intake of protein, BCAA and serum prealbumin level with muscle strength in elderly people. The methodology of this research is a cross-sectional study with 52 elderly people from April-May 2016. Food intake include energy, non-protein calorie (NPC), protein, and BCAA which is obtained from 2x24 hours food records. Blood sampling was performed after the subjects fasted for ± 8 hours, and muscle strength was measured with a Jamar's handgrip dynamometer. The results show there are no correlation between protein intake with the hand grip strength (r = 0,21 and p = 0,11), as well as AARC intake (r = 0,18 and p = 0,19) and prealbumin serum level (r = -0,056 and p = 0,69). This study concludes that low protein intake but accompanied with sufficient energy intake and BCAA will affect serum prealbumin level and muscle strength will be remained at normal values, however a statistically significant relationship is not found."

"Leukemia limfoblastik akut adalah penyakit keganasan hematologi yang paling sering ditemukan pada anak. Perubahan metabolisme pasien kanker dan pengobatan kemoterapi menyebabkan pasien mengalami anoreksia sehingga dapat mengakibatkan pasien mengalami malnutrisi. Kondisi tersebut dapat menurunkan respons terhadap terapi, rendahnya kualitas hidup, dan tingginya mortalitas. Terapi medik gizi yang adekuat diperlukan untuk mendukung proses penyembuhan anak dengan pasien kanker. Asam amino rantai cabang (AARC) merupakan salah satu zat gizi spesifik yang dapat memperbaiki asupan makan dengan cara berkompetisi dengan triptofan pada transporter di otak pada mekanisme lapar-kenyang sehingga menurunkan efek anoreksigenik. Penelitian sebelumnya menunjukkan efek positif pemberian AARC terhadap asupan makan dan menurunkan kadar triptofan bebas di otak pada pasien kanker. Serial kasus ini memaparkan tiga pasien laki-laki dan satu pasien perempuan, berusia 8-14 tahun dengan malnutrisi, mengalami penurunan asupan makan, dan peningkatan kadar inflamasi. Seluruh pasien mendapatkan terapi medik gizi sejak awal perawatan hingga sebelum pulang dari rumah sakit. Pemberian energi dan protein sesuai fase pada penatalaksanaan gizi buruk dan AARC yang berasal dari bahan makanan sumber serta makanan cair. Asupan energi tertinggi pasien kasus sebesar 54-140 kkal/kgBB dan asupan protein tertinggi sebesar 2-4,7 g/kgBB dengan AARC tertinggi sebesar 8,9-23,4 g. Terdapat penurunan kadar inflamasi pada seluruh pasien kasus. Skala lapar-kenyang terendah sebelum makan 2 dan setelah makan 5, perbaikan tingkat lapar-kenyang pada seluruh pasien kasus diikuti dengan peningkatan jumlah asupan. Satu orang pasien mengalami penurunan berat badan, dua orang tetap, dan satu orang mengalami peningkatan berat badan. Terapi medik gizi yang adekuat dengan pemberian AARC dapat menunjang keberhasilan pengobatan pasien anak malnutrisi dengan lekemia limfoblastik akut yang menjalani kemoterapi.

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Acute lymphoblastic leukemia is the most common hematological malignancy in children. Metabolic changes in cancer patients and chemotherapy cause patients to experience anorexia which can increase the risk of malnutrition. These conditions can reduce the response to therapy, lower quality of life, and high mortality. Adequate nutritional management is needed to support the healing process of children with cancer patients. Branched-chain amino acids(BCAA) are specific nutrients that can improve calorie intake by competing with tryptophan on transporters in the brain on the hunger-satiety center, thereby reducing anorexigenic effects. Previous research has shown a positive effect of BCAAs on improving calorie intake and reducing levels of free tryptophan in the brain in cancer patients. This case series describes three male and one female patient, aged 8-14 years, malnutrition, decreased calorie intake, and inflammation. All patients received medical nutrition therapy from early treatment until before leaving the hospital. Provision of energy and protein according to the phase in the management of malnutrition and specific nutrients, BCAAs derived from food and liquid food. The highest energy intake of patients in the case of 54-140 kcal/kg BW, and the highest protein intake of 2-4.7 g/kg BW with the highest AARC of 8.9-23.4 g. All patients experienced a reduction in inflammation. The level of hunger-satiety is 2 before eating, and it is 5 thereafter. In all cases, patients increase their intake after experiencing improvements in their hunger-satiation levels. Two patients' weights remained the same, one gained weight, and one patient lost weight. Adequate nutritional therapy and AARC supplementation can support the successful treatment of malnourished pediatric patients with acute lymphoblastic leukemia on chemotherapy."

"Kasus gagal ginjal akut misterius yang berkaitan dengan cemaran etilen glikol dan dietilen glikol menjadi pencetus bagi BPOM agar semakin ketat dalam melakukan pengawasan terhadap industri farmasi untuk memenuhi pedoman CPOB dengan mewajibkan setiap industri farmasi melakukan verifikasi metode analisis terhadap kompendial terbaru, tidak terkecuali PT Finusolprima Farma Internasional. Namun, untuk melakukan verifikasi metode analisis dalam waktu yang singkat sesuai batas waktu yang ditetapkan oleh BPOM, diperlukan suatu protokol untuk mempermudah analis dalam melakukan verifikasi. Pembuatan tugas khusus ini dilakukan melalui penyusunan protokol verifikasi metode analisis terhadap bahan baku di PT Finusolprima Farma Internasional, salah satunya adalah glisin, agar salah satu aspek CPOB yaitu verifikasi metode analisis dapat terpenuhi. Protokol verifikasi metode analisis glisin disusun mengacu pada Farmakope Indonesia VI dan menggunakan poin poin berisi kalimat perintah serta dibuat dalam bahasa inggris untuk mempermudah analis dalam melakukan verifikasi. Terdapat delapan parameter uji yang dilakukan menurut FI VI yaitu identifikasi, susut pengeringan, sisa pemijaran, klorida, sulfat, logam berat, senyawa terhidrolisis, dan penetapan kadar. Kedelapan parameter uji ini dibagi ke dalam 3 poin sesuai dengan ketentuan CPOB yaitu: uji identifikasi, uji impuritas, dan penetapan kadar. Protokol verifikasi metode analisis bahan baku glisin telah disusun mengikuti spesifikasi dan metode analisis yang dicantumkan oleh Farmakope Indonesia VI sehingga protokol ini dapat diterapkan dengan mudah oleh analis dalam proses verifikasi metode analisis glisin di PT Finusolprima Farma Internasional.

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The mysterious case of acute renal failure related to ethylene glycol and diethylene glycol contamination became the trigger for the Indonesian Drug and Food Control Agency (BPOM) to tighten its supervision of the pharmaceutical industry, ensuring compliance with the Good Manufacturing Practices (GMP) guidelines. One of the measures taken is to mandate all pharmaceutical industries, including PT Finusolprima Farma Internasional, to verify their analytical methods against the latest compendial standards within the set time limit by BPOM. To achieve this verification within the given timeframe, a protocol is needed to facilitate the analysts in conducting the verification process. This specific task focuses on developing a protocol for the analysis method verification of raw materials at PT Finusolprima Farma Internasional, particularly for glycine, to meet one of the aspects of GMP, which is the verification of analytical methods. The protocol for the analysis method verification of glycine refers to the Indonesian Pharmacopoeia VI (FI VI) and is presented in English to ease its implementation by the analysts. It encompasses eight test parameters according to FI VI, namely identification, loss on drying, residue on ignition, chloride, sulfate, heavy metals, hydrolyzable substances, and assay. These eight parameters are categorized into three points in compliance with GMP requirements, which are identification test, impurity test, and assay determination. The developed protocol adheres to the specifications and analytical methods outlined in the Indonesian Pharmacopoeia VI, ensuring its straightforward application in the verification process of glycine analysis at PT Finusolprima Farma Internasional."