Jamu: Indonesian traditional herbal medicine towards rational phytopharmacological use

Evaluation of the antiplasmodial and anti-Toxoplasma activities of several Indonesian medicinal plant extracts

ETHNOPHARMACOLOGICAL RELEVANCE

Malaria, caused by Plasmodium parasites, remains a significant global health challenge, particularly in tropical and subtropical regions. At the same time, the prevalence of toxoplasmosis has been reported to be 30% worldwide. Traditional medicines have long played a vital role in discovering and developing novel drugs, and this approach is essential in the face of increasing resistance to current antimalarial and anti-Toxoplasma drugs. In Indonesian traditional medicine, various plants are used for their therapeutic properties. This study focuses on eleven medicinal plants from which nineteen extracts were obtained and screened for their potential medicinal benefits against malaria and toxoplasmosis.

AIMS OF THE STUDY

The aim of this study was to evaluate the efficacy of extracts from Indonesian medicinal plants to inhibit Plasmodium falciparum, a parasite responsible for malaria, and Toxoplasma gondii, an opportunistic parasite responsible for toxoplasmosis.

METHODS

Nineteen extracts from eleven plants were subjected to in vitro screening against P. falciparum 3D7 (a chloroquine-sensitive strain) and the T. gondii RH strain. In vitro treatments were conducted on P. falciparum 3D7 and K1 (multidrug-resistant strains) using the potent extracts, and in vivo assessments were carried out with mice infected with P. yoelii 17XNL. LCMS analysis was also conducted to identify the main components of the most effective extract.

RESULTS

Seven extracts showed significant antiplasmodial activity (>80% inhibition) at a concentration of 100 μg/ml. These extracts were obtained from Dysoxylum parasiticum (Osbeck) Kosterm., Elaeocarpus glaber (Bl.) Bijdr., Eleutherine americana Merr., Kleinhovia hospita L., Peronema canescens Jack, and Plectranthus scutellarioides (L.) R.Br. Notably, the D. parasiticum ethyl acetate extract exhibited high selectivity and efficacy both in vitro and in vivo. Herein, the key active compounds oleamide and erucamide were identified, which had IC50 values (P. falciparum 3D7/K1) of 17.49/23.63 μM and 32.49/51.59 μM, respectively.

CONCLUSIONS

The results of this study highlight the antimalarial potential of plant extracts collected from Indonesia. Particularly, extracts from D. parasiticum EtOH and EtOAc stood out for their low toxicity and strong antiplasmodial properties, with the EtOAc extract emerging as a notably promising antimalarial candidate. Key compounds identified within this extract demonstrate the complexity of extracts' action against malaria, potentially targeting both the parasite and the host. This suggests a promising approach for developing new antimalarial strategies that tackle the multifaceted challenges of drug resistance and disease management. Future investigations are necessary to unlock the full therapeutic potential of these extracts.

Revealing the mechanism and efficacy of natural products on treating the asthma: Current insights from traditional medicine to modern drug discovery

Asthma remains a significant global health challenge, demanding innovative approaches to treatment. Traditional medicine has a rich history of using natural products to alleviate asthmatic symptoms. However, transitioning from these traditional remedies to modern drug discovery approaches has provided fresh insights into the mechanisms and effectiveness of these natural products. This study provides our comprehensive review, which examines the current state of knowledge in the treatment of asthma. It delves into the mechanisms through which natural products ameliorate asthma symptoms, and it discusses their potential in the development of novel therapeutic interventions. Our analysis reveals that natural products, traditionally employed for asthma relief, exhibit diverse mechanisms of action. These include anti-inflammatory, bronchodilatory, immunomodulatory effects, and reducing gene expression. In the context of modern drug discovery, these natural compounds serve as valuable candidates for the development of novel asthma therapies. The transition from traditional remedies to modern drug discovery represents a promising avenue for asthma treatment. Our review highlights the substantial efficacy of natural products in managing asthma symptoms, underpinned by well-defined mechanisms of action. By bridging the gap between traditional and contemporary approaches, we contribute to the growing body of knowledge in the field, emphasizing the potential of natural products in shaping the future of asthma therapy.

Ethnobotany and diversity of Citrus spp. (Rutaceae) as a source of "Kem-kem" traditional medicine used among the Karo sub-ethnic in North Sumatra, Indonesia

The Karo sub-ethnic is one of five Batak sub-ethnicities in the Karo Regency, North Sumatra Province, Indonesia. They are famous for their local knowledge about the traditional use of medicinal plants to treat various diseases. The "Kem-kem" traditional medicine is one of the traditional healing practices that involve using plants passed down through generations from their ancestors. One of the plant genus group in the Rutaceae family utilized in the traditional "Kem-kem" healing practice is a citrus known as "Rimo". This study aims to document the local knowledge about the diversity of Citrus spp. as Kem-kem's herbal medicinal plant. This study was conducted from April to July 2023 in the Kabanjahe and Berastagi districts, Karo Regency, North Sumatra. Data was collected using interviews with traditional healers, herbal medicine vendors, and direct observations at traditional markets, involving a total of 8 Citrus spp. The Karo uses "Rimo" with different local names as sources of traditional medicinal ingredients in practicing "Kem-kem". There are 15 local names comprising eight species of Citrus. Four are hybrids, i.e., Citrus x aurantiifolia (Christm.) Swingle, Citrus × aurantium L, Citrus × junos Siebold ex Yu.Tanaka, and Citrus × taitensis Risso. Two of the remaining species are recognized in infraspecific rank, one variety (Citrus medica var. sarcodactylis (Hoola van Nooten) Swingle) and one form (Citrus × aurantium f. deliciosa (Ten.) M.Hiroe). They were used as material sources for Kem-kem traditional medicine to treat at least nine health problems. There are two species with six local names included in the Least Concern (LC) category, namely C. medica (Rimo Gawang, Rimo Hantuantu, Rimo Kayu), C. medica var. sarcodactylis (Rimo Kuku Harimau), and C. medica (Rimo Telur Buaya), C. maxima (Burm.) Merr. (Rimo Malem). Nine local names are included in the Not Evaluated (NE) category, namely C. × junos (Rimo Kejaren), C. × taitensis (Rimo Jungga), C. × aurantium f. deliciosa (Rimo Keling), C. × aurantium (Rimo Kersik), Citrus hystrix DC. (Rimo Mukur), C. × taitensis (Rimo Puraga), C. × aurantium (Rimo Kalele), Citrus swinglei Burkill ex Harms (Rimo Pagar), and C. x aurantiifolia (Rimo Bunga). Rimo Kejaren (C. × junos) is a species that has the most benefits.

Biosynthesis of copper nanoparticles using Alstonia scholaris leaves and its antimicrobial studies

The utilization of plants for the production of metallic nanoparticles is gaining significant attention in research. In this study, we conducted phytochemical screening of Alstonia scholaris (A. scholaris) leaves extracts using various solvents, including chloroform, ethyl acetate, n-hexane, methanol, and water. Our findings revealed higher proportions of flavonoids and alkaloids in both solvents compared to other phytochemical species. In the methanol, extract proteins, anthraquinone and reducing sugar were not detected. On the other hand, the aqueous extract demonstrated the presence of amino acids, reducing sugar, phenolic compounds, anthraquinone, and saponins. Notably, ethyl acetate and chloroform extracts displayed the highest levels of bioactive compounds among all solvents. Intrigued by these results, we proceeded to investigate the antibacterial properties of the leaf extracts against two major bacterial strains, Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). All extracts exhibited significant zones of inhibition against both bacterial isolates, with S. aureus showing higher susceptibility compared to E. coli. Notably, the methanol extract displayed the most potent I hibitory effect against all organisms. Inspired by the bioactivity of the methanol extract, we employed it as a plant-based material for the green synthesis of copper nanoparticles (Cu-NPs). The synthesized Cu-NPs were characterized using Fourier infrared spectroscopy (FT-IR), UV-visible spectroscopic analysis, and scanning electron microscopy (SEM). The observed color changes confirmed the successful formation of Cu-NPs, while the FTIR analysis matched previously reported peaks, further verifying the synthesis. The SEM micrographs indicated the irregular shapes of the surface particles. From the result obtained by energy dispersive X-ray spectroscopic analysis, Cu has the highest relative abundance of 67.41 wt%. Confirming the purity of the Cu-NPs colloid. These findings contribute to the growing field of eco-friendly nanotechnology and emphasize the significance of plant-mediated approaches in nanomaterial synthesis and biomedical applications.

In vitro investigation on Pennisetum purpureum leaf extracts grown in Indonesia of phytochemical components, optical characteristics, and antioxidant-antibacterial activities

Medicinal plants hold significant cultural significance and play a crucial role in the advancement of potentially safe drugs for the therapy of disease worldwide. Pennisetum purpureum or elephant grass has been used for traditional medications in Indonesia without understanding the phytochemicals of those plants. Herein, our report revolves around the qualitative and quantitative examination of phytochemical components, optical properties, antioxidants, and antibacterial assessments of solvent fractions derived from Pennisetum purpureum leaf. The Pennisetum purpureum leaf was successfully soaked with ethanol, n-hexane, and chloroform. The study aimed to assess the total phenolic content (TPC), total flavonoid content (TFC), and total alkaloid content (TAC) within different of extracts. The optical properties of extract were analyzed by absorption light and photoluminescent. Moreover, evaluation of antioxidant activities of extracts through DPPH free radical scavenging and FRAP assays, followed by an evaluation of their effectiveness in antibacterial therapy against different bacterial strains. The qualitative and quantitative phytochemical of Pennisetum purpureum presented as highest in ethanol TPC (85.5 mg GAE/g extracts), TFC (87.9 mg QE/g extracts), and TAC (86.2 mg ATE/g extracts) as compared to other solvents extract. Pennisetum purpureum extract had antioxidant capacity against DPPH radical and FRAP assay. Furthermore, each of the samples displayed antibacterial effectiveness that was dependent on the dosage towards different strains of bacteria. Our findings clearly demonstrated that Pennisetum purpureum leaf extracts grown in Indonesia containing alkaloid, flavonoid, glycoside, saponin, steroids, tannin, and terpenoids that support its capability as antioxidant and antibacterial.

Malondialdehyde and TNF-α lowering effects of purified gambier (Uncaria gambir Roxb.) in diabetic rats

BACKGROUND

Malondialdehyde (MDA) is one of a dominat marker in oxidative stress condition, and when inflammation occurred tumor necrosis factor- α (TNF-α) played a significant influence in the propagation this process. Purified gambier (Uncaria gambier Roxb.) contained 90% catechin which is proven to have antioxidant activity and may prevent unwanted inflammatory responses during diabetic state.

OBJECTIVE

The objective of this research was to assess how purified gambier affected plasma MDA and TNF- α levels in alloxan-induced diabetic rats.

MATERIAL AND METHODS

In this study, 35 rats were used. Alloxan 120 mg/kg BW intraperitoneal injection was administered to induce diabetes conditions in rats. All animals were divided into 5 groups, diabetic control group treated with vehicle, positive control group treated with glibenclamide dose 0.45 mg/kg BW), and treatment groups treated with purified gambier dose of 2.5; 5 and 10 mg/kg BW. All animals were treated respectively for 14 days. Plasma MDA and TNF- α levels were measured on day 3, and 14.

RESULTS

Two-way ANOVA was applied to analyze all of the data, these findings suggested that purified gambier has antioxidant-related anti-inflammation actions. possesses blood sugar-lowering activity (p<0.05). The plasma MDA and TNF- α level of treatment group were significantly reduced (p<0.05) compared to diabetes control group.

CONCLUSION

These results depicted that at doses of 2.5-10 mg/kg BW, purified gambier has antioxidant-associated anti-inflammation effects when given for 14 days on diabetic rat model by reducing plasma levels MDA and TNF-α.

Blood pressure lowering effects of Vernonia amygdalina Del. Aqueous fraction on hypertensive Wistar Kyoto rats

OBJECTIVES

Vernonia amygdalina (VA) is a plant that consumed as vegetable by Indonesians contained numerous secondary metabolites. VA's pharmacological action, including its antioxidant properties, anticancer, antidiabetic, and hepatoprotective. The purpose of this research is to reveal the activity of Vernonia amygdalina. leafs aqueous fraction (VALAF) as a blood pressure-lowering agent in hypertensive model.

METHODS

Combination of prednisone and NaCl were used as hypertensive inducer. The animals were split into five different groups, normal control group treated with distilled water, treatment VALAF groups with dose of 10; 20 and 40 mg/kg BW respectively, while the last group was treated with captopril at dose of 2.25 mg/kg BW. All animals were given an oral treatment for 15 days. On days 5, 10, and 15, systolic and diastolic blood pressure, heart rate (HR), mean arterial pressure (MAP), and blood flow (BF) were all measured. On days 0 and 15, NO level were assessed. All data were analyzed using two-way ANOVA, and Duncan Multiple Range Test.

RESULTS

The V. amygdalina leaf aqueous fraction has blood pressure lowering activity. The blood pressure parameter of the rats treated with VALAF were lower as compared to the normal control group (p<0.05). NO levels in the VALAF group were not significantly higher than in the normal control group (p>0.05). The VALAF 20 give the greatest percentage of decrease in blood pressure, heart rate and blood volume on the 15th day of examination.

CONCLUSIONS

These study indicated that V. amygdalina leaf aqueous fraction has the potential to be an alternative therapy for managing blood pressure in hypertensive animal models.

Indonesian Euphorbiaceae: Ethnobotanical Survey, In Vitro Antibacterial, Antitumour Screening and Phytochemical Analysis of Euphorbia atoto

Indonesia is among the countries with the most significant biodiversity globally. Jamu, the traditional medicine of Indonesia, predominantly uses herbal materials and is an integral component of the Indonesian healthcare system. The present study reviewed the ethnobotanical data of seven Indonesian Euphorbiaceae species, namely Euphorbia atoto, E. hypericifolia, Homalanthus giganteus, Macaranga tanarius, Mallotus mollissimus, M. rufidulus, and Shirakiopsis indica, based on the RISTOJA database and other literature sources. An antimicrobial screening of the plant extracts was performed in 15 microorganisms using the disk diffusion and broth microdilution methods, and the antiproliferative effects were examined in drug-sensitive Colo 205 and resistant Colo 320 cells by the MTT assay. The antimicrobial testing showed a high potency of M. tanarius, H. giganteus, M. rufidulus, S. indica, and E. atoto extracts (MIC = 12.5-500 µg/mL) against different bacteria. In the antitumour screening, remarkable activities (IC50 0.23-2.60 µg/mL) were demonstrated for the extracts of H. giganteus, M. rufidulus, S. indica, and E. atoto against Colo 205 cells. The n-hexane extract of E. atoto, with an IC50 value of 0.24 ± 0.06 µg/mL (Colo 205), was subjected to multistep chromatographic separation, and 24-methylene-cycloartan-3β-ol, jolkinolide E, tetra-tert-butyl-diphenyl ether, α-tocopherol, and β-sitosterol were isolated.

A Polymer-Based Indicator for Detecting Dexamethasone in Herbal Medicine Using Polymethylmethacrylate (PMMA)

Dexamethasone is a chemical drug that is usually added to herbal medicine because of its effects on pain relief, arthritis, anti-inflammation, etc. Chemical drugs should not be used in herbal medicine because uncontrolled consumption causes some side effects. A polymer-based indicator was developed to detect dexamethasone in herbal medicine samples in a fast and simple way compared to instrumental analysis. The indicator strips were made by mixing polymethylmethacrylate (PMMA) polymer with sulfuric acid (H₂SO₄) as a reagent. When reacting with dexamethasone, H₂SO₄ can cause the color to change into a specific light pink-purple color. Indicator strips were prepared with a composition of 5% PMMA in ethyl acetate:H₂SO₄ (9:1) by using the reagent blending method. The indicator strips showed a pink-purple color when they were applied to a positive herb containing dexamethasone. The indicator strips could selectively detect dexamethasone rather than other active substances that are often found in herbal medicine. These indicator strips could also detect dexamethasone with the smallest detection limit of 13.13 ppm, and they had a stability of up to 36 days. Detection was carried out in real samples to show the performance of the indicator strips. The result showed that of nine samples, five were confirmed to contain dexamethasone. These results showed a good agreement with the results of thin-layer chromatography (TLC) and high-performance liquid chromatography (HPLC). According to the result, these indicator strips provide a simple and applicable method for on-site analysis to detect dexamethasone in samples.

Treatment of the common cold with herbs used in Ayurveda and Jamu: monograph review and the science of ginger, liquorice, turmeric and peppermint

Background

The common cold is typically managed with decongestants, antihistamines, antitussives and antipyretics. In addition to these established medications, herbal ingredients have been used over centuries to help treat common cold symptoms. The Ayurveda and Jamu systems of medicine, originating from India and Indonesia, respectively, have leveraged herbal therapies to treat many illnesses.

Method

An expert roundtable discussion comprising specialists in Ayurveda, Jamu, pharmacology and surgery along with a literature review was conducted to evaluate the use of four herbs - ginger, liquorice, turmeric and peppermint - for common cold symptom management in Ayurvedic texts, Jamu publications and monographs from the World Health Organization, Health Canada and various European guidelines.

Discussion

Due to a lack of antivirals, common cold management revolves around maintaining personal hygiene and symptom management. Herbal medicines have been an integral part of many cultures worldwide. Despite its growing acceptance, there is a perception that healthcare providers lack interest and may prevent patients from discussing the use of herbal medicines. Limited education and training may also widen the communication gap between patients and healthcare providers, hindering effective management.

Conclusion

Evaluation of scientific evidence and the standing in international monographs can offer perspectives on the use of herbal medicines for common cold management.

The Optimal Dosage of Fermented Herbal Extract on Growth and Feed Efficiency of Nile Tilapia (Oreochromis niloticus)

Owing to their availability, cost effectiveness and environmental-friendly nature, plant extracts are promising additives for fish farming. This study aims to determine the optimal dosage of fermented herbal extract (FHE)-composed of Morus alba (33.3%), Curcuma xanthorrhiza (33.3%), and Boesenbergia rotunda (33.3%)-for growth enhancement and feed utilisation efficiency of Oreochromis niloticus fingerlings. Fermentation was conducted using probiotics Lactobacillus casei (Yakult®, Tokyo, Japan) and Saccharomyces cereviceae (commercial baker's yeast). The FHE was high in flavonoid and alkaloid, vitamin C, potassium, natrium, lipase and protease. Four doses of FHE treatments, namely treatment A (0 mg/kg of feed); treatment B (100 mg/kg of feed); treatment C (300 mg/kg of feed); treatment D (500 mg/kg of feed) were compared. After subjected to 35 days of culture, tilapias subjected to FHE-coated feed exhibited better weight gain (WG), specific growth rate (SGR), and feed efficiency (FE) compared to control. The best dosage that gave the highest growth and feed efficiency was treatment C (300 mg/kg of feed). Furthermore, the feed efficiencies of FHE-incorporated treatments were positively influenced by the increased in length and density of intestinal villi, number of goblet cells, lymphocytes, as well as nutrient retention to support growth. The results of this study indicate that FHE is a promising functional feed additive to stimulate growth and improve feed efficiency in tilapia farming.

Menstrual Health Problems of Women Indigenous Peoples around Protected Forest Area in Sumatra, Indonesia, and Plants' Usefulness to Treat It

BACKGROUND

Some cultures have a favorable view of menstruation, consider it sacred, and respect the female body, so some local wisdom and the practice of using plant species are also attached to it. Moreover, menstruation is an integral part of reproductive health for women as mothers of a nation. However, the management of menstrual problems included in the United Nations Sustainable Development Goals (gender justice) goals in several indigenous communities around the forest has not received attention.

OBJECTIVE

This study aims to explain the situation of menstrual management, predict indications of reproductive problems, and record the practice of using plants to overcome these problems in indigenous tribal communities around the forest.

MATERIAL AND METHODS

A total of 15 youths of the Orang Rimba, one of the marginal indigenous people in Jambi Province, Sumatra Island, Indonesia, were the subjects of measurement of all variables using anthropometric measurement procedures. The 15 girls were also interviewed regarding menstrual problems, personal hygiene management, and using plant species to overcome them. Meanwhile, ten adults became respondents to the complementary primary data.

RESULTS

No plant species were explicitly used to treat menstrual problems. Four species are used by the Orang Rimba concerning labor management (pre- and postpartum).

CONCLUSION

There are no significant reproductive problems despite the incidence of dysmenorrhea. However, aspects of nutrition and personal hygiene, including during menstruation, still need special attention, especially considering that the typology of Orang Rimba varies according to their Tumenggung and the characteristics of their forest habitat; It is challenging to measure their health as a group. This condition may also apply to other communities around the forest due to their limited reproductive health knowledge.

Potential Plant-Based New Antiplasmodial Agent Used in Papua Island, Indonesia

Resistance to antimalarial medicine remains a threat to the global effort for malaria eradication. The World Health Organization recently reported that artemisinin partial resistance, which was defined as delayed parasite clearance, was detected in Southeast Asia, particularly in the Greater Mekong subregion, and in Africa, particularly in Rwanda and Uganda. Therefore, the discovery of a potential new drug is important to overcome emerging drug resistance. Natural products have played an important role in drug development over the centuries, including the development of antimalarial drugs, with most of it influenced by traditional use. Recent research on traditional medicine used as an antimalarial treatment on Papua Island, Indonesia, reported that 72 plant species have been used as traditional medicine, with Alstonia scholaris, Carica papaya, Andrographis paniculata, and Physalis minima as the most frequently used medicinal plants. This review aimed to highlight the current research status of these plants for potential novel antiplasmodial development. In conclusion, A. paniculata has the highest potential to be developed as an antiplasmodial, and its extract and known bioactive isolate andrographolide posed strong activity both in vitro and in vivo. A. scholaris and C. papaya also have the potential to be further investigated as both have good potential for their antiplasmodial activities in vivo. However, P. minima is a less studied medicinal plant; nevertheless, it opens the opportunity to explore the potential of this plant.

Traditional medicine users in a treated chronic disease population: a cross-sectional study in Indonesia

BACKGROUND

Traditional medicine (TM) is commonly used as a treatment in Indonesia. This raises the need for an analysis of its potential development and irrational use. Therefore, we analyze the proportion of TM users among chronic disease patients and its associated characteristics to optimize the use of TM in Indonesia.

METHODS

A cross-sectional study of treated adult chronic disease patients was conducted using the fifth Indonesian Family Life Survey (IFLS-5) database. Descriptive analysis was used to identify the proportion of TM users, while a multivariate logistic regression was used to analyze their characteristics.

RESULTS

This study included 4901 subjects and identified 27.1% as TM users. The highest TM use was in subjects with cancer (43.9%), liver issues (38.3%), cholesterol issues (34.3%), diabetes (33.6%), and stroke (31.7%). Characteristics associated with TM users were a perception of one's current health as unhealthy (OR 2.59, 95% CI 1.76-3.81), low medication adherence (OR 2.49, 95% CI 2.17-2.85), age above 65 years (OR 2.17, 95% CI 1.63-2.90), having higher education (OR 1.64, 95% CI 1.17-2.29), and residence outside of Java (OR 1.27, 95% CI 1.11-1.45).

CONCLUSIONS

Low medication adherence among TM users highlights the potentially irrational use of treatment in chronic diseases. Nevertheless, the longstanding use of TM users indicates the potential for its development. Further studies and interventions are needed to optimize TM use in Indonesia.

An Indonesian slimming drug with undeclared ingredients causing harm

This paper reports the presence of undeclared drugs in the herbal slimming supplement Sulami®. The four cases of the adverse drug reactions related to Sulami® were reported to the Dutch Pharmacovigilance Centre (Lareb) or the Dutch Poisons Information Centre (DPIC). The analysis of all four collected samples revealed adulteration with sibutramine and canrenone. Both drugs can cause serious adverse drug reactions. From a legal point of view, it is clear that Sulami® does not meet the legal requirement for safety. As defined in the European General Food Law Regulation, food business operators are responsible for food safety. This also applies to online store owners who sell herbal preparations. Thus, it is clear that it is forbidden to sell Sulami® on the European and Dutch market. Collaboration between involved national authorities makes it possible to identify risky products. This allows the nationally responsible regulators to take targeted action. They can call on users to report sell points what makes it possible to arrest the sellers and confiscate the dangerous products. Beyond the national, also, the European enforcement organizations should take legal measures where possible, to protect public health. The Heads of Food Safety Agencies Working Group on Food Supplements "an Initiative on European level" is a good example of efforts to improve consumer safety.

Physicochemical Characteristics and Antibacterial Activities of Freeze-Thawed Polyvinyl Alcohol/Andrographolide Hydrogels

Andrographolide (AG) is one of the compounds in Andrographis paniculata, which has a high antibacterial activity. This paper reports the freeze-thaw method's use to synthesize polyvinyl alcohol (PVA) hydrogels loaded with AG and its characterization. From the morphological examination, the porosity of the PVA/AG hydrogel was found to increase with the increasing AG concentration. The swelling degree test revealed that the hydrogels' maximum swelling degrees were generally greater than 100%. The composite hydrogel with the highest fraction of andrographolide (PAG-4) showed greater weight loss than the hydrogel without AG (PAG-0). The molecular interaction between PVA and AG resulted in the narrowing of the band attributed to the O-H and C=O stretching bonds and the emergence of an amorphous domain in the composite hydrogels. The loading of AG disrupted the formation of hydroxyl groups in PVA and interrupted the cross-linking between PVA chains, which lead to the decrease of the compression strength and the crystallinity increased with increasing AG. The antibacterial activity of the composite hydrogel increased with increasing AG. The PAG-4 hydrogel had the highest antibacterial activity of 37.9 ± 4.6^b %. Therefore, the PVA/AG hydrogel has the potential to be used as an antibacterial device.

Classification of Curcuma longa and Curcuma zanthorrhiza using transfer learning

Curcuma longa (turmeric) and Curcuma zanthorrhiza (temulawak) are members of the Zingiberaceae family that contain curcuminoids, essential oils, starch, protein, fat, cellulose, and minerals. The nutritional content proportion of turmeric is different from temulawak which implies differences in economic value. However, only a few people who understand herbal plants, can identify the difference between them. This study aims to build a model that can distinguish between the two species of Zingiberaceae based on the image captured from a mobile phone camera. A collection of images consisting of both types of rhizomes are used to build a model through a learning process using transfer learning, specifically pre-trained VGG-19 and Inception V3 with ImageNet weight. Experimental results show that the accuracy rates of the models to classify the rhizomes are 92.43% and 94.29%, consecutively. These achievements are quite promising to be used in various practical use.

A review of pathobiological mechanisms and potential application of medicinal plants for vascular aging: focus on endothelial cell senescence

Endothelial cell (EC) senescence plays a pivotal role in aging and is essential for the pathomechanism of aging-related diseases. Drugs targeting cellular senescence, such as senolytic or senomorphic drugs, may prevent aging and age-related diseases, but these bullets remain undeveloped to target EC senescence. Some medicinal plants may have an anti-senescence property but remain undiscovered. Deep learning has become an emerging approach for drug discovery by simply analyzing cellular morphology-based deep learning. This precious tool would be useful for screening the herb candidate in senescent EC rejuvenescence. Of note, several medicinal plants that can be found in Indonesia such as Curcuma longa L., Piper retrofractum, Guazuma ulmifolia Lam, Centella asiatica (L.) Urb., and Garcinia mangostana L. might potentially possess an anti-senescence effect. This review highlighted the importance of targeting EC senescence, the use of deep learning for medicinal plant screening, and some potential anti-senescence plants originating from Indonesia.

Bipartite graph search optimization for type II diabetes mellitus Jamu formulation using branch and bound algorithm

Jamu is an Indonesian traditional herbal medicine that has been practiced for generations. Jamu is made from various medicinal plants. Each plant has several compounds directly related to the target protein that are directly associated with a disease. A pharmacological graph can form relationships between plants, compounds, and target proteins. Research related to the prediction of Jamu formulas for some diseases has been carried out, but there are problems in finding combinations or compositions of Jamu formulas because of the increase in search space size. Some studies adopted the drug–target interaction (DTI) implemented using machine learning or deep learning to predict the DTI for discovering the Jamu formula. However, this approach raises important issues, such as imbalanced and high-dimensional dataset, overfitting, and the need for more procedures to trace compounds to their plants. This study proposes an alternative approach by implementing bipartite graph search optimization using the branch and bound algorithm to discover the combination or composition of Jamu formulas by optimizing the search on a plant–protein bipartite graph. The branch and bound technique is implemented using the search strategy of breadth first search (BrFS), Depth First Search, and Best First Search. To show the performance of the proposed method, we compared our method with a complete search algorithm, searching all nodes in the tree without pruning. In this study, we specialize in applying the proposed method to search for the Jamu formula for type II diabetes mellitus (T2DM). The result shows that the bipartite graph search with the branch and bound algorithm reduces computation time up to 40 times faster than the complete search strategy to search for a composition of plants. The binary branching strategy is the best choice, whereas the BrFS strategy is the best option in this research. In addition, the the proposed method can suggest the composition of one to four plants for the T2DM Jamu formula. For a combination of four plants, we obtain Angelica Sinensis, Citrus aurantium, Glycyrrhiza uralensis, and Mangifera indica. This approach is expected to be an alternative way to discover the Jamu formula more accurately.

Analysis of botanicals and botanical supplements by LC-MS/MS-based molecular networking: Approaches for annotating plant metabolites and authentication

Prior to the advent of modern medicine, humans have used botanicals extensively for their therapeutic potential. With the majority of newly approved drugs having their origins in natural products, plants remain at the forefront of drug discovery. Continued research and discovery necessitate the use of high-throughput analytical methods to screen and identify bioactive components and potential therapeutic molecules from plants. Utilizing a pre-generated plant extract library, we subjected botanicals to LC-MS/MS-based molecular networking to determine their chemical composition and relatively quantify already known metabolites. The LC-MS/MS-based molecular networking approach was also used to authenticate the composition of dietary supplements against their corresponding plant specimens. The networking procedures provided concise visual representations of the chemical space and highly informative assessments of the botanicals. The procedures also proved to define the composition of the botanical supplements quickly and efficiently. This offered an innovative approach to metabolite profiling and authentication practices and additionally allowed for the identification of new, putatively unknown metabolites for future isolation and biological evaluation.

Saurauia vulcani (Korth.) As Herbal Medicine Potential From North Sumatera, Indonesia: A Literature Review

According to some studies, two-thirds of the world's plant species have therapeutic worth. Saurauia vulcani (Korth.) is one of them. This is something that can be found in Indonesia. Traditionally, this herb was known as pirdot and was used to cure diabetes. This article examines the scientific activities of pirdot leaves as well as their safety for usage. This study used a literature review article as its design. Searching for related publications using data from Pubmed, Proquest, Ebsco, ScienceDirect, and Google Scholar for the last ten years (2011–2021) yielded 141 articles. There are 14 pertinent articles that explore their substance and application in health. The content of secondary metabolites that have been reported proves that pirdot has properties as an antidiabetic, immunostimulant, antidiarrhoea, anticholesterol, and hepatoprotective.

Bioactive triterpenoids from Indonesian medicinal plant Syzygium aqueum

A large common species, Syzygium aqueum, belonging to the genus Syzygium possesses numerous bioactive phytochemical constituents. Moreover, the different parts of this species have been used as folk medicine since centuries ago. In this study, a phytochemical exploration was carried out on the plant’s stem bark. Isolation of the compounds was carried out through the extraction step with some organic solvents, followed by separation and purification using chromatography techniques until the two triterpenoids were isolated from nonpolar and semipolar extracts. Structure elucidation was done using spectroscopic methods. These compounds were identified as alphitolic acid and arjunolic acid. Subsequently, these two compounds were used in anticancer tests against human cancer cells HeLa, T47D, and A549 using colorimetric assay. The result showed that both compounds showed more inhibition of the growth of HeLa and T47D than A549 cancer cells, with the highest activity shown by arjunolic acid against HeLa cell lines.

TLC-Based Fingerprinting Analysis of the Geographical Variation of Melastoma malabathricum in Inland and Archipelago Regions: A Rapid and Easy-to-Use Tool for Field Metabolomics Studies

Melastoma malabathricum is an Indo-Pacific herb that has been used traditionally to treat numerous ailments such as wounds, dysentery, diarrhea, toothache, and diabetes. The objective of this study was to evaluate the variability of the metabolic profiles of M. malabathricum across its geographic distribution. By employing thin layer chromatography (TLC), specimens collected from six terrestrial and archipelago regions of Indonesia were analyzed by densitometry for metabolomic fingerprinting analysis combined with chemometric tools: principal component analysis (PCA) and hierarchical cluster analysis (HCA). Two PCAs were identified as PC1 and PC2 with 41.90% and 20.36%, respectively. Our results indicate the importance of considering geographic distribution during field-collection efforts since they demonstrate regional metabolic variation in secondary metabolites of M. malabathricum, as illustrated by TLC and their biological activities.

Moringa oleifera Leaves Extract Alters Exercise-Induced Cardiac Hypertrophy Adaptation

&lt;b&gt;Background and Objective:&lt;/b&gt; Cardiomyocyte adaptation to exercise might require ROS as a central regulator. There is a limited study regarding the importance of ROS for inducing exercise-induced adaptation and its correlations with changes in histological scoring of cardiac muscles. The study aimed to explore the importance of physiological ROS induced by exercise and its correlation with Cardiomyocyte' histological appearance that is altered by &lt;i&gt;Moringa oleifera&lt;/i&gt; leaves extract in Wistar rats. &lt;b&gt;Materials and Methods:&lt;/b&gt; This was an animal experimental study, which use 4 groups of 24 Wistar rats divided into Control (Co), &lt;i&gt;Moringa&lt;/i&gt; leaves extract (Mo), Exercise (Ex) and a combination of &lt;i&gt;Moringa &lt;/i&gt;leaves extract and Exercise (MoEx). The &lt;i&gt;Moringa&lt;/i&gt; leaves extract were given orally, 5 days a week, for 4 consecutive weeks. The exercise was given in moderate intensity, 5 days a week, also for 4 consecutive weeks. &lt;b&gt;Results:&lt;/b&gt; This study found significant differences in heart weight and heart weight/body weight ratio in Ex group compared to the control. As for histology scoring, found that MoEx group has 16.7% cardiac hypertrophy and myofiber disarray compared to 83.3% mild hypertrophy and 50% mild disarray in Ex group. &lt;b&gt;Conclusion:&lt;/b&gt; In summary, the study showed that the potential central role of exercise-induced physiological ROS for cardiac hypertrophy adaptation is altered by &lt;i&gt;Moringa oleifera &lt;/i&gt;leaves extract treatment.

The role of behavioural immune system and belief in COVID-19 misinformation on COVID-19 protective behaviours in Indonesia

This study (N = 1306) investigated the role behavioural immune system and specific beliefs in COVID-19 misinformation in predicting COVID-19 protective behaviours. By analysing the data from an online survey, we found that germ avoidance significantly predicted social distancing and was negatively correlated to transportation use. Belief in conspiracy theories and non-psychological cures and prevention methods were negatively associated to social distancing, while the latter also predicted lower preventive commodities purchasing. These findings suggested that germ aversion should be incorporated in the promotion of COVID-19 prevention behaviours and that any misinformation related to COVID-19 should be minimized to improve people's protective behaviours.

Molecular Docking Approach of Natural Compound from Herbal Medicine in Java against Severe Acute Respiratory Syndrome Coronavirus-2 Receptor

Indonesia's diversity of natural resources presents an intriguing opportunity for the exploration of potential herbal medicines. Numerous compounds, both purified and crude, have been reported to exhibit antiviral activity. The ACE-2 receptor may be a therapeutic target for SARS-CoV-2 infection. We used a search engine to search for herbal medicines with ACE-2 inhibitory activity to predict the potential inhibition of natural compounds (i.e., theaflavin, deoxypodophyllotoxin, gallocatechin, allicin, quercetin, annonamine, Curcumin, 6-gingerol, and cucurbitacin B) to SARS-CoV2 – ACE-2 complex. We performed molecular docking analysis using the ACE-2 protein target from Protein Data Bank. Protein stabilization was carried out to adjust to the body's physiology, carried out using Pymol by removing water atoms and adding hydrogen atoms. Ligands of active compounds from natural resources were selected and downloaded from the PubChem database, then optimized by Pymol software. The complexes of the tested ligand compounds and ACE-2 receptors, which have a bond strength smaller than the control were selected for analysis.  Theaflavin, Deoxypodophyllotoxin, Gallocatechin, Curcumin, and Cucurbitacin B had a strong bond affinity than the control ligands. Based on our data, deoxypodophylotoxin and Curcumin had the same interaction amino acid residus compare to the control ligand. This study concludes that deoxypodophyllotoxin and Curcumin have the greatest potential to inhibit the formation of the SARS-Cov2-ACE-2 complex; additionally, these compounds exhibit favorable pharmacological and pharmacodynamic properties. It is suggested that additional research be conducted to determine the biological effects of deoxypodopyllotoxin and Curcumin on ACE-2 receptors.

Factors Associated With Adherence to Fluid Restriction in Patients Undergoing Hemodialysis in Indonesia

BACKGROUND

The factors related to fluid intake adherence among patients undergoing hemodialysis have been explored in many studies. However, most of these were conducted in Western countries and have produced inconsistent results. A study of this issue in Indonesia, a tropical country with strong herbal medicine traditions, may show different results. In addition to demographic characteristics, self-efficacy is a standard measurement used in chronic care management activities such as hemodialysis treatment. Understanding the reasons behind patient nonadherence in Indonesia may help nurses better manage the fluid intake of patients.

PURPOSE

This study was designed to determine the factors that predict patient adherence to fluid intake restrictions.

METHODS

A cross-sectional study was conducted on 153 patients undergoing hemodialysis at two hospitals. Intradialytic weight gain over a 1-month period was recorded to assess the participants' adherence to fluid intake restrictions. Intradialytic weight gains of more than 2 kg was considered to be nonadherent. A daily urine output and level of thirst were also recorded. The participants completed an adapted self-efficacy questionnaire, Swedish Fluid Intake Appraisal Inventory, and the data were analyzed together with demographic characteristic and clinical parameters using hierarchical multiple regression.

RESULTS

The results revealed that most of the respondents did not adequately adhere to fluid intake restrictions (59.5%). Intradialytic weight gain was shown to strongly correlate with self-efficacy (p < .05, β = -.201), gender (p < .05, β = -.179), educational background (p = .05, β = .159), and urine output (p < .05, β = -.168). Demographic characteristic explained 10.6% and self-efficacy explained 3.9% of the variance in fluid adherence.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Female participants with higher self-efficacy scores reported the lowest average level of intradialytic weight gain, indicating better adherence to fluid intake restrictions. Several demographic factors as well as self-efficacy were identified as potential predictors of fluid intake restriction adherence. Therefore, measuring self-efficacy periodically is a good initial step toward detecting those patients who are at higher risk of noncompliance with fluid intake restrictions.

Sauropus brevipes ethanol extract negatively regulates inflammatory responses in vivo and in vitro by targeting Src, Syk and IRAK1

CONTEXT

Sauropus brevipes Müll. Arg. (Phyllanthaceae) has been used as an effective ingredient in a decoction for the treatment of diarrhoea. However, there was no report on its modulatory role in inflammation.

OBJECTIVE

This study investigates anti-inflammatory effect of S. brevipes in various inflammation models.

MATERIALS AND METHODS

The aerial part of S. brevipes was extracted with 95% ethanol to produce Sb-EE. RAW264.7 cells pre-treated with Sb-EE were stimulated by lipopolysaccharide (LPS), and Griess assay and PCR were performed. High-performance liquid chromatography (HPLC) analysis, luciferase assay, Western blotting and kinase assay were employed. C57BL/6 mice (10 mice/group) were orally administered with Sb-EE (200 mg/kg) once a day for five days, and peritonitis was induced by an intraperitoneal injection of LPS (10 mg/kg). ICR mice (four mice/group) were orally administered with Sb-EE (20 or 200 mg/kg) or ranitidine (positive control) twice a day for two days, and EtOH/HCl was orally injected to induce gastritis.

RESULTS

Sb-EE suppressed nitric oxide (NO) release (IC₅₀=34 µg/mL) without cytotoxicity and contained flavonoids (quercetin, luteolin and kaempferol). Sb-EE (200 µg/mL) reduced the mRNA expression of inducible NO synthase (iNOS). Sb-EE blocked the activities of Syk and Src, while inhibiting interleukin-1 receptor associated kinases (IRAK1) by 68%. Similarly, orally administered Sb-EE (200 mg/kg) suppressed NO production by 78% and phosphorylation of Src and Syk in peritonitis mice. Sb-EE also decreased inflammatory lesions in gastritis mice.

DISCUSSION AND CONCLUSIONS

This study demonstrates the inhibitory effect of Sb-EE on the inflammatory response, suggesting that Sb-EE can be developed as a potential anti-inflammatory agent.

Cytotoxic activity of flavonoid from local plant Eriocaulon cinereum R.B against MCF-7 breast cancer cells

Eriocaulon cinereum R. Br is used as traditional medicine by the local community in Bangka Belitung Island, Indonesia. The plant is processed as an infusion for fever, boosts the immune system, and treats tumor cells. However, scientific research on this species is still limited. The aims of this study were to determine the cytotoxic of E. cinereum against MCF-7 cells. The results suggested that one of the compounds has a good cytotoxic activity. Therefore, it is quite promising in the effort of cancer drug discovery. The active compound has a flavonoid, which plays a role in several anticancer mechanisms. This study provided scientific evidence regarding the utilization of E. cinereum by the local community for cancer therapy. The plant can be further developed as an alternative agent to treat cancer or as cancer adjuvant therapy.

Recent Analytical Method for Detection of Chemical Adulterants in Herbal Medicine

Herbal medicine has become popular in recent years as an alternative medicine. The problem arises when herbal medicines contain an undeclared synthetic drug that is illegally added, since it is a natural product that does not contain any chemical drugs due to the potential cause of harmful effects. Supervision of herbal medicines is important to ensure that these herbal medicines are still safe to use. Thus, developing a reliable analytical technique for the determination of adulterated drugs in herbal medicine is gaining interest. This review aims to provide a recent analytical method that has been used within the past 5 years (2016-2021) for the determination of chemical adulterants in herbal medicine.

Traditional Chinese Medicine and Traditional Indonesian Medicine: A Comparative Review of Herbal Medicines Restricted in Pregnancy

The decline in birth rates has become a very serious problem in various parts of the world. Many countries have implemented national programs for increasing birth rates, one of which involves the use of traditional medicine as an alternative solution. Among the fast-growing traditional medicines, traditional Chinese medicine (TCM) and traditional Indonesian medicine (TIM) have attracted a lot of demand globally. Here, we analyzed and compared the herbal medicines from TCM and TIM that must be avoided by pregnant women for preventing miscarriage and maintaining safety during pregnancy and the postpartum period. This review uses data from official reports from the respective government and national and international electronic databases for analysis. Although TCM and TIM have their own characteristics of treatment, they also have some similarities in concept and treatment, especially those related to herbal medicines. This review can be used as a reference base to help pregnant women consume herbal medicines at appropriate conditions and doses.

Current Status, Distribution, and Future Directions of Natural Products against Colorectal Cancer in Indonesia: A Systematic Review

In 2020, an estimated 19.3 million new cancer cases and nearly 10 million cancer deaths have occurred worldwide, with colorectal cancer ranking as the third most frequently diagnosed (10.0%). Several attempts have been conducted against cancer, including surgery, radiation, monoclonal antibodies, and chemotherapy. Many people choose natural products as alternatives against cancer. These products will not only help in human life preservation but also work as a source of up-to-date information, leading people away from incorrect information. We discuss the current status, distribution, and future implications of protecting populations with natural products as an alternative against colorectal cancer in Indonesia. Thirty-eight studies were included in this review for data extraction. The distribution of natural products in Indonesia that have potential activity against colorectal cancer cells was predominated by terpenoids, followed by phytosterols, phenolics, alkaloids, and polyisoprenoids. The type of cell line utilized in the cytotoxic activity analysis of natural products was the WiDr cell line, followed by HT-29 cells and HCT-116 cells. This review showed that MTT in vitro assay is a general method used to analyze the cytotoxic activity of a natural product against colorectal cancer cells, followed by other in vitro and in vivo methods. The systematic review provided predictions for several secondary metabolites to be utilized as an alternative treatment against colorectal cancer in Indonesia. It also might be a candidate for a future co-chemotherapy agent in safety, quality, and standardization. In addition, computational methods are being developed to predict the drug-likeness of compounds, thus, drug discovery is already on the road towards electronic research and development.

Nutrition Interventions for Healthy Ageing in Indonesia

Background: Including Indonesia, the elderly population worldwide is on the rise. This situation is closely related to the increase in the incidence and prevalence of non-communicable diseases. Eating behavior is related to the risk of non- communicable the risk of NCDs in the elderly. Therefore, nutrition intervention should be carried out from old age.Objectives: The purpose of this study is to review potential nutritional interventions to prepare for a healthy ageing process in an Indonesian context.Discusion: This review uses social cognition theory to emphasize the importance of nutrition education, the development of nutritional products with biologically active compounds, and practical guidelines that influence individual dietary behavior. Nutritional interventions should take into account Indonesia’s existing food-based balanced nutrition diet guidelines and the dietary patterns of adults and the elderly. Indonesia has a large population, ethnic and cultural diversity, which together affect people’s daily consumption of various foods.Conclusions: Customized nutrition education programs and the development of functional foods are appropriate interventions that can be implemented in Indonesia.

Micropropagation and Secondary Metabolites Content of White-Purple Varieties of Orthosiphon aristatus Blume Miq

<b>Background and Objective:</b> The cat whiskers plant (<i>Orthosiphon aristatus</i> Blume Miq) is a plant that has been widely used as raw material for traditional medicine. The population of white-purple varieties of <i>O. aristatus</i> is decreasing efforts to maintain the white-purple <i>O. aristatus</i> need to be done keeping in mind its potential as raw material for traditional medicine. This study aims to determine the composition of a suitable medium in growing plantlet <i>O. aristatus</i> white-purple varieties and the content of its secondary metabolites. <b>Materials and Methods:</b> The internode explants were induced on MS medium added by various combinations of zeatin and 2,4-Dichlorophenoxyacetic acid (2,4-D). Root induction was carried out on shoots formed on MS medium with Indole-3-Butyric Acid (IBA). The acclimatization process was carried out using soil media. Determination of secondary metabolite levels was carried out on <i>O. aristatus</i> (<i>in vitro</i> culture) and wild-type plants aged ten months using high-performance liquid chromatography (HPLC). <b>Results:</b> MS+BAP 2ppm+NAA3 ppm media was the optimal medium for growing shoots in leaf explants. Media MS+zeatin 3 ppm+2,4-D 2 ppm produced good shoot growth on internode explants. The best root induction occurred in MS+IBA media of 0.75 ppm. The acclimatization process was successful on shoots originating from the internode, while those from leaf explants had not succeeded in growing and developing. <b>Conclusion:</b> The levels of rosmarinic acid and sinensetin in the white-purple variety <i>O. aristatus</i> (<i>in vitro</i> culture) were 1.08 and 1.62% w/w and higher than those of wild varieties.

In silico and in vitro studies on the anti-cancer activity of andrographolide targeting survivin in human breast cancer stem cells

Breast cancer stem cells (BCSCs) express high levels of the anti-apoptotic protein, survivin. This study aimed to discover a natural active compound with anti-cancer properties that targeted survivin in human breast cancer stem cells. From the seven examined compounds, andrographolide was selected as a lead compound through in silico molecular docking with survivin, caspase-9, and caspase-3. We found that the affinity between andrographolide and survivin is higher than that with caspase-9 and caspase-3. Human CD24-/CD44+ BCSCs were treated with andrographolide in vitro for 24 hours. The cytotoxic effect of andrographolide on BCSCs was compared to that on human mesenchymal stem cells (MSCs). The expression of survivin, caspase-9, and caspase-3 mRNA was analyzed using qRT-PCR, while Thr34-phosphorylated survivin and total survivin levels were determined using ELISA and Immunoblotting assay. Annexin-V/PI flow cytometry assays were performed to evaluate the apoptotic activity of andrographolide. Our results demonstrate that the CC50 of andrographolide in BCSCs was 0.32mM, whereas there was no cytotoxic effect in MSCs. Moreover, andrographolide decreased survivin and Thr34-phosphorylated survivin, thus inhibiting survivin activation and increasing survivin mRNA in BCSCs. The apoptotic activity of andrographolide was revealed by the increase of caspase-3 mRNA and protein, as well as the increase in both the early and late phases of apoptosis. In conclusion, andrographolide can be considered an anti-cancer compound that targets BCSCs due to its molecular interactions with survivin, caspase-9, and caspase-3, which induce apoptosis. We suggest that the binding of andrographolide to survivin is a critical aspect of the effect of andrographolide.

Hypoglycemic Effect of a Combined Andrographis paniculata and Caesalpinia sappan Extract in Streptozocin-Induced Diabetic Rats

Introduction

Researchers usually use herbal combinations to explore and develop traditional medicine to obtain additional benefits in the treatment of diseases, including diabetes. This study aims to evaluate the hypoglycemic effect of the combination of Andrographis paniculata (Burm. f.) Wall ex Nees and Caesalpinia sappan Linn extract (APCSE) on diabetes-induced rats. There has not been sufficient research on this combination; however, single extract studies of these plants have been widely conducted.

Materials and Methods

Male Sprague Dawley rats (160–200 g) were induced by injecting a low dose of streptozotocin (35 mg/kg BW) twice and fed with a high-fat diet containing 25% fat, whereas control animals received only standard feed. Rats were treated with APCSE at doses of 100 mg and 200 mg/kg BW for seven days and compared to the APE and CSE groups treated with the extract at 100 mg, respectively. For the control group, rats were treated with metformin with a dose of 250 mg/kg. The antihyperglycemic and antihyperlipidemic effects were determined by measuring blood glucose levels and lipid profiles (cholesterol, triglycerides, HDL, and LDL). To assess the impact of the extract on pancreatic and adipose tissue, the number of pancreatic beta cells and adipocytes was evaluated through histopathological and immunohistochemical study. Results and Discussion. In a nonfasting state, the blood glucose change in APCSE 200 mg was 18.65% and was significantly lower from the DM group. However, a single extract of APE and CSE showed lower fasting blood glucose levels compared to the combined extract. Lipid profiles show no significant differences in cholesterol levels between groups; however, all treatment groups, including metformin, showed higher triglyceride levels. The APE-treated group showed significantly lower HDL and LDL, whereas CSE only showed lower LDL. The β-cell number was significantly higher after treatment with single extract CSE. The CSE and the combined extract groups showed hyperplasia adipocytes.

Conclusion

The combined extract of APCSE has a moderate antihyperglycemic effect; however, a single extract may have better potential than the combined extract.

Factors affecting the use of herbal medicines in the universal health coverage system in Indonesia

ETHNOPHARMACOLOGICAL RELEVANCE

Medicinal plants play an essential role in primary healthcare practices in Indonesia, particularly in rural areas. While medicinal plants are broadly used in Indonesia, the country has made a commitment to healthcare services based on modern medicine through the provision of universal health coverage (UHC).

AIM OF THE STUDY

In the context of the UHC system in Indonesia, we explore the utilization of medicinal plants in rural West Java by examining how herbal medicine use varies with socio-economic and demographic factors and whether herbal medicine use remains important when modern healthcare becomes available.

MATERIALS AND METHODS

A total of 634 households in the two rural communities were randomly selected to participate in the survey. A semi-structured questionnaire was administered to a randomly selected adult in each household.

RESULTS

Herbal medicine use prevalence was found to be 68% (431/634). Out of 549 total respondents with perceived illness, 40% (219/549) self-medicated with herbal medicines in the last six months. A total of 102 medicinal plant species belonging to 43 families were reported, each with their local names, medicinal use, and parts used. We found that herbal medicine use was significantly associated with the area of residence, age, education level and occupation, and was not correlated to gender or health insurance possession.

CONCLUSION

Medicinal plant remains a significant aspect of healthcare for rural communities in the West Java area. The presence of healthcare services under the UHC system is not a critical determining factor for treatment-seeking and may have less impact on the pervasive practice of herbal medicine use in rural areas.

An ethnobotanical study of medicinal plants used by the Tengger tribe in Ngadisari village, Indonesia

The people of Tengger, Indonesia have used plants as traditional medicine for a long time. However, this local knowledge has not been well documented until recently. Our study aims to understand the utilization of plants in traditional medicine by the people of Tengger, who inhabit the Ngadisari village, Sukapura District, Probolinggo Regency, Indonesia. We conducted semi-structured and structured interviews with a total of 52 informants that represented 10% of the total family units in the village. The parameters observed in this study include species use value (SUV), family use value (FUV), plant part use (PPU), and the relative frequency of citation that was calculated based on fidelity level (FL). We successfully identified 30 species belonging to 28 genera and 20 families that have been used as a traditional medicine to treat 20 diseases. We clustered all the diseases into seven distinct categories. Among the recorded plant families, Poaceae and Zingiberaceae were the most abundant. Plant species within those families were used to treat internal medical diseases, respiratory-nose, ear, oral/dental, and throat problems. The plant species with the highest SUV was Foeniculum vulgare Mill. (1.01), whereas the Aloaceae family (0.86) had the highest FUV. Acorus calamus L. (80%) had the highest FL percentage. The leaves were identified as the most used plant part and decoction was the dominant mode of a medicinal preparation. Out of the plants and their uses documented in our study, 26.7% of the medicinal plants and 71.8% of the uses were novel. In conclusion, the diversity of medicinal plant uses in the Ngadisari village could contribute to the development of new plant-based drugs and improve the collective revenue of the local society.

Selected Indonesian Medicinal Plants for the Management of Metabolic Syndrome: Molecular Basis and Recent Studies

Increased prevalence of metabolic syndrome (MetS) in the world influences quality of health in all respective countries, including Indonesia. Data from Indonesian Family Life Survey reported in 2019 showed that the prevalence of MetS in Indonesia currently is 21.66%, estimated with the provincial incidence ranging up to 50%; additionally, the most common components of MetS discovered in Indonesia were poor high-density lipoprotein (HDL) cholesterol and hypertension. Management treatment of MetS involves a combination of lifestyle changes and pharmacological interventions to decrease cerebrovascular disease. Various natural substances have been shown to govern any cardiovascular or metabolic disorders through different mechanisms, such as triggering anti-inflammation, lipid profile correction, sensitization of insulin reception, or blood glucose control. In Indonesia, the utilization of natural compounds is part of the nation's culture. The community widely uses them; even though in general, their effectiveness and safety have not been thoroughly assessed by rigorous clinical trials. Scientific evidence suggested that cinnamon, mangosteen, and curcumin, as well as their derived components possess a broad spectrum of pharmacological activity. In this review, an enormous potential of cinnamon, mangosteen, and curcumin, which originated and are commonly used in Indonesia, could be treated against MetS, such as diabetes, hyperlipidemia, hypertension, and obesity. The findings suggested that cinnamon, mangosteen, curcumin and their derivatives may reflect areas of promise in the management of MetS.

Development of plant-based emulsion formulations to control bacterial leaf blight and sheath brown rot of rice

Bacterial leaf blight (BLB) and sheath brown rot (SBR), caused by Xanthomonas oryzae pv. oryzae (Xoo) and Pseudomonas fuscovaginae, respectively, are bacterial diseases that lead to substantial yield losses in rice. Natural plant-based products represent a sustainable alternative to combat bacterial diseases due to their biodegradability and overall safety. However efficient ways of delivering them are crucial to their success. In an attempt to maximize the antibacterial properties of botanical bactericides for the control of these pathogens, this study evaluated the efficiency of different emulsion formulations of Piper sarmentosum extracts. The emulsion formulations were demonstrated to be effective in controlling BLB and SBR of rice in in vitro plate assays and in planta under glasshouse conditions. The observed in vitro inhibition of the bacterial pathogens and significant disease suppression in planta indicate that these plant extract formulations represent promising alternatives to be adopted in management strategies for controlling rice diseases.

Medicine taking behaviours of people with type 2 diabetes in Indonesia: a qualitative study

Background Medicine-taking behaviour of people in Indonesia is particularly complex because of Indonesia's pluralistic health system, in which public and private medical services co-exist with traditional and alternative treatments. Objective This study aimed to explore medicine-taking behaviours of people with type 2 diabetes in Indonesia. Setting Rural and urban communities in East Nusa Tenggara and West Sumatera Provinces. Method Qualitative study with focus group discussions. Six focus groups, involving 45 diabetes patients, were conducted. The discussions were recorded and transcribed verbatim in the original language. The transcripts were translated into English and analysed for common themes. Main outcome measure People's medicine-taking behaviours after being diagnosed with diabetes. Results Medicine-taking behaviours of diabetes participants aligned with the concept of resistance to medicine taking and a therapeutic decision model. It varied based on individual lay evaluation processes. After being diagnosed, participants commonly took the prescribed medicines for some period. They then self-evaluated the effectiveness of the prescribed medicines. Based on the self-evaluation, patients either continued to take the prescribed medicines or made a variety of changes: they discontinued taking the prescribed medicines, combined or alternated prescribed medicines with traditional medicines, or occasionally took medicines they bought without prescription. Reasons mentioned by participants for choosing traditional medicines including perceived ineffectiveness or side effect of the prescribed-medicines. Long-term medicine taking burdened the participants as the notion of being fed up with taking medicines was frequently mentioned. Problems of inaccessibility of the prescribed-medicines also emerged. Conclusion Diabetes patients' medicine-taking behaviours and their reasons for decision-making need to be acknowledged to improve adherence to medicine. Health professionals should assist patients on how to evaluate effectiveness, manage side effects, and reduce the medicine-related burden.

A comparison of attitudes towards complementary and alternative medicine between psychologists in Australia and Indonesia: a short report

Background

The growth of complementary and alternative medicine (CAM) has been increasing, including amongst psychological clients. Therefore, it is important to investigate psychologists' attitudes towards CAM. Negative attitudes towards CAM among psychologists could be a barrier to CAM integration into psychological services and may prevent clients to trust psychologists. This study aims to compare Indonesian and Australian psychologists' attitudes towards CAM using the previously published study on Psychologists' Attitudes Towards Complementary and Alternative Therapies (PATCAT) scale validation.

Methods

The PATCAT scale was adapted from an Australian study to an Indonesian version using backward-and-forward translation. This scale was used to investigate attitudes towards: (1) CAM knowledge; (2) CAM integration; and (3) the risks associated with CAM. An online survey was sent to all Indonesian psychologists and completed by 247 participants. Afterward, the data were compared with the published data from 115 Australian psychologists.

Results

In general, psychologists in Indonesia and Australia showed relatively similar ambivalent attitudes towards CAM. This uncertainty may stem from the same Western psychology education, which is a basis for the medical models in both nations. They also considered it somewhat important to have an understanding of CAM. Participants in both nations displayed positive attitude towards CAM integration into psychological services. However, they felt that CAM usage for mental health holds some risks.

Conclusion

Australian and Indonesian psychologists reported ambivalent attitudes towards CAM that might be reduced with clear regulation of CAM integration into psychological services from the government and professional organizations.

Indole Diterpenoids from an Endophytic Penicillium sp

A chemical investigation of the endophyte Penicillium sp. (strain ZO-R1-1), isolated from roots of the medicinal plant Zingiber officinale, yielded nine new indole diterpenoids (1-9), together with 13 known congeners (10-22). The structures of the new compounds were elucidated by 1D and 2D NMR analysis in combination with HRESIMS data. The absolute configuration of the new natural products 1, 3, and 7 was determined using the TDDFT-ECD approach and confirmed for 1 by single-crystal X-ray determination through anomalous dispersion. The isolated compounds were tested for cytotoxicity against L5178Y, A2780, J82, and HEK-293 cell lines. Compound 1 was the most active metabolite toward L5178Y cells, with an IC₅₀ value of 3.6 μM, and an IC₅₀ against A2780 cells of 8.7 μM. Interestingly, 1 features a new type of indole diterpenoid scaffold with a rare 6/5/6/6/6/6/5 heterocyclic system bearing an aromatic ring C, which is suggested to be important for the cytotoxic activity of this natural product against L5278Y and A2780 cells.