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Venous thromboembolism (VTE) is a serious complication that can occur during and after postoperative treatment, including in treatment after orthopedic surgery. The current guidelines for VTE prophylaxis in postoperative patients recommend the use of LMWHs, one of which is enoxaparin. Another recommendation for use in pharmacological VTE prophylaxis is rivaroxaban, which has better efficacy than enoxaparin but a higher bleeding risk. The aim of this systematic review is to provide an update on the profile of rivaroxaban for VTE prophylaxis after orthopedic surgery. PubMed, SCOPUS, EMBASE, and EBSCOhost were searched up until May 2022. The outcome sought was efficacy and safety, described by the incidence of VTE and incidence of bleeding, respectively. Five randomized controlled trials (RCT) were finally included. Rivaroxaban was confirmed to have better efficacy by significantly reducing the risk of VTE and all-cause mortality (RR = 0.38; 95% CI = 0.27–0.54) compared to enoxaparin. However, regarding the safety variable, no significant difference was found between the incidence of major bleeding in rivaroxaban and enoxaparin (RR = 0.97; 95% CI = 0.56–1.68). The results of the analysis show that rivaroxaban has better efficacy than enoxaparin but the same safety profile, so when used, the bleeding of patients should still be monitored.

Over the past few decades, treatment options have become more advanced for multiple myeloma (MM), one of the most prevalent hematological cancers; however, multiple myeloma remains an incurable disease due to its poor response to therapy and high rates of resistance, which cause relapsed/refractory or multiple myeloma. Researchers have described anti-BCMA (B-cell maturation antigen) as a promising treatment regimen that targets the BCMA biomarker in the affected plasma cells. BCMA is a protein that is specifically expressed in plasma-cell neoplasms by using several mechanisms, such as CAR T cells (Chimeric Antigen Receptor T cells), antibody-drug conjugates, and bispecific T-cell engagers, thus allowing for a rapid response in the treatment of resistant or relapsed/refractory multiple myeloma patients. Anti-BCMA treatment is novel and specific in its mechanisms of action, with noninferior complete responses, higher overall survival rates, and fewer reported adverse events compared to other currently available treatment of MM. In this review, we compared anti-BCMA mechanisms with those of previously available therapies, such as those using immunomodulators and proteasome inhibitors, and discussed the advantages of using anti-BCMA as a potential first-line treatment for multiple myeloma patients.

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Breast cancer is the most common cancer worldwide and in Indonesia. Kaempferia pandurata Roxb. is a herbal plant from South-East Asia which is known for its ability to inhibit the growth of Estrogen Receptor (ER) + breast cancer cell line from the former study. However, its effect on ER-breast cancer cell lines had not been studied. Therefore, we want to examine the cytotoxicity effect of K. pandurata Roxb. on ER-breast cancer cell line (MDA-MB-231). Nanoparticle is a form of preparation that optimizes the activity of any compound to the targeted cell. Therefore, it is expected that it can increase the effectivity of anticancer in Kaempferia pandurata Roxb. In this study, the rhizome of K. pandurata Roxb. trituration was dried and extracted with n-hexane solvent. Nanoparticle of K. pandurata Roxb. was synthesized with CaCl2, chitosan, and alginate by stirring with a magnetic stirrer, adjusting pH, and centrifugation. Then, nanoparticle was analized by UV/VIS spectrofotometry and transmission electron microscopy (TEM). The cytotoxicity of K. pandurata Roxb. extract and nanoparticle were examined with MTT assay. The result of this test is data of inhibition percentage and IC 50 value. The result showed that n-hexane extract of K. pandurata Roxb. is synthesized into nanoparticle form with 99,43% yield percentage (entrapment value). Anticancer activity of n-hexane extract and nanoparticle of K. pandurata Roxb. is moderate with IC 50 value of the extract is 87,23 μg/ml and the nanoparticle is 24,23 μg/ml. The nanoparticle's activity is better than the extract. n-Hexane extract and nanoparticle of K. pandurata Roxb. has cytotoxicity effects towards MDA-MB-231 cell line. Nanoparticle can increase the cytotoxicity effect of K. pandurata Roxb. extract because its hydrophobic feature and nanometer size. . The free variables in this study are K. pandurata Roxb n-hexane extract and nanoparticle, the bound variable is MDA-MB-231 breast cancer cell, and the confounding variables are temperature and pH. K. pandurata Roxb. preparationKaempferia pandurata Roxb. was used in this study was obtained from Banjarnegara, West Java. MDA-MB-231 cell lines where obtained from Biobank Research FKUI-RSCM. The cell was supplemented with 10% fetal bovine serum (FBS) and incubated at 37 o C with 4% CO 2 . The viability of the cell is determined with trypan blue 0,1%. GRAPHICAL ABSTRACTNanoparticle is a form of preparation that optimizes the activity of any compound to the targeted cell. Therefore, it is expected that it can increase the effectivity of anticancer by MTT assay on cell line from extracts of Kaempferia pandurata Roxb. In this study, rhizome of K. pandurata Roxb. as anticancer activity on MDA-MB-231 breast cancer cell line of n-hexane extract and nanoparticle of K. pandurata Roxb. is moderate with IC 50 value of the extract is 87,23 μg/ml and the nanoparticle is 24,23 μg/ml. SUMMARYFadilah Fadilah obtained his doctor's degree from the pharmaceutical chemistry, Faculty of pharmacy Universitas Indonesia. She has lecturer and research...