Eureka Herba Indonesia (EHI - E-Journal)
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Phytotherapeutic Interventions Targeting Microvascular Dysfunction in Early Non-Proliferative Diabetic Retinopathy: A Systematic Review and Meta-Analysis of Effects on Retinal Perfusion and Function
Full text linkMicrovascular dysfunction, encompassing impaired perfusion and subsequent functional deficits, is a hallmark of early non-proliferative diabetic retinopathy (NPDR). Phytotherapeutic agents, with their potential antioxidant, anti-inflammatory, and vasculoprotective properties, have emerged as candidate interventions. However, synthesized evidence regarding their specific impact on retinal perfusion and function in early NPDR remains limited. This systematic review and meta-analysis aimed to evaluate the efficacy of phytotherapeutic interventions on quantitative measures of retinal perfusion and visual function in patients with early NPDR. A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) published between January 2013 and December 2024. Studies evaluating any phytotherapeutic intervention versus placebo or standard care in patients with early NPDR, reporting outcomes related to retinal perfusion (including Foveal Avascular Zone [FAZ] area, capillary density via Optical Coherence Tomography Angiography [OCT-A]) or retinal function (including Best-Corrected Visual Acuity [BCVA], Contrast Sensitivity [CS], electroretinogram [ERG] parameters) were considered. Data from seven RCTs meeting eligibility criteria were analyzed. Data extraction and risk of bias assessment (Cochrane RoB 2 tool) were performed. Meta-analyses using a random-effects model were conducted for key outcomes, calculating Mean Differences (MD) or Standardized Mean Differences (SMD) with 95% Confidence Intervals (CIs). Heterogeneity was assessed using the I² statistic. Seven RCTs (total N=585 patients) were included. The interventions evaluated included Ginkgo biloba, Bilberry extract, Curcumin, Saffron, Pycnogenol, Mirtogenol, and a standardized Traditional Chinese Medicine (TCM) formula. Risk of bias across the studies varied, with concerns primarily in blinding and outcome measurement domains in some trials. Meta-analysis indicated that phytotherapeutic interventions were associated with a statistically significant improvement in retinal perfusion markers compared to control. This included a reduction in FAZ area (MD: -0.04 mm², 95% CI [-0.06, -0.02], P<0.001; I²=58%) and an increase in parafoveal superficial capillary density (MD: +1.85 %, 95% CI [+1.10, +2.60], P<0.001; I²=65%). Functional improvements were also observed, including BCVA (MD: -0.03 logMAR, 95% CI [-0.05, -0.01], P=0.005; I²=35%) and contrast sensitivity (SMD: 0.35, 95% CI [0.15, 0.55], P<0.001; I²=48%). Safety data suggested no significant increase in major adverse events compared to control groups (Risk Ratio: 1.12, 95% CI [0.75, 1.68], P=0.58; I²=0%). In conclusion, this systematic review and meta-analysis found that phytotherapeutic interventions improve retinal microvascular perfusion and associated visual function in patients with early NPDR, with an acceptable safety profile. These findings support the potential role of specific phytotherapies as adjunctive treatments in managing early diabetic microvascular changes. Further large-scale trials are warranted to confirm these benefits and explore long-term outcomes
Modulation of the Cognition-Sleep Nexus in Subjective Cognitive Decline: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial of a Standardized Cordyceps militaris Extract
Full text linkSubjective cognitive decline (SCD) and sleep disturbance form a vicious cycle, accelerating neurodegeneration. Cordyceps militaris (CM), a traditional medicinal fungus rich in nucleosides, possesses potent neuroprotective and adenosinergic (sleep-promoting) properties. We investigated the efficacy of a standardized CM extract on this cognition-sleep nexus in adults with SCD. This 12-week, single-center, randomized, double-blind, placebo-controlled, parallel-group trial was conducted in Palembang, Indonesia. We randomized 120 adults (aged 45-65) with SCD to receive 300 mg/day of a standardized CM mycelial extract (3% cordycepin) or a matching placebo. The primary outcome was the change from baseline in the Montreal Cognitive Assessment-Indonesian (MoCA-INA) score. Key secondary outcomes (Bonferroni-corrected) were the Pittsburgh Sleep Quality Index (PSQI), Rey Auditory Verbal Learning Test (RAVLT) Delayed Recall, and polysomnography (PSG)-derived Sleep Efficiency (SE). Analyses were performed on the Intention-to-Treat (ITT) population (N=120) using a Linear Mixed-Effects Model (LMM). The LMM analysis revealed a significant group-by-time interaction for the primary outcome, MoCA-INA (Adjusted Mean Difference [AMD]: +1.95 [95% CI: 1.10, 2.80], p < 0.001). The CM group also showed significant improvements in all three key secondary outcomes: PSQI (AMD: -2.90 [95% CI: -3.81, -1.99], p < 0.001), RAVLT Delayed Recall (AMD: +2.15 [95% CI: 1.30, 3.00], p < 0.001), and Sleep Efficiency (AMD: +5.8% [95% CI: 3.1, 8.5], p < 0.001). After FDR correction, significant benefits were also seen for processing speed, %REM sleep, and serum BDNF and hs-CRP. The intervention was well-tolerated. In conclusion, twelve weeks of supplementation with a standardized C. militaris extract significantly improved cognitive function, episodic memory, and both subjective and objective sleep in adults with SCD. These benefits were associated with enhanced neuroplasticity and reduced systemic inflammation, supporting its potential as a multi-target, disease-modifying intervention for this at-risk population
Antibacterial Effectiveness Test of Methanol Extract of Red Galangal Rhizome (Alpinia purpurata (Vieill) K. Schum) Against Streptococcus pyogenes and Klebsiella pneumonia Bacteria
Full text linkRed galangal rhizome (Alpinia purpurata (Vieill) K. Schum) is a medicinal plant belonging to the family Zingiberaceae. Red galangal rhizomes have antibacterial benefits because they contain active substances such as flavonoids, saponins, triterpenoids, alkaloids, and tannins. Streptococcus pyogenes causes bacterial infections of the skin and upper respiratory tract, while Klebsiella pneumonia is the bacteria that causes pneumonia. This study aims to determine the antibacterial effectiveness of methanol extract of red galangal rhizomes (Alpinia purpurata (Vieill) K. Schum) against Streptococcus pyogenes and Klebsiella pneumonia bacteria. This research is an experimental laboratory with a post-test-only controlled group design. Red galangal rhizomes were extracted using methanol solvent and tested for antibacterial effectiveness using the well method. There were 6 groups in the study, namely the chloramphenicol positive control group, the distilled water negative control group, and the 20%, 40%, 60%, and 80% concentration groups. The largest inhibition zone diameter was found at a concentration of 80%, with an average of 25.50 mm in Streptococcus pyogenes bacteria and 28.73 mm in Klebsiella pneumonia bacteria. In conclusion, methanol extract of red galangal rhizome (Alpinia purpurata (Vieill) K. Schum) effective against bacteria Streptococcus pyogenes and Klebsiella pneumonia
Comparison of the Effectiveness of Kencur Warm Water Soaking with Salt Warm Water Against Leg Edema of Third Trimester Pregnant Women in the Working Area of Rawang Health Center, Indonesia
Full text linkLeg edema is a common complaint in third trimester pregnant women. It is believed that soaking in kencur warm water and salt warm water can help overcome this. Comparing the effectiveness of soaking in warm kencur water with warm salt water on leg edema in third trimester pregnant women. Quasi-experimental research with a pretest-posttest design with the control group. A total of 60 third trimester pregnant women were divided into two groups: the kencur warm water immersion group (n=30) and the salt warm water immersion group (n=30). The intervention was carried out for 15 minutes, twice a day for 3 days. Leg edema was measured using a measuring tape before and after the intervention. There was a significant reduction in leg edema in both groups after intervention (p<0.05). The reduction in leg edema in the kencur warm water immersion group was greater than in the salt warm water immersion group (p<0.05). Kencur warm water soaks are more effective than salt warm water soaks in reducing leg edema in third-trimester pregnant women
The Effect of Giving Dates (Phoenix dactylifera) on Hemoglobin Levels in Anemic Adolescent Girls at Prima Nusantara Vocational School, Bukittinggi, Indonesia
Full text linkAnemia in adolescent girls is a health problem that often occurs in Indonesia. Dates (Phoenix dactylifera) is a fruit that is rich in iron and folate, which play an important role in the formation of hemoglobin. This study aims to determine the effect of giving dates on hemoglobin levels in anemic adolescent girls at Prima Nusantara Vocational School, Bukittinggi Indonesia. This research used a quasi-experimental design with a pretest-posttest with the control group design. A total of 30 adolescent girls who experienced anemia were randomly divided into two groups, namely the intervention group which was given 3 dates per day for 4 weeks and the control group which was given no dates. Hemoglobin levels were measured before and after the intervention. The results showed that there was a significant increase in hemoglobin levels in the intervention group compared to the control group (p < 0.05). Giving dates can increase hemoglobin levels in adolescent girls who suffer from anemia
The Effect of Topical Virgin Coconut Oil on Striae Gravidarum Prevention and Severity: A Randomized Controlled Trial
Full text linkStriae gravidarum (SG), commonly known as stretch marks, is a common concern during pregnancy. Virgin coconut oil (VCO) is traditionally used for skin health and may have potential in SG prevention. This randomized controlled trial (RCT) aimed to assess the efficacy of topical VCO in preventing and reducing the severity of SG among pregnant women in Kerinci Regency, Indonesia. Pregnant women (n=200) in their second trimester were randomized to receive either topical VCO or a placebo (standard emollient) twice daily. SG severity was assessed using a modified striae gravidarum assessment scale (SGAS) at baseline, 32 weeks gestation, and six weeks postpartum. VCO application was associated with a significantly lower incidence of new SG compared to the placebo (25% vs. 45%, p < 0.05). Furthermore, the VCO group showed a significant reduction in SG severity at 32 weeks and postpartum (mean SGAS scores: VCO 1.8 vs. placebo 2.6 at 32 weeks, p < 0.05; VCO 1.4 vs. placebo 2.2 at postpartum, p < 0.01). No adverse effects were reported. In conclusion, topical VCO appears to be safe and effective in preventing new SG and reducing the severity of existing SG during pregnancy. Further research is warranted to explore the underlying mechanisms and long-term effects
Curcuminoids for the Management of Diabetic Macular Edema: A Meta-Analysis Evaluating Effects on Central Macular Thickness and Visual Acuity
Full text linkDiabetic macular edema (DME) is a leading cause of vision loss in diabetic patients, driven primarily by inflammation, oxidative stress, and increased vascular permeability. Current standard therapies, while effective, have limitations. Curcuminoids, derived from Curcuma longa, possess potent anti-inflammatory, antioxidant, and anti-angiogenic properties, suggesting potential therapeutic value in DME. However, clinical evidence requires synthesis. This meta-analysis aimed to evaluate the efficacy of curcuminoid supplementation on Central Macular Thickness (CMT) and Best-Corrected Visual Acuity (BCVA) in patients with DME. A literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases from January 1st, 2013, to December 31st, 2023. We included randomized controlled trials (RCTs) and controlled clinical trials comparing curcuminoid supplementation (as adjunct or monotherapy) against placebo or standard care alone in patients with DME, reporting CMT and/or BCVA outcomes. Two reviewers independently performed study selection, data extraction, and quality assessment using the Cochrane Risk of Bias tool 2 (RoB 2). Data were pooled using a random-effects model, calculating the Mean Difference (MD) with 95% Confidence Intervals (CIs). Heterogeneity was assessed using the I² statistic. Six studies (comprising 388 patients) met the inclusion criteria. The included studies varied in curcuminoid formulations, dosages (ranging from 80 mg to 1500 mg daily), and follow-up durations (3 to 12 months). The overall risk of bias across studies was mixed, with some concerns primarily related to blinding and outcome reporting in several trials. Meta-analysis demonstrated that curcuminoid supplementation was associated with a statistically significant reduction in CMT compared to control groups (MD = -28.54 μm; 95% CI [-45.11, -11.97]; p = 0.0007). Moderate heterogeneity was observed (I² = 62%, p = 0.02). For BCVA (LogMAR), curcuminoid supplementation showed a trend towards improvement, but the result was not statistically significant (MD = -0.04 LogMAR; 95% CI [-0.09, 0.01]; p = 0.11). Heterogeneity for BCVA was low (I² = 15%, p = 0.31). In conclusion, adjunctive curcuminoid supplementation may contribute to a modest but statistically significant reduction in CMT in patients with DME. No statistically significant improvement in BCVA was confirmed, although a favourable trend was observed. Significant heterogeneity in CMT results and methodological limitations in primary studies necessitate cautious interpretation. Larger, well-designed RCTs with standardized, bioavailable curcuminoid formulations and longer follow-up are warranted to definitively establish the clinical role of curcuminoids in DME management
Study of the Potential of Rice Bran as an Anticancer: A Systematic Literature Review
Full text linkThe bioactive compounds in rice bran have various health benefits, including anticancer potential. Cancer is a disease characterized by uncontrolled cell growth. Cancer cells can originate from any cell in the body and can spread to other parts of the body. Cancer is one of the highest causes of death in the world. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding analysis of the anti-cancer potential of rice bran. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. Rice bran contains various bioactive compounds, including antioxidants, anti-inflammatory, anti-proliferative, and apoptosis-inducing agents. These compounds can work together to inhibit the growth of cancer cells and prevent their spread
Analysis of Ethnopharmaceutical Studies of Traditional Medicine for the Management of Jaundice Due to Hepatic Disorders by the Mandar Tribe of West Sulawesi, Indonesia
Full text linkJaundice, or icterus, is a medical condition characterized by yellowing of the skin and whites of the eyes. This is caused by a buildup of bilirubin in the blood, which is a waste product of the breakdown of red blood cells. Liver disorders, such as hepatitis, are the most common cause of jaundice. The Mandar tribe in West Sulawesi Indonesia has a traditional healing tradition that has been passed down from generation to generation. This traditional medicine is often used to treat various diseases, including jaundice. This study aims to analyze the ethnopharmaceutical traditional treatment for jaundice in the Mandar tribe in West Sulawesi. This research used a descriptive observational method with traditional healthcare respondents. Data was collected through interviews and observations of traditional healers and patients who used traditional medicine. The data was analyzed descriptively to determine the type of plant, part of the plant used, processing methods, and how traditional medicines are used. This research found 14 plant species from 13 families that were used as medicine for jaundice. Two types of plants are typically used by the Mandar tribe, namely lapo-lapo (Melanolepis multiglandulosa) and barorang (Blumea balsamifera). The parts of the plant most commonly used as medicine are leaves (43%), followed by fruit (29%), stems (14%), roots (7%), rhizomes (4%), and herbs (3%). Plant processing by pressing and boiling is the most widely used (50% each). The most common method of use is boiling (70%), followed by pounding (20%) and eating directly (10%). This research found 14 plant species from 13 families that were used by the Mandar tribe as medicine for jaundice. Two types of plants are typically used, namely lapo-lapo and barorang. This research provides important information about the Mandar tribe's ethnopharmacology for jaundice and can be a basis for the development of more effective and safer traditional medicines
The Effect of Giving Ginseng Tea on Anxiety During Premenopause in the Mekarjaya Village Area, Purwakarta Regency, Indonesia
Full text linkPremenopause is a natural transition phase in women marked by hormonal changes that can cause a variety of symptoms, including anxiety. Ginseng is an herbal plant that has long been used to treat various diseases, including anxiety. This study aims to determine the effect of giving ginseng tea on anxiety during premenopause in the Mekarjaya Village area, Purwakarta Regency, Indonesia. This research uses a pre-experimental research design, with a one group pretest-posttest design. The research population was all premenopausal women in Mekarjaya Village, Purwakarta Regency, Indonesia. The research sample was 20 people, taken using purposive sampling technique. The measuring tool used is the Hamilton Anxiety Scale Questionnaire (HAMA). The results of the study showed that there was an effect of giving ginseng tea on reducing anxiety during premenopause. This can be seen from the results of the Wilcoxon test with p-value <0.05. The average HAMA score before giving ginseng tea was 25.45, while after giving ginseng tea it was 18.55. Based on the results of this study, it can be concluded that giving ginseng tea can reduce anxiety during premenopause