ANTIANEMIA SUPPLEMENTATION COMBINATION WITH VITAMIN C ON HEMOGLOBIN LEVELS AMONG PREGNANT WOMEN IN PRIMARY HEALTH CARE CENTER, JEPARA, INDONESIA

lood volume escalation during pregnancy leads to an increase in iron needs. Pregnant women are prone to maternal anemia that is caused by iron, folic acid, vitamins B2, B12, A, and C deficiency and may serve as causative factors that aggravate anemia. Concerning the problem, this clinical investigation determined the effect of antianemia supplementation and its combination with vitamin C on hemoglobin levels during pregnancy. This study is a quasi-experimental involving 34 patients who consumed antianemia supplements with or without vitamin C. The treatment group was given a combination of antianemia supplement Fe Fumarate 180 mg-Folic Acid 400 mcg and vitamin C 100 mg. The positive-control group was administrated with antianemia supplement Fe Fumarate 180 mg-Folic Acid 400 mcg. After 28 days, blood samples were taken to measure the hemoglobin levels. The hemoglobin levels were found to have a statistically significant difference (p<0.05) between that group receiving a combination of antianemia-vitamin C and the other group administered with antianemia alone.

INHIBITORY ACTIVITY OF SNAIL (Achatina fulica (Lam.) Bowdich) MUCUS ON GROWTH OF MAMMARY CANCER IN RAT INDUCED WITH DMBA (7,12-DIMETHYLBENZ(α)ANTHRACENE)

Back to nature as a medication concept has been accepted widely because it has fewer side effects than modern medicines. Researches on natural products as anticancer agent therapies are in progress. This present research was conducted to determine that the inhibitory activity of snail (Achatina fulica (Lam.) Bowdich) mucus inhibits the growth rate of mammary cancer in SpragueDawley rats. Five groups of female rats, with four individuals each, were induced with 7,12-dimethylbenz(α)anthracene (DMBA) for five weeks. Snail mucus was applied every seven days to the treated rats with three different dosages (15, 20, and 25 mg/kg BW). Observations were done on diameters and growth rate of the mammary cancer lump developed at the end of week 8, 10, 12, 14, and 16. Histopathological examination was carried out at the end of the 16th week. Inhibitory activity results showed a row of average diameter of the cancerous lumps on rats with the following details. The results obtained from the application of snail mucus at dosage of 15, 20, and 25 mg/kg BW were at 0.40, 0.60, and 0.09 cm respectively along with average growth rate of cancerous lumps at 1.50, 0.75, and 0.25. The histopathology results of the snail mucus treatment at dosage of 15, 20, and 25 mg/kg BW showed normal tissue depiction and similarly normal histopathological form indicated by the presence of their sub-clinic components. The results showed that a snail mucus dose of 25 mg/kg BW was able to perform inhibitory activity on growing mammary cancer in rats induced by DMBA.

IN VITRO ANTIBACTERIAL ACTIVITY OF CEFADROXIL CAPSULES CONSUMED BY PATIENTS IN THE HOSPITAL

Clinical use of cefadroxil, particularly in Bangka Tengah Hospital, is proven beneficial to overcome mild to moderate infections which especially occur in soft tissues such as skin, upper respiratory tract, pharyngitis, tonsillitis and urinary tract. For this reason, it is necessary to procure cefadroxil to be available enough for the treatment of cases of these diseases. The cefadroxil used by the Central Bangka Hospital was obtained from several pharmaceutical industries with different prices and distributions, due to the possibility that the active raw materials and ingredients had different origins, so there was concern that the microbiological quality would be different. Drug procurement is carried out using the e-catalog or non-e catalog method. This study aimed to examine the microbiological quality of six preparations (A, B, C, D, E, and F) in terms of their inhibitory activities against Gram-positive and Gram-negative bacteria. The bioassay was carried out by diffusion agar method using Escherichia coli ATCC 29522 and Staphylococcus aureus ATCC 29523 as the bacterial test, and nutrient agar as the test medium. The inhibitory activities were compared to cefadroxil standard for measuring the ratio potency. The results showed that all samples fulfilled USP 41 requirements with potential ratio of 90% to 120% and minimum inhibitory concentration of ≤ 8 ppm and ≤ 2 ppm against Escherichia coli and Staphylococcus aureus respectively. The potency ratios to cefadroxil standard were 95.9%, 99.1%, 100.0%, 96.7%, 96.2% and 98.2% against Staphylococcus aureus while the potency ratios of 95.6%, 99.3%, 103.8%, 97.1%, 95.7% and 100.4% were achieved against Escherichia coli for A, B, C, D, E, and F samples, respectively.

FORMULATION AND CARACTERIZATION OF QUERCETIN NIOSOME WITH CONCENTRATION VARIATIONS OF SPAN 20 SURFACTANT

Quercetin has low solubility, absorption and bioavailability which limits its practical use as a drug or supplement. Therefore, it is important to formulate a quercetin niosome system with various concentrations of span 20 as a surfactant. This investigation aimed to formulate and analyse a quercetin niosome preparation with span 20 variations to provide optimal quercetin solubility. Niosomes were prepared using various concentrations of span 20. In the present study, the quercetin niosome used the reverse phase evaporation (RPE) method. Quercetin niosome is characterised by its organoleptic properties, pH value, particle morphology comprising the particle shape and size, and encapsulation efficiency. Organoleptic observations of the quercetin niosome included a yellow colour, distinctive quercetin odour and thick consistency for all formulas. The pH remained within the physiological pH range of skin. Quercetin niosome morphology was close to spherical while the niosome particle size results were 2.13 µm (F1), 2.99 µm (F2) and 3.31 µm (F3). The quercetin niosome encapsulation efficiency results were 81.86 ± 0.47% (F1), 84.02 ± 0.26% (F2) and 88.24 ± 0.10% (F3). Quercetin niosome were successfully prepared using multiple span 20 concentrations below the cholesterol concentration characterised by the measurement results of organoleptic, pH, particle morphology and encapsulation efficiency.

STUDY OF CORONAVIRUS DISEASE 2019 (COVID-19) VACCINATION IN INDONESIA: A LITERATURE REVIEW

Research and development of the COVID-19 vaccine give hope to all people to stop the COVID-19 pandemic in the world. This literature review explores the safety and efficacy of the COVID-19 vaccine used in Indonesia and discusses Indonesia's current vaccination process. The primary databases for the reviewed articles were PubMed and Mendeley. Others are official websites, such as World Health Organization (WHO); COVID-19 and National Economic Recovery Committee in Indonesia (KPCPEN); the National Agency of Drug and Food Control (NA-DFC–in Bahasa Indonesia: BPOM) of the Republic of Indonesia; the US Food and Drug Administration (FDA), Clinical Trials.gov, COVID-19 vaccine Tracker, the Indonesian regulations, and guidelines regarding COVID-19. The inclusion criteria of the searched articles were those published from December 2019 to April 30, 2021, and those which discussed vaccines' types, efficacy, and safety. Acceptance of the COVID-19 vaccination is quite high (65%). Refusal was related to vaccine safety (30%); effectiveness (22%); distrust of vaccines (13%); fear of side effects (12%); and religious reasons (8%). The COVID-19 vaccines planned by the Indonesia Government have gone through clinical trials phases I to III. The Coronavac vaccine efficacy showed seroconversion that occurred was 92.4% to 97.4%, and no severe side effects have been reported. The ChAdOx1 nCoV-19 efficacy was 66.7% to 76.0%, and none of the tested participants was hospitalized, serious side effects were very small (0.9% to 1.1%). The mRNA-1273 efficacy was 94.1%, and its reactogenicity was mild to moderate. The BNT162b2 efficacy was ≥ 92%, and no severe or specific safety concerns have occurred. The efficacy of the BBIBPCorV vaccine has not been established. Ongoing phase I, II, and III clinical trials will provide more information on safety and immunogenicity for the BBIBP-CorV. Three of the six vaccines have obtained EUA from BPOM and approval from the Indonesian Ulema Council (MUI). A health promotion program about the safety, efficacy, and the 'halal' of the COVID-19 vaccine; acceleration and ensuring access to the COVID-19 vaccination program are urgent to end this pandemic immediately.

VALIDATION OF ANTIBODY RAPID TEST FOR SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 INFECTION IN BETHESDA HOSPITAL YOGYAKARTA

Since March 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection has been around in Indonesia with a case fatality rate was 4.7% on August, 1th 2020. So far, the Real-Time Polymerase Chain Reaction (RT-PCR) method is the gold standard for the SARS-CoV-2 infection diagnosis. This method, however, has some limitations where it has a long turnaround time, complicated operations, and high prices. Hence, the rapid test kits are now readily available to identify the SARS-CoV-2 patients. The purpose of this study is to measure the diagnostic performance, including sensitivity, specificity, positive and negative predictive value, likelihood ratio or LR of antibody rapid test if compared with RT-PCR for the SARS-CoV-2 suspected patients in Bethesda Hospital Yogyakarta. This research was analytical observational research with a cross-sectional design approach, in which data were collected retrospectively. The instruments used in this study included e-medical record (ERM), Laboratory Information System (LIS) data from patients with suspected SARS-CoV-2 infection in Bethesda Hospital Yogyakarta. We collected demographic data of patients, RT-PCR results, antibody rapid test results using Standard Q COVID-19 IgM/IgG Combo. The data were obtained from 50 patients. The results showed that the Rapid test kit has a 100% sensitivity value, 74.4% specificity value, 38.9% positive and 100% negative predictive value, 3906 positive likelihood ratio compared with the RT-PCR results.

COST AND EFFECTIVENESS OF ATYPICAL-ATYPICAL ANTIPSYCHOTIC COMBINATIONS AND ATYPICAL-TYPICAL ANTIPSYCHOTIC COMBINATIONS IN PATIENTS OF PSYCHOTIC DISORDERS IN INSTALLATION OF EMERGENCY IN GRHASIA MENTAL HOSPITAL, YOGYAKARTA

Psychotic disorders create a burden on the government, family, and society because of decreasing patient productivity. The use of atypical-atypical and atypical-typical antipsychotic combinations is one of the most commonly used combinations for patients with psychotic disorders. The study was conducted to determine the average total cost and effectiveness of the therapy measured by the difference in PANSS-EC pre-post scores during intensive care. The study was conducted prospectively to analyse the total cost and effectiveness of the therapy using combinations of antipsychotics in psychotic disorders patients. The measured costs include the cost of nursing classes, laboratory, medical treatment, doctor's visit, and antipsychotic. The effectiveness is measured by the difference in PANSS-EC pre-post scores. As many as 32 treated patients with psychotic disorders met the inclusion criteria. The average cost of atypical-typical antipsychotic combination group (Rp1,184,043) was higher than atypical atypical antipsychotic combination group (Rp1,115,829). The effectiveness of the therapy was represented by the value of the difference between the PANSS-EC pre and post scores, which in this research yielded a mean of 7,125 for atypical-atypical antipsychotic combinations and 8,375 for atypical-typical antipsychotic combinations. In conclusion, there is a difference in the total average cost and effectiveness of the therapy. There is a difference between PANSS-EC pre and post scores during the time period from intensive room to quiet room in atypical-typical antipsychotic combinations compared with atypical-atypical antipsychotic combinations.

THE EFFECTIVENESS OF SOUTH SUMATRA COFFEE (Coffea arabica L.) EXTRACT CREAM IN BURN WOUND RECOVERY OF MALE WHITE MICE (Mus musculus)

The effectiveness of South Sumatra coffee extract cream in burn wound recovery of white male mice had been analyzed. This research aims to ensure which one between immature and mature coffee bean that was better to recover burn wounds of male white mice after 14-day testing. The prepared concentrations for both coffee beans were 0.1%, 0.2%, and 0.3%. We then figured out that ethanol contained by young and old coffee beans had a recovery effect on burn wounds of male white mice (Mus musculus). Findings indicate that 0.3% of mature coffee beans were more effective in recovering burn wounds of male white mice (Mus musculus), in which the wound recovery percentage was close to that in the positive control (burnazin).

OPTIMIZATION OF CARBOPOL 940 AND PROPYLENE GLYCOL CONCENTRATION ON THE CHARACTERISTIC AND INHIBITORY EFFECT OF ETHANOL EXTRACT GEL OF PAPAYA (Carica papaya L.) SEEDS AGAINST Staphylococcus aureus

Papaya (Carica papaya L.) seeds contain alkaloids, flavonoids, tannins, phenolic compounds and saponins have been proven its synergistic effect in inhibiting the growth of Staphylococcus aureus. In this research, ethanol extract of papaya seeds was formulated in gel preparations. Optimization of the composition of the gelling agent and humectant was carried out to obtain the gel preparation of papaya seed ethanol extract with good physical properties and stability. The parameters used to determine the stability of the preparation are Physical properties which include viscosity, spreadability, and percentage of viscosity shift. Data analysis was performed using Design-Expert software version 12 and SPSS. The inhibitory activity test was carried out by the disk-diffusion agar method with Staphylococcus aureus ATCC 25923 as the test bacteria. The results of the inhibitory activity test of papaya seed ethanol extract at a concentration of 20% had moderate activity and at concentrations of 40%, 60%, 80% and 100% classified as strong against the Staphylococcus aureus. Carbopol 940 is dominant factor in influencing the response of viscosity (92.504%) and spreadability (59.539%). Preparations with good physical properties and stability were obtained on the use of carbopol 940 and propylene glycol as much as 1.06604 grams and 13.2146 grams respectively.

PHARMACEUTICAL CARE PRACTICE IN THE COMMUNITY PHARMACY BY UTILIZING PROBLEM-BASED LEARNING IN REFLECTIVE PEDAGOGY PARADIGM METHOD

This study follows the previous study entitle Problem-based Learning (PBL) in reflective pedagogy paradigm (RPP): Innovative learning in pharmaceutical care, which identified the learning material as complicated. This study aimed to provide an appropriate method for performing pharmacy management and pharmaceutical care in Community Pharmacy. Data collection was done using an assessment instrument to identify student’s achievement. The previous study encompasses preceptors and students in developing learning material, which cause it more valid and reliable to be implemented. The study was conducted in Yogyakarta, Surakarta, and Semarang city. The effectiveness of the learning material was shown by the grade of student’s achievement in learning outcome and the clear state with confidence in the expression of reflection and action-plan. Most of the students in the 3 cities achieved an excellent grade both in the problem-solving field, and presentation of the assignment. The students reflected that the learning material is simple and suitable in practicing pharmaceutical care and pharmacy management, moreover, they can state their plan to work as a Community Pharmacist with confidence. Therefore, PBL in the RPP method is ready to be used in practicing pharmaceutical care in the Community Pharmacy.