Zullies Ikawati

The importance of ARG513 as a hydrogen bond anchor to discover COX-2 inhibitors in a virtual screening campaign

Structure-based virtual screening (SBVS) protocols were developed to find cyclooxygenase-2 (COX-2) inhibitors using the Protein-Ligand ANT System (PLANTS) docking software. The directory of useful decoys (DUD) dataset for COX-2 was used to retrospectively validate the protocols; the DUD consists of 426 known inhibitors in 13289 decoys. Based on criteria used in the article describing DUD datasets, the default protocol showed poor results. However, having ARG513 as a hydrogen bond anchor increased the quality of the SBVS protocol. The modified protocol showed results that could be well considered, with a maximum enrichment factor (EFmax) value of 32.2.

Molecular docking and ADME-toxicity studies of potential compounds of medicinal plants grown in Indonesia as an anti-rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease with recurrent bone destruction around the joints that could lead to permanent joint damage. DMARDs (Disease Modifying Anti-Rheumatoid Drugs) and NSAIDs (Non-Steroid Anti-Inflammatory Drugs) are the RA therapies with many side effects on long term use. Based on the ethnomedicine, there are many plants that could be found in Indonesia that contain the potential compounds as alternative RA therapies. The aim of this study is to assess the potential of compounds of various medicinal plants against multiple proteins that play an important role on RA through the molecular docking study and pharmacokinetic prediction. Hesperidin, EGCG (Epigallocatechin gallate), and mangiferin showed higher activity compared to the other compounds against TACE (TNF-α converting enzyme) which play an important role in the inhibition of TNF-α. Inhibition on it could suppress macrophage cell and T-cell activity by suppressing the regulation of cytokine secretion against inflammati...

Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage

Highlights • Chronic use of metformin 1500 mg/day may exceed the recommended therapeutic level.• It is necessary to consider combination therapy to avoid metformin accumulation.• Obese patients with T2DM are recommended to use metformin with a shorter interval.

The Effectiveness of Video Education How to Use Diskus® DryPowder inhaler on Out-Patients Copd In Mojokerto, Indonesia

COPD therapy aims to prevent and overcome acute exacerbation on COPD which could be fatal and even lead to death. Thus, it must be prevented with optimum medication during stable condition. Bronchodilator in the form of inhalation are preferred in COPD medication because systemic bronchodilator has many side effects compared to that of topical bronchodilator (inhalation). DPI (dry-powder inhaler) has been developed and introduced to the market since 1967 as a solution or choice concerning MDI (metered-dose inhaler) setbacks where patients felt difficult in coordinating hands and lungs. Evidences suggested that multi-unit dose DPI such as Diskus® offered most reliable and consistent performance and it is preferred by patients. The improper using of inhaler is one of the main causes holding up asthma control since it can affect patients dosage intake which is not optimal. This research aimed to know the efficacy of Diskus® preparation usage education given to COPD patients. Method used in this research was one study group pre-test dan post test. The number of respondents involved in this research was 55 respondents. The result of t-test suggested that t-count is fewer than p-value (0.05) suggesting that there was difference between pre and post test score as a result of oral or motor evaluation. It is then concluded that Diskus® usage education affected the patients in the improvement of inhaler usage accuracy based on oral and motor evaluation. This research only reviewed COPD patients skill in using Diskus®, thus it is required to conduct further research to dig the understanding in the usage of Diskus® like drug indications, interval, how to notice side effects and how to overcome them. Also, this research only reviewed knowledge increase, but yet described outcome improvement from the using of COPD therapy itself.

A Rapid, Simple, and Validated RP-HPLC Method for Quantitative Analysis of Levofloxacin in Human Plasma

To conduct a bioequivalence study for a copy product of levofloxacin (LEV), a simple and validated analytical method was needed, but the previous developed methods were still too complicated. For this reason, a simple and rapid high performance liquid chromatography method was developed and validated for LEV quantification in human plasma. Chromatographic separation was performed under isocratic elution on a Luna Phenomenex ® C18 (150 × 4.6 mm, 5 µm) column. The mobile phase was comprised of acetonitrile, methanol, and phosphate buffer 25 mM that adjusted at pH 3.0 (13:7:80 v/v/v) and pumped at a flow rate of 1.5 mL/min. Detection was performed under UV detector at wavelength of 280 nm. Samples were prepared by adding acetonitrile and followed by centrifugation to precipitate plasma protein. Then followed successively by evaporation and reconstitution step. The optimized method meets the requirements of validation parameters which included linearity (r = 0.995), sensitivity (LLOQ and LOD was 1.77 and 0.57 µg/mL respectively), accuracy (%error above LLOQ ≤ 12% and LLOQ ≤ 20%), precision (RSD ≤ 9%), and robustness in the ranges of 1.77-28.83 µg/mL. Therefore, the method can be used as a routine analysis of LEV in human plasma as well as in bioequivalence study of LEV.

EFEKTIVITAS JAMU TETES SOMAN 1® TERHADAP HbA1C DAN EVALUASI ADVERSE EVENTS PADA PASIEN DIABETES MELLITUS TIPE 2 DI RUMAH SAKIT

Penelitian ini dilakukan untuk mengetahui efektivitas jamu tetes Soman 1® terhadap HbA1C dan mengetahui adverse events pada pasien diabetes mellitus tipe 2 di rumah Sakit UGM. Rancangan penelitian adalah experimental double blind, dengan teknik consecutive sampling pada pasien rawat jalan, dengan diagnosa diabetes mellitus tipe 2 di Rumah Sakit UGM. Sejumlah 30 pasien masuk dalam kriteria inklusi, kemudian dilakukan random allocation untuk menentukan pasien menerima perlakuan uji jamu tetes Soman 1® kombinasi metformin atau plasebo kombinasi metformin selama 12 minggu. Pasien yang di drop out berjumlah 3 orang. Uji independent t-test digunakan untuk membandingkan rata-rata penurunan HbA1C pada kedua kelompok, dengan nilai signifikansi p 0,05). Begitu pula secara klinis, penurunan rata-rata HbA1C pada kelompok uji cenderung lebih tinggi daripada kelompok plasebo, dengan nilai selisih perbedaan rerata penurunan HbA1C diantara kedua kelompok adalah 0,41%, walaupun secara klinis tidak berbeda signifikan (< 0,6%). Jumlah kejadian adverse events yang terjadi pada kelompok uji adalah 27 adverse events, antara lain mual (33,33%), diare (20%), nyeri perut (20%), nyeri badan, lemas dan pusing masing-masing 13,33%, alergi/gatal-gatal, nafsu makan meningkat, tenggorokan sakit, konstipasi, mulut terasa pahit, sakit pinggang, susah tidur, kaki kaku/pegal dan mengantuk masing-masing 6,67%, sedangkan pada kelompok plasebo, adverse events yang terjadi yaitu diare (13,33%) dan mual (6,67%). Kata Kunci: diabetes mellitus tipe 2, jamu tetes Soman 1®, HbA1c, adverse events

EVALUASI TERAPI ORAL TERHADAP HASIL TERAPI PASIEN ASMA

Asma merupakan salah satu penyakit kronis yang banyak ditemui dan secara klinis ditandai oleh adanya episode batuk rekuren, napas pendek, rasa sesak di dada dan mengi ( wheezing ). Terapi asma pada pasien dewasa diberikan secara oral, inhalasi dan parenteral. Peresepan pasien asma rawat jalan di Balai Kesehatan Paru Masyarakat (BKPM) Wilayah Magelang sebagian besar menggunakan obat yang diberikan secara oral karena mahalnya harga inhaler. Penelitian ini bertujuan untuk mengetahui pengaruh terapi oral terhadap hasil terapi pasien asma. Penelitian ini merupakan penelitian observasional dengan pengambilan data secara prospektif dari Februari sampai April 2014. Data diambil dari hasil pemeriksaan Peak Flow Meter , rekam medis dan lembar pengumpul data. Pasien yang memenuhi kriteria inklusi sebanyak 75 pasien tetapi hanya 71 pasien yang mengikuti seluruh proses penelitian. Untuk membuktikan adanya pengaruh sebelum dan sesudah menggunakan terapi oral terhadap hasil terapi digunakan uji t paired dan uji Wilcoxon . Untuk membandingkan besarnya perubahan digunakan uji t independent dan uji Chi-square dan alternatifnya Fisher . Hasil penelitian menunjukkan terjadi peningkatan nilai Arus Puncak Ekspirasi (APE) sebesar 92,68± 66,70 setelah 1 bulan menggunakan terapi oral Frekuensi serangan pada awal penelitian sebagian besar pasien ≥4x/minggu sebanyak 33 pasien (46,48%), setelah 1 bulan menggunakan terapi oral frekuensi serangan sebagian besar pasien menjadi 1-2x/bulan sebanyak 48 pasien (67,61%). Penggunaan terapi oral menunjukkan kemajuan hasil terapi berupa peningkatan nilai APE dan penurunan frekuensi serangan asma. Kata kunci: asma , terapi oral, hasil terapi