Piper betle (L) is a popular medicinal plant in Asia. Plant leaves have been used as a traditional medicine to treat various health conditions. It is highly abundant and inexpensive, therefore promoting further research and industrialization development, including in the food and pharmaceutical industries. Articles published from 2010 to 2020 were reviewed in detail to show recent updates on the antibacterial and antifungal properties of betel leaves. This current review showed that betel leaves extract, essential oil, preparations, and isolates could inhibit microbial growth and kill various Gram-negative and Gram-positive bacteria as well as fungal species, including those that are multidrug-resistant and cause serious infectious diseases. P. betle leaves displayed high efficiency on Gram-negative bacteria such as Escherichia coli and Pseudomonas aeruginosa, Gram-positive bacteria such as Staphylococcus aureus, and Candida albicans. The ratio of MBC/MIC indicated bactericidal and bacteriostatic effects of P. betle leaves, while MFC/MIC values showed fungicidal and fungistatic effects. This review also provides a list of phytochemical compounds in betel leaves extracts and essential oils, safety profiles, and value-added products of betel leaves. Some studies also showed that the combination of betel leaves extract and essential oil with antibiotics (streptomycin, chloramphenicol and gentamicin) could provide potentiating antibacterial properties. Moreover, this review delivers a scientific resume for researchers in respected areas and manufacturers who want to develop betel leaves-based products.

COVID-19 and changes in the health order in the new normal era have led to health problems, especially in blind people. Blind people have more difficulty accessing and getting health information. Good quality education and providing information with appropriate media are very important to improve a healthy lifestyle in the new normal era. Education and information about the healthy lifestyle in a new normal era with an audiobook aimed to improve knowledge about the healthy lifestyle in the new normal era at Dria-Raba Foundation. The method in this activity was to provide knowledge about the healthy lifestyle in new-normal using the audiobook to 23 blind people at Dria-Raba Foundation. A pre-test and post-test were analyzed using the Wilcoxon signed-rank test to evaluate the efficacy of the audiobook. The result showed a significant increase in knowledge from a score of 70 to 80 (p<0.05), thus education using the audiobook for blind people at the Dria-Raba Foundation to increase knowledge about a healthy lifestyle in new-normal. To improve the health quality of blind people, various types of audiobooks on health topics can be created. ABSTRAK Adanya pandemi Coronavirus Disease (COVID-19) dan perubahan tatanan kesehatan di era normal baru menyebabkan masalah terkait kesehatan yang dihadapi oleh penyandang disabilitas sensorik netra menjadi semakin kompleks. Penyandang disabilitas sensorik netra sulit untuk mendapatkan akses dan informasi tentang kesehatan. Dukungan berupa edukasi dan pemberian informasi dengan media yang sesuai menjadi sangat penting untuk memperbaiki perilaku hidup sehat di era normal baru. Pemberian edukasi terkait perilaku hidup sehat di era normal baru dengan menggunakan audiobook bertujuan untuk meningkatkan pengetahuan para penyandang disabilitas sensorik netra di Yayasan Dria-Raba tentang perilaku hidup sehat di era normal baru. Metode yang diterapkan dalam kegiatan pengabdian kepada masyarakat ini yaitu memberikan edukasi melalui audiobook kepada 23 orang penyandang disabilitas sensorik netra di Yayasan Dria-Raba. Untuk mengukur keberhasilan audiobook, dilakukan pre-test dan post-test yang kemudian dianalisis menggunakan uji Wilcoxon Signed-rank test. Hasil uji menunjukkan adanya peningkatan pengetahuan yang signifikan dari skor 70 menjadi 80 (p<0,05), sehingga dapat disimpulkan bahwa edukasi menggunakan audiobook bagi penyandang disabilitas sensorik netra di Yayasan Dria-Raba mampu meningkatkan pengetahuan para penyandang disabilitas sensorik netra tentang perilaku hidup sehat di era normal baru. Dalam hal meningkatkan kualitas kesehatan bagi para penyandang disabilitas sensorik netra, diharapkan dapat diciptakan berbagai audiobook dengan tema kesehatan lainnya.

COVID-19 with bacterial pneumonia co-infection is a condition with bacteria present in COVID-19 patients. The prevalence of bacterial co-infection in COVID-19 patients ranges from 12.4%–50%. This study aims to determine the relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection at Hospital "X" Bali Province, Indonesia. This research is an observational study with a cross-sectional approach. Data collection was carried out retrospectively on medical record data of COVID-19 inpatients with pneumonia co-infection at Hospital "X" Bali Province, Indonesia for the period January - December 2021. The sampling technique used total sampling according to inclusion and exclusion criteria. Appropriate use of antibiotics antibiotic was analyzed using Pharmaceutical Care Network Europe (PCNE) version 9.1. The patient severity index was an assessment based on the Pneumonia Severity Index (PSI) score. The relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection was analyzed using Fisher's test. Of the 80 COVID-19 inpatients with pneumonia co-infection, 90% experienced inappropriate use of antibiotics. Fisher's test results showed that there was no significant relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection at Hospital "X" Bali Province, Indonesia (p > 0.05). COVID-19 dengan koinfeksi bakteri pneumonia merupakan suatu kondisi adanya patogen kedua pada pasien COVID-19. Prevalensi kejadian koinfeksi bakteri pada pasien COVID-19 berkisar antara 12,4%–50%. Penelitian ini bertujuan untuk mengetahui hubungan antara ketepatan penggunaan antibiotik terhadap derajat keparahan pasien rawat inap COVID-19 dengan koinfeksi pneumonia di Rumah Sakit “X” Provinsi Bali, Indonesia. Penelitian ini merupakan penelitian observasional dengan pendekatan cross sectional. Pengumpulan data dilakukan secara retrospektif terhadap data rekam medis pasien rawat inap COVID-19 dengan koinfeksi pneumonia di Rumah Sakit “X” Provinsi Bali, Indonesia periode Januari - Desember 2021. Teknik pengambilan sampel menggunakan total sampling sesuai kriteria inklusi dan eksklusi. Analisis ketepatan penggunaan antibiotik dilakukan menggunakan Pharmaceutical Care Network Europe (PCNE) versi 9.1. Derajat keparahan pasien merupakan penilaian kondisi keparahan pneumonia berdasarkan skor Pneumonia Severity Index (PSI). Analisis hubungan antara ketepatan penggunaan antibiotik terhadap derajat keparahan pasien rawat inap COVID-19 dengan koinfeksi pneumonia menggunakan uji Fisher. Dari 80 pasien rawat inap COVID-19 dengan koinfeksi pneumonia, sebanyak 90% terjadi ketidaktepatan penggunaan antibiotik. Hasil uji Fisher menunjukkan bahwa tidak terdapat hubungan yang signifikan antara ketepatan penggunaan antibiotik terhadap derajat keparahan pasien rawat inap COVID-19 dengan koinfeksi pneumonia di Rumah Sakit “X” Provinsi Bali, Indonesia (p > 0,05).

Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, dan Escherichia coli merupakan kelompok critical-priority bacteria yang telah mengalami multi drug resistant (MDR) dan sering ditemukan di Intensive Care Unit (ICU). Isolat bakteri-bakteri berjumlah lebih dari 75% mengalami MDR di ICU sebuah rumah sakit umum daerah di Bali, Indonesia. Penggunaan antibiotik yang tinggi berkaitan dengan tingkat resistensi bakteri terhadap antibiotik. Pola resistensi bakteri terhadap antibiotik dapat berbeda di setiap wilayah yang disebabkan oleh adanya perbedaan lingkungan dan perbedaan tingkat penggunaan antibiotik di wilayah tersebut. Penelitian ini bertujuan untuk mengetahui tren penggunaan antibiotik sistemik, pola resistensi dan hubungan antara tingkat penggunaan dengan persentase resistensi bakteri terhadap antibiotik pada kelompok critical-priority bacteria di ICU rumah sakit “X” provinsi Bali. Penelitian ini merupakan penelitian ekologikal yang menggunakan data sekunder selama tahun 2017-2019. Analisis tren penggunaan antibiotik dianalisis menggunakan time series analysis. Hubungan antara tingkat penggunaan antibiotik dan persentase resistensi bakteri prioritas kritis dianalisis dengan regresi linier. Hasil penelitian menunjukkan bahwa antibiotik gentamisin, amikasin, dan siprofloksasin mengalami peningkatan tren penggunaan sedangkan ampisilin, ampisilin-sulbaktam, seftazidim, dan meropenem mengalami penurunan tren penggunaan. Time series analysis menunjukkan penggunaan antibiotik yang fluktuatif. Selain itu, didapatkan bahwa A. baumannii masuk dalam dua kategori fenotipik CDC yaitu, carbNS_Acine dan MDR_Acine sedangkan K. pneumoniae masuk dalam kategori ESCklebsiella. Tingkat penggunaan antibiotik sistemik di ICU dengan persentase resistensi E. coli, K. pneumoniae, dan P. aeruginosa di ICU (p<0,05) terdapat hubungan signifikan, tetapi tidak terdapat hubungan yang signifikan antara penggunaan antibiotik sistemik pada pasien di ICU dengan persentase resistensi bakteri A. baumannii (p>0,05).

Lontar Usada Pemunah Cetik Kerikan Gangsa contains the Balinese poison, which containing the ingredients of poison, signs and symptomps of poison, and traditional therapy for poison. The Balinese community believed that the chronic illness may caused by cetik. Until now, there has been no evidence about Balinese poison and Balinese traditional therapy for poison. It is this which has inspired the researcher to explore the traditional therapy in usada pemunah cetik kerikan gangsa. This was an ecological study based on Lontar Usada Cetik Kerikan Gangsa and experience of traditional medicine practicioners in Denpasar area. This study was a descriptive qualitative research with in-depth interview method. We colected the information about usada pemunah cetik from traditional medicine practicioners in Denpasar area. The result showed that ingredients of cetik containing the heavy metal which high toxicity such as plumbum and copper. The traditional therapy for cetik kerikan gangsa using the lemon grass (Cymbopogon citratus) and coconut water (Cocos nucifera L).