Anti-inflammatory Effect of Trigona spp. Propolis in Restricting Edema Volume

  Background: Inflammation is a normal response that potentially harmful if it is uncontrolled. On the other hand, it is necessary to find an alternative anti-inflammatory as most anti-inflammatory drugs available nowadays still have adverse effects. Trigona spp. propolis is one of the potential anti-inflammatory alternatives because of its flavonoid, especially caffeic acid phenethyl ester, which is known as an active compound in anti-inflammatory process. This study aimed to understand the anti-inflammatory effect of Trigona spp. prolisin reducing edema volume in rat’s paw.Methods: An experimental study was performed on 20 male wistar rats. The rats were divided into control and experimental groups with 10 rats in each group. Control group was treated by propylene glycol 1 ml/day and experimental group was treated by Trigona spp. propolis 200 mg/kg body weight/day. The inflammation was induced by subcutaneous injection of λ-carrageenan 1% at plantar one hour after the treatment. Edema volumes were measured by plethysmometer every hour at 1 to 6 hours and once at 24 hours after induction. The difference in edema volumes was calculated in percentage. This study was conducted during October 2012 at the Pharmacology and Therapy Laboratory, Faculty of Medicine, Universitas Padjadjaran Bandung.Results: The increase of edema volume (in percentage) in control group and Trigona spp. propolis treated group are 100.64±32.22 and 56.46±20.38 respectively (p value=0.000). Multiple comparisons using Dunnet and Duncan post hoc test showed significant differences that were observed at 3, 4, 5, and 6 hours after inflammatory induction.Conclusion: Trigona spp. propolis has an anti-inflammatory effect in reducing edema volume in rat’s paw. The most significant effect was observed at 3, 4, 5, and 6 hours after inflammatory induction. Trigona spp. propolis might have a potential to be developed as a future anti-inflammatory drug.Keywords: Edema volume, inflammation, propylene glycol, Trigona spp, propolisDOI: 10.15850/amj.v2n1.440

Drug Allergy Clinical Characteristics in Pediatrics

Background: A drug allergy causes a morbidity and a mortality due to its various range of clinical manifestation. Unfortunately, a study  focusing in pediatric drug allergy is insufficient, especially in Bandung. Thus, this study is conducted to determine the clinical characteristic of pediatric drug allergy in Dr. Hasan Sadikin General Hospital Bandung.Methods: This study was a retrospective descriptive study using medical records of pediatric drug allergy patients between 2010–2015 in Dr. Hasan Sadikin General Hospital Bandung taken with total sampling method. The variables were patient age, gender, causative drug, and clinical manifestation. Clinical manifestation was then divided into exanthem, urticaria, erythema multiforme, Steven-Johnson’s syndrome/toxic epidemiolytic necrosis (SJS/TEN), and fixed drug eruption (FDE). Results: Out of 101 patients, only 71 were included in the study due to incomplete medical records of the rest. There were 34 (47.89%) males and 37 (52.11%) females. Patients’ age ranged from 1–18 years old with the mean of 7.4 years old. The most common clinical manifestation was SJS/TEN with 25 (35.21%) patients, followed by exanthem with 22 (30.98%) patients. The most common suspected causative drug was non-steriodal anti inflammatory drugs (NSAID) (24%), followed with penicillin (21%).Conclusions: Most common manifestation of pediatric drug allergy in female is SJS/TEN, meanwhile in male is exanthema. Steven-Johnson’s syndrome/toxic epidemiolytic necrosis mostly occurs at the age group of 12–18 years old, and exanthema at the age group of 0–3 years old. This condition is mostly caused by NSAID and penicillin.DOI: 10.15850/amj.v4n2.109

Effect of Antihyperglycemic Agents on Hemoglobin A1c Level in Type 2 Diabetes Mellitus Patients

Background: Type 2 diabetes mellitus (T2DM) patients require continuous lifelong attention to pharmacotherapy to achieve and maintain optimal glucose control, which can be monitored through measuring HbA1c. This study aimed to see the comparrison of HbA1c levels before and after a minimum of two months use of antihyperglycemic agents in patients with T2DM. Methods: This analytical cross-sectional  study used medical records of patients with T2DM in the center of outpatient medical records at the Department of Clinical Pathology, Dr. Hasan Sadikin General Hospital, in  2013. Sampling was conducted using consecutive sampling technique. The data analysis used the paired t-test and Wilcoxon test for not normal data distribution. Results: Before and after a minimum of two months use  of antihyperglycemic agents, HbA1c concentration was 7.15% (6.1–12.2) and 7.3% (5.9–11.9) respectively. Statistically, the difference of HbA1c concentration of T2DM patients between those period  was not significant (0.15%; p=0,812). Mean HbA1c concentration was found with greatest decrease in patients treated with sulfonylurea (2.25%), followed by insulin (0.1%). There were increases in mean HbA1c concentration in patients treated with metformin (0.05%), metformin+insulin (1.1%), sulfonylurea +metformin (0.6%), sulfonylurea+alpha-glucosidase inhibitor (1.1%), and sulfonylurea + metformin + alpha-glucosidase inhibitor (0.05%). Conclusions: There is no significant difference of HbA1c levels before and after two months to two years use of antihyperglycemic agents in T2DM patients. This result showed the importance of comprehensiveness in T2DM therapy. The therapy should not merely consist of antihyperglycemic medication alone, but also physical exercise, lifestyle modification, and diet control

Effectiveness of Allergic Rhinitis Management Related to WHO Guideline on Allergic Rhinitis and Its Impact on Asthma (ARIA)

Background: The standard procedure of Allergic Rhinitis (AR) Management in Indonesia is based on Allergic Rhinitis and Its Impact on Asthma (ARIA) World Health Organization (WHO) 2008 guideline; however, it needs some adjustment to get an effective use locally in Indonesia. The data related to the problem however did not exist in Indonesia. The study aimed to evaluate the effectiveness of AR patient management based on the ARIA WHO guideline in the Department of Otorhinolaryngology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital Bandung.Methods: The study was conducted from September to October 2015 using quantitative descriptive design to observe the development of ARIA classification, total nasal symptom score (TNSS), and quality of life (QoL) during the first 6 months of therapy. The data were obtained from medical records of AR patients who visited the Rhinology-Allergy clinic Department of Otorhinolaryngology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital within one year. Thirty three patients were included in the study using total sampling.Results: There was significant improvement (p<0.001) in ARIA classification, TNSS, and QoL between the initiation of therapy, the third, and the sixth month. In contrary, there was no significant difference in ARIA classification (p=0.109), TNSS (p=0.317), and QoL (p=1.000) between the third and the sixth month of therapy.Conclusions: Allergic rhinitis patient management based on the 2008 ARIA WHO guideline is effective. [AMJ.2016;3(4):538–44]Keywords: Allergic rhinitis, asthma, effectiveness, management DOI: 10.15850/amj.v3n4.65

Effect of Anti-tuberculosis Drugs on Liver Damage Based on Alanine Aminotransferase Level in Pulmonary Tuberculosis Patients

Background: Antituberculosis (anti-TB) drugs could cause serious effect such as hepatotoxicity signed by the increase of Alanine Aminotransferase (ALT) level. Anti-TB drugs are still needed by TB patients who have hepatotoxicity, although  clinicians who manage this condition have not recognize whether the advantage of anti-TB drugs is higher than its adverse effect, and there is no data describing about that issue. This study was conducted to discover the liver damage based on the ALT changes before and 12 days after initial anti-TB treatment. Methods: This was a cross-sectional study with total sampling of medical records of pulmonary tuberculosis inpatients from 1st January 2013–31th December 2014 at the Department of Internal Medicine of Dr. Hasan Sadikin.General Hospital. From 141 data, only 14 medical records were eligible to be included in this study. The data used were ALT level before and after therapy. These data were analyzed using Wilcoxon test and considered as significant if p<0.05. Results: The median age of the subject study was 48(18-65) years. Among 14 patients, 8 were female and 6 were male. Five out of fourteen patients developed hepatotoxicity. Four out of five developed grade 1 hepatotoxicity and one out of five developed hepatotoxicity grade 4. The analysis of the data showed the differences of ALT level before anti-TB therapy (22(4-447)) and 12 days after initial therapy (18.5(4-1206)) was not significant (p=0.660). Conclusions: There is no liver damage based on ALT changes after anti-TB treatment so the treatment can be continued

Anti-inflammatory Effect of Trigona spp. Propolis in Restricting Edema Volume

  Background: Inflammation is a normal response that potentially harmful if it is uncontrolled. On the other hand, it is necessary to find an alternative anti-inflammatory as most anti-inflammatory drugs available nowadays still have adverse effects. Trigona spp. propolis is one of the potential anti-inflammatory alternatives because of its flavonoid, especially caffeic acid phenethyl ester, which is known as an active compound in anti-inflammatory process. This study aimed to understand the anti-inflammatory effect of Trigona spp. prolisin reducing edema volume in rat’s paw.Methods: An experimental study was performed on 20 male wistar rats. The rats were divided into control and experimental groups with 10 rats in each group. Control group was treated by propylene glycol 1 ml/day and experimental group was treated by Trigona spp. propolis 200 mg/kg body weight/day. The inflammation was induced by subcutaneous injection of λ-carrageenan 1% at plantar one hour after the treatment. Edema volumes were measured by plethysmometer every hour at 1 to 6 hours and once at 24 hours after induction. The difference in edema volumes was calculated in percentage. This study was conducted during October 2012 at the Pharmacology and Therapy Laboratory, Faculty of Medicine, Universitas Padjadjaran Bandung.Results: The increase of edema volume (in percentage) in control group and Trigona spp. propolis treated group are 100.64±32.22 and 56.46±20.38 respectively (p value=0.000). Multiple comparisons using Dunnet and Duncan post hoc test showed significant differences that were observed at 3, 4, 5, and 6 hours after inflammatory induction.Conclusion: Trigona spp. propolis has an anti-inflammatory effect in reducing edema volume in rat’s paw. The most significant effect was observed at 3, 4, 5, and 6 hours after inflammatory induction. Trigona spp. propolis might have a potential to be developed as a future anti-inflammatory drug.Keywords: Edema volume, inflammation, propylene glycol, Trigona spp, propolisDOI: 10.15850/amj.v2n1.440

ANALISIS GLIKOSIDA KARDIOAKTIF DIGOKSIN MENGGUNAKAN ULTRA PERFORMANCE LIQUID CHROMATOGRAPHY (UPLC)

Digoksin merupakan glikosida kardioaktif, salah satu senyawa yang penting dalam terapi yang saat ini tersedia sebagai obat untuk pengobatan penyakit jantung. Penggunaan obat ini meningkat sejalan dengan bertambahnya penderita penyakit jantung. Oleh karena itu, perlu dilakukan penelitian dan monitoring penggunaan obat ini pada penderita penyakit jantung dalam proses terapi kesembuhan. Tujuan dari penelitian ini adalah untuk mengetahui metode analisis digoksin dengan menggunakan alat Ultra Performance Liquid Chromatography (UPLC). Digoksin yang digunakan adalah Fargoksin (Injection 0,25 mg/mL, ampoule/berbentuk cairan). Pengenceran digoksin dilakukan dengan penambahan pelarut metanol. Kolom yang digunakan adalah kolom BEH C18. Optimasi metode analisis yang dilakukan meliputi perbandingan pelarut yang digunakan, suhu kolom, dan laju alir. Setelah melakukan optimasi, diperoleh kondisi fasa gerak yang optimum adalah larutan air-asetonitril (72:28%), laju alir 0,3 mL/menit, waktu selama ± 6 menit, suhu kolom off, dan detektor yang digunakan adalah spektrofotometer UV dengan panjang gelombang 218 nm. Pengulangan analisis dengan menggunakan hasil yang diperoleh secara optimum dilakukan sebanyak sepuluh kali. Berdasarkan data tersebut, proses analisis dengan menggunakan UPLC dapat berlangsung lebih cepat dibandingkan dengan menggunakan HPLC

A Validated Ultra Performance Liquid Chromatography Method for Quantification of Metformin in Human Plasma

Metformin is oral hypoglycemic or blood sugar-lowering drug which is used for the first- line drug in the treatment of diabetes mellitus type 2. This study presented the validated Ultra Performance Liquid Chromatography UltraViolet (UPLC-UV) method for the determination of metformin in human plasma. Metformin levels were measured using UPLC with a UV detector and liquid-liquid extraction method. Separation was carried out on an Acquity UPLC HSS T3 100mm × 2.1mm i.d. column (1.8μm particle size) using gradient elution of acetonitrile and phosphate buffer 0.02 M (0.6 mL/min) as mobile phase at 30°C. The analyte was monitored at 236 nm. No endogenous substances were found to interfere with the peaks of drug and internal standard. The value of percent deviation and the coefficient variation obtained respectively less than the percentage set in the FDA guidelines. The linearity factor values were more than 0.997 and LOD was 0.01µg/mL. UPLC with UV detector is able to analyze metformin in a short time with good precision and accuracy which is useful for bioequivalence and bioavailability studies