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Erwin Saspraditya

Erwin Saspraditya

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Erwin Saspraditya

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  1. Erwin Saspraditya THE ROLE OF OMEGA 3 (n-3) LONG CHAIN POLYUNSATURATED FATTY ACID (LCPUFA) FOR FRACTURE HEALING IN RATTUS NOVERGICUSGALUR SPRAGUE-DAWLEY

  2. Background • Incidence (WHO ,2004): • Increasing number of traffic accident • World health problem • Indonesian Ministry of Health ( 2005): • Health problem in indonesia • Cause of death at 6th most common

  3. Increasing number of traffic aciident will effect to increase the incedence of fracture( praemer, 1999) • It will become challenge for orthopaedic surgeon  bone healing

  4. OMEGA 3 LCPUFA • Its help to encourage intelligency of child during growth • Its Cheap !!!

  5. Function of Omega 3 ( werkman, 1996)( Hoffman, 2000) : • Decresasing cardiovascular disease • Brain development • Reducing cancer risk • Bone health ?? • Watkins (2003): • Omega 3 has benefit in osteoporosis case • Inhibit osteoclast activity , enhance osteoblastic acitvity

  6. How about fracture case????? • Lack of information about role of omega 3 with fracture case

  7. Problem • Does Consuming Omega 3 (n-3) LCPUFA increased number of osteoblast cell production and level of CbFA 1 during fracture healing? • Does taking high dose omega 3 (n-3) LCPUFA increased number of osteoblast cell production and level of CbFA 1 during fracture healing?

  8. Objectives • General • To revealed the effect of omega 3 (n-3) LCPUFA in bone healing

  9. Spesific: • To know the effect of taking omega 3 (n-3) LCPUFA in number of osteoblast cells production and CbFA 1 serum level • To know the effect of taking high dose omega 3 (n-3) LCPUFA will influence number of osteoblast cell production and CbFA 1 serum level

  10. Purpose of Research Theoretical • Provide data on the effect of omega 3 (n-3) LCPUFA on bone healing in fracture case Clinical • This study is expected to be the basic data to support therapy in patients with fracture to get bone healing Methodological • This study can be used as a reference for further research aboutrole of omega 3 LCPUFA in bone healing

  11. Literature Review • Fracture is a break in the structural continuity of bone ( appley, 2010) • Phase on bone healing ( Kan, 2001)(Dimitriou, 2005): • Inflammation Phase • Cartilage forming phase and periosteal response • Bone formation • Remodeling

  12. Prostaglandin (PG) • PGs are lipid, arachidonic acid derived mediators • PG which include PGE2 and PGE4 • PGE2 has a role in bone healing (Li et al, 2007) (Xie et al. 2009)

  13. Omega 3 Polyunsaturated Fatty Acid • Omega 3 polyunsaturated fatty acids (PUFA) include within essential fatty acid because it can’t be synthesized within body • Derived from α-linolenic acid (ALA)  converted into eicosapentaenoic acid (EPA) dandocosahexaenoic acid (DHA)

  14. Pharmacological Effect of n-3 LCPUFA • Anti Cancer (watkins, 2003) • Anti cardiovascular disease ( Guiterrez, 2006) • Anti osteoporotic ( Garrison, 2010) • Omega 3 in bone formation • Incresing osteoblast proliferation and alkaline fosfatase ( Garrison,2010) • Influence on osteoblastogenesis process ( watkins, 2003)

  15. Role Of n-3 for PG secretion • Giving positive effect on PG modulation (Watkins, 2003)

  16. Theoretical Frame (Haversath et al, 2012)

  17. Conceptual Frame

  18. Hypotheses • Consumption of n-3 in fracture case will increase number osteoblast cell production and level CbFA 1 • Higher dose dietary intake of n-3 on fracture case that would increased osteoblast cell production and level of CbFA 1

  19. Study Design • Randomissed Post-test only group design • P : Population ( male white rat) • S :Sampel (male white rat) • R :Randomized (male white rat) • A1,A3, A5 :Intramedulary nail( K-Wire) on Femur  Fractured on Shaft Femur • P0 : Control Group without given omega 3 • P1 : First treatment group given omega 3 orally 40mg/kg/day for 4 weeks • P2 :Second treatment group given omega 3 orally 60 mg/kg/day for 4 weeks

  20. Research Schema

  21. Result • Mean level of CbFA 1 in serum is higher in first and second group treatment compare with control • Mean level of CbFA 1 in serum is not much different between first and second group treatment

  22. Mean number of Osteoblast cell is higher in first and second group treatment compare with control • Mean number of osteoblast cell is not much different between first and second group treatment

  23. Histological examination (200x) showed that number osteoblast cell is higher on first group treatment (B) and second group treatment (C) compare with control group (A).

  24. Inferensial Test Result Data analysis using one way ANOVA • Level of CbFA 1 in serum Based on data analysis using ANOVAp<0,05 (p=0,000), indicating a significant difference between the three groups Based on Post Hoc test : • Mean of level CbFA 1 in serum have significant difference between group treatment and control (p<0.05) • Mean of level CbFA 1 in serum between group 1 and 2 is not different with p= 0.71 (p>0.05)

  25. 2. Number of Osteoblast cell Based on data analysis using ANOVAp<0,05 (p=0,000), indicating a significant difference between the three groups Based on Post Hoc test : • Number of osteoblast cell have significant difference between group treatment and control (p<0.05) • Number of osteoblast cell between group 1 and 2 is not different with p= 0.48 (p>0.05)

  26. Discussion • The mean level of CbFA 1 and number of osteoblast cell in treatment group is significantly different (p<0,05) • It shows that omega 3 has a role in osteoblast production • Omega 3 has correlation with increasing osteoblast proliferation and activation of alkaline phosphatase ( Watkins et al. 2003) • Watkins et al found that positive effect on modulation of PGE2 after giving diet of n-3 (Watkins et.al.2003)

  27. Conclusion • The effect of giving n-3 on bone healing in fracture case shows significant different between treatment group and control (p<0.05) • With taking higher dose of omega 3 shows no different result between 1st group treatment and 2nd group treatment (p>0.05)

  28. Suggestion • Further study that could be applied to humans with taking omega 3 in fracture case • Method to calculate number of osteoblast cell needs good technique to get objective result

  29. Thank You