Introduction: Stroke is one of the most common neurological diseases, often causing death or gross physical impairment or disability. The associated risk factors such as hypertension, high cholesterol, diabetes, heart disease, and smoking should serve as warnings. However, most people are still not aware of these risks. The main aim of this study is to identify stroke awareness behavior using the construct variable from the Theory of Planned Behavior as the predictor (attitude factor, subjective norm factor, perceived behavioral factor, and intention to perform behavior). Methods: A cross-sectional study was conducted on 256 people who have a high risk of stroke at the Poncokusumo Health Center, Malang, Indonesia. The sampling technique used was purposive sampling. The authors used all the construct variables in the Theory of Planned Behavior. The stroke awareness behavior was measured using a questionnaire developed from the National Stroke Awareness Guide, while the attitude factor, subjective norm factor, perceived behavioral factor, and intention were measured using the instruments developed from standard instruments from the Theory of Planned Behavior. Structural Equation Modeling (SEM-PLS) was used to analyse the data. Result: This study found that 68.4% of respondent with high or low intention of preventing a stroke can be predicted by attitude factors, subjective norm factors, and perceived behavioral factors. While 96.1% of good or bad stroke awareness behavior can be predicted by the model used in this study, the rest (3.9%) is explained by other variables outside this research model. Conclusion: The hypothesis testing results showed that all construct variables in the Theory of Planned Behavior can be strong predictors of stroke awareness behavior. All variables in the Theory of Planned Behavior can be powerful predictors of stroke awareness behavior.

Introduction: In 2019, according to the World Health Organization (WHO), pneumonia is the leading infectious cause of death in children under the age of five. In 2017, pneumonia killed 808,694 children under five, accounting for 15% of all fatalities among children under the age of five. Methods: An observational analytic survey with a case control design was used as the study approach. The research samples were collected using a simple random sampling procedure with 48 children under the age of five separated into two groups, 24 samples for the case group and 24 samples for the control group. The research was carried out between February and July of 2020. This study tools used were observation sheets and rollmeters.The data was analyzed using univariate and bivariate analysis using the Chi-Square test at a significance level of 0.05. Results: The results showed that there was a relationship between incidence of pneumonia in children under five with different variables, respectively, ventilation area, floor type, wall type, presence of smoke hole. Conclusion: It implies that the community should pay attention to the overall condition of the house, one of which is by improving home ventilation, adjusting the room area to the number of occupants, quitting smoking in the house, and cleaning the floor more often.

Viral diseases are the most devastating health concern worldwide. Outbreaks of coronavirus (CoVs)-related acute respiratory diseases are responsible for the massive health/socio-economic breakdown in the last two decades including the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), the third reported spillover SARS-CoV-2 from an animal coronavirus to humans. After the H1N1 pandemic influenza (2009), SARS-CoV-2 (novel-beta coronavirus) causing COVID-19 has stretched across 215 countries in 5 major continents with 200,523,190 confirmed cases (4 August 2021; https://www.worldometers.info/coronavirus/). COVID-19 patients had cough, fever, dyspnea, headache, and respiratory failure, as well as shock, acute respiratory distress syndrome, and sepsis in severe instances. Independent of two preceding epidemics, SARS (2002) and MERS (2012), a knowledge gap about the emerging medical manifestations as well as complications of SARS-CoV-2 (2019-2020) infections in humans must be filled, with a focus on immunological complications and computational genomics for forecasting/ preparedness for a similar outbreak in the future. This paper aims to address aspects of this gap.
Drug Repositioning

Introduction: Amino acids are important role-playing components in the maintenance of the normal functions of parts of eye like retina and conjunctiva. In the current study the methyl and ethyl esters of amino acids such as lysine, phenyl alanine and valine were used to enhance the corneal permeation of ketorolac tromethamine. Methods: The amino-acid esters were coupled with the drug ketorolac tromethamine to obtain the test products and were characterized by various analytical techniques. The characterized test products were used to formulate the test ophthalmic solutions of Ketorolac tromethamine such as KPD-1, KPD-1A, KPD-2, KPD-2A, KPD-3 and KPD-3A with methyl and ethyl esters of corresponding amino-acids. These test products were subjected percentage corneal hydration and to permeation studies by using Franz diffusion cell mounted with freshly isolated goat cornea. Results: All the test results were compared with those of the standard Ketorolac tromethamine ophthalmic solution and observed that all the test solutions have exhibited less percentage corneal hydration and enhanced corneal permeation of ketorolac tromethamine. Conclusion: From all the results it can be concluded that the NonsteroidalAnti-Inflammatory Ketorolac has enhanced trans-corneal permeation and reduced corneal hydration when formulated with amino acid transporters by the pro-drug approach in ophthalmic solutions as the formulated pro-drugs have revealed high vitreal drug concentration.

Introduction: Diabetes is a chronic metabolic disease and noted to be incidence is intensifying globally and contemplated as epidemic. The study is aimed to assess the coronary artery disease risk profile associated diabetes mellitus patient and to identify the clinical pharmacist care services in the management and to control the risk burden in the clinical practice. Method: A prospective observational study was conducted among the consecutive patients of coronary artery disease associated diabetic patients in a tertiary care teaching hospital over 6 months period. A sample of 150 patients was recruited in the study. Data analysis was done with graph pad prism software 5.01. Results: The present study revealed that coronary artery disease in diabetes was more prevalent in age group between 41-50 years. About 54.66% patients with hyperlipidemia were at risk to develop the coronary artery disease complication. Glycated hemoglobin test was detected in 40% of the patient showing abnormal levels and around 43.33% of patient had an abnormal fasting blood sugar level. The study showed only 32% of patients was prescribed Insulin & oral hypoglycemic agents and 13 % were treated with statins. Conclusion: It could be concluded that the causative factors should be controlled and treated with an early need for amalgamation of clinical pharmacist care services with the health care team on life style modification counseling could ultimately improve the patient health outcomes and also lowers progression of coronary artery disease risk complications among diabetic patients.

Introduction: The need for ARV (Anti Retro Viral) for the population aged 15-49 years increased from 145,706 in 2011 to 248,903 in 2016. People with HIV/AIDS who received ARVs were estimated at 16.60% in 2011 increased to 18% in 2016. In Indonesia up to September 2014, there were 108,060 people with HIV/AIDS who received ARV therapy from 33 provinces and 300 districts / cities. There were 19,670 people with HIV/AIDS who stopped ARV, 15,046 were not followed up due to various causes and as many as 14,547 died. Methods: This research used a quasi-experimental methods with non equivalent control group design and used a pretest, posttest 1 and posttest 2. There was two groups, the first group was treated using SMS (Short Message Service) reminder and leaflets and the second group was treated with the usual method (counselling). Results: Research with the Mann-Whitney statistical test shows that after 1 month of treatment, there was differences in the average score of knowledge (p value = 0.001), attitude (p value = 0.008), and adherence of Antiretroviral Consumption (p value = 0.010) between the intervention group and the control group. After 2 months of treatment, there was differences in the average knowledge score (p value = 0.001), attitude (p value = 0.001), and adherence of Antiretroviral Consume (p value = 0.001) between the intervention group and the control group. Conclusion: There is the interventions that able to improve the knowledge, attitudes and adherence of taking antiretroviral at PLWHA.

Introduction: The ability of nurses to conduct triage greatly influences the success rate of help when patients experience emergency. The aim of the study was to determine the factors associated with the accuracy of the implementation of triage in the X Hospital's Emergency Departments. Methods: The research method that the researcher used was cross sectional approach. The number of samples were 32 respondents. Questionnaire and observation were used to collect the data. Results: Respondents characteristics (age, sex, education, and tenure) with the accuracy of the triage were obtained by age with p value = 0.386, p value = 1,000 for gender, p value = 0.242 for education, and years of work with p value = 0.000162. Knowledge of respondents with the implementation of the determination of triage p value = 0.045 and motivation of respondents with the accuracy of the implementation of triage p value = 0.0017. Conclusion: The accuracy of the implementation of triage has no relationship with characteristics (age, sex, education), there is a relationship between knowledge, motivation and years of work with the implementation's accuracy of triage in the Emergency Room X Hospital. Suggestions are expected by the Hospital to make guidelines, triage algorithms, training, regeneration to improve nurse triage knowledge.

Introduction: Malaria is devastating infectious disease not only India but also throughout the globe due to its high morbidity and mortality factor for last few centuries. From 19th and early 20th centuries, almost a quarter of the Indian populations were severely suffering from malaria. The economic loss due to increased mortality in malaria was estimated 10 million rupees per year in 1935. According to the World Malaria Report of 2017, malaria incidence accounted for 58% of cases in India. The objective of this study is to prediction of “annual” malaria incidences in India, depending on the basis of last 22 years national malaria epidemiology data. Methods: This study uses data from the official website of the National Program for the Control of Vector borne Diseases (NVBDCP) (http://nvbdcp. gov.in/) from 1995 to 2016. For creating a forecasting tool on Malaria surveillance in India, Econometric forecasting model (ARIMA Model ((0,1,1) (1,0,0) 12)) was used. Results: ARIMA statistical model ((0,1,1) (1,0,0) 12) found to be highly effective and significant (P < 0.05) in prediction of future epidemiological surveillance of malaria in India. ARIMA statistical model could be successfully use in prediction of annual malaria incidences in India after adjusting different highly contributing environmental and geographical factors, such as climate change, temperature, rainfall, and relative humidity. Conclusion: The historical forecast of the occurrence of malaria in India will allow the government to improve planning, control and prevention through public health interventions. In addition, the pharmaceutical industry will assist medical members in pre-treatment and drug interventions to respond to the increased or decreased occurrence of malaria.

Introduction: Diabetes characterized by hyperglycemia can cause long term damages and malfunction of different organ and systems, especially the eye, kidney, nerve and cardiovascular systems. The main problem in Diabetes Mellitus patients is a difficulty in regulating blood glucose levels. Various attempts were made to reduce blood sugar levels so that patients can be free from insulin. Exercise and diet are the primary therapies in DM patients, but apart from that, relaxation techniques can help patients reduce stress and anxiety levels, which will ultimately have a good effect on lowering glucose levels in the blood. Benson relaxation techniques modified with aromatherapy are expected to provide a relaxing effect so that this condition can have a better impact on reducing blood glucose. The present study aims to look at the effect of Benson relaxation exercises and aromatherapy on blood glucose levels. Methods: The researchers intervened in two groups of respondents. The intervention group conducted Benson relaxation exercises and aromatherapy while the control group only conducted Benson relaxation. Results: Differences in the average blood glucose levels before and after exercise in the intervention group and in the control group has been observed. Relaxation conditions will provide a good impact for DM patients because at the time of relaxation stress hormones that trigger an increase in blood glucose levels, will not be released by the body. Conclusion: Present study shows that Benson relaxation exercise and aromatherapy is effective for lowering glucose levels.

Introduction: Worldwide fractures among individuals are a major public health problem. As a result, fracture are the most common cause of severe enduring pain and physical disability, and they affect innumerable globally. It has been studied that nutrients that contain high protein helps in the fracture healing process. Eels contains many nutrients, such as phosphate, calcium, protein, collagen and amino acids that can help bone growth. The aim of this study was to examine the effect of eel flour (Monopterus albus) at multilevel dose content to accelerate the healing process of fracture in male Rattus novergicus Wistar Albino rat. Methods: This study design include experimental study with post-test only on controls group. The wok was conducted from May-June 2019 in the Laboratory of Anatomy of Stikes Piala Sakti Pariaman. The sampling was purposive sampling technique with a sample size of 24 rats. Results: The results of the ANOVA test have proved that administration of eel flour accelerates the healing process of the fracture showing 0.000, followed by Post Hoc LSD to determine the test of significant differences between groups. Conclusion: It was observed that with the increase in the dose of flour given to Wistar Albino rat fracture healing process became faster. From the present study it was evident that consumption of eel flour can accelerate the process of fracture healing. But there is need for further testing on humans as an effort to test the safety of the dose.