ACTA Medical Health Sciences

Hypolipidemic effect of lime (Citrus aurantifolia) fruit ethanol extract on total cholesterol levels in rats

Welya Putri, Evi Sovia, Sherly Y Ferriani — Sun, 02 Mar 2025 00:00:00 +0100

High cholesterol levels are a significant risk factor for cardiovascular disease. Statins are commonly used to reduce total cholesterol levels; however, long-term use can lead to adverse effects such as myalgia, an increased risk of type 2 diabetes, and liver damage. As a result, there is a growing need for research into natural medicines for cholesterol management. Lime
(Citrus aurantifolia) is rich in flavonoids, which have been shown to reduce cholesterol by inhibiting the HMG-CoA reductase enzyme, a mechanism similar to that of statins. This study aimed to evaluate the effect of lime fruit ethanol extract on total cholesterol levels in male Wistar strain rats induced with a high-fat diet and PTU. This study was conducted as a laboratory experiment using a post-test control group design. Male Wistar rats were divided into six groups: a normal control group, a negative control group (high-fat diet + PTU), a positive control group (simvastatin), and three test groups (lime fruit ethanol extract 0.875, 1.75, and 3.5 g/kg BW). The high-fat diet and PTU were induced for 14 days, and total cholesterol levels were determined using the enzymatic colorimetric method (CHOD/PAP) at the end. The administration of lime fruit ethanol extract at a dose of 0.875 g/kgBW significantly reduced total cholesterol compared to the negative control group (p=0.013), with no significant difference from the normal group (p=0.965). However, higher doses of 1.75 and 3.5 g/kg BW caused mortality in the test groups. These findings suggest that lime fruit ethanol extract effectively reduces total cholesterol levels at a dose of 0.875 g/kg BW. Further research is needed to determine the optimal dose and toxicity profile of lime fruit ethanol extract for
hyperlipidemia therapy.

Phytochemical screening and antidyslipidemic effect of lime fruit (Citrus aurantifolia) ethanol extract on high-density lipoprotein levels of high-fat diet-induced rats

Nabila D M Putri, Evi Sovia, Jusron Iriawan — Sun, 02 Mar 2025 00:00:00 +0100

Dyslipidemia is a significant health problem in Indonesia and a major cause of coronary heart disease (CHD). According to the 2018 Riset Kesehatan Dasar Nasional (RISKESDAS), 24.3% of Indonesians aged ≥15 years had low high-density lipoprotein (HDL) levels, while 13.8% had high HDL levels. Treatment with traditional medicine is a popular approach in Indonesia. Lime (Citrus aurantifolia) contains flavonoids that can inhibit the activity of the hydroxymethylglutaryl-coenzyme A reductase (HMG-CoA reductase) enzyme. This study aimed to identify the chemical compounds found in lime peel and fruit, as well as to determine
the effective dose of ethanol extract from lime fruit in increasing HDL levels. This research is a true experimental study conducted in the laboratory using an in vivo approach. The research used a randomized post-test only control group design involving both control and treatment groups. Based on the results of phytochemical screening, the lime fruit ethanol
extract contains flavonoids, alkaloids, tannins, polyphenols, saponins, and quinones. Using the Saphiro-Wilk normality test, the data obtained are normally distributed with a p-value of 0.809 (p > 0.05). Statistical analysis was continued with the one-way ANOVA parametric test, and a p-value of 0.146 (p > 0.05) was obtained. An increase in the average HDL levels was also observed in the treatment group given a dose of 0.875 g/KgBW of lime fruit ethanol extract, but there was no significant difference in the average HDL levels between the groups.

Assessment of GeneXpert MTB/RIF performance for tuberculosis at doctor chasbullah abdulmajid hospital, bekasi city

Denty Hawafirdaus, Lily B Shurianto, Susanti Ratunanda — Sun, 02 Mar 2025 00:00:00 +0100

Tuberculosis (TB) remains a critical global health threat, with effective detection methods continuing to pose challenges. Since 2012, the Indonesian National TB Control Program has utilized the GeneXpert examination with the Xpert MTB/RIF (Mycobacterium Tuberculosis/Rifampicin) cartridge, enabling rapid identification of Mycobacterium tuberculosis (MTB) and simultaneous detection of rifampicin resistance. This descriptive study assesses the performance of the GeneXpert MTB/RIF assay in patients at Doctor Chasbullah Abdulmajid Hospital. Results were classified into successful tests (MTB detected, MTB not detected, MTB detected with rifampicin resistance, and MTB detected with rifampicin indeterminate) and failed tests (invalid, error, and no result). Data were sourced from the National Tuberculosis Information System (SITB), comprising 2,408 patients who met the inclusion criteria. The findings indicate that most suspected TB patients were between 19 and 44 years old (36.62%), with a higher prevalence in males (58.39%) than in females (41.6%). The majority were new TB cases (88.88%). The GeneXpert MTB/RIF assay exhibited an impressive 99.8% success rate, alongside a failure rate of 0.12%. Among successful tests,
30.06% detected MTB, with 26.61% being rifampicin-sensitive and 3.44% resistant. Notably, 69.80% of tests resulted in undetectable MTB. Error results may arise from various factors, including undetectable MTB DNA and system malfunctions. While a significant number of negative results were observed, these findings merit further investigation, particularly in suspected pediatric TB cases.

Efficacy and safety of short vs. Standard long regimens for multidrug- resistant tuberculosis: a network meta-analysis

Josephine G R Simanjuntak, Made A K Gandhy, Kynthia Sadha — Sun, 02 Mar 2025 00:00:00 +0100

Drug-resistant tuberculosis (DR-TB) remains a critical health concern, particularly in high- burden regions like Indonesia. Shorter treatment regimens have been proposed to improve outcomes for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). This systematic review and Bayesian network meta-analysis aimed to evaluate the efficacy and safety of these shorter regimens. Using PRISMA-NMA guidelines, we systematically searched multiple databases, including PubMed, Cochrane, Scopus, WOAJ, and WOS, for studies published between 2014 to 2024. We included 23 eligible studies comprising a total of 6,343 MDR/RR- TB patients. Results showed that treatment with a 9-12 month regimen, specifically Kanamycin (Km)/Capreomycin (Cm), Moxifloxacin (Mfx)/Levofloxacin (Lfx), Prothionamide (Pto), Clofazimine (Cfz), Pyrazinamide (Z), Ethambutol (E), High-dose Isoniazid (Hh) demonstrated almost twice the probability of favorable outcomes defined as cure or treatment completion, compared to the standard regimens [RR 1.66 (95%CrI 1.34;2.04), P=0.0094]. Additionally, the 6-month regimen Bedaquiline (Bdq), Pretomanid (Pa), Linezolid (Lzd), Moxifloxacin (Mfx) also showed significantly higher favorable outcomes [RR 1.59 (95%CrI 1.29;2.03), P<0.001]. For safety outcomes, regimens containing bedaquiline, such as the 6-month Bdq, Pa, Lzd, Mfx regimen, had a 38% reduction in the risk of adverse events compared to the standard [RR 0.623 (95%CrI 0.280;1.29), P < 0.0001]. This was followed by the 6-month Bdq, Pa, Lzd and the Bdq, Pa, Lzd, Cfz regimen, which also showed lower risks of adverse events. In conclusion, shorter MDR/RR-TB regimens, especially those containing bedaquiline, appear to enhance cure rates while reducing adverse effects, supporting current WHO guidelines for 6-month treatment options

The relationship between family support factors and substance abuse relapse: an updated literature review

Laila Astyningtyas — Sun, 02 Mar 2025 00:00:00 +0100

Current global data indicate that 296 million individuals engage in drug abuse, representing an increase of 12 million compared to previous figures. In Indonesia, the prevalence was 1.73%, with 173 individuals having used drugs in the past year. This study aimed to examine the supportive factors and challenges faced by substance abusers in overcoming dependence, achieving abstinence, and preventing relapse, focusing on resilience, self-esteem, and family functioning. This study employed a literature review methodology. Literature sources were identified using search engines through electronic media, including Google Scholar, PubMed, and ScienceDirect, covering publications from 2014 to 2024. The selected articles were assessed and evaluated based on predefined inclusion criteria, resulting in a final selection of 20 articles relevant to the topic. The findings indicate that the risk of relapse can be minimized with strong social support, especially from family members, which increases self-efficacy and resilience, thereby strengthening commitment to treatment. Therefore, intervention strategies that focus on improving family dynamics, strengthening self-esteem, and enhancing resilience are essential to facilitate sustainable recovery for individuals with substance use disorders. Family support has a positive impact on reducing the likelihood of relapsing in substance abusers. This article also compared similar findings from previous studies and presented the latest expert opinions supporting the importance of family communication in drug prevention. Adequate family support, in the form of communication and emotional support, can increase the resilience of substance users, thereby minimizing the risk of relapse in substance abuse.

Efficacy safety of chemoprophylactic plasmodium falciparum and sporozoite vaccines for malaria prevention: a systematic review and meta- analysis

Alya I N Kamila, Aqilla S Chandrarini, Rossi S Devi — Sun, 02 Mar 2025 00:00:00 +0100

PfSPZ-CVac, an innovative vaccine, aims to combat malaria by using live, weakened Plasmodium falciparum sporozoites in combination with chloroquine. This approach employs the whole parasite, triggering a strong immune response and potentially providing long-term protection. The objective of this study is to assess the efficacy and safety of the PfSPZ- Chemoprophylaxis Vaccine (PfSPZ-CVac) for malaria prevention. A systematic review following PRISMA guidelines was conducted, focusing on randomized controlled trials (RCTs) that assessed the efficacy and safety of the vaccine. Seven eligible studies were selected from eight electronic databases. The quality was assessed using the Cochrane Risk of Bias tool, and data analysis was performed using Review Manager 5.4. PfSPZ-CVac combines live sporozoites with chloroquine, which prevents the parasite from entering the liver and enhance the body’s immune response, particularly T-cell activation, to provide long- lasting protection against malaria. The meta-analysis revealed a significant reduction in parasitemia (P<0.00001, I²=35%, MD=0.38). Local solicited adverse events did not show a significant increase (MD=0.73, P=0.45, I²=0%). Similarly, systemic solicited adverse events and unsolicited adverse events demonstrated minimal risks (MD=0.89, P=0.56, I²=23%; MD=0.65, P=0.20, I²=0%). Although PfSPZ-CVac exhibits high efficacy, its administration is complex, and it carries a slight of rare adverse reactions. PfSPZ-CVac demonstrates potential for providing strong, long-term protection against malaria , with a positive safety profile, making it a promising candidate for widespread use in high-transmission regions.