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Schizophrenia is a mental disorder that can affect behavior, emotions and communication. In the agitation phase ithe patient is acompanied by destructive or violent behavior. In these conditions, the patient must immediately calm down to avoid risk. Monotherapy Treatment in acute agitation schizophrenia is recommended than combination therapy. The purpose of this study was to determine the effectiveness of treatment costs and the factors that influence the total cost of schizophrenia patients at the Mental Hospital of West Java Province. This study was observational by cross sectional study design according to the hospital perspective. This method is retrospective data. The subject were inpatients aged 18-65 years with diagnosis of schizophrenia disorder and receiving antipsychotic therapy for at least 1 month. The results showed that average cost-effectiveness ratio (ACER) Rp.288.659/ 1 score PANSS EC with an average decrease score of 9,70. There is a difference in variant data compared because p-value = 0.011

Plants in the Costus genus are known to have various activities, starting from an antibacterial agent, anti-inflammatory, antioxidant, anticancer, antidiabetic, and so on. From some previous studies that have been conducted, it is stated that some Costus plants have a high potential to be a prospective anticancer candidate in the future. This review will discuss botanical and chemical overview, traditional uses, and potential anticancer activity of several Costus plants, namely C.speciosus, C.igneus, C.spiralis, and C.pictus. In conclusion, anticancer activity assay was carried out by several methods using various cell cultures resulting in an IC50 value ranging from strong and very strong, with the strongest potency belonging to C.speciosus with an IC50 value of 13.87 µg/ml. In addition, the active phytoconstituent, mainly diosgenin, contributes to the anticancer activity, which also strengthens the potential of Costus plants.

Background: Since hypertension prevalence has increased, its economic burden has also increased in all regions, including Pandeglang District in Banten Province, Indonesia. In 2014, the government launched a chronic disease management programme (Prolanis) to optimise hypertension treatment in Primary Healthcare Centres (PHCs) through the Social Health Insurance Administration Body (BPJS Kesehatan). Pharmacists' counseling is important in this as it can increase the effectiveness of hypertension treatment. Objective: To investigate the cost-effectiveness of pharmacists’ counselling for Prolanis hypertension patients at PHCs. Methods: An experimental study was conducted at 16 PHCs using a purposive sampling method. The total sample included 96 Prolanis hypertension patients divided into two groups of 48 participants (an intervention and control group). Incremental cost-effectiveness ratio (ICER) was applied by comparing the cost per quality-adjusted life-year (QALY) gained in both groups. A validated EuroQol-5 Dimension-5 Level (EQ-5D-5L) questionnaire and its Indonesian value set were employed to measure patient quality of life, and the local GDP per capita threshold for cost-effectiveness was used. Results: Pharmacists' counseling intervention is cost-effective (ICER: IDR.2,000-28,307 per QALY-gained) within several scenarios with varying fees. Sensitivity analysis showed that the patient's utility score and the pharmacist`s counseling fee were the most influential parameters impacting the ICER. Conclusion: Pharmacist`s counselling can be considered as a promising intervention to optimise Prolanis hypertension treatments at PHCs.

Diabetes mellitus is one of chronic diseases with high treatment cost. Purpose of this research was to analyze the cost-effectiveness of (Prolanis) for patients with type 2 DM and to establish the most significance parameter affecting the cost-effectiveness value. This study is a non-experimental retrospective by collecting medical record data of Prolanis patients with type 2 DM at Bandung Health Center during 2015 and 2016 with 246 samples that met the inclusion criteria. Cost-effectiveness analysis was conducted by calculating Average Cost Effectiveness Ratio (ACER) and Incremental Cost Effectiveness Ratio (ICER). In particular, sensitivity analysis was conducted to investigate the most significance parameter affecting those ratios. The result of unpaired t test confirmed that there was not significance difference on ACER values of 2015 and 2016, whereas the value of arithmetic (0,202) < t table (4,303) with significance value ? 0,04

Background: Garlic (Allium sativum, L) was used empirically by the ancestors as a useful plant for hypercholesterolemia. The processed garlic product, namely black garlic, has gone through an optimal heating process at a temperature of 70oC for 21 days. Black garlic can become a standardized herb if it has been through characterization and toxicity tests. Methods: The characterization test is known by measuring several general standard parameters of Indonesian extracts. Acute toxicity test was carried out by dividing 5 treatment groups namely negative control, group I (5 mg/kg BW), group II (50 mg/kg BW), group III (300 mg/kg BW), group IV (2000 mg/kg BW). Results: The results showed that the standardization of black garlic extract has a drying shrinkage content of 7.24%, a water content of 8.8%, a total ash content of 4.79%, an acid insoluble ash content of 1.52%, a water soluble extract content of 7.47% and an ethanol soluble extract content of 9.3% which is still into the Indonesian herbal pharmacopoeia standard and the administration of black garlic ethanol extract caused mild toxic symptoms during the acute toxicity test and obtained LD50 values > 2000 mg/kg BW. Conclusion: Characterization of black garlic extract according to standardization parameters of Indonesian plant extracts and administration of ethanolic extract of black garlic has an LD50 value > 2000 mg/kg BW which is included in category 5 in the OECD.

Alopecia is a condition characterized by excessive hair loss. This condition can be caused by various factors, such as heredity, aging, drugs, or lifestyle. This study aims to determine the affinity, stability, and pharmacokinetic profiles of several bioactive compounds from the Sansevieria trifasciata plant as anti-alopecia by applying the In-Silico method. Molecular simulation of forty-nine bioactive compounds was successfully docked to the active site of the androgen receptor (AR). The best compounds 1,2-(dipalmitoyl)-3-O-β-D-galactopyranosylglycerol, Sansevierigenin, and Spirosta-5,25(27)dien-1b,3b-diol-1-O-a-L-rhamnopyranosyl-(1,2)-a-L-arabinopyranoside showed stable results after 100 ns molecular dynamics simulation based on the root mean square deviation (RMSD) and the root mean squared fluctuation (RMSF). The binding free energy calculation using the MM-PBSA method and pharmacokinetic profiles of these three compounds showed satisfactory results compared to the minoxidil.

Objective: This research was conducted to isolate the alkaloid carpaine by chromatography method and to determine it quantitatively by Thin Layer Chromatography Scanner. Methods: Dried leaves were macerated with ethanol 70% and fractionated with dichloromethane. Isolation of carpaine alkaloid from the dichloromethane fraction was carried out by column chromatography and preparative thin-layer chromatography according to the Rf value in Thin Layer Chromatography (TLC) after exposure by Dragendorff reagent. Results: The content of carpaine alkaloid was 7.5 mg with Rf 0.58 and dichloromethane: methanol (9.2:0.8) as eluent. Validation showed the linearity (R2) 0.9988, the limit of detection(LOD) was 0.05 ppm, the Limit of Quantification (LOQ) was 0.19 ppm, the recovery from 98.93-102.43%, and the % coefficient of variation was 0.16%. Conclusion: Carpaine alkaloid in papaya leaf extract was 10.52%.

Yuni Elsa Hadisaputri,1,2 Ummi Habibah,1,2 Fajar Fauzi Abdullah,2,3 Eli Halimah,1 Mutakin Mutakin,1 Sandra Megantara,1 Rizky Abdulah,1 Ajeng Diantini1 1Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, West Java, 45363, Indonesia; 2Central Laboratory, Universitas Padjadjaran, Jatinangor, West Java, 45363, Indonesia; 3Department of Chemistry, Faculty of Mathematic and Sciences, Universitas Padjadjaran, Jatinangor, West Java, 45363, IndonesiaCorrespondence: Ajeng DiantiniFaculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM.21, Jatinangor, West Java, 45363, IndonesiaTel +62-22-84288888 Ext. 3510Email diantini.ajeng@gmail.comIntroduction: Breast cancer is the second most common cancer in women globally, and the incidence rate has increased annually. Traditional medicine is frequently used as a cancer treatment, and soursop or Annona muricata L (A. muricata) is a traditional medicinal plant that has been widely used as an anticancer treatment and requires more thorough study.Methods: In this research, we prepared ethanol extract and three solvents, ie, ethyl acetate, n-hexane and water fractions of A. muricata leaves and assessed their antiproliferation and cytotoxic activity on MCF7 breast cancer cells compared with that on CV1 normal kidney cells; observation of cell morphology by stained with mixture of propidium iodide and 4ʹ,6-diamidino-2-phenylindole indicated that this treatment induced an ongoing process of apoptotic cell death in MCF7 cells. To clarify the cell death mechanism via apoptosis, we assessed the mRNA expression in the caspase cascade of caspase-9, caspase-3, and PARP-1, and anti-apoptotic, Bcl-2 which mediated cytotoxic activity of extracts and ethyl acetate fractions of A. muricata leaves against MCF7 cells.Results: The ethanol extract, ethyl acetate, n-hexane, and water fractions of A. muricata leaves had IC50 values of 5.3, 2.86, 3.08, and 48.31 μg/mL, respectively, in MCF7 cells but had no activity in CV1 cells. The high cytotoxic activity of A. muricata leaves was reflected by changes in the morphology of cancer cells that appeared after 6 h exposure to A. muricata leaf extract and ethyl acetate fraction; the membrane and nucleus of cells undergoing apoptosis were characterized by the rupture and loss of membranes and nuclei. The mechanism that mediates this cytotoxic activity in MCF7 cells was mediated through a decrease in the expression of Bcl-2 mRNA and an increase in caspase-9 and caspase-3 mRNA expression.Conclusion: Therefore, the leaves of the medicinal plant A. muricata contained compounds that on extraction exerted a highly effective activity as an anticancer treatment for breast cancer via induced apoptotic cell death.Keywords: soursop, Annona muricata L., MCF7 breast cancer cell, cytotoxicity, caspase-cascade

Drug interaction is a type of Drug-Related Problems (DRPs) that caneventually increase morbidity and mortality rates. CKD patients have asignificant risk of developing polypharmacy due to comorbid diseases andpharmacokinetics' alteration. The literature review was conducted byexploring all of the articles related to the drug interaction using druginteraction analysis program in CKD patients, which obtained from threedatabases, namely Google Scholar, PubMed, and Science Direct, usingseveral keywords combination. Based on the comprehensive reviewsconducted, it is known that the most common effects of antihypertensivedrug interactions in CKD patients are decreasing effects of antihypertensivedrugs, hypotension, and hyperkalemia. Handling management used for theemergence of potential drug interactions is based on the severity of the druginteractions and complete knowledge of the patients' clinical condition. Themanagement of drug interaction by monitoring blood pressure, diuresis, andpotassium levels; Monitor the related effect symptoms; Monitor the fluidand body weight; Monitor the kidney and heart function. On the conditionwhere the handling management of potential drug interactions is not carriedout, elevated morbidity and mortality rates are the risks of complicationsarising from the drug interactions.

Resistensi antibiotik menjadi salah satu topik yang mendapat perhatian lebih dari pemerintah Indonesia. Pada PMK No. 8 Tahun 2015 tentang Program Pengendalian Resistensi Antimikroba di Rumah Sakit mewajibkan Rumah sakit untuk membentuk tim pelaksana Program Pengendalian Resistensi Antimikroba (PPRA) di Rumah Sakit. Tugas dari tim pelaksana PPRA diantaranya melakukan evaluasi penggunaan antibiotik. Metode ATC/DDD (Anatomical Therapeutic Chemical/Daily Defined Dose) digunakan untuk evaluasi kuantitatif penggunaan antibiotik. Tujuan dari penelitian ini adalah untuk mengetahui gambaran penggunaan antibiotik dalam satuan jumlah ATC/DDD dan mengetahui antibiotik yang termasuk kedalam DU90% (Drug Utilization 90%) pada pasien rawat jalan di poli penyakit dalam (Internis) di RS Al-Islam Bandung. Pengumpulan data pada penelitian ini dilakukan secara retrospektif. Pengamatan dilakukan pada resepOktober-Desember 2019 sebanyak 990 resep. Hasil dari perhitungan menunjukkan bahwa 12% resep menggunakan antibiotik dan 88% resep tidakmenggunakan antibiotik. Isoniazid merupakan antibiotik dengan nilai ATC/DDD tertinggi yaitu 163750 dan amoxycillin merupakan antibiotik dengan nilai ATC/DDD terendah yaitu sebesar 750. Antibiotik yang termasuk kedalam DU90% adalah isoniazid, rifampisin, ethambutol dan pyrazinamide.

Meningkatnya kejadian resistansi antibiotik menyebabkan terbatasnya pilihan terapi antibiotik, sehingga berdampak terhadap morbiditas dan mortalitas pasien. Untuk mengendalikan resistansi antibiotik, maka dikeluarkan Peraturan Menteri Kesehatan (Permenkes) No.8 Tahun 2015 tentang Program Pengendalian Resistansi Antimikroba (PPRA) di rumah sakit yang diharapkan dapat memperbaiki penggunaan antibiotik baik secara kuantitatif maupun kualitatif. Kajian literatur ini bertujuan untuk mengetahui evaluasi penggunaan antibitoik secara kualitatif serta hambatan yang terjadi dalam penerapan PPRA pada beberapa rumah sakit di Indonesia. Metode pencarian literatur menggunakan Google Scholar dengan kriteria inklusi menggunakan algoritma Gyssen, merupakan artikel primer, artikel nasional bereputasi terakreditasi SINTA Ristekdikti dengan tahun publikasi 2015-2022. Berdasarkan hasil seleksi artikel, diperoleh 25 artikel yang akan dikaji. Hasil pengkajian menunjukkan 72% rasionalitas penggunaan antibiotik masih berada pada angka ≤60%. Rendahnya rasionalitas penggunaan antibiotik pada beberapa penelitian disebabkan penerapan PPRA yang tidak berjalan dengan baik, sehingga diperlukan sosialisasi dan pelatihan yang intensif serta kebijakan dalam penggunaan antibiotik di setiap rumah sakit.

The investigation efforts of an alternative treatment of the kidney stone disease by utilizing Indonesian native plants have still continued both for treatment and prevention. This study aims to strengthen the scientific evidence of the activity of celery as an anticalculi by in vivo assessment using hydroxyprolineinduced rat method. The white male wistar rats used in this study were intraperitoneally induced by hydroxyproline in order to form kidney stones, the celery extract preparations were then given at a dose of 50, 100, and 200 mg/kg of body weight orally for 5 days and observed following parameters: concentration of filtrate urinary calcium, concentration of urinary sediment calcium, as well as kidney to body weight ratio. The results showed that the concentration of filtrate urinary calcium in the test group at a dose of 200 mg/ kg body weight was significantly higher than those of negative control group, whereas the other test groups were not significantly different with the negative control group. The similar result was also shown on the parameter of calcium concentration in the urine sediment, while the ratio of kidney to body weight showed significant differences between all test groups and the negative control group. It can be concluded that the ethanol extract of the herb celery has an anticalculi activity in rats at a dose of 200 mg/kg of body weight.

BACKGROUND: The mechanism of aging goes along with age, one of which is characterized by cellular senescent, which occurs mostly in adipose tissue. Adipose tissue is the site of accumulation of large cell senescent, in the regulation of obesity and aging. Proteins p53 is marker for cell senescent, which are also known to induce inflammation. This study was aimed to determine the relationship between circulating protein p53 and high sensitivity C-reactive protein (hsCRP) in central obese men with inflammaging.METHODS: The study design is an observational study with cross-sectional approach. The subjects were 75 central obese men (waist circumference/WC > 90 cm), aged ≥ 45 years old. Subjects were divided into 2 age groups, those are middle age group: 45-59 years old (50.7%) and elderly group: ≥ 60 years old (49.3%). Examination of circulating p53 was done using enzyme-linked immunosorbent assay (ELISA) method, and the hsCRP examination was done by chemiluminescent method.RESULTS: It was found that there was a correlation between circulating p53 and hsCRP in elderly (r=-0.414; p

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.

Negara Indonesia memiliki keberanekaragaman hayati jenis tanaman yang tersebar di seluruh wilayah. Bawang hitam merupakan produk olahan bawang putih yang telah melalui proses pemanasan optimal pada suhu 70oC selama 21 hari. Bawang hitam dapat menjadi herbal terstandar bila telah melalui uji kualitas dan keamanan. Tujuan penelitian ini yaitu mengetahui tingkat keamanan ekstrak etanol bawang hitam. Uji keamanan dengan cara uji toksisitas akut dengan 5 kelompok perlakuan yaitu kontrol negatif, kelompok I (5 mg/kg BB), kelompok II (50 mg/kg BB), Kelompok III (300 mg/kg BB), kelompok IV (2000 mg/kg BB). Penelitian yang diperoleh menyatakan bahwa parameter standar bawang hitam memenuhi parameter standar umum tumbuhan Indonesia. Pemberian ektrak etanol bawang hitam menimbulkan gejala-gejala toksik ringan selama pengamatan pada uji toksisitas akut dan memperoleh nilai LD50 > 2000 mg/kg BB yang termasuk pada kategori 4 pada OECD Guidelines for The Testing of Chemicals.

Menurut Data Globocan, International Agency for Research on Cancer (IARC) pada tahun 2018, kanker payudara merupakan salah satu jenis kanker yang mempunyai prevalensi cukup tinggi dan penyebab utama kedua mortalitas di seluruh dunia sebesar 11,6% atau 2.089 Juta Jiwa dan morbiditas menempati urutan ke-5 sebesar 6,6% atau 627.000 Juta Jiwa. Di Indonesia angka mortalitas kanker payudara menempati peringkat pertama sebesar 16,7% atau 58.256 juta jiwa dan angka morbiditas sebesar 11% atau 22.692 juta jiwa. SADARI adalah pemeriksaan payudara yang dilakukan kita sendiri dengan belajar mandiri yaitu melihat dan memeriksa perubahan payudaranya sendiri setiap bulan. Pemeriksaan yang dilakukan secara berkala akan dapat diketahui adanya benjolan atau bahkan masalah lain dari sejak awal walaupun masih berukuran kecil sehingga lebih efektif untuk diobati. Metode survey, pre tes dan post test telah diterapkan sebagai upaya promosi SADARI ke ibu-ibu PKK Desa Sayang, Kecamatan Jatinangor, Sumedang. Masyarakat Desa Sayang dikatakan cukup tahu mengenai kanker payudara (68%), namun kurangnya informasi tentang pencegahan dini mengakibatkan kesadaran terhadap informasi kesehatan termasuk tentang pencegahan kanker payudara menjadi kurang (58,82 %). Hasil post test menunjukkan bahwa program promosi preventif SADAR meingkatkan pengetahuan dan kesadaran masysrakat sehingg disimpulkan bahwa masysrakat Desa Sayang perlu diberikan promosi secara bverala agar pengetahuan dan kesadaran meningkat dalam mencegah kanker payudara.

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia.Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported.Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives.Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.

Introduction The prevalence of hypertension in Indonesia is increasing, not least in some peripheral areas, including in Pandeglang District, Banten Province. The government of Indonesia, through the Social Health Insurance Administration Body (BPJS Kesehatan) has launched a chronic disease management program (Prolanis) to achieve more optimal results in treating patients with chronic diseases, including hypertension. Objective This study aimed to measure the quality of life of Prolanis hypertension patients at the primary healthcare centers (PHCs) using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument and taking pharmacists' counseling intervention into account. This study was conducted in 96 Prolanis patients, consisting of 48 patients from 8 PHCs who did not receive pharmacists' counseling intervention (control group) and 48 other patients from 8 different PHCs who received 4 times intervention (intervention group). This study was conducted in a period of 3 months (June–August 2019) in 16 sub-districts of Pandeglang District. Methods An experimental study design was applied by considering a purposive sampling method. Patients' quality of life were measured by using EQ-5D-5L instrument and its Indonesian value set. For data analysis, we applied the Kruskal–Wallis, Mann–Whitney, Wilcoxon, and Binomial tests to investigate the differences of patients' quality of life in both groups of control and intervention. Results and Conclusions The results showed that the average utility value of the intervention group experienced an improvement at each meeting (m1 = 51.25%; m2 = 66.25%; m3 = 84.17%; and m4 = 91.67%), while the control group experienced a lower and more fluctuative improvement than the intervention group (m1 = 65.42%; m2 = 70.42%; m3 = 80.42%; and m4 = 76.67%). The same results also occurred in the average value of visual analogue scale (VAS). There was a better improvement in the intervention group than in the control group. Clinical Trial Registration Number 62/UN6.KEP/EC/2019., Video Abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/e0ehLVzB4Ig

Pneumonia merupakan salah satu penyebab utama kematian anak usia di bawah lima tahun (balita) di dunia. Terapi antibiotik untuk pneumonia biasanya dipilih secara empirik karena mikroorganisme penyebab pneumonia belum dapat diketahui saat diagnosis. Penelitian ini bertujuan untuk membandingkan efektivitas terapi antibiotik empirik pneumonia dengan menggunakan ampisilin tunggal maupun dikombinasikan dengan gentamisin pada balita yang dirawat dengan pneumonia di salah satu rumah sakit di kota Bandung pada tahun 2013–2015. Metode penelitian yang digunakan adalah potong lintang dengan pengambilan data sekunder secara retrospektif. Data yang diperoleh dianalisis dengan uji Chi Square , uji Fisher, dan uji Mann-Whitney . Hasil penelitian menunjukkan bahwa tidak ada perbedaan efektivitas antara pasien yang diterapi menggunakan ampisilin maupun ampisilin-gentamisin dari parameter perbaikan batuk (p=0,381), sesak (p=0,294), demam (p=0,405), maupun laju pernapasan (p=0,306), namun terdapat perbedaan pada lama hari rawat (p

Sistem kekebalan adalah sistem pertahanan tubuh, yang bertujuan untuk mengenali dan merespons dari berbagai macam patogen atau cedera untuk melindungi tubuh. Sistem imun dapat mengalami ketidakseimbangan yang berdampak pada inflamasi yang tidak terkontrol dan menyebabkan berbagai penyakit. Dalam mengatasinya diperlukan imunomodulator dan antiinflamasi. Tumbuhan yang memiliki efek imunomodulator dan antiinflamasi yaitu tumbuhan meniran (genus Phyllanthus). Diketahui tumbuhan yang masih satu genus dengan meniran yang memiliki kemiripan kandungan kimia. Kesamaan kandungan kimia dari masing-masing tumbuhan genus Phyllanthus berkemungkinan memiliki efek dan potensi aktivitas yang sama. Tujuan dari artikel review ini adalah untuk menelusuri potensi aktivitas imunomodulator dan antiinflamasi tumbuhan genus Phyllanthus. Pencarian sumber dilakukan secara elektronik melalui situs PubMed. Berdasarkan hasil penelusuran didapatkan 43 artikel yang memenuhi kriteria penulisan. Senyawa tumbuhan genus Phyllanthus seperti: filtetralin, filantin, etil 8-hidroksi-8-metil-tridekanoat, 1,7,8-trihidroksi-2-naftaldehida, corilagin, geranin, tanin, kuersetin, rutin, dan asam galat berpotensi sebagai imunomodulator dengan cara mengatur respon imun humoral dan respon imun seluler. Senyawa tumbuhan genus Phyllanthus seperti: asam galat, filantin, hipofilantin, fisetin, katekin, corilagin, geranin, urolitin A, dan englerin A, telah terbukti berpotensi sebagai antiinflamasi dengan cara mengatur regulasi sitokin, enzim, dan protein inflamasi, serta menargetkan jalur persinyalan inflamasi.

Pandemi coronavirus yang diakibatkan oleh SARS-CoV-2 (Covid-19) telah menyebabkan berbagai permasalahan, meliputi kesehatan, ekonomi, dan sosial. Penyesuaian dalam menjalani kehidupan sehari-hari di masa pandemi penting untuk dilakukan demi mencegah penularan dan menjaga stabilitas ekonomi masyarakat. Dalam kegiatan pengabdian kepada masyarakat Desa Sayang, Kabupate Sumedang, dilakukan survey mengenai pengetahuan dan kesadaran masyarakat dalam masa adaptasi kebiasaan baru (AKB) dan ditindaklanjuti dengan pemberian materi berupa “Sosialisasi Protokol Adaptasi Kebiasan Baru pada Masyarakat Kabupaten Sumedang” dalam bentuk webinar. Hasil survey menunjukkan bahwa 95,2% masyarakat sudah mengetahui adanya penerapan protokol kesehatan di masa AKB. Namun demikian, hanya 64% masyarakat saja yang mengetahui tata cara pelaksanaan protokol kesehatan di masa AKB. Dengan demikian, diharapkan bahwa melalui sosialisasi protokol kesehatan di masa AKB dapat meningkatkan pengetahuan dan kesadaran masyarakat dalam menjalankan hidup sehat di masa AKB

The prevalence of pneumonia is particularly high among pediatric patients. Appropriate antibiotics selection is required to reduce mortality and morbidity rates associated with these diseases. However, information on cost-effectiveness of empirical antibiotics treatment for pneumonia was limited. This study was aimed to evaluate cost-effectiveness of cefotaxime and ceftazidime for pneumonia in pediatric patients. This study was a retrospective cross sectional study conducted at a hospital in Bandung during January-December 2012. Data were derived from medical records of pediatric pneumonia inpatients during study period. Cost was calculated based on direct medical cost, i.e., inpatient care, medical support, and medicines that were used from admission until hospital discharge. The results showed that there was no statistical difference in the average medical cost of the treatment using cefotaxime (1,197,017 IDR) and ceftazidime (2,245,748 IDR). Incremental cost effectiveness ratio (ICER) showed that cefotaxime is more cost effective than ceftazidime with greater reduction of leukocytes level (576 IDR/mm3 ). The use of cefotaxime is recommended for the treatment of pnuemonia in pediatric patients. Keywords: cost minimization, cost effectiveness, cefotaxime, ceftazidime, pneumonia

Stroke merupakan sindrom neurologis yang bersifat akut yang terjadi karena adanya penurunan aliran darah yang disebabkan oleh terhambat atau pecahnya pembuluh darah otak (cerebrovaskular) yang menyebabkan kerusakan jaringan otak. Berdasarkan patogenesisnya, terdapat dua jenis stroke, yaitu stroke iskemik dan hemoragik, di mana penanganan pengobatan pada kedua jenis stroke tersebut sangat berbeda sehingga diperlukan diagnosis diferensial untuk membedakan kedua jenis stroke tersebut. Tujuan penelitian ini yaitu untuk menentukan apakah Heart-type Fatty Acid-Binding Protein (H-FABP) dapat dijadikan sebagai parameter penanda biokimiawi untuk membedakan stroke iskemik dan hemoragik. Penetapan kadar H-FABP dilakukan dengan menggunakan serum darah dan dianalisis dengan metode Enzyme Linked Immunosorbent Assay (ELISA) sandwich masing-masing menggunakan H-FABP test kit. Serum darah diambil dari 20 orang pasien stroke iskemik dan 18 orang pasien stroke hemoragik dari Instalasi Gawat Darurat (IGD), Unit Stroke dan Instalasi Rawat Inap di salah satu Rumah Sakit Umum di Jakarta. Hasil penelitian menunjukkan bahwa kadar rata-rata H-FABP pada pasien stroke iskemik sebesar 9,07 ng/mL sedangkan pasien stroke hemoragik sebesar 18,54 ng/mL; secara statistik terdapat perbedaan kadar H-FABP yang signifikan antara pasien stroke iskemik dan hemoragik (α=0,05). Dengan demikian, Heart-type Fatty Acid-Binding Protein (H-FABP) dapat dijadikan sebagai salah satu parameter penanda biokimiawi untuk membedakan stroke iskemik dan hemoragik.

Cyclooxygenase (COX) or prostaglandin H2 synthase (PGHS) catalyzes the conversion of arachidonic acid into prostaglandins. Nonsteroidal anti-inflammatory drugs (NSAIDs) work by inhibiting both COX-1 and COX-2 isoforms, thus disturbing this reaction. In Indonesia, Andrographis paniculata (local name: sambiloto), is empirically used to reduce inflammation by consuming the herb tea of this plant. This work studied the inhibitory activity of andrographolide and andrograpanin, diterpenoids of the plant, on the rate of prostaglandin formation. Previous works have proven that andrographolide inhibited PGE2 production in LPS-induced human fibroblast cells. This study was performed by measuring the absorbance of TMPD (tetramethyl-p-phenyldiamine) oxidized by andrographolide and andrograpanin. Acetosal was used as a control drug. The rate of PGH2 formations on either COX-1 or COX- 2 was affected by andrographolide and andrograpanin. Andrographolide and andrograpanin interact longer with COX-1 than COX-2. Andrographolide shows weak inhibition on the rate of PGH2 formation, whilst andrograpanin might be further developed for potential antiinflammatory drugs. Keywords: Andrographis paniculata, anti-inflammatory, COX, cyclooxygenase, prostaglandin

Menurut Data Globocan International Agency for Research on Cancer (IARC) pada tahun 2018, kanker payudara merupakan salah satu jenis kanker yang mempunyai prevalensi cukup tinggi dan penyebab utama kedua mortalitas di seluruh dunia sebesar 11,6% atau 2.089 juta jiwa dan morbiditas menempati urutan ke-5 sebesar 6,6% atau 627.000 juta jiwa. Di Indonesia, angka mortalitas kanker payudara menempati peringkat pertama sebesar 16,7% atau 58.256 juta jiwa dan angka morbiditas sebesar 11% atau 22.692 juta jiwa. Periksa Payudara Sendiri (Sadari) adalah pemeriksaan payudara yang dilakukan kita sendiri dengan belajar mandiri yaitu melihat dan memeriksa perubahan payudaranya sendiri setiap bulan. Pemeriksaan yang dilakukan secara berkala akan membantu mengetahui adanya benjolan atau bahkan masalah lain dari sejak awal walaupun masih berukuran kecil sehingga lebih efektif untuk diobati. Metode survei, pre-test, dan post test telah diterapkan sebagai upaya promosi Sadari ke ibu-ibu PKK Desa Sayang, Kecamatan Jatinangor, Sumedang. Masyarakat Desa Sayang dikatakan cukup tahu mengenai kanker payudara (68%), namun kurangnya informasi tentang pencegahan dini mengakibatkan kesadaran terhadap informasi kesehatan termasuk tentang pencegahan kanker payudara menjadi kurang (58,82 %). Hasil post test menunjukkan bahwa program promosi preventif Sadari meningkatkan pengetahuan dan kesadaran masyarakat sehingga disimpulkan bahwa masyarakat Desa Sayang perlu diberikan promosi secara berkala agar pengetahuan dan kesadaran meningkat dalam mencegah kanker payudara.

Penelitian ini dilakukan sebagai tahap awal evaluasi peresepan obat di salah satu fasilitas kesehatan yang akan dilakukan berkala untuk meningkatkan kualitas pengobatan pasien dengan menggunakan lima indikator peresepan berdasarkan guideline World Health Organization (WHO) yaitu jumlah obat per lembar resep, penggunaan obat generik, antibiotik, obat injeksi, dan obat esensial. Pengumpulan data resep rawat jalan diambil secara retrospektif pada periode April 2015–Maret 2016 di salah satu fasilitas kesehatan di Bandung. Sebanyak 1.814 lembar resep dengan 3.886 obat yang termasuk kriteria inklusi, diperoleh rata-rata jumlah obat per lembar yaitu 2,13 obat. Penggunaan obat generik sebesar 57,47% dari 3.886 obat. Persentase penggunaan antibiotik sebesar 15,52% dan sediaan injeksi 0,41% dari 1.814 lembar resep, sedangkan penggunaan obat esensial sebesar 39,49% dari 3.886 obat yang diresepkan. Berdasarkan hasil tersebut penggunaan obat generik dan esensial masih sangat jauh dari standar WHO (100%) sedangkan penggunaan antibiotik dan obat injeksi memiliki nilai rendah dibandingkan dengan nilai rujukan World Health Organization. Kata kunci : Indikator peresepan, obat, WHO Prescribing of Outpatient: Observational Study Using WHO Prescribing Indicator in One of Health Care Facilities in Bandung This study was held to evaluate drug pattern in one of the health facilities in Bandung using five World Health Organization guideline for prescribing indicators, which include average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic, injection prescribed, and drugs prescribed from essential drugs list or formulary. Outpatient prescriptions were collected retrospectively from April 2015–March 2016. Average number of drugs per encounter 2.13 was gained by dividing 3,886 drugs with 1,814 prescriptions. Percentage of using generic drugs were 57.47%, antibiotics were 15.52 % and 0.41% for injections per encounters, whereas percentage of drugs prescribed from essential drugs list was 39.49%. The result showed that usage of generic and essential drugs were still far from WHO standard (100%) while the usage of antibiotics and injections were lower than World Health Organization recommendation. Keywords: Drug, prescribing indicators, WHO

Osteocalcin merupakan senyawa penanda untuk pembentukan tulang sedangkan β-CrossLaps (β-CTx) merupakan fragmen hasil pemecahan kolagen tipe 1. Tujuan penelitian ini yaitu untuk menentukan N-MID osteocalcin (N-MID Oc) dan β-CTx sebagai penanda biokimia Bone Turn Over untuk deteksi dini osteoporosis pada wanita menopause. Nilai N-MID Oc dalam serum ditentukan dengan pereaksi Elecsys N-MID Osteocalcin kit dan nilai β-CTx dalam serum ditentukan dengan pereaksi Elecsys β-CROSSLAPS kit yang bekerja berdasarkan prinsip Electrochemiluminescence Immunoassay (ECLIA). Data yang diperoleh diuji dengan menggunakan Uji-T. Sampel yang dikumpulkan berasal dari wanita normal, osteopenia, dan penderita osteoporosis pada wanita menopause. Hasil penelitian menunjukkan terdapat perbedaan nilai N-MID Oc pada wanita menopause normal dengan wanita menopause osteopenia, wanita menopause normal dengan wanita menopause penderita osteoporosis dan wanita menopause osteopenia dengan wanita menopause penderita osteoporosis (α=0,05), sedangkan pada nilai β-CTx terdapat perbedaan antara wanita menopause normal dengan wanita menopause osteopenia, wanita menopause osteopenia dengan wanita menopause osteoporosis, tetapi antara wanita menopause osteopenia dengan wanita menopause osteoporosis tidak menunjukkan perbedaan (α=0,05). Penelitian ini menunjukkan bahwa N-MID Oc dan β-CTx dapat dijadikan parameter untuk deteksi dini osteoporosis. Kata kunci: N-MID Osteocalcin (N-MID Oc), Osteoporosis, β-CrossLaps (β-CTx) N-MID Osteocalcin (N-MID Oc) and β-Crosslaps (β-CTx) as Biochemical Markers of Bone Turnover in Menopausal Women Osteocalcin is a marker compound for bone formation while the β-crosslaps a fragment split from collagen type 1. The aims of this study were to determined of the value of N-MID osteocalcin (N-MID Oc) and β-CTx as a biochemical marker of Bone Turn Over as early detection of osteoporosis in postmenopausal women. The value of N-MID Oc in serum was determined by reagent Elecsys N-MID Osteocalcin kit and the value of β-CTx in serum was determined by reagent Elecsys β-Crosslaps kit which works with the principle of Electrochemiluminescence Immunoassay (ECLIA). The data obtained were examined using T-test. The sample collected from normal, osteopenia, and osteoporotic in menopausal women. There were a significant difference N-MID Oc between normal, osteopenia, and osteoporotic in menopausal women (α=0,05). There were significant differences of β-CTx between normal and osteopenia, normal and osteoporosis but between osteopenia and osteoporotic menopausal women not showed any difference (α=0,05). N-MID Osteocalcin (N-MID Oc) and β-CTx can be used as parameter for early detection of osteoporosis. Key words : N-MID Osteocalcin (N-MID Oc), Osteoporosis, β-CrossLaps (β -CTx)

Penggunaan antibiotik yang tidak rasional dapat menyebabkan peningkatan morbiditas dan mortalitas. Monitoring penggunaan antibiotik diperlukan dalam mendukung program pemerintah khususnya Dinas Kesehatan yang menyatakan penggunaan antibiotik untuk penyakit ISPA non-pneumonia adalah kurang dari 20%. Evaluasi penggunaan antibiotik ini menggunakan metode ATC/DDD dan DU 90%. Antibiotik yang digunakan untuk ISPA non-pneumonia adalah sebanyak 9 jenis dan antibiotik yang masuk dalam DU90% sebanyak 3 jenis yaitu amoksisilin 500 mg (2,723 DDD/1000 pasien-hari), siprofloksasin (0,378 DDD/1000 pasien-hari) dan sefadroksil (0,202 DDD/1000 pasien-hari). Analisis data secara kuantitatif menggunakan ATC/DDD menunjukkan bahwa antibiotik yang banyak digunakan adalah amoksisilin (500 mg) 2723 DDD/1000 pasien-hari dan yang paling sedikit yaitu amoksisilin (125 mg/5 ml) 1,5 DDD/1000 pasien-hari. Efek peresepan penggunaan antibiotik jangka pendek pada pelayanan pengobatan dasar dapat meningkatkan kejadian resistensi. Diperlukan studi kualitatif untuk mengetahui pola ketidakrasionalan penggunaan antibiotik di pusat pelayanan kesehatan masyarakat tersebut dan mengembangkan model intervensinya. Kata kunci: ATC/DDD, DU 90%, ISPA non-pneumonia antibiotik Monitoring the Use of Antibiotics by the ATC/DDD Method and DU 90%: Observational Studies in Community Health Service Centers in North Gorontalo District Irrational use of antibiotics may lead to increase morbidity and mortality. Monitoring of antibiotics was required to support government programs, especially The Department of Health stating the use of antibiotics for non-respiratory diseases pneumonia was less than 20%. The evaluation of antibiotics use in this research applied ATC / DDD methods and DU 90%. The antibiotic used for non-pneumonia ARI were 9 types and the antibiotics contained DU 90% were three types namely amoxicillin 500 mg (2,723 DDD/1000 patients-year), ciprofloxacin (0,378 DDD/1000 patients-day) and cefadroxil (0,202 DDD/1000 patients-day). Quantitative data analysis using the ATC / DDD indicated that the most used antibiotic was amoxicillin (500 mg) 2723 DDD / 1000 patients-day and the least was amoxicillin (125 mg / 5 ml) 1.5 DDD / 1000 patients-day. The effects of short-term use of antibiotic prescribing in primary medical care could increase the resistance. Qualitative studies were needed to determine the pattern of irrational antibiotic use in community health service center and to develop the intervention model. Keywords: ARI non-pneumonia antibiotics, ATC/DDD, DU 90%