Depression is Associated with the Increase Risk of Multimorbidity Among the General Population in Indonesia.

Purpose: Depression is common among patients with chronic disease. However, little is known about the association between depression and the risk of developing multimorbidity. This study aims to identify the association between depression and the incidence of multimorbidity among the general population in Indonesia. Patients and Methods: The national cross-sectional population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among respondents aged ≥15 years. Depression was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. The number of chronic diseases and amount of sociodemographic information were obtained from self-reported data. A logistic regression analysis was used to assess the association between depression and multimorbidity, adjusting for confounders. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: The study recruited 2222 respondents; the majority of them were male (68.0%) and aged 55-64 years (34.7%). Of the total number of respondents, 69.6% have depression and 36.5% have multimorbidity. The prevalence of depression in respondents increases with age. Depressive symptoms were more likely to report multimorbidity (OR 2.05, 95% CI: 1.66-2.52). Conclusion: Depression is associated with the increased risk of multimorbidity among the general population in Indonesia. Therefore, screening for and treatment of depression for those at risk of developing multimorbidity are urgently needed.

BDNF val66met genotype is not associated with psychological distress: A cross-sectional study in Indonesian Pharmacy young adults.

The number of mental disorders has been increasing but has yet to receive sufficient attention. In particular, healthcare students and professionals tend to have high stress burden. Finding the root cause of psychological distress is important to formulate a method for early detection and prevention. The association of brain-derived neurotrophic factor val66met polymorphism to neuropsychiatric disorders has been widely studied. To study the interplay between brain-derived neurotrophic factor val66met polymorphism and sociodemographic factors in the pathogenesis of psychological distress among Indonesian Pharmacy students. Level of psychological distress and sociodemographic profiling was collected by using the Kessler Psychological Distress Scale and sociodemographic questionnaires, respectively. Genotyping was performed using polymerase chain reaction-amplified refractory mutation system. Pearson's chi square and binomial logistic tests were used to evaluate the correlation. This study recruited 148 participants. The psychological distress levels of the participants were well (27.03%), mild (37.16%), moderate (25.00%), and severe (10.81%). Genotypic distributions were AA (25.67%), GA (50.68%), and GG (23.65%). No statistical significance between genotype and psychological distress was found in the study (P = .076). The sociodemographic factors also showed non significance, except for the source of tuition fee among women students (P = .049). Psychological distress is not affected by genotypic and sociodemographic factors. Further confirmatory research with larger and broader populations is required.

Transporter and metabolizer gene polymorphisms affect fluoroquinolone pharmacokinetic parameters.

Tuberculosis (TB) is an infectious disease that occurs globally. Treatment of TB has been hindered by problems with multidrug-resistant strains (MDR-TB). Fluoroquinolones are one of the main drugs used for the treatment of MDR-TB. The success of therapy can be influenced by genetic factors and their impact on pharmacokinetic parameters. This review was conducted by searching the PubMed database with keywords polymorphism and fluoroquinolones. The presence of gene polymorphisms, including UGT1A1, UGT1A9, SLCO1B1, and ABCB1, can affect fluoroquinolones pharmacokinetic parameters such as area under the curve (AUC), creatinine clearance (CCr), maximum plasma concentration (Cmax), half-life (t1/2) and peak time (tmax) of fluoroquinolones.

A highly sensitive, simple, and fast gas chromatography-mass spectrometry method for the quantification of serum short-chain fatty acids and their potential features in central obesity.

Short-chain fatty acids (SCFAs) are the main gut microbe metabolites, which have no more than six carbons. SCFAs are an emerging biomarker in metabolic diseases, including central obesity. Commonly, SCFAs are measured in fecal samples, where they are highly abundant, but here they do not reflect direct interactions with related organs. Serum SCFAs are assumed to be more associated with metabolic disease than fecal SCFAs, albeit at very low concentrations. The aim of the present study is to develop a highly sensitive, simple, and fast method for measuring six SCFAs in the serum by gas chromatography-mass spectrometry (GCMS). The serum is mixed with meta-phosphoric acid and 2,2-dimethylbutyric acid, followed by homogenization and centrifugation. Supernatant is then injected into the fused silica capillary column. The method is linear from 0.12-500 µmol/L for all SCFAs with an accuracy of 90-117%. The total coefficient of variation for precision ranges from 3.8 to 14.1%. A preliminary study is performed with 32 centrally obese subjects and 17 lean subjects. The mean values of all SCFAs, including acetic, propionic, isobutyric, butyric, isovaleric, and valeric acid, in the centrally obese subjects are significantly higher compared with lean subjects. A significant correlation also exists between all SCFAs, with the waist circumference indicating that serum SCFAs have potential features with respect to metabolic diseases, especially central obesity. The validated GCMS method provides highly sensitive, fast, simple, and reliable SCFA quantitation in the serum and demonstrates the potential features of circulating SCFAs in central obesity.

Effectiveness and Safety Profile of Alternative Tobacco and Nicotine Products for Smoking Reduction and Cessation: A Systematic Review.

BACKGROUND: Alternative tobacco and nicotine products such as electronic cigarettes (EC), smokeless tobacco, and nicotine replacement therapy (NRT) are currently being assessed as options in tobacco harm reduction due to their potential role in smoking reduction and smoking cessation. OBJECTIVE: To provide the current evidence on the effectiveness and safety of various alternative tobacco and nicotine products for smoking reduction and cessation. METHODS: A systematic review using databases from MEDLINE (PubMed), EMBASE, and The Cochrane Library was conducted up to December 2020 to identify eligible experimental and observational studies assessing the use of alternative tobacco and nicotine products on smoking reduction and smoking cessation and the safety of these products. The Cochrane Risk of Bias 2 (RoB 2) and ROBINS-I tools were used to assess the risk of bias of the included studies. Results were described through a narrative synthesis of the evidence. RESULTS: From 1955 retrieved references, 44 studies (31 randomized controlled trials/RCTs and 13 prospective cohort studies) met the inclusion criteria and were included in the review. Twenty-nine studies were assessing EC, one study evaluated heat-not-burn (HNB) product, five studies were focused on snus, and nine studies assessed NRT in the form of nicotine patch, gum, etc. The overall results suggested that alternative tobacco and nicotine products in the form of EC, snus, and NRT can moderately reduce daily cigarette consumption and has potential to assist smoking cessation attempts, with fewer adverse events. CONCLUSION: The findings suggested that alternative tobacco and nicotine products have a potential role in assisting smoking reduction and cessation, highlighting their role in the tobacco harm reduction approach. Further studies should focus on investigating long-term outcomes, safety, and effectiveness of alternative tobacco and nicotine products to better inform smoking reduction/cessation policy. PROSPERO REGISTRATION NUMBER: CRD42020205830.

Genetic Polymorphisms and the Efficacy of Platinum-Based Chemotherapy: Review.

Previous studies have indicated that genetic variations in individuals may result in changes in gene expression and amino acids. The effect of these changes may lead to different responses to platinum-based chemotherapy. A vast response rate interval and a short survival rate indicate that the efficacy and efficiency of the selection of chemotherapy have not been optimized. This article aims to illustrate the potential relationship of various genetic polymorphisms in response to platinum-based chemotherapy for several types of cancer. This review was conducted using articles from the last three- and five-year periods (2014-2019) that use gene polymorphism and its relationship to the efficacy of platinum-based chemotherapy as their theme. A total of 26 out of 488 relevant articles were included based on specific criteria. Through various mechanisms, genes, including ERCC1, ERCC2/XPD, XPC, XPA, XRCC1, APE-1, PARP1, OGG1, ABCC2, MRP, GSTP1, GSTM1, GSTT1, MATE1, and OCT2, have been associated with patient response to platinum-based chemotherapy. We conclude that genetic polymorphism analysis is recommended for the management of cancer so that each patient can be administered therapy based on his or her genetic profile to achieve an effective and efficient outcome.

Polymorphism Of The APM1 Gene In Subjects With Central Obesity Related To Lower High-Density Lipoprotein Cholesterol.

BACKGROUND: Central obesity is a risk factor for metabolic syndrome. Subjects with central obesity have a higher risk of developing type 2 diabetes and cardiovascular disease. Many conditions affect the prevalence of central obesity, including energy expenditure, aging, proinflammatory conditions, and hormonal, genetic, and ethnic differences. Polymorphism of the APM1 gene, encoding the protein adiponectin, is closely related to metabolic syndrome. Adiponectin influences fatty acid oxidation and glucose intake in muscle. Therefore, variation in the APM1 gene is associated with diabetes and obesity. PURPOSE: The aim of the present study was to investigate the correlation of the single-nucleotide polymorphism (SNP) of the APM1 SNP rs2241766 with body mass index (BMI) and lipid profiles in Indonesian (Bandung) subjects. PATIENTS AND METHODS: Genotyping of the APM1 gene was performed using the Amplification Refractory Mutation System. Whole blood and serum of 54 subjects with central obesity (waist circumference [WC] ≥90 cm) and 53 healthy subjects (WC <90 cm) were collected. Measurements of the lipid profile (low-density lipoprotein [LDL], high-density lipoprotein [HDL], and total cholesterol [TC]) and BMI were examined. RESULTS: The TT and GT genotype were observed (no GG genotype) in all subjects. The TC, LDL, fasting blood glucose, and BMI did not show a significant correlation between genotype variations of APM1 with central obesity. Otherwise, subjects with central obesity with the TT genotype had lower HDL levels than those with the GT genotype (p = 0.014, significant OR 1.045; 95% CI). CONCLUSION: This finding suggests that the T allele of the APM1 SNP rs2241766 is dominant in the Bandung population, and subjects with the homozygous TT genotype have a higher incidence of metabolic disorder.

Pattern of medication use in geriatric patients at primary health care facilities in Karawang, Indonesia.

BACKGROUND: Rational drug use is a critical component in patient care, particularly among the elderly who often have multiple medical problems. The aim of this study was to assess the pattern of medication use among the elderly visiting primary health care facilities. METHODS: A retrospective cross-sectional study was conducted at 25 primary health care facilities in Karawang District, Indonesia, and patients aged ≥60 years visiting the facilities from January to December 2014 were included. A systematic random sampling technique was used to select the study samples. Each prescription was assessed using the WHO prescribing indicators. RESULTS: A total of 10,118 prescriptions with 31,927 drugs were assessed. The average number of drugs prescribed was 3.15 (range: 1-7). Drugs prescribed by generic name comprised 98.09% (n=31,318) of the total number of drugs. Medical appointments wherein an antibiotic was prescribed constituted 23.45% (n=2373) of the total number of prescriptions. No injections were prescribed in this study setting. Drugs prescribed from the essential drug list comprised 83.07% (n=26,522). Paracetamol (13.44%), vitamin B complex (8.05%), and aluminum-magnesium hydroxide (7%) were the most frequently prescribed drugs, whereas amoxicillin (44.03%), chloramphenicol (13.10%), and ciprofloxacin (12.00%) were the most frequently prescribed antibiotics. CONCLUSION: Our findings highlight that polypharmacy and prescription of essential drugs remain subjects of concern in geriatric health care. Regular medication review and promoting the use of the essential drug list among health care professionals are encouraged in primary care settings.

Type 2 Diabetes-Associated Genetic Polymorphisms as Potential Disease Predictors.

Diabetes is a major cause of mortality worldwide. There are several types of diabetes, with type 2 diabetes mellitus (T2DM) being the most common. Many factors, including environmental and genetic factors, are involved in the etiology of the disease. Numerous studies have reported the role of genetic polymorphisms in the initiation and development of T2DM. While genome-wide association studies have identified around more than 200 susceptibility loci, it remains unclear whether these loci are correlated with the pathophysiology of the disease. The present review aimed to elucidate the potential genetic mechanisms underlying T2DM. We found that some genetic polymorphisms were related to T2DM, either in the form of single-nucleotide polymorphisms or direct amino acid changes in proteins. These polymorphisms are potential predictors for the management of T2DM.

Knowledge, Attitudes, and Practices of Lung Cancer Risk Factors in West Bandung Society.

BACKGROUND: Lung cancer is one of the leading causes of morbidity and mortality worldwide, so prevention of lung cancer is necessary. The aim of this study was to measure level of knowledge, attitude, and actions concerning risk factors of lung cancer in West Bandung. MATERIALS AND METHODS: The research was conducted by quantitative study design with a quasi-experimental approach. Measurement of respondents' knowledge, attitudes, and actions was carried out by giving questionnaires of knowledge, attitudes, and actions. Questionnaires were given to respondents before and after providing education about risk factors of lung cancer. Respondents were from 42 societies in Bandung. The data obtained were tested by using comparison and correlation test. RESULTS: The results showed a significant difference between knowledge and attitudes (P = 0.001). Meanwhile, the action did not change significantly (P > 0.05). Correlation test showed that knowledge and attitude had a correlation of P = 0.001 in the pretest and P = 0.23 (P < 0.05) in the posttest. CONCLUSION: This research concludes that the level of knowledge and attitudes toward risk factors of lung cancer has increased.

Effect of Atypical Antipsychotic on Blood Pressure in Inpatients with Schizophrenia of Prof. Dr. Soerojo Mental Health Hospital Magelang.

CONTEXT: Schizophrenia ranks the top of all mental disorders with poor prognosis. Central Java Province is in the top five of schizophrenia incidents in Indonesia. Antipsychotic is the main therapy for schizophrenia, which is divided into 2, atypical and typical. The atypical antipsychotic is more preferable because of the minimal effect of the extrapyramidal syndrome but affects the blood pressure. AIMS: To analyze the blood pressure of schizophrenia inpatients during the pre and post-use of atypical antipsychotics in RSJ Prof. Dr. Soerojo Magelang. SETTINGS AND DESIGN: This study was an observational study with cohort retrospective methods. METHODS AND MATERIAL: The research was approved and reviewed by the committee of ethics and law of Prof. Dr. Soerojo Mental Hospital. The inclusion criteria are those diagnosed with schizophrenia based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM IV), aged about 17-55 years old, receiving antipsychotic atypical therapy for at least 3 months.The exclusion criteria are inpatients who also receive antidepressants and antihypertension, have a history of cardiovascular disease and hypertension, and incomplete medical records. STATISTICAL ANALYSIS USED: Wilcoxon, Mann-Whitney, and Kruskal-Wallis test. RESULTS: The result of this study most of them were treated using combination risperidone and clozapine (82.1%). In this study, 43 inpatients experienced a decrease in systolic blood pressure, 57 in systolic blood pressure, 6 with no change in systolic blood pressure, 47 a decrease in diastolic blood pressure, 50 an increase in diastolic blood pressure, and 9 with no change in diastolic blood pressure. CONCLUSIONS: There was no significant difference in the blood pressure before and after the treatment.

Polymorphism of TPH2 Gene rs120074175 Is Not Associated with Risk Factors of Schizophrenia.

CONTEXT: Polymorphism on tryptophan hydroxylase 2 (TPH2) gene rs120074175 can cause the synthesis of neurotransmitter serotonin in the brain to reduce up to 80%. Reduced serotonin in the brain can cause dopamine release to occur continuously. Excess dopamine in the brain may cause positive symptom of schizophrenia. AIM: The aim of this study was to investigate the genotype distribution of TPH2 rs120074175 gene on patients with schizophrenia at Prof. Dr. Soerojo Magelang Psychiatric Hospital, Indonesia, and the relationship between the genetic polymorphism of the TPH2 rs120074175 gene against risk factors of schizophrenia. SETTINGS AND DESIGN: This was a cross-sectional study. MATERIALS AND METHODS: The method used was amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Whole blood from healthy subjects and patients with schizophrenia, Wizard genomic deoxyribonucleic acid (DNA) purification kit (Promega, Fitchburg, Wisconsin), PCR master mix (Promega), ARMS-PCR primers, ddH2O, agarose (Thermo Scientific, Seoul, South Korea), Tris, Acetic Acid, EDTA (TAE) 1X, ethidium bromide, loading dye 6×, and DNA ladder (Thermo Scientific) were the materials used. STATISTICAL ANALYSIS: Hardy-Weinberg equilibrium and chi-square (χ2) tests were used. RESULTS: The results showed that both groups (healthy subjects and patients with schizophrenia) at the Prof. Dr. Soerojo Magelang Psychiatric Hospital have a wild-type GG genotype (100%) without anyone having a mutant A allele. CONCLUSION: TPH2 rs120074175 gene polymorphism was not associated with risk factors for schizophrenia.

Single-nucleotide Polymorphism of CTLA-4 (rs5742909) in Correlation with Schizophrenia Risk Factor.

BACKGROUND: Cytotoxic T protein lymphocyte antigen-4 (CTLA-4) plays a key role in regulating the T-cell system, where occurrence of disturbances in the system seen by imbalances in Th1 and Th2 levels is believed to be one of the etiologies of schizophrenia. Single-nucleotide polymorphisms (SNPs) at rs5742909 in the CTLA-4 gene (C→T) might affect the expression level of CTLA-4 protein. AIMS AND OBJECTIVES: The aim of this study was to determine the genotype distribution of the CTLA-4 gene (rs5742909) in patients with schizophrenia at Rumah Sakit Jiwa Prof. Dr. Soerojo Magelang and identify the correlation of these genetic polymorphisms as the risk factors of schizophrenia. MATERIALS AND METHODS: This research was conducted through the stage of submitting ethical approval, primer design, chromosomal DNA isolation, optimization of polymerase chain reaction conditions, and data analysis. RESULTS: Based on the results of the study, the CC genotype was shown in 36 patients (78.26%), TT genotype in 10 patients (21.73%), and no TT genotypes. However, statistical analysis using Fisher's exact and binary logistic regression statistical test showed no significant relationship between genetic polymorphism of the CTLA-4 rs5742909 against risk factors for schizophrenia (P = 0.05; α = 5%). CONCLUSION: SNP at rs5742909, C-to-T-allele transition, was not significant associated with the risk of schizophrenia.

Dosage and Duration of Methylprednisolone Therapy Affect the Occurrence of Cushing Habitus in Patients with Systemic Lupus Erythematosus.

CONTEXT: Systemic lupus erythematosus (SLE) is a multisystem disease with very diverse developments. Corticosteroid is mostly used for the treatment of SLE as antiinflammatory and immunosuppressant, but its long-term use and high dose can cause the side effects such as Cushing habitus. AIM: Analyze the risk factors of Cushing habitus occurrence in patients with SLE comprising pulse dose, duration of therapy, daily dose, and total dose of methylprednisolone. SETTINGS AND DESIGN: Case Control study. MATERIALS AND METHODS: 40 patients with SLE treated at Rheumatology outpatient clinic at Hasan Sadikin Hospital in Bandung was conducted. Each of these patients were divided into case and control groups. The design of this study was a case control study, the data was retrieved from medical record of patients with and without cushing habitus. STATISTICAL ANALYSIS: Chi-squared test was used to test the relationship between independent variables followed by linear logistic regression analysis to determine the influence of the most influential variable in causing Cushing habitus. RESULTS: The results of this study showed that the use of total dose of methylprednisolon (> 8040 mg) has a significant effect on the incidence of Cushing habitus p = 0.029; odds ratio [OR] = 3.55). In addition, daily dose of methylprednisolone >9.4 mg has a significant effect on Cushing habitus (p = 0.012; OR = 2.98). CONCLUSION: Significant relationship between daily dose and total dose of methylprednisolone on the occurrence of Cushing.

Correction to: Reduced Serum Selenium Concentration in Miscarriage Incidence of Indonesian Subjects.

The original version of this article unfortunately contained a mistake. The name of "Herlambang herlambang" is now corrected in the author group of this article.

Polypharmacy leads to increased prevalence of potentially inappropriate medication in the Indonesian geriatric population visiting primary care facilities.

BACKGROUND: The geriatric population is particularly vulnerable to being prescribed potentially inappropriate medication (PIM); however, the prevalence of this occurrence remains poorly investigated in Indonesia. Thus in this research, we focused on investigating the prevalence and predictors of PIM among the Indonesian geriatric population in a primary health care setting. METHODS: A retrospective observational study was conducted in 25 primary health care facilities in Karawang District, Indonesia. The medical prescriptions of patients aged ≥60 years during January-December 2014 were documented, and the PIM was assessed based on Beers and McLeod criteria. The influence of age, sex, number of diseases, and polypharmacy toward PIM was assessed using a logistic regression model. A P-value of <0.05 defined statistical significance. RESULTS: A total of 3,819 subjects were included in the study. PIM was highly prevalent (52.2%) among the Indonesian elderly. Chlorpheniramine, mefenamic acid, ibuprofen, and nifedipine were the most commonly prescribed PIM. Polypharmacy (odds ratio: 1.2 [0.6, 2.1]) was the only factor associated with the use of PIM, while sex, age, and multiple diseases did not show significant association. CONCLUSION: PIM is a concern in the Indonesian geriatric population. Health care professionals are encouraged to review the medications of their geriatric patients using updated safety guidelines to prevent risks associated with PIM.

Inhibition of Phosphorylated c-Jun NH(2)-terminal Kinase by 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone Isolated from Eugenia aquea Burm f. Leaves in Jurkat T-cells.

BACKGROUND: Indonesian medicinal plants have been used for their anticancer activity for decades. However, the therapeutic effects of medicinal plants have not been fully examined scientifically. As cancer is a major health problem worldwide, searching for a new anticancer compound has attracted considerable attention. Our previous study found that 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone, an active compound isolated from leaves of Indonesian medicinal plants Eugenia aquea Burm f. (Myrtaceae), had anticancer activity in MCF-7 human breast cancer cells through induction of apoptosis. OBJECTIVE: To investigate the molecular mechanism of 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone antiproliferative activity. MATERIALS AND METHODS: Leaves of E. aquea were extracted by ethanol, fractionated by ethyl acetate, n-hexane, or water, and isolated for its active compound. Jurkat T-cells were treated with 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone for 12 and 24 h, and a cell viability assay and real-time-reverse transcriptase polymerase chain reaction for interleukin-2 (IL-2) mRNA measurement were performed. The effects of active compound to mitogen-activated protein kinases were also examined to investigate the mechanism of its antiproliferative activity. RESULTS: 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone inhibited Jurkat T-cell proliferation with a half maximal inhibitory concentration of 59.5 mM. Although IL-2 mRNA expression was slightly increased after treatment, it inhibited c-Jun N-terminal kinase expression but not p38 and extracellular signal-regulated kinase expression. CONCLUSIONS: Our study indicated that the molecular mechanism mediating the antiproliferative activity of 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone may be attributed to the stimulation of an immunological microenvironment in the cells. SUMMARY: 2',4'-dihydroxy-6-methoxy-3,5-dimethylchalcone was isolated from Eugenia aquea. The antiproliferative activity of 2',4'-dihydroxy-6- methoxy-3,5-dimethylchalcone significantly showed in Jurkat T-cells with a half maximal inhibitory concentration of 59.5 mM through inhibition of c-Jun N-terminal kinase phosphorylation. Interleukin-2 mRNA expression was also slightly increased after treatment with the compound, and this result may be indicated to the stimulation of the immunological microenvironment in T-cells. Abbreviations used:E. aquea: Eugenia aquea, IL-2: Interleukin-2, MAPK: Mitogen-activated protein kinase, ERKs: Extracellular signal-regulated kinases, JNKs: c-Jun N-terminal kinases, p38: p38 MAPK, PI3K: Phosphatidylinositol-3 kinase, IC50: Half maximal inhibitory concentration.

Incidence, causative drugs, and economic consequences of drug-induced SJS, TEN, and SJS-TEN overlap and potential drug-drug interactions during treatment: a retrospective analysis at an Indonesian referral hospital.

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute life-threatening adverse drug reactions (ADRs) that are commonly caused by medications. Apart from their contribution to morbidity and mortality, these diseases may also present substantial consequences on health care resources. In this study, we aimed to identify the incidence, causative drugs, and economic consequences of these serious ADRs and potential drug-drug interactions (DDIs) during treatment. METHODS: A retrospective study that included 150 patients diagnosed with drug-induced SJS, SJS-TEN overlap, and TEN, from 2009 to 2013 in a referral hospital in West Java Province, Indonesia, was conducted to analyze the causative drugs, cost of illness (COI) as a representation of economic consequences, and potential DDIs during treatment. RESULTS: The results showed that analgesic-antipyretic drugs were the most frequently implicated drugs. The COIs for SJS, SJS-TEN overlap, and TEN patients were 119.49, 139.21, and 162.08 US dollars per day, respectively. Furthermore, potential DDIs with several therapeutic medications and corticosteroids used to treat SJS, SJS-TEN overlap, and TEN were also identified. CONCLUSION: This study showed that analgesic-antipyretic was the major causative drug which contributed to SJS, SJS-TEN overlap, and TEN. Furthermore, our results also showed that SJS, SJS-TEN overlap, and TEN may cause considerable financial consequences to patients.

Catechin Isolated from Garcinia celebica Leaves Inhibit Plasmodium falciparum Growth through the Induction of Oxidative Stress.

BACKGROUND: Resistance of antimalarial drugs to Plasmodium falciparum has become a major concern in malaria eradication. Although it is also affected by several socioeconomic factors, a new antiplasmodial agent is needed for a global malaria control program. OBJECTIVE: In this study, we attempted to uncover the antiplasmodial properties of Garcinia celebica, an Indonesian medicinal plant, along with the responsible compound and its possible mechanism. MATERIALS AND METHODS: The G. celebica leaves were ethanol extracted and fractionated based on their polarity using n-hexane, ethyl acetate, and water. The antiplasmodial activity was tested in vitro against chloroquine-resistant P. falciparum at 100 µg/ml for 72 h. The active compound of the most active ethyl acetate fraction was subsequently isolated using column chromatography and identified by nuclear magnetic resonance. RESULTS: The IC50 of (+)-catechin, the characterized compound, against P. falciparum was 198 µM in 24 h and experiment. The isolated catechin inhibited P. falciparum growth in both trophozoite and schizont stages. An additional experiment also suggests that the antiplasmodial property of catechin occurs through the induction of the oxidative stress to P. falciparum. CONCLUSION: This result shows that the potential of catechin and its antimalarial properties should be explored further. SUMMARY: Garcinia celebica leaf extract and fractions inhibit Plasmodium falciparum growthCatechin, the active compound of Garcinia celebica leaf extract, inhibits Plasmodium falciparum growth in a time- and dose-dependent manner Abbreviations used: RBC: Red Blood Cells; IC50: Inhibition Concentrattino 50; MeOH: Methanol; RPMI: Roswell Park Memorial Institute; EI: Electron Ionization.

ANTIBACTERIAL PROPERTIES OF SELECTED PLANTS CONSUMED BY PRIMATES AGAINST ESCHERICHIA COLI AND BACILLUS SUBTILIS.

Bacterial antimicrobial resistance is a major health problem worldwide. Plants consumed by non-human primates are potentially safe for humans. In this study, we examined the potential antibacterial properties of plants consumed by non-human primates in Indonesia. We studied the antibacterial properties of the leaf extracts of 34 primate-consumed plants against Escherichia coli and Bacillus subtilis in vitro. The plants were collected from the Pangandaran Conservation Area, West Java Province, Indonesia. The leaves were dried and then powdered by crushing and the potential active ingredients were extracted with 95% ethanol at room temperature for 24 hours. The obtained solvent was then dried at 50ºC under reduced pressure. The antibacterial properties of each product were then tested to determine the minimum inhibitory and minimum bactericidal concentrations using the broth microdilution technique and a disc diffusion test was also performed. The results show Kleinhovia hospita, Dillenia excelsa and Garcinia celebica had the best antibacterial properties against Escherichia coli and Ficus benjamina, Ficus altissima, and Elaeocarpus glaber had the best antibacterial properties against Bacillus subtilis. Some of the studied leaf extracts in our study have the potential to be developed into antibacterial medications and need to be studied further.