Index

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

The geriatric population in Indonesia is increasing rapidly every year. The large number of drugs consumed by geriatric patients results in potentially inappropriate prescriptions (PIP) in the form of mis-prescribing drugs (potentially inappropriate medicines or PIM) and under-prescribing drugs (potentially prescription omission or PPO). In Indonesia, especially in Bandung, there is limited research on PIP in geriatric patients with cardiovascular disorders (CVDs). This study aims to identify PIP and factors that influence PIM and PPO based on STOPP/START criteria and the relationship between the incidence of PIM and kidney function in geriatric inpatients with CVDs at Hasan Sadikin Hospital, Bandung, West Java, Indonesia. The present retrospective study was cross-sectionally conducted from January to December 2022. The Chi-square tests were carried out to determine factors that were significantly related to PIM and PPO. Of the 192 patients, 33.4% patients experienced PIM with the most being NSAIDs with eGFR <30 mL/min/1.73 m2 (36%). As many as 35% of patients experienced PPO with the most frequent PPO not being given angiotensin-converting enzyme inhibitor (ACEi) in patients with systolic heart failure (41.8%). Factors that were significantly associated with PIM were comorbid kidney dysfunctions (OR 5; 95% CI: 2.367-10.342), and no factors were found that were significantly associated with PPO. Taking everything into consideration, it was found that PIM and PPO were common in hospitalized geriatric patients with CVDs. Kidney dysfunctions are a risk factor for PIM. These findings suggest that it is important to evaluate prescribing for geriatric patients during hospitalization using STOPP/START criteria to reduce the prevalence of PIP

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).

Hypoglycemia is one of the most important complications of diabetes treatment and it becomes an obstacle in hypoglycemia medication. Besides, hypoglycemia can cause nerve damage and impaired cognitive function so that it influences the patients mortality, morbidity, and quality of life. Recognition of hypoglycemia risk factors, blood glucose monitoring, selection of appropriate regimens and educational programs for healthcare professionals and patients with diabetes are the major issues to maintain good glycemic control, minimize the risk of hypoglycemia, and prevent long-term complications. This research employs retrospective method and the design of the research is case control.  The sample of this research is 72 patients with type 2 diabetes which is divided into two groups.  The first group is case and It consists of 23 patients (31,9%) getting hypoglycemia. Then, the second group is control and it consists of 49 patients (68,1%). In the second group the 49 patients do not get hypoglycemia and they do not receive any hypoglycemia medication in the hospital. The Results of multivariate logistic regression analysis shows that there is a significant different between the variables reduction in food intake (p 0,011) and lower laboratory result of HbA1C (p 0,003) on the incidence of hypoglycemic, where the variable reduction in food intake has the strong relationship with most major hypoglycemic (OR 9,329). On the other hand, other variables such as the use of antidiabetic drugs, diabetes duration, age, comorbidities and polypharmacy showed no significant association with hypoglycemic events. Thus, the hypoglycemic risk factors in patients with type 2 diabetes receiving antidiabetic therapy due to reduction in food intake and lower laboratory results of HbA1C. Patients with reduction in food intake at risk of hypoglycemic events nine times greater than patients with normal food intake. Keywords: type 2 diabetes mellitus, hypoglycemia, food intake, HbA1C

Diabetes mellitus (DM) is a group of common metabolic disorders that share the phenotype of hyperglycemia. India is emerging as the world diabetic capital. Insulin is a therapeutic option to treat either type 1 and type 2 DM. Inadequate awareness about the use of insulin is likely to influence its acceptance and adherence. The present study was done to assess the knowledge, attitude, and practice regarding insulin use among diabetic patients at Victoria Hospital, Bangalore, India. Knowledge, attitude, and practice of sixty diabetic patients (either inpatients or outpatients) were assessed by using a validated questionnaire consisting of 24 items. Scores were allotted to each question and evaluated after applying appropriate statistical tests. The mean age of the patients was 53.51±6.48 years (58.33% males). The mean knowledge score was 9.06±1.88 out of 22, attitude score was 4.78±1.37 out of 12 and practice score was 7.75±1.24 out of 11. The mean score of attitude was better in females compared to male patients (5.32±1.34 vs. 4.4±1.28). Male patients scored 38.57% compared to female patients (41.33%) for the question regarding symptoms of hypoglycemia. 57.14% of male patients and 72% of female patients carried simple carbohydrates when going out. Despite good practice scores, the knowledge and attitude scores regarding insulin use were inadequate. Potential adverse effects of insulin can be avoided and better knowledge, attitude, and practice can be achieved by providing proper education to patients. Keywords: knowledge, attitude, practice, diabetic, insulin

Many diseases occur due to inflammation that is not handled properly. One of the feature of inflammation is swelling or edema. Inflammation can be handled with traditional medicine, such as Muntingia calabura L. (M. calabura L.) Pharmacologically, this plant extract is reported to have antipyretic, analgesic, anti-inflammatory, antioxidant, and antibacterial. Metabolite compound contained in M. calabura L. has the potential as an anti-inflammatory agent. The objective of this study is to ascertain the secondary metabolites contained in M. calabura L. leaves infusion. This experimental research method includes the simplicia making and infusion of M. calabura L. leaves by cold infusion and phytochemical screening. This study also showed that the infusion of M. calabura L. leaves contained flavonoids, alkaloids, and triterpenoids. Overall, the findings indicate potential as an anti-inflammatory agent that requires further investigation, specifically in preclinical testing.

Differences in drugs consumption time may affect its absorption and metabolism in the bodywhich could lead to differences in its efficacy. For hypertension patients, one of the mostfrequently used drugs for lowering blood is captopril. However, information regarding theinfluence of consumption time on captopril efficacy was limited. Therefore, this study wasconducted to compare the efficacy of captopril in lowering blood pressure when administeredbefore and after meal. This was an experimental study with two treatment groups,conducted at Dr. Soedarso General Hospital, Pontianak, Indonesia, during April-June 2015.Statistical analysis was performed using Mann-Whitney, Exact-Fisher, and T-test. We foundout that the reduction of systolic blood pressure in group who consumed captopril beforeand after meal was 30 mmHg and 25 mmHg, respectively (p<0.05). The similar reduction indiastolic bloos pressure was observed in both groups (10 mmHg, p>0.05). In conclusion, itis recommended to take captopril on an empty stomach since it showed better efficacy whenadministered before meal compared to after meal consumption.Keywords: hypertension, captopril, absorption

Tobacco (Nicotiana tabacum L.) is a commercial plant that often used for making cigarettes. In 2012, the government issued regulations for the diversification of tobacco products besides cigarettes. Some of these diversified tobacco products include organic pesticides, anesthetics, cosmetic ingredients, and biochar as an alternative to coal. Therefore, in order to further to diversification of tobacco product, this study aimed to determine the antioxidant activity from n-hexane extract from leaves using the Soxhlet extraction method. Antioxidant activity was assessed by the DPPH (2,2-diphenyl-1-picrylhydrazyl) method, while the total phenolic content was determined using the Folin-Ciocalteu method that allowed quantification of phenolic compounds in the extract, which possesses the role of antioxidant. The IC50 value obtained from the antioxidant activity assay of the n-hexane extract of tobacco leaves was 426.042 μg/mL, classified as very weak. Meanwhile, the total phenolic content was 51.93 mg GAE/g. These results suggest that the high total phenol content may have other potential activities that can be tested, such as antibacterial activity.

Anredera cordifolia or binahong is one of the Indonesian medicinal plants that is used to treat peptic ulcer. The purpose of this study was to evaluate the effect of the addition of sodium carboxymethylcellulose (CMC) and sorbitol on anti-peptic ulcer activity of A. cordifolia leaves extracts in male Wistar rats. The plants were extracted using decoction method and freeze dried. Three liquid formulas were used i.e., i) a combination of sodium CMC and sorbitol; ii) only sorbitol; iii) extract only. The rats were divided into 6 groups, i.e., positive control (sucralfate 35 mg/kg body weight); negative control (80% ethanol); normal control; and 3 formulas. After the administration of the liquid formula, all groups, except normal control, were given 80% ethanol (l5 ml/kg body weight) to induce peptic ulcer. Antipeptic ulcer activity was evaluated using direct observation on rats gastric mucosa, and histopathology assessment. The result showed that the strongest anti-peptic ulcer  was shown by sorbitol only (96.95% inhibition),  followed by the combination of sodium CMC and sorbitol (92.68% inhibition). The formula which only contained extract showed only  31.70% inhibition.  Statistical analysis showed significant differences between formula 1 and 2 with negative controls. In conclusion, A. cordifolia leaves extract with the addition of sorbitol showed the strongest anti-peptic ulcer activity. Keyword: Anredera cordifolia, peptic ulcer, suspense, Wistar rat.

Antibiotics play a vital role in prevention and treatment of various infections. But inappropriate antibiotic choice could lead to emergence of multi-drug resistance (MDR) among microorganisms. Since, the antibiotic susceptibility pattern of organisms could vary from place to place; forming a local prophylaxis and treatment protocol could hugely reduce this global burden. The primary objectives of the study were to observe the frequency of multi-drug resistant organisms causing Surgical Site Infections (SSIs) and to study the pattern of antibiotic usage for the prophylaxis and treatment of SSIs. A descriptive study was carried out in general surgical wards of KR hospital, Mysore for a period of 18 months (2015-2016). The relevant data was collected from the case sheets of patients who were diagnosed with SSI. Pus samples were collected, and culture-sensitivity was done. Collected data were analyzed using relevant statistical tests. A total of 263 study subjects including both males and females were enrolled in the study. Cefotaxime was the most common antibiotic used for pre-surgical prophylaxis (n=221). Out of 263 pus samples 92% were culture positive. The most common organisms causing SSI were E-coli-ESBL (n=73) and MRSA (n=44). About 95% of organisms showed multi-drug resistance. Imipenem, Gentamicin, Piperacillin-Tazobactum and Linezolid were the most common antibiotics used in the treatment of SSIs. The result of the study is alarming. Overall, there is great rise in the prevalence of MDR organisms causing SSIs. The hospital antibiotic policy should be revised in such a way to decrease the emergence of MDR microbes.

Non-genetic traits as predictors of variation in response to pharmacological interventions in ASD need to be identified for better management. This review aims to identify these non-genetic traits and the role of adjuvant medications in ASD. Electronic database searches in PUBMED and Cochrane libraries were conducted using MeSH search terms "Autism" and "Risperidone." Randomized or cross-over trials comparing the efficacy of ‘risperidone plus placebo’ vs. ‘risperidone plus adjuvant medications’ using Aberrant Behavior Checklist-Community Version (ABC-CV) scores in ASD patients of any age group were included in the analysis. The quantity of reduced irritability (ABC-I) sub-score was the primary outcome measure analyzed.In contrast, the reduction in remaining ABC-CV sub-scores at the end of 10 weeks were the secondary outcome measures analyzed. All the outcome measures were estimated by calculating the Mean Difference (MD) values and their 95% Confidence Intervals (CI) by both fixed and random effect models using Revman 5.4.1 software. A total of 13 trials were found to be eligible and included in the quantitative synthesis of efficacy. A small but significant decrease in the ABC irritability sub-score was evident in the ‘risperidone plus adjuvants’ group (MD: -3.19, 95% CI:-3.82, -2.56, N=658). The meta-analysis results attributed the highest decrease in ABC-irritability sub-scores to adjuvant topiramate. There is a possibility of bias and minimal impact of adjuvants in alleviating irritability symptoms of ASD. Baseline severity of irritability symptoms and the dose/medication regimen appear to be possible non-genetic traits responsible for variation in response to pharmacological intervention.

Psidium guajava (P. guajava) leaves have been empirically used to stop bleeding. Tannin, one of this plant’s secondary metabolites, may contribute to this activity. However, information regarding its pharmacologicy activity was limited. Therefore, this study was performed to evaluate local hemostatic activity of P. guajava leaves. This study used Duke method with male Swiss Webster mice as test animals. The animals were grouped into three i.e., negative control (distilled water), positive control (epinephrin), and P. guajava group. Its tail was cut (2-3 mm) and the bleeding time was calculated. Statistical analysis was performed using   Kruskal-Wallis test and continued with Least Significant Different (LSD) test. The mean (SD) of bleeding time for those groups were 246.00 (22.95),  72.40 (5.55), and 88.40 (7.03), respectively.  There was a significant difference between the negative control group with the other two groups, but there was not significant difference between the positive control group and the P. guajava group. In conclusion, P. guajava showed promising local hemostatic activity and can be further developed as potential hemostatic agents.  Keywords: Psidium guajava, hemostatic, bleeding time

Authors and Keywords Index of Volume 1 No 3

AIDS is the late stage of infection with the Human Immunodeficiency Virus (HIV). Even though the Highly Active Antiretroviral Therapy (HAART) for the management of HIV/ AIDS has been in existence in Ghana since 2003, there is still limited data on their effectiveness. This study therefore sort to ascertain the effectiveness of HAART used at Anti-retroviral therapy (ART) Centres in the Ashanti region of Ghana by assessing its effects on immunological and haematological markers as well as some significant indicators such as body temperature and blood pressure changes. The study was a retrospective cross sectional study which reviewed medical record folders of 156 HIV infected patients who had attended the selected ART centres in the Ashanti region of Ghana between 2010 and 2014. About 49% of the study population had a significant rise in their CD4 counts after six months strict adherence to specific HAART regimen. HAART effectively reduced viral loads and increased CD4 counts in most of the patients whose medical record folders were reviewed. Socioeconomic factors, formal education and lack of health literacy had a significant effect on adherence to the HAART regimen, however; marital status of patients did not have any significant effect on adherence, CD4 counts and the haemoglobin concentration of patients. Based on results obtained from this study, HAART could be considered as effective in the adult population in the Ashanti region of Ghana provided there is a high level of adherence. Immunological and haematological markers for the assessment of effectiveness could also improve with high adherence recommended HAART regimen