Pharmacogenomics-guided drug dose adjustment is an important approach in personalized medicine because genetic polymorphisms can influence drug metabolism, therapeutic response, dose requirements, and the risk of adverse drug reactions. This systematic literature review synthesized recent evidence on pharmacogenomics-guided dose adjustment, clinically relevant pharmacogenomic biomarkers, and emerging technologies supporting precision medicine. Literature searches were conducted in Scopus and PubMed for studies published between January 2021 and May 2026. Eligible studies were selected using predefined PICOS criteria and synthesized narratively because of heterogeneity in study design, therapeutic area, biomarkers, and reported outcomes. A total of 23 studies were included in the qualitative synthesis. The evidence covered various therapeutic areas, including infectious diseases, neurology, psychiatry, oncology, cardiovascular medicine, and transplantation. Pharmacogenomic-guided dosing was most clearly supported for clinically established gene–drug pairs, including CYP2C9/VKORC1–warfarin, CYP2C19-related therapies, DPYD–fluoropyrimidines, SLCO1B1–statins, CYP2B6–efavirenz, and selected CYP3A5-related immunosuppressant therapies. Other biomarkers, such as ABCB1, APOE, GABRG2, UGT genes, and receptor-related polymorphisms, were associated with treatment response or drug disposition but still require stronger clinical validation for routine dose-adjustment recommendations. Emerging technologies, including clinical decision support systems, model-informed precision dosing, population pharmacokinetic modeling, bioinformatics, artificial intelligence, and machine learning, may strengthen biomarker interpretation and individualized dose optimization. Overall, pharmacogenomic-guided dose adjustment is a promising strategy to support safer and more precise pharmacotherapy, although broader implementation requires standardized guidelines, prospective validation, population-specific evidence, and integration into routine healthcare systems.
Solid-state properties of active pharmaceutical ingredients are important in dosage-form development because phase transformation, hydrate or solvate formation, and crystal habit modification can influence manufacturing performance and physicochemical properties. Amodiaquine hydrochloride (AQ) is an antimalarial active pharmaceutical ingredient used in artemisinin-based combination therapy and is known to occur as a hydrated crystalline form. This study evaluated the solid-state characteristics of AQ and the effects of recrystallization, heating, and milling on its crystal structure, crystallinity, thermal behavior, and morphology. AQ samples before and after treatment were characterized using powder X-ray diffraction (PXRD), thermal analysis, Fourier-transform infrared spectroscopy (FT-IR), hot-stage/polarized-light microscopy, scanning electron microscopy (SEM), and single-crystal X-ray diffraction. Recrystallization from methanol, chloroform, and acetone did not produce new PXRD peaks or meaningful changes in crystal habit. Heating at 170 °C for 1 hour produced thermal changes consistent with dehydration, without evidence of polymorphic conversion. Milling for 10, 30, and 60 minutes reduced crystallinity and thermal enthalpy, indicating lattice defects rather than formation of a new polymorph. FT-IR spectra retained the main absorption bands after thermal and mechanical treatments, suggesting that no major spectroscopic changes indicating chemical degradation were detected. Single-crystal analysis confirmed a monoclinic crystal system with space group P21/c, consistent with amodiaquine hydrochloride dihydrate. Overall, AQ maintained the same crystalline phase under the evaluated recrystallization, heating, and milling conditions, although hydration-state changes after heating should be interpreted cautiously.
Stunting management requires strong cross-sectoral collaboration; therefore, this research is considered urgent, with the aim of accelerating stunting prevention efforts through a concrete synergy between academics, the government (Health Office), Posyandu cadres, and target communities. The main strategy of this synergy focuses on introducing innovation in complementary feeding (MP-ASI) recipes based on local food wisdom to sustainably improve children’s nutritional quality. The implementation method combines interactive two-way education with hands-on demonstrations of MP-ASI preparation innovations designed to be practical, affordable, and nutrient-dense for households. This program synergy produced highly positive evaluation results; there was a significant increase in participants’ average nutrition knowledge score from 65.35 to 80.71. The proportion of participants with good knowledge increased from 30.0% to 87.5%, while the proportion in the poor knowledge category decreased from 20.0% to 0.0%. The high level of community participation and cadres’ enthusiasm in cooking practices demonstrates that local MP-ASI recipe innovations, when driven by multi-stakeholder synergy, serve as a highly effective strategy to strengthen Posyandu capacity and address stunting at the grassroots level.
Hypertension remains a leading global risk factor for cardiovascular mortality. While lifelong pharmacological therapy is essential, poor medication adherence is a critical challenge. This study aimed to evaluate the association between familial support and medication adherence among hypertensive patients through a comparative analysis at X Hospital and Y Hospital. Using a quantitative cross-sectional design, 350 respondents were recruited via purposive sampling. Data were collected utilizing a validated Family Support Questionnaire and the Probabilistic Medication Adherence Scale (ProMAS). Descriptive analysis showed a high prevalence of familial support at both X Hospital (85.3%) and Y Hospital (87.0%). However, Chi-square tests revealed a significant difference in medication adherence levels ($p 0.001$), with Y Hospital reporting a higher proportion of "High Adherence" (84.5%) compared to X Hospital (33.3%). Despite this baseline difference, Spearman’s rank correlation demonstrated a significant positive relationship between familial support and adherence at both X Hospital ($r = 0.250$, $p = 0.004$) and Y Hospital ($r = 0.317$, $p 0.001$). The primary limitations of this study are its cross-sectional design and reliance on purposive sampling, which restrict causal inferences. In conclusion, stronger family engagement is significantly associated with better medication adherence across different healthcare settings.
Ice products including crystal ice and commercially packaged ice cubes are routinely consumed in peri-urban Indonesia, yet freezing does not confer sterility. This descriptive, laboratory-based study examined four ice specimens from Cilengkrang Village, Cirebon Regency, using the three-stage Most Probable Number (MPN) method for coliform enumeration and IMViC–TSIA profiling for Escherichia coli identification. All specimens exceeded the regulatory threshold of 0 CFU/100 mL stipulated under Permenkes No. 2/2023, with MPN values ranging from 29 to 1,100/100 mL. Biochemical characterisation was substantially consistent with E. coli, however, a positive Simmons Citrate reaction was observed a finding that, in the absence of single colony purification, cannot be attributed exclusively to atypical E. coli, as it is equally consistent with the co-presence of citrate-positive Coliform genera such as Klebsiella spp. or Enterobacter spp. within a mixed microbial population. These results constitute preliminary evidence of microbiological risk, warranting expanded sampling and molecular confirmation.
