Endang Susalit

Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: Comparison with Captopril

A double-blind, randomized, parallel and active-controlled clinical study was conducted to evaluate the anti-hypertensive effect as well as the tolerability of Olive leaf extract in comparison with Captopril in patients with stage-1 hypertension. Additionally, this study also investigated the hypolipidemic effects of Olive leaf extract in such patients. It consisted of a run-in period of 4 weeks continued subsequently by an 8-week treatment period. Olive (Olea europaea L.) leaf extract (EFLA(®)943) was given orally at the dose of 500 mg twice daily in a flat-dose manner throughout the 8 weeks. Captopril was given at the dosage regimen of 12.5 mg twice daily at start. After 2 weeks, if necessary, the dose of Captopril would be titrated to 25 mg twice daily, based on subjects response to treatment. The primary efficacy endpoint was reduction in systolic blood pressure (SBP) from baseline to week-8 of treatment. The secondary efficacy endpoints were SBP as well as diastolic blood pressure (DBP) changes at every time-point evaluation and lipid profile improvement. Evaluation of BP was performed every week for 8 weeks of treatment; while of lipid profile at a 4-week interval. Mean SBP at baseline was 149.3±5.58 mmHg in Olive group and 148.4±5.56 mmHg in Captopril group; and mean DBPs were 93.9±4.51 and 93.8±4.88 mmHg, respectively. After 8 weeks of treatment, both groups experienced a significant reduction of SBP as well as DBP from baseline; while such reductions were not significantly different between groups. Means of SBP reduction from baseline to the end of study were -11.5±8.5 and -13.7±7.6 mmHg in Olive and Captopril groups, respectively; and those of DBP were -4.8±5.5 and -6.4±5.2 mmHg, respectively. A significant reduction of triglyceride level was observed in Olive group, but not in Captopril group. In conclusion, Olive (Olea europaea) leaf extract, at the dosage regimen of 500 mg twice daily, was similarly effective in lowering systolic and diastolic blood pressures in subjects with stage-1 hypertension as Captopril, given at its effective dose of 12.5-25 mg twice daily.

A 3-Year Survival Rate of Kidney Transplant Recipient in Cipto Mangunkusumo General Hospital in Indonesia

The highly-dosed infusion with Procaine-HCl with sodium-bicarbonate as additive was firstly published twenty years ago. The method advanced to a routine in many centers for pain treatment, rehabilitation and natural medicine. The aim of the procedure is the systemic use of the various pharmacological features of Procaine, especially to inhibit pain and inflammation, for vasodilatation, anti-oxidation and to harmonize the vegetative nervous system. On one hand shall the addition of sodium-bicarbonate balance the common latent pH-decrease in the periphery. On the other hand also the degradation products of Procaine (DAE and PABA) have a systemic effect. For the safety of the patients and to improve the success rate of the method it was shown that the classic Procaine-Base-infusion should be only realized on the base of a prior acid-base-diagnostic. Review Article Citation: Ralf Oettmeier, Uwe Reuter. The Procaine-Base-Infusion: A Review after Twenty Years of Use. J Med Clin Res & Rev. 2017;F Pyrophosphate Citrate (FPC) is a novel, highly soluble iron salt for parenteral delivery via hemodialysis solution. FPC donates iron directly and rapidly to transferrin, avoiding iron sequestration in the reticuloendothelial system. Randomized, placebo-controlled clinical trials in chronic hemodialysis (CKD 5HD) patients have demonstrated that FPC delivery by hemodialysis can maintain iron balance by replacing regular iron losses, while reducing ESA use and maintaining hemoglobin (Hgb). In the double-blind PRIME study, 104 iron replete (serum ferritin, 20Background: Kidney transplant has been developing rapidly in Indonesia in recent years. Cipto Mangunkusumo General Hospital (CMGH) has performed 491 transplants in the last 6 years. The survival of graft and patient in CMGH in the first year was 95.4% and 88.5%. However, there was no data on survival in the next following years. This study was aimed to establish the 3-year survival of graft and patient of kidney transplant in CMGH. Methods and findings: Descriptive study with retrospective cohort design on all kidney transplant patients at CMGH from January 2011 to May 2014. Each patient was observed from the date of transplantation until death or May 2017. Graft and patient survival rate within 3 years and at the end of the study were documented. The Kaplan-Meier method was used to describe graft and patient survival. 138 of 147 kidney transplant recipients were included. All patients receive kidneys from living donors. The mean age was 47.94 + 14.06 years old. The 3-year death-censored graft survival, all-cause graft survival and patient survival were 90.6%, 76.1% and 79.7%, in sequence. At the end of the study, these survival rates were lower (89.1%, 71.7%, and 76.1%). The median of observation time was 42 months (36-72 months). Kaplan-Meiers curve showed the highest mortality rates occurred in the early months. Infection was the main cause of death. Conclusion: The 3-year graft and patient survival in CMGH 90.6% and 79.7%. Infection is the major factor that affects the survival rates.

The Change of Circadian Pattern of Blood Pressure in Patients with Chronic Kidney Disease Before and After Kidney Transplantation in Cipto Mangunkusumo Hospital

Background: Circadian pattern of blood pressure (BP) is a 24 hours BP curve. Decreasing of BP 10–20% at night is called a dipper, while less than 10% a nondipper. Prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. Kidney transplantation will improve BP and nondipper. Objective: To determine the change of dipper and nondipper, and the mean of 24 hours BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. 15 subjects CKD 5D before kidney transplantation, age 16–60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 24 hours BP measurement were recorded with 24 hours Ambulatory Blood Pressure Monitoring in all subjects, before and one month after kidney transplantation. McNemar and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 subjects were nondippers and 3 subjects were dippers. One month after kidney transplantation, all subjects (15) became nondippers. The decreasing of the mean of 24 hours systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p > 0.05), while decreasing of the mean of 24 hours diastolic BP was statistically significant (p < 0.05). Conclusion: There were still no improvement in nondipper. There were a decrease in the mean of 24 hours systolic BP but not significant and a decrease in the mean of 24 hours diastolic BP significantly in patients one month after kidney transplantation.