Indonesian Journal of Pharmacy

Exploring the Mood-Boosting Potential of Bananas: A Comprehensive Review

Thu, 20 Mar 2025 00:00:00 +0700

Food, like bananas, can be used as a depression therapy. Bananas are known for their high tryptophan content. Tryptophan is the precursor of the neurotransmitter serotonin which is closely related to the pathophysiology of anxiety and depression. The purpose of this comprehensive review is to examine the available research on the link between banana consumption and mood. Screening of original articles or reviews on the Google Scholar database, Science Direct, MedLine (PubMed), Scielo, and Proquest with the keywords "banana", "Musa", "depression", and "anxiety" published no later than March 31, 2023. After selecting from 8,469 articles, 18 studies were selected. From the experimental trial articles obtained (9 studies), most reported positive antidepressant and antianxiety effects, but not all of them were significant. The results of the three clinical trials were also inconsistent. Bananas have antianxiety and antidepressant properties, but the scientific literature on their efficacy is limited. Therefore, more evidence is needed to justify its use as a primary or adjunctive treatment for depression and anxiety.

Potential of Macroalgae for Anti Alopecia: A Systematic Review

Thu, 20 Mar 2025 00:00:00 +0700

Alopecia or baldness is a disease where the amount of hair that falls out is greater than the hair that grows. The most common alopecias are androgenetic alopecia (AGA) and alopecia areata (AA). Macroalgae contain secondary metabolites that have quite large ecological potential that can be utilized, namely red algae (Rhodophyta), green algae (Chlorophyta), and brown algae (Phaeophyta). Bioactive components one of the benefits of this macroalgae is as anti-alopecia. The purpose of this review article is to discuss a summary of the mechanisms of action of macroalgae with their active compounds for the treatment of alopecia by stimulating hair growth in hair follicles. This review uses the literature study method of several articles from the online databases PubMed, Sciencedirect, Google Scholar in the form of secondary data analysis with the keywords "algae for androgenetic alopecia and algae for alopecia". The results of this review presented 18 articles on different types of algae, which have the potential to become alternative anti- alopecia drugs with different mechanisms of action. From this review of macroalgae, it is hoped that it can be developed into an anti-alopecia herbal medicinal product.

Characteristics and Economic Impact of Pharmacist Intervention on Older Adults with Chronic Disease: A Systematic Review

Yeni Farida, Tri M. Andayani, Anna W. Widayanti, Probosuseno Probosuseno — Thu, 20 Mar 2025 00:00:00 +0700

Several pharmacist interventions were carried out to enhance medication safety and effectiveness, but not all are cost-effective. This review aimed to investigate the characteristics and the economic impact of pharmacist intervention for older adults with chronic disease. Articles published from January 2013 to June 2023 were retrieved from PubMed, Science Direct, and Google Scholar. After applying the PICO strategy, a total of 13 studies were included, and the studies without cost evaluation were excluded. The quality of the studies was assessed using the CHEERS checklist. Pharmacist intervention for geriatric patients included medication review, patient-centered care approach intervention, and multidisciplinary collaboration care. The follow-up ranged from 10 days to 36 months. Among the five cost-utility analyses (CUA), four indicated negative incremental total cost, meaning the intervention outperformed the control group. Subsequently, two cost-benefit analyses (CBA) showed benefit-to-cost ratios ranging from 3.3 to 6.2. The cost savings on medication ranged from €37.57 to €232 per patient in a year. This review suggested that pharmacist intervention in both outpatient and inpatient settings could decrease the risk of adverse drug events (ADE), enhance clinical outcomes, improve quality of life, and cut down on medication expenditure for older adult patients. Almost all investigations concluded that pharmacist intervention has a beneficial economic impact. Evaluating the economic impact of a large-scale intervention requires further study with more precise estimates of overall intervention cost and rigorous methodology applied to economic evaluations of initiatives.

Exploring Marine Invertebrate-Associated Bacteria for Novel Antibiotics: Isolation, Activity Screening, and Potential Bioactive Compounds

Thu, 20 Mar 2025 00:00:00 +0700

Marine bacteria associated with marine invertebrates are an interesting source to find compounds with potential bioactivities due to their ability to survive along with their host through evolution. Recent studies also found that secondary metabolites that previously isolated from marine invertebrates such as bryostatins were produced by the bacterial symbionts. Therefore, we screened bacteria from various marine invertebrates in Pulau Pari, Kepulauan Seribu, Jakarta for their antibacterial activities. The aim of this study to obtain potential bacterial strains that produce novel antibiotics. Isolation of bacteria from 16 marine invertebrates were accomplished using media Marine Agar, ISP2, YMA, and MS. We picked 97 bacterial strains for the testing of antibacterial activity against Mycobacterium smegmatis, Staphylococcus aureus, Eschericia coli, Pseudomonas aeruginosa, and Bacillus subtilis. The result showed that 19 of the bacterial strains showed activity against at least one of the test bacteria. One of the strains exhibited potent antibacterial activity against M. smegmatis. Partial identification using 16S rRNA revealed that the strains has 99.58% sequence similarity to Micrococcus luteus NCTC 2665T. Chemical analysis using GC-MS showed 9,12- Octadecadienoic acid, methyl ester; 9,12-Octadecadienoic acid (Z,Z); Octadecanoic acid; 2-(Dimethylamino)ethyl vaccenoate; and Cyclopropane,1,1-dichloro-2,2,3,3-tetramethyl- were major compounds with putative antibacterial activity. The results of this study emphasize the prospect of targeting this strain for further exploration to isolate and to characterize novel antibiotics from marine bacteria.

Anredera cordifolia Extract in Reducing Immunoglobulin E Expression in Wistar Rats Allergic Model

Thu, 20 Mar 2025 00:00:00 +0700

Anredera cordifolia (AC), the binahong plant in Indonesia, has been extensively used in herbal medicine since ancient times. AC contains secondary metabolites, such as flavonoids, with anti-oxidative, anti-inflammatory, anti-mutagenic, and anti-carcinogenic properties. Many flavonoid compounds with anti-inflammatory activity can potentially treat nasal inflammation, such as allergic rhinitis. This study aims to determine whether there is a decrease in IgE expression after AC extract administration in the Wistar rats allergic model. The research was conducted on 36 Wistar rats classified into nine groups: control group (K1), negative control group (K2), positive control group (K3), treatment group with hydrogel intranasal AC extract of 2.5% (P1), 5% (P2), and 7.5% (P3), and treatment group with oral AC extract of 25 mg/200 g BW (P4), 50 mg/200 g BW (P5), and 75 mg/200 g BW (P6). Afterward, ELISA examined the expression of IgE. The t-test results for treatment groups applied with hydrogel intranasal AC extract of 2.5% revealed a significant difference in decreasing IgE levels. In conclusion, the finding supports that AC extract exerts its anti-allergy properties by suppressing IgE levels in the Wistar rats allergic model.

The Characterization of Fructose-Based High-Fat Diet and Low-Dose Streptozotocin in A Type 2 Diabetes Mellitus Rat Model

Fitriana Hayyu Arifah, Agung Endro Nugroho, Abdul Rohman, Wawan Sujarwo — Thu, 20 Mar 2025 00:00:00 +0700

Animal models with valuable information on biochemical profiles are essential for preclinical trials of new antidiabetic agents. This study was to optimize and characterize of high-fat, high-fructose diet (HFFD) and low-dose streptozotocin (STZ) induced type 2 diabetes mellitus (type 2 DM). Wistar rats were fed with HFFD for 2, 4, and 6 weeks, followed by STZ (35 mg/kg BW), thus measuring the biochemical parameters. Non-induction HFFD and STZ were used as a normal control group. HFFD and low-dose STZ-induced rats demonstrated an elevation in the body weight, fasting blood glucose, triglyceride, triglyceride/ glucose index, necrosis score, and the insulin-negative cells. Moreover, this induction also reduced the number of insulin-positive cells and the percentage of insulin-positive cells. The findings imply that feeding Wistar rat HFFD for two weeks, followed by a single dose of STZ at 35 mg/kg BW will result in a reliable and stable diabetic rat model that closely resembles the biochemical characteristics of type 2 DM.

Expression and Purification of Recombinant Envelope (rE) Protein of Dengue Virus in Escherichia coli BL21(DE3) with Computational Analysis

Thu, 20 Mar 2025 00:00:00 +0700

Dengue Hemorrhagic Fever (DHF) caused by the Dengue Virus has become an endemic problem in countries with tropical and subtropical climates, thus categorizing it as a global challenge. One molecular biology approach for DHF prevention is through vaccination. A protein-based recombinant vaccine approach can be employed by utilizing the Envelope protein (E) of the Dengue Virus, as this protein is an ideal target as a vaccine candidate. This study optimized the gene sequence of recombinant Envelope (rE) coding for the recombinant Envelope protein (rE), followed by in silico testing of protein characteristics and structure modeling. The obtained results revealed that the rE protein exhibited instability index, aliphatic index, and isoelectric point values of 32.14, 75.08, and 7.17, respectively. The Ramachandran plot analysis indicated that 95.4% of amino acid residues were within the allowed region, while 4.7% were within the disallowed region, demonstrating the accuracy of the in silico protein modeling for rE. Consequently, the in silico testing results demonstrated that the rE protein possessed a stable and high-quality structure. The rE gene was then inserted into the pET-15b vector plasmid for subsequent expression using the Escherichia coli BL21(DE3) expression host system. Positive Escherichia coli colonies carrying the rE gene were induced with 1 mM IPTG. The expression results were analyzed using SDS-PAGE, followed by purification using a Ni-NTA column, and further analyzed by SDS-PAGE and western blot. The research findings demonstrated the successful insertion of the recombinant pET-15b-rE plasmid into E. coli BL21(DE3). The rE protein, with a size of 50.68 kDa, was successfully expressed in Escherichia coli BL21(DE3), as evidenced by the SDS-PAGE analysis showing a band within the 50-60 kDa range. In conclusion, this study successfully achieved the expression and purification of the recombinant Envelope protein (rE) of Dengue Virus in Escherichia coli BL21(DE3).

Effect of Ethanol Percentage on Phytochemical Constituent, Antioxidant Activity, and Dermatological Potential of Cayratia trifolia (L.) Domin

Thu, 20 Mar 2025 00:00:00 +0700

The present investigation evaluated four different solvent compositions (water, 50% ethanol, 70% ethanol, and pure ethanol) for their relative capacity to extract, total phenolic (TP), total flavonoid (TF) components, antioxidant activities, and dermatological potential of leaves of Cayratia trifolia (L.) Domin. The TP and TF of extracts were measured using the Folin–Ciocalteau and AlCl₃, respectively. Antioxidant activity was evaluated using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and ferric-reducing antioxidant power (FRAP). Meanwhile, in vitro dermatological potential, tyrosinase, and elastase inhibitory are by the colorimetric method. The extract obtained by pure ethanol presented the most potent antioxidant activity. DPPH and FRAP IC₅₀ values were 16.60±0.62 µg/mL and 27.53±0.69 µg/mL, respectively. The same extract also exhibited the highest TP (3.82±0.15 mg GAE/g DW) and TF (3.23±0.09 mg QE/g DW). Our finding additionally suggested that pure ethanol provides the highest extraction yield. However, 70% ethanol extract was a good source of tyrosinase (IC₅₀, 60.49±7.73 µg/mL) and elastase inhibitor (IC₅₀, 45.49±0.37 µg/mL). Overall, the experimental results revealed that C. trifolia has significant antioxidant and inhibitory action on skin-related tyrosinase and elastase, indicating that they might be used as bioactive metabolites in cosmetic and medicinal formulations to combat skin drooping and hyperpigmentation.

Antimicrobial Prospects of Domesticated Ornamental Leaf Extracts Against Skin Pathogens

Nurshahira Ezzany Shamshul Hakimi, Aliff Zulkarnain Zaini, Mohd Faiz Mustaffa — Thu, 20 Mar 2025 00:00:00 +0700

The increasing popularity of natural plant-based treatments offers an alternative to conventional therapies for various cutaneous infections due to their potential efficacy and lower side effects. Thus, the present study aimed to investigate the antimicrobial and cytotoxic properties of leaf extracts from five selected domesticated ornamental plants against pathogens implicated in acne vulgaris and dermatophytosis. The selected plant leaves were successively macerated with solvents of increasing polarity and the extracts were underwent qualitative phytochemical analysis. The antimicrobial activities were evaluated using the broth microdilution method. Extracts with high antimicrobial activity (MIC≤128µg/mL) were subsequently tested for cytotoxicity on BJ fibroblast cells, and the selectivity index (SI) was calculated. Extraction yields were highest in Bougainvilea glabra (72.04%) and lowest in Plumeria obtusa (21.6%). Phytochemical screening revealed the presence of alkaloids, flavonoids, terpenoids, tannins, phenols, quinolones, saponins, and coumarins, with phenols found in all extracts. The aqueous extract of Alamanda cathartica (AC-Aq) and the methanol extract of Ixora coccinea (IC-Met) showed the most potent antibacterial activities against P. acnes and S. epidermidis, with MIC values of 128μg/mL and 64μg/mL, respectively. Antifungal activity was most pronounced in AC-Aq against T. mentagrophytes and T. rubrum, with MIC values of 32μg/mL. The six active extracts revealed varying degrees of toxicity, with the aqueous extract of P. obtusa (PO-Aq) exhibited the least cytotoxicity (CC₅₀: 713.31±3.71 μg/mL), while IC-Aq was the most cytotoxic (CC₅₀: 116.72±2.28 μg/mL). AC-Aq demonstrated the highest SI values, indicating effective antimicrobial activity at non-toxic concentrations.

Formulation of Cinnamon Essential Oil (Cinnamomum burmannii) and Clove Essential Oil (Syzygium aromaticum) Nanoemulsion-Based Liquid Soap

Thu, 20 Mar 2025 00:00:00 +0700

Soap is a cosmetic that acts as a cleaning agent, to protect the body from various diseases, such as skin diseases caused by bacteria and fungi. One of the bacteria that causes infection is Staphylococcus aureus. The eugenol content in cloves and cinnamaldehyde in cinnamon can inhibit the growth of bacteria. This research aims to determine the liquid soap formulation based on a nanoemulsion combination of clove and cinnamon essential oils that meets the physicochemical characteristics and its activity in inhibiting the growth of S. aureus bacteria using the diffusion method. The research results showed that clove and cinnamon essential oils had antibacterial activity, with the concentration of clove essential oil used being 2% and cinnamon essential oil 3%. Then it was formulated into a nanoemulsion with a composition ratio of Tween 80 and PEG 400 as the most optimal surfactant and cosurfactant of 40:10. The nanoemulsion is formulated into liquid soap where the nanoemulsion combination of clove and cinnamon essential oils is added to the liquid soap base. The resulting liquid soap has good physicochemical properties and meets the requirements.

Pharmacological Therapy for Ischemic Stroke Patients Accordance to Clinical Practice Guidelines

Ahmed Alaa Al-Temimi, Hanis Hanum Zulkifly, Christine Shalin Selvaraj — Thu, 20 Mar 2025 00:00:00 +0700

Stroke ranks as the second most common cause of mortality and the third most significant cause of disability globally. The frequency of stroke remains elevated in low- and middle-income countries, affecting 70% of the population. Additionally, stroke-related deaths and disability-adjusted life years might reach as high as 87%. This study aims to evaluate the suitability of a pharmacological treatment approach for stroke patients in Malaysia, specifically in a public hospital setting. The evaluation will be based on the Clinical Practice Guidelines (CPG) 2012. A four-year retrospective, cross-sectional study was undertaken using medical records conducted among (n=682) hospitalized patients at Sungai Buloh Hospital; only (n=126) conforms with inclusion criteria and confirmed ischemic stroke diagnoses. Data was gathered utilizing a self-created data-collecting form that included demographic information, comorbidity, and pharmacological treatment. The mean age of the reported cases was 66.66 years, with the majority (58%) males and only (42%) females. The compliance to the Clinical Practice Guideline Malaysia 2012 for ischemic stroke inpatient setting in a public hospital is (>72%) (p=0.001). A significant proportion of patients had pharmacological therapeutic management in adherence to stroke recommendations, which is considered a critical factor in reducing stroke-related disability and mortality.

Age-Specific Patterns in Biologic and Targeted Synthetic DMARDs Discontinuation and Drug-Specific Risks

Thu, 20 Mar 2025 00:00:00 +0700

This study aims to analyse and delineate the predictor factors linked to the likelihood of treatment failure, encompassing adverse drug reactions (ADRs) or inefficacy. The specific focus of this investigation is on elderly Malaysian rheumatoid arthritis (RA) patients undergoing therapy with biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARDs). An observational, prospective longitudinal study on individuals with RA used Cox proportional hazards regression to compare treatment failure risk due to ADRs or lack of effectiveness across age groups. To ensure contributing factors related to treatment failure, adjustments were made for factors such as age, gender, disease duration, comorbidities, smoking, DAS28, and steroid use. In a cohort of 270 patients, 32.2% were classified as elderly. The elderly group exhibited higher RA disease activity, measured by DAS28 ESR, compared to the younger population (mean DAS28 ESR 6.748 versus 5.916, p<0.001). Regarding treatment, elderly individuals were more likely to receive biologic and targeted synthetic DMARDs as monotherapy rather than combination therapy (52.9% versus 47.1%, p = 486), with non-TNF inhibitors being more prevalent than TNF inhibitors (50.6% versus 37.9%, p = 0.040). Notably, the administration of targeted synthetic DMARDs in the elderly showed a significant negative association with treatment failure compared to TNF inhibitor therapy (adjusted HR: 0.12, 95% CI: 0.038, 1.265, p<0.001) after adjustment. Noteworthy predictors of failure in both biologic and targeted synthetic DMARD therapies, encompassing comorbidities, polypharmacy, smoking, corticosteroid use, and gender, were discerned. The utilisation of targeted synthetic DMARDs among elderly RA patients suggests a potentially more suitable and secure treatment option compared to biologic DMARDs. The identified predictors hold potential significance for guiding clinical decisions, particularly in the context of considering the discontinuation of biologic and targeted synthetic DMARDs in patients.

Decision-Making System for Extended Bacteremia Treatment in Patients with Hematologic Malignancy

Thu, 20 Mar 2025 00:00:00 +0700

Patients with hematologic malignancy (HM) experiencing bloodstream infections by Acinetobacter baumannii (AB) encounter considerable mortality risks, despite 14 days of standard antibiotic therapy. This research addresses a critical clinical challenge by developing a decision-making system to identify patients with hematologic malignancy and Acinetobacter baumannii bloodstream infections who would benefit from extended antibiotic therapy. Retrospective cohort research was conducted on patients with hematologic malignancies (HM) who developed bloodstream infections and were treated with a 14-day course of antibiotics within the specified period from January 2019 to April 2024. The odds ratio (OR) and risk ratio (RR) were calculated to examine the relationships among clinical and demographic data. A multivariable logistic regression model has been applied and adjusted to account for various predictors. The predictive model and the “Ex-CSEPA” decision-making system were developed using logistic regression. The performance metrics, including sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC-ROC), were evaluated. The developed model demonstrated exceptional performance, achieving an accuracy of 98.7%. It exhibited a sensitivity of 99.07% and a specificity of 98.33% in predicting mortality, setting a cut-off point of 0.5 or higher as indicative of high risk for mortality after 14-day treatment. The system's ability to identify patients who would benefit from antibiotic (ATB) treatment beyond the standard 14-day period was particularly significant. The application of this predictive model in clinical practice has pushed up the potential to enhance decisions for extended-ATB duration and decrease 30-day mortality for patients with HM who are morbid with AB bloodstream infections.

Risk Factors of Symptoms Occurrence in SARS-CoV-2 Infection After Implementing Vaccination Program in Bali

Thu, 20 Mar 2025 00:00:00 +0700

The real-world data have shown the effectiveness of many variants of Covid-19 vaccines. However, many people still get infected and indicate various symptoms after vaccination. This study aims to assess the risk factors of symptom occurrence in Covid-19 after implementing the vaccination program in Bali. This retrospective, case-control study used surveillance data include demographic, vaccination status, symptom occurrence, and severity from Pemecutan Kaja Village, North Denpasar district. Participants were included if they tested positive for SARS-CoV-2 with a minimum age of 18 years old. There was a total of 592 data on Covid-19 patients, the cases group was symptomatic and the control group was asymptomatic. Between May to September 2021, the vaccination program was implemented in Bali with Sinovac and Astra Zeneca. The risk factor analysis showed that age (OR 2.57, 95% CI 1.376-4.818; p = 0,003) and vaccination status (OR 3.104, 95% CI 2.089-4.611; p = < 0,001) were associated with symptom occurrence in Covid-19. Elderly and unvaccinated subjects have a higher risk of developing symptomatic SARS-CoV-2 infection. Vaccinations were not 100% effective in protecting people from infection, but almost all symptoms were reported as less frequent in vaccinated. A better understanding of the risk factor of severe infection has apparent implications for additional prevention and treatment for those with a higher risk of developing the severe condition. Adopting strategies are required to facing the probability of infection and controlling any future epidemic.

The Usability Assessment of PRiSMA and My.Pharma-C Web Application System

Thu, 20 Mar 2025 00:00:00 +0700

The Pharmaceutical Services Program (PSP) has not yet evaluated the usability of the web application system. The System Usability Scale (SUS) and Net Promoter Score (NPS) assessment tools give you a quick overview of your system's usability and help you improve it further. The goal of this study was to assess the usability of the PRiSMA and My.Pharma-C systems using SUS and NPS. From April 2019 to July 2020, a survey was conducted using a validated self-administered questionnaire that was prompted after each successful log-out from the PRiSMA and My.Pharma-C systems. The questionnaire was divided into three sections: demographic, device type, and SUS and NPS questionnaire. The mean SUS and NPS scores were computed. The survey was completed by 3,959 PRiSMA users and 811 My.Pharma-C users. The SUS score was interpreted as a grade, adjective, and range of acceptability. The PRiSMA mean SUS score was 70.2 (SD 15.44), indicating a 'Grade C' and 'Good' system. The mean SUS score for My.Pharma-C was 58.2 (SD 15.13), indicating a 'Grade D' and 'OK' system. Users accepted both systems on the basis of their usability. Calculated NPS value for PRiSMA was p=42%, n=49% and d=9%, NPS value=+33, whereas My.Pharma-C p=18%, n=46% and d=36%, NPS value=-18. A positive NPS value for PRiSMA represents the user's readiness to recommend the system to others compared to My.Pharma-C. The findings also established that SUS alone is insufficient and needs to be complemented by another method, such as qualitative instruments. It could help to drill down in depth to understand how to address potentially problematic areas for web application systems and assist in the improvement phases. However, both of the tools are applicable to be used to evaluate the usability of the web application systems that managed by the Pharmaceutical Services Program.

Pharmacists' and Community Knowledge on The Safety and Halal Status of Pediatric Medications Containing Alcohol

Thu, 20 Mar 2025 00:00:00 +0700

Knowledge of the halal characteristics of products is essential in evaluating product quality, especially within societies where this consideration holds substantial significance. In this context, the presence of alcohol in medicinal substances can significantly impact consumer preferences due to potential halal implications and safety concerns. Therefore, this study aims to assess the level of awareness and comprehension concerning these critical aspects among pharmacists and the broader community. This study involved a convenience sampling method of 180 participants from the Special Region of Yogyakarta, Indonesia. The sample consisted of 100 community members with prior experience purchasing pediatric cough and flu syrups and 80 community pharmacists. Data collection utilized a self-administered, paper-based questionnaire distributed from April-June 2023. Descriptive statistics were used for data analysis. The study revealed that 76.1% of the community exhibited good knowledge of the halal considerations regarding alcohol in pediatric cough and flu syrup medications. However, there appeared to be a lack of specific knowledge regarding the permissible alcohol content necessary for these medications to qualify as halal. Concerning community pharmacists, they demonstrated a nuanced understanding of both the health risks associated with alcohol in such syrups and the halal considerations, reflecting an average knowledge score of 73.88%. Notably, The community pharmacist did not have adequate knowledge regarding the legally permissible alcohol content limits in pediatric medications, as well as the resulting blood alcohol concentration in children following consumption. This study highlights the imperative for pharmacists to enhance their comprehension of alcohol content within pediatric formulations and actively disseminate this information within the community.