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All Journal The International Journal of Medical Science and Health Research The Indonesian Journal of General Medicine
Melati Ganeza
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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In Silico Evaluation of Phytochemicals from Amorphophallus muelleri as Potential PPARG Modulators in Polycystic Ovary Syndrome (PCOS): A Molecular Docking Study Melati Ganeza; Enricko Hotma Jonifar Siregar
The International Journal of Medical Science and Health Research Vol. 18 No. 10 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/rddj9034

Abstract

Objective: Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine disorder that affects women of reproductive age and is frequently associated with insulin resistance, hyperandrogenism, and metabolic abnormalities. Peroxisome Proliferator-Activated Receptor Gamma (PPARG) is a nuclear receptor involved in glucose and lipid metabolism and plays a pivotal role in the pathogenesis of PCOS. Amorphophallus muelleri is known to contain various fatty acid derivatives that may influence metabolic pathways through PPARG modulation. Methods: This study aimed to evaluate the binding affinity and interaction profiles of nine phytochemicals derived from A. muelleri toward PPARG using molecular docking analysis. The three-dimensional structure of PPARG (PDB ID: 3DZY) was retrieved from the Protein Data Bank, and docking simulations were conducted using the Molecular Operating Environment (MOE) software. Ligand preparation was performed through energy minimization using the MMFF94x force field, and the docking site was defined based on the co-crystallized ligand binding domain. Results: Docking results showed that all tested compounds had negative binding free energy values, indicating spontaneous interactions. Linoleic acid ethyl ester showed the strongest binding affinity with a docking score of –10.85 kcal/mol, followed by (9E)-9-octadecenoic acid (–10.42 kcal/mol) and 9-octadecenoic acid methyl ester (–10.20 kcal/mol). These compounds interacted with key residues in the PPARG ligand-binding domain, including Cys285, Tyr473, and His323, through hydrophobic interactions and hydrogen bonding, indicating a stable ligand–receptor complex. Conclusion: The findings of this study demonstrate that specific phytochemicals from Amorphophallus muelleri possess strong binding affinity and favorable interaction profiles with PPARG, supporting their potential relevance in the molecular mechanism underlying PCOS therapy.
Pharmacodynamic Profiling of Bevacizumab in Combination with Paclitaxel for Advanced Cervical Cancer: A Network Pharmacology and Molecular Docking Approach Melati Ganeza; Enricko Hotma Jonifar Siregar
The Indonesian Journal of General Medicine Vol. 21 No. 1 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/mprsd476

Abstract

Introduction: Cervical cancer is a leading cause of cancer-related morbidity and mortality in women globally. The combination of Bevacizumab, an anti-VEGFA monoclonal antibody, with Paclitaxel-based chemotherapy has demonstrated significant clinical benefit in advanced stages, yet the underlying pharmacodynamic mechanisms of synergy are not fully understood. This study aims to elucidate these mechanisms using an integrated computational approach. Methods: A network pharmacology and molecular docking strategy was employed. Drug targets for Bevacizumab and Paclitaxel were sourced from DrugBank and PubChem, while cervical cancer-associated genes were obtained from GeneCards and DisGeNET. Shared targets were identified via intersection analysis. A Protein-Protein Interaction (PPI) network was constructed using STRING and analyzed with Cytoscape. Functional enrichment analysis (GO/KEGG) was performed using clusterProfiler and DAVID. Molecular docking simulations between Bevacizumab-VEGFA and Paclitaxel-β-tubulin were conducted using AutoDock Vina. Results: Intersection analysis yielded 168 overlapping targets. PPI network topology identified VEGFA, AKT1, TP53, EGFR, and MAPK1 as core hub proteins. Enrichment analysis revealed significant involvement in biological processes and pathways central to cervical cancer, including angiogenesis, apoptosis, PI3K-AKT, VEGF, mTOR, p53, and MAPK signaling (p < 0.01). Molecular docking confirmed strong binding affinities for Bevacizumab with VEGFA (-10.2 kcal/mol) and Paclitaxel with β-tubulin (-9.8 kcal/mol). Discussion: The findings suggest that the Bevacizumab-Paclitaxel combination exerts synergistic anti-tumor effects through multi-target, multi-pathway regulation. Bevacizumab inhibits angiogenesis and may promote vascular normalization, potentially enhancing Paclitaxel delivery. Paclitaxel induces mitotic arrest and apoptosis. Their concerted action on interconnected hubs and pathways (PI3K-AKT, VEGF, mTOR, p53, MAPK) provides a mechanistic rationale for the improved clinical outcomes observed in trials like GOG-240. Conclusion: This integrative computational study delineates a pharmacodynamic model for the synergy of Bevacizumab and Paclitaxel in advanced cervical cancer, involving complementary modulation of angiogenesis, proliferation, and apoptosis pathways. The results support the clinical use of this combination and highlight the utility of network pharmacology and molecular docking as predictive tools in oncology.
What are The Rates of Mortality, Major Morbidity, and Hospital Readmission Within 30 Days Following Elective Gynecological Procedures in Patients Over 80 Years? : A Systematic Review Melati Ganeza; Yahya Nurlianto; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/gj4gt527

Abstract

Introduction: The global population is aging, and more women over 80 years are considered for elective gynecological surgery. However, evidence on short-term postoperative outcomes in this specific age group remains scarce. Methods: We conducted a systematic review following PRISMA guidelines, searching multiple databases for studies reporting 30-day mortality, major morbidity, or hospital readmission after elective gynecological procedures in patients ≥80 years. Observational studies, RCTs, etc were included. Results: The pooled 30-day mortality was 0–1% (Friedman et al., 2006; Fitzgerald et al., 2008). Major morbidity was elevated in elderly patients, particularly medical complications (UTI, respiratory failure, sepsis) (Friedman et al., 2006; Bourgin et al., 2016). No study reported 30-day readmission rates specifically for patients over 80. Length of stay was consistently longer in older patients (Friedman et al., 2006; Gultekin et al., 2015). Minimally invasive and obliterative procedures (e.g., colpocleisis) were associated with better outcomes (Raffone et al., 2021; Sadeh et al., 2022). Discussion: There is a profound evidence gap regarding perioperative outcomes in women over 80 undergoing elective gynecological surgery. Available data suggest low mortality but increased morbidity compared to younger patients. Readmission remains unmeasured. Frailty, hypoalbuminemia, and open surgical approach are key risk factors. Conclusion: Elective gynecological surgery in selected patients over 80 is feasible with low mortality, but major morbidity is higher. No readmission data exist. Future research must include this age group, report geriatric-specific outcomes, and evaluate ERAS protocols.
How Does Telemedicine-Based Postoperative Monitoring Affect Recovery Outcomes and Healthcare Costs for Women Undergoing Gynecological Procedures? : A Systematic Review Melati Ganeza; Yahya Nurlianto; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 39 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/75y50z88

Abstract

Introduction: Postoperative care following gynecological surgery traditionally relies on in-person visits, which impose burdens on patients and healthcare systems. Telemedicine offers a potential alternative, but its impact on recovery outcomes and costs specifically for gynecological procedures requires systematic evaluation. Methods: This systematic review followed structured screening and data extraction procedures. We included randomized controlled trials, etc involving adult women (≥18 years) undergoing routine gynecological procedures. Studies examined telemedicine-based postoperative monitoring (remote technologies, virtual consultations, mobile apps, telehealth platforms) compared to standard care. Outcomes included recovery measures (complications, readmissions, patient satisfaction, quality of life, return to activities) and healthcare costs. Sixteen studies met inclusion criteria for final analysis. Results: Patient satisfaction was noninferior or superior to standard care across 10 studies (Lee et al., 2020; Wherley et al., 2025; Robin et al., 2025). Functional recovery improved significantly with comprehensive eHealth programs combining activity tracking and personalized advice, reducing return-to-normal-activities by 13 days (den Bakker et al., 2023). Simple telephone follow-up showed no benefit on quality of life or pain in enhanced recovery settings (Kassymova et al., 2020; Kassymova et al., 2022). Telemedicine was safe across all studies, with no increased complications or readmissions. Cost-effectiveness was demonstrated for internet-based programs (Bouwsma et al., 2018) and automated low-cost interventions (Sajnani et al., 2020; Robin et al., 2025), while nurse-led telephone models doubled costs without clinical benefit (Kassymova et al., 2025). Discussion: Intervention complexity predicts functional recovery benefits; personalized, interactive eHealth platforms outperform passive monitoring. Enhanced recovery after surgery (ERAS) contexts may attenuate marginal benefits of simple telephone follow-up. Satisfaction is universally preserved across all telemedicine modalities. Telemedicine does not increase low-acuity healthcare contacts and may reduce them through structured coaching. Cost-effectiveness depends on mechanism of savings—technology-mediated scalable interventions are superior to staffing-intensive models. Patient age, technological literacy, and psychological factors influence uptake and outcomes. Conclusion: Telemedicine-based postoperative monitoring for gynecological procedures is safe and achieves patient satisfaction equivalent or superior to standard care. Functional recovery benefits require comprehensive, personalized interventions with active patient engagement rather than simple follow-up. Cost-effectiveness favors automated or internet-based programs over labor-intensive telephone models. Future implementation should match intervention complexity to clinical context, target specific care gaps (activity guidance, expectation management), and consider patient digital literacy and psychological needs.
What are The Optimal Surgical Staging Procedures for Fallopian Tube Cancer in Terms of Diagnostic Accuracy, Morbidity, and Long-Term Patient Outcomes? : A Systematic Review Melati Ganeza; Yahya Nurlianto; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 39 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/nsxw3t27

Abstract

Introduction: Primary fallopian tube cancer (PFTC) is a rare gynecologic malignancy that shares clinical and histological features with epithelial ovarian cancer. The optimal surgical staging procedures for PFTC and its precursor, serous tubal intraepithelial carcinoma (STIC), remain incompletely defined due to limited prospective data. Methods: This systematic review synthesized evidence from 16 studies, including RCT, etc. Data were extracted on diagnostic accuracy (upstaging rates), surgical morbidity, long-term outcomes (survival, recurrence), and comparative effectiveness of staging approaches (laparoscopy vs. laparotomy, complete vs. incomplete staging, extraperitoneal vs. transperitoneal lymphadenectomy). Results: For PFTC, comprehensive surgical staging (hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, peritoneal cytology/biopsies) improved 5-year survival from 33.3% to 65.4% (p=0.043) (Yu et al., 2007). Optimal cytoreduction significantly improved survival (68.4% vs. 41.7%, p=0.044) (Yu et al., 2007). Upstaging rates for apparent early-stage adnexal cancers were 23% (Brockbank et al., 2013). For STIC, upstaging varied from 0% in BRCA carriers undergoing risk-reducing surgery (Hoeven et al., 2018) to 43% in incidental STIC in low-risk women (Chay et al., 2015). Minimally invasive staging reduced blood loss, hospital stay, and lymphatic ascites (p<0.05) compared to laparotomy (Nezhat et al., 2010; Pérez-Medina et al., 2015; Kerbage et al., 2020). Extraperitoneal para-aortic lymphadenectomy had fewer intraoperative complications (OR 0.40, p=0.001) but more lymphoceles (OR 4.12) than transperitoneal approach (Li et al., 2021). Discussion: The evidence supports complete surgical staging and optimal cytoreduction for PFTC. For STIC, staging is most clearly indicated when incidentally found in non-BRCA patients. Minimally invasive approaches are preferred due to lower morbidity, provided tumor rupture is avoided. The independent prognostic value of lymphadenectomy remains debated, while omentectomy shows consistent survival benefit. Conclusion: Optimal surgical staging for fallopian tube cancer should include systematic lymphadenectomy, omentectomy, peritoneal biopsies, and cytology, aiming for no residual disease. Laparoscopic staging is safe and effective for early-stage and selected advanced cases. STIC management should be individualized based on BRCA status and clinical context.
Co-Authors Enricko Hotma Jonifar Siregar Mutia Juliana Yahya Nurlianto