No abstract

<p>Di Indonesia, angka kematian ibu akibat perdarahan pasca-persalinan (PPP) masih tinggi, terutama di wilayah pedesaan dengan akses terhadap oksitosin sebagai obat lini utama masih sangat terbatas. Misoprostol berpotensi menjadi alternatif oksitosin untuk penanganan PPP di wilayah pedesaan. Telaah literatur manfaat misoprostol menggunakan search engine Google Scholar, PubMed, dan NCBI, dengan kata kunci “misoprostol”, “perdarahan pasca-persalinan”, “wilayah dengan sumber daya rendah”, farmakokinetika”, “farmakodinamika”, dan “Indonesia”. Ditinjau dari aspek Cmax, Tmax, dan AUC, jalur sublingual diduga paling efektif. Penelitian lebih lanjut diperlukan untuk memastikan rute pemberian serta dosis misoprostol yang paling efektif untuk penanganan kasus PPP. Namun, misoprostol belum terdaftar di Daftar Obat Esensial Nasional (DOEN). Ditetapkannya misoprostol dalam DOEN akan memastikan ketersediaannya di fasilitas kesehatan di Indonesia, sehingga manajemen PPP di wilayah pedesaan dapat lebih efektif.</p><p>In Indonesia, postpartum hemorrhage (PPH) continues to be a leading cause of maternal death, especially in rural areas with limited access to oxytocin as the first-line therapy in PPH management. Misoprostol can become an alternative drug for PPH management in rural areas. Literature search was conducted using Google Scholar, PubMed, and NCBI, with keywords including “misoprostol”, “perdarahan pasca persalinan”, “wilayah dengan sumber daya rendah”, “farmakokinetika”, “farmakodinamika”, and “Indonesia”. Evaluation of Cmax, Tmax, and AUC showed that the most effective route of delivery for misoprostol is by sublingual administration. Further research is needed to confirm the most effective delivery route as well as optimal misoprostol dosage for PPH management. However, misoprostol has not been enlisted in Daftar Obat Esensial Nasional (DOEN). Inclusion of misoprostol in DOEN will help ensure its availability in health facilities across Indonesia, towards a more effective management for PPH in rural areas.</p>

<p>Perdarahan pasca-persalinan (PPP) adalah komplikasi persalinan yang menyebabkan 35% seluruh kematian ibu di dunia. Meskipun PPP mulai jarang ditemui di negara maju, kondisi ini masih merupakan salah satu penyebab utama kematian ibu di negara berkembang seperti Indonesia. Hal ini antara lain akibat infastruktur kesehatan yang kurang optimal, sehingga terlambat mengidentifikasi faktor risiko PPP, merujuk, serta memberikan intervensi tepat waktu. Kajian pustaka ini mengamati adanya hubungan signifikan antara penurunan kematian ibu akibat PPP dan implementasi sistem peringatan dini obstetri, manajemen efektif, dan optimalisasi alur rujukan. Namun, karena tiap wilayah memiliki aspek sosioekonomis dan geografis yang berbeda, studi lanjutan diperlukan untuk menentukan pendekatan yang tepat bagi masing-masing wilayah di Indonesia.</p><p>Postpartum hemorrhage (PPH) is a life-threatening condition that contributes to 35% of all maternal deaths worldwide. Although the risk of PPH has greatly declined in developed countries, it remains a leading cause of maternal mortality in developing countries like Indonesia. This issue could mainly be attributed to poor healthcare system and infrastructure leading to delay in identifying risk factors, referring mothers-at-risk to health centers, and appropriate intervention. We observed a notable relationship between decrease in maternal deaths due to PPH and the implementation of early warning system, effective PPH management, and optimization of referral system. These healthcare innovations showed promising potential in reducing the burden of PPH. However, since there is no single health policy that can be universally implemented, further research is needed to decide the best approach for each area depending on individual, socio-economic and geographic aspects.</p>

Ageing involves destruction on the molecular, cellular, and organ level, causing disease and death. Previous research has discovered that both diet and genetics can affect ageing. Forkhead helix box (FOXO) transcription factors are found to be the major transcription factors correlated with longevity. In addition, one of the best-known signals that are also capable to affect ageing is a dietary restriction (DR) which is evolutionary conserved. The objective of this paper is to expand our knowledge regarding the FOXO3 gene expression as anti-ageing biomarker, and how DR could impact its expression. This review was written through a rigorous searching process from various databases including Google Scholar, Science Direct, Scopus, and PubMed, by utilizing keywords such as the ‘anti-ageing’, ‘dietary restriction’ along with ‘forkhead box O3 gene’. FOXO3 exerts its essential role through the protein kinase B (Akt/PKB) signaling pathway, as well as post-translational modifications, further activating downstream target genes. This would result in cell apoptosis, cell cycle arrest, DNA repair, and other important physiological processes. Relating to diet, the FOXO3 gene is expressed when organisms face low nutrient availability. It can also be downregulated by reducing the amount of circulating insulin-like growth factor 1 (IGF-1) level which can be achieved through fasting. Meanwhile, DR can enhance the FOXO3 expression, anti-ageing effects and further establish longevity. However, the research regarding the effect of DR in humans is still limited. Future studies need to investigate the optimal type of DR along with uncovering the molecular mechanism behind the FOXO3 expression and ageing.