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Pharmacist counseling improves medication compliance of schizophrenia patients
Full text linkSchizophrenia is a disorder characterized by abnormal behavior, impaired thinking, disorganized speech, and a reduced ability to perceive reality. One of the key factors influencing the success of schizophrenia therapy is patient adherence. Pharmacy plays a crucial role in the treatment of schizophrenia patients. This study aimed to determine the effect of pharmacist counseling on drug adherence of schizophrenia patients from the first month to the second month. The method used in this study was a one-group pre-test and post-test design that used quasi-experimental research. The subjects of this study were schizophrenia patients in the outpatient installation of Prof.Dr.Soerojo Mental Hospital, Magelang. This study used the Medication Adherence Rating Scale (MARS) questionnaire to measure the level of adherence and drug use monitoring sheet (pill count) to monitor the amount of patient medication. The population in this study was calculated using the Lameshow formula. Data analysis was performed using the chi-square test and the Wilcoxon test. After analyzing data of 108 patients, it was found that there was a significant difference between before and after counseling conducted by pharmacists on medication adherence in schizophrenia patients, with a significance value of p <0.05. Counseling conducted by pharmacists has a good impact on patient medication adherence and monitoring the amount of medication taken. These results indicate the effect of counseling conducted by pharmacists on adherence to taking medication and the monitoring of the amount of medication taken by patients
Assessment of medication-related liver and kidney impairment in admitted patients in Depok, Indonesia: an observational study employing the Naranjo algorithm
Full text linkLiver and kidney impairment caused by medications represents serious side effects that may extend hospital stays and increase the risk of patient death. Implementing strategies to recognize, document, and analyze cases of patient harm related to drug use is crucial for medicines optimization. This study aimed to evaluate the prevalence of medication-related liver and kidney impairment among hospitalized patients, while also identifying the specific medication categories implicated. A retrospective review of patient records was conducted at Universitas Indonesia Hospital (Depok, Indonesia), focusing on adult patients diagnosed with liver or kidney impairment during their 2021 hospital admission. The Naranjo algorithm was applied to assess the likelihood that these injuries were caused by medications. Among the 4,273 admitted patients, it was found that 1.01% experienced medication-related liver impairment (MRLI), while 0.77% experienced medication-related kidney impairment (MRKI). The most common medications associated with liver impairment were antibiotics (31.58%), cardiovascular medications (24.21%), pain relievers (14.74%), anti-ulcer medications (11.58%), antiviral medications (8.42%), antiemetics (8.42%), and antidiabetic medications (1.05%). In contrast, kidney disease was primarily linked to diuretics (29.76%), antibiotics (21.43%), ACE inhibitors/ARBs (21.43%), antiviral medications (9.52%), and NSAIDs (7.14%). Importantly, there was no statistically significant correlation between the occurrence of MRLI or MRKI and factors such as gender, age, body mass index (BMI), or the presence of other health conditions (p > 0.05). These findings underscore the need for heightened awareness regarding the potential for medication-related impairments in hospitalized patients and suggest that careful monitoring of medication use is essential to mitigate these risks
Undesirable events in the use of high-alert medicine geriatric patients at RSUPN Dr. Cipto Mangunkusumo
Full text linkHigh-Alert Medications (HAM) are drugs that have a high risk of causing significant harm to patients if misused. It is estimated that one in ten geriatric patients experiences undesirable events during hospitalization related to medication use. Detect undesirable events due to the use of high-alert insulin and high-alert heparin drugs in geriatric patients at Rumah Sakit Umum Pusat Nasional (RSUPN) Dr Cipto Mangunkusumo using the trigger tool method based on positive predictive value (PPV) and determine the effect of using high-alert insulin and high alert heparin drugs on undesirable events. A retrospective cohort study will review secondary data from patient medical records (MR). The sample used was from 300 geriatric patients, 82 patients used insulin and 79 patients used heparin which met the inclusion criteria. Data were analyzed in the form of frequencies and percentages (%), calculation of PPV values, and the effect of using high-alert insulin and high-alert heparin on undesirable events using the Chi-Square test. There were 8 trigger-positive patients with undesirable events in the form of hypoglycemia from 82 insulin patients and 4 trigger-positive patients with undesirable events in the form of extended activated partial thromboplastin time (aPTT) values from 79 heparin patients. Based on the PPV value, both insulin (9.75%) and heparin (5.33%), the trigger tool has not been able to detect undesirable events when using high-alert insulin and high-alert heparin. Based on statistical tests, the p-value= 0.033 (p<0.05) for insulin and heparin p-value= 0.043 (p<0.05) meaning that there is an influence of the use of high-alert insulin and high-alert heparin on undesirable events when using both drugs. The trigger tool method cannot detect undesirable events when using high-alert insulin and high-alert heparin drugs based on laboratory triggers
Impact of Black Garlic extract on cardio-renal protection in hypertensive animal models
Full text linkA strong link exists between arterial stiffening and cardiovascular conditions, particularly hypertension. Hypertension, a significant contributor to mortality rates, particularly affects elderly populations. The processed form of Allium sativum, known as black garlic, is renowned for its medicinal properties, including its ability to lower blood pressure. This study examined the blood pressure-lowering effects of black garlic extract, employing male Wistar rats aged two to three months.The experiment involved six distinct rat groups, each comprising of four animals. The two groups served as controls, whereas the remaining four underwent different treatments. Captopril was administered to one group at a dose of 2.5 mg/kg, whilst the remaining three groups were given black garlic extract as BG50, BG100, and BG200. All groups, with the exception of the control normal, underwent a 28-day induction protocol that included 25% fructose in drinking water, cholesterol (200 mg/kg), and propylthiouracil (12.5 mg/kg). The test substances were administered starting on day 14 concurrently with the induction phase. The evaluated parameters included blood pressure, arterial stiffness, nitric oxide (NO) levels, and renal histopathology. Black garlic extract significantly lowered blood pressure, enhanced arterial elasticity, and increased NO levels (p < 0.05) compared with the controls. Renal histopathological analysis revealed protective effects, suggesting prevention of kidney damage. These findings suggest that black garlic may have cardiorenal protective effects and could be useful for managing hypertension and arterial stiffness
Cross-resistance to antibiotics of Escherichia coli in the inpatient installation of general regional hospital “X” Bali, Indonesia
Full text linkEscherichia coli (E. coli) is a critical-priority group of MDR bacteria and its spread can occur in hospital inpatient settings. Several studies showed that antibiotics consumption for inpatients can cause E. coli resistance to other antibiotics called cross-resistance. The aim of this study to determine the cross-resistance in E. coli to antibiotics in the inpatient installation of the regional general hospital "X" in Bali, Indonesia by analyzing the relationship between the antibiotic consumption and the percentage of antibiotic resistance of E. coli. This research is an ecological study with the independent variable is the antibiotics consumption defined as defined daily doses/100 bed-days and the dependent variable is the percentage of E. coli resistance during 2017-2020. The correlation between the level of antibiotic consumption and the percentage of E. coli resistance to antibiotics was analyzed using the Pearson correlation tests. The results showed that the consumption of tetracycline had a significant correlation with increased resistance of E. coli to meropenem and piperacillin-tazobactam (r=0.8-1.0; p<0.05). This showed that there is cross-resistance in E. coli. This incident is associated with selective pressure, horizontal and vertical gene transfer in E. coli. The consumption of tetracycline, apart from inducing the production of the tet gene which is the cause of resistance to tetracycline, can also induce the production of resistance genes to broad-spectrum beta-lactam antibiotics such as piperacillin-tazobactam and meropenem
Ethanol solvent and pH effect on antioxidant activity of purple sweet potato (Ipomoea batatas L.)
Full text linkAir pollution induces the production of reactive oxygen species (ROS), which can cause tissue damage when excessive. Antioxidants help counteract this damage, and purple sweet potatoes, rich in anthocyanins, are a promising natural antioxidant source. This study aimed to determine the effect of solvent acidity variations on the antioxidant activity of purple sweet potato (PSP) tuber extract and identify the optimal pH condition. Using the DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging assay, ethanol solvents at different pH levels (non-acidified ethanol, pH 2.5, pH 2, and pH 1.5) were tested. The results showed that higher acidity enhanced antioxidant activity, with the strongest activity observed at pH 1.5, yielding an IC50 value of 9.74±0.23 ppm. Although less potent than Vitamin C (IC50 1.22±0.04 ppm), the extract demonstrated significant potential as a natural antioxidant source. Further studies on anthocyanin content are recommended to better understand its contribution to antioxidant activity
Flavonoid synergy in antioxidant optimization: a study of Apium graveolens and Orthosipon stamineus
No full textOxidative stress, which arises by an imbalance among the formation of free radicals and the body's antioxidant defenses, is a pivotal factor in the pathogenesis of numerous degenerative abnormalities, comprising cardiovascular abnormality. Flavonoids, that are natural chemicals by antioxidant capabilities, have been identified as potential agents for protection against the adverse impacts of oxidative stress. The objective of this study was to ascertain the flavonoid substance of Apium graveolens and Orthosipon stamineus extracts and their antioxidant activity. The technique comprising qualitative and quantitative phytochemical tests to decide the flavonoid substance of the extracts. In addition, bioactive compounds were screened utilizing LC-HRMS, and antioxidant activity was evaluated utilizing the DPPH technique. The outcomes of this study drawn the presence of flavonoid compounds, alkaloids, tannins, and saponins in the Apium graveolens and Orthosipon stamineus extracts. The Orthosipon stamineus extract was found to contain steroid compounds. The screening of flavonoids compounds utilizing LC-HRMS has drawn the presence of the greatest diversity of flavonoid compounds in the Apium graveolens extract. The antioxidant activity assay employed quercetin as the standard, possessing an IC₅₀ value of 3.95 μg/mL. Apium graveolens extract exhibited an IC₅₀ value of 58.86±0.44μg/mL, Orthosiphon stamineus extract drawn an IC₅₀ value of 61.69±0.21 μg/mL, whereas the combined extract yielded an IC₅₀ value of 46.32±0.34 μg/mL. The outcomes indicate that the extract combination shows superior free radical scavenging ability compared to the individual extracts, suggesting its potential to enhance the antioxidant efficacy of bioactive compounds derived by herbal plants
In vitro assessment of antioxidant and photoprotective activities of torch ginger leaf extract (Etlingera elatior (Jack.) R.M.Sm.)
No full textThe torch ginger plant (Etlingera elatior (Jack) R.M.Sm.) is a member of the Zingiberaceae family and is frequently called kecombrang in Java. This plant has been used as a traditional medicine and food flavor enhancer but is limited as a cosmetic ingredient. Flavonoids and phenolic compounds are examples of secondary metabolites found in this plant. Most flavonoid compounds show sunscreen activity due to the chromophore groups (conjugated single double bonds) capable of absorbing UV A and UV B radiation. According to BPOM Decree No. 17/2022, only listed ingredients in Annex 4 are considered as UV filters but natural herbal compounds with antioxidant properties are applied as sunscreens. This study focused on the in vitro assessment of antioxidant and photoprotective activity from E. elatior leaf extract. First, extracting a 70% ethanol extraction of torch ginger leaves, then evaluated the extract’s quality, its antioxidant activity via the DPPH assay, and its in-vitro photoprotective activity using a UV spectrophotometer. The results showed that the extract from E. elatior leaves possesses remarkably strong antioxidant properties, as shown by its IC50 value of 47.46 μg/mL, and the extract at concentration of 1000 μg/mL provided photoprotection activity calculated as an SPF of 24.05 (ultra protection), erythema transmission value of 1.18% (extra protection) and pigmentation transmission value of 3.49% (total block). It can be concluded that torch ginger leaf extract has high potential as a cosmetic natural ingredient because of very strong antioxidant activity and photoprotective ultra protection.
Analysis of antioxidant and standardization of ethanol extract of rumput mutiara (Oldelandia corymbosa L.)
No full textThe majority of traditional medicinal plants in Indonesia lack scientific validation. Scientific assessment, in conjunction with traditional knowledge, is crucial for acquiring effective pharmaceuticals for commercial use. Rumput mutiara (Oldelandia corymbosa L) is a member of the Rubiaceae family and has been utilized as a traditional medicinal plant for the treatment of various ailments. The objective of this research was to assess the quality of both specific and non-specific parameters and to investigate the antioxidant potential of rumput mutiara. Antioxidant activity was evaluated with 2,2-diphenyl-1-picrylhydrazy (DPPH). The findings for non-specific parameters indicated that the shrinkage drying of the extract and the water content were 18.00 ± 0.000% and 12.20 ± 0.000%, respectively. Simultaneously, particular parameters indicate that the extracts possess a distinct odor, exhibit a blackish-brown hue, and display a viscous consistency. Microscopic parameters of rumput mutiara simplicia showed fragments such as anthers, leaf mesophyll, epidermis and stomata, transport bundles, stem parenchym, and sclerenchyma. Spesific parameters, such as the water-soluble content, and ethanol-soluble compounds were 72.00 ± 0.000 % and 35.00± 0.000 % , respectively. In addition, TLC profiles showed that secondary metabolites of extract were 6 alkaloids, 5 phenolics, 5 flavonoids, 5 tanins, 3 saponins, 5 steroid, and 5 glycosides. The extract has strong antioxidant activity with IC50 value of 14.11 ±0.008 µg/mL
Prebiotic effect of purple sweet potato resistant starch and the development of its mucoadhesive granule formulation
No full textPurple sweet potatoes are recognized for their prebiotic properties including againts Lactobacillus casei and L. bulgaricus bacteria. This prebiotic effect is due to the high starch content in purple sweet potatoes. The amylose content in starch which is difficult to digest in gastointestinal tract, functions as a prebiotic. To enhance the prebiotic effect of purple sweet potato starch, modification into resistant starch can be performed. Resistant starch exhibits a higher prebiotic effect compared to regular starch because it cannot be broken down by digestive enzymes, allowing it to reach the large intestine in significant amounts. Additionally, the prebiotic effect can be further enhanced by creating mucoadhesive granule formulations that increase the contact time of a substance on the mucosa of the digestive tract. This study aims to evaluate the prebiotic effect of resistant starch from purple sweet potatoes and to develop its mucoadhesive granule formulation. The resistant starch from purple sweet potatoes was prepared using the heat moisture treatment method. The prebiotic activity of resistant starch was tested against Lactobacillus acidophilus and Escherichia coli. The granule formulation was prepared by varying the concentration of polymers used, namely a combination of HPMC and carbopol as mucoadhesive polymers. The results showed that resistant starch from purple sweet potatoes had a prebiotic index of 0.930. The granule formulation F3 with an HPMC and Carbopol polymer ratio of 1:2 was identified as a good mucoadhesive granule formulation. It met pharmaceutical evaluation with a mucoadhesive percentage value of 40%