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Toxoplasma encephalitis in HIV/AIDS patients in Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia Suryapraba, Anak Agung Ayu; Sintarani, Cokorda Istri Dyah; Vania, Aurelia; Ni Made Susilawathi; Anak Agung Raka Sudewi
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.16763

Abstract

Toxoplasma gondii, an opportunistic infection in HIV/AIDS patients, is an obligate intracellular parasite that causes toxoplasma encephalitis (TE). The symptoms of TE range from subacute focal or global neurologic impairments to neuropsychiatric disorder, and infectious mass lesions. In clinical practice, presumptive diagnosis, including clinical syndrome, finding single or multiple brain lesions on neuroimaging evaluation are preferred. This study aimed to identify neurologic and radiologic characteristics of HIV/AIDS patients with TE in Prof. Dr. I.G.N.G Ngoerah Hospital, Denpasar, Bali. It was a retrospective study using medical records of patients with TE from January 2018 to December 2021. Of 122 subjects, 66.4% were male and 33.6% were female, age ranged from 19-59 y.o. with a median of age 33 y.o., and the CD4 count median was 29.5 cell/mm3. Decreased consciousness was the most prevalent clinical symptom in 40.2% of subjects followed by headache in 18.9% of subjects. A structural lesion in neuroimaging was primarily found in the basal ganglia area of the brain (44.3%). The fatality rate (30.3%) was significantly associated with decreased consciousness, higher leukocyte levels, and a higher neutrophil-to-lymphocyte ratio (p<0.05). Diagnosis of TE should be considered in immunocompromised young adults with subacute onset of focal and/or global neurological deficit and neuroimaging results showing hypodense lesion, particularly with ring-like enhancement, in thebasal ganglia and corticomedullary junction area of the brain. An altered state of consciousness and NLR can indicate poor outcomes in HIV/AIDS patients with TE.
Serum Nerve Growth Factor Levels in Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis Putu Indah Mahardika Putri; Ni Made Susilawathi; I Putu Eka Widyadharma
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.v9i12.1453

Abstract

Background: Painful diabetic neuropathy (PDN) is a severe complication of type 2 diabetes mellitus (T2DM). Nerve Growth Factor (NGF) is vital for neuronal health, but its status as a systemic biomarker in PDN is contested due to conflicting reports on serum levels. This study aimed to quantitatively synthesize the literature on the association between serum NGF concentrations and the presence of PDN in patients with T2DM. Methods: PubMed, Scopus, Web of Science, and Embase were searched for observational studies from January 2015 to August 2025 that measured serum NGF in T2DM patients with PDN versus control groups (T2DM without PDN or healthy individuals). Data were independently extracted by two reviewers. A random-effects model was used to calculate the pooled Standardized Mean Difference (SMD) and 95% confidence intervals (CIs) to account for assay variability. Heterogeneity was explored using the I² statistic and meta-regression. Results: From 1,482 records, seven cross-sectional studies (485 PDN patients, 511 controls) were included. The meta-analysis revealed that patients with PDN had significantly lower serum NGF concentrations compared to controls, with a pooled SMD of -1.28 (95% CI: -1.79 to -0.77, p < 0.00001). Substantial heterogeneity was present (I² = 84%). Meta-regression showed that a longer duration of diabetes was significantly associated with a greater reduction in NGF levels (p = 0.02). No significant publication bias was detected. Conclusion: This meta-analysis provides consolidated evidence that lower systemic NGF levels are a strong feature of established PDN. The findings support the neurotrophic deficit hypothesis in PDN pathophysiology and identify NGF as a candidate biomarker requiring rigorous validation in longitudinal studies that carefully differentiate painful from painless neuropathy phenotypes.
Serum Nerve Growth Factor Levels in Painful Diabetic Neuropathy: A Systematic Review and Meta-Analysis Putu Indah Mahardika Putri; Ni Made Susilawathi; I Putu Eka Widyadharma
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.v9i12.1453

Abstract

Background: Painful diabetic neuropathy (PDN) is a severe complication of type 2 diabetes mellitus (T2DM). Nerve Growth Factor (NGF) is vital for neuronal health, but its status as a systemic biomarker in PDN is contested due to conflicting reports on serum levels. This study aimed to quantitatively synthesize the literature on the association between serum NGF concentrations and the presence of PDN in patients with T2DM. Methods: PubMed, Scopus, Web of Science, and Embase were searched for observational studies from January 2015 to August 2025 that measured serum NGF in T2DM patients with PDN versus control groups (T2DM without PDN or healthy individuals). Data were independently extracted by two reviewers. A random-effects model was used to calculate the pooled Standardized Mean Difference (SMD) and 95% confidence intervals (CIs) to account for assay variability. Heterogeneity was explored using the I² statistic and meta-regression. Results: From 1,482 records, seven cross-sectional studies (485 PDN patients, 511 controls) were included. The meta-analysis revealed that patients with PDN had significantly lower serum NGF concentrations compared to controls, with a pooled SMD of -1.28 (95% CI: -1.79 to -0.77, p < 0.00001). Substantial heterogeneity was present (I² = 84%). Meta-regression showed that a longer duration of diabetes was significantly associated with a greater reduction in NGF levels (p = 0.02). No significant publication bias was detected. Conclusion: This meta-analysis provides consolidated evidence that lower systemic NGF levels are a strong feature of established PDN. The findings support the neurotrophic deficit hypothesis in PDN pathophysiology and identify NGF as a candidate biomarker requiring rigorous validation in longitudinal studies that carefully differentiate painful from painless neuropathy phenotypes.