Polymeric nanoparticles are particles ranging from 1 to 1,000 nm that can be loaded with active compounds. Polymeric nanoparticles can be classified based on their morphological structure into nanocapsules and nanospheres. In addition, polymeric nanoparticles can also be classified based on the compound’s origin into natural and synthetic polymer. The nanoparticle production method is adjusted based on the type of drug that will be loaded. The methods commonly used for the production of polymeric nanoparticles are solvent evaporation, solvent emulsification/ diffusion, nanoprecipitation, emulsification/ reverse-salting out, and nanoprecipitation. This review also provides several examples of clinical applications of nanoparticles in the formulation of several drugs/bioactives including hyperforin, curcumin, and amphotericin B.

The emergence of resistant bacteria strain has become a global health concern. It encourages the exploration of potential antibacterial agents, particularly from natural sources. The aim of this study was to investigate the antibacterial activity of ethanol extract of root, stems, leaves, and flowers of Polygonum pulchrum Blume against Staphylococcus aureus and Escherichia coli, through disc diffusion method using cup-plate method. Inhibition zone against S. aureus from roots, stems, leaves, and flowers ethanol extract were 3.5 mm, 2.5 mm, 2.25 mm, and 2.62 mm, respectively, while the inhibition zone against E. coli were 2.25 mm, 2.12 mm, 1.62 mm, and 1.75 mm, respectively. In conclusion, ethanol extract of root, stem, leaves, and flower of P. pulchrum Bl possessed weak antibacterial activity against S. aureus and E. coli.Keywords: P. pulchrum Bl, antibacterial, E. coli, S. aureus, cup-plate technique

Curcumin is a secondary metabolite compound that has diverse biological activities. However, it is easily hydrolyzed at physiological pH due to the presence of the β-diketone group. Therefore, the replacement of the β-diketone group with mono ketone is expected to overcome this issue. We hereby report the synthesis of mono ketone curcumin derivatives from piperidone by two-steps reactions. The synthesis of curcumin derivate 3 was carried out by Claisen-Schmidt condensation between 4-piperidone and 4-methoxybenzaldehyde using alkaline catalyst. The synthesized curcumin derivate 3 was then reacted with the 1-bromo-3-chloropropane to produce curcumin derivate 5, 1-(3-chloropropyl)-3.5-bis((E)-4-methoxybenzylidene)piperidin-4-one, with 72% yield. The calculated docking scores, the curcumin derivate 5 possessed a better affinity for receptors than the standard panduratin A. The curcumin derivate 5 has a lower docking score of -6.40 kcal/mol compared to panduratin A with value of -5.18 kcal/mol and also had strong binding interactions to DEN2 NS2B/NS3 protease. Thus, this compound is promising candidate as a new anti-dengue agent.

Studying drug utilization helps to develop twin concepts for therapeutic formulation and essential drug lists. The main preference of using Antiepileptic drug (AED) therapy is that patients can be seizure-free for their lifetime. Treating children with epilepsy remains a major challenge, despite having several AEDs. Hence, we aimed to study drug utilization patterns among pediatric patients with epilepsy. This prospective study was conducted on 150 patients lesser than 18 years of age, receiving antiepileptic drugs. A specially designed case record form was used to collect the data on socioeconomic status, disease data, and treatment details. The majority of the children were females (60.6%), ages ranged from day 1 to 4 years (56.6%). About 35.33% were skilled laborers followed by 32.23% semi-skilled. Around 49.3% of patients belonged to the lower-middle-class family and 41.33% were diagnosed to have generalized tonic-clonic seizures (GTCS). The majority of the children were on monotherapy (81.33%) while 18.66% were on dual therapy or polytherapy. Regarding the usage of antiepileptic drugs, we found that 70.66% of children were on older AEDs like sodium valproate (27.33%) followed by clobazam (31.33%). Levetiracetam was the only new antiepileptic drug that was prescribed in 10% of patients. Monotherapy is considered as best modality, due to its low cost, safety profile, and lesser drug interactions. It can also improve drug treatment compliance and adherence. Along with older AEDs, there has been an increase in the utilization of newer AEDs, which help to broaden the therapeutic option towards the management of childhood epilepsy with a better safety profile.

Diabetes mellitus (DM) is a group of metabolic illnesses identified by elevated blood glucose levels. The glycated hemoglobin (HbA1C) test is used to evaluate a person’s control of their blood glucose levels. According to a recent study, mHealth interventions may be particularly helpful for assisting patients with diabetes mellitus to self-monitor their status on their HbA1c level. Therefore, this systematic review aims to provide an overview of how mHealth affects individuals with diabetes mellitus, concentrating on HbA1c evaluation. A systematic review was conducted by reviewing the PubMed, Google Scholar, and Mendeley databases for randomized control trials published between February 2017 and September 2023. The studies of mHealth on the result of HbA1c were then examined. A drop in HbA1c was seen in all intervention groups. The overall average reduction in HbA1c across all intervention groups was - 0.79%, while the reduction in control groups was - 0.42%. The influence of mHealth could significantly reduce HbA1c levels. Studies show that HbA1c decreased more in patients who underwent a 3 to 6-month intervention. This study discovered 12 papers that discuss health for people with diabetes mellitus type 1 and 2. This study found that mHealth interventions significantly lower HbA1c in DM patients. For further research, bigger sample sizes and data on self-care results are needed. The views and perspectives of patients regarding the physical characteristics and design aspects of different interventions—mobile applications, texts, and phone calls—need to be further investigated.

Scabies is an infectious skin disease caused by mite Sarcoptes scabiei. Neem tree (Azadirachta indica) has the potential to be used as an anti-parasite due to the presence of azadirachtin compound that is commonly found in the seeds. The aim of this study was to evaluate in-vivo effectiveness of neem oil as an anti-scabies. This study used an experimental method.  The effectiveness of the cream as an anti-scabies was tested on New Zealand white rabbits which were infected with scabies. Permethrin cream was used as a positive control and cream base was used as a negative control.  Cream was applied once daily and left for 8 hours. The data were analyzed using Kruskal Wallis and Mann Whitney. Dermal acute irritation test was performed by applying  0.5 g cream on the rabbit dorsal. We found that 5% neem oil cream was effective as an anti-scabies with 20-21 days recovery time. The recovery time is longer than permethrin cream (7-8 days), but shorter compared to negative control with recovery time over 30 days. Primary irritation index for 5% neem oil creams was 0, indicating negligible irritation category. In conclusion, A. indica cream was effective for the treatment of scabies although its recovery time is shorter than permethrin cream.  Keywords: effectiveness test, irritation test, neem oil cream, scabies

Leishmaniasis is one of the most important endemic diseases in Sudan. The glycolytic pathway is one of the essential pathways in the survival and pathogenicity of the leishmania parasite. This study aimed to evaluate the antileishmanial activities of three antimalarial drugs through targeting the glycolytic pathway of the parasite. Anti-leishmanial activities of artesunate, quinine and mefloquine were evaluated using an in vitro anti-promastigote assay. Then, in silico molecular docking was conducted using Autodock 4.0 software to study the molecular interactions of antimalarial drugs to different key glycolytic enzymes. The results of the current study, Artesunate, quinine, and mefloquine showed effective inhibitory activities against L. donovani with IC50 values of 58.85, 40.24, and 20.06 μg/ml, respectively. Molecular docking analysis revealed interesting interactions between different antimalarial drugs and various glycolytic enzymes (Glucose-6-phosphate isomerase, Triosephosphate isomerase, Glycerol-3-phosphate dehydrogenase, Glyceraldehyde-3-phosphate dehydrogenase and Pyruvate kinase). Moreover, these drugs interact with different amino acid residues of the proteins with satisfactory binding energies, particularly with artesunate. According to binding energies, Glycerol-3-phosphate dehydrogenase was represented the most potential target for three tested drugs. Collectively, our results showed promising antileishmanial activities of different antimalarial that may mediated through inhibition of glycolysis process in leishmania donovani promastigote.

Curcumin, the active compound found in turmeric, is believed to delay the development of diabetes through several mechanisms. This study aimed to investigate if an aqueous extract of turmeric can improve glucose uptake and uric acid in mouse tissues in vitro, after inclusion of turmeric in the diet for four weeks. Fourteen adult male Swiss mice were divided into three groups. The first group was the control (n=6) that was given clean water, the second group of mice (n=4) was given 5% autoclaved turmeric extract in drinking water, and the third group (n=4) was given 5% non-autoclaved turmeric extract in drinking water. After four weeks, the cardiac muscle, skeletal muscle, pancreas, and liver tissues were dissected and used for analysis.  The results showed that the aqueous 5% turmeric extract reduced glucose in cardiac tissues while the plasma glucose was not changed. Cardiac muscle, liver, pancreas, and skeletal muscle showed glucose absorption after the 5% turmeric treatment. This research shows that turmeric did improve glucose uptake in most tissues, although it was not significant due to the limitations of this study. Tissues may need to be cultured longer and media processed quicker to prevent evaporation. Turmeric continues to show great potential in the treatment of type 2 diabetes and may present an alternative way of treating diabetes.

Adverse Drug Reaction (ADR) is any unfavorable and unexpected drug response in patients dosed for prevention, diagnosis, or therapy. Tuberculosis is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. Multi-drug resistance Tuberculosis (MDR TB) is caused by bacteria that are resistant to the two most powerful first-line anti-TB drugs - isoniazid and rifampicin; cases of resistance to both drugs result in worse treatment outcomes, longer treatment duration, high costs, and various other complications. All medications used to treat MDR TB patients have the potential to cause mild, moderate, and severe side effects, especially Bedaquiline. This article will explain information on drug side effects that occur in patients treated with MDR TB and Bedaquiline. The data was collected and discussed from primary journals through Google Scholar and PubMed online databases. Bedaquiline has the potential to cause side effects such as QT interval prolongation or irregular heart rhythm, cardiac arrhythmia, gastrointestinal disorders, joint and muscle pain, hearing loss, acne, and chest pain. Therefore, treatment of MDR TB with Bedaquiline requires monitoring to ensure patient compliance and early detection of possible side effects to ensure the safety and effectiveness of treatment.

Lisinopril (angiotensin converting enzyme inhibitor) and valsartan (angiotensin II receptorblocker) are the first-line treatment for patients with congestive heart failure (CHF). Thesetwo drugs potentially cause side effects on renal functions. However, limited informationwas available regarding the comparison of potential nephrotoxicity of these drugs in IndonesianCHF patients. This research was aimed to compare the potential nephrotoxicitybetween lisinopril and valsartan in outpatients with CHF at a hospital in Palu, Indonesia.This was an observational study conducted during April-May 2015. Potential nephrotoxicitywere assessed by measuring serum creatinin (SCr) and blood urea nitrogen (BUN). Datawere obtained from Cardiology Unit from a hospital in Palu, Indonesia. Statistical analysiswas conducted using T-test and Mann-Whitney test. The increasing trend of SCr and BUNwere observed in lisinopril-treated patients with the mean of increase were 21% and 59%,respectively. Relatively higher increase was observed in valsartan treatment group with 47%and 51% in SCr and BUN, respectively. The analysis showed that there were significant differencesin SCr level between lisinopril and valsartan groups (p=0.001), but the oppositeresults observed in BUN parameter (p=0.697). Therefore, valsartan was potentially morenephrotoxic than lisinopril based on the increase of SCr parameter. Thus, lisinopril is recommendedfor CHF patients who are particularly at high risks of having renal impairment.Keywords: lisinopril, valsartan, nephrotoxicity, congestive heart failure

Vernonia amygdalina, a traditionally used medicinal plant, has been purported to possess health-promoting properties.The aim of this study is to investigate the phytochemical and nutritional composition of V. amygdalina, evaluate its antioxidant and antidiabetic efficacy, and assess its hematological benefits. Phytochemical screening, proximate analysis, antioxidant assays (DPPH, ABTS), antidiabetic evaluations in streptozotocin-induced diabetic rats, and hematological assessments were conducted according to standard protocol. V. amygdalina exhibited a rich phytochemical profile, comprising flavonoids, phenolic acids, and terpenoids, alongside significant antioxidant activity (IC50 = 12.5 μg/mL) and complete source of protein. Proximate analysis revealed high protein (21.1%) and fiber (15.6%) content. Antidiabetic evaluations demonstrated significant reductions in blood glucose levels (p < 0.01). Hematological assessments showed significant improvements in hemoglobin (14.1 ± 0.6 g/dL), packed cell volume (42.9 ± 1.8%), red blood cell count (7.1 ± 0.3 x 10^12/L), and differential WBC count, including reduced monocyte (6.3 ± 0.9%) and eosinophil (2.6 ± 0.6%) percentages, and increased lymphocyte (34.4 ± 2.4%) percentage. This study provides comprehensive evidence for the phytochemical, nutritional, and pharmacological value of V. amygdalina, underscoring its potential as a functional food and phytomedicine for oxidative stress and diabetes management, as well as a natural adjunct for improving hematological parameters.

Carbapenem is one of antibiotic to treat respiratory infections such as pneumonia that frequently used in tertiary care facilities and started to create resistances. This study aims to review the resistance of carbapenems, assess the risk factors for resistance that leads to mortality, and the more effective antibiotic treatment options to overcome the resistance. Assessment of the use of carbapenems in pneumonia through previous studies were carried out by searching the articles in search engine databases in 2011 to 2021. Articles reporting carbapenems resistance, risk factors, and mortality were selected based on inclusion and exclusion criteria. Of 14 articles included in inclusion criteria, 4 studies reported the occurrence of resistance to gram-negative bacteria such as Acinetobacter aumanii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, and 10 articles reported risk factors and mortality. The risk factors for carbapenems resistance are the history of carbapenems use, duration of hospitalization, use of mechanical ventilation, high Simplified Acute Physiology Score (SAPS) scores, and high Acute Physiologic and Chronic Health Evaluation (APACHE). Carbapenems resistance causes mortality such as septic shock, high Sequential Organ Failure Assessment (SOFA) scores, and elevated risk at > 60 years of age, female sex, and inappropriate choice of antibiotics. The results showed that imipenem has higher resistance than other carbapenems members, the risk factors for carbapenems resistance are dominated by a history of carbapenems use, mortality caused by high score SOFA, and colistin can be the current choice to overcome carbapenems resistance.

Hypokalemia is one of the most frequently seen electrolyte disturbances in clinical practice. Various drugs are known to induce hypokalemia, such as furosemide, thiazides, dicloxacillin, ampicillin, etc. The objective of this study is to assess hypokalemia adverse drug reactions (ADRs) for severity, preventability, and causality in a tertiary care centre in the southern part of India. It is a retrospective, cross-sectional study. Data collected at DMWIMS Medical College, India, as per the ongoing pharmacovigilance program of India from November 1st, 2016 to October 30th, 2017 (12 month period) was included for analysis in this study. The SADR form published by the Government of India under the PVPI program was used for collecting the data. In-patients who were on at least one medication and experienced hypokalemia ADR with or without other symptoms or signs were included. Both primary suspected drugs and concomitantly prescribed drugs were analyzed. For the assessment of ADRs, modified Hartwig and Siegel assessment scales and plasma K+ level criteria were used for severity, Schumock and Thornton criteria for preventability, the WHO-UMC scale, and Naranjo's algorithm for causality, respectively. Sixty hypokalemia ADRs were considered for analysis. Both genders were equally affected, with a mean age of 64.28 ± 3.02 years. Four groups of drugs were suspected to cause hypokalemia viz., anti-asthmatics (36.67 %), diuretics (31.67 %), antibiotics (18.33 %), and antidiabetics (13.33 Polypharmacy was reported in 43.33% of cases, with 4.40 ± 01.689 drugs prescribed on average. To summarize, hypokalemia is a preventable ADR and minor variations in serum K+ levels can have a negative impact on patients' outcomes and mortality. FDC of Levosalbutamol with Ipratropium Bromide was the most common causative agent suspected of causing hypokalemia. Elderly patients receiving one or more drugs that are known to alter K+ levels, need close monitoring, and correction of hypokalemia should be done to improve prognosis. Further studies are required to understand the mechanisms involved in DDIs and DDiIs to derive preventive strategies.

Alcohol is the commonest psychoactive substance used by Indians. The prevalence of alcohol dependence in India is estimated to be 2.7%. In Maharashtra, the prevalence of Alcohol Use Disorders (AUD) is about 4.9%. Prescription pattern monitoring studies are a tool for assessing the prescribing, dispensing and distribution of medicines. They promote appropriate use of drugs and reduction of their misuse. With changing guidelines and availability of newer drugs, it is the need of time to monitor the prescriptions. So, this study was done from October 2019 - January 2021 in a tertiary care teaching institute in western India on 100 patients which focuses on analysing the prescribing pattern of drugs in AUD patients. Along with this, potential drug interactions were checked using Medscape drug interaction checker. Comparison of prescriptions with 2018 APA guidelines was also done. Average 4.77 drugs were prescribed per patient per encounter. 65% patients were prescribed anti-craving drugs as oral tablets. Only 11% of them were listed in the NLEM, but none in hospital drug formulary. The maximum prescribed drugs of other groups were Vitamins (25.7%), Benzodiazepines (22.3%) and Antipsychotics (20.6%). 53.3% of these drugs were from hospital formulary. Potential drug-drug interactions were found in 76%. Adherence to 2018 APA guidelines was present in 89% cases. This study would provide an insight into the trends of drug utilization and feedback to prescribers to create an awareness about rational use of drugs. The evaluation of potential drug interactions can help in solving the problem of polypharmacy.

Geriatric physiologically undergoes aging process that can cause decreasing cell functionand increasing risk of degenerative diseases caused by the accumulation of reactive oxygenspecies (ROS) in the body. Selenium (Se) is an antioxidant, which is needed for maintainingthe balance of ROS. The aim of this study was to observe the selenium-binding protein(SELENBP1) level in relation with the geriatric patients charcateristics including sex, age,body mass index (BMI), activity of daily living (ADL), instrumental activity of daily living(IADL), cognitive function, nutrition, depression, and insomnia status. The study usedcross-sectional quantitative descriptive study design on 14 geriatric patients in Geriatric OutpatientsClinics, at a hospital in Bandung. The data was obtained by interviewing the patientsand then blood samples were taken. The analysis of SELENBP1 was done using ELISA kit.The average level (SD) of SELENBP1 from all of the characteristics group was 2.68 (0.69)ng/ml. The highest SELENBP1 level was identified in female geriatric patients and followedby male and pre-obese groups. The lowest SELENBP1 level was identified in geriatric patientsaged 70-79 years.Keywords: elderly, SELENBP1, selenium.

Authors and Keywords Index of Volume 1 No 2

Elderly is one of the most vulnerable groups to nutritional problems. Elderly people should maintain nutritional status at optimum conditions, so they can help their physical condition in the process in adjusting to the changes they experience. The purpose of this study was to determine the description of the nutritional status of the elderly at Posbindu Caringin Health Center. The research method was descriptive using a cross-sectional approach.  The number of respondents was 125 people that chosen using purposive sampling technique. Data collection using a Mini Nutrition Assessment questionnaire and analyzed using percentage and frequency distribution. The study found that the elderly had normal nutritional status (68.0%), the risk of malnutrition (27.2%), and malnutrition (4.8%). The conclusions in this study are the nutritional status of the elderly in Posbindu Pusingin Caringin, most of the elderly have normal nutrition. Community nurses are expected to be able to use this information in determining appropriate interventions and prevention related to the nutrition problems of the elderly.

Spinal anesthesia is among the most often employed regional anaesthetic procedures in perioperative clinical practice. Notwithstanding its multiple benefits, including swift onset of action and effective pain management, this approach remains associated with the potential for post-procedural problems that may affect patient recovery and the quality of anesthesia care. This study aimed to delineate the numerous common problems that arise following spinal anesthesia in adults, utilising findings from current studies via a scoping review methodology. This research employed a scoping review methodology in accordance with the PRISMA-ScR criteria. Fifteen articles were retrieved from the PubMed, Scopus, and Garuda databases utilising pertinent keywords within the publication period of 2020–2025. The inclusion criteria comprised full-text papers authored in either Indonesian or English that addressed issues following spinal anesthesia. Fifteen publications were selected and analysed according to their objectives, methodologies, populations, and findings. The research identified that the most commonly reported problems comprised hypotension, bradycardia, post-dural puncture headache, nausea, shivering, urine retention, and modest neurological sequelae. Factors influencing the occurrence of problems encompass gender, age, hydration condition, technique, and the utilisation of spinal needles. The majority of issues are temporary and can be addressed with supportive or pharmaceutical measures. Complications following spinal anesthesia are prevalent and should be anticipated in the practice of anaesthesiology nursing. A comprehensive grasp of problem types and their associated risk factors might enhance nurse anaesthetists’ efficacy in monitoring, patient education, and post-anesthesia treatment. This study underscores the necessity of enhancing clinical practice standards and education to reduce adverse occurrences

There are many causes of maternal mortality, and one of them is preeclampsia, especially in Indonesia. Pregnant women could prevent maternal mortality caused by preeclampsia with understanding the signs and the dangers of preeclampsia. This research aimed to assess the effect health education using video and leaflets on pregnant women's knowledge about preeclampsia. This study was a quasi-experimental study with pretest and posttest without a control group. The respondent did a pretest about preeclampsia and given an intervention and the posttest. The sampling method was quota sampling with 74 respondents. This research provided collected data through questionnaires of knowledge about preeclampsia and education through video or leaflets. The result of the normality test showed normal distribution. Knowledge value of preeclampsia presented in mean and SD (Standard Deviation). The paired average comparison test used a paired sample t-test; meanwhile, the comparison test average unpaired used Independent Sample t-test. The results showed that video and leaflet affected improving pregnant mothers' knowledge about preeclampsia with a p-value of 0.000 <0.05. The work can be seen from the mean before and after being given video education. It has increased from 67,784 to 86,703 and leaflet education, which also increased from 71,135 to 89,514. Videos and leaflets also have the same level of effectiveness in improving maternal knowledge about preeclampsia, with a p-value of 0.854> 0.05. There was an increased level of expertise after the education by video and leaflet on pregnant women about preeclampsia. Besides, the two media also have the same level of effectiveness in improving maternal knowledge about preeclampsia. A suggestion for further research is to use another learning media such as pamphlet, poster, PowerPoint, or flip chart.

Background: Many elderly people in Indonesia experience falling every year and the half had fallen more than once. This falls due to loss of bone and muscle mass which results in poor of balance. This study aimed to show whether balance excercise could improve muscle strength and balance on elderly people with risk of falling. Methods: This was a quasi-experimental design with two-group pretest-posttest control group. The sample was taken by purposive sampling and the total of 27 elderly people was selected into 2 groups: intervention (n = 14) and control (n = 13). The intervention group received the balance exercise regularly 3 times a week for 3 weeks. The balance exercise consists of plantar flexion, knee flexion, hip flexion, hip extention, and single leg side. Results: As an independent t test showed a significant difference in the balance and muscle strength between the intervention and the control group. Paired t-test on balance values obtained (p = 0.003) and the muscular strength (p = 0.000) which means that there was effect of balance exercise on muscle strength and balance in elderly with risk of falling. Conclusions: Balance exercise for 3 weeks regularly could improve balance score and muscle strength on the older people. Therefore, elderly people escpecially who are at risk of falling better to do balance exercise as their routine and getting support for doing this from family and health workers.