Sintesis dan Evaluasi Antimalaria In Vitro Turunan Kinin Terhadap Plasmodium falciparum

Nowadays kinin is the most effective antimalarial drug and its used as an alternative in malaria treatment. However, toxicity of quinine restrict its use as an antimalarial drug. Lipophilicity and long half-life (t½) of quinine that reach 10-20 hours are responsible for its toxicity. The aim of this research is to obtain more polar quinine derivatives by means of hydrogen peroxide reactions to reduce the toxicity. The reactions using hydrogen peroxyde is performed analogously to the procedures reported in the literature. Extract of pure anhydrous kinin is purified in coloumn chromatography followed by structure elucidation. Synthetic product is tested in vitro against Plasmodium falciparum. The characterization of reaction products is performed with proton (1H) and carbon 13 (13C) nuclear magnetic resonance (NMR) spectroscopy. It showed that the reaction using reagents led to epoxidation of vinyl substituents of chinuclidine ring with 61,08% yields. Antimalarial test against Plasmodium falciparum obtained 1.250-2.500 μg/mL of IC50 value. The IC50 values indicated that the synthesis products were not potential for malaria treatment.

Profil Distribusi Apotek di Kabupaten Banyumas berdasarkan Sistem Informasi Geografi dan Korelasinya dengan Jumlah Kunjungan dan Resep Tahun 2019

The distribution of pharmacies in Indonesia is still becoming a problem. Pharmacies are mostly available around healthcare facilities such as hospitals, service providers, trade centers, transportation facilities, and main roads. The study aims to describe the distribution profile of pharmacies based on Geographic Information System (GIS) analysis and to study the relation between pharmacy distribution profiles with the number of consumer visits and prescriptions. The study is conducted in 27 sub-districts in Banyumas Regency, Central Java using Arc Gis 3.10.2 Software. Pharmacy profile, the number of consumer visits, and prescriptions at the pharmacy are obtained by distributing research questionnaires to pharmacists. The results showed that the distribution of pharmacies in the Banyumas Regency was still dominant in urban areas, which reached 55%. The average distance of pharmacies was 2.34 km. The research results on the distribution pattern of pharmacies in 27 sub-districts showed that in 3 districts (11.1%) were grouped in certain areas, in 24 other districts (88.9%), the pharmacies' distribution had a spread distribution pattern. The conclusion of the research that the distribution of pharmacies in the Banyumas Regency based on GIS visualization was still dominant in urban areas and especially in sub-districts around the capital of Banyumas Regency, Purwokerto. Based on the study, there was a relation between the average distance of pharmacies and the number of healthcare facilities on consumer visits. There was a relation between pharmacy density, population density, and the number of healthcare facilities with the number of prescriptions.

Formulasi dan Uji Aktivitas Antibakteri Sediaan Emulgel Minyak Biji Jintan Hitam (Nigella sativa L.) terhadap Bakteri Staphylococcus epidermidis

Acne is a skin problem that often occurs, one of the causes is the bacterium Staphylococcus epidermidis. Black cumin seed oil (Nigella sativa L.) can be used as an antibacterial because it contains thymoquinone and α-pinene. This study aims to obtain black cumin seed oil emulgel preparations that has antibacterial activity against Staphylococcus epidermidis. The preparations were formulated with concentrations of 3% (FI), 5% (FII), and 7% (FIII). Evaluation of the preparation was carried out for eight weeks including organoleptic tests, spreadability, emulsion type, pH, viscosity, homogeneity. Antibacterial activity tests was carried out using the well-diffusion method. The results of the evaluation of all three formulas obtained showed a semi-solid consistency, light brown in color, characteristically smelled of black cumin seed oil, stable, M/A emulsion type, homogeneous, non-irritating, pH FI = 4.51-4.95, FII = 4.72-4.99, FIII = 4.57-4.87, dispersion FI = 3.2-3.8 cm, FII = 3.3-3.9 cm, FIII = 3.4-3.9 cm, viscosity FI = 10.7-26.1 Ns/m2, FII = 11.2-32.0 Ns/m2, FIII = 11.5-34.1 Ns/m2. The antibacterial activity test showed the inhibitory power of FI 11,66±0,09 mm, FII 14.48±0.03 mm, FIII 17.35±0,.8 mm, lower than the positive control (clindamycin). All three black cumin seed oil emulgel preparations obtained met the physical requirements and had bacterial inhibition (p

Optimasi Penggunaan High Shear Mixer pada Pembuatan Fraksi Alkaloid dari Daun Awar-awar (Ficus septica) dengan Desain Faktorial

Awar-awar (Ficus septica) is an Indonesian anticancer plant that contains alkaloids as the active compound. The n-hexane insoluble fraction (FTLH) is alkaloid-containing fraction obtained from the ethanolic extract of F. septica leaves (EEDFS) by fractionation using n-hexane. High shear mixer (HSM) can be used to optimize the separation processes, including fractionation. The application of HSM in the fractionation of EEDFS is affected by fractionation duration, amount of solvent per gram extract, and strirring strength. Thus, these parameters must be optimized to obtain the optimum condition for the production of FTLH with the highest alkaloid content. This study aimed to optimize the production of FTLH using HSM with factorial designs. The single factor experimental design was employed to determine the influence of the individual variable on the alkaloid content and to define the optimum range value of each variable. A full factorial design was used to determine the presence of interaction among the factors and to determine the optimal fractionation condition. The results showed that all investigated factors independently affected alkaloid contents. The solvent volume of 14-18 mL per gram extract, the fractionation duration of 2.5-5.0 minutes, and the stirring strength of 3000 rpm are the optimal range value of each factor. The optimal conditions were solvent volume of 14.0-14.4 mL/gram extract, fractionation duration of 2.5-2.7 minutes, and strirring strength at 3000 rpm. At the optimal condition, the total alkaloid content in the FTLH reached 0.1466% or 1.3 times higher than the extract (0.1128%).

Pola Peresepan Anak dengan Infeksi Saluran Pernapasan Akut (ISPA) Non Pneumonia di Klinik

Acute respiratory infection (ARI) is a common disease in the community. Riskesdas 2018 stated that ARI prevalence was 4.4% and the highest was in 1-4 years old children (8%). The capitation payment system in clinics collaborated with BPJS Kesehatan demands the physician to prescribe as effective and as efficient as possible. On the other hand, the capitation tariff obtained by clinics is considered as too low, thus constrains of the prescription leading to irrational prescribing is likely to occur. This study analyses further the prescribing pattern for ARI children in clinics and its rationality based on the difference in source of funding. A cross sectional research using retrospective method was conducted. Data were gathered from 409 medical records and or patients’ prescription of children between 1-12 years old and diagnosed as having non pneumonia ARI during 1st January to 30th November 2019. Result showed that non pneumonia ARI patients were mostly boys (54,3%) aged 1-5 years old (6.0%). The average number of items for BPJS patients was 3,45, the percentage of generic prescribing was twofold higher for BPJS group (63.94%), the percentage of essential medicine prescribing was 63.96% while the percentage of antibiotic use was lower (48.50%). Dosage propriety for BPJS patients was 70.80% which was slightly higher than non-BPJS group. Overall, the prescribing indicators and dosage properness for BPJS patients were better than non-BPJS patients.

Penentuan Aktivitas Antioksidan dan Antidiabetes Ekstrak Daun Matoa (Pometia pinnata J.R. Forst. & G. Forst.) secara In Vitro

Matoa (Pometia pinnata J.R. Forst. & G. Forst.) Matoa (Pometia pinnata J.R. Forst. & G. Forst.) is one of the plants that is used as a traditional medicine for diabetes mellitus due to an imbalance between the amount of ROS and antioxidants in the body. Therefore, it was carried out in vitro to see the antioxidant and antidiabetic activity in matoa leaf extract. The extraction of matoa leaves was carried out using the ultrasonication method for 30 minutes with methanol, ethanol, and ethyl acetate as solvents. Antioxidant activity is release through DPPH free radical inhibition, through the antidiabetic potential released by inhibiting the work of the α-amylase enzyme. Phytochemical test results showed the presence of secondary metabolites in the form of flavonoids, polyphenols, tannins, alkaloids, and terpenoids. The results of the research on methanol, ethanol, and ethyl acetate extracts of matoa leaves showed high antioxidant activity with IC50 values of 6.416 ± 0.176 ppm, 8.622 ± 0.066 ppm, and 170.637 ± 4.441 ppm, respectively, but they were less potent than vitamin C as a comparison which is 1.646 ± 0.015 ppm. Inhibition of the α-amylase enzyme showed IC50 values of 91.037 ± 0.750 ppm, 105,166 ± 2,423 ppm, and 785,436 ± 11,740 ppm in each of the methanol, ethanol, and ethyl acetate extracts while the IC50 value of acarbose as a comparison was 23,479 ± 0.347 ppm. The statistical data analysis of Pearson correlation showed that it had a positive relationship between the antioxidant and antidiabetic activity of matoa leaf extract as seen from the R-value of 0.998. The higher antioxidant activity, so the higher potential for inhibition of α-amylase enzyme.

Kepatuhan Minum Obat pada Pasien Diabetes Melitus Tipe 2 di Beberapa Puskesmas Kabupaten Banyumas

Diabetes mellitus (DM) is considered as ”the mother of all diseases" because it causes many complications. Knowing and measuring medication adherence may have a greater effect on DM patients. Several studies in Indonesia used a questionnaire scale to measure adherence, however they do not validate the study population, so it could still be found anomalous correlation analysis between adherence and clinical data even though it measured in the same country and scale. This study measure the adherence level of type 2 diabetes patients, evaluates the validity of the medication adherence scale, and analyze the correlation with the clinical outcome of type 2 diabetes patients in four health centers in Banyumas district. The study uses a cross-sectional design in Prolanis type 2 DM patients of January -April 2020. The adherence is measured by MARS-10, backward-forward translation method followed by content and internal validation. Clinical outcome is evaluated based on fasting blood glucose measurement. The results of the MARS-10 Gregory index analysis showed content validity in the high category (IG ≥ 0.8). The content validity showed the results of 9 questions with the value of r count> r table (n = 30, r table = 0.361). Reliability analysis showed Cronbach's Alpha 0.747> 0.6. The measurement showed 80.3% was adherent patients and 19.3% was non-adherent patients. Correlation analysis showed that there was no significant relationship (p> 0.05) between patient adherence and clinical outcome. Those results showed that type 2 diabetes mellitus patients in 4 health centers were categorized as adherent but not correlated with the clinical outcome. This was enable due to the clinical outcome was simultaneously influenced by several factors: general factors, individual factors, and unpredictable factors.

Formulation and Evaluation of Mangosteen (Garcinia mangostana L.) Fruit Pericarp Extract Gel

The topical antioxidant product may be useful for the treatment of oxidative stress-related skin disorder. This research aimed to evaluate a topical gel formulation of Garcinia mangostana L. fruit pericarp (GMP) extract. GMP extract was formulated into a gel and characterized for its physical properties. The antioxidant activity was evaluated based on the radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity. The ability of gel formulation to release GMP extract and promote skin delivery was estimated based on DPPH scavenging method and also compared to that of suspension form. The results showed that the GMP extract gel showed characteristics for topical application. The radical DPPH scavenging activity was confirmed both in GMP extract and GMP extract gel. In vitro study release showed that the GMP extract was released from gel. Some degree of GMP extract was also delivered into the shed snakeskin in vitro. When compared with the suspension form, GMP extract gel provided a more profoundly lower release.

Uji Klinik Keamanan Ramuan Jamu Penurun Kolesterol

Research on the safety of Jamu (herbal medicine) formula is important to guarantee its use in community. The Jamu Saintification development program has been resulted a cholesterol-lowering herb containing of 7 plants. This study aimed to determine the safety of the cholesterol-lowering herb. This study is a phase one of clinical trial with a pre-post group design, a single arm, involving 50 subjects with mild hypercholesterolemia without any complications and comorbidities. The intervention was conducted for 28 days at the Hortus Medicus Herbal Medicine Research House (RRJ) in 2014. Outcome parameters included clinical signs and symptoms, liver function laboratory tests (SGOT, SGPT), renal function (ureum, creatinine) and routine blood counts (hemoglobin, leukocyte, platelets, hematocrit). Subjects were requested to boil the herb everyday and drank it twice a day. The data were analyzed descriptively and statistically using SPSS. The results showed increasing in bowel frequencies of 92% subjects and abdominal pain in bowel movements of 34% subjects. These effects were still in a normal range and can be tolerated by the subjects. The paired t test analysis showed no differences in average laboratory parameters on day (D)-14 and D-28 compared to the baseline (p > 0.05). The cholesterol-lowering herbal medicine does not change the function of the liver, kidneys and blood, with mild side effects of increasing the frequencies of bowel movements and stomachaches.

Gambaran Drug Related Problems (DRPs) pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Tuminting

Diabetes mellitus (DM) is a chronic disease with a very high complication rate and the third-highest cause of death in Indonesia. The management of DM cannot be separated from the action of drug therapy. It is necessary to have pharmaceutical care in handling drug related problems (DRPs) in order to achieve optimal drug effects on patients. The purpose of this study is to describe the characteristics and incidence of DRPs in type 2 DM patients at the Tuminting Public Health Centre, Manado. Sampling of 42 samples is conducted with a purposive sampling method using medical records and patient medical treatment history data for type 2 DM patients retrospectively from January to June 2019. The data is analyzed descriptively. The results obtained from the incidence of type 2 diabetes mellitus in women were 53.10% and men 46.90%. Most patients with type 2 diabetes were at the age of >60 years, 66.67%. The highest co-morbidity were cardiovascular disorders 24,24%. The most widely used antihyperglycemic drug was metformin 72.50%. The most DRPs incidence occurred in May 2019 at 36.36%, with 59.05% was needing drugs was, 13.64% did not need drugs, 20.45% wrong drugs, 2.27% less dose and 4.55% over dose.