Introduction: Breast cancer is the second most common cancer in women globally, and the incidence rate has increased annually. Traditional medicine is frequently used as a cancer treatment, and soursop or Annona muricata L (A. muricata) is a traditional medicinal plant that has been widely used as an anticancer treatment and requires more thorough study. Methods: In this research, we prepared ethanol extract and three solvents, ie, ethyl acetate, n-hexane and water fractions of A. muricata leaves and assessed their antiproliferation and cytotoxic activity on MCF7 breast cancer cells compared with that on CV1 normal kidney cells; observation of cell morphology by stained with mixture of propidium iodide and 4ʹ,6-diamidino-2-phenylindole indicated that this treatment induced an ongoing process of apoptotic cell death in MCF7 cells. To clarify the cell death mechanism via apoptosis, we assessed the mRNA expression in the caspase cascade of caspase-9, caspase-3, and PARP-1, and anti-apoptotic, Bcl-2 which mediated cytotoxic activity of extracts and ethyl acetate fractions of A. muricata leaves against MCF7 cells. Results: The ethanol extract, ethyl acetate, n-hexane, and water fractions of A. muricata leaves had IC₅₀ values of 5.3, 2.86, 3.08, and 48.31 μg/mL, respectively, in MCF7 cells but had no activity in CV1 cells. The high cytotoxic activity of A. muricata leaves was reflected by changes in the morphology of cancer cells that appeared after 6 h exposure to A. muricata leaf extract and ethyl acetate fraction; the membrane and nucleus of cells undergoing apoptosis were characterized by the rupture and loss of membranes and nuclei. The mechanism that mediates this cytotoxic activity in MCF7 cells was mediated through a decrease in the expression of Bcl-2 mRNA and an increase in caspase-9 and caspase-3 mRNA expression. Conclusion: Therefore, the leaves of the medicinal plant A. muricata contained compounds that on extraction exerted a highly effective activity as an anticancer treatment for breast cancer via induced apoptotic cell death.

In various countries, approximately 80% of patients use herbal medicine, both in single form or in combination with antihypertensive drugs, for the treatment of hypertension. Therefore, this research summarized studies on the simultaneous use of herbal medicines and antihypertensive drugs among hypertensive patients in the community. A literature search was conducted on PubMed in April 2020, and the following keywords were used: “herbal medicines” and “antihypertensive patients.” In total, 15 of 263 articles were found to be eligible in the initial research. Results showed that studies were performed in different countries worldwide including America and those in Europe, Asia, and Africa between 1960 and 2020. The factors associated with the use of herbal medicines and antihypertensive drugs were age, gender, education level, income, and residence. Herbal medicines and antihypertensive drugs are simultaneously utilized primarily due to their safety and high efficacy. Herbal medicine is frequently recommended by friends or colleagues, herbalists, advertisements, and health workers. Garlic is the most common herbal medicine used along with antihypertensive drugs. The side effects of combination therapy with herbal medicines and prescription drugs for the management of antihypertension include shortness of breath and cough, ulcers, diarrhea, knee cramps, and abdominal discomfort. The lack of communication between patients and health care workers could cause an increase in the simultaneous use of herbal medicines and antihypertensive drugs. Therefore, effective communication among health care workers and appropriate care are important in preventing the side effects and other risks of combined therapy.

Androgenetic Alopecia (AGA) occurs due to over-response to androgens causing severe hair loss on the scalp, and requires the development of new and efficient drugs to treat this condition. This study explores and identifies secondary metabolites from Sansevieriatrifasciata Prain using the LC-MS/MS and in-silico method. The inhibitory activity of bioactive compounds from S. trifasciata Prain against androgen receptors (PDB ID: 4K7A) was evaluated molecularly using docking and dynamics studies by comparing their binding energies, interactions, and stability with minoxidil. The results of the LC-MS/MS analysis identified Methyl pyrophaeophorbide A (1), Oliveramine (2), (2S)-3′, 4′-Methylenedioxy-5, 7-dimethoxyflavane (3), 1-Acetyl-β-carboline (4), Digiprolactone (5), Trichosanic acid (6) and Methyl gallate (7) from the leaves subfraction of this plant. Three alkaloid compounds (compounds 1, 3, and 4), and one flavonoid (compound 2), had lower docking scores of −7.0, −5.8, −5.2, and −6.3 kcal/mol, respectively. The prediction of binding energy using the MM-PBSA approach ensured that the potency of the four compounds was better than minoxidil, with energies of −66.13, −59.36, −40.39, and −40.25 kJ/mol for compounds 1, 3, 2, and 4, respectively. The dynamics simulation shows the stability of compound 1 based on the trajectory analysis for the 100 ns simulation. This research succeeded in identifying the compound and assessing the anti-alopecia activity of Sansevieria trifasciata Prain. Seven compounds were identified as new compounds never reported in Sansevieria trifasciata Prain. Four compounds were predicted to have better anti-alopecia activity than minoxidil in inhibiting androgen receptors through an in silico approach.

Introduction: The prevalence of hypertension in Indonesia is increasing, not least in some peripheral areas, including in Pandeglang District, Banten Province. The government of Indonesia, through the Social Health Insurance Administration Body (BPJS Kesehatan) has launched a chronic disease management program (Prolanis) to achieve more optimal results in treating patients with chronic diseases, including hypertension. Objective: This study aimed to measure the quality of life of Prolanis hypertension patients at the primary healthcare centers (PHCs) using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument and taking pharmacists’ counseling intervention into account. This study was conducted in 96 Prolanis patients, consisting of 48 patients from 8 PHCs who did not receive pharmacists’ counseling intervention (control group) and 48 other patients from 8 different PHCs who received 4 times intervention (intervention group). This study was conducted in a period of 3 months (June–August 2019) in 16 sub-districts of Pandeglang District. Methods: An experimental study design was applied by considering a purposive sampling method. Patients’ quality of life were measured by using EQ-5D-5L instrument and its Indonesian value set. For data analysis, we applied the Kruskal–Wallis, Mann–Whitney, Wilcoxon, and Binomial tests to investigate the differences of patients’ quality of life in both groups of control and intervention. Results and Conclusions: The results showed that the average utility value of the intervention group experienced an improvement at each meeting (m1 = 51.25%; m2 = 66.25%; m3 = 84.17%; and m4 = 91.67%), while the control group experienced a lower and more fluctuative improvement than the intervention group (m1 = 65.42%; m2 = 70.42%; m3 = 80.42%; and m4 = 76.67%). The same results also occurred in the average value of visual analogue scale (VAS). There was a better improvement in the intervention group than in the control group. Clinical Trial Registration Number: 62/UN6.KEP/EC/2019.

Androgenic alopecia (AA) is a condition that most commonly affects adult men and is caused by an increase in the hormone dihydrotestosterone (DHT) in the hair follicles. Anti-alopecia drugs should be discovered for hair follicles to enter the anagen growth phase. Therefore, this study evaluated the hair growth-promoting activity of Noni fruit’s water, ethyl acetate, n-hexane fractions, and sub-fractions from the active fraction in the alopecia male white rabbit model. The Matias method was modified by inducing rabbits using DHT for 17 days, followed by topical application of Noni fruit solution for 21 days. Meanwhile, hair growth was evaluated by histological observation of the follicular density and the anagen/telogen (A/T) ratio in skin tissue. In the first stage, five groups of male white rabbits were studied to obtain the active fraction; DHT+Minoxidil as standard, DHT+vehicle (NaCMC 1%), DHT+FW, DHT+FEA, and DHT+FH. The FEA as the active fraction was followed by open-column chromatography separation (DCM:Methanol) with a gradient of 10% to produce sub-fractions. In the second stage, the six main sub-fraction groups of male rabbits studied were DHT+FEA-1 to DHT+FEA-6. The follicular density of groups FEA-3 was 78.00 ± 1.52 compared with 31.55 ± 1.64 and 80.12 ± 1.02 in the Vehicle and Minoxidil groups. Additionally, group FEA-3 showed large numbers of anagen follicles with an A/T ratio of 1.64/1 compared to the vehicle group of 1/1.50 and 1.39/1 for Minoxidil control. Group FEA-3 was identified by LC-MS/MS-QTOF, followed by molecular docking to the androgen receptor (PDB: 4K7A), causing alopecia. The results showed that three alkaloid compounds with skeleton piperazine and piperidine, namely (compounds 2 (−4.99 Kcal/mol), 3 (−4.60 Kcal/mol), and 4 (−4.57 Kcal/mol)) had a binding affinity similar to Minoxidil, with also has alkaloid skeleton piperidine–pyrimidine (−4.83 Kcal/mol). The dynamic behavior showed the stability of all androgen receptor compounds with good RMSD, SMSF, and SASA values after being studied with 100 ns molecular dynamics (MD) simulations. This study produced a common thread in discovering a class of alkaloid compounds as inhibitors of androgen receptors that cause alopecia.

Pharmacists have undergone obstacles in the process of detecting, resolving, and preventing CKD patients’ DRPs. Thus, optimal strategies were needed. A total of 19 articles were included based on the article searching process. Based on the articles, it can be concluded: The strategies of detecting DRPs in CKD patients were carried out through medication reconciliation and medication review. The outcomes of these strategies were the number of DRPs/patients and types of DRPs detected. Strategies to resolve and prevent DRPs in CKD patients were conducted through interprofessional collaboration, education, and counselling. The outcome of these strategies was a change in the patients’ DRPs status. Optimization of detection, resolution, and prevention strategies were performed by improving pharmacists’ professional hard and soft-skills as well as modifying the pharmaceutical care delivery model. A decrease in the number of DRPs/patients and a change in DRPs status were reported as the outcomes of optimizing this process.