Background: Diabetes Mellitus is a metabolite disorder with parameters of high blood sugar levels. In the management of diabetes can be used the drug metformin is the gold of choice to achieve a therapeutic effect and rarely causes side effects of the drug, but it still has debate view. However, if used in excessive doses for patients with kidney disease, it will be contraindicated with side effects such as lactic acidosis. Objective: This study aims to evaluate the side effect of Metformin for diabetic kidney diseases (DKD) patients. Method: This study used the Narrative Review Method that was obtained from 2011 to 2021, in the English language from PubMed, Google Scholar, and Cochrane Library. Results: Metformin is at the forefront of the treatment of type 2 diabetes mellitus (DM2). Metformin is likely to have lactic acidosis-related adverse effects in chronic kidney disease (CKD) patients, such as increased arterial lactate. Lactic acidosis is defined as an increase in arterial lactate with an indicator of more than five mmol/L and an arterial blood pH of less than 7.35. Metformin-induced lactate levels are considered to be below the parameters. DKD risk factors can be conceptually classified as several susceptibility factors, initiation factors, and developmental factors. The two most prominent risk factors are hyperglycemia and hypertension. Conclusion: Metformin can increase lactate levels in CKD patients but is still below the parameters of lactic acidosis. This study may have some weaknesses and requires further prospective research to validate the results.

One of the plants that has been used for generations in Borneo is kratom or Mitragyna speciosa. The leaves are used as analgesics and antidepressants. The plant is grown for export to countries other than Indonesia where consumption of this plant as a beverage is still legal, generally in tea from leaves brewed with hot water or tea bags. Some researches found that tea products from kratom leaves contained potentially dangerous levels of toxic metals and microbes. This study aims to examine the food contaminants in tea products from three types of kratom tea leaves used by the people of Borneo: Red, white, and green kratom variants.Bacterial colony tests for red kratom samples produced 2.9 x 10 -3 colony forming unit (CFU)/gram. In comparison, white kratom samples produced 9.9 x 10 -3 CFU/gram and green kratom samples produced 2.9 x 10 -3 CFU/ gram. White kratom samples produced the highest CFU compared to red and green samples. Red kratom samples produced an uncountable number of yeasts at 10 -2 and 10 -3 dilution, while at 10 -4 dilution, it produced a total of 4.8 x 10 -5 CFU/gram. White kratom samples produced 3.04 x 10 -4 CFU/gram and green kratom samples produced 1.7 x 10 -4 CFU/gram. Red kratom samples produced the highest number among the three samples, while green kratom produced the lowest number. Identification with other specific media, namely Eosin Methylene Blue Agar (EMBA) and Salmonella-Shigella Agar (SSA), produced negative results for all samples. The red samples produced the highest of 6.6% b/b sample compared to 6.1% of white and 5.2% of green samples. All samples produced a positive qualitative test of mitragynine alkaloid. White kratom samples showed the highest Cd and Cu contamination, green kratom samples showed the highest Pb contamination and red samples showed the highest Hg contamination. Before preclinical and human clinical trial, it is advised to sterilize herbal simplicias of kratom as they tend to induce bacterial and fungal colonization. In some countries where kratom beverages are still legal, before the leaves were prepared for sale as tea it is better to

Background: Diabetes mellitus is a metabolite disorder with parameters of high blood sugar levels. In the management of diabetes can be used the drug metformin is the gold of choice to achieve a therapeutic effect and rarely causes side effects of the drug, but it still has debate view. However, if used in excessive doses for patients with kidney disease, it will be contraindicated with side effects such as lactic acidosis. Objective: This study aims to evaluate the side effect of metformin for diabetic kidney disease (DKD) patients. Methods: This study used the Narrative Review Method that was obtained from 2011 to 2021, in the English language from PubMed, Google Scholar, and Cochrane Library. Results: Metformin is at the forefront of the treatment of type 2 diabetes mellitus (DM2). Metformin is likely to have lactic acidosis-related adverse effects in chronic kidney disease (CKD) patients, such as increased arterial lactate. Lactic acidosis is defined as an increase in arterial lactate with an indicator of more than five mmol/L and an arterial blood pH of less than 7.35. Metformin-induced lactate levels are below the parameters. DKD risk factors can be conceptually classified as several susceptibility factors, initiation factors, and developmental factors. The two most prominent risk factors are hyperglycemia and hypertension. Conclusion: Metformin can increase lactate levels in CKD patients but is still below the parameters of lactic acidosis. This study may have some weaknesses and requires further prospective research to validate the results.

Background: One of the deadliest parasite infections is malaria. A combination of quinine sulphate and doxycycline is another therapeutic option for malaria that is resistant to chloroquine and is anticipated to be able to both combat the issue of anti-malarial medication resistance as well as the compliance to malaria therapy that is still raging in certain locations of Indonesia. Aim: This study will focus on evaluating the possibility of interaction between quinine sulphate and doxycycline followed by formulating the fixed-dose combination of both active pharmaceutical ingredients. Method: The study was designed as a laboratory experiment and applied some examinations. The examination from the organoleptic test of active pharmaceutical ingredients powder, crystallography analysis, and physical analysis of fixed-dose tablet including hardness, friability, and disintegration time testing. Result: The crystallography study reported there was no physical interaction found between quinine sulphate and doxycycline. The formula found excellent tablet printability with a composition of Quinine sulphate and doxycycline (Qidox). Conclusion: quinine sulphate with doxycycline can be combined into one tablet as Fixed-Dose Combination (FDC).

Background: The COVID-19 pandemic is a devastating blow to the entire world community and changes the order of human life. Purpose: All efforts and strategies are being carried out to contain and reduce the spread of the SARS-CoV-2 virus by tightening the health protocol and using vaccines for the public. Currently, several vaccines are available and have passed phase 3 clinical trials, such as vector vaccines (Gamaleya Sputnik V Russia, University of Oxford/AstraZeneca, CanSino, and Janssen Pharmaceutical Companies), mRNA-based vaccines (Moderna/BioNTech/Fosun Pharma/Pfizer), inactivated vaccines (Sinovac and Sinopharm from China, Covaxin from Bharat Biotech India) and adjuvanted recombinant protein nanoparticles (Novavax from the USA), which are expected to be able to suppress the spread of the virus and produce a minimum of 70% herd immunity in a population. This study uses a narrative review from reputable publications and is closely related to the topic. Result: Each vaccine's efficacy varies from the lowest, namely, the Sinovac vaccine (CoronaVac) 50%, to the highest the Novavax vaccine (NVX-Cov2373) 96% effectivity value. However, further rigorous research is still being carried out to develop an effective and efficient vaccine. Health workers are the last bastion to handle COVID-19 patients. Conclusion: The primary purpose of the present immunization is to prevent and minimize the spread of COVID-19. At this time, the availability of a variety of vaccines is expected to provide strategic answers to the pandemic scenario that has afflicted countries all over the world.