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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research MEDICINUS
Dian Rizki Fitria
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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A Neuroinflammatory Biomarker Profile Associated with Neuropathic Pain in Hansen's Disease: A Systematic Review and Meta-Analysis of S100B, TNF-α, and IL-6 Dian Rizki Fitria; I Putu Eka Widyadharma; Ni Made Susilawathi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1475

Abstract

Background: Neuropathic pain (NP) is a severe, chronic complication of Hansen's disease (HD), persisting after antimicrobial therapy and profoundly diminishing quality of life. Its pathophysiology is driven by persistent, complex neuroinflammatory processes within the peripheral nervous system. Circulating biomarkers, especially the glial-derived protein S100B, offer a potential objective window into this underlying pathology. This study aimed to meta-analyze the association between circulating S100B, TNF-α, and IL-6 and the presence of NP in patients with HD. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted for observational studies published between January 2015 and December 2025 that compared biomarker levels in HD patients with and without NP, diagnosed using validated screening instruments. Data from eligible studies were extracted independently, and methodological quality was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to compute the pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) for each biomarker. Results: Seven studies, comprising 812 patients (405 with NP, 407 without NP), met the inclusion criteria. The meta-analysis revealed that serum S100B levels were significantly elevated in HD patients with NP compared to those without (SMD = 1.28, 95% CI [0.95, 1.61], p < 0.001). This finding was accompanied by very high statistical heterogeneity (I² = 78%). Concurrently, the analysis demonstrated significantly higher circulating levels of TNF-α (SMD = 0.89, 95% CI [0.62, 1.16]) and IL-6 (SMD = 0.75, 95% CI [0.48, 1.02]) in the NP group. Conclusion: This meta-analysis establishes a strong statistical association between a distinct neuroinflammatory biomarker profile—characterized by elevated circulating S100B, TNF-α, and IL-6—and the presence of neuropathic pain in Hansen's disease. S100B, as a marker of Schwann cell distress, is a particularly relevant component of this profile. These findings underscore the pivotal role of neuroinflammation in HD-related NP, although the high heterogeneity and non-specific nature of these systemic markers necessitate a cautious interpretation regarding their immediate clinical applicability.
A Neuroinflammatory Biomarker Profile Associated with Neuropathic Pain in Hansen's Disease: A Systematic Review and Meta-Analysis of S100B, TNF-α, and IL-6 Dian Rizki Fitria; I Putu Eka Widyadharma; Ni Made Susilawathi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1475

Abstract

Background: Neuropathic pain (NP) is a severe, chronic complication of Hansen's disease (HD), persisting after antimicrobial therapy and profoundly diminishing quality of life. Its pathophysiology is driven by persistent, complex neuroinflammatory processes within the peripheral nervous system. Circulating biomarkers, especially the glial-derived protein S100B, offer a potential objective window into this underlying pathology. This study aimed to meta-analyze the association between circulating S100B, TNF-α, and IL-6 and the presence of NP in patients with HD. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted for observational studies published between January 2015 and December 2025 that compared biomarker levels in HD patients with and without NP, diagnosed using validated screening instruments. Data from eligible studies were extracted independently, and methodological quality was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to compute the pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) for each biomarker. Results: Seven studies, comprising 812 patients (405 with NP, 407 without NP), met the inclusion criteria. The meta-analysis revealed that serum S100B levels were significantly elevated in HD patients with NP compared to those without (SMD = 1.28, 95% CI [0.95, 1.61], p < 0.001). This finding was accompanied by very high statistical heterogeneity (I² = 78%). Concurrently, the analysis demonstrated significantly higher circulating levels of TNF-α (SMD = 0.89, 95% CI [0.62, 1.16]) and IL-6 (SMD = 0.75, 95% CI [0.48, 1.02]) in the NP group. Conclusion: This meta-analysis establishes a strong statistical association between a distinct neuroinflammatory biomarker profile—characterized by elevated circulating S100B, TNF-α, and IL-6—and the presence of neuropathic pain in Hansen's disease. S100B, as a marker of Schwann cell distress, is a particularly relevant component of this profile. These findings underscore the pivotal role of neuroinflammation in HD-related NP, although the high heterogeneity and non-specific nature of these systemic markers necessitate a cautious interpretation regarding their immediate clinical applicability.
Hubungan antara Asam Traneksamat dan Insiden Kejang pada Pasien dengan Perdarahan Subaraknoid Fitria, Dian Rizki; Dian Rizki Fitria; I Wayan Widyantara
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/4p5c2188

Abstract

Background: Subarachnoid hemorrhage (SAH) accounts for 2–7% of all strokes but contributes disproportionately to morbidity and mortality due to severe complications such as rebleeding, delayed cerebral ischemia, and seizures.Tranexamic acid (TXA) is used to prevent rebleeding in SAH; however, the association between TXA use and seizure riskremains controversial.Methods: A systematic literature review was conducted to identify clinical studies reporting seizure incidence in adult patients with SAH who received TXA. Randomized controlled trials, cohort and case-control studies were included as primary studies. Data were synthesized narratively, with limited quantitative analysis performed when feasible.Results: Five studies met the inclusion criteria. Most studies demonstrated a signal toward an increased risk of seizuresor adverse neurological effects in patients receiving TXA compared with control groups. Safety data suggests that seizure risk tends to increase with total TXA doses exceeding 2 g per day, whereas low-to-moderate doses administered for a shortduration were not consistently associated with an increased incidence of seizures.Conclusion: TXA use in patients with SAH may be associated with an increased risk of seizures, particularly at higher doses. Although TXA provides benefits in reducing rebleeding, careful risk–benefit assessment and appropriate dose selection are essential, especially in patients with neurological vulnerability.
Co-Authors Fitria, Dian Rizki I Putu Eka Widyadharma I Wayan Widyantara Ni Made Susilawathi