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Peningkatan Ekspresi PD-L1 pada Squamous Cell Carcinoma Nasofaring Tipe Undifferentiated Non Keratinizing Yusuf, Franky; Prasetyo, Awal; Karlowee, Vega; Astuti, Meira Dewi Kusuma; Nur, Rizki Widya
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Increased Expression of PD-L1 in Undifferentiated Non Keratinizing Squamous Cell Carcinoma Nasopharynx ABSTRACT BACKGROUND: PD-L1 expressed by tumor cells in nasopharyngeal carcinoma (NPC) can be used by tumor cells to avoid the patient's immune system. This can affect prognosis such as age, gender, histopathological type, tumor stage and quality of life through immunosuppressive activity. PD-L1 expression is expected to be a biomarker for prognostic factor assessment and immunotherapy. OBJECTIVE: To determine whether there is a relationship between the level of PD-L1 expression and prognostic factors in NPC. METHODS: This is analytic observational study with a cross-sectional design. PD-L1 expression was examined immunohistochemically using 61 samples of paraffin block, which had been diagnosed as NPC in the Laboratory of Anatomical Pathology, Dr. Kariadi from January 2017 to June 2020. Patient clinical data were used as prognostic factors, namely age, gender, histopathological type, tumor stage and quality of life. Analysis was performed with the Chi-Square test to determine the relationship between the level of PD-L1 expression and prognostic factors. RESULTS: There was a significant correlation between PD-L1expression in tumor cells and histopathological type (p=0.001). No significant correlation between PD-L1 expression and age (p=0.405), gender (p=0.241), tumor stage (p=0.928) and quality of life (p=0.103). CONCLUSION: PD-L1 expression in this study cannot be used as a prognostic factor in NPC patients, although the histopathological type shows a significant relationship, so further research is needed with a larger sample and a longer period. Keywords: Nasopharyngeal carcinoma; PD-L1; prognostic factor

Correlation Between Testosterone Level With HBA1C Level As Glycemic Control Marker Among Type 2 Diabetes Mellitus Patient Halim, Fenny; Listiana, Devia Eka; Karlowee, Vega; Istiadi, Hermawan; Prasetyo, Awal; Astuti, Meira Dewi Kusuma
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.959

BACKGROUND: Helicobacter pylori is classified as a grade 1 carcinogen by the International Agency for Research on Cancer. Identification of Helicobacter pylori infection is crucial for the prevention of malignancy. Immunohistochemistry is more specific and sensitive than modified Giemsa because it based on the antigen- antibody binding so it can exclude other organisms. However, it can be expressed in all species of Helicobacter genus. OBJECTIVE: To compare the identification methods of Helicobacter spp in stomach biopsy between modified Giemsa and immunohistochemistry. METHOD: This research was a cross-sectional study. There were 64 biopsies taken by simple random sampling. They consisted of 32 positive and 32 negative Helicobacter spp based on the interpretation of modified Giemsa. Statistical analysis using x2 test. RESULT: The number of atypical Helicobacter spp was 42.%. The number of samples that received Proton Pump Inhibitor (PPI) therapy was 93.75%. Helicobacter spp was positive in 31 samples and negative in 33 samples based on the interpretation of immunohistochemistry staining. There was no significant difference (p=0.617) between the identification results of Helicobacter spp using immunohistochemistry compared to the Modified Giemsa at both 400x and 1000x magnification. CONCLUSION: Modified Giemsa is still reliable for identifying Helicobacter spp, especially in classical form, compared to immunohistochemistry. Due to the administration of PPI, there are a lot of cases with atypical form of Helicobacter spp which can be differentiated into coccoid form and intraepithelial located. Immunohistochemistry staining is useful in identify these cases.

Extranodal NK/T-cell Lymphoma, Nasal Type (Angiocentric T-cell Lymphoma): Laporan Kasus dan Kajian Diagnosis Histopatologik Prasetyo, Awal; Istiadi, Hermawan; Puspasari, Dik
Majalah Patologi Indonesia Vol. 32 No. 1, Januari 2023
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i1.566

Extranodal NK/T-cell lymphoma, nasal type (ENKL) is a lymphoid neoplasm, which in the past has been grouped as a type of granulomatous diseases, is an aggressive non-Hodgkin’s lymphoma. The aggressiveness of ENKL is characterized clinically by nonrelenting destruction of the midline structures of the palate and nasal fossa. The histopathological diagnosis of this disease is difficult to enforced despite the malignant clinical course recognizably because of extensive tissue necrosis and multiple biopsies are often required. ENKL has an ominous prognosis, as the average survival rate is between 6 and 25 months. This case report describes the difficulties in making histopathological diagnosis of a 52-year-old male patient who presented with nasal obstruction and foul smelling, destructive and ulseratif lesion over for 3 months duration, and failed to treat with antibiotics and anti-inflammatories drugs. The diiferential diagnosis of the multiple biopsies was nasal cavity granuloma, NK/T cell lymphoma and Wegener granulomatosis. After immunohistochemical panel analysis of Pansitokeratin (AE1/3), LCA, CD3 and CD56, the patient be confirmed had an ENKL, nasal type which in the past also known as angiocentric T-cell lymphoma.

The Association of Demographic Characteristics and Top Management Team Heterogeneity on Hospital Performance Prasetyo, Awal; Isa, Muzakar; Sutrisna, EM
Jurnal Ikatan Sarjana Ekonomi Indonesia Vol 12 No 3 (2023): December
Publisher : Jurnal Ekonomi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52813/jei.v12i3.264

This study aims to show how the demographic characteristics and heterogeneity of the top management team (TMT) associate with hospital’s performance as measured by the balanced scorecard (BSC). The study employs cross-sectional primary data from hospitals in Central Java Indonesia, collected from 242 hospitals. The result shows that the demographic characteristics including age, female, period of experience serving as TMT, level and specialization of education, were not associated with the hospital’s performance. Likewise, the short period of experience in the organization inside or outside of a hospital’s TMT members was not associated with the hospital’s performance. However, TMT’s heterogeneity showed a positive result towards the hospital’s performance. The academic and practical implications of the findings are discussed.

Harnessing Nature's Adjuvant: A Systematic Review and Meta Analysis of Phyllanthus niruri's Immunomodulatory and Chemosensitizing Mechanisms in Colorectal Cancer Adhi Setradian Anto Maria; Albertus Ari Adrianto; Awal Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1374

Background: Colorectal cancer (CRC) poses a significant global health burden, and the limitations of conventional therapies necessitate the exploration of effective adjuvants. Phyllanthus niruri (PNL), a medicinal herb, has demonstrated notable anticancer properties. This study aims to systematically review and quantitatively synthesize the evidence from preclinical and clinical studies on PNL's efficacy in CRC. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for in vitro, in vivo, and clinical trials on PNL and CRC published up to December 2023. Primary outcomes included cell viability, tumor volume, and immunological biomarkers. Data were extracted for meta-analysis, calculating standardized mean differences (SMD) with 95% confidence intervals (CI) using a random-effects model to account for heterogeneity, which was assessed using the I² statistic. Results: Twenty-one primary studies were included in the systematic review, with a subset eligible for meta-analysis. The qualitative synthesis confirmed PNL's multimodal action, including apoptosis induction, Wnt/β-catenin pathway inhibition, and immunomodulation. The meta-analysis revealed that PNL treatment resulted in a significant reduction in tumor volume in animal models (SMD: -2.54; 95% CI: -3.87 to -1.21; p < 0.001) and a favorable decrease in the Neutrophil-to-Lymphocyte Ratio (NLR) (SMD: -1.89; 95% CI: -2.78 to -1.01; p < 0.001). Significant heterogeneity was observed across studies. Conclusion: This systematic review and meta-analysis provides robust, synthesized evidence for the therapeutic efficacy of Phyllanthus niruri in colorectal cancer. PNL significantly reduces tumor growth and modulates key prognostic biomarkers, underscoring its potential as a powerful adjuvant therapy. These findings strongly advocate for the initiation of large-scale, standardized clinical trials to translate this promising natural agent into clinical practice.

Harnessing Nature's Adjuvant: A Systematic Review and Meta Analysis of Phyllanthus niruri's Immunomodulatory and Chemosensitizing Mechanisms in Colorectal Cancer Adhi Setradian Anto Maria; Albertus Ari Adrianto; Awal Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1374

Background: Colorectal cancer (CRC) poses a significant global health burden, and the limitations of conventional therapies necessitate the exploration of effective adjuvants. Phyllanthus niruri (PNL), a medicinal herb, has demonstrated notable anticancer properties. This study aims to systematically review and quantitatively synthesize the evidence from preclinical and clinical studies on PNL's efficacy in CRC. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for in vitro, in vivo, and clinical trials on PNL and CRC published up to December 2023. Primary outcomes included cell viability, tumor volume, and immunological biomarkers. Data were extracted for meta-analysis, calculating standardized mean differences (SMD) with 95% confidence intervals (CI) using a random-effects model to account for heterogeneity, which was assessed using the I² statistic. Results: Twenty-one primary studies were included in the systematic review, with a subset eligible for meta-analysis. The qualitative synthesis confirmed PNL's multimodal action, including apoptosis induction, Wnt/β-catenin pathway inhibition, and immunomodulation. The meta-analysis revealed that PNL treatment resulted in a significant reduction in tumor volume in animal models (SMD: -2.54; 95% CI: -3.87 to -1.21; p < 0.001) and a favorable decrease in the Neutrophil-to-Lymphocyte Ratio (NLR) (SMD: -1.89; 95% CI: -2.78 to -1.01; p < 0.001). Significant heterogeneity was observed across studies. Conclusion: This systematic review and meta-analysis provides robust, synthesized evidence for the therapeutic efficacy of Phyllanthus niruri in colorectal cancer. PNL significantly reduces tumor growth and modulates key prognostic biomarkers, underscoring its potential as a powerful adjuvant therapy. These findings strongly advocate for the initiation of large-scale, standardized clinical trials to translate this promising natural agent into clinical practice.

Dismantling Immunosuppression in Colorectal Cancer: A Systematic Review and Meta-Analysis on Phyllanthus niruri as a Potent Antagonist of the IL-10 Axis in the Tumor Microenvironment Jeffrey Eka Wijaya; Albertus Ari Adrianto; Awal Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1404

Background: The immunosuppressive tumor microenvironment (TME) of colorectal cancer (CRC), orchestrated largely by Interleukin-10 (IL-10), presents a formidable barrier to effective anti-tumor immunity. Phytochemicals from traditional medicines offer a promising avenue for immunomodulation. Phyllanthus niruri, a plant with a long history in herbal medicine, has demonstrated significant immunomodulatory potential. This systematic review aims to synthesize and critically evaluate the evidence regarding the efficacy of P. niruri and its bioactive compounds in modulating the IL-10-mediated immunosuppressive axis in CRC. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between January 2015 and August 2025. The review included in vitro, in vivo, and clinical studies investigating the effect of P. niruri on IL-10 expression and associated immune responses in CRC models. The PRISMA guidelines were followed. Study quality was assessed using SYRCLE's risk of bias tool for animal studies and the RoB 2 tool for clinical trials. A meta-analysis of IL-10 concentration data from preclinical models was performed using a random-effects model. Results: From an initial 874 records, seven studies met the inclusion criteria: three in vitro, three in vivo, and one early-phase clinical trial. The selected studies consistently demonstrated that P. niruri extracts and its lignan, phyllanthin, significantly reduced IL-10 production in CRC cell lines, tumor tissues, and patient serum. Based on three preclinical studies, a meta-analysis revealed a significant standardized mean difference (SMD) in IL-10 reduction (SMD = -2.45; 95% CI: -3.10, -1.80; p < 0.00001). This IL-10 downregulation was correlated with a significant increase in cytotoxic T lymphocyte (CD8+) infiltration, repolarization of M2 to M1 macrophages, and enhanced expression of pro-inflammatory cytokines such as IFN-γ and TNF-α. Mechanistically, P. niruri was shown to inhibit the STAT3 and NF-κB signaling pathways, key regulators of IL-10 transcription. Conclusion: While based on a limited but consistent body of evidence, our findings strongly support the role of Phyllanthus niruri as a potent modulator of the CRC immunosuppressive microenvironment by specifically targeting the IL-10 signaling axis. By reducing IL-10 production, P. niruri unleashes anti-tumor immunity, suggesting its potential as an adjuvant therapy to enhance the efficacy of conventional treatments and immunotherapies in CRC. Rigorous, large-scale clinical trials are warranted to translate these preclinical findings into clinical practice.

Dismantling Immunosuppression in Colorectal Cancer: A Systematic Review and Meta-Analysis on Phyllanthus niruri as a Potent Antagonist of the IL-10 Axis in the Tumor Microenvironment Jeffrey Eka Wijaya; Albertus Ari Adrianto; Awal Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1404

Background: The immunosuppressive tumor microenvironment (TME) of colorectal cancer (CRC), orchestrated largely by Interleukin-10 (IL-10), presents a formidable barrier to effective anti-tumor immunity. Phytochemicals from traditional medicines offer a promising avenue for immunomodulation. Phyllanthus niruri, a plant with a long history in herbal medicine, has demonstrated significant immunomodulatory potential. This systematic review aims to synthesize and critically evaluate the evidence regarding the efficacy of P. niruri and its bioactive compounds in modulating the IL-10-mediated immunosuppressive axis in CRC. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between January 2015 and August 2025. The review included in vitro, in vivo, and clinical studies investigating the effect of P. niruri on IL-10 expression and associated immune responses in CRC models. The PRISMA guidelines were followed. Study quality was assessed using SYRCLE's risk of bias tool for animal studies and the RoB 2 tool for clinical trials. A meta-analysis of IL-10 concentration data from preclinical models was performed using a random-effects model. Results: From an initial 874 records, seven studies met the inclusion criteria: three in vitro, three in vivo, and one early-phase clinical trial. The selected studies consistently demonstrated that P. niruri extracts and its lignan, phyllanthin, significantly reduced IL-10 production in CRC cell lines, tumor tissues, and patient serum. Based on three preclinical studies, a meta-analysis revealed a significant standardized mean difference (SMD) in IL-10 reduction (SMD = -2.45; 95% CI: -3.10, -1.80; p < 0.00001). This IL-10 downregulation was correlated with a significant increase in cytotoxic T lymphocyte (CD8+) infiltration, repolarization of M2 to M1 macrophages, and enhanced expression of pro-inflammatory cytokines such as IFN-γ and TNF-α. Mechanistically, P. niruri was shown to inhibit the STAT3 and NF-κB signaling pathways, key regulators of IL-10 transcription. Conclusion: While based on a limited but consistent body of evidence, our findings strongly support the role of Phyllanthus niruri as a potent modulator of the CRC immunosuppressive microenvironment by specifically targeting the IL-10 signaling axis. By reducing IL-10 production, P. niruri unleashes anti-tumor immunity, suggesting its potential as an adjuvant therapy to enhance the efficacy of conventional treatments and immunotherapies in CRC. Rigorous, large-scale clinical trials are warranted to translate these preclinical findings into clinical practice.

Effectiveness of Spiritual-Based Interventions in Enhancing Quality of Life Among Breast Cancer Patients: A Systematic Review Su, Hansen Maikel; Ismail, Suhartini; Prasetyo, Awal
Journal of Health and Nutrition Research Vol. 4 No. 2 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i2.406

Breast cancer is the most prevalent cancer among women and significantly affects patients' quality of life. Beyond physical symptoms, patients often experience emotional and social burdens that deteriorate their overall well-being. While medical and psychosocial interventions are widely applied, spiritual aspects are often underemphasized. Therefore, spiritual-based interventions are needed to support recovery by fostering hope, emotional stability, and a sense of life meaning.To explore the effectiveness of spiritual-based interventions in improving the quality of life of breast cancer patients. This study employed a systematic review design. Articles were retrieved from three databases CINAHL, PubMed, and Scopus using the main keywords: “breast cancer,” “quality of life,” “spiritual care,” and “spiritual intervention.” Inclusion criteria were original research articles, written in English, published between 2011 and 2025, and involving breast cancer patients. Data were extracted using structured tables and analyzed descriptively using qualitative synthesis. Seven eligible studies demonstrated that spiritual-based interventions, such as prayer, group therapy, meditation, and religious counseling, positively affect the quality of life of breast cancer patients. Key outcomes included enhanced hope, reduced pain, improved emotional, physical, and social well-being, stronger spiritual resilience, better coping mechanisms, and increased social support through group-based activities. Spiritual-based interventions significantly improve the quality of life of breast cancer patients through a holistic approach, integrating physical, emotional, social, and spiritual dimensions.

Masker Herbal Nephrolephis Exaltata Menghambat Pemanjangan Waktu Transpor Mukosilier Hidung Pekerja Industri Tekstil Nurhayadi, Tommy; Prasetyo, Awal; Miranti, Ika Pawitra
Jurnal Biomedika dan Kesehatan Vol 6 No 1 (2023)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2023.v6.51-61

Background Herbal masks are made from lamination-spraying of Nephrolepis exaltata (NE) extract on regular medical masks, which may absorb Volatile Organic compounds (VOC) in the occupational exposure of the textile industry'sindustry's dyeing area. Therefore, clinically, the effect on nasal mucociliary transport time (TMSH) needed to be tested and compared with ordinary cloth-mask teens used by textile industry workers as their daily personal protective equipment. Methods Pre- and post-test randomized control trials on 30 textile-dyeing areas of textile industry workers in Bawean Indonesia, divided into two groups; 1) users of NE herbal masks (N=17) as the treatment group and 2) regular cloth mask users (N=13) as control-group, for eight weeks. First, the TMSH time (seconds) was carried out before and after treatment using the saccharin test by an ENT specialist, followed by a different test on delta. Results The TMSH-time of NE herbal mask users before vs after treatment was 1169.60 ± 644.55 seconds vs 1075.75 ± 677.36 (p = 0.102). On subjects wearing regular cloth masks was 1113.75 ± 479.43 vs 1187.40 ± 544.96 (p = 0.003). The mean delta'sdelta's difference before and after treatment was 25.5 seconds, with a significant difference in mean delta TMSH-time between the treatment and control groups (p = 0.048). Conclusions Textile-industry workers who wear NE herbal masks have better TMSH times than regular cloth mask wearer

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