Borneo Journal of Pharmacy

Evaluation of Amikacin Regimens, Cmax/MIC Ratios, and Clinical Outcomes in a Hospital at Yogyakarta, Indonesia

Firdhani Satia Primasari — 2026-06-30

Amikacin is widely used to treat infections caused by gram-negative bacteria. Its narrow therapeutic range necessitates plasma concentration monitoring through Therapeutic Drug Monitoring (TDM). However, limited infrastructure has restricted TDM implementation in many Indonesian healthcare settings. This study aims to evaluate amikacin dosing, estimate blood concentrations using pharmacokinetic equations, assess the PK/PD profile, and analyze clinical outcomes. This descriptive-analytic study employed a retrospective cross-sectional design. It was conducted at a hospital in Yogyakarta by collecting data on amikacin dosing regimens, patient clinical outcomes, serum creatinine levels, and antibiotic sensitivity test results. The study subjects were hospitalized patients with infections who received amikacin therapy. Descriptive analysis was performed on patient characteristics, while estimated blood drug levels and PK/PD profiles were calculated using pharmacokinetic formulas and analyzed descriptively. A total of 44 amikacin dosing regimens from 40 patients met the inclusion and exclusion criteria. Of these, 39 regimens were appropriate according to dosing guidelines, and 26 (66.7%) resulted in favorable clinical outcomes. In contrast, five inappropriate regimens were associated with poor clinical outcomes. Among the 39 appropriate regimens, only 18 (46.2%) achieved the target peak plasma concentration (C_max). Furthermore, of these 18 regimens, only two (11.1%) achieved the target C_max/MIC ratio, with one associated with a favorable clinical outcome and one without improvement. These findings suggest that, despite appropriate dosing, most amikacin regimens failed to achieve the optimal Cmax/MIC ratio required for effective clinical outcomes, highlighting the potential value of TDM and individualized dosing strategies to optimize amikacin therapy.

Traditional vs. Modern Medicine: Community Preferences and Health Anthropology in North Sulawesi

Weny Indayany Wiyono — 2026-06-30

This study explores community preferences and decision-making in the use of traditional and modern medicine in North Sulawesi from a health anthropology perspective. Using a qualitative descriptive approach, in-depth interviews were conducted with 15 participants, and data were analyzed thematically to identify patterns of perception and factors influencing treatment choice. The results show that traditional medicine is preferred for mild illnesses due to perceptions of safety, affordability, and cultural familiarity, whereas modern medicine is favored for severe or chronic conditions because of its clinical validation, measurable outcomes, and professional supervision. However, a growing trend of complementary use, combining both traditional and modern treatments, was observed, motivated by safety concerns, family or peer advice, and information obtained through the internet, especially social media. The study concludes that decision-making in the use of traditional and modern medicine in North Sulawesi is influenced by illness severity, perceptions, social factors, and access to information. Traditional medicine is preferred for mild conditions, whereas modern medicine is used for severe or chronic illnesses. The combined use of both reflects a pragmatic approach within a pluralistic health system. These findings highlight the need for culturally grounded integration and improved health literacy.

Enhanced Antioxidant Gel Formulation with Papaya Leaf Extract and Virgin Coconut Oil: Optimization Approach

Dyani Primasari Sukamdi — 2026-06-30

Redness, pigmentation, premature aging, xerosis, and even the risk of cancer can result from excessive exposure to free radicals in the form of ultraviolet (UV) radiation, which can cause skin damage. Antioxidants, including β-carotene, α-tocopherol, ascorbic acid, and flavonoids, are present in papaya (Carica papaya) leaves and Virgin Coconut Oil (VCO). Therefore, these two components may mitigate skin imperfections caused by premature aging. This study aims to formulate and determine the antioxidant activity contained in C. papaya leaf extract gel and VCO. A laboratory-based experimental approach was implemented in this study. Using the infusion method, C. papaya leaves were extracted for 15 minutes to initiate the gel formation. The C. papaya leaf extract gel with VCO was divided into five formulations, with varying amounts of each ingredient. Organoleptic, homogeneity, viscosity, pH, spreadability, and antioxidant activity tests, conducted using the DPPH method, are included in the preparation testing process. The antioxidant activity test of C. papaya leaf extract gel with VCO in each formula yielded 91.32 ppm, 121.21 ppm, 80.19 ppm, 67.04 ppm, and 55.31 ppm. The results indicated that the quality of the gel preparation and the IC₅₀ value of the C. papaya leaf extract gel were influenced by variations in VCO concentration.

Studies of the Physicochemical Properties, Stability, Irritability, and Efficacy of Red Boroco (Celosia argentea) Leaf Extract Patch for Diabetic Wound Healing

Siti Fatmawati Fatimah — 2026-06-30

Red Boroco (Celosia argentea) leaves contain flavonoids that act as wound healers by promoting skin tissue repair and fibroblast growth. The 15% w/w C. argentea leaves extract was formulated into a patch for diabetic wound healing. This study aims to evaluate the physicochemical characteristics, physical stability, irritability, and efficacy of the C. argentea leaves extract patch for diabetic wound healing. Celosia argentea leaves were macerated in 70% ethanol, the flavonoid content was measured, and the extract was formulated into a patch. Evaluation of the patch included measurements of organoleptic properties, pH, weight uniformity, folding resistance, patch thickness, moisture content, and moisture uptake. A stability study was conducted using a freeze-thaw cycle method. The Hen's Egg Test-Chorioallantoic Membrane (HET-CAM) to confirm the irritability of the patch. The efficacy study was conducted by measuring the percentage of wound closure in male Wistar rats. The results showed that C. argentea leaves contained 1.101 ± 0.012 μg QE of flavonoids. The patch characteristics were as follows: pH 6.16 ± 0.01; weight uniformity 0.513 ± 0.038 g; folding resistance >300 folds; patch thickness 0.4 mm; moisture content 0.031 ± 0.028%; and moisture uptake 0.030 ± 0.009%. Statistical analysis (unpaired t-test) showed no significant changes in physical properties after the freeze–thaw cycle (p >0.05), indicating good stability. The one-way ANOVA test of wound closure showed no significant difference between the patch group and the positive control group (p = 0.948). Patch exhibited good physical stability, no irritation, and an 89.88% wound-healing rate in the test animal.

Analysis of Antibiotic Use in Outpatient Pneumonia Patients at X Blitar Health Center using the Gyssens Method and the Defined Daily Dose

Hesti Rima Hariyani — 2026-06-30

Pneumonia is one of the respiratory infections that is still a public health problem and requires appropriate antibiotic therapy. However, irrational use of antibiotics has the potential to increase resistance and worsen patient clinical outcomes. This study aims to analyze antibiotic use in outpatient pneumonia patients at the X Blitar Health Center using the Defined Daily Dose (DDD) and Gyssens methods. This study employed a cross-sectional approach, utilizing secondary data from 109 medical records and prescriptions for pneumonia patients (ICD-10 codes J12-J18) from February 2024 to May 2025. Quantitative analysis was conducted using the DDD/1,000 patients per day method, while qualitative analysis of prescriptions was performed using the Gyssens method. The results showed that Amoxicillin (J01CA04) was the most widely used antibiotic, namely 232.42 DDD/1,000 patients per day, followed by Cefadroxil (87.04 DDD/1,000 patients per day), Ciprofoxacin (18.35 DDD/1,000 patients per day), and Azithromycin (15.29 DDD/1,000 patients per day). Gyssens' analysis revealed that most prescriptions fell into categories IIA (33.94%), IVA (29.36%), and V (27.52%). Inaccurate dosage and suboptimal antibiotic selection were the leading causes of irrational antibiotic use. Additionally, 30 pneumonia patients were identified who did not receive antibiotics despite having clinical indications for them. The results of this study emphasize the need for rationalization training in therapy, prescription audits, and the strengthening of clinical guidelines implementation in primary care facilities.

Rapid and Controlled: Microflow Reactor-Assisted Synthesis of Cinnamaldehyde and Ethyl Cinnamate along with Their Cytotoxic Activity Against Several Cell Lines

Nindita Fransiska Rahmawati — 2026-06-30

Cinnamaldehyde is a major aromatic compound utilized in the pharmaceutical industry due to its diverse biological activities, including anticancer potential. This study aims to develop a rapid and controlled synthesis method for cinnamaldehyde and ethyl cinnamate using microflow reactor technology, followed by structural elucidation and cytotoxic evaluation against HeLa, MCF-7, and T47D cancer cell lines. The synthesis of cinnamaldehyde was performed via aldol condensation of benzaldehyde and acetaldehyde (1.3:1 molar ratio) at 70°C, while ethyl cinnamate was synthesized through a two-step process involving Pinnick oxidation and Fischer esterification. The results demonstrated that microflow synthesis achieved a cinnamaldehyde yield of 52% with high purity (100% based on HPLC relative area), and ethyl cinnamate with 99% purity. In cytotoxic assays, synthesized cinnamaldehyde exhibited moderate activity, most notably against HeLa cells with an IC₅₀ of 95 µg/mL, whereas ethyl cinnamate showed lower potency (IC₅₀ > 200 µg/mL). Although the synthesized compounds were less potent than the standard cinnamaldehyde (IC₅₀ 1.56 µg/mL) and Doxorubicin control, this study confirms that microflow reactor technology is a highly effective and time-efficient method for producing high-purity cinnamate derivatives.

In Silico Evaluation of Kaempferol, Gallic Acid, and Stigmasterol from Lagerstroemia speciosa as Multi-Target Antidiabetic Agents: Molecular Docking and Dynamics Simulation Study

Aditya Maulana Perdana Putra — 2026-06-30

Diabetes mellitus (DM) is a chronic metabolic disorder that leads to severe complications and continues to increase in prevalence worldwide. Although Lagerstroemia speciosa is a well-recognized antidiabetic medicinal plant, most in silico studies have focused exclusively on its major constituent, leaving the antidiabetic potential of its other phytochemicals largely unexplored. This study investigated the multi-target antidiabetic potential of phytochemicals derived from L. speciosa leaves using an in silico approach targeting three key enzymes: aldose reductase, glucokinase, and glycogen synthase kinase 3-beta (GSK3-β). A total of 62 compounds were screened by molecular docking with AutoDock Vina, followed by toxicity predictions using ProTox-II and ToxTree. The top ligand for each target, kaempferol (aldose reductase), gallic acid (glucokinase), and stigmasterol (GSK3-β), was selected for further evaluation through molecular dynamics simulations using GROMACS 2016.3 for 100 ns. Structural and interaction stability were assessed through RMSD, RMSF, SASA, radius of gyration (Rg), and radial distribution function (RDF) analyses. Binding free energies were calculated using the MM/PBSA method via g_mmpbsa. The results indicated that stigmasterol exhibited the most favorable MM/PBSA binding free energy (–133.377 kJ/mol), followed by kaempferol (–65.714 kJ/mol) and gallic acid (–45.629 kJ/mol). However, this favorable energy was dominated by nonspecific van der Waals contributions, consistent with the diffuse interaction patterns and low hydrogen-bond occupancy (4.24%) for stigmasterol. Kaempferol exhibited the highest hydrogen-bond occupancy (64.38%), indicating a stable, consistent interaction with its target enzyme. Rg and RDF analyses confirmed the compactness and specific atomic interactions of the kaempferol and gallic acid complexes.

Integration of Chitosan and Ageratum conyzoides Extract in Hydrogel Patches for Enhanced Wound Closure Kinetics under the TIME Framework

Malinda Prihantini — 2026-06-30

Chronic wounds pose a significant healthcare challenge in Southeast Asia, with prevalence rates reaching 50.8%. Conventional systemic therapies often fail due to persistent inflammation and bacterial biofilm formation. This study presents a novel approach that combines chitosan, a hydrophilic scaffold that maintains optimal moisture and prevents microbial contamination, with Ageratum conyzoides, which is rich in flavonoids with anti-inflammatory and pro-proliferative properties. This study aimed to evaluate the impact of chitosan combined with A. conyzoides in a hydrogel patch formulation on wound healing as a comprehensive approach to the TIME (Tissue, Inflammation, Moisture, Epithelization) concept. The standardized plant material was formulated into patches by a solvent‐casting method using three extract‐to‐chitosan ratios: F1 (2:0), F2 (1:1), and F3 (2:1). Evaluation encompassed physical characterization, acute dermal irritation, and wound‐healing activity assessment. Plant material met the Indonesian Herbal Pharmacopeia standards, yielding 9.96 ± 0.10% total flavonoid content, with phytochemical screening confirming flavonoids, phenolics, and quinones. All formulations demonstrated favorable physical characteristics: thickness of 0.08–0.11 mm, folding endurance of 64–479 folds, and moisture absorption of 6.12–9.39%, with no acute dermal irritation observed in rabbits. In a 14-day linear incision wound model using male Wistar rats, F3 achieved superior healing efficacy (97% closure, rate constant 0.2972 day⁻¹), reaching 90% closure by day 7.75, significantly outperforming the positive control (Bioplacenton®, 89%) and negative control (79%). These results highlight F3's synergistic effects via anti-inflammatory and proliferative mechanisms, following first-order kinetics and comprehensively addressing the TIME framework to enhance wound healing.

Comparative Toxicity and LC50 Determination of Phaleria macrocarpa Leaf Extracts from Sequential Maceration

Sara Nurmala — 2026-06-30

Phaleria macrocarpa is a plant renowned for its bioactive compounds, including flavonoids, alkaloids, saponins, and tannins, which are believed to have various pharmacological properties. This study aimed to determine the lethal concentration 50 (LC₅₀) of P. macrocarpa leaf extracts obtained by sequential maceration in n-hexane, ethyl acetate, and 70% ethanol. The toxicity of the extracts was evaluated using the Brine Shrimp Lethality Test (BSLT) against Artemia salina leach larvae, a commonly used model organism in toxicity testing due to its sensitivity to various toxic substances. The results indicated that the 70% ethanol extract exhibited moderate toxicity with an LC₅₀ of 126.981 ppm, the ethyl acetate extract was categorized as weakly toxic (LC₅₀ of 691.730 ppm), and the n-hexane extract was classified as non-toxic (LC₅₀ of 1416.537 ppm). These findings indicate that solvent polarity influences the extraction of bioactive compounds and their biological activity. This study highlights the novelty of sequential maceration as a selective extraction approach that enhances toxicity profiling and supports preliminary pharmacological screening for natural product-based drug development. Furthermore, the study underscores the importance of using selective extraction methods to isolate bioactive compounds based on their polarity. This study provides preliminary data on the toxicity profile of P. macrocarpa leaves and highlights the potential of its bioactive compounds for further pharmacological research, particularly in the development of natural-based therapeutic agents. Future studies should focus on isolating and identifying the active compounds responsible for the observed toxicity and on their potential for use in drug development.

Evaluation of Clove Volatile Extract Vaporizer Mats for Mosquito Control Against Aedes aegypti: Bioassay and Computational Analysis

Mochammad Aqilah Herdiansyah — 2026-06-30

Syzygium aromaticum contains bioactive compounds that may serve as natural alternatives to synthetic mosquito control agents. This study aimed to evaluate the mosquitocidal activity of stem, leaf, and bud extracts of S. aromaticum, formulated as vaporizer mats, against Aedes aegypti and to identify potential molecular targets of the major compounds in these extracts through computational analysis. Volatile extracts from stems, leaves, and buds were prepared by ethanol maceration and formulated into vaporizer mats at concentrations of 0.5% and 1%. A total of 525 adult A. aegypti (F330 strain) were exposed under controlled laboratory conditions in accordance with WHO guidelines. Mortality, LT50, and LT90 values were recorded after exposure. Molecular docking was performed against odorant-binding protein AaegOBP1 and pyruvate kinase (PK1), followed by molecular dynamics simulation. Among all treatments, bud extract at 1% produced the highest mortality (33%), compared with 2% in the negative control. LT50 and LT90 values for this treatment were 1.468 minutes and 50.543 minutes, respectively, indicating prolonged biological activity. Docking analysis showed that β-caryophyllene had the strongest affinity toward AaegOBP1 (-8.4 kcal/mol), while chavicol showed the strongest interaction with PK1 (-6.5 kcal/mol). Molecular dynamics simulation confirmed stable ligand-receptor interactions with RMSF values below 3 Å. These findings indicate that S. aromaticum bud extract has moderate mosquitocidal potential in vaporizer mat formulation and may act through olfactory disruption and metabolic interference in A. aegypti.

The Effect of Thymoquinone on Progressive Brain Damage: An Experimental Study in a Wistar Rat Model of Intracerebral Hemorrhage

Khamim Thohari — 2026-06-30

Background: ICH accounts for 20% of stroke cases, with a mortality rate of 40-50%. Despite available agents such as citicoline and piracetam, neuroprotective therapy for ICH remains unsatisfactory. TQ, the main active compound of Nigella sativa, has antioxidant and anti-inflammatory properties, but its role in ICH has not been studied. Objective: To evaluate the effect of thymoquinone on inhibiting the progression of brain damage in a Wistar rat model of ICH and to explore potential mechanisms Methods: Male Wistar rats (n=55, 200–220 g) were randomly assigned to five groups: control (no treatment), ICH without thymoquinone (terminated immediately), ICH with corn oil (terminated after 7 days), and ICH with thymoquinone at doses of 150 and 250 mg/kg body weight orally for 7 days (terminated after 7 days). ICH was induced by autologous blood injection (0.12 ml) into the brain parenchyma. Brain and serum samples were analyzed for NLRP3, TNF-α, IL-6, IL-1β, MMP-9, SOD, MDA, and necrotic cells using ELISA, immunohistochemistry, and histology. Statistical analyses included univariate analysis, Shapiro–Wilk, Kruskal–Wallis, and Mann–Whitney U tests. Results: TQ administration significantly altered MMP-9 levels (p=0.000), which increased compared with untreated ICH. TQ was associated with reductions in NLRP3, TNF-α, and IL-1β, while increasing SOD activityMDA levels remained elevated. These effects were dose-dependent, with the most consistent changes observed at 250 mg/kg. Conclusion: TQ modulated inflammatory and oxidative pathways in ICH and unexpectedly upregulated MMP-9, suggesting a dual role in early injury and later tissue remodeling. These findings support TQ as a potential natural neuroprotective agent.

Cover, Content, and Editorial Note from Borneo J Pharm Vol. 9 No. 2 June 2026

Mohammad Rizki Fadhil Pratama — 2026-06-30

Assalamu'alaikum Wr. Wb.

Alhamdulillahirabbil 'alamin. The next edition of Borneo Journal of Pharmacy (Borneo J Pharm) has been published in June 2026. This edition contains twelve articles spanning: Pharmacology-Toxicology, Pharmacognosy-Phytochemistry, Pharmaceutics, Analytical Pharmacy-Medicinal Chemistry, Microbiology Pharmacy, Natural Product Development, Community Pharmacy, and Clinical Pharmacy Practice. This edition includes writings from three countries: Indonesia, Malaysia, and South Korea.
The editorial board is fully aware that there is still room for improvement in this edition; hence, with all humility, we are willing to accept constructive suggestions and feedback to improve the publication in future editions. The editorial board would like to thank all editors, reviewers, and contributors of the scientific articles who have provided the repertoire in this issue. We hope that all parties, especially the contributors, will participate again in the publication of the next edition, scheduled for September 2026.

Wassalamu'alaikum Wr. Wb.

Palangka Raya, June 2026

Editor-in-Chief

Public Knowledge, Trust, Attitude, and Behavioral Intention toward the Integration of Jamu into National Health Services

Mohamad Kashuri — 2026-06-30

The integration of jamu into Indonesia's formal healthcare system remains an important policy issue, particularly in ensuring that regulatory development is matched by public acceptance and behavioral readiness. This study aimed to examine public perceptions of integrating jamu into national health services using a Theory of Planned Behavior (TPB)-informed framework. A quantitative cross-sectional survey was conducted among 300 webinar participants aged 18 years or older using purposive sampling. Data were collected through an anonymous online questionnaire comprising 12 items across four latent constructs: knowledge, trust, attitude, and behavioral intention. The relationships among constructs were analyzed using partial least squares structural equation modeling (PLS-SEM). The results showed that attitude was the strongest predictor of behavioral intention (β = 0.837, p <0.001), while knowledge significantly influenced trust (β = 0.651) and attitude (β = 0.248), and trust also significantly influenced attitude (β = 0.486). The model explained 70% of the variance in behavioral intention, indicating substantial explanatory power. These findings suggest a coherent behavioral pathway in which knowledge and trust strengthen attitude, which in turn drives public intention to support the integration of jamu into formal healthcare services. The study concludes that successful integration depends not only on regulatory readiness but also on strengthening public knowledge, trust, and attitudes toward traditional medicine. However, the findings should be interpreted cautiously because the sample was non-random and relatively digitally literate. Future studies should include more diverse populations and use longitudinal or mixed-method approaches to support evidence-based integration policies.