Phytoestrogens are a class of compounds that have estrogen-like functions or structure. This research was conducted to find out the phytoestrogens activity in Chrysophyllum cainito leaves, in increasing the vertebrae trabecular bone density of female mice, using dexamethasone induction as osteoporosis model.  The 70% ethanol extract of C. cainito leaves was given to female mice with dose of 100; 200; and 400 mg/kgBW mice/day after being induced orally with dexamethasone with 0.145 mg/kgBW mice/day. The positive control used was 1.3 mg/kgBW mice/day alendronate. This research had been done in four weeks. The increasing of trabecular vertebrae bone density of female mice was measured with Histomorphometry staining methods. The result showed the 70% ethanol extract of C. cainito leaves have activity in increasing trabecular vertebrae bone density for female mice with optimum dose of 400 mg/kgBW mice/day. This activity occurs because phytoestrogens content in 70% ethanol extract of C. cainito leaves, that may replace the function of estrogen in its bond with ER.

Objectives Estrogen deficiency causes various health problems in postmenopausal women, including osteoporosis. Phytoestrogen emerged as a potential alternative of estrogen with minimum side effects. The aims of this study were to analyze the metabolite profiling results of various extract of Chyrsophyllum cainito L. leaves, which contain phytoestrogen, through in silico study against 3OLS protein, an X-ray protein of ERβ, so it can predict the types of the phytoestrogen contents which have antiosteoporosis property. Methods In silico analysis was carried out for the compounds from the metabolite profiling data of C. cainito leaves from our previous study. The structure compounds from metabolite profiling results of various extract of C. cainito leaves were prepared with Avogadro 1.0.1 software, molecular docking was done using PyRx 0.8 software, and Biovia Discovery Studio Visualizer 2016 software was used to visualize the structure of compounds against 3OLS protein. The physicochemical characteristics of the compounds were analyzed using the SwissADME web tool. Results From in silico studies, it was known that there were total 11 compounds in C. cainito leaves that predicted as phytoestrogens which have ERβ agonist properties against 3OLS protein. The ERβ agonist was a compound that has parameters similar to 17β-estradiol in its interaction with 3OLS protein, which has a pharmacophore distance of 10.862 Å, and binding to amino acids His 475 and Glu 305 or Arg 346 at receptor-ligand docking simulation. Conclusions C. cainito leaves contain 11 compounds that are predicted to be phytoestrogens with ERβ agonist properties, which is responsible for antiosteoporosis activity.

Quercetin is a flavonoid compound of the flavonol group that has various biological activities for health. Moringa leaf is one of the plants rich in quercetin which is about 384.61 mg / 100 g. Quercetin is practically insoluble (4.5 μg / mL). To increase the solubility and release of quercetin microemulsion may be used as Drug Delivery Systems formulated with gels for transdermal use.The aim of this research is to obtain optimum combination formulation of surfactant (tween 80): cosurfactant (propylene glycol) to form optimal microemulsion system, to find out the characteristics of the preparation and to find out the rate of quercetin release of Moringa leaf extract (M. oliefera) in a gel-microemulsion preparation compared with a control gel (without microemulsion) using an HPMC (Hydroxypropyl methylcellulose) gel basis.The result shows that optimal concentration tween 80 comparison : propylene glycol to form optimal microemulsion system up to 30%: 20 % with VCO (virgin coconut oil) oil phase 5%. The characteristics observed including organoleptic, pH, viscosity, and stability are showing optimal condition. The average of quercetin content in gel-microemulsion preparation was 2,22 ± 0,077 ppm and on control gel was 2.37 ± 0.042 ppm. Quercetin release test using Franz diffusion cell using cellophane membrane, saline phosphate buffer pH 7,4 ± 0,05 and temperature 37 ± 0,5 °C for 6 hours. The average quercetin release flux in the gel-microemulsion preparation was 9.436 ± 1.178 (μg/cm 2 /min 1/2 ) and the control gel was 5,816 ± 0.485 (μg/cm 2 /min 1/2).Based on these results it can concluded that the microemulsion gel preparation gives significant difference of quercetin flux rate compared with gel preparation.

Triage bertujuan untuk memberikan prioritas perawatan kepada pasien sesuai tingkat keurgensiannya. Perawat IGD dalam melakukan triage harus berdasarkan suatu standar prosedur. Untuk dapat melakukan prosedur triage yang tepat, perawat harus memiliki kompetensi yang dibutuhkan dalam triage yang terdiri dari pengetahuan, skill/ketrampilan dan sikap. Selain kompetensi, ada beberapa faktor lain yangberperan, yaitu faktor intrinsik perawat. Tujuan penelitian ini adalah menganalisa faktor apa saja yang berhubungan dengan ketepatan perawat dalam melakukan prosedur triage di instalasi gawat darurat. Rancangan penelitian ini menggunakan analitik korelasional dengan pendekatan cross sectional. Populasi pada penelitian ini adalahkeseluruhan perawat yang bekerja aktif di Instalasi Gawat DaruratRSUD di Kabupaten Malang dan Kota Blitardan jumlah sampel 32 responden dengan menggunakan teknik total populasi.Instrumen yang digunakan adalah lembar observasi dan kuesioner. Data penelitian dianalisis menggunakan analisis multivariat Partial Least Squares (PLS). Hasil analisis multivariat menunjukkan terdapat hubungan tingkat pengetahuan (p-value 0.000), tingkat keterampilan (p-value 0.000), sikap (p-value 0.000), faktor intrinsik (p-value 0.000) terhadap ketepatan perawat dalam melakukan prosedur triage. Berdasarkan hasil tersebut, perlunya peran pihak manajemen rumah sakit dapat meningkatkan kompetensi perawat dalam melakukan triage, terutama dengan mengikutsertakan dalam pelatihan kegawatdaruratan lanjut dan pelatihan triage.