Inflammation is one of the important biological responses to injury. Anti-inflammatory is therefore proposed to treat both acute and chronic inflammation. Chemical compounds of various plants are widely used in treatment of inflammation. Objective: This study aims to evaluate anti-inflammatory potential of G. vulgaris extract (GVE) and A. muricata extract (AME) on LPS-stimulated murine macrophage cell line (RAW264.7). Cell viability assay to evaluate nontoxic concentration in cell line was performed with MTS assay. Parameters to determine anti-inflammatory activity between treatment group and non treated cells, were IL-1β, TNF-α, and IL-6 which was measured with Elisa, and NO level which was measured with nitrate/nitrite colorimetric assay. Both GVE and AME of 50 and 10 µg/mL showed high viability (>90%) and it was not significantly different compared to control, makes it suitable for treatment. GVE and AME of 50 µg/mL resulted low TNF-α level in RAW264.7(313.16pg/mL and 264.69 pg/mL respectively), as well as IL-1β level (903.53 pg/mL and 905.00 pg/mL respectively) and IL-6 (175.88 pg/mL and 219.13 pg/mL respectively). Whereas, GVE and AME of 75 µg/mL showed lower NO level (9.76 µM and 9.79 µM respectively) compared to untreated cells. This research revealed that GVE and AME possess the anti-inflammatory potential indicated by inhibition of inflammatory mediators including TNF-α, IL-1β, IL-6 and NO. Anti-Inflammatory Potential of Gandarusa (Gendarussa vulgaris JOURNAL OF NATURAL REMEDIES AbstractIpomoea reniformis Chaos is claimed in Indian traditional medical practice to be useful in the treatment of epilepsy and neurological disorders. In the present study, pretreatment effect of methanolic extract of Ipomoea reniformis on epilepsy and psychosis was evaluated in rodents using standard procedures. Besides evaluating epileptic and behavioral parameters, neurotransmitters such as Gamma-Amino Butyric Acid (GABA) in epilepsy and in psychosis dopamine, noradrenaline and serotonin contents in the rodent brain were estimated. The extract pretreatment reduced maximal electro shock; Isoniazid (INH) and Pentylenetetrazole (PTZ) induced seizures and also significantly inhibited the attenuation of brain GABA levels by INH and PTZ in mice. These results suggested that the observed beneficial effect in epilepsy may be by enhancing the GABAergic system. The test drug also inhibited the apomorphine induced climbing and stereotyped behavior and showed significantly reduced levels of brain dopamine, noradrenaline and serotonin which may be due to blocking of central dopaminergic, noradrenergic and serotonergic pathways or by enhancing the GABAergic system. The results obtained in present study suggest that the title plant possesses antiepileptic and antipsychotic activities in rodents.
<p><strong>Objective: </strong>To identify and evaluate drug-related problems (DRPs) in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A prospective observational three-month study was conducted in adult patients with CKD hospitalized in five general medical wards and one intensive cardiac care unit in a major teaching hospital in Indonesia. Principal researcher (pharmacist) identified the occurrence of DRPs through the direct patient interview, discussion with nurses and assessment of patients’ medication charts and medical records. The identified DRPs were validated by a senior pharmacist and classified using Pharmaceutical Care Network Europe/PCNE classification scheme for DRP V6.2. Descriptive analysis was applied for demographic data, drug utilization and DRP profiles.</p><p><strong>Results: </strong>There were 105 patients who met the inclusion criteria and 80% of these patients had end-stage renal disease. A total of 2404 medication orders were reviewed and 1026 DRPs were identified. Potential DRPs accounted for around two-thirds of the cases. The rate of overall DRPs was 42.7 DRPs per 100 medication orders and each patient in the study experienced approximately ten DRPs during their hospitalization. Treatment effectiveness and adverse reaction domains contributed to the majority of DRPs primary domains for problems. Drugs for cardiovascular diseases and drugs for correcting electrolyte imbalance were most commonly implicated in DRP incidence.</p><p><strong>Conclusion: </strong>This study uncovered higher rate of DRPs experienced by each patient compared to other CKD studies. There were variations of DRP types when comparing with similar studies. Pharmacists’ competencies to identify, prevent and resolve DRPs are vital measures to improve clinical outcomes in CKD patients.</p>
Background: Indonesia's social health insurance (Jaminan Kesehatan Nasional, JKN) has been implemented since 2014. To support medicine provision, the government launched policies reform on medicine pricing, procurement and reimbursement; hence, the system might affect medicine prices in the country.Objective: To evaluate the effects of the pharmaceutical policies reforms on medicine procurement prices.Methods: This was a pre-post observational study. Medicine price data were collected retrospectively from the 2013 Ministry of Health procurement price list, the 2017 e-catalogue procurement system, and the procurement departments at 2 hospitals in Jakarta and Cilegon (both categorized as region I). The 2013 national procurement price was compared with the 2017 e-catalogue price. The hospitals' procurement prices were collected from the data 3 years before and 3 years under Indonesia's social health insurance JKN (2011JKN ( -2016, and the data were used to assess the medicine procurement prices in real conditions. The outcome measure was the difference in procurement prices before and under the JKN. Results:The results showed that the procurement prices of 429 (79.6%) of 539 medicines listed in the 2017 e-catalogue decreased, of which 210 items (39.0%) showed over a 50% decrease. Nevertheless, the procurement prices of 104 items (19.3%) increased, especially those that were still under patent or those with a few brands registered in Indonesia. The procurement prices in public and private hospitals showed a similar trend, that is, a significant decrease. Interestingly, non-e-catalogue medicine prices also decreased quite steeply, although the prices of the branded generic category in the private hospital remained unchanged. Conclusion:The pharmaceutical policies under the JKN implementation had a profound impact on decreasing medicine procurement prices in Indonesia.
Paediatric patients with cancer are a high-risk patient population for medication misadventures. This study aimed to document and evaluate the role of pharmacists' interventions during dispensing-related activities in minimising the occurrence of medication misadventure in haematology-oncology patients. The primary investigator observed and documented all clinical interventions during dispensing-related activities performed by clinical pharmacists in a haematology-oncology pharmacy during 33-day. A total of 359 interventions were performed for 1028 patients. The rates of intervention were 20.04 per 100 medication orders and 34.92 per 100 patients. Provision of drug information was the most common interventions constituting more than three quarters of all interventions. According to therapeutic groups, cytotoxic antineoplastics made up more than half of all interventions. Of all interventions, 22 involved recommendations leading to changes in patients' treatment (active interventions), and all recommendations were accepted. The top three medication errors were due to inappropriate dosing, labelling error, and unfulfilled indication. Clinical pharmacists' intervention during dispensing in a paediatric haematology-oncology pharmacy improved medication safety and patient care by minimising the incidence of medication misadventures.
AimsThis study aimed to document and compare the nature of clinical pharmacists’ interventions made in different practice settings within a children’s hospital.MethodsThe primary investigator observed and documented all clinical interventions performed by clinical pharmacists for between 35–37 days on each of the five study wards from the three practice settings, namely general medical, general surgical and hematology-oncology. The rates, types and significance of the pharmacists’ interventions in the different settings were compared.ResultsA total of 982 interventions were documented, related to the 16,700 medication orders reviewed on the five wards in the three practice settings over the duration of the study. Taking medication histories and/or patient counselling were the most common pharmacists’ interventions in the general settings; constituting more than half of all interventions. On the Hematology-Oncology Ward the pattern was different with drug therapy changes being the most common interventions (n = 73/195, 37.4% of all interventions). Active interventions (pharmacists’ activities leading to a change in drug therapy) constituted less than a quarter of all interventions on the general medical and surgical wards compared to nearly half on the specialty Hematology-Oncology Ward. The majority (n = 37/42, 88.1%) of a random sample of the active interventions reviewed were rated as clinically significant. Dose adjustment was the most frequent active interventions in the general settings, whilst drug addition constituted the most common active interventions on the Hematology-Oncology Ward. The degree of acceptance of pharmacists’ active interventions by prescribers was high (n = 223/244, 91.4%).ConclusionsThe rate of pharmacists’ active interventions differed across different practice settings, being most frequent in the specialty hematology-oncology setting. The nature and type of the interventions documented in the hematology-oncology were also different compared to those in the general medical and surgical settings.
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