Melisa I. Barliana

Reduced serum selenium concentration in miscarriage incidence of Indonesian subjects.

Selenium is an essential nutrient for human health, and maternal selenium concentration has been reported to be associated with pregnancy outcome. To further investigate the possible role of selenium (Se) in miscarriage, we conducted a case–control study to evaluate the correlations among selenium status, glutathione peroxidase activity, and spontaneous abortion. A total of 46 subjects with normal pregnancies and 25 subjects with spontaneous abortion were recruited, and their serum selenium concentrations and serum glutathione peroxidase activities were analyzed. The total serum selenium concentrations in subjects with normal pregnancies were significantly higher than those of subjects with spontaneous abortion; however, the glutathione peroxidase activities were similar in both groups. We further separated the subjects into smoking and nonsmoking groups, and the logistic regression analysis suggested that total serum selenium concentration, but not serum glutathione peroxidase activity or smoking, was significantly correlated with the incidence of miscarriage. The present study thus reaffirms that low serum selenium levels are associated with miscarriage and that selenium plays an important role in pregnancy maintenance.

Polymorphism Of PXR Gene Associated With The Increased Risk Of Drug-induced Liver Injury in Indonesian Pulmonary Tuberculosis Patients

Tuberculosis is still a major infectious disease in Indonesia. Patients are treated mostly using fixed‐dose combination treatment in primary public health facilities. The incidence of antituberculosis drug‐induced liver injury (AT‐DILI) is approximately 10% among Indonesian tuberculosis patients who used standard fixed combination regimens during the intensive phase of treatment. However, information regarding genetic polymorphism associated with the increase risk of drug‐induced liver injury is still limited. The aim of this study was to investigate pregnane X receptor (PXR) gene polymorphisms as one of the risk factors of AT‐DILI.

Off-label paediatric drug use in an Indonesian community setting.

Off‐label medication is often used in the treatment of paediatric patients. However, it should be restricted due to the lack of evidence related to its efficacy and safety. Little is known about the frequency of off‐label drug use or the degree of scientific evidence supporting this practice in Indonesia. The aim of this study was to investigate the off‐label prescribing practice for paediatric patients in Bandung city, Indonesia.

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.

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.

Identification of Dysbiosis Related Bacteria from New Zealand’s White Rabbit Intestinal Treated With Lactobacillus plantarum IS-10506 as Probiotics Food Supplementation

The gastrointestinal microoganisms encompass thousands of bacterial species that constitute a relatively stable ecosystem inside human body. Dysbiosis is an imbalance condition of beneficiary microbacteria cause by newer microorganism. This research aimed to investigate the effect of L. plantarum IS-10506 as probiotics supplementation on total bacterial and Enterobacteriaceae count; and also to identify the dysbiosis causing bacteria. Total bacterial and Enterobacteriaceae number on both control and test group were determined by Total Plate Count method. Identification of dysbiosis related bacteria were determined by fermentation test, gram staining, and Microbact™ 12A kit. The TPC result of total bacterial population on control group was 222.67 x 10 6 cfu/ml, while the probiotics induced group was 210.33 x 10 6 cfu/ml. As for the TPC result for Enterobacteriaceae population from control group was 12.00 x 10 6 cfu/ml, Enterobacteriaceae population in the probiotics induced group was 11.66 x 10 6 cfu/ml. Four genera related to dysbiosis has been isolated from the intestinal sample and all are rod-shaped Gram negative bacteria. In conclusion, the use of L. plantarum IS-10506 as food supplementation has reduced the total bacterial count. Four genera of dysbiosis related bacteria has been identified from the intestinal sample which include Eschericia, Serratia, Enterobacter, and Citrobacter .

Recent Strategies and Patients Preferences of Community Pharmacists Asthma Service

Asthma control depends on the accessibility of effective medicines and its appropriate use. Given that many issues in the asthma management are related to inappropriate use of medication, community pharmacists are in the excellent position to improve asthma outcomes. This review aims to summarize recent strategies of community pharmacists asthma services and patients’ preferences on such program. Various servicessuch as medication use review, patients counseling, inhaler training, telephone consultation, SMS reminder, dispensing data screening, and small group discussion were shown to have positive impacts on clinical outcomes, adherence to medication, and quality of life of the patients. Limited evidence showed that these services were beneficial in economic perspectives. Patients preferred these aspects included in suchprogram; protection of their privacy during the program, positive attitudes of pharmacists, and various useful services including education on asthma, adherence review, and lung function testing.

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.

DNA methyltransferase 3A gene polymorphism contributes to daily life stress susceptibility

Daily life stress markedly affects the response toward stressful stimuli. DNA methy-lation is one of the factors that regulate this response, and is a normal mechanism of somatic cell growth, but its regulatory gene variations may cause alterations in the stress response. The aim of the present study was to investigate genotypic variants of the DNA methyltransferase 3A (DNMT3A) gene in 129 healthy subjects and evaluate its association with daily life stress. Blood samples were collected, and genomic DNA was isolated. DNA was amplified using specific tetra primers for DNMT3A (C/T) rs11683424 and visualized following 2% agarose gel electrophoresis. The association of DNMT3A genetic variants with daily life stress was analyzed using the Kessler Psychological Distress Scale (K10). We observed that the distribution of subjects with genotype CC (wild type), CT (heteromutant), and TT (homomutant) was 13.95%, 81.4%, and 4.65%, respectively. Genetic variations significantly affected the daily life stress condition (p=0.04) in Indonesian healthy subjects, but most of the subjects with the CT phenotype were classified in a stress condition.

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 IC50of (+)-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. Abbreviations used: RBC: Red Blood Cells; IC50: Inhibition Concentrattino 50; MeOH: Methanol; RPMI: Roswell Park Memorial Institute; EI: Electron Ionization.