Celery (Apium graveolensLinn ABSTRAKSeledri adalah tanaman yang memiliki kandungan kimia seperti alkaloid, flavonoid, saponin, dan tanin. Penelitian ini bertujuan untuk membuktikan efektivitas ekstrak etanol daun seledri dalam menurunkan kadar asam urat pada tikus putih jantan dan menentukan dosis ekstrak daun seledri yang efektif dalam menurunkan kadar asam urat pada tikus putih jantan. Ekstrak daun seledri dibuat secara maserasi dengan pelarut etanol 96%. Rancangan penelitian yang digunakan adalah Rancangan Acak Kelompok. Data yang diperoleh dianalisis dengan mengunakan uji statistik Analisis Sidik Ragam pada taraf kepercayaan 95% yang mengunakan 30 ekor tikus putih jantan dibagi 6 kelompok perlakuan, tiap perlakuan terdiri dari 5 ekor. Model hewan dibuat hiperurisemia menggunakan penginduksi kalium oksonat dengan dosis 250 mg/kg BB. Kelompok I (normal) diberikan pakan standar, kelompok II (negatif) diberi suspensi Na CMC 0,5%, kelompok III (positif) diberi suspensi allopurinol 5,4 mg/kg BB, kelompok IV, V, dan VI diberi ekstrak etanol daun seledri masing-masing dengan dosis 50 mg/kg BB, 100 mg/kg BB, dan 200 mg/kg BB. Berdasarkan uji lanjut BNJ diperoleh hasil bahwa dosis ekstrak etanol daun seledri yang efektif adalah 50 mg/kg BB.
Background Up to now, the combinations of ferrous fumarate–folic acid (FF-FA) and ferrous gluconate–multivitamins (FG-MV) have been implemented by the local government in the province of Papua. Nevertheless, there is no a specific economic evaluation that has been applied to investigate the cost-effectiveness of FF-FA and FG-MV. Objective This study aimed to investigate the cost-effectiveness of FF-FA and FG-MV to be implemented in Teluk Bintuni, as one of the districts with the highest prevalence of iron deficiency anemia in Papua by taking the healthcare perspective into account. Methods A prospective observational study was applied by considering two groups of women (15–49 years old) with iron deficiency anemia who received FF-FA and FG-MV from September to November 2018. Applying a purposive sampling method, respondents were selected from 875 targeted women in six sub-districts, who met inclusion criteria. To estimate the total cost, we applied a healthcare perspective that considered direct medical cost only (eg, the procurement cost of iron tablets, cost of Hb test, and cost of healthcare visit). To estimate the effectiveness of intervention, we applied two major parameters, such as Hb level and utility score in quality-adjusted life year (QALY). The cost-effectiveness values were evaluated by using the criteria on the cost-effectiveness of healthcare intervention according to the threshold of gross domestic product (GDP) per capita (cost per QALY gained). Results From 875 targeted women in six sub-districts who met inclusion criteria, we found approximately 222 women with moderate–severe iron deficiency anemia and 110 women with complete data in the group of FF-FA (n=69) and FG-MV (n-41). The results showed that there were significant differences ( p -value <0.05) on the number of respondents, age, oral iron cost, total healthcare cost and utility score in both intervention groups. Comparing the use of FG-MV with FF-FA, we estimated the incremental cost-effectiveness ratios (ICERs) would be $255.77 per controlled patient, $142.09 per patient with Hb increment >2.00 g/dL, $79.93 per patient with Hb increment >1.00 g/dL, and $11.59 per QALY gained. Conclusion The ICER was estimated to be $11.59 per QALY gained, which was highly cost-effective, according to GDP-based cost-effectiveness threshold. In addition, the utility score of women with iron deficiency anemia was considered to be the most influential factor impacting the cost-effectiveness value.
Objectives: Monitoring iron supplementation effectiveness in the affected populations is important in assuring its success. The research objective of this study is to evaluate the effectiveness of iron supplementation and its related factors in increasing the hemoglobin levels of women with anemia that reside in the area of Teluk Bintuni Regency in West Papua Province, Indonesia. Materials and Methods: A quasi-experimental study was performed to determine the changes in hemoglobin levels and the adherence between two supplementation groups (before and after supplementation). From the initial screening of hemoglobin levels of 875 reproductive-age women, 110 women with moderate and severe anemia were enrolled for a month-long iron supplementation therapy. This study was conducted from September 2018 until November 2019 at Teluk Bintuni Regency, West Papua, Indonesia. The changes in hemoglobin levels were measured after 30 days of iron supplementation. The associated factors, including participants’ characteristics, chronic energy deficiency (CED) levels, adherence to supplementation programs, and knowledge of anemia, were also assessed. The adherence level to the supplementation was measured using the Medication Adherence Rating Scale (MARS) questionnaires and the pill counting method. Results: The mean hemoglobin level significantly increased from 9.12±1.70 before supplementation to 10.15±1.65 after 30 days (P<0.001). Interestingly, results from the MARS questionnaires and pill counting method suggested that only 76% and 66% of participants adhered to the supplementation program, respectively. Further univariate analysis showed that adherence, ethnicity, and type of supplementation were factors that may influence the success of the iron supplementation therapy. Conclusions: Based on this study findings, it can be concluded that anemia is related to various factors, and its implementation should be carefully monitored, not solely depending on individual adherence.
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