Background and Aim: Metaflammation plays a significant role in the pathogenesis, development, and complication of diabetes mellitus (DM). This inflammation is associated with insulin resistance. Therefore, the inflammatory pathways have been targeted for pharmacological treatment. Petiveria alliacea can decrease blood glucose levels and has anti-inflammatory and antioxidant activities; however, there are still insufficient data regarding its efficacy for the treatment of DM. This study aimed to investigate the effect of the self-nanoemulsifying drug delivery system (SNEDDS) of P. alliacea leaf extract on the homeostatic model assessment (HOMA)-insulin resistance (IR) value and interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) levels in a streptozotocin (STZ)-induced diabetic rat model. Materials and Methods: Thirty-five diabetic rat models were randomly divided into five groups. The first group received the SNEDDS of P. alliacea leaf extract at a dose of 50 mg/kg body weight (BW), the second group received it at a dose of 100 mg/kg BW, the third group received it at a dose of 200 mg/kg BW, the fourth group received 18 mg of metformin, and the fifth group only received the SNEDDS formula. The treatment was administered once a day, orally, for 14 days. On the 15th day after treatment, the rats were sacrificed to obtain blood samples for cardiac examination. The IL-6, TNF-α, and insulin levels in the serum were measured using the enzyme-linked immunosorbent assay method. The HOMA-IR value was calculated using a formula. Results: The mean IL-6 and TNF-α levels were low in the group that received the SNEDDS of P. alliacea leaf extract. There was no significant difference in the insulin level in all treatment and control groups. However, a significant difference in the HOMA-IR value was noted between the group that received the SNEDDS of P. alliacea leaf extract and metformin and the group that did not receive treatment (p<0.05). Conclusion: The SNEDDS of P. alliacea leaf extract reduced the HOMA-IR value and suppressed the TNF-α and IL-6 levels in the STZ-induced diabetic rat model.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe eruptive skin reactions that can cause death. The incidence of SJS and TEN cases in the United States is 1.5–9.6 per 1,000,000 per year. Drugs are the primary etiology of SJS and TEN. Some drugs are at high risk and used frequently. The SJS and TEN mortality rates were relatively high, with SJS 4.8%, SJS / TEN overlap 19.8%, and TEN 14.8%. In Indonesia, there are lack of studies on the SJS and TEN. This study is needed to determine the epidemiological profile of SJS and TEN. Purpose: This study aimed to describe SJS and TEN patients' profiles. Methods: Drug-induced SJS and TEN cases from January 2016 to December 2019 were evaluated from the medical records patients' profile, incidence, suspected drugs, risk factors, and comorbidities of SJS and TEN were described. Result: There were 28 SJS and TEN patients, comprising of 24 SJS patients (85.7%), 3 TEN patients (10.7%), and 1 SJS overlapping TEN patients (3.5%). The most common suspected drugs were paracetamol (22.2%), carbamazepine (20.4%), cefadroxil (8.8%), and ciprofloxacin (8.8%). Women (53.5%) experienced more severe drug eruptions than men (46.4%). The largest age group was 25–44 years (35.7%). Most comorbidities were epilepsy (21%), diabetes (15.7%), hypertension (15.7%), and stroke (15.7%). Conclusion: The most common manifestation was SJS with paracetamol as the most common suspected drug, followed by carbamazepine.

This study aimed to measure supplement consumption behavior and mental health status among Indonesian adults during the second year of COVID-19. Participants and Methods: Online questionnaire regarding supplement consumption, and Depression, Anxiety, Stress Scale 21 (DASS-21) was distributed from March to June 2021 and obtained 1006 valid and completed questionnaires. Descriptive and inferential analyses were conducted to determine the frequency and predictor factors of the respondents' supplement consumption behavior and mental health status. Results: Respondents were divided into two groups, vulnerable and non-vulnerable individuals. The finding showed that 34.5% respondents were vulnerable individuals, including the elderly and those with comorbid disease(s). The vulnerable and non-vulnerable groups exhibited a high prevalence of supplement consumption, with the vulnerable group demonstrating a greater tendency for regular use. The incidence of mental health problems in both groups did not significantly differ (23-38%), where anxiety was higher than depression and stress. Supplement consumption was associated with mental health status. Several positive predicting factors for supplement consumption behavior included older age, higher economic status, and higher education. While the younger age and unmarried respondents were more likely to develop mental health problems. Conclusion: Taken together, given dietary supplement consumption increased during the pandemic and the potential associations between supplement consumption and mental health, controlling the correct information and regulation regarding supplements, especially their risks and benefits, was important. Additionally, support for mental health issues was necessary, since it might affect self-medication behavior.

Objective: Formulation of Singawalang leaves extract should be considered because the extract contains a variety of compounds so that there maybe a competitor in the absorption process and will cause the absorption of active ingredients in the gastrointestinal decline. One way to increase theabsorption and disposition of active ingredients on target organs is to use a nanoparticle formulation. Therefore, this study will conduct research onself-nanoemulsifying drug delivery system (SNEDDS) formulation of Singawalang (Petiveria alliacea) leaves extract.Methods: The systems were developed by investigating the solubility Singawalang leaves extract in various carrier oil, the suitable surfactant,and cosurfactant, construction of SNEDDS of Singawalang leaves extract and characterization of droplet size through particle size analyzer andtransmission electron microscopy.Results: The results of this study indicate that the optimum carrier oils for Singawalang leave extract are miglitol and virgin coconut oil (VCO),the compatible surfactant component is tween 80 and the compatible cosurfactant is propylene glycol (PG). The average droplet size is 13 nm andpolydisperse index 0,004 and 0,006.Conclusion: It can be concluded, the present study demonstrated that the optimum SNEDDS formulations of Singawalang leave extract are themixture of VCO, tween 80, PG at ratio 1:8:1 and miglitol, tween 80, and PG at ratio 2:5:3.

Background: To increase vaccination coverage, it is important to understand COVID-19 vaccination programs and respondents’ acceptance. Therefore, this study aimed to measure respondents’ knowledge of the COVID-19 vaccine and its acceptance among Indonesian adults in Java. Methods: A web-based survey was distributed through social media on self-claimed knowledge, risk and benefits of the vaccine, as well as respondents’ acceptance and experiences of the vaccination. The survey period was from March to July 2021, and 910 responses were included for further analysis. The frequency of each categorical factor, including self-claimed knowledge of the COVID-19 vaccine, their descriptive benefit and side effects of the COVID-19 vaccine, and their experiences receiving or not receiving the vaccine were explored. Predictor factors on vaccine knowledge and acceptance are investigated using multivariate ordinal regression analysis. Results: This study showed that almost all the respondents in both groups have knowledge about COVID-19 vaccination, or at least ever heard about it. The main source of information is social media. More than two third of respondents from each group had already received a COVID-19 vaccine or were at least on the waiting list. Moreover, a quarter of the respondents still hesitate to receive the vaccination. Only less than 10% of respondents reject the vaccination, with the strongest reason being scared of the side effect. Moreover, it found that respondents’ knowledge of the vaccination was influenced by age, medical background, a history of relatives who tested positive for COVID-19, source of information, economic status, and education levels. Moreover, the acceptance was influenced by age, knowledge about vaccines, and having medical background. Conclusions: This study showed high levels of knowledge and acceptance of the COVID-19 vaccine among adults in Java. Increasing understanding or knowledge about COVID-19 vaccine risks and benefits is necessary to reduce vaccination hesitancy.