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All Journal Eureka Herba Indonesia Sriwijaya Journal of Obstetrics and Gynecology
Indri Yani Septiana
Department of Physiology, CMHC Research Center, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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Peer-Led Nutritional Education Plus Iron-Folic Acid for Adolescent Iron-Deficiency Anemia: A Cluster Randomized Controlled Trial in Indonesia Indri Yani Septiana; Annisa Annisa
Sriwijaya Journal of Obstetrics and Gynecology Vol. 3 No. 2 (2025): Sriwijaya Journal of Obstetrics & Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v3i2.279

Abstract

Introduction: Iron-deficiency anemia affects roughly one-third of adolescent girls and, by entering reproductive life with depleted iron stores, propagates intergenerational maternal risk. Standard weekly iron-folic acid (IFA) supplementation is undermined by poor adherence. We evaluated whether adding a peer-led nutritional-education program to IFA improves hematologic and psychosocial outcomes more than IFA alone. Methods: In a single-blind, parallel-group cluster randomized controlled trial in urban Palembang, Indonesia, 16 school clusters were randomized 1:1 to peer-led education plus weekly IFA (60 mg iron, 2.8 mg folic acid) or IFA alone. We enrolled 320 post-menarcheal girls aged 13–17 years with baseline hemoglobin 8.0–11.9 g/dL. Co-primary outcomes were hemoglobin and serum ferritin; the secondary outcome was the WHO-5 Well-Being Index, assessed at baseline, 3 and 6 months. Generalized linear mixed models with cluster random intercepts (intention-to-treat) were used. Results: At 6 months the intervention produced adjusted mean differences of +1.42 g/dL hemoglobin (95% CI 1.05–1.79; Cohen's d 2.11), +13.5 µg/L ferritin (10.2–16.8; d 2.75) and +23.4 WHO-5 points (19.8–27.0; d 3.14), all p<0.001. Anemia resolved in 89.3% versus 33.1% (RR 2.70, 95% CI 2.13–3.42; NNT 2). Adherence was higher with the intervention (92.5% vs 74.3%; OR 4.25). The multivariable model discriminated resolution well (AUC 0.89, 0.85–0.93). No severe adverse events occurred. Conclusion: A peer-led nutritional-education program markedly enhanced the efficacy of standard IFA, normalizing hemoglobin, replenishing iron stores and improving psychosocial well-being in anemic adolescent girls. This low-cost, scalable, school-based strategy is a promising preconception reproductive-health intervention for Indonesia and similar settings.
Network-Pharmacology-Guided Validation of Phyllanthus niruri Nephroprotection Against Doxorubicin: An In Vitro–In Vivo Translational Study Rachmat Hidayat; Vania Delma; Indri Yani Septiana
Eureka Herba Indonesia Vol. 6 No. 2 (2025): Eureka Herba Indonesia
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ehi.v6i2.140

Abstract

Doxorubicin is a corner-stone anthracycline chemotherapeutic whose clinical utility is constrained by dose-limiting nephrotoxicity, and no approved pharmacological prevention currently exists. Phyllanthus niruri L. (Family Phyllanthaceae) — locally known in Indonesia as meniran — is a phytotherapeutic herb whose constituents (phyllanthin, hypophyllanthin, quercetin, rutin, gallic acid, and corilagin) target oxidative-stress and inflammatory pathways implicated in doxorubicin renal injury. We applied a tiered translational design: (i) network-pharmacology discovery using SwissTargetPrediction, TCMSP, GeneCards, and OMIM intersected six P. niruri active compounds with 842 nephrotoxicity-associated genes, identifying six hub targets (TNF, IL6, NFKB1, CASP3, BAX, BCL2) and four enriched KEGG pathways (TNF signaling, MAPK, PI3K-Akt, Apoptosis); (ii) in vitro validation in HK-2 human proximal tubular cells exposed to doxorubicin (2 µM, 24 h) with or without standardised P. niruri 70% ethanolic extract (25, 50, 100 µg/mL); and (iii) in vivo validation in 48 male Sprague-Dawley rats (eight per arm) given a single intraperitoneal dose of doxorubicin (15 mg/kg) and oral P. niruri at 100, 200, or 400 mg/kg/day for 14 days. P. niruri produced a dose-dependent rescue of HK-2 viability (84.6% at 100 µg/mL versus 41.8% in doxorubicin-only controls; p < 0.001) and reduced serum creatinine, blood urea nitrogen, urinary KIM-1, and NGAL by 55–70% at the 400 mg/kg dose with concordant restoration of glutathione and superoxide dismutase. Network-pharmacology hub targets showed transcriptionally coherent modulation. The findings support standardised P. niruri ethanolic extract as a mechanism-anchored herbal candidate for adjunctive prevention of doxorubicin-induced kidney injury, warranting clinical translation.
Co-Authors Annisa Annisa RACHMAT HIDAYAT Vania Delma