Kino Kino, Rofila Dita Karmia, Harnavi Harun

Background, anaphylactic shock (AS) caused by iodinated contrast media (ICM) is a rare but potentially life-threatening immediate hypersensitivity reaction. Despite widespread use of ICM in diagnostic imaging, data on ICM-related AS are limited, particularly in Indonesia. Early recognition and timely intervention are crucial to reduce morbidity and mortality. Case presentation, a 28-year-old female underwent renal arteriography with iodixanol. Within 5 minutes of contrast administration, she developed a generalized pruritic rash, dyspnea, vomiting, hypotension, and unstable cardiac parameters. Clinical presentation confirmed iodixanol-induced anaphylactic shock. Management, initial management included intramuscular epinephrine, rapid intravenous fluids, intravenous antihistamines and corticosteroids, and norepinephrine infusion. The patient’s hemodynamic status stabilized, and she was monitored in the CVCU for 48 hours. Outcome and conclusion, the patient recovered fully without complications. This case emphasizes the importance of rapid recognition and prompt pharmacologic intervention in ICM-induced anaphylaxis, while highlighting the value of thorough allergy documentation and preventive counseling.

Sciences of Pharmacy

Rissa Maharani Dewi, Abdur Rosyid, Willi Wahyu Timur, Nindita Sari Nastiti, Dwi Monika Ningrum, Dimas Widiyanto

Inappropriate prescribing of parenteral analgesics in patients with mild pain or uncomplicated fever remains a relevant concern in emergency care. This study reports findings from a retrospective internal audit conducted in the emergency department of a private hospital in Banjarbaru, Indonesia, to evaluate the appropriateness of non-steroidal anti-inflammatory drug (NSAID) use. Medical records of 384 emergency department visits were reviewed, including data on pain intensity using the Numeric Rating Scale (NRS), clinical indications, route of administration, and immediate adverse reactions. Inappropriate use was defined as administration of parenteral NSAIDs in patients with mild pain (NRS 1–3) or uncomplicated fever when oral therapy was feasible, based on Royal College of Emergency Medicine (RCEM) guidelines. The audit identified inappropriate parenteral NSAID use in 7 patients (3.6%). These cases were associated with mild, immediate adverse effects such as nausea and dizziness. Although the proportion was small, the findings indicate potentially avoidable use of injectable analgesics and highlight the need for improved adherence to guideline-based analgesic selection. Reinforcement of routine pain assessment, clinician re-education, and periodic prescribing audits are recommended to support rational and patient-centered analgesic use in emergency settings.

Sciences of Pharmacy

Woro Supadmi, Shafira Diestra Afifa, Fiya Nailil Izzah, Rizky Gustinanda

Hypertension prevalence in the Special Region of Yogyakarta (31.8%) is higher than the national average (30.8%), and long-term medication use may create a burden that negatively affects adherence. This study aimed to evaluate the relationship between medication-related burden and adherence among hypertensive outpatients at Panembahan Senopati Bantul Regional Hospital and Yogyakarta City Regional Hospital. Using a cross-sectional design, 161 patients were recruited between January and February 2025. Medication-related burden was assessed with the Living with Medicines Questionnaire version 3 (LMQ-3), while adherence was measured using the Medication Adherence Rating Scale-5 (MARS-5). Most patients experienced a low burden (76.4%), followed by no burden (15.5%) and moderate burden (8.1%). Regarding adherence, 83.2% showed moderate adherence and 16.8% high adherence. Spearman’s correlation analysis revealed a significant negative relationship between medication-related burden and adherence (p=0.000; Rho = -0.461). These findings suggest that a higher treatment burden reduces adherence to antihypertensive therapy, highlighting the need for strategies to minimize patient burden and improve treatment outcomes.

Sciences of Pharmacy

Rika Sari Dewi, Puspita Eka Wuyung, Melva Louisa, Ni Made Dwi Sandhiutami, Irandi Putra Pratomo

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) represent critical events in disease progression, yet their complex pathophysiology remains incompletely understood. Understanding the mechanisms underlying these exacerbations is essential for developing effective therapeutic strategies and improving patient outcomes. This literature review aims to synthesize current knowledge on the cellular and molecular mechanisms driving acute exacerbations of COPD, highlighting the importance of utilizing appropriate animal models for future research. This review identified rodent models, particularly mice (C57BL/6 strain) and rats (Sprague-Dawley) are predominantly employed due to their genetic tractability and physiological relevance, with occasional use of guinea pigs for airway hyperresponsiveness studies. Combined approaches using cigarette smoke exposure followed by inflammatory triggers (LPS, viral infections) showed the highest translational relevance. Key pathophysiological mechanisms studied include neutrophilic inflammation, oxidative stress, airway remodelling, and mucus hypersecretion. Current animal models provide valuable insight into AECOPD pathophysiology but face limitations in fully recapitulating human disease complexity. Future directions should focus on incorporating comorbidities, aging, and standardized outcome measures.

Sciences of Pharmacy

Cholid Muzakar, Ni Made Dwi Sandhiutami, Hesty Utami Ramadaniati, Bimantoko Hadi Sriyono

Vertical transmission of hepatitis B virus (HBV) remains a major public health challenge in Indonesia, particularly among pregnant women with high viral loads. Tenofovir disoproxil fumarate (TDF) has been recommended to prevent perinatal transmission; however, local data regarding its efficacy and safety remain limited. This study aimed to evaluate Analyzing the effectiveness and safety of TDF in HBsAg-reactive pregnant women and its relationship with the infant's HBsAg status is necessary. An observational cohort study was conducted on 103 HBsAg-reactive pregnant women at five referral health facilities in Jakarta. Maternal effectiveness was measured by changes in SGPT and SGOT levels before and after therapy using the Wilcoxon test. Safety was assessed based on adverse events, pregnancy complications, and renal function using the chi-square test. Infant effectiveness was analyzed based on HBsAg status and tested using multivariate logistic regression. TDF significantly reduced SGPT and SGOT levels (p < 0.001). No significant association was found between TDF duration and adverse events, complications, or renal impairment (p > 0.05). Ninety-one-three percent of infants were HBsAg non-reactive, and 93.2% received complete hepatitis B vaccination. Complete vaccination (OR = 414.52; p < 0.001) and the absence of pregnancy complications (OR = 0.048; p = 0.021) were the main protective factors. TDF is safe and effective in preventing vertical transmission of HBV. Successful prophylaxis is highly dependent on infant vaccination and maternal health. These results support the integration of TDF into the national hepatitis B elimination program. 

Sciences of Pharmacy

Fajriansyah Fajriansyah, Keri Lestari, Zulfahmidah Zulfahmidah

Evidence on health-related quality of life (HRQoL) among hospitalized COVID-19 patients in Indonesia remains limited, particularly during the acute phase of infection. This study aimed to describe HRQoL and its associated sociodemographic and clinical factors among hospitalized COVID-19 patients in Indonesia. A cross-sectional study was conducted among adult patients with polymerase chain reaction confirmed COVID-19 who were hospitalized at Rumah Sakit Darurat COVID-19 (RSDC) Wisma Atlet, Jakarta, between October - December 2021. HRQoL was assessed using the validated Bahasa Indonesia version of the EQ-5D-5L questionnaire, including the utility index derived from the Indonesian value set and the EQ visual analogue scale (EQ-VAS). Descriptive statistics were used to summarize HRQoL distributions, and group differences were analyzed using the Mann–Whitney U test and Kruskal–Wallis test. A total of 154 patients were included in the analysis. The mean EQ-5D-5L utility index was 0.762 (SD 0.23; 95% CI: 0.726–0.798), and the mean EQ-VAS score was 75.00 (SD 15.81; 95% CI: 72.48–77.52). Utility index values ranged from 0.311 to 1.000, with 31.17% of participants reporting full health. Among the EQ-5D-5L dimensions, anxiety/depression was the most frequently reported problem (68.83%). Statistically significant differences in utility index scores were observed across sex, age groups, and occupational status (p < 0.05). In conclusion, hospitalized COVID-19 patients in Indonesia reported moderately high overall HRQoL, while psychological problems particularly anxiety and depression were highly prevalent. These findings highlight the importance of integrating mental health support into inpatient care and recovery services. 

Sciences of Pharmacy

Yuliawati Yuliawati, Fathnur Sani Kasmadi, Elisma Elisma, Hasna Dewi, Amelya Afryandes, Vanya Gita Puteri

In addition to its widespread use as a culinary spice, white turmeric rhizome (Curcuma zedoaria (Christm.) Roscoe) exhibits important pharmacological activities, including anti-inflammatory, anticancer, and antioxidant effects. The rhizome contains secondary metabolites such as flavonoids, alkaloids, saponins, phenols, tannins, and terpenoids, which are believed to contribute to its potential efficacy in treating burns. This study used a fully randomized post-test-only control group design consisting of five treatment groups: P1 (5% ethanol extract of white turmeric rhizome), P2 (10%), P3 (15%), K⁺ (positive control: Bioplacenton), and K⁻ (negative control: Vaseline flavum). Parameters observed included reduction in burn wound diameter and collagen density, which were assessed through histological analysis. The results showed significant differences between treatment groups (p &lt; 0.05). The 10% concentration showed the highest wound healing activity, reaching a healing rate of 54.72% and producing denser collagen compared to the other treatments. However, its effect did not exceed the positive control (Bioplacenton). The 5% concentration showed moderate healing activity (43.84%) with intermediate collagen density, while the 15% concentration produced the lowest effect. Overall, the findings indicate that the ethanol extract of white turmeric rhizome, particularly at a concentration of 10%, enhances burn wound healing and increases collagen formation, supporting its potential as a natural therapeutic agent for the treatment of burns.

Sciences of Pharmacy

Theodorus Rexa Handoyo, Juniar Kalpika Resmi, Rahmi Hutabarat, Yovi Guanse

Red apple (Malus domestica) extract, rich in hydrophobic quercetin, was formulated into oil-in-water (O/W) emulsion using a 22 factorial design to evaluate Tween 80 (8-10 g) and Span 80 (2-4 g) concentrations, targeting pH (4.5-6.0), transmittance (90-100%), and viscosity (10-2000 cPs). Design-Expert® 13 analysis identified formulations F1, FA, and FAB within acceptable physical property ranges, with all red apple emulsions exhibiting O/W type, skin-compatible pH (5.20-5.48), high transmittance, and suitable viscosity. Freeze-thaw cycling (3 cycles, -15/25°C) and centrifugation showed physical stability with non-significant changes for F1 (p > 0.05). The agar well diffusion assay was performed on F1 (n = 3), which exhibited optimal physical parameters and met stability criteria, revealing Cutibacterium acnes inhibition zones up to 22.7 ± 0.577 mm. Thus, F1 emerges as a promising nanoemulsion candidate demonstrating antibacterial activity against acne-causing bacteria.

Sciences of Pharmacy

Sahat Saragi, Embriana Dinar P., Aditya Jamaludin

The rapid development of digital health technology has encouraged startups to continuously adapt their business models in response to regulatory, technological, and market challenges. This study aims to explore how a digital health startup in Indonesia adapts and transforms its business model within the evolving digital healthcare ecosystem. This research employed a qualitative exploratory case study design focusing on HonestDocs as a single case. Data were collected through semi-structured in-depth interviews with three key informants representing strategic managerial roles and were analyzed using thematic analysis following Braun and Clarke’s framework. To enhance credibility, interview findings were compared with selected internal documents and operational information. The findings indicate that business model adaptation in this case is characterized by three main patterns: the use of lightweight digital infrastructure, the integration of personalized customer service, and flexible operational strategies in responding to regulatory and logistical constraints. The study also shows that organizational culture and collaborative work practices appear to play an important role in supporting operational adaptability. However, the findings should be interpreted with caution, as this study is based on a single case and relies primarily on internal managerial perspectives, which may limit generalizability. Despite these limitations, the study provides exploratory insights into how digital health startups in emerging markets may respond to structural constraints and evolving user needs.

Sciences of Pharmacy

Nsikakabasi Enefiok Sunday, Chinyelu Clementina Osigwe, Godwin Ndarake Enin, Ugonma Florence Uwaeme, Grace Emmanuel Essien, Jude Efiom Okokon

Telfairia occidentalis Hooke. F. (Cucurbitaceae family), a vegetable whose parts are used for both nutritional and medicinal purposes was investigated for anti-malarial activity in mice. The dried seed powder was separately cold extracted in 50% ethanol and gradient solvents (n-hexane, dichloromethane, ethyl acetate and methanol) along polarity gradient to obtained crude ethanol extract and solvents fractions of T. occidentalis seed. Based on previously established median lethal dose, the seed extract (138-553 mg/kg) and solvents fractions (276 mg/kg) were investigated for in vivo activity against Plasmodium berghei infection in mice using suppressive, prophylactic and curative standard models. Gas chromatography-mass spectroscopy (GC-MS) analysis of the active fraction was also done to identify its chemical constituents. The seed extract and fractions (138-553 mg/kg, p.o.) exerted significant (p &lt; 0.05–0.001) chemosuppressive activity against P. berghei infection in suppressive (65.67%; 18.33 ± 3.71 days), prophylactic (55.39%; 17.66 ± 2.18 days) and curative (77.48%; 18.00 ± 1.15 days) tests with methanol fraction having the highest activity. GC-MS analysis of the active methanol fraction revealed the presence of polyunsaturated fatty acids and monoterpenes which have been implicated previously in antimalarial activity of plants. These results revealed the strong antimalarial potentials of the methanol seed fraction and its phytochemical constituents which can be exploited in the development of antimalarial remedies.

Sciences of Pharmacy

Wawang Anwarudin , Salwa Diana Hanum, Liska Marlindasari, Anna Khalida Sya'bany, Nur Azizah

Tuberculosis (TB) remains a major global health concern, particularly in high-burden countries such as Indonesia. Although TB is curable, prolonged therapy, potential adverse effects, and social stigma may affect medication adherence and patients’ quality of life (QoL). Evaluating the association between adherence and QoL is important to support patient-centered TB management. This study aimed to examine the association between medication adherence and quality of life among tuberculosis patients at Permata Kuningan Hospital. A cross-sectional analytic study was conducted involving 62 TB patients selected through purposive sampling. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), and quality of life was measured using the EQ-5D-5L instrument. Data were analyzed using Spearman rank correlation. Most patients demonstrated high adherence (95.2%) and reported good quality of life (96.8%). Statistical analysis showed a significant positive correlation between medication adherence and quality of life (r = 0.384; p = 0.002), indicating that higher adherence was associated with better quality of life. These findings suggest a significant association between medication adherence and quality of life among TB patients. Strategies to support adherence, including education, counseling, and monitoring, may be considered as part of comprehensive TB care to optimize patient-centered outcomes.

Sciences of Pharmacy

Courage Chandipwisa, Agness Shimilimo, Tendai Pride Zenda, Harrison Banda

Conventional vaccines face challenges in antigen stability, delivery efficiency, and scalability, particularly in low- and middle-income countries. Nanochemistry offers innovative approaches through lipid nanoparticles, polymeric carriers, and hybrid systems. This review evaluates these platforms using criteria such as physicochemical properties, immunological outcomes, translational feasibility, and One Health relevance. A narrative literature review was conducted across major databases between 2015 and 2025. Studies were screened by title and abstract, excluded if not directly relevant to vaccine delivery, and weighted according to design, with clinical trials prioritized over in vitro or modeling studies. Reference lists of key papers were also examined to ensure comprehensive coverage. Lipid nanoparticles supported mRNA delivery in licensed COVID-19 vaccines, achieving strong immune responses but with variability across populations and reported adverse events including myocarditis and anaphylaxis. Polymeric nanoparticles such as PLGA and chitosan enabled controlled antigen release, though cost-effectiveness remains constrained by manufacturing and scalability challenges. Hybrid lipid-polymer systems demonstrated enhanced stability and multi-antigen presentation, with current evidence largely limited to preclinical studies. One Health implications are defined as the potential of nanochemistry to contribute to zoonotic disease prevention, food safety, and cross-species vaccine design, requiring clearer frameworks for integration. In conclusion, nanochemistry-based vaccine platforms show promise for advancing immunization strategies, but unresolved issues in safety evaluation, regulatory harmonization, and equitable access highlight the need for cautious interpretation and further interdisciplinary collaboration.

Sciences of Pharmacy