Intracranial pressure is the total amount of pressure exerted by the brain, blood and cerebrocinal fluid in the rigid cranial space. Compliance is an indicator of the brain's tolerance for increased ICP, when compliance is exceeded, there will be a dramatic increase in the pressure/volume curve so that ICP will increase rapidly. In the injured brain, cerebral blood flow (CBF) is regulated to supply sufficient oxygen and substrates to the brain. Certain physiological factors such as hypercarbia, acidosis and hypoxemia cause vasodilation which causes an increase in CBF, seizure activity and fever will increase the level of brain metabolism and CBF. Cerebral edema is the most common cause of non-traumatic brain injury such as central nervous system infections, metabolic and systemic encephalopathy. Vasogenic brain edema occurs due to injury to the blood-brain barrier and increased capillary permeability in the area around the injury, or to inflammation, especially in CNS infections. Medical management of elevated intracranial pressure includes sedation, cerebrospinal fluid drainage, and osmotherapy with either mannitol or hypertonic salts.
Background: Gambir (Uncaria gambir) is empirically used to treat abdominal pain and vomittus caused by gastritis because of its anti-inflammatory effects, especially flavonoid. This study aims to determine the effect of active gambir fraction on TNF-α protein expression and wound size in white rats gastritis model. Methods: The research method used experimental study design in vivo with post test with control group design. Rats were divided randomly in 11 groups and were induced to be gastritis for 1 day. Group 1 (negative control) was given aquadest of 5 mL, group 2 (positive control) was administered ranitidine 10 mg/kgBW, groups 3, 4, and 5 were given n-hexane fraction, groups 6, 7 and 8 were given a water fraction, and groups of 9, 10, and 11 were given ethyl fractions with each group receives dose of 20, 40, and 80 mg/kgBW and all groups were treated for 3 days. Rats were dissected on 5th day for examination of gastric mucosal lesion size and performed ELISA expression of TNF-α expression of gastric mucosal tissue. The results of this study were assayed by SPSS 18. Results: The result of the research using Kruskal-Wallis test showed that there were significant differences (p <0.05) of the lesions size between the sample groups where control positive, ethyl fraction 20, 40, 80 mg/kgBW, and water fraction 20, 40 mg/kgBB had the gastric ​​mucosal lesion size differed significantly with the negative control group, while the TNF-α protein expression test using Kruskal-Wallis showed that there was a significant difference (p <0.05) TNF-α levels of all groups against the negative control. Conclusion: Active gambir fraction had a potention to reduce size of mucose gaster lesion and reduce expression of TNF-α protein. Keywords: Gambir – TNF-α – antiinflamatory – gastiritis
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