The prevalence of metabolic diseases has increased over time, especially in Indonesia where 17.5% of the population suffers from metabolic syndrome. Metabolic diseases themselves are related to each other such as diabetes mellitus, gout, and dyslipidemia. One of the causes of metabolic diseases is environmental factors so this research aims to examine whether there was a relationship between metabolic diseases between two villages with different environmental conditions (Krangkeng Village and Karangjaladri Village). Data analysis used IBM SPSS Statistics 25 with random blood glucose, total cholesterol, and uric acid data taken using the Multi-Monitoring System Autocheck 3 in 1. The results of the analysis showed that random blood glucose and uric acid levels in men were greater in Karangjaladri village compared to Krangkeng village with statistically significantly different results. Meanwhile, uric acid in women was also greater in Karangjaladri village compared to Krangkeng village but not statistically different. Total cholesterol levels in Krangkeng village were greater than those in Karangjaladri village with statistically significantly different results. This difference could be caused by differences in daily consumption due to differences in geographic location and the main livelihoods of the two villages, where the majority of the residents of Krangkeng village work as farmers and Karangjaladri village as fishermen. The conclusion appears to be that there was a relationship between metabolic diseases and the environmental factors in the two villages studied.

Amla plant (Phyllanthus emblica L) has been empirically used to treat diabetes. The aim of this study was to determine the most potential part of amla plant that can be used as α-glucosidase and α-amylase inhibitors. The fruit was subjected to cold extraction method, while the stem underwent soxhlet extraction process. Ethanol was used as solvent for both extracts. In-vitro inhibiton against α-glucosidase and α-amylase enzyme was measured by calculating IC50 of water fractions of stem and fruits. Fruit fraction exhibited the highest percentage of inhibitory activity on α-amylase (IC50=5.68% w/v), while the strongest inhibition against α-glucosidase was shown by leaves fraction (IC50=0.87% w/v). In conclusion, the stem of P. emblica L was potential inhibitor of α-amylase , while the leaves was potential α-glucosidase inhibitor.Keywords: Phyllanthus emblica, α-glucosidase inhibitor, α-amylase inhibitor, fruit, leaves

Immunomodulator is a substance that increases or suppresses the immune response through the certain mechanism. The marine sponge Xestospongia sp. has immunomodulatory activity by increasing phagocytic activity. In addition, the phagocytic activity is affected by CD4+ and CD14 cells levels. Thus, this study aims to investigate the effect of Xestopongia sp. extract toward CD4+ and CD14 cells level in model rat. Animals were divided into 4 groups (n=5) and treated for 7 days, as follow: Group I (Ethanolic extract of Xestospongia sp. dose of 300 mg/KgBW); Group II (Ethanolic extract of Xestospongia sp. dose of 400 mg/KgBW); Group III (Phylantus niruri extract); and Group IV (0.5% Na CMC). On day 8, animals were infected with Staphylococcus aureus intraperitoneally. And the blood was collected by cardiac puncture and assayed with ELISA kit CD4 (elabscience®) and ELISA kit CD14 (elabscience®). Ethanolic extract of Xestospongia sp. provided high levels of both CD4+ and CD14 cells (Group II) compared to baseline (Group IV)  (p<0.05). Group I provided similar activity to group III (p>0.05) and Group II provided significant activity with higher levels of CD4+ and CD14 cells compared to group III (p<0.05). In conclusion, both doses of Xestospongia sp. extract provide activity as immunomodulator by increasing CD4+ and CD14 cells levels, yet dose of 400 mg/KgBw provides the higher immunomodulatory activity.

The use of warfarin was monitored using the International Normalized Ratio (INR) value. This study aims to determine the relationship between the patient’s demographic variables and INR, as well as the therapy result and differences in their INR value. A cross-sectional study was used with retrospective observational data collected by tracing secondary information of medical records from outpatients with heart disease on warfarin therapy at Dr. Hasan Sadikin hospital Bandung between 2016 to 2020. Subsequently, the difference in patients’ INR value was analyzed with the Mann-Whitney test based on dosage. At the same time, the relationship between demographic variables and INR was examined using the Chi-square test and Spearman correlation. The INR examination results in 192 subjects showed 124 patients (64.6%) reached the target with an average value of 2.37 ± 0.21 and a warfarin dose of 19.31 ± 6.25 mg weekly, while 68 (35.4%) had an average of 1.82 ± 0.73 and a dose of 20.24 ± 6.24 mg weekly. Subsequently, the difference test with Mann Whitney (p = 0.004) showed a variation in the INR value based on the warfarin dose. The Spearman correlation analysis results indicated a relationship between BMI (p = 0.009), daily (0.010), and weekly dose (0.008) on the INR value with the correlation coefficient of 0.188; 0.186; and 0.192;  indicating a negative association with very weak correlation strength. This study showed that a majority of patients reached the INR value of 2-3, and the demographic variables associated with this ratio were BMI and warfarin dose. The decision to increase and decrease the warfarin dose is determined by INR value and BMI.

Cisplatin is a platinum-based anticancer drug that, in long-term use, causes nephrotoxicity due to oxidative stress and increases total cholesterol and triglycerides in animal models. Angelica keiskei (Miq.) Koidz., (A. keiskei) or Japanese celery ashitaba, has been reported for its antioxidant and nephroprotective activity. This study aims to determine the activity of A. keiskei sap on total cholesterol levels of cisplatin-induced Wistar rats. The sap of A. keiskeiwas freeze-dried until a yield of 3.62% w/v was obtained. The fat content in A. keiskei sap powder was obtained at 7.36%. A total of 60 g of A. keiskei sap powder was macerated with 96% ethanol solvent (1:10) for 5 x 24 h until the ethanol extract of A. keiskei sap (ASEE) of 82.08% w/w was obtained. The pharmacology activity was conducted on male Wistar rats, which were divided into 5 groups, namely normal (treated with CMC Na 0.3%), negative (nephrotoxicity induced with cisplatin 5 mg/kg BW), positive (nephrotoxicity induced with cisplatin 5 mg/kg BW and treated with quercetin 20 mg/kg BW), and two test groups which were nephrotoxicity induced with cisplatin 5 mg/kg body weight and treated with ASEE 1000 mg/kg BW, and ASEE 1500 mg/ kg BW. It was found that neither dose of ASEE altered the total cholesterol levels in cisplatin-induced male Wistar rats and could maintain the cholesterol levels in the normal range.

Drugs consultation by pharmacist is an important service to improve the quality of medication use in patients with type 2 diabetes mellitus (T2DM). Perception of patients regarding this service is very useful to boost pharmacists confidence to conduct such service. The purpose of this study is to provide an overview regarding interests and categories of drugs consultation needed by T2DM patients and to determine the effect of quality of drugs consultation on patients interest to participate in such program. Survey and interviews were conducted with T2DM patients in outpatient clinic, Dr. M. Salamun Air Force Hospital, Bandung during April-June 2013. One hundred patients were recruited for this study. Most of the patients consumed combination of oral antidiabetic and non-antidiabetic medication (71 %) and were given polypharmacy (45 %). The results showed that the information regarding drugs interactions, adverse drugs reaction (ADR), and drugs dosage were among the aspects that should be included in drugs consultation service by pharmacists. The quality of drug information service was associated with increased interest to participate in such program. These aspects should be considered in the implementation of drugs consultation program by pharmacists.Keywords: drugs consultation, T2DM, pharmacists

they differ from adults in pharmacokinetic and pharmacodynamics responses. ADRs reported in adults do not predict those in children. Thus, this study aimed to intensively monitor ADRs occurred in inpatients of paediatric department of tertiary care teaching hospital to assess the same in terms of incidence, causality, severity and preventability. A prospective observational single centre study was done in the paediatric department of SSG hospital, Vadodara over duration of 8 months. The ADRs were actively monitored and collected reports were analysed for ADR pattern, demographic profile, causality, severity, and preventability. A total of 66 ADRs were documented during the period of 8 months. Among these 53.03% ADRs occurred below the age of 1 year, 89.13% ADRs occurred due to antibiotics, 56.06% ADRs are of Diarrhoea and vomiting and 80.43% ADRs developed after receiving drug intravenously. As per WHO-UMC criteria, 46.96 % ADRs were of probable while 51.51% ADRs were of possible causality while as per Naranjo scale 60.61% ADRs were of probable and 39.39% ADRs were of possible category. As per severity scale 69.70% reactions were mild and 30.30 % reactions were moderate. Probably preventable ADRs were about 57.58%. ADRs occurred more among infants and antibiotics were more commonly implicated. Most of the reactions were of mild severity and were probably preventable. Certain Precautionary measures can lead to significant prevention of ADRs in paediatric patients.

The last few years have seen a significant rise in the incidence of cutaneous mycosis infections resistant to conventional therapy. Topical nanostructured lipid formulations of Amphotericin B have emerged as a novel system to tackle this menace. The present study is an open-label, single-arm, prospective study to analyze the efficacy and safety of topical nanostructured lipid-based Amphotericin B gel in treating patients attending Dermatology OPD, Victoria hospital, with cutaneous mycosis resistant to conventional therapy. Thirty patients diagnosed with tinea corporis/cruris resistant to conventional therapy were included in the study.  Patients were advised to apply amphotericin B gel 0.1% on the affected area twice daily for four weeks. Outcome parameters like pruritus, erythema, vesicles, desquamation, and KOH mount were noted weekly for the assessment of efficacy and safety.  One-way ANOVA was used for statistical analysis. After treatment with Amphotericin B gel, patients showed a statistically significant reduction in pruritus, erythema, vesicles, and desquamation from baseline across time towards the end of 4 weeks (p<0.05).  Also, the Mean total score of all symptoms, which was 8.3±3.1 at baseline, was reduced to 0.9±0.7 at the end of the 4th week (p<0.05). All the patients treated were mycologically negative for KOH mount at the end of the study period. No serious adverse drug reactions were reported to treatment. To conclude, topical nanostructured lipid-based amphotericin B gel in patients with cutaneous mycosis resistant to conventional treatment was efficacious and safe.

Inducing hyperglycemia in animal models is crucial for preclinical research on anti-diabetic drug development, especially when genetically diabetic test animals are unavailable. Various induction methods have been employed to elevate glycemic levels in test animals. However, there is a lack of substantial literature proving the effectiveness and stability of these induction alternatives. This study aims to compare the stability of glycemic levels and assess histopathological changes in mice induced by dextrose, streptozotocin, and alloxan. Our protocol involved dividing mice into six groups of five, each with a control group. Mice in Groups A and D were exposed to alloxan monohydrate, Groups B and E to streptozotocin, and Groups C and F to dextrose monohydrate, inducing hyperglycemia for nine days following a seven-day acclimatization period. Pancreatic histopathology examination included features such as cytoplasmic vacuolization, fat infiltration, and islet deformation. The study revealed that, compared to dextrose and streptozocin, alloxan demonstrated superior efficacy in inducing and maintaining hyperglycemic stability in mice. However, the histopathological assessment of the pancreas indicated the relatively benign nature of dextrose monohydrate and streptozotocin, with no apparent exacerbation of pancreatic impairment. In contrast, alloxan induced evident islet deformation and cytoplasmic vacuolization. Our findings suggest that, in comparison to alloxan, dextrose monohydrate and streptozotocin are more favorable for inducing hyperglycemia in test animals. They pose a lower risk of significant pancreatic impairment, indicating their potential suitability for modeling type 2 diabetes mellitus due to their stability and relatively benign impact on pancreatic histopathology.

Developing new cytotoxic agent which has minimal effect against normal cell is requiredto reduce the side effects obtained from the existing chemotherapy agents. Celery (Apiumgraveolens) showed several pharmacology activities, including anti-cancer. This study wasconducted to predict and visualize the binding mode of ten secondary metabolites in A. graveolens,i.e., apigenin, caffeic acid, kaempferol, limonene, shikimic acid, chlorogenic acid,ascorbic acid, quercetin, eugenol and ferulic acid against Bcl-2. Navitoclax was employed asreference. Molecular dokcing simulation was performed using AutoDoc Vina v.1.5.6. Theresults showed that the interaction enery (Ei) ranged from -4.20 to -6.01 kcal/mol, whereasinhibition constant (Ki) were 40.15 to 842.29 μM. Kaempferol showed the best affinity toBcl-2 (Ei=-6.01 kcal/mol; Ki=24,21 μM). Hydrogen bonds were bond between kampferoland Lys20, Ser102, and Arg103, amino acid residues in Bcl-2.In conclusion,Keywords: anti-cancer, Apium graveolens, Bcl-2, navitoclax

Hypertension is a significant health issue that significantly increases the risk of cardiovascular disease. Angiotensin II receptor blockers (ARBs) are commonly used in Indonesia to treat hypertension, yet comprehensive comparative efficacy data within this drug class remain limited. This review seeks to evaluate the blood pressure-lowering efficacy of three particular angiotensin receptor blockers (ARBs)—Valsartan, Candesartan, and Losartan—in individuals diagnosed with hypertension. This systematic review identified randomized controlled trials (RCT) obtained from PubMed and Google Scholar using several keyword combinations. Among 20 RCTs with 6.425 patients treated with three ARBs, all included studies demonstrated significant blood pressure reductions. The mean reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were the greatest for Candesartan (-18.69/-10.25 mmHg), followed by Losartan (-14.80/-7.8 mmHg), and Valsartan (-8.94/-7.58 mmHg). Candesartan achieved the largest reduction, decreasing baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) by 38.16/18.95 mmHg over 12 weeks. In contrast, Valsartan showed the smallest reduction, with SBP decreasing by 0.81/0.04 mmHg after 66 months. It can also be linked to the pharmacokinetic properties of the drugs, where Valsartan has a higher bioavailability, and Losartan has a lower bioavailability compared to the other ARBs. It can be concluded that ARBs, including Valsartan, Candesartan, and Losartan, are generally effective in reducing blood pressure in hypertensive patients, with Candesartan showing the greatest efficacy. Future research should involve direct comparative trials of Valsartan, Candesartan, and Losartan, along with studies on their molecular mechanisms, to increase effective hypertension treatments.

Fermented  Artocarpus altilis leaves contains phenolic compound  that has pharmacological activity. Differences in fermentation method, i.e., aerobic and anaerobic fermentation might change its characteristics and biological activity. The purpose of this study was to compare toxicity properties between aerobically and anaerobically fermented  Artocarpus altilis leaves  using brine shrimp lethality (BSL) test. Both types of fermented leaves were cold extracted using ethanol solvent (1:6) for 3 x 24 hours. Phytochemical screening was then performed to examine the presence of secondary metabolite compounds. BSL test was performed in 7 treatment groups, i.e., negative control, 1000, 500, 100, 50, 25, 12.5 ppm of extract. Each vial contained 10 Artemia larvae, extract, and sea water up to 10 ml. Toxicity is measured by calculating LC50 after 24 hours observation. The  experiment was repeated three times. The results of the study showed that LC50 of aerobic extract was 712 ppm, thus it can be categorized as toxic, while that of anaerobic extract is 1.927 ppm, or non-toxic to the Artemia salina larvae. In conclusion, aerobically fermented  Artocarpus altilis leaves had toxicity potency, while anaerobically fermented  Artocarpus altilis leaves had no toxicity potency against Artemia salina in BSL test. Key words: Artocarpus altilis, brine shrimp lethality test, toxicity.

Using probiotics as a pharmaceutical intervention is based on the fact that dysbiosis affects many people with autism spectrum disorders (ASD). This study aimed to quantify various probiotics’ overall and individualized benefits in treating ASD. Randomized or cross-over trials comparing the efficacy of placebo or active control vs. probiotics in patients of any age diagnosed with ASD based on DSM IV/V criteria were considered under inclusion criteria.  An electronic database search in PUBMED and Cochrane Library was conducted using MeSH search terms “probiotics” AND “Autism.”  Mean change in the total score of clinical parameters used to assess ASD symptom severity was the primary outcome measure analyzed. All the outcome measures were estimated by calculating the Standardized Mean Difference (SMD) values and their 95% Confidence Intervals (CI), considering the different clinical parameters used to assess the change in ASD symptoms in identified clinical trials. An insignificant decrease in the total score value of primary outcome measure by -0.14 (SMD: 0.14, 95% CI:-0.45 to 0.17) in patients treated with probiotics was observed. The quantity of decrease remained insignificant in subgroup analyses also. Observed insignificant clinical benefits of probiotics in ASD patients could be due to the presence of gastrointestinal symptoms as co-morbidity. We hypothesize that intolerance to dietary components is responsible for gastrointestinal symptoms and inflammation. Perhaps probiotics are still beneficial in ASD patients without gastrointestinal symptoms, while their combination with prebiotics is effective in patients with gastrointestinal symptoms.

Thyroid hormone (TH) play crucial roles in the growth and development of brain. Efficiency of TH during the perinatal period results in severe mental and physical retardation, known as cretinism in humans. Animal models have largely focused on mild and severe hypothyroidism associated with deficits in body weight, developmental delays, and cognitive deficits. Although various behavioral analyses have been reported, the effect of perinatal hypothyroidism in adult female mice has not been clarified. The aim of this study was to examine whether propylthiouracil (PTU)-induced hypothyroidism could impair motor coordination in female offspring. We used C57BL/6j mice and divided them into three groups based on the dose of PTU which was applied during perinatal period (embryonic day-14 to postnatal day-14); control, 5 ppm, and 50 ppm groups. We observed motor coordination function and additional nociceptive test in female offspring. We found that motor coordination and nociceptive threshold were affected in 50 ppm groups. We concluded that the moderate hypothyroidism could impair motor coordination in adult offspring.

Hypertension is a significant global health problem, with a growing prevalence worldwide. The most commonly documented ADRs of hypertension medication in primary care records include those associated with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). The purpose of this paper is to review and evaluate the potential adverse drug reactions (ADRs) associated with the use of Angiotensin Receptor Blockers (ARBs), specifically valsartan, candesartan, and losartan in the management of hypertension and related diseases. We conducted a systematic review of randomized controlled trial articles that involved valsartan, candesartan, and losartan monotherapy compared with placebo or other standard antihypertensive drugs. PubMed and Google Scholar databases were used in the search for articles in May 2024 and 21 articles were included in this review. This study comprised 21 randomized controlled trials. The study participants' ages ranged from 34.4 years to 76 years. Sample sizes ranged from 16 to 1381 patients with a total 4606 patients. A total of 44 ADRs were observed and the most likely ADRs were headache, dizziness, hypotension, hyperkalemia, nausea, upper respiratory tract infection, and fatigue. Generally, the ADRs that occurred were not fatal and did not lead to discontinuation of therapy. The safety and tolerability profiles of ARBs are among the best for antihypertensive drugs, then overall, the comparison of ARB agents between valsartan, candesartan, and losartan in this class is similar. The most frequent adverse events in the group receiving therapy include headache, dizziness, hypotension, hyperkalemia, nausea, nasopharyngitis, and fatigue.

Endophytic bacteria is an excellent candidates for the biological control of pathogenic fungi in plantations. The objectives of this study were to isolate and examine anti-fungal activity of endophytic bacteria from oil palm plantations in South Kalimantan against Ganoderma boninense. This research was performed in three phases, i.e., isolation, selection, and assessment of endophytic bacteria isolates against Ganoderma boninense. A total of 126 colonies of endophytic bacteria were isolated. The result of the anti-fungal activity test with dual culture method demostrated that BKA 10 isolate had the largest inhibition zone (62.22%). Molecular identification by DNA analysis using 16S rRNA primers showed that BKA 10 is most closely related to Bacillus cereus. In conclusion, isolate with the best anti-fungal acitivity against Ganoderma boninense has the closest kinship with Bacillus cereus. Keywords: antifungal, dual culture, Bacillus cereus.

Authors and Keywords Index of Volume 3 No. 2

Index

Moderate and high aerobic exercises are the activities that can induce high oxidant. Demandof endogen and exogen antioxidant for neutralizing oxidant induced by exercise will playimportant role in maintaining body performance. Microtrace elements, such as selenium,may able to balance high oxidant formation. However, limited research and data have beencollected with regards to the exercise and selenium. Therefore, this research was conductedto investigate the effect of aerobic exercise on selenium level in plasma. An analytic studywith experimental method of data collection was performed from October -November 2016.17 male students with the age between 19-25 years old and without medically compromiseddisease from Universitas Padjadjaran, Jatinangor, were selected as subjects. Blood sampleswere taken pre- and post-aerobic exercise, i.e., brisk walking with the intensity of 4.5 mi/h.Selenium level in plasma was then examined by enzyme linked immunosorbent assay (ELISA)kit as selenium binding protein (SELENBP1). This study found that 11 (65%) subjectshad a decrease in their selenium plasma after exercise (3.1 ± 2.58 ng/ml), 5 (29%) subjectshad an increase in their selenium plasma after exercise (2.08 ± 2.8 ng/ml) and 1 (6%) subjecthad unchanged selenium (SELENBP1) plasma (1.4 ± 1.4 ng/ml) level. Effect of aerobicexercise on selenium level in plasma varied among individuals.Keywords: aerobic exercise, selenium, young adult

Diabetes Mellitus, also known as diabetes, is a chronic disease characterized by blood sugar levels that exceed normal limits. Poor management of diabetes mellitus patients can cause various macrovascular and microvascular complications. Complications in diabetes mellitus sufferers are one of the factors that can affect quality of life. This study aims to determine the effect of macrovascular and microvascular complications on the quality of life of diabetes mellitus patients at Mardi Rahayu Kudus Hospital. The method used in this research is prospective, quantitative research using a cross-sectional approach. Data for quality of life researchers used the WHOQOL-BREF questionnaire. The respondents involved and meeting the inclusion criteria were 104 patients. The results of the study showed that there were macrovascular and microvascular complications. The highest incidence of complications was macrovascular (37.5%), followed by microvascular complications (26.0%), and macrovascular + microvascular complications (36.5%).  Meanwhile, the highest quality of life category with complications was the high category at (52.9%) and the moderate category at (47.1%). DM and complications are mostly suffered by women (58.7%), with an average age of 45-65 years. The highest use of antidiabetic therapy includes metformin (53.1%), metformin + glimepiride (31.8%) and glimepiride + metformin + sansulin log-g (21.4%), as well as medication for comorbidities given according to the complications suffered by the patient. patient. Research shows that macrovascular and microvascular complications have no influence on quality of life due to the results of the binary logistic regression test (Sig. > 0.05).