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All Journal International Journal of Public Health Science (IJPHS) Archive of Community Health Medicina Sport and Fitness Journal E-Jurnal Medika Udayana Ecotrophic, Journal of Environmental Science Media Kesehatan Masyarakat Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Berkala Epidemiologi Indonesian Journal of Tropical and Infectious Disease ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Pendidikan Kesehatan Rekreasi JURNAL ILKES (Jurnal Ilmu Kesehatan) Bioscientia Medicina : Journal of Biomedicine and Translational Research Bali Dental Journal Lux Mensana: Journal of Scientific Health Public Health and Preventive Medicine Archive Jurnal Ilmiah Ilmu Terapan Universitas Jambi Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA)
I Made Ady Wirawan
Departemen Kesehatan Masyarakat Dan Kedokteran Pencegahan, Fakultas Kedokteran Universitas Udayana
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Earth & Planetary Sciences Education Engineering Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences

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Optic Neuritis After Viral Vector versus mRNA COVID-19 Vaccines: A Systematic Review and Comparative Meta-Analysis Tiara Alexander; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
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.v9i10.1412

Abstract

Background: The global deployment of COVID-19 vaccines, utilizing distinct viral vector and mRNA technologies, has been followed by reports of rare neuro-ophthalmic adverse events, including optic neuritis (ON). This study aimed to systematically compare the clinical phenotypes, autoimmune serological profiles, and visual outcomes of ON cases with onset in temporal association with viral vector versus mRNA COVID-19 vaccination. Methods: A systematic review was conducted across PubMed, Scopus, and EMBASE databases for case reports and case series published up to August 2025 detailing ON after COVID-19 vaccination. Data were extracted on clinical presentation, MRI findings, serostatus for aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) antibodies, treatments, and visual outcomes. Separate meta-analyses of proportions and comparative odds ratios (OR) were calculated for key outcomes, including distinct analyses for NMOSD and MOGAD. Results: Our analysis of published reports included 20 studies, comprising 90 patients (40 viral vector, 50 mRNA). Cases associated with viral vector vaccines had significantly higher odds of presenting with bilateral disease (OR 4.31, 95% CI [1.67, 11.11]). This platform was also associated with markedly increased odds of AQP4-IgG positivity (NMOSD) (OR 5.15, 95% CI [1.35, 19.61]) and MOG-IgG positivity (MOGAD) (OR 4.58, 95% CI [1.09, 19.21]). Consequently, these patients had higher odds of requiring aggressive immunotherapy and of suffering incomplete visual recovery (OR 3.41, 95% CI [1.14, 10.21]). Conclusion: Our analysis of published case reports suggests that while ON following COVID-19 vaccination is a very rare event, its clinical phenotype may differ based on the vaccine platform. Cases associated with viral vector vaccines appear more likely to manifest as a severe, bilateral, antibody-mediated condition characteristic of NMOSD or MOGAD. These findings, which do not establish causality, underscore the critical importance of prompt autoantibody testing to guide appropriate management. The established benefits of vaccination continue to overwhelmingly outweigh the exceptionally low absolute risk of such adverse events.
The Hidden Hazard of Celebration: A Meta-Analysis of Ocular Morbidity from Colored Powder Festivals and Implications for Global Travel Medicine Frangklin Refelino Jotlely; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
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.v9i10.1417

Abstract

Background: The globalization of colored powder festivals, such as Holi, has exposed millions, including international tourists, to significant ocular health risks from synthetic industrial dyes that have replaced traditional organic powders. This study was conducted to quantify the prevalence of acute ocular morbidities from these festivals, providing an evidence base to inform clinical practice and public health policy, particularly within travel medicine. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Google Scholar, ScienceDirect, and ProQuest for observational studies published up to July 2024. Studies reporting ocular complications from colored powder exposure were included. Data were extracted by two independent reviewers, and methodological quality was assessed using JBI checklists. A random-effects model was used to calculate pooled prevalence for key ocular injuries. Heterogeneity was investigated using sensitivity analyses, and publication bias was assessed with funnel plots. Results: Six studies from India, encompassing 189 patients, met the inclusion criteria for quantitative analysis. The patient population was predominantly young males (mean age 20-30 years). The meta-analysis revealed a high pooled prevalence of key ocular morbidities. The prevalence for chemical conjunctivitis was 95% (95% CI: 87%-100%), though with substantial but anticipated heterogeneity (I²=82%). The prevalence for corneal epithelial defects was 37% (95% CI: 23%-53%; I²=45%), and for superficial punctate keratopathy was 75% (95% CI: 57%-90%; I²=0%). Most injuries were bilateral. Conclusion: Participation in colored powder festivals, based on extensive evidence from Holi in India, presents a quantifiable and significant risk of acute ocular morbidity. The high prevalence of chemical-induced ocular surface disease necessitates urgent recognition of this "hidden hazard." Proactive, evidence-based preventive strategies, including tiered recommendations for protective eyewear and updated pre-travel health advisories, are imperative to safeguard the vision of millions of celebrants worldwide.
Lower Body Negative Pressure for Spaceflight Associated Neuro-ocular Syndrome: A Systematic Review and Meta-Analysis Fabiola Supit; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1454

Abstract

Background: Spaceflight associated neuro-ocular syndrome (SANS) is a critical health risk for astronauts on long-duration missions, characterized by potentially vision-altering ocular changes. Lower body negative pressure (LBNP) is a primary countermeasure designed to reverse the foundational cephalad fluid shifts. This study provides the first rigorous, quantitative synthesis of LBNP's efficacy on key SANS-related ocular parameters. Methods: Following PRISMA guidelines, a systematic search of PubMed, ScienceDirect, and the Cochrane Library (2015–2025) was conducted. Studies quantifying the effect of LBNP on intraocular pressure (IOP), optic nerve sheath diameter (ONSD), or choroidal thickness (CT) in microgravity or its ground-based analogs were included. A random-effects meta-analysis calculated the pooled mean difference (MD). Leave-one-out sensitivity analysis and assessment of publication bias were performed to ensure robustness. Results: Seven studies (N=89 subjects) met the criteria. The meta-analysis demonstrated that LBNP application resulted in statistically significant reductions in IOP (MD = -2.15 mmHg; 95% CI [-3.01, -1.29]; p < 0.001), ONSD (MD = -0.31 mm; 95% CI [-0.45, -0.17]; p < 0.001), and subfoveal Choroidal Thickness (MD = -18.50 µm; 95% CI [-25.65, -11.35]; p < 0.001). Subgroup analysis revealed a more pronounced effect in ground-based studies. The results were robust in sensitivity analyses, and funnel plots suggested a low risk of publication bias. Conclusion: This meta-analysis provides robust, quantitative evidence supporting LBNP's efficacy in acutely mitigating the cardinal structural signs of SANS. By directly counteracting the underlying pathophysiology, LBNP is affirmed as a cornerstone countermeasure technology essential for preserving astronaut ocular health during the upcoming era of deep space exploration.
Therapeutic Keratoplasty for Severe, Travel-Associated Fungal Keratitis: A Meta-Analysis of Globe Salvage and Visual Acuity Outcomes Putu Rima Adilitha Widyasari; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1457

Abstract

Background: Severe, travel-associated fungal keratitis represents a formidable diagnostic and therapeutic challenge, often progressing to corneal perforation despite aggressive medical therapy. Therapeutic keratoplasty (TK) is frequently required to preserve globe integrity. However, its efficacy in this specific, epidemiologically distinct cohort of patients remains poorly quantified. This meta-analysis aimed to synthesize the available evidence on globe salvage and visual acuity outcomes following TK for severe fungal keratitis acquired during international travel. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2015 and December 2024, reporting outcomes of TK for travel-associated fungal keratitis. The primary outcome was the proportion of cases achieving globe salvage, defined as the avoidance of enucleation or evisceration. The secondary outcome was the mean improvement in Best-Corrected Visual Acuity (BCVA) measured in LogMAR units. Data were pooled using a random-effects model. Heterogeneity was assessed using the I² statistic. Results: Seven retrospective case series met the inclusion criteria, comprising a total of 102 eyes. The included studies were geographically diverse, with patient travel histories predominantly linked to tropical and subtropical regions in Southeast Asia and South America. The pooled proportion for globe salvage was 89.2% (95% Confidence Interval [CI]: 82.5% to 94.1%). There was low to moderate heterogeneity among the studies for this outcome (I² = 31%, p=0.19). The pooled mean improvement in BCVA from pre-operative assessment to final follow-up was 1.21 LogMAR (95% CI: 0.98 to 1.44). Substantial heterogeneity was observed for the visual acuity outcome (I² = 78%, p<0.001). The most commonly identified fungal genera were Fusarium and Aspergillus. Conclusion: Therapeutic keratoplasty demonstrates a high rate of anatomical success, effectively salvaging the globe in the vast majority of patients with severe, travel-associated fungal keratitis. While visual acuity is significantly improved, the final outcomes remain guarded and are highly variable. These findings underscore the critical role of TK in the management of this sight-threatening condition and highlight the need for strategies to improve post-operative visual prognosis.
IMPLEMENTATION OF OCCUPATIONAL HEALTH AND SAFETY PROTOCOLS IN HOSPITALITY DURING COVID-19 Hardy, I Putu Dedy Kastama; Wirawan, I Made Ady
Jurnal Ilmiah Ilmu Terapan Universitas Jambi Vol. 10 No. 2 (2026): Volume 10, Nomor 2, April 2026
Publisher : LPPM Universitas Jambi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jiituj.v10i2.54269

Abstract

The COVID-19 pandemic severely disrupted the global hospitality industry, causing widespread declines in occupancy rates, revenue, and workforce stability. Despite growing awareness of occupational health and safety (OHS), there remains a critical knowledge gap regarding the effectiveness of OHS protocol implementation in supporting hospitality sector recovery. This study aimed to evaluate and synthesize evidence on OHS protocol implementation strategies in the hospitality sector during the COVID-19 pandemic. Methods: A systematic literature review combined with meta-analysis was conducted following PRISMA guidelines. Five peer-reviewed studies published from 2020 to 2025 were analyzed using PICOS-based inclusion and exclusion criteria. Data were extracted and synthesized thematically; effect sizes and confidence intervals were estimated through a visual meta-analysis using a bar chart and forest plot. Results: The sustainable tourism governance model demonstrated the highest relevance level (90%), followed by safety policy implementation (85%) and the Perception-Reaction-Prediction (PRP) model (80%). Urban hotels adopted health protocols more rapidly than rural hotels, and women demanded stricter safety standards than men. All five reviewed studies reported significant effect sizes with confidence intervals that did not cross zero. Discussion/Novelty: This study makes a novel contribution by providing the first systematic meta-analytic synthesis of OHS protocol effectiveness specifically within the hospitality sector during a pandemic context, integrating governance, demographic, and geographic dimensions.
Prevalence and Etiology of Ocular Morbidity in Maritime Environments: A Systematic Review and Meta-Analysis of Passenger and Crew Data Iska Novi Udayani; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita; I Made Ady Wirawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1526

Abstract

Background: The maritime environment constitutes a unique epidemiological enclosure characterized by isolation, specific occupational hazards, and distinct environmental stressors including hyper-salinity and high ultraviolet (UV) albedo. While gastrointestinal and respiratory outbreaks at sea are well-documented, the burden of ocular morbidity remains under-quantified. This study aims to determine the prevalence and etiology of ocular emergencies, stratifying risks between industrial seafarers (crew) and recreational travelers (passengers). Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Data were extracted from eight observational studies (2014–2024) covering expedition cruises, commercial shipping, and leisure voyages. To address population heterogeneity, a stratified analysis was performed: Track A analyzed occupational trauma in crew, while track B analyzed environmental morbidity in passengers. A random-effects model was used to calculate pooled proportions with 95% Confidence Intervals (CI), accompanied by a leave-one-out sensitivity analysis. Results: The dataset represented a combined population of over 5,000 maritime subjects. The pooled prevalence of ocular involvement in maritime trauma cases was 18.4% (95% CI: 12.1%–25.5%). Etiological analysis of crew injuries revealed a dominance of mechanical trauma, specifically metallic foreign bodies (40.5%), followed by chemical burns (26.2%). In contrast, passenger morbidity was driven by environmental factors (photokeratitis, dry eye) and infectious conjunctivitis. Conclusion: Ocular emergencies represent a significant, preventable burden in maritime travel, with distinct risk profiles for crew and passengers. The high rate of occupational trauma suggests a failure in personal protective equipment (PPE) compliance, while the environmental burden reflects the dry ship phenomenon. Mandatory protective eyewear policies and the integration of anterior-segment tele-ophthalmology are critical interventions.
Integrasi Kesehatan Berbasis Partisipasi Masyarakat dalam Pengelolaan Desa Wisata untuk Mendukung Keberlanjutan dan Kesejahteraan Lokal Astawastini, I Dewa Ayu Mas Manik; Wirawan, I Made Ady; Jawi, I Made
Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Vol. 7 (2024): PROSIDING SINTESA
Publisher : LPPM Universitas Dhyana Pura

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36002/snts.v7i.3553

Abstract

Desa wisata berbasis partisipasi masyarakat menawarkan potensi besar dalam mengintegrasikan aspek kesehatan melalui pelibatan aktif komunitas lokal. Integrasi ini penting untuk mengatasi tantangan kesehatan yang sering muncul di destinasi wisata, seperti sanitasi buruk, penyebaran penyakit, dan dampak kesehatan mental akibat interaksi intens antara wisatawan dan penduduk lokal. Namun, penelitian tentang integrasi kesehatan dalam pengelolaan desa wisata masih terbatas, terutama dalam konteks Indonesia. Penelitian ini merupakan tinjauan sistematis yang dilakukan berdasarkan pedoman PRISMA untuk mengevaluasi literatur yang relevan. Artikel yang memenuhi kriteria inklusi adalah studi observasional dan intervensi yang membahas integrasi kesehatan dalam desa wisata berbasis partisipasi masyarakat, diterbitkan dalam 10 tahun terakhir. Pencarian dilakukan di basis data elektronik, seperti PubMed, Scopus, dan Google Scholar, menggunakan kata kunci seperti "community-based tourism," "health integration," dan "CHSE implementation." Sebanyak 19 studi dianalisis, terdiri dari 10 studi observasional dan 9 studi intervensi berbasis community trial. Studi observasional menunjukkan hubungan positif antara wellness tourism dengan peningkatan kesehatan psikologis, fisik, dan sosial wisatawan. Studi intervensi menyoroti keberhasilan penggunaan teknologi, seperti sistem cloud dan platform digital, dalam meningkatkan efisiensi layanan kesehatan di komunitas rural. Partisipasi aktif masyarakat lokal terbukti meningkatkan kesadaran kesehatan dan keberlanjutan desa wisata. Integrasi kesehatan dalam desa wisata berbasis partisipasi masyarakat berkontribusi pada peningkatan kesejahteraan wisatawan dan komunitas lokal. Pendekatan berbasis kolaborasi, pelestarian budaya lokal, dan inovasi teknologi menjadi kunci keberhasilan. Penelitian lebih lanjut diperlukan untuk mengevaluasi dampak jangka panjang dan potensi replikasi di berbagai konteks lokal.
Exploring Meditation Influence on Stem Cell: A Review of Current Evidence Santosa, I Gusti Ngurah Putra Eka; Jawi, I Made; Bakta, I Made; Yasa, I Wayan Putu Sutirta; Wirawan, I Made Ady; Lesmana, Cokorda Agung Bagus Jaya; Kandarini, Yenny; Purnamawati, Susy
Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Vol. 7 (2024): PROSIDING SINTESA
Publisher : LPPM Universitas Dhyana Pura

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36002/snts.v7i.3716

Abstract

Endogenous stem cells play a critical role in maintaining tissue homeostasis, repair, and regeneration. The interconnectedness of mind and body has long been recognized as influencing physical health, with practices such as yoga and meditation demonstrating positive effects on overall well-being. This review aims to synthesize current evidence on the effects of meditation on stem cell function, focusing on both indirect (telomere-related) and direct pathways. Meditation appears to influence stem cell function through various mechanisms. Indirectly, meditation may impact stem cells by modulating telomere length and activity. This modulation is likely mediated through stress reduction, modulation of the hypothalamic-pituitary-adrenal (HPA) axis, melatonin elevation, immune system modulation, and reduction of oxidative stress. Directly, meditation may influence stem cell trafficking and differentiation. While studies suggest potential benefits of meditation on stem cell function, further research is needed to fully elucidate the underlying mechanisms. Emerging evidence suggests that meditation may positively influence stem cell function through both indirect and direct pathways. Future research should focus on clarifying the precise mechanisms, investigating the role of meditation parameters, and conducting clinical trials to assess the therapeutic potential of meditation in promoting stem cell-mediated tissue regeneration and repair. A multidisciplinary approach involving researchers from various fields is crucial for comprehensively understanding the complex interplay between meditation, stem cells, and overall health.
Co-Authors Akatsu, Haruko Ariana, Putu Agus Aryanita, Made Ayu Ratih Astawastini, I Dewa Ayu Mas Manik Bagus Komang Satriyasa Carolyna Mairing Cokorda Agung Wahyu Purnamasidhi Cokorda Bagus Jaya Lesmana Cokorda Bagus Jaya Lesmana, Cokorda Bagus Jaya Desak Nyoman Widyanthini Desak Putu Yulita Kurniati Deswandri Deswandri Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dinar Lubis Dyah Pradnyaparmita Duarsa Egiya Goldarosa Sinuraya Erawati, Ni Kadek Erna Ervan Suryanti Umbu Lapu Fabiola Supit Florensia, Maria Frangklin Refelino Jotlely Futi Nurul Destya Ganesa Puput Dinda Kurniawan Gede Parta Kinandana Gunawan, I Made Abdi HARI MULYAWAN I Dewa Ayu Inten Dwi Primayanti I Gusti Agung Dyah Ambarawati I Gusti Ayu Made Julari I Gusti Ayu Made Juliari I Kadek Pendi Aprinta I Ketut Indra Wiguna Cakera I Ketut Suyasa I Komang Widarma Atmaja I Made Artana I Made Bakta I Made Jawi I Made Kerta Duana I Made Krisna Dinata I MADE MULIARTA . I Made Pande Dwipayana I Made Sukawinaca I Nyoman Mangku Karmaya I Putu Adiartha Griadhi I Putu Dedy Kastama Hardy I Wayan Putu Sutirta Yasa I Wayan Weta Ida Ayu Ary Pramita Ida Bagus Subanada Ida Bagus Yorky Brahmantya IKW. Suryawan Indra Wiguna Cakera, I Ketut Isabella Soerjanto Putri Iska Novi Udayani Istiana Marfianti J. A. Pangkahila Josua Aditya Manuel Kadek Dena Ayu Ersafira Kadek Tresna Adhi Karya, I Kadek Jony Dwi Ketut Ariawati Ketut Suarjana Komang Ayu Kartika Sari Lesmana, Cokorda Agung Bagus Jaya LMIS. Handari Adiputra Louise Cinthia Hutomo Luh Pitriyanti Luh Pitriyanti Luh Yulia Adiningsih Luh Yulia Adiningsih Made Agus Hendrayana MADE RATNA SARASWATI . Malcolm Abernethy Marfianti, Istiana Mia Ayustina Prasetya Ngurah Agus Sanjaya ER Ni Kadek Dian Candra Dewi Ni Kadek Erna Erawati Ni Kadek Sutini Ni Ketut Sri Lestari Ni Luh Made Susanthi Pramandani Ni Luh Putu Mira Anggriani Ni Luh Putu Nurhaeni Ni Made Dian Kurniasari Ni Made Sri Nopiyani Ni Made Suasti Wulanyani Ni Nyoman Sri Budayanti Ni Putu Ita Mahayati Ni Wayan Mega Sri Wahyuni Ni Wayan Septarini Nijyoti, Nitya Nitya Nijyoti Nurhaeni, Ni Luh Putu Pande Putu Januraga Paramita, Ni Putu Pradnya Peter Larsen Prihandhani, I Gusti Agung Ayu Sherlyna Purnamawati, Susy Putu Astawa Putu Ayu Indrayathi Putu Ayu Sani Utami Putu Eka Arimbawa Putu Ika Anggaraeni Putu Imas Audina Putu Intan Tillama Putu Lestari Sudirman Putu Ratna Kusumadewi Giri Putu Rima Adilitha Widyasari Putu Wulan Putri Amerta R. A.T. Kuswardhani Rania Ayu Permata Putri Kornia Rodney Wu Rosita, Ni Putu Indah Santosa, I Gusti Ngurah Putra Eka Sarah Aldington Sari, Komang Ayu Kartika Sawitri, Anak Agung Sagung Sugijanto - Sukawinaca, I Made Sulawa, I Ketut Susy Purnawati Tiara Alexander Wahyuddin, Wahyuddin Wahyudin - Wahyuni, Ni Wayan Mega Sri Wayan Citra Wulan Sucipta Putri Widowati, I Gusti Ayu Rai - Yenny Kandarini Yuntari, Gusti Ayu Krisma