Self-medication Practices for COVID-19 Prevention: A Study among Medical Students in Yogyakarta, Indonesia

The corona virus disease 2019 (COVID-19) pandemic has increased the interest in self-care strategies, including self-medication. Medical students, as future health practitioners, learn more about medications than other students. This study aimed to describe self-medication practices for preventing COVID-19 among medical students at Universitas Islam Indonesia. This observational study used a cross-sectional design and was undertaken in November- December 2020. The study sample included 336 undergraduate medical students determined using a consecutive sampling technique based on inclusion and exclusion criteria. Data were collected using an online questionnaire about self-medication practices in the preceding 3 months. Among a total of 336 students, 137 (41%) reported using self-medication intending to prevent COVID-19, and 126 (92%) of these 137 took preventive supplements, mainly vitamins C, D, and E, and omega-3. Seven students reported the use of zinc, mainly in combination with other vitamins. Students who practiced self-medication lived closer to people confirmed with COVID-19, washed their hands more often, and desinfected their belongings more frequently than their counterparts (p<0.05). The mean duration for consuming vitamins was 11-16 days. Forty students (29%) used herbal medicine to prevent COVID-19;ginger, turmeric, honey, black seed, cutcherry, and Curcuma were the most often consumed herbal remedies. Fourteen students (10%) reported taking over-the-counter medications to relieve symptoms related to COVID-19, including antipyretic, analgesic, antiseptic, antihistamine, decongestant, antitussive, and expectorant medications. Most respondents (82%) purchased their medications at pharmacies, and 11 (9%) obtained them from online shops. These findings show the high rate of self-medication using vitamins and herbal remedies for COVID-19 prevention among university medical students. Further studies are needed to explore students' knowledge about the risks of self-medication including the use of herbal medicines.Copyright © 2022 Marmara University Press.

Antimicrobial and anticancer activities of Hainan dry noni fruit alcoholic extracts and their novel compounds identification using UPLC-Q-Exactive Obitrap-MS/MS.

Morinda citrifolia Linn (noni) is an important plant in the Pacific Asian region. The fruit has been used as a food source and has shown therapeutical benefits for health. Recently, it has become a source for bioactive compounds. In this study, we investigated the antimicrobial and anticancer activities of alcoholic extracts of Hainan dry noni fruit with machinery assistance and identified their novel compounds by UPLC-Q-Exactive Obitrap-MS/MS. By IE extractor aided method, the extraction of both NFE (Noni Fruit Ethanol) and NFM (Noni Fruit Methanol) solvent crude sample extracts were obtained with recovery yields of 98.48% and 71.65%, respectively. The antimicrobial effect of the crude extracts was subjected to disc diffusion test screening against two microbial strains bacterium SA (Staphylococcus aureus) and, fungal CA (Candida albicans). The MIC values of SA and CA were 35.34 and 47.80 mg/mL for NFE, 117.40 and 108.01 mg/mL for NFM, respectively. Further on, cell viability assay showed that IC50 values of extract NFE and NFM on human UMUC-3 bladder carcinogenic cells were 865.1 and 789.1 µg/mL with less effect to human SVHUC-1 normal cell line for 72hr incubation. Using UPLC-Q-exactive Orbitrap-MS/MS, ten compounds were identified in the noni extracts and confirmed from the HMDB and FooDB. Five known bioactive compounds had been used for treatments in anti-cancer, anti-obesity, and Covid-19 patients. The remaining five compounds were found novel in noni fruit. They were Cyanidin 3-(2 G-xylosylrutinoside), Inulobiose, Clausarinol, Pectachol, and 4,7-Megastigmadien-9-ol. The potential bioactivities of these novel compounds will be studied in the near future. These findings form a basis on screening natural medicinal plant extracts for beneficial use as a food and health source.

Fermented Carica papaya and Morinda citrifolia as Perspective Food Supplements for the Treatment of Post-COVID Symptoms: Randomized Placebo-Controlled Clinical Laboratory Study.

Food supplements based on fermented Carica papaya and Morinda citrifolia, known for their immune modulating, redox balancing, and anti-inflammatory effects, were added to conventional treatment protocols prescribed to patients recovering after severe and moderate COVID-19 disease in order to alleviate long-lasting post-COVID symptoms. A randomized single-center placebo-controlled clinical laboratory study was designed and performed (total number of participants 188, with delta variant of virus 157, with omicron 31). Clinical statuses were assessed using computer tomography, electrocardiography, a questionnaire, and physical endurance. Plasma cytokines (IL-6, IL-8, IL-17A, and INF-gamma), nitrate/nitrite ratio, antioxidant activity (AOA), and polymorphonuclear leukocyte (PMN) ATP levels were determined before and 20 days following the addition of 28 g of fermented supplements twice per day. The capacity of PMN to phagocyte and the oral-nasal-pharyngeal microbiota were assessed. Clinical symptoms, IL-6, IL-8, and nitric oxide metabolites diminished significantly compared to the placebo group and their background expression. The PMN capacity to phagocyte, AOA, and ATP content remarkably increased. The oral-nasal-pharyngeal microbiota were unchanged. On these grounds, we suggest that fermented tropical fruits could efficiently diminish post-COVID clinical symptoms through several immune-modulating, redox balancing, and pro-energy mechanisms.