Jurnal Kefarmasian Indonesia

Penggunaan Deksametason pada Pasien COVID-19: Systematic Review dan Meta-analisis

2023-02-09T06:03:10SE Asia Standard Time

COVID-19 is associated with disseminated lung damage in patients, Dexamethasone can reduce lung injury caused by inflammation and there reduce the progression to respiratory failure and prevent death. This systematic review aimed to determine the benefits and safety of Dexamethasone in COVID-19 treatment. The study was performed by a comprehensive literature search which were published in several databases i.e., PubMed, Science Direct, VHL Regional Portal, and ClinicalTrials.gov within the search time of 28 November 2020. Inclusion criteria were articles on the study on COVID-19 patients who received Dexamethasone, observational and experimental studies on the outcomes use evaluation of Dexamethasone. Exclusion criteria are the articles that do not provide control in controlled studies and do not show clear research results on the use of Dexamethasone. An initial search from four databases by entering keywords resulted in 1,046 articles. After screening articles duplication we obtained 835 studies. Finally, 6 articles were obtained after we screened for the article that it can be obtained its full text and 5 articles joined in articles included in the meta-analysis. The analysis showed that Dexamethasone in Covid-19 patients could reduce the incidence of death within 28 days with RR of 0.78 (95% CI 0.57–0.97 P=0.13) compared with Methylprednisolone, Dexamethasone was compared without corticosteroids with RR 0.89 (95% CI 0.82-0.97 P=0.01). Dexamethasone also reduced mechanical ventilator use during treatment with RR 0.95 (95% CI = 0.86-1.05 P = 0.28) compared without corticosteroids. The conclusion from these results: the use of Dexamethasone can reduce the number of deaths in COVID-19 patients, especially severe and critically ill category patients.

Evaluasi Pola dan Rasionalitas Penggunaan Antibiotik pada Pasien Neonatus di Ruang NICU dan Perinatal RSUD Banjarnegara

2023-02-09T06:03:12SE Asia Standard Time

Neonates are particularly susceptible to infections caused by exposure to microorganisms during labor or shortly after birth. Some neonates require treatment in the NICU and perinatal rooms because of cases of infection that require antibiotics as therapy. This study aimed to determine the pattern of antimicrobial administration, antimicrobial rationality, and its relationship to clinical outcomes. This study used a cross-sectional design with prospective data collection using the medical record of neonates in the NICU and Perinatal rooms at RSUD Banjarnegara during November 2020-January 2021. The samples in this study were all neonatal patients who received antibiotics. Evaluation of antibiotics use was carried out using the Gyssens method. Descriptive analysis was conducted to determine the description of the research sample and the antibiotics used. A total of 131 samples had normal birth weight characteristics of 71%. The single antibiotic most frequently used as amoxicillin (21 patients), and the combination antibiotic was ampicillin+gentamicin (106 patients). The results of the evaluation using the Gyssens method showed that patients received 265 antibiotics, 85.55% were in category 0, 8.75% in category IIa, 3.8% in category IIIb, and 1.9% in category IIb. Of the 131 neonates treated, 124 patients were declared improved and 7 others died. The correlation between antibiotic rationality and clinical outcomes was analyzed by Chi-square, the result of the Asymp value. Sig (2-sided) 0.138 which means there is no relationship between the two. The rationality and effectiveness of clinical outcomes of antibiotics used during the study were considered good because the number of patients who were discharged with improved conditions was much greater than those who died.

Pengaruh Variasi Gliseril Monostearat pada Krim Ekstrak Kulit Buah Naga Merah Super (Hylocereus costaricensis) dan Uji Antioksidannya

2023-02-09T06:03:13SE Asia Standard Time

A Glyceryl monostearate can be used as an emulsifier because it can affect the increase in antioxidant activity. The study aims to determine the effect of fluctuations in the concentration of glyceryl monostearate (GMS) on the physical properties of cream preparations containing 70% ethanol extract from the skin of super red dragon fruit and their antioxidant activity. The research methods carried out experimentally include the manufacture of extracts from super red dragon fruit peel, phytochemical screening using thin layer chromatography, formulations using various concentrations of glyceryl monostearate 8%, 10%, 12% then the physical quality of the cream and antioxidant activity test using the DPPH method. The results of one-way ANOVA for pH, dispersion, adhesion, and viscosity tests showed a p-value of> 0.05, indicating that there was no significant difference. The IC50 results obtained with equations 1, 2, and 3 are 3.69 mg/L, respectively. 3.98mg/L; and 4.78mg/L. Formula 3 is the best formula and estimates the antioxidant activity of Vitamin C, which is a positive control, at a value of 5.83 mg/L. The results of the irritation test showed that none of the formulations caused irritation. The preference test results showed that the respondents liked all the formulas. The conclusion of this study is that increased fluctuations in the concentration of glyceryl monostearate did not affect the physical properties of super red dragon fruit skin extract cream, but did affect its antioxidant activity.

Efektivitas Gel Ekstrak Etanol 70% Daun Anggrek Oncidium (Oncidium Aliceara alice) terhadap Penyembuhan Luka Kulit Dorsum Tikus Sprague Dawley

2023-02-09T06:03:14SE Asia Standard Time

Wounds are tissue damage that is generally caused by physical contact. Wound healing is a complex mechanism involving biochemical and biocellular processes. Various therapies can be done to speed up the wound healing process, one of which is treatment using natural ingredients. One of the plants that have the potential to heal wounds is Oncidium Aliceara alice. The purpose of this study was to determine the phytochemical content of Oncidium Aliceara alice and its activity in wound healing when it is formulated in a gel form. This research is experimental research with extraction stages, phytochemical assay, gel formulations, quality test, and wound healing activity tests in animals. The gel formulation was made with various concentrations of Oncidium Aliceara alice extract 2.5%, 5% and 10%. Male Sprague Dawley rats were given an incision wound on the dorsum of the longitudinal axis along 3 cm. Wound care by administering topical Bioplacenton as a positive control, base gel as a negative control, and gel extract concentration variants according to each treatment group. Based on the research, the results of qualitative phytochemical tests showed that the 70% ethanol extract of Oncidium Aliceara alice contains flavonoids (catechins), tannins, steroids, and saponins. The best results were seen on the 7th day of observation for the 10% gel extract treatment group with more perfect signs of wound closure than the bioplacenton treatment.

Pengembangan dan Validasi Metode Bioanalisis Trimetoprim dalam Sampel Plasma dan Urin Manusia Simulasi Menggunakan KCKT-PDA

2023-02-09T06:03:15SE Asia Standard Time

To monitor trimethoprim levels (TMP) in humans, a validated, simple, and cost-efficient analytical method is needed to be applied regularly. However, most of the methods used to establish TMP levels in urine and plasma use complex instrumentation. Therefore, in this study, a simpler High-Performance Liquid Chromatography-based (HPLC) method was developed. The separation was carried out using a GIST® C18 column (150 × 4.6 mm, 5 μm) at a temperature of 35°C which was fed by a mobile phase in the form of an acetic acid solution pH 2.5: acetonitrile (87:13, v / v) at a speed of 1.4 ml/min. Detection was performed with Photodiode Array Detector (PDA) at wavelengths of 254 nm and 243 nm to quantify TMP in urine and plasma samples respectively. The preparation of urine and plasma sequentially was carried out by the liquid-liquid extraction (ECC) method using ethyl acetate and the protein precipitation using acetonitrile. This method proved to be selective, linear (R=0.997), accurate with %error ≤ 10.29% at LLOQ level and above LLOQ value %error ≤ 10.45%, precision with %RSD ≤ 11.79% at LLOQ level and %RSD ≤ 10.82% above LLOQ. In addition, this method is quite sensitive for pharmacokinetic studies in the urine and monitoring of TMP levels in the blood with LLOQ 5 mg/L in both urine and plasma. The stability of trimethoprim in solution, urine, and plasma was conducted to ensure storage time. The developed method is proven to be valid and can be applied in pharmacokinetic studies and monitoring of trimethoprim drug levels in urine and plasma.

Validasi Metode Analisis Penetapan Kadar Protein Ekstrak Ikan Gabus dengan Metode Lowry dan Bromocresol Green

2023-02-09T06:03:16SE Asia Standard Time

Snakehead fish is one of the biological resources with high economic value because it contains high albumin levels. Analytical methods for the determination of protein content in snakehead fish are available not been validated. This study aims to obtain a comparison of the accuracy, repeatability, intermediate precision, and linearity between the Lowry and Bromocresol-green methods in determining albumin levels from snakehead fish extracts. This study was performed with the SHIMADZU UV-1280 spectrophotometer at a wavelength of 778 nm for the lowry method and 638 nm for the bromocresol-green method. The results of the study show that all parameters meet the requirements for accepting validation. The results were tested statistically with the independent t-test, the p-value was 0.172 (p> 0.05) the accuracy between the Lowry and Bromocresol-green methods did not have a significant difference, that the Lowry and Bromocresol green methods had the same ability to determine accuracy parameters and precision parameters, the p-value is 0.000 (p <0.05) the precision between the Lowry and bromocresol-green methods has a significant difference, that the bromocresol-green method is better than the Lowry method.

Pengaruh Pemberian Kombinasi Ekstrak Etanol Piper crocatum dan Ekstrak Akuades Elaeocarpus ganitrus pada Kadar Gula Tikus

2023-02-09T06:03:17SE Asia Standard Time

Diabetes mellitus is a disease characterized by hyperglycemia. Antidiabetic research using natural ingredients has been carried out a lot, one of which is by utilizing red betel leaves and granite leaves. Combining two plants must be done to increase the antihyperglycemic effect and reduce the toxic effects. This study aimed to obtain the most effective dose variations in combinations of plants that are safer and have better results so that they can be used as alternative treatments. The blood sugar levels were measured in vivo on white Wistar rats induced with streptozotocin using a glucometer. The results showed that a single extract of red betel leaf (100 mg/kg BW) and a single extract of granite leaf (100 mg/kg BW) had a percentage decrease in blood sugar levels of 27% and 10%, respectively. While the combination of extracts with a ratio of 100:100, 50:50, 100:50, and 50:100 mg/kg BW has a decrease in blood sugar levels of 50%, 42%, 33%, and 19% after 21 days of observation. The study also showed that the positive control of 0.036 mg glimepiride caused a 36% decrease in sugar levels. Statistical analysis proved that the effect of reducing blood sugar levels on days 0 to 21 differed for each treatment group with a p-value of 0.05. The study concluded that the combination of red betel leaf extract and granite leaf extract was more effective on blood sugar levels than the single extract of each plant in white male Wistar rats. The percentage reduction in blood sugar levels of the combination extract with a dose ratio of 50:50 mg/kg BW and 100:100 mg/kg resulted in better antidiabetic activity than the positive control glimepiride. The combination ratio of 100:100 mg/kg BW extract had the best antidiabetic activity compared to the other extract treatment groups.

Efek Ekstrak Etanol Daun Kelor terhadap Kadar Kreatinin Serum dan Superoksida Dismutase Tikus Model 5/6 Subtotal Nefrektomi

2023-02-09T06:03:18SE Asia Standard Time

Chronic Kidney Disease (CKD) is still a major problem in the health sector in the world, including in Indonesia. One of the main pathomechanisms in CKD is oxidative stress. Superoxide dismutase (SOD) is an enzyme that plays a role in fighting oxidative stress. Oxidative stress can be overcome with antioxidants both from inside the body and from the outside obtained from natural materials. Moringa leaves (Moringa oleifera L.) have the potential to prevent the progressivity of CKD because of their flavonoid content which has an antioxidant effect. This study aimed to analyze the effect of Moringa leaf ethanol extract (MLEE) on serum creatinine and SOD levels in rat model 5/6 subtotal nephrectomy. This research is an experimental study with a post-test only with a control group design. A total of 30 male white rats were randomly divided into 5 groups. Group A: sham control, B: subtotal nephrectomy, C, D, and E: treatment groups with MLEE of 200, 400, and 800 mg/kg BW, respectively. On the 15th day after the administration of extracts or aqua dest, sham surgery was carried out in group A, and 5/6 of subtotal nephrectomy in groups B, C, D, and E continued to administer extracts and aqua dest until the 21st day. A blood sample is taken on the 22nd day after surgery, checked serum creatinine levels and SOD. Data were analyzed using One-way ANOVA. The results showed that there was a significant difference in the average serum creatinine levels (p<0.001) and SOD (p<0.001) between groups. The treatment group showed lower serum creatinine levels and higher SOD compared to the nephrectomy subtotal group. Administration of MLEE for 35 days may prevent elevated serum creatinine levels and decreased SOD levels in rat model 5/6 subtotal nephrectomy

Evaluasi Penggunaan Ramipril dan Candesartan pada Pasien Rawat Inap COVID-19 dengan Komorbid Hipertensi di RSUD Dr. Moewardi

2023-02-09T06:03:20SE Asia Standard Time

Hypertension is the most common comorbid in patients infected by COVID-19. Drugs often given for the treatment of hypertension, namely ramipril, and candesartan, are thought to increase the development of COVID-19 because the angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs) increase the expression of ACE-2, which is the binding site of SARS-CoV-2. This study aims to analyze the effect of using ramipril and candesartan on healing in hospitalized patients with COVID-19 with hypertension at RSUD dr. Moewardi in 2020. This study was conducted retrospectively. The results were presented descriptively and used medical record data of hospitalized patients with COVID-19 with comorbid hypertension at RSUD dr. Moewardi in 2020. Using ramipril and candesartan affects patient recovery in terms of length of stay (LOS), symptom relief, and RT-PCR test results. Analysis of the research data using SPSS with Spearman correlation test. The Spearman correlation test showed that there was a fairly strong relationship between the use of ramipril and candesartan in patients with COVID-19 with comorbid hypertension on LOS, symptom relief, and RT-PCR test results. The study results show that using ramipril and candesartan can improve the recovery of patients with COVID-19 with comorbid hypertension. ACEI and ARB drugs have not been proven to worsen the patient's condition so their use can be continued.

Analisis Efektifitas Biaya Terapi Pengobatan Pasien Diabetes Mellitus Tipe 2 terhadap Kontrol Glukosa Darah

2023-02-09T06:03:21SE Asia Standard Time

Diabetes mellitus (DM) is a chronic disease characterized by blood glucose levels exceeding normal. The length of therapy in DM patients causes the large amount of treatment costs incurred, although in Indonesia BPJS insurance is used but this puts the burden of health financing on the Indonesian government, so there is a need for an analysis of costs associated with therapeutic outcomes. The purpose of this study was to analyze the Cost Effectiveness of Type 2 DM patients in a hospital in the South Surabaya area. The method used is observation, with retrospective observation on type 2 DM patients in outpatient internal polyclinics for the period April – December 2021. The results obtained were 30 patients who routinely controlled 2, 3, 4, 5, 6, 7, 8 and 9 months, receiving single therapy or a combination of antidiabetic drugs. In this study, a cost and effectiveness analysis was carried out with the measurement of therapeutic outcomes, namely pre-post GDP and pre-post GD2PP. The conclusion of this study were 30 female patients (100%), age > 45 years 24 people (80%). The effectiveness of sulfonylurea single therapy is 50% with an ACER of between Rp. 4,392.48 – Rp. 18,686.86 routine control 2, 3 and 9 months. For the treatment of 2 combinations of Thiazolidinediones + Insulin has an effectiveness value of 100% with ACER Rp. 42,490.08 routine control 6 months. While the 3 combinations that have a 100% effectiveness value are the combination of Sulfonylurea + Thiazolidinedione + Biguanide with an ACER price of Rp. 6,668.4 routine follow-up for 3 months. In 3 combinations of oral antidiabetic with insulin (Insulin + Sulfonylurea + Thiazolidioine + alpha glucosidase inhibitor) has a 100% effectiveness value, the ACER price is Rp. 36,082.36 routine control 7 months.