The present research is on a milky sap obtained from the Antiaris toxicaria tree (Moraceae) which is called Upas or Ipoh in Indonesia. The crude sap was administered to anesthetized rats, and changes in electrocardiogram (ECG) and systemic blood pressure was observed. Biologically and pharmacologically active components were extracted from the crude sap by means of water-acetone solution. Based on the strength of chemical qualitative detection tests of the sap extract (SE), cardiac glycosides are supposed to be the main components. The SE inhibited the Na+-, K+-ATPase (EC 126.96.36.199) which was partially purified from guinea pig heart muscle. When the SE and, concurrently, authentic ouabain were applied to isolated frog heart muscles, the fall of twitch tension was observed after the increased tension on mechanograms. These facts suggest that the main components of the milky sap are cardiac glycosides, and glycosides affect Na+, K+-ATPase activity of muscle membrane and heart muscle contraction.
With about 1% of Malaysian medical practitioners being psychiatrist, the patients need the psychiatric skill and care of general practitioners for both early referral and follow-up care. The psychological reactions aroused by the mentally ill patients may be jointly managed by the doctors and their families. The primary care doctor can play an effective therapeutic and supporting role in the rehabilitation of the patient that may include, when available, other workers in social and psychiatric services.
MeSH terms: Physicians; Primary Health Care; Rehabilitation; General Practitioners