Journal of Pharmaceutical and Sciences

Pharmacist Interventions in Education and Management of Obesity as a Risk Factor for Type 2 Diabetes Mellitus: A Literature Review

2025-10-27T05:37:09-07:00

Obesity is one of the major modifiable risk factors contributing to the rising prevalence of type 2 diabetes mellitus (T2DM). Pharmacists play an essential role in health promotion and preventive care through patient education and lifestyle counseling. This review aims to summarize and critically evaluate pharmacist-led interventions in obesity management as an effort to prevent T2DM. Literature searches were conducted using Google Scholar and PubMed with the keywords “pharmacist,” “obesity,” “type 2 diabetes,” and “lifestyle modification.” From the search results, ten international intervention studies published within the last ten years met the inclusion criteria and were analyzed in detail. Findings indicate that pharmacist interventions, such as structured education, medication optimization, motivational counseling, and clinical monitoring, significantly improved weight reduction, body mass index, HbA1c levels, and adherence to healthy behaviors. Pharmacists also play a key role in deprescribing, monitoring metabolic outcomes, and supporting patient self-management. Overall, pharmacist involvement in obesity prevention and T2DM control demonstrates measurable clinical benefits and has strong potential to be adapted into national healthcare systems.

Literature Review: Comparison of Activity of Chemical Compounds with Potential as Oral Breast Cancer Drug Candidates Using the In Silico Method

2025-10-27T05:46:06-07:00

Breast cancer is a type of cancer with a high prevalence rate, especially in women, which contributes significantly to the global death rate from cancer. This disease is characterized by abnormal cell growth that attacks body tissues and is often difficult to treat due to the limitations of effective treatment and minimal side effects. Although treatments such as chemotherapy, surgery, and radiation therapy are available, significant side effects, including impaired patients' quality of life, remain a major challenge. Therefore, a new approach is needed to find drug candidates with high efficacy and lower side effects. This study aims to compare the activity of chemical compounds that have the potential to be used as a breast cancer drug using the in silico method. The method involves computer simulations to evaluate molecular interactions with cancer receptors, such as ER-α and HER-2, as well as verify their pharmacokinetic feasibility through compliance with Lipinski's rules. This review literature draws on eight relevant recent studies, showing that some compounds have significant activity against cancer receptors and meet pharmacokinetic criteria for oral administration. The results of the analysis revealed that Longipinocarvone compounds had the best affinity for ER-α receptors (-8.20 kcal/mol), while Galagin showed the best affinity for HER-2 (-7.79 kcal/mol). Both also meet Lipinski's rule, indicating the potential to be developed into an oral drug. This in silico simulation provides efficient and cost-effective initial insight into the drug discovery process. The study concluded that both compounds have the potential to be promising breast cancer drug candidates, although further validation through in vitro and in vivo trials is needed to support these results.

Dapagliflozin in Heart Failure with Reduced Ejection Fraction (HFrEF): A Systematic Review of Its Mechanisms and Clinical Effectiveness

2025-10-27T06:06:03-07:00

Background: Heart failure with reduced ejection fraction (HFrEF) is a serious condition associated with high morbidity and mortality. Dapagliflozin has demonstrated cardioprotective effects in patients with HFrEF. Objective: This review explores the mechanisms underlying the clinical benefits of dapagliflozin and summarizes current evidence from the DAPA-HF trial and its sub-analyses regarding its effectiveness in patients with HFrEF. Methods: Relevant literature was systematically searched in PubMed, Google Scholar, and Scopus. Eligible studies were analyzed using a narrative approach to summarize the drug’s mechanisms of action and clinical outcomes. Results: Dapagliflozin improves cardiac energy efficiency, stimulates erythropoiesis, reduces myocardial fibrosis, and lowers oxidative stress and NT-proBNP levels. Clinically, 10 mg/day therapy reduces heart failure hospitalizations and cardiovascular mortality by 26% (HR: 0.74), with recently hospitalized patients experiencing benefits up to 49% (HR: 0.51), consistent across subpopulations and providing added advantages to standard therapy. Conclusion: Dapagliflozin serves as an effective adjunct therapy for HFrEF, offering rapid and sustained benefits, reducing morbidity and mortality, and improving patients’ quality of life. Further research is warranted to expand its clinical application.

Drug-Herb Interactions with Hormonal Agents in Cancer Therapy: A Review of Mechanisms and Clinical Implications

2025-10-28T07:36:13-07:00

Hormone therapy is the cornerstone of treatment for hormone-dependent cancers, such as breast and prostate cancer. On the other hand, the high rate of herbal medicine use as complementary treatment in cancer patients has the potential to cause herbal drug interactions (HDIs), which can affect the efficacy and safety of the primary therapy. This study aims to identify and categorize drug-herbal interactions (DHIs) in cancer hormone therapy based on pharmacokinetic mechanisms (including CYP450 enzyme and drug transporter modulation) and pharmacodynamic mechanisms (including hormone receptor and signaling pathway modulation), as well as to conclude their clinical implications. A systematic review was conducted following the PRISMA-ScR guidelines. A literature search was performed in the PubMed, Scopus, ScienceDirect, Frontiers, and Google Scholar databases for relevant in silico, in vitro, and in vivo studies published between 2015 and 2025. Analysis showed that HDI can be categorized into two main groups. First, pharmacokinetic interactions that occur through the modulation of cytochrome P450 (CYP) enzymes and drug transporters, such as the reduction in the bioavailability of tamoxifen by Hedyotis diffusa. Second, pharmacodynamic interactions at hormone receptors, such as the synergistic effect between Boswellia serrata and enzalutamide. The nature of interactions varies greatly, from antagonistic to synergistic, depending on the specific herbal-drug pair. These findings emphasize the importance of clinical vigilance, such as open communication with patients, dose adjustments, therapeutic monitoring, and interprofessional collaboration. These measures are necessary to reduce the risk of HDI and improve the efficacy of cancer therapy.

Evaluating the Evidence From Clinical Trials on Antibiotic-Antacid Interactions: A Systematic Literature Review

2025-11-02T22:43:49-08:00

Drug interactions between antibiotics and antacids represent an important clinical issue that can affect therapeutic efficacy and increase the risk of treatment failure. The concurrent use of these drug classes frequently occurs in clinical practice, particularly in patients receiving antibiotic therapy who also present with gastrointestinal complaints. This systematic literature review aims to evaluate the clinical trial evidence regarding antibiotic–antacid interactions, focusing on pharmacokinetic and pharmacodynamic mechanisms, clinical implications, and current research limitations. Relevant articles were identified through PubMed, Google Scholar, and other scientific databases using standardized keywords. Literature selection followed the PRISMA guidelines to ensure the quality and relevance of included studies. The analysis revealed that antacids and proton pump inhibitors (PPIs) can significantly reduce the bioavailability of antibiotics, especially fluoroquinolones and tetracyclines, through chelation with metal ions and by increasing gastric pH, thereby impairing drug absorption. Concomitant use of antibiotics and PPIs was also associated with a higher risk of Clostridioides difficile infection (CDI), particularly in elderly or comorbid patients. Conversely, newer acid-suppressing agents such as vonoprazan demonstrated good efficacy in Helicobacter pylori eradication regimens without compromising antibiotic activity. Despite these findings, most studies were retrospective, with limited sample sizes and specific populations. Therefore, large-scale prospective clinical trials are needed to strengthen the evidence base. A comprehensive understanding of antibiotic–antacid interactions is essential to support rational, safe, and effective prescribing practices in clinical settings.

Hypnotherapy in Pain Management for Cancer Patients: A Systematic Review

2025-11-06T07:04:36-08:00

Cancer remains one of the leading causes of mortality worldwide, with over 20 million newly diagnosed cases and nearly 10 million deaths globally, as reported by the International Agency for Research on Cancer (IARC) in 2020. In Indonesia, the incidence reached 408,661 new cases with 242,988 cancer-related deaths recorded in 2022. This growing burden has resulted in numerous clinical implications, with pain identified as the most frequently reported symptom among cancer patients, significantly impairing their quality of life. Among emerging approaches in pain management, non-pharmacological interventions such as hypnotherapy have gained attention due to their potential to reduce pain intensity without inducing serious adverse effects. This systematic review aims to evaluate the effectiveness of hypnosis therapy in managing cancer-related pain by analyzing six selected studies sourced from five international databases: ScienceDirect, EBSCO, PubMed, ProQuest, and Sage Journals. All included studies met the eligibility criteria, comprising randomized controlled trials (RCTs) and one meta-analysis, published within the last ten years. Five out of the six studies demonstrated that hypnosis interventions were effective in reducing pain intensity, while one study showed no statistically significant effect. Additionally, several studies explored integrative approaches combining hypnosis with complementary modalities such as music therapy and cognitive behavioral therapy. The findings of this review suggest that hypnotherapy serves as a promising complementary intervention to support effective pain management in oncology care. Further research employing more rigorous methodologies and larger sample sizes is recommended to strengthen the evidence base regarding its clinical utility.

Literature Review: Evaluation of Medication Therapy Adherence in Type 2 Diabetes Mellitus Patients Using Booklet Educational Media

2025-11-06T07:55:27-08:00

Type 2 diabetes mellitus is a chronic disease that requires long-term treatment and continuous management, with its prevalence increasing in Indonesia. Patient adherence to treatment is crucial for effective disease control. This article explains that the use of booklets as educational media can play an important role in improving treatment adherence among patients with type 2 diabetes. A Systematic Literature Review was conducted following the PRISMA guidelines by searching PubMed and Google Scholar for articles published between 2015 and 2025. The findings show that booklets are effective when used independently or in combination with other educational methods; however, combining them with direct education from healthcare professionals yields more optimal results in improving adherence. Factors such as age, educational level, family support, and ease of access to information influence the success of this intervention. Booklets are superior to other educational media because they can be reread, provide comprehensive information, and are affordable without requiring advanced technology. The results indicate that booklets are an effective and valuable educational tool to enhance treatment adherence among patients with type 2 diabetes mellitus. Therefore, it is recommended that they be incorporated into chronic disease management strategies in primary healthcare facilities.

The Clinical Impact of Drug Interaction between Clopidogrel and Proton Pump Inhibitors : A Narrative Review

2025-11-06T19:12:20-08:00

Dual antiplatelet therapy (DAPT), consisting of aspirin and P2Y12 receptor antagonists such as clopidogrel, is the mainstay treatment for patients with acute coronary syndrome (ACS). However, its widespread use can increase the risk of gastrointestinal bleeding. Proton pump inhibitors (PPIs) are often used as prophylaxis to prevent bleeding. On the other hand, PPIs are suspected of reducing the effectiveness of clopidogrel due to pharmacokinetic drug interactions. Nevertheless, findings from various studies regarding the clinical impact of this interaction remain inconsistent and controversial. The aim of this narrative review is to evaluate the effectiveness and safety of using PPIs concurrently with clopidogrel. The method used was a literature review of international journal articles discussing the interaction between PPIs and clopidogrel. The review findings indicate that certain PPIs, such as omeprazole, can inhibit the CYP2C19 enzyme involved in clopidogrel activation, potentially reducing its effectiveness. Conversely, some PPIs such as pantoprazole have minimal effects on CYP2C19 and are considered safer for concomitant use with clopidogrel. Overall, the use of PPIs can reduce the risk of gastrointestinal bleeding; however, the selection of PPI type must be carefully considered to minimize drug interactions that may compromise clopidogrel’s efficacy.

Systematic Review: The Effect of Storage Conditions on The Stability of Vitamin C and Aspirin Tablets

2025-11-25T07:18:07-08:00

This study aims to determine the most optimal storage conditions for maintaining the stability of vitamin C and aspirin tablets by considering key environmental factors such as temperature, humidity, light exposure, and storage duration. The review was conducted using a systematic review approach based on the PRISMA guidelines. Literature searches were performed through three main sources, namely PubMed, ScienceDirect, and Google Scholar, covering publications from 2015 to early 2025. The search through Google Scholar was carried out to complement the findings and minimize publication bias. A total of 14 research articles that met the inclusion criteria were analyzed in depth. The results indicate that vitamin C tablets exhibit the highest stability at low to room temperature (<30°C), under dry conditions with relative humidity below 75% RH, and protected from direct light exposure. In contrast, aspirin tablets show optimal stability at room temperature (around 25°C), under moderate humidity (<60% RH), and when stored in tightly sealed, light-resistant containers. The degradation of vitamin C is primarily driven by oxidation induced by heat, light, and moisture, whereas aspirin undergoes hydrolysis under humid and high-temperature conditions. Therefore, storing both tablets in a cool, dry place away from direct light is the most effective approach to preserve their stability and therapeutic efficacy throughout their shelf life.

Article Review: Characterization and Anti-Cancer Activity Test of Gold Nanoparicles (AuNPs) and Silver Nanoparicles (AgNPs) with Tumeric (Curcuma spp.) Extract as Bioreductor

2025-12-04T07:04:15-08:00

Cancer is one of the leading causes of death in the world with major challenges in the form of therapeutic side effects, poor selectivity, and drug resistance. Nanotechnology, particularly the use of gold (AuNPs) and silver (AgNPs) nanoparticles, offers a promising alternative to improve the effectiveness of cancer therapy. This article reviews recent developments in the synthesis of AuNPs and AgNPs using turmeric as a natural, environmentally friendly bioreductor. Characterization of nanoparticles through UV-Vis, TEM, SEM, and FT-IR methods showed particle sizes ranging from 1-100 nm, spherical or hexagonal morphology, and the presence of functional groups such as -OH and C=O that support stability and bioactivity. Anticancer studies show that these nanoparticles are effective against various types of cancer cells, including breast (MCF-7, MDA-MB-231), lung (A549, NCI-H661, NCI-H1975, NCI-H1573, NCI-H1563), cervical (HeLa), and epithelial (Hep-2) cancers.

Identification of Drug-Related Problems among Chronic Kidney Disease Patients Hospitalized at X Hospital Surakarta in 2024

2025-10-10T05:52:14-07:00

Background: Chronic kidney disease (CKD) is a condition characterized by impaired kidney function lasting at least three months. In patients with chronic kidney failure, the use of multiple medications has the potential to increase the risk of drug-related problems (DRPs), which can hinder the expected effectiveness of therapy. Objective: This study aims to determine the incidence of DRPs in patients with chronic kidney disease treated at the inpatient facility of Hospital X in Surakarta. Methods: This study employed a cross-sectional methodology and a non-experimental design. Data were collected retrospectively through the medical records of patients with chronic kidney disease treated at the inpatient facility of Hospital X in Surakarta. Data analysis was performed univariately by describing and analyzing the study variables. DRPs were identified based on the Pharmaceutical Care Network Europe (PCNE) classification. Results: The most common comorbidity was anemia at 27.93%, while the most frequently used drug class was vitamins and minerals at 24.70%. Of the 108 patients analyzed, 12 patients experienced at least one DRP (11.11%). In total, 15 cases of DRPs were identified with code P1.3 (problem) and codes C3.1, C3.2, C3.3, and C3.4 (causes) from those 12 patients. Conclusion: This study shows the occurrence of DRPs in patients with chronic kidney disease treated at Hospital X in Surakarta.

Optimization Formula and Stability Evaluation of Facial Toner of Keji Beling Leaf Extract (Strobilanthes crispus L.)

2025-10-11T03:30:24-07:00

Facial skin is prone to dryness due to UV radiation, which accelerates premature aging (photoaging) and triggers various skin problems such as atopic dermatitis. In Indonesia, the prevalence of dry skin reaches 50%–80%. Several commercial toner products still contain alcohol, which can further dry the skin when used for a long period of time. Therefore, natural ingredients with moisturizing effects are needed, one of which is Strobilanthes crispus (keji beling) leaves, containing flavonoids with antioxidant activity. This study aimed to determine the effect of varying concentrations of Tween 80 surfactant on the stability of toner formulations. The research method was experimental, formulating four formulas with surfactant concentrations of 0% (F0), 5% (FI), 7.5% (FII), and 10% (FIII), followed by stability testing using the cycling test and evaluating organoleptic properties, homogeneity, viscosity, pH, irritation, and hedonic acceptance. The organoleptic evaluation showed that FI, FII, and FIII produced clear yellowish-green liquid preparations with a characteristic odor of keji beling leaves, whereas F0 produced a dark green liquid with the same odor. All formulas were homogeneous with a pH of 5. The viscosity values were 1.72 cPs for FI, 1.82 cPs for FII, 2.37 cPs for FIII, and 1.35 cPs for F0. Irritation testing showed negative results for all formulas, indicating no signs of primary irritation. Hedonic testing revealed that FIII was the most preferred by panelists. Based on these findings, it can be concluded that the formula containing 10% polysorbate (FIII) provided the best physical stability and panelist acceptance. Thus, variation in surfactant concentration affects the physical stability of Strobilanthes crispus leaf extract toner formulations.

Relationship Between Rational Antibiotic Use and Treatment Success in Paediatric Patients Diagnosed with Pneumonia in the Inpatient Ward of dr. R. Soedjati Purwodadi Regional General Hospital Using the Gyssens Method

2025-10-11T04:22:25-07:00

Pneumonia is an inflammation of the lung parenchyma that can be caused by microorganisms including fungi, viruses, bacteria, and mycobacteria. In addition, chronic inflammatory diseases of the respiratory tract can be characterized by wheezing, chest tightness, and coughing accompanied by flu. To evaluate the rational use of antibiotics, the Gyssens method was developed, which includes the appropriate selection of antibiotics based on effectiveness, toxicity, lower cost, narrower spectrum, duration of administration, dose, interval, route, and timing of administration. A patient's improvement or lack thereof can be assessed based on body temperature, white blood cell count, respiratory rate, and clinical symptoms. The study design is non-experimental (observational) with a cross-sectional study design. Data collection was conducted retrospectively using data from medical records of pediatric patients diagnosed with pneumonia at Dr. R. Soedjati Purwodadi General Hospital, with a total of 110 pediatric patients meeting the inclusion criteria. The results showed that 38 patients (34.55%) received antibiotics irrationally, with the most inaccuracies in the drug selection category (IV A, IV C, and IV D). A total of 72 users (65.45%) were rational and 38 users (34.55%) were irrational. The results of statistical analysis of the data using the Chi-Square test show that these results were obtained from the Exact Sig (2-sided) value, namely p = 0.003 (p < 0.05), so it can be interpreted that there is a rational relationship between the use of antibiotics and the success of therapy in pediatric patients.

Relationship of Education, Knowledge and Parity with the Ability to Care for Newborns

2025-10-14T12:52:28-07:00

Background: Neonates are children aged 0 to 28 days. Efforts to establish a healthy lifestyle should begin during the neonatal period, as this is a stage of rapid growth and development. The mother's role is crucial as the primary caregiver, supporting the baby's physical, social, and emotional development. To address various challenges in infants, mothers are required to possess good knowledge and skills in caring for their babies. Objective: To determine the correlation between knowledge, education, and parity on the ability to care for newborns at the Sunggal Primary Clinic. Methods: This study was a quantitative analytical study with a cross-sectional approach. Data were collected through questionnaires and direct interviews with 60 respondents. Data analysis employed univariate and bivariate analysis using the chi-square test, supplemented with the association measure Prevalence Ratio (PR) and 95% Confidence Interval (CI). Results: The bivariate analysis results showed that education (p = 0.000; PR = 3.58; 95% CI: 1.45-8.83), knowledge (p = 0.000), and parity (p = 0.000; PR = 2.79; 95% CI: 1.83-4.24) were significantly associated with the ability to care for newborns. The PR values indicate that mothers with higher education were 3.58 times more likely to be capable of caring for their babies, and mothers with higher parity were 2.79 times more likely. Conclusion: The variables of education, knowledge, and parity have a significant and meaningful relationship with maternal competence in caring for neonates. Education and parity demonstrate a strong influence on the ability to care for newborns.

The Effectiveness of Tactile Sensory Play on the Cognitive Development of Infants Aged 12–15 Months in Mekar Sari Village, Deli Tua District

2025-10-15T12:20:41-07:00

Background: The period from birth to five years of age is known as the golden period, a crucial phase for a child’s growth and development. During this stage, developmental monitoring—particularly of cognitive aspects—is essential as a foundation for the child’s future. Tactile sensory play is one form of stimulation that contributes to infants’ cognitive development. A lack of stimulation may hinder this development. Objective: To determine the effectiveness of tactile sensory play on the cognitive development of infants aged 12–15 months in Mekar Sari Village, Deli Tua District. Method: This study employed a quantitative design using a quasi-experimental approach with a one-group pretest–posttest design. The sample consisted of 30 respondents selected through accidental sampling. The tactile sensory play intervention was administered three times. Data were collected through observation using observation sheets and analyzed using a t-test with SPSS software. Results: The t-test results showed a p-value of 0.000 (p < 0.05), indicating a significant effect of tactile sensory play on the cognitive development of infants aged 12–15 months in Mekar Sari Village, Deli Tua District. Conclusion: Tactile sensory play is effective in improving the cognitive development of infants aged 12–15 months.

Evaluation of Physical Quality, Moisture Test, and Potential Activity of Lip Balm Sunscreen from Ethanol Extract of Red Shoot Leaves (Syzygium myrtifolium Walp

2025-10-24T08:06:28-07:00

Background: Lip balm is a cosmetic preparation containing key components such as waxes, fats, and oils—derived from either natural or synthetic extracts—to prevent lip dryness by enhancing moisture and protecting against harmful environmental factors. The red shoot plant (Syzygium myrtifolium Walp.) is commonly known as an ornamental plant but also contains beneficial chemical compounds. Objective: This study aims to formulate red shoot leaf ethanol extract into a lip balm with good physical quality, sun protection capability, and moisturizing effects. Methods: This research uses an experimental method with quantitative and qualitative data collection. The stages include simplicia characterization, secondary metabolite identification, extract preparation through maceration, lip balm formulation, and evaluation of physical quality (organoleptic test, homogeneity, pH, stability, irritation, melting point, and hedonic test), moisture test, and Sun Protection Factor (SPF) value determination. Results: The red shoot leaf extract was successfully formulated into a stick lip balm at concentrations of 5%, 7%, and 10%. The formulas demonstrated good physical quality in all tests, increased lip moisture and oil content (especially at 10% concentration), and high SPF values with ultra protection at the 10% concentration. Conclusion: Red shoot leaf extract (Syzygium myrtifolium Walp.) can be used as an active ingredient in lip balm, providing optimal physical quality, moisturizing effects, and UV radiation protection.

Enhanced Anti-Inflammatory Effects of Multicomponent Etoricoxib Formulations on TNF-α Suppression

2025-10-24T08:06:20-07:00

Etoricoxib, a selective COX-2 inhibitor, is widely used for its anti-inflammatory effects but is associated with dose-dependent adverse events. Multicomponent formulations with coformers or solubilizing agents offer a potential strategy to improve efficacy while minimizing toxicity. This study aimed to evaluate the anti-inflammatory efficacy of pure etoricoxib and its multicomponent formulations with nicotinamide, N-methyl glucamine, and piperine using TNF-α as a coformer. A controlled laboratory experiment was conducted in Wistar rats using a carrageenan-induced granuloma pouch model. TNF-α levels were measured at baseline (0 hours) and at 6 hours post-treatment. Normality tests, two-way ANOVA, and Tukey HSD post-hoc analyses were applied to assess group differences and time effects. All treatment groups significantly reduced TNF-α levels compared to the control (p < 0.001). While pairwise comparisons between treatments were not statistically significant, the P4 formulation (etoricoxib–piperine) showed the most consistent reduction. P3 (etoricoxib–N-methyl glucamine) exhibited a near-significant difference from pure etoricoxib (P1), suggesting enhanced efficacy. The main effect of time confirmed the temporal decline of TNF-α (p = 0.0101), without significant group × time interaction. Multicomponent formulations, particularly those containing piperine and N-methyl glucamine, enhance the anti-inflammatory action of etoricoxib. These research support further development of bioenhanced etoricoxib as safer alternatives for antiinflammatory.

Association Between Length of Hospital Stay and Blood Pressure and Proteinuria Outcomes in Severe Preeclampsia

2025-10-24T08:06:31-07:00

Severe preeclampsia is a major obstetric complication associated with maternal and perinatal morbidity and mortality. Hospitalization duration may influence clinical outcomes, including blood pressure and proteinuria, particularly in patients receiving antihypertensive therapy with nifedipine or methyldopa.

This study aims to evaluate the association between the length of hospital stay and changes in systolic and diastolic blood pressure, as well as proteinuria, in patients with severe preeclampsia treated with nifedipine or methyldopa. This retrospective study reviewed medical records of patients diagnosed with severe preeclampsia and admitted to Dr. M. Djamil Central General Hospital, Padang, between January and December 2023. Patients were categorized into two groups based on hospitalization duration: <5 days and ≥5 days. All patients received monotherapy with either nifedipine or methyldopa. Data on patient demographics, clinical parameters, and hospitalization length were collected. Statistical analyses were performed using the independent t-test and the Mann–Whitney test, with a significance level of p<0.05. Of 60 patients included, 44 (73.3%) were hospitalized for ≥5 days, while 16 (26.7%) stayed <5 days. Patients with ≥5 days of hospitalization experienced a significantly greater reduction in systolic blood pressure (40.93 mmHg vs. 29.00 mmHg, p=0.025) and proteinuria (23.06 vs 33.20, p=0.031) compared to the <5-day group. No significant difference was observed in diastolic blood pressure reduction (p=0.128).

Breast Cancer Patients Receiving Tamoxifen Therapy at Two Private Hospitals in Central Java: Sociodemographic, Clinical, and Medication Profiles

2025-10-27T04:06:04-07:00

Breast cancer is one of the most common types of cancer, including in Central Java Province, Indonesia, which reports a high incidence. The number of cases continues to increase, likely due to low public awareness of breast self-examination (BSE), limited health education, and a lack of motivation to undergo regular check-ups. One of the main treatment options is hormonal therapy, with Tamoxifen being the most widely used drug. To date, there is limited data on the sociodemographic and clinical characteristics among breast cancer patients who use Tamoxifen in Central Java. This information is essential for improving patient care and treatment strategies. This study aimed to describe the sociodemographic and clinical characteristics of breast cancer patients who received Tamoxifen at two private hospitals in Central Java. The results showed that most patients were under 50 years old (66%), had a low level of education (65.2%), and were employed (34.8%). Clinically, most patients were in advanced stages (56.5%), had no comorbidities (89.7%), and were not taking other medications (85%). These findings provide an initial overview of the profile of breast cancer patients using tamoxifen at two private hospitals in Central Java. However, these results cannot be generalized to the entire Central Java region due to the limitations of the study locations. Further studies with a broader scope are needed to obtain more representative data.

The Side Effect Analysis of Anti-Tuberculosis Drugs Using K-Means Clustering at RSUD Prof. Dr. H. Aloei Saboe Kota Gorontalo

2025-10-27T04:06:02-07:00

Background: The side effects of anti-tuberculosis drugs (OAT) experienced by patients often interfere with their daily activities and affect their compliance in completing relatively long-term treatment. This is one of the reasons patients discontinue OAT therapy unilaterally, which can lead to treatment failure for tuberculosis (TB). Objective: To analyse the side effects of OAT in patients at Prof. Dr. H. Aloei Saboe General Hospital in Gorontalo City using k-means clustering. Methods: Data including gender, age, OAT regimen, laboratory results, comorbidities, and types of OAT side effects were analyzed using the k-means method to determine patient clustering patterns. Research Results: The analysis yielded three clusters. Cluster 1 (25 patients) was predominantly male (80%), aged 45–54 years, received first-line OAT (88%), experienced elevated SGPT/SGOT levels (88%), had hypertension as the most common comorbidity (28%), and primarily experienced liver dysfunction as the main side effect (96%). Cluster 2 (348 patients) was predominantly male (58%), aged 35–44 years, receiving OAT line 1 (96.1%), no increase in SGPT and SGOT levels (0%), almost no increase in urea and creatinine levels (0.2%), the most common comorbidity being diabetes mellitus (22.1%). The main side effect being gastrointestinal disorders (58.9%). Cluster 3 (40 patients) was predominantly male (70%), aged 45–54 years, received OAT line 1 (97.5%), experienced an increase in urea and creatinine levels (97.5%), and the most common comorbidity was diabetes mellitus (47.5%). The main side effect was renal dysfunction (95%). Conclusion: The k-means algorithm is effective in generating clusters of patient characteristics. This clustering supports specific interventions such as comorbidity therapy management and monitoring of side effect risks, thereby optimising individualised tuberculosis (TB) treatment.

Drug Related Problems (DRPs) in Hospitalized patient with Eye Diseases: a Retrospective Cross-Sectional Study Over Two Years

2025-10-27T04:06:00-07:00

Drug-related problems (DRPs) in ophthalmic inpatients may compromise the effectiveness and safety of therapy. This study aimed to identify the characteristics of DRPs among inpatients with eye diseases at Hospital X Tangerang during September 2022–August 2024. A retrospective cross-sectional design was applied, involving 178 patients who met the inclusion criteria. DRPs were identified using the Pharmaceutical Care Network Europe (PCNE) classification version 9.1 through review of prescriptions, clinical data, and medication records. Descriptive analysis were used to determine the DRP occurrence. Results showed that most patients were aged 18–60 years (71.9%), female (55.1%), without comorbidities (82.0%), and received an average of 5 medications during hospitalization. Four DRP cases (2.2%) were identified, consisting of one case of treatment effectiveness (P1.2) 25% and three cases of drug safety problems (P2.1) 75%. The main causes were contraindicated drug use despite guideline adherence (C1.2) 50%, inappropriate drug combinations (C1.4) 25%, and patient non-adherence (C7.1) 25%. The low DRP incidence was likely related to the short hospitalization duration and the predominance of topical therapy with minimal systemic exposure. These findings highlight the important role of clinical pharmacists in therapy monitoring to prevent DRPs in ophthalmic inpatients.

The Relationship Between Maternal Knowledge of Stimulus Touch Massage Application and the Improvement of Infant Sleep Quality.

2025-10-27T11:25:30-07:00

Background: Baby massage is a non-pharmacological stimulation technique believed to improve infant sleep quality through gentle touch that stimulates the nervous system and circulation. A mother's knowledge of massage techniques plays a vital role in its effectiveness. Objective: To determine the relationship between maternal knowledge of stimulus touch massage application and the improvement of infant sleep quality at Siti Hajar Clinic. Methods: This study used an analytical survey design with a cross-sectional approach. A total of 30 mothers with infants aged 0–12 months who visited Siti Hajar Clinic in April 2025 were selected using total sampling. Data were collected using a questionnaire and analyzed using the Chi-Square test. Results: Based on the results obtained, out of the total respondents, the majority—27 mothers with good knowledge—had babies whose sleep quality improved, representing 90%. Two respondents with moderate knowledge also experienced improved sleep quality in their babies (6.7%), while one respondent with poor knowledge showed no improvement in the baby's sleep quality (0%). Statistical analysis revealed a significant result (p = 0.000 < 0.05), indicating a relationship between maternal knowledge and improved infant sleep quality. Conclusion: There is a significant relationship between maternal knowledge of stimulus touch massage and the improvement of infant sleep quality.

The Effect of Extraction Methods on Total Flavonoid Content and Antioxidant Activity of Kenop (Gomphrena globosa)

2025-10-27T23:33:20-07:00

Gomphrena globosa is a medicinal plant with attractive pigments and therapeutic properties, including antihypertensive, anticancer, and antioxidant effects. These activities are mainly attributed to phenolic compounds such as flavonoids. Previous studies have shown that ethanolic extracts of G. globosa flowers and leaves obtained by maceration have potent antioxidant activity. However, no study has yet reported Soxhlet extraction of G. globosa leaves. Therefore, this study aimed to compare Soxhlet extraction and maceration extraction methods to evaluate their efficiency in extracting flavonoids and antioxidant activity. Flavonoid levels were determined using the aluminium chloride colourimetric method with quercetin as a standard, and antioxidant activity was evaluated using the DPPH radical scavenging assay. The results showed that maceration produced a higher flavonoid content (78.33 ± 2.14 mg QE/g extract) than Soxhlet extraction (57.43 ± 1.53 mg QE/g extract). Consistently, antioxidant activity was more potent in the macerated extract (IC₅₀ = 53.93 ± 1.78 μg/mL) compared to the Soxhlet extraction (IC₅₀ = 62.50 ± 0.39 μg/mL). Evaluation using the t-test showed that the antioxidant activities of these methods were significantly different (p < 0.05). These findings indicate that maceration is more effective in extracting flavonoids from G. globosa leaves, resulting in high antioxidant activity. Moreover, G. globosa leaves emerged as a promising natural antioxidant source for pharmaceutical and functional food applications.

Formulation of Self-Nanoemulsifying Drug Delivery System (SNEDDS) from Ethanolic Extract of Pegagan Leaves (Centella asiatica) as an Oral Antidiabetic Drug

2025-10-28T01:17:10-07:00

This research aims to develop a SNEDDS formulation based on the ethanolic extract of pegagan leaves (Centella asiatica). The goal is to improve the solubility and effectiveness of asiaticosida, an active compound that holds promise as a diabetes therapy. The extract is obtained through a soaking process with 96% ethanolic, resulting in a yield of 32.8%. The asiaticosida content in 200 mg of extract was analyzed using the HPLC method. To compile the SNEDDS, a combination of oils, surfactants, and cosurfactants that are most compatible with asiaticosida is selected. The selection results showed that soybean oil, Tween 20, and PEG 400 had the highest solubility levels: 375 mg/L, 115.73 mg/L, and 71.62 mg/L, respectively. This formulation used a 5:4:1 ratio of all three components, resulting in nanoemulsions with an average particle size of 127.6 nm, PDI 0.33, and a zeta potential of -45.86 mV that a best indicator of stability. Experimental results indicated that fast emulsification times and high levels of transmittance in various media (water, AGF, and AIF), approximately 47.33 s, respectively; 52.66 s; and 40.33 s, with a transmittance value above 85%. The nanoemulsion remained stable for 4 hours of observation. Further analysis showed that the asiaticosida dissolved in SNEDDS reached 12,34 ± 2,91 mg (4,11 mg/mL, n=3), slightly lower than the pure extract of dan 13,05 ± 2,62 mg (6,525%b/b, n=3). Overall, the SNEDDS of pegagan leaves show great potential as an innovation in the development of herbal medicines, especially for future clinical applications.

Antidiabetic Activity Test of Moringa Leaf Extract Combination (Morinaga oleifera Lam.) and Guava Leaves (Psidium guajava L.) in Male Wistar Rats

2025-10-28T06:23:58-07:00

Purpose: to test whether the combination of Moringa oleifera L. and guava (Psidium guajava) leaf extract has a better effect in reducing blood glucose levels compared to single extracts. Method: an experiment with a pre- and post-test with control group design. The samples were Moringa leaves, guava leaves with 30 Wistar rats divided into 6 groups. Normal control group, negative control group (Na CMC 1%), positive control group (glibenclamide 5 mg/kgBW), Moringa leaf extract group dose 100 mg/kgBW, guava leaf extract group dose 105 mg/kgBW, and a combination group of Moringa leaf extract with guava leaves. Data analysis used a computerized program using the Welch ANOVA and Post Hoc Games-Howell tests. Results: showed that all treatment groups significantly reduced blood glucose levels compared to negative controls (p<0.05), but the effect was not comparable to positive controls and was not significant with normal controls on day 21. The combination of EEDK and EEDJB did not provide a better effect than the single extract. Conclusion: This study shows that the single extract and the combination of moringa leaf and guava leaf extracts have antidiabetic activity, but the combination of moringa leaf and guava leaf extracts did not show a better effect.

Potential Antioxidant and Antibacterial Activity of Curry Leaf Ethanol Extract (Murraya koenigii) against Propionibacterium acnes

2025-10-29T01:11:09-07:00

Indonesia is renowned for its rich natural resources, particularly medicinal plants with significant therapeutic potential. This study examined how the ethanolic extract of curry leaves (Murraya koenigii) can act as an antioxidant and antibacterial agent against Propionibacterium acnes, the primary cause of acne vulgaris. This study used phytochemical screening to identify secondary metabolites, such as alkaloids, flavonoids, tannins, saponins, and glycosides, which are associated with biological activities such as killing bacteria and protecting cells from damage. The DPPH method for testing antioxidants showed that the extract had an IC₅₀ value of 45.88 mg/L, which is not significantly different from quercetin as a reference, at 23.7 mg/L. This result is still significant for the strong antioxidant category. We assessed antibacterial efficiency using a disc diffusion technique, which showed a zone of inhibition corresponding to the extract concentration. The widest zone of inhibition, measuring 17.77 ± 0.15 mm, was recorded at a concentration of 250 mg/mL, classifying its activity as strong by existing standards. These findings underscore the extract's promise as a natural acne therapy, addressing bacterial growth and oxidative stress. Furthermore, these results support the development of safe and efficacious pharmaceutical or cosmetic products derived from natural components. Future investigations should examine synergistic formulations and enhance bioavailability to optimize therapeutic outcomes.

Plant-Based Matrix-Derived Lactic Acid Bacteria Strain SBM10 from Fermented Red Rice Syrup: In Vitro Safety Assessment and Characterization

2025-10-29T13:08:27-07:00

Plant-based fermentation offers a route to develop nondairy probiotic candidates, yet syrup-like matrices remain underexplored compared with solid or beverage systems. This study investigated fermented red rice syrup (prepared from red rice and barley malt powder) as a source of lactic acid bacteria (LAB) and advanced one isolate, SBM10. Cultivation on MRS supplemented with CaCO₃ yielded acidogenic colonies. A stable morphotype (SBM10) was purified and exhibited a LAB consistent profile, Gram-positive rods, catalase negative, TSIA K/A without H₂S, Simmons citrate negative, gelatinase negative, CO₂ positive in Durham and γ-hemolytic on 5% sheep blood agar. Under gastrointestinal stress models (4 h, 37 °C), tolerance relative to controls was 27.14% at pH 3.0 and 35.58% in 0.3% oxgall. In disk diffusion assays, the cell-free supernatant (CFS) showed no inhibition of Escherichia coli or Staphylococcus aureus. Thus, no antibacterial activity was detected by disk diffusion under the conditions tested, whereas amoxicillin produced zones of 13.95 mm and 12.43 mm, respectively. SBM10 presents a safety-supportive, LAB-typical profile with partial tolerance to gastric-like acidity and bile. Although no disk diffusion antagonism was detected for the CFS, the results motivate taxonomic confirmation and process/formulation optimization, such as improving acid/bile robustness and re-evaluating antimicrobial potential with complementary assays, to clarify the suitability of SBM10 for plant-based functional applications.

The relationship between waiting time for bpjs patient prescription services and patient satisfaction level at outpatient pharmacy At Hospital 'X' In Malang City

2025-10-31T03:20:44-07:00

One of the minimum standards of hospital pharmacy services is waiting time. Waiting time is one of the potential components that can affect the level of patient satisfaction and also the quality of the hospital. Another indicator of the success of health services is patient satisfaction. Patient satisfaction is a reflection of the quality of health services they receive. The purpose of this study was to determine the relationship between waiting time for BPJS patient prescription services and the level of patient satisfaction at the outpatient pharmacy of Hospital 'X' in Malang City. This study design is quantitative descriptive with a Cross Sectional approach. The data collection method is Prospective, sampling using Random Sampling techniques during the period December 2023 - January 2024. The data analysis used is bivariate analysis of the Chi Square test to see the relationship between waiting time and patient satisfaction. The number of samples taken was 84 respondents. The results showed that the waiting time for compounded prescription services at the outpatient pharmacy of Hospital 'X' in Malang City was obtained as much as (51.2%) not according to standards with an average time of 81.25 minutes. The level of patient satisfaction as many as (46.4%) felt satisfied with the service at the outpatient pharmacy of Hospital 'X' in Malang City and the p-value was 0.04 (˂ 0.05). Based on the results of this study, it can be concluded that the waiting time for BPJS compounded prescription services is related to the level of patient satisfaction at Hospital 'X' in Malang City.

Determinants of Vasectomy Contraceptive Method Selection Among Men in the Working Area of Buhit Public Health Center, Pangururan District, Samosir Regency, 2024

2025-11-02T11:12:45-08:00

Introduction: High population growth rates impact development, necessitating restrictive policies through Long-Term Contraceptive Method (LTCM) programs. Vasectomy, as one of the LTCMs, still has very low acceptance, as seen in Pangururan District, where participation is less than 1%. Objective: This study aimed to analyze the factors associated with the selection of vasectomy as a contraceptive method among men in the working area of Buhit Public Health Center, Pangururan District, Samosir Regency. Methods: This study used a cross-sectional design with a quantitative approach. The population consisted of men with fertile-age wives, with a sample of 73 individuals selected through simple random sampling. Data were collected using a validated and reliable questionnaire. Data analysis used the Chi-Square test and logistic regression. Results: Bivariate analysis results showed significant relationships between the husband’s age (p = 0.039), number of children (p = 0.019), husband’s knowledge level (p = 0.047), attitude (p = 0.029), social norms (p = 0.016), and wife’s support (p = 0.001) with the decision to undergo vasectomy. Multivariate analysis proved that wife’s support was the most dominant variable (p=0.003; OR=23.500), meaning that husbands who received wife’s support were 23.5 times more likely to choose vasectomy. Conclusion: Wife’s support is the most dominant factor influencing the selection of vasectomy. Therefore, healthcare workers are expected to enhance their role through health education about vasectomy to the community, especially wives, to provide good support for their husbands.

Antioxidant Activity Test of Durian Seed Herbal Tea (Durio zibethinus Murr.) with Addition of Stevia Leaves (Stevia rebaudiana Bertoni) as a Natural Sweetener Using DPPH Method

2025-11-03T00:27:47-08:00

Free radicals are an important health concern due to their role in the development of various diseases. Antioxidants, capable of neutralizing free radicals, are abundant in plants such as durian seeds (Durio zibethinus Murr.) and stevia leaves (Stevia rebaudiana Bertoni). Herbal tea formulated from these materials has potential as an alternative functional drink because both contain phenolic compounds with antioxidant activity. This study aimed to evaluate the potential of durian seeds and stevia leaves as herbal tea with antioxidant properties. The research involved sample collection, identification, preparation of simplicia, characterization, formulation of herbal tea, quality testing, and determination of antioxidant activity. The simplicia characteristics of durian seeds and stevia leaves showed water content of 6.16% each, water-soluble extract of 35% and 15.8%, ethanol-soluble extract of 25.5% and 14.6%, total ash of 0.73% and 0.3%, and acid-insoluble ash of 0.5% and 0.26%. Quality testing of the herbal tea showed water content of 2.18%, total ash of 3.90%, water-soluble ash of 73.85%, and acid-insoluble ash of 3.80%. Antioxidant activity based on IC50 values was 68.45 ± 1.32 ppm for durian seed tea, 61.6 ± 1.05 ppm for stevia tea, 39.28 ± 0.98 ppm (1:1), 44.64 ± 1.11 ppm (1:2), and 42.32 ppm ± 1.07 (2:1). These results indicate that combining durian seeds and stevia leaves can enhance antioxidant activity compared to individual extracts. Overall, durian seeds and stevia leaves can be developed into herbal tea formulations with very strong antioxidant activity, as reflected in their ability to reduce DPPH radicals. Radikal

Optimization of the Most Active Fraction Gel Formula of Noni Fruit (Morinda citrifolia L.) as a Topical Antioxidant

2025-11-03T05:44:11-08:00

Introduction: Flavonoid compounds and vitamin C from noni fruit have the potential to be antioxidants. The unpleasant odor, soft texture, and unpleasant taste of noni fruit are minimized through a fractionation process and formulated into a gel preparation, which is expected to increase the acceptance of noni fruit in the community. Objective: to determine the optimal gel formula of the most active fraction of noni fruit with variations of HPMC, carbopol 940, and propylene glycol through critical parameters of viscosity, pH, and antioxidant activity using the Simplex Lattice Design method. Method: The extraction used is maceration and continued with a fractionation process. Physical properties tests include organoleptic, homogeneity, viscosity, adhesiveness, spreadability, and pH. Determination of the IC₅₀ value of antioxidants with DPPH using a UV-Vis spectrophotometer. The statistical results of the data obtained were processed using ANOVA, Wilcoxon, and the T-test. Results: showed that the noni fruit fraction that had the best antioxidant activity was the ethyl acetate fraction (20.35±0.18 ppm), variations of 13 gel formula compositions with the most optimal viscosity, pH, and IC₅₀responses were carbopol 940:HPMC 8060-M: propylene glycol (1.491:0.509:8.000). Variations in the combination of HPMC 8060-M, carbopol 940, and propylene glycol in the gel preparation of the most active noni fruit fraction affected the critical parameters of viscosity, pH, and antioxidant activity. Conclusion: The ethyl acetate fraction has the best antioxidant activity and the optimal gel formula composition is carbopol 940:HPMC 8060-M:propylene glycol (1.491:0.509:8.000) which is predicted to have a very high desirability value (0.917) and has been validated.

The Relationship Between Early Breastfeeding Initiation and Reduced Postpartum Bleeding and Uterine Involution at PMB Supiani

2025-11-04T10:34:49-08:00

Background: The postpartum period is a critical time for mothers. Postpartum hemorrhage and delayed uterine involution are complications that can increase maternal morbidity and mortality. Early Breastfeeding Initiation (EBI) is hypothesized to prevent these complications by stimulating the release of oxytocin, which triggers uterine contractions. Objective: This study aimed to analyze the relationship between the implementation of EBI and the reduction of postpartum hemorrhage and the acceleration of uterine involution at PMB Supiani. Methods: This research employed a cross-sectional design with a quantitative approach. The sample consisted of 80 postpartum mothers selected using a purposive sampling technique. Data were collected using an observational questionnaire and analyzed using the Chi-Square statistical test to identify relationships between variables. Results: A total of 87.5% of respondents performed EBI. The analysis results showed a significant relationship between EBI and reduced postpartum hemorrhage (p-value = 0.001) and between EBI and accelerated uterine involution (p-value = 0.001). Mothers who performed EBI tended to experience normal bleeding and a faster uterine involution process. Conclusion: EBI has a significant relationship with the reduction of postpartum hemorrhage and the acceleration of uterine involution. Therefore, education and support to encourage the implementation of EBI in delivering mothers are essential to prevent postpartum complications.

Test of the Effectiveness of Rose Apple Leaf Ethanol Extract (Syzygium aqueum) on the Healing of Cut Wounds in White Rabbits (Oryctolagus cuniculus)

2025-11-04T10:34:47-08:00

Cut wounds, physical damage to the skin often caused by sharp instruments, require alternative treatments. This study aims to evaluate the effectiveness and determine the optimal concentration of water apple leaf (Syzygium aqueum) ethanol extract in accelerating the healing of cut wounds. Rose apple leaves are known to be rich in bioactive compounds such as flavonoids, alkaloids, and tannins, which have the potential to be wound healing agents. Extraction was carried out using the remaceration method with 96% ethanol for three days, and the extract was then formulated into concentrations of 5%, 10%, and 20%. Effectiveness tests were carried out on incision wounds on the backs of rabbits. The results showed that the healing time was inversely proportional to the extract concentration. The treatment group with a concentration of 5% healed on the 13th day, the concentration of 10% on the 12th day, while the concentration of 20% showed the highest effectiveness among all extract groups, with healing on the 10th day. Statistical analysis using the One Way ANOVA test (p=0.000; p<0.05) showed a significant difference between treatment groups. The higher the concentration of rose apple leaf ethanol extract, the faster the healing process of the incision wound, but the effectiveness of the 20% extract was still lower than the positive control (Bionet Cream), which healed the wound faster (10 days vs. 10 days) through a different mechanism, so further research is needed to compare their effectiveness statistically.

Plasma pTau181 and Neuropsychiatric Symptoms in Alzheimer’s Dementia: Insights from a Cross-Sectional Study

2025-11-05T03:14:05-08:00

Alzheimer’s disease is the leading cause of dementia, marked by progressive cognitive decline and neuropsychiatric disturbances collectively known as behavioral and psychological symptoms of dementia (BPSD). Plasma phosphorylated tau at threonine-181 (pTau181) has emerged as a minimally invasive biomarker of tau-related neurodegeneration, but its association with BPSD remains uncertain. This study investigated the relationship between plasma pTau181 levels and BPSD in Alzheimer’s dementia. An analytical observational study with a cross-sectional design was conducted in patients clinically diagnosed with predefined eligibility criteria. Plasma pTau181 concentrations were measured using enzyme-linked immunosorbent assay (ELISA), while BPSD was assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Statistical analyses were performed to examine associations between plasma pTau181 and BPSD status. Plasma pTau181 levels ranged from 4.32 to 97.23 pg/mL, with a median plasma pTau181 level of 19.29 pg/mL (IQR: 11.81-25.05) in patients without BPSD and 20.67 pg/mL (IQR: 11.81-43.41) in those with BPSD. No significant differences in pTau181 levels were observed between patients with and without BPSD (p = 0.310). These findings suggest that plasma pTau181 may not be directly related to the presence of BPSD in Alzheimer’s dementia. While plasma pTau181 remains a promising biomarker of tau pathology, its predictive value for neuropsychiatric symptoms appears limited. Longitudinal studies are needed to explore its role in BPSD pathophysiology further.

Overview of Bronchitis Treatment at Hasri Ainun Habibie Regional Hospital

2025-11-08T08:23:21-08:00

Chronic bronchitis, a subtype of chronic obstructive pulmonary disease (COPD), is characterized by persistent inflammation of the bronchial tubes and chronic cough accompanied by mucus production. This condition is commonly caused by prolonged exposure to irritants such as cigarette smoke, air pollution, or occupational dust. Acute exacerbation of chronic bronchitis (AECB) can significantly impair a patient’s quality of life and often requires hospitalization. This study aims to evaluate the management of bronchitis at Hasri Ainun Habibie Regional General Hospital, Gorontalo Regency. The research is descriptive in nature, using a retrospective method by analyzing patient medical records dated February 25, 2025, utilizing the SOAP method (Subjective, Objective, Assessment, Plan) and supported by literature review. The treatment regimen included a combination of antibiotics (ceftriaxone and azithromycin), nebulized bronchodilators (Meprovent and Budesma), mucolytics (Resfar), neuroprotective agents (citicoline), and electrolyte replacement therapy (NaCl 0.9%, KAEN 3B). Overall, this case study concludes that the management of chronic bronchitis in patients at Hasri Ainun Habibie Regional General Hospital includes a combination of medical and non-medical therapies that are in accordance with the management guidelines and treatment algorithms for chronic bronchitis.

Formula Optimization and Taste Masking Efforts for Orally Dissolving Film (ODF) Preparations of Green Betel Leaf Extract (Piper Betle L.) as a Mouth Freshener

2025-11-10T05:58:22-08:00

Halitosis is caused mainly by bacterial decay and the generation of volatile sulfur compounds. Halitosis has oral causes, such as poor oral hygiene, periodontal disease, tongue coat, food impaction, dentures, damaged restorations, oral carcinoma, and throat infections. Green betel leaves are beneficial for oral health. Betel leaves contain flavonoid compounds, polyphenols, tannins and essential oils. Betel leaves contain essential oils of 1 – 4.2%, phenol compounds and kavikol. Kavikol has activity as a bactericide five times stronger than phenol. This extract can potentially be used as an active ingredient component in orally dissolving film (ODF) preparations. The purpose of this study was to determine the optimal concentration value of HPMC as a polymer and propylene glycol as a plasticizer based on physical properties such as pH, weight uniformity, film thickness, dissolving time and taste masking test of orally dissolving film (ODF) preparations of green betel leaf extract (Piper betle l.). The method used was Simplex Lattice Design (SLD) with a composition of 2% HPMC and 5% propylene glycol. The response results from the pH and dissolution time experiments with an average standard deviation, respectively, ranged from 6.67±0.020-6.73±0.026; 122.21±0.33 -122.85±0.29 mg; 0.2±0.005 mm - 0.21±0.01 mm, and 20.5±0.06 - 30.1±0.05 seconds. In taste masking, it has a fairly good ability to cover the bitter taste of green betel leaf extract.

Antioxidant Activity Test of Extract and Fractionation of Tekelan Leaves (Chromolaena odorata (L.) R.M.King & H.Rob) and Antibacterial Test on Staphylococcus aureus and Escherichia coli

2025-11-11T06:05:14-08:00

Background: Tekelan leaf (Chromolaena odorata (L.) R.M.King & H.Rob) is one of Indonesia's natural resources rich in bioactive compounds. Its traditional use for treating wounds, sore throats, diarrhea, and various other ailments is suspected to be linked to its antioxidant and antibacterial content. Objective: This research aimed to analyze the antioxidant activity of the ethanol extract, n-hexane fraction, and ethyl acetate fraction of tekelan leaves, and to test their antibacterial activity against Staphylococcus aureus and Escherichia coli. Method: The study used an experimental method. Antioxidant activity was tested using the DPPH (2,2-diphenyl-1-picrylhydrazyl) method with a UV-Vis spectrophotometer, and the results were expressed as IC₅₀ values. The antibacterial test against S. aureus and E. coli was conducted using the disc diffusion method, and the inhibitory power was measured based on the inhibition zone diameter (mm). Results: The antioxidant test results showed that the ethanol extract and ethyl acetate fraction had strong activity with IC₅₀ values of 98.26 ppm and 75.43 ppm, respectively, while the n-hexane fraction showed weak activity (IC₅₀ 110.54 ppm). In the antibacterial test at a 40% concentration, the ethanol extract, n-hexane fraction, and ethyl acetate fraction inhibited the growth of both bacteria with strong to very strong categories. The highest average inhibition zones against E. coli and S. aureus were 19.03 mm and 21.36 mm (ethanol extract), 10.56 mm and 12.13 mm (n-hexane fraction), and 13.60 mm and 15.40 mm (ethyl acetate fraction), respectively. This activity was still lower than the positive control chloramphenicol, which produced inhibition zones of 28.23 mm (E. coli) and 27.43 mm (S. aureus). Conclusion: It was concluded that the extract and ethyl acetate fraction of tekelan leaves have strong antioxidant activity, while the n-hexane fraction is classified as weak. All samples (extract, n-hexane fraction, and ethyl acetate fraction) showed strong antibacterial activity against E. coli and S. aureus, although they have not matched the effectiveness of chloramphenicol.

Formulation of Siwak (Salvadora persica) Extract as a Mouth Spray and Its Effectiveness Against Staphylococcus aureus

2025-11-12T08:17:27-08:00

Mouth-related problems often occur in human life, one of which is bad breath. Mouth spray is a health product that contains a combination of active ingredients and additional ingredients such as antibacterial, freshener, or moisturizer that work to support dental and oral health. Miswak (Salvadora persica) contains large amounts of chloride, fluorine, trimethylamine and resin, silica sulfur and vitamin C, where these chemical ingredients have great benefits for dental and oral health. This study aims to formulate miswak extract in the form of a mouth spray preparation and test its effectiveness against Staphylococcus aureus bacteria and use Simple Lattice Design as an optimization method. Extraction was carried out by the maceration method using 96% ethanol, then the extract was formulated in the form of a mouth spray preparation. The physical properties of the mouth spray were evaluated through organoleptic tests, pH, clarity and viscosity, while the antibacterial activity test was carried out by the well diffusion method. The results of the organoleptic test showed that all formulas had a dark brown color and a distinctive odor. The results of the clarity test for the five formulas looked clear and there were no visible particles. The pH test showed that all formulas had pH results within the safe range. The viscosity test did not meet the requirements, with an average result of 11.43 ± 0.52 cP. The antibacterial test showed that the miswak extract had antibacterial activity with an inhibition zone diameter of 16.25 mm against Staphylococcus aureus bacteria.

Analysis of Factors Influencing the Occurrence of Overnutrition in Infants

2025-11-12T08:17:29-08:00

Background: Overnutrition in infants aged 6-12 months is an increasingly prevalent health issue. The main factors suspected to play a role are maternal knowledge about nutrition and inappropriate feeding practices. Based on initial observations in Mekar Sari Village, Deli Serdang, 30 infants were found to be overnourished, indicating the need to identify the influencing factors. Objective: This study aimed to analyze the factors influencing the occurrence of overnutrition in infants aged 6-12 months, with a focus on maternal knowledge and feeding practices. Methods: The study used a cross-sectional design with a quantitative approach. Data were collected through interviews using questionnaires and anthropometric measurements. Infant nutritional status was determined based on Weight-for-Height (WHZ) measurements referring to WHO Growth Standards (2006), where infants were categorized as overnourished if the WHZ Z-score > +2 SD. The sample consisted of 30 infants who met the inclusion criteria. Results: WHZ measurements showed that 17 infants (56.7%) were overnourished. A total of 19 mothers (63.3%) had poor nutritional knowledge and 17 mothers (56.7%) implemented inappropriate feeding practices. Bivariate analysis showed significant relationships between overnutrition and maternal knowledge (p-value = 0.000; OR = 22.713) and feeding practices (p-value = 0.000). Conclusion: Maternal knowledge and feeding practices are factors that significantly influence the occurrence of overnutrition in infants at the research location. Public health interventions focusing on improving maternal nutritional literacy and promoting appropriate feeding practices are essential for preventing this problem.

Testing of Antioxidant and Antibacterial Activity of Extracts and Fractions from Bandotan Leaves (Ageratum conyzoides L.) on Escherichia coli and Staphylococcus aureus

2025-11-12T10:13:55-08:00

Bandotan (Ageratum conyzoides L.) is a plant distributed worldwide, especially in tropical and subtropical regions. Bandotan can be used as a traditional medicine because it contains beneficial phytochemical compounds such as terpenoids, alkaloids, essential oils, saponins, and phenolics that play a role in inhibiting bacterial growth and serving as natural antioxidants. The objective of this research was to determine the antioxidant and antibacterial activity of the extract, n-hexane fraction, and ethyl acetate fraction from bandotan leaves. This research used an experimental method. It included antioxidant testing of the ethanol extract fractions of bandotan leaves (Ageratum conyzoides L.) using the DPPH method and antibacterial testing using Escherichia coli and Staphylococcus aureus bacteria. The phytochemical screening results showed that bandotan leaves contain alkaloids, saponins, tannins, flavonoids, and glycosides. The antioxidant testing for DPPH radical scavenging revealed that the bandotan leaf extract had an IC50 value of 499.3633 μg/ml, the n-hexane fraction had an IC₅₀ value of 945.7837 μg/ml, and the ethyl acetate fraction had an IC₅₀ value of 382.9216 μg/ml, all categorized as very weak antioxidants. Antibacterial testing indicated that the extract, n-hexane fraction, and ethyl acetate fraction of bandotan (Ageratum conyzoides L.) exhibited antibacterial activity, inhibiting the growth of Escherichia coli and Staphylococcus aureus, with strong activity at the highest concentration of 40% and moderate activity at the lowest concentration of 10%. In conclusion, bandotan leaves have very weak antioxidant activity due to the low content of flavonoids and strong antibacterial activity at 40% concentration and weak activity at 10% concentration.

Antioxidant Activity Test of Avocado Leaf Kombucha (Persea americana Mill.) Based on Fermentation Duration Using the ABTS Method

2025-11-13T18:58:59-08:00

Kombucha tea is a widely consumed herbal beverage. Avocado leaves (Persea americana Mill.) are known to contain various bioactive compounds such as flavonoids, quercetin, and polyphenols, which play an important role in providing health benefits, particularly as antioxidants. Objective: This study aimed to evaluate the antioxidant activity of avocado leaf kombucha using the Azinobis Ethylbenzothiazoline Sulfonic Acid (ABTS) method. Methods: This research employed an experimental design with quantitative antioxidant activity testing using the ABTS method. The IC₅₀ values were determined through linear regression analysis based on the relationship between sample concentration and percentage inhibition of the ABTS radical. Results: The IC₅₀ value of non-fermented avocado leaf kombucha was 106.40 ppm, which falls within the moderate antioxidant category (IC₅₀: 100–150 ppm). Fermentation for 9 days produced an IC₅₀ of 67.99 ppm (strong), 12 days resulted in 49.91 ppm (very strong), and 14 days resulted in 40.18 ppm (very strong). Vitamin C, used as a positive control, showed an IC₅₀ of 9.160 ppm (very strong). Conclusion: The antioxidant activity of avocado leaf kombucha increased with the duration of fermentation. Non-fermented kombucha exhibited moderate antioxidant activity, while fermentation for 9, 12, and 14 days resulted in strong to very strong antioxidant capacity. Keywords: Kombucha Tea, Avocado Leaves, Antioxidant, ABTS, IC₅₀.

Formulation of Denture Cleanser Preparation with Miswak (Salvadora persica) Extract and Effectiveness Test Against Staphylococcus aureus Bacteria

2025-11-14T10:52:34-08:00

Plaque buildup and bacterial accumulation on the surface of dentures are common problems faced by denture users. One alternative that can be used to clean dentures is miswak (Salvadora persica). Miswak contains many natural ingredients, including sodium chloride, potassium chloride, salvadourea, oleic acid, linoleic acid, trimethylamine, thiocyanate, benzyl isothiocyanate, and nitrate, silica, vitamin C, resin, tannin, saponin, N-benzyl-2 phenylacetamide, lignan, flavonoid, fluoride, calcium, sodium bicarbonate, and salvadorin. The purpose of this study was to formulate an effective denture cleanser from miswak extract using the Simplex Lattice Design (SLD) optimization method and to test its effectiveness against Staphylococcus aureus bacteria. The method used for the extraction process was the maceration method using 96% alcohol. For the antibacterial test of the denture cleanser preparation, the time kill assay method was used. The physical properties of the denture cleanser preparations were tested including organoleptic tests, clarity tests, pH tests, and viscosity tests. The results of the physical properties of the preparations in the organoleptic test for formulas 1 to 5 showed the characteristics of mint odor, brown color, and liquid form. The clarity test for all five formulas showed clear results and also no foreign particles and was declared to have met the requirements. The pH test results for the five formulas ranged from 6.28 ± 0.01 to 6.43 ± 0.01 and had met the requirements. The viscosity test did not meet the requirements because the results ranged from 10 ± 2 to 12.67 ± 1.15. The antibacterial test showed that there was no significant difference between all test groups regarding antibacterial activity.

Development of an Evidence-Based Practice-Based Participatory Education Model for the Implementation of Clean and Healthy Living Behavior in Islamic Boarding Schools

2025-11-14T10:52:36-08:00

Clean and Healthy Living Behavior (CHLB) is a crucial preventive measure to improve health status in Islamic boarding schools (pesantren). This study aimed to develop an evidence-based education model for CHLB in a pesantren in West Sumatra. The research applied a Research and Development (R&D) design through the stages of analysis, design, development, implementation, and evaluation. Data were collected through observation, in-depth interviews, and pre- and post-test questionnaires. The findings revealed that unhealthy behaviors among students remained high, with 93.47% not practicing handwashing with soap, 50% littering, 65.22% spitting in public areas, and 76.08% not engaging in mosquito larvae control. Interviews with caregivers and administrators indicated the absence of nutritionists in meal planning, lack of educational media, and limited health education, which was only provided once during the Covid-19 pandemic. The developed educational model proved effective, demonstrated by significant improvements in knowledge (increase of 43 points) and attitudes (increase of 25 points) after the intervention. Respondents considered the model practical, easy to understand, and culturally appropriate within the pesantren context. Therefore, the participatory, evidence-based education model is feasible to be implemented more widely to strengthen CHLB practices and prevent behavior-related diseases in Islamic boarding schools.

Formulation, Evaluation and Antioxidant Activity of Used Nano Tea Bags Solid Soap

2025-11-16T17:04:17-08:00

Background: Ideal soap should not only cleanse the skin but also contain substances that protect it from adverse effects, including those of free radicals, which can accelerate aging and cause other skin problems. Antioxidant compounds are needed to counteract free radicals. Used tea bags are a waste product that still contains antioxidant compounds. The use of nanotechnology is expected to enhance the stability and long-term effectiveness of cosmetic formulations, including soap. Objective: This study aimed to formulate a solid soap containing used nano tea bag powder, evaluate the physical characteristics of the soap, and test its antioxidant activity. Method: This research used a True Experimental method with a Post Test Only Control Group Design. The used tea bag powder sample was processed into nano powder using a Ball Mill. Solid soap was formulated in three variations: F0 (control without powder), F1 (containing 1.4% used tea bag powder), and F2 (containing 1.4% used nano tea bag powder). The soap preparations were then evaluated for their physical characteristics (organoleptic, pH, foam stability, hardness, cleaning power) and tested for antioxidant activity using the DPPH method. Results: The used tea bag powder was successfully converted into nano powder with an average particle size of 684.35 nm. Phytochemical screening results showed that both the powder and nano powder contained alkaloids, steroids, flavonoids, saponins, and tannins. Evaluation of the solid soap showed that all formulas (F0, F1, F2) met the physical quality requirements. The antioxidant activity test yielded IC50 values for F0, F1, and F2 of 975.2861 µg/ml (very weak), 211.3533 µg/ml (very weak), and 168.3053 µg/ml (weak), respectively. Conclusion: It can be concluded that the used tea bag powder meets the characteristics of nano powder. The solid soap formulation containing used nano tea bag powder meets physical quality requirements and demonstrates antioxidant activity, albeit in the weak category. The F2 formula (nano powder) showed better antioxidant activity than F1 (coarse powder) and F0 (control).

Analysis of Nicotine Content and Identification of Bioactive Compounds in Gayo-Origin Tobacco Leaf (Nicotiana tabacum L.) Extract Using GC–MS and Titration

2025-11-17T08:38:17-08:00

Gayo-origin tobacco leaves (Nicotiana tabacum L.) are a locally cultivated tobacco variety widely grown in Central Aceh, Indonesia. Tobacco leaves are known to contain nicotine, a bioactive compound with various pharmacological and economic potentials. This study aimed to identify the nicotine content and phytochemical profile of Gayo tobacco leaf extract. The research procedures included sample collection, macroscopic and microscopic examinations, simplicia preparation, characterization of the simplicia and extract, phytochemical screening, quantitative nicotine determination using acidimetry titration, and qualitative analysis using Gas Chromatography–Mass Spectrometry (GC–MS). Macroscopic examination showed that the leaves were oval to round in shape, broad-surfaced, green in color, with a characteristic odor and a bitter taste. Microscopic observation revealed the presence of vascular bundles, covering trichomes, and glandular hairs in the leaf fragments. The titrimetric test showed nicotine levels of 0.95 ± 0.3% in the simplicia powder and 1.87 ± 0.45% in the ethanol extract. GC–MS analysis identified several major compounds, including nicotine (20.99%) and Labda-8(20),13-dien-15-oic acid (29.85%) as dominant components, along with minor compounds such as Quinolin, 8-amino-6-hydroxy-Quinazoline (2.39%). These findings indicate that the Gayo tobacco leaf extract contains a relatively high level of nicotine and is dominated by alkaloid and diterpenoid acid derivatives, suggesting its potential for further phytochemical and pharmacological exploration.

The Effect of Pineapple Leaf Extract on the Growth of Candida albicans and Malassezia furfur in Herbal Shampo Formulations

2025-11-19T21:57:52-08:00

Background: Dandruff is a common scalp problem often caused by the overgrowth of fungi such as Candida albicans and Malassezia furfur. Pineapple leaves (Ananas comosus (L.) Merr.) are known to contain active antifungal compounds, such as alkaloids, flavonoids, saponins, and tannins, making them a potential active ingredient for anti-dandruff preparations. Objective: This study aimed to formulate an herbal anti-dandruff shampoo using pineapple leaf ethanol extract and to evaluate its effectiveness in inhibiting the growth of Candida albicans and Malassezia furfur. Methods: This experimental research used the disc diffusion method with PDA and SDA media to test antifungal inhibition. The shampoo preparations were formulated with varying extract concentrations (10%, 20%, 30%). The evaluation of the preparations included organoleptic tests, homogeneity, pH, foam height, viscosity, stability (cycling test), skin irritation, and hedonic tests. Results: The resulting shampoo preparation had a blackish-brown color, liquid form, and a menthol odor. Evaluation results showed the preparation was homogeneous, with pH values (5.0-5.8), foam height, and viscosity meeting the requirements. The preparation was also stable during the cycling test and did not cause irritation. The antifungal activity test showed that increasing the extract concentration increased the inhibitory power. The formula with a 30% concentration (F3) provided the greatest inhibition against Candida albicans (average 15.76 mm) and Malassezia furfur (average 15.9 mm), which is categorized as strong. Conclusion: Pineapple leaf ethanol extract was successfully formulated into an effective herbal anti-dandruff shampoo preparation, with the 30% concentration being the most optimal. It is recommended that further research investigate the antifungal activity of this extract against other types of fungi and in different dosage forms.

Analysis of Drug-Related Problems in Prescriptions of Type 2 Diabetes Mellitus Patients at Hospital “X”, Aceh Province: A Retrospective Cross-Sectional Study

2025-11-20T05:53:03-08:00

Background: The complexity of treatment regimens and the simultaneous use of multiple medications increase the risk of drug-related problems (DRPs), which can affect the effectiveness, safety, and security of patient treatment. Objective: This study aims to explore and identify Drug-Related Problems in the treatment of patients with type 2 diabetes mellitus (T2DM) at Hospital “X”, Aceh Province, Pidie District, Aceh. Methods: This study is a quantitative descriptive study with a retrospective cross-sectional design of prescriptions for T2DM patients during the period of January-December 2024 at Hospital “X”, Aceh Province. Results: Analysis of 395 T2DM patient prescriptions that met the inclusion criteria identified a total of 1,275 Drug-Related Problems (DRPs) incidents. Potential MTO in category P.2 (drug safety) were the most common, accounting for 1,080 cases. The majority of these cases were attributed to inappropriate drug selection, followed by 132 incidents related to drug preparation. The high incidence of MTO was primarily due to adverse drug reactions and drug interactions, which were closely associated with inappropriate drug choices or improper drug combinations. The importance of a pharmaceutical service approach in improving patient safety and therapeutic effectiveness in the management of DMT2, especially in the prevention and management of drug-related problems (MTO). Conclusion: The most dominant DRP category identified was drug safety (P.2), primarily caused by inappropriate drug selection. Drug interactions resulting from suboptimal therapeutic combinations were the main contributing factor to MTO, with the majority classified as moderate in severity. These findings highlight the need for more active and systematic clinical pharmacy interventions in reviewing medication regimens, along with interprofessional collaboration to enhance therapeutic effectiveness, ensure patient safety, and reduce the incidence of MTO in the management of type 2 diabetes mellitus (T2DM).

The Relationship Between Mothers' Knowledge and Attitudes towards the Growth and Development of Infants Aged 6–24 Months at PMB Pera in 2025

2025-11-20T17:26:55-08:00

Background: Growth and development are often considered similar as both involve changes in infants. Growth refers to quantitative changes related to physical maturation, such as increases in body size and weight, which are irreversible. In contrast, development refers to qualitative changes involving the maturation of body functions and structures, and this process continues throughout life. Several factors, including parental knowledge and attitudes, significantly influence and are correlated with infant growth and development. Mothers with low levels of knowledge and negative attitudes are at higher risk of experiencing deviations in their infants’ growth and development. Objective: This study aims to identify the correlation between parental knowledge and attitudes toward infant growth and development among mothers at PMB Pera. Methods: This research used a quantitative approach with an observational design and a cross-sectional study method. Data were gathered by distributing questionnaires and interviews involving 30 respondents. The acquired dataset was processed utilizing univariate and bivariate techniques and tested with the Chi-Square test to examine the correlation between variables. Results: Considering the Chi-Square analysis, there was a significant relationship between parental knowledge and infant growth and development, with a p-value of 0.000. Likewise, parental attitudes toward infant growth and development showed a significant relationship, with a p-value of 0.044. These outcomes indicate that the independent variables in this study have a significant correlation with the growth and development of infants aged 6–24 months at PMB Pera.

Cardiovascular Drug–Drug Interactions (DDIs) in Coronary Heart Disease Patients with Hypertension

2025-11-20T20:23:53-08:00

Coronary heart disease (CHD) accompanied by hypertension often necessitates the use of multiple cardiovascular agents. The concurrent use of multiple drugs increases the risk of drug-drug interactions (DDIs), which may alter drug metabolism, reduce therapeutic efficacy, or cause adverse effects. This study aimed to characterize the potential, mechanisms, and severity of drug interactions; to assess differences in the average number of drugs used per day in relation to the potential for drug interactions; and to assess the clinical profile based on DDI severity levels. A retrospective, analytic, observational method was applied, utilizing secondary data from hospital medical records. Statistical analysis included the Mann–Whitney test to compare the mean number of drugs per day between the interaction potential groups. A total of 52 patients met the inclusion criteria through purposive sampling. The results showed that most CHD patients with a history of hypertension were male (75%) and aged 18–64 years (73.1%). A total of 405 potential DDIs were identified. From these, 80 unique drug-pair interactions were selected for detailed analysis of their mechanisms and severity. Most were pharmacodynamic (77.5%), with aspirin–nitroglycerin the most frequent (7.6%). Among the 80 interactions analyzed in detail, those with moderate severity predominated (58.8%), followed by minor (35%) and major (6.2%). Polypharmacy (defined as the use of three or more medications) was observed in all patients who experienced DDIs. There was a significant difference in the average number of medications per day between patients with potential drug interactions and those without, p = 0.023 (p < 0.05).

Evaluation of Adverse Drug Reaction in Pediatric Tuberculosis Patients at The Tegal District Public Health Center

2025-11-21T00:03:06-08:00

Tuberculosis (TB) is a disease caused by bacteria, namely Mycobacterium tuberculosis (MTB) and needanti-TB drugs (ATD) treatment. The success of ATD therapy is influenced by various factors, including ADRs and their management, which play a role in treatment and retention in care. The frequency and severity of ADRs caused by ATD are always a concern, especially in children. The study aims to determine the prevalence of ADRs, determine the management and outcome of ADR treatment in pediatric TB patients at the Tegal Regency Community Health Center. This study used a cross-sectional design in pediatric TB patients aged 0-18 years. This study showed The most frequent ADRs were gastrointestinal disturbances (16.7%), joint pain (8.3%), peripheral neuropathy (6.7%), and flu-like syndrome (6.7%). The ADR event category is likely to have a percentage of 91% of the overall number of events, followed by the possibility with a percentage of 9% of events. Management strategies, including vitamin B complex supplementation, antacids, multivitamins, probiotics, antipyretics, and topical agents, effectively reduced or eliminated ADRs. The most common ADRs werw gastrointestinal disorders, joint pain and flu syndrome. Management of ADRs related to anti-tuberculosis drugs (ATD) has been successful in reducing or eliminating ADRs. Special attention from healthcare workers should be given to patients at spesific risk groups for ADR management to improve therapy success.

Antioxidant Activity and α-Glucosidase Inhibitory Activity of Endophytic Bacteria Isolated from Areca catechu Seeds

2025-11-22T12:27:04-08:00

Introduction: Diabetes mellitus is a chronic metabolic disorder with a high global prevalence and serious complications. The prediabetes stage is a critical target for prevention, often managed with α-glucosidase inhibitors. However, synthetic drugs such as acarbose are frequently associated with gastrointestinal side effects, highlighting the need for safer alternatives. Endophytic microbes from medicinal plants, including areca nut (Areca catechu), have the potential to produce bioactive compounds with antioxidant and antidiabetic activities. Objective: This study aimed to explore endophytic bacteria from fresh areca nut seeds as a source of metabolites with antioxidant and α-glucosidase inhibitory activity. Methods: Fresh areca nut seeds were sterilized using the surface sterilization method, followed by endophytic bacterial isolation and Gram staining. Cultures were fermented in Nutrient Broth, and supernatants were obtained by centrifugation. Antioxidant activity was assessed using the DPPH method, while α-glucosidase inhibition was tested in vitro with p-nitrophenyl α-D-glucopyranoside as substrate. Acarbose served as the positive control. Results: Seven Gram-negative, rod-shaped endophytic isolates (BP1-BP7) were obtained. Isolate BP1 exhibited the highest antioxidant activity with 45.7% inhibition. Furthermore, the BP1 supernatant demonstrated potent α-glucosidase inhibitory activity up to 93,6%, comparable to that of acarbose (91%). Conclusion: Endophytic bacteria from areca nut seeds possess dual bioactivity as antioxidants and α-glucosidase inhibitors, suggesting their potential as sustainable alternative antidiabetic agents worthy of further investigation.

Drug Interactions in Insulin Therapy Among Patients with Type 1 Diabetes Mellitus: A Retrospective Study

2025-11-22T18:17:29-08:00

Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disorder resulting in the destruction of pancreatic β-cells, leading to absolute insulin deficiency and hyperglycemia. Insulin remains the cornerstone of therapy; however, its use may be complicated by drug interactions that alter treatment effectiveness through pharmacodynamic or pharmacokinetic mechanisms. This study aimed to evaluate the prevalence and mechanisms of potential insulin drug interactions in patients with T1DM. A retrospective, cross-sectional study was conducted using a total sampling method. The study was conducted at Dr. M. Djamil General Hospital Padang. The study population consisted of all hospitalized patients diagnosed with type 1 diabetes mellitus (T1DM) during the period 2019–2022. Patient characteristics, patterns of insulin therapy, and the occurrence of drug interactions were analyzed. The majority of patients were female (70%), and most were in the 0–18-year age group (83%). Insulin therapy was prescribed in 86.6% of cases. Potential drug–drug interactions were identified in 33.3% of hospitalized patients with type 1 diabetes mellitus, predominantly pharmacodynamic in nature. The basal–bolus insulin regimen constituted the most frequently prescribed therapeutic option among the patients. The Spearman correlation analysis indicated a statistically insignificant association between the metric of polypharmacy and the incidence of drug interactions. Systematic monitoring remains essential, and larger prospective studies are needed to confirm these findings.

Minimum Inhibitory Concentration and Minimum Fungicidal Concentration of Extract and Nanoparticles of Ethanol Extract of Golden Trumpet Leaves (Allamanda cathartica L.) Against Malassezia furfur

2025-11-23T16:35:16-08:00

Background: Fungal skin infections such as pityriasis versicolor caused by Malassezia furfur remain a common health problem in tropical regions. Limitations of conventional antifungal therapy have encouraged the development of alternative agents derived from natural products. Golden trumpet leaves (Allamanda cathartica L.) contain flavonoids and iridoids with potential antifungal activity, and nanoparticle formulations are being developed to enhance the extracts’ effectiveness. Objective: To evaluate the improvement of antifungal efficacy of the nanoparticle formulation of the ethanolic extract of golden trumpet leaves against Malassezia furfur by comparing the Minimum Inhibitory Concentration (MIC), Minimum Fungicidal Concentration (MFC), and inhibition zone diameter with the conventional extract. Methods: This experimental study employed a posttest-only control group design. Treatment groups included ethanolic extract (6.25%, 12.5%, 25%, 50%) and nanoparticle extract (0.625%, 1.25%, 2.5%, 5%). Nanoparticles were prepared using a high-pressure homogenizer and characterized with a Particle Size Analyzer (PSA). MIC and MFC were determined using the broth dilution method, while antifungal activity was assessed using the disc diffusion method. Data were analyzed using one-way ANOVA at a 95% confidence level. Results: Nanoparticle characterization revealed a particle size of 367.51 nm. The MIC values for the extract and nanoparticles were 12.5% and 1.25%, respectively, while the MFC values were 50% and 5%, respectively. The highest inhibition zones for the extract and nanoparticles were 21.1 mm (50%) and 20.3 mm (5%), respectively. Statistical analysis showed significant differences (p < 0.05) in inhibition zone diameters across concentrations for both extract forms. Conclusion: The nanoparticle formulation of the ethanolic extract of golden trumpet leaves significantly enhances antifungal activity against Malassezia furfur, demonstrating equivalent inhibitory effects at concentrations ten times lower than the conventional extract. These findings indicate the potential of nanoparticle-based formulations as promising antifungal candidates.

The Effectiveness of Topically Applied Berastagi Orange (Citrus sinensis L.) Peel Extract on Serum C-reactive Protein Levels in Male Rats (Rattus norvegicus) with Incision Wounds

2025-11-26T18:29:59-08:00

Introduction: Cutaneous wounds in male rats (Rattus norvegicus) are widely used as models for wound-healing research. C-reactive protein (CRP) is an inflammatory biomarker that increases in response to injury. Berastagi orange peel extract (Citrus sinensis L.) is known for its anti-inflammatory properties; however, its effectiveness in reducing serum CRP levels in cutaneous wounds has not been extensively studied. Objective: This study aimed to evaluate the effectiveness of topically administered Berastagi orange peel extract on serum CRP levels in male rats with cutaneous wounds. Methods: A total of 25 male rats were divided into three groups: control, treatment with orange peel extract, and treatment with a standard ointment. Wounds were inflicted on the rats' backs, and treatments were administered for a few days. Serum CRP levels were measured using the ELISA method. Results: Results indicated that the group receiving Berastagi orange peel extract exhibited a significant reduction in CRP levels compared to the control group (p < 0.05). The standard ointment group also showed a reduction, but not as effectively as the orange peel extract. Conclusion: Berastagi orange peel extract significantly reduces serum C-reactive protein levels in male rats with cutaneous wounds. These findings support the use of natural extracts as alternatives in wound healing therapy.

Soursop Leaf (Annona muricata L.) Extract Gel: Formulation and Effectiveness against Microsporum canis

2025-12-02T06:28:54-08:00

Soursop (Annona muricata L.) leaves contain genistein, steroids, and coumarins, which exhibit potential as natural antifungal agents against Microsporum canis, the causative agent of ringworm. This study aimed to formulate a soursop leaf extract gel using Na-CMC and carbopol 940 as gelling agents, optimized through the Simplex Lattice Design (SLD) with DE version 13, and to evaluate its physical characteristics and antifungal activity. Extraction was carried out by maceration with 96% ethanol. The optimum formula was obtained with 4.3% Na-CMC and 1.7% carbopol 940. The optimized gel exhibited homogeneous texture, characteristic soursop odor, greenish-brown semi-solid appearance, pH of 6.56 ± 0.17, viscosity of 326 ± 16.73 dPas, spreadability of 3.96 ± 0.43 cm², and adhesiveness of 1.58 ± 0.71 seconds. Antifungal testing using the well diffusion method showed an inhibition zone of 15.33 mm, classified as strong activity. ANOVA analysis revealed a significance value of 0.000 (< 0.05), indicating significant differences among the positive control, negative control, optimized gel, and soursop leaf extract. The antifungal activity of the optimum formula was not significantly different from that of the soursop leaf extract (p = 0.795). These results indicate the potential of soursop leaf extract gel as an effective antifungal alternative.

Antidiabetic Potential of the Ethyl Acetate Fraction from Ethanol Extract of Yacon (Smallanthus sonchifolius) Stems in Vivo

2025-12-03T01:49:38-08:00

Diabetes mellitus is one of the global health problems that requires alternative therapies based on natural products. The stem of yacon (Smallanthus sonchifolius) is known to contain various secondary metabolites with potential antidiabetic effects. This study aimed to identify the secondary metabolites in the ethyl acetate fraction of yacon stem, evaluate its antidiabetic activity in alloxan-induced male Wistar rats, and determine the lowest effective dose. Phytochemical screening revealed the presence of flavonoids, terpenoids, steroids, tannins, and alkaloids. The in vivo test was conducted by administering the ethyl acetate fraction at doses of 25, 50, and 100 mg/kgBW to Wistar rats, with negative and positive control groups using metformin. The results showed that all treatment doses significantly reduced blood glucose levels compared to the negative control, with hypoglycemic effects observed from day 7 and becoming more pronounced until day 21. The 25 mg/kgBW dose was the lowest dose that produced effects comparable to metformin and thus can be considered the lowest effective dose. These findings indicate that yacon stem has the potential to be developed as a natural agent for antidiabetic therapy.

Effectiveness of Propolis in Protecting Against Gastric Ulcers in Male Wistar Rats (Rattus norvegicus) Induced by Ibuprofen

2025-12-03T07:24:03-08:00

Background: The use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen often associated with gastric mucosal damage commonly referred to as gastric ulcer. This damage occurs due to the inhibition of the cyclooxygenase (COX) enzyme, which plays a cytoprotective role. Propolis, a natural product from honeybees, is known to contain flavonoids with anti-inflammatory, antioxidant, and anti-ulcer activities that can protect the gastric mucosa. Objective: This study aimed to determine the protective effect of propolis against gastric ulcers in male Wistar rats (Rattus norvegicus) induced by ibuprofen. Methods: True Experimental method with a Post-Test Only Control Group Design. The sample consisted of 30 male Wistar rats divided into five groups: a control group without treatment, a negative control group treated with ibuprofen 400 mg/kg, and three treatment groups administered propolis doses of 0.13 ml, 0.26 ml, and 0.52 ml. The treatment was conducted for the first seven days, followed by ibuprofen induction at 400 mg/kg for the next seven days. Results: The lowest mean number and severity of ulcers were found in the P3 group (3.1 ± 0.75; 2.4 ± 0.48). The Kruskal Wallis test results indicated a significant difference in the number and severity of ulcers between the control and treatment groups (p < 0.05). However, the post hoc Mann Whitney test revealed no significant differences among the treatment groups (p > 0.05). Conclusion: Propolis administration reduced the number and severity of ulcers caused by ibuprofen induction. Nevertheless, the dose of propolis used in this study have not yet achieved optimal efficacy

Effectiveness of Rambutan (Nephelium lappaceum L.) Peel Extract on Creatinine Levels and Kidney Histology Structure of Obese Rats

2025-12-03T23:50:39-08:00

Obesity is a condition characterized by the accumulation of excess fat in the body that can cause systemic metabolic changes. Rambutan peel is known to be rich in bioactive compounds such as geraniin, corilagin, ellagic acid, and other active compounds. This study aims to analyze the effect of rambutan peel extract on creatinine levels and kidney histology in obese rat models. The experimental research method used a post-test only control group design. A total of 25 male rats were divided into 5 groups: Normal group (K-); Obese group induced by coconut oil and 15% sugar water (K+); Obese group given ellagic acid (T1); Groups T2 and T3 induced by coconut oil and 15% sugar water and rambutan peel extract at doses of 15 mg/kgBW and 30 mg/kgBW. The parameters of this study were creatinine levels and kidney glomerular diameter. Data analysis used one-way ANOVA and Tukey HSD tests. The results of the study showed that rambutan peel extract could significantly reduce creatinine levels and glomerular diameter (p<0.05). The most optimal reduction was shown at a dose of 30 mg/kgBW for both creatinine levels and glomerular diameter. It can be concluded that rambutan peel extract has the potential to reduce creatinine levels and improve glomerular diameter in obese rat models.

The Relationship between Postpartum Mothers' Knowledge and the Implementation of Bounding Attachment in Newborns

2025-12-04T08:19:46-08:00

Background: The puerperium is a crucial period after childbirth that lasts for 6 weeks. During this time, the mother's body undergoes physical changes such as the return of the uterus to its original size, the release of lochea, and other hormonal changes. During this postpartum period, the mother can build closer affection. It is the cornerstone of the child's psychological development because of the significance of emotional bonding (bounding attachment) between mother and child. However, a lot of mothers continue to overlook this. Some factors that can influence the implementation of bounding attachment are through good maternal knowledge. Objective: to ascertain how postpartum mothers' understanding and the use of bounding attachment in infants at Pratama Sunggal Clinic relate to one another. Methods: 33 respondents were given questionnaires or had in-person interviews as part of this quantitative study, which uses a cross-sectional design and an analytical survey approach. To determine the link between variables, univariate and bivariate data analysis were employed, along with the chi-square test. Results: The chi-square test revealed a p-value of 0.002 for the association between postpartum moms' knowledge and the application of bounded attachment. Thus, the results indicate that the independent and dependent variables have a substantial association.

Detection of Coliform and Escherichia coli Contamination in Iced Tea Beverages in City X

2025-12-04T06:25:27-08:00

Iced tea is a popular and refreshing beverage commonly sold by street vendors. However, because the production process utilizes water and relies on the level of hygiene during processing, there remains a risk of bacterial contamination. This study aims to determine the level of bacterial contamination, specifically Coliform and Escherichia coli, in iced tea samples sold in X City, in accordance with food safety standards. This study was conducted using the Most Probable Number (MPN) method with three dilution series. The presence of Coliform was identified using a presumptive test with Lactose Broth (LB) media and a confirmatory test with Brilliant Green Lactose Bile Broth (BGLB) media. The presence of Escherichia coli was identified using Eosin Methylene Blue Agar (EMBA) media and biochemical tests using Triple Sugar Iron Agar (TSIA) media. Samples were taken from 10 different locations spread across 5 subdistricts in X City, with 2 samples taken from each subdistrict. The results showed that there was Coliform bacterial contamination in 10 samples and Escherichia coli bacterial contamination in 6 of the 10 iced tea samples in X City with MPN values ranging from 3-460 MPN/100 mL. Based on the Mann-Whitney test, a p-value of 0.004 (p < 0.05) was obtained, indicating a significant difference in MPN values between Escherichia coli-positive and negative samples. These results indicate that all samples did not meet the microbiological quality requirements based on Peraturan Menteri Kesehatan Republik Indonesia No. 2 of 2023, which stipulates that the maximum allowable levels of total Coliform and Escherichia coli in drinking water is 0 MPN/100 mL.

Validation of Analiytical Method and Determination of Encapsulated Retinol Content Using UV Spectrophotometric Method

2025-12-04T22:43:11-08:00

Retinol is a widely used active anti-aging ingredient in cosmetic products, but it is unstable to light and oxidation. Encapsulation technology enhances its stability and reduces skin irritation, yet complicates its quantitative analysis. This study aims to validate a UV spectrophotometric method for determining the concentration of encapsulated retinol in BPOM-labeled commercial serum preparations. Validation was carried out for linearity, accuracy, intraday precision and interday precision, LOD, and LOQ according to AOAC (2002) and ICH Q2(R1) guidelines. Sample preparation involved sonication to release retinol from its encapsulating matrix prior to measurement. The maximum wavelength was observed at 325 nm using ethanol as solvent. The calibration curve yielded the equation y = 0.139x + 0.0033 with R² = 0.998, indicating excellent linearity. Recovery ranged from 92-105%, while precision showed %RSD < 2%, confirming high reproducibility. LOD and LOQ were 0.01 ppm and 0.03 ppm, respectively. Specificity evaluation demonstrated that both the standard and sample solution exhibited a maximum peak at 325 nm, whereas the blank serum matrixs showed a distinct peak at 280 nm with no absorbance at the analytical wavelength, confirming the selectivity of the method. Thus, the UV spectrophotometric method was validated and proven suitable for the routine quantification of free retinol released from encapsulated system in commercial skincare serums.

Cost-Effectiveness Analysis of Antibiotic Use in BPJS-Covered Pneumonia Patients at the Inpatient Unit of Hospital X

2025-12-05T07:25:48-08:00

Pneumonia is a lower respiratory tract infection that remains a major challenge to public health worldwide. The use of antibiotics as primary therapy is often irrational in terms of indications, dosage, and drug selection, which can impact clinical effectiveness and treatment costs. This study aims to assess the rationality and analyze the cost-effectiveness of antibiotic therapy for BPJS patients with pneumonia in the inpatient unit of Hospital X. This study is a non-experimental study with a descriptive observational method using the payer perspective (BPJS) approach. Data were collected retrospectively from the medical records of pneumonia patients from January 2023 to June 2025. Rationality was analyzed using the 4T method. Cost-effectiveness analysis was performed using the CEA method through ACER and ICER calculations. Based on the results of the rationality evaluation, it shows that the rationality of antibiotic use based on the 4T approach includes appropriate indications (100%), appropriate drugs (100%), appropriate patients (97.7%), appropriate dose (97.1%), appropriate frequency (100%), appropriate duration (98.8%), and appropriate route (100%). The total direct medical costs of patients with cefoperazone therapy were Rp 6,073,156, while those with ceftriaxone therapy were Rp 5,474,146. The ACER value of cefoperazone was Rp 65,614 per 1% clinical effectiveness, the ACER value of ceftriaxone was Rp 57,900 per 1% clinical effectiveness, while the ICER value was Rp 866,667 per additional 1% effectiveness.