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Universa Medicina
Published by Universitas Trisakti
ISSN : 19073062     EISSN : 24072230     DOI : -
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Universa Medicina (univ.med) is a four-monthly medical journal that publishes new research findings on a wide variety of topics of importance to biomedical science and clinical practice. Universa Medicina Online contains both the current issue and an online archive that can be accessed through browsing, advanced searching, or collections by disease or topic
Arjuna Subject : -
Articles 15 Documents
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Search results for , issue "Vol. 44 No. 2 (2025)" : 15 Documents clear
Systematic review and meta-analysis of antibiotic strategies for survival in patients with drug-resistant Acinetobacter baumannii infection: does quantity matter? De Rorna, Masrahma Reinataya; Ramadhani, Alfiyah; Hibatulloh, Muhammad Farhan; Agustina, Dini
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.232-244

Abstract

Background Acinetobacter baumannii is an opportunistic pathogen frequently associated with severe hospital-acquired infections, particularly in intensive care units, and is characterized by high levels of antibiotic resistance, including to carbapenems. The rising prevalence of multidrug- and pan-drug-resistant strains poses significant therapeutic challenges and underscores the need for optimized treatment strategies to improve survival outcomes. This systematic review and meta-analysis evaluates the impact of different antibiotic treatment modalities (monotherapy versus combination) on the clinical outcome of patients with Acinetobacter baumannii infection. Methods This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To find pertinent studies released up to 3 January 2025 a thorough search was done in electronic databases such as PubMed, Embase, ScienceDirect, Cochrane, EBSCOhost, Google Scholar, and Scopus.  Results This systematic review and meta-analysis identified 20 studies for inclusion. No statistically significant overall survival difference was found (Pooled OR = 0.83, 95% CI [0.66- 1.03], p = 0.09), but subgroup analyses indicated that combination therapy markedly enhanced survival rates in patients with carbapenem-resistant Acinetobacter baumannii  (CRAB) infection, APACHE II scores below 20, and bloodstream infections. Meta-regression suggested that age may adversely affect treatment efficacy.   A trend favoring combination therapy was consistent across subgroups, despite some results not reaching statistical significance. Conclusion This systematic review and meta-analysis highlights the treatment challenges of drug-resistant Acinetobacter baumannii, particularly MDRAB, XDRAB, and CRAB strains. Combination therapy offers potential benefits in CRAB and moderate-severity cases but is not universally superior to monotherapy. Treatment outcomes are influenced by patient-specific factors such as age, infection type, and disease severity.
Diabetic retinopathy: pathogenesis, pathophysiology, and treatment Yudistira, Yudistira; Hendrawan, Kevin Anggakusuma; Andayani, Ari; Suryathi, Ni Made Ari
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.270-284

Abstract

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and one of the leading causes of vision impairment worldwide. Prolonged hyperglycemia initiates a cascade of molecular events including chronic inflammation, oxidative stress, advanced glycation end products, and the activation of plasma kallikrein and protein kinase C signaling pathways, which leads to endothelial damage and pericyte loss. The resulting endothelial barrier dysfunction promotes serum leakage and retinal edema, while advanced disease stages are characterized by ischemia-driven retinal neovascularization mediated by elevated intraocular vascular endothelial growth factor (VEGF) levels. Current therapeutic strategies for diabetic retinopathy include laser therapy, intravitreal administration of anti-VEGF agents or corticosteroids, and vitreoretinal surgery. Despite their efficacy, a number of patients experience suboptimal responses. Consequently, novel therapeutic approaches are under investigation, including alternative anti-angiogenic agents, gene therapies, and visual cycle modulators currently undergoing clinical trials. A comprehensive understanding of the pathogenesis and pathophysiology of diabetic retinopathy is essential to improve existing treatment modalities and address current limitations in patient outcomes. In this review, we systematically searched and analyzed articles published in English from 2014 to 2024 using PubMed, ScienceDirect, SpringerLink, and Google Scholar. Relevant search terms included “diabetic retinopathy,” “pathophysiology,” “pathogenesis,” “treatment,” and “diabetic macular edema.” This review presents recent insights into the pathogenesis of diabetic retinopathy, including oxidative stress, inflammation, and neurodegeneration, followed by an overview of its pathophysiology such as microvascular dysfunction and neovascularization. Finally, current and emerging treatment modalities, encompassing both pharmacological and surgical approaches, are discussed. This structured approach provides essential background to understand the complexity of diabetic retinopathy and recent advances in its management.
Analysis of serum levels of B cell activating factor and soluble B cell activating factor receptor with disease activity in systemic lupus erythematosus Raveinal, Raveinal; Elvira, Dwitya; Delfin, Muhamad
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.181-189

Abstract

Background Systemic lupus erythematosus (SLE) is caused by B-cell hyperactivity, which stimulates the production of autoantibodies, leading to the formation of immune complexes and resulting in tissue damage. Increased B-cell activation is associated with disease activity in SLE. The cytokine B-cell Activating Factor (BAFF) and its soluble BAFF receptor (sBAFF-R) play a crucial role in B-cell activation and survival. Their serum levels may serve as potential biomarkers for SLE severity. This study aimed to compare serum levels of BAFF and sBAFF-R between SLE patients with mild, moderate, and severe disease activity. Methods A cross-sectional study was conducted involving 33 female SLE patients. Subjects were divided into mild, moderate, and severe disease activity groups. Disease activity was assessed using Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) scores. Serum BAFF and sBAFF-R levels were measured using ELISA. Data were analyzed using the Kruskal–Wallis and Mann-Whitney tests. A p-value < 0.05 was considered statistically significant. Results The median serum BAFF level in SLE patients was 0.51 ng/mL, and 4.66 ng/mL in sBAFF-R level.There was a statistically significant difference in serum BAFF and sBAFF-R levels between mild, moderate, and severe disease activity among SLE patients (p<0.0001). Conclusion Increased serum levels of BAFF and sBAFF-R may influence disease activity in SLE. Serum concentrations of BAFF and sBAFF-R were found to be associated with disease severity, including mild, moderate, and severe categories. These findings suggest that serum BAFF and sBAFF-R levels may serve as potential biomarkers for assessing SLE activity.
Effectiveness of medium-chain triglyceride diet and low glycemic index therapy in drug-resistant childhood epilepsy: a systematic review, meta-analysis, and meta-regression Wiradarma, Elbert; Khosama, Herlyani; Warouw, Finny; Wariki, Windy M. V.; Jehosua, Seilly Yunita; Pertiwi, Junita Maja
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.245-256

Abstract

Background Drug-resistant epilepsy (DRE) challenges clinical management, with many patients failing to find relief. Medium-chain triglyceride diet (MCTD) and low glycemic index therapy (LGIT) are emerging variants of the ketogenic diet. MCTD and LGIT show promise but lack clear efficacy data. The purpose of this systematic review was to evaluate and compare the efficacy of MCTD and LGIT in the management of pediatric patients with DRE. Methods Four databases were searched (PubMed, Embase, Scopus, and Cochrane Library) from November 2024 to February 2025. Two independent reviewers meticulously screened titles, abstracts, and full texts, ensuring adherence to predefined criteria.  Data extraction encompassed study characteristics, participant demographics, intervention details, and outcomes, including seizure frequency, percentage reduction, and adverse events. Statistical analyses were performed using R 4.2.2 software, assessing heterogeneity with Cochrane Q and I² and utilizing random-effects and common-effects models. Results From 1489 articles found, 487 duplicates were removed, 897 were excluded based on title and abstract screening, and of the 47 full-text articles assessed for eligibility, 31 articles were excluded, resulting in 16 articles (9 MCTD and 7 LGIT) included in this review. The pooled estimates for the proportion of children achieving seizure freedom, ≥90% seizure reduction, and ≥50% seizure reduction following the intervention were comparable between the MCTD and LGIT groups. Based on the random-effects model, the overall success proportion of MCTD in reducing seizure frequency was 0.20 [95 % Confidence Interval (CI), 0.14-0.27] (p<0.01). Meanwhile, in the LGIT group, the overall success proportion was 0.27 [95% CI,0.14- 0.45] (p<0.01). Conclusion Both MCTD and LGIT demonstrate comparable efficacy, and no definitive conclusion can be drawn regarding the superiority of one diet over the other.
An integrative review on the shadow of abuse in pediatric head trauma SÖNGÜT, Semra
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.257-269

Abstract

Introduction Abusive head trauma (AHT) is a significant public health issue that can lead to severe neurological damage or death in childhood. Often difficult to detect, AHT carries long-term consequences and requires high diagnostic vigilance. This integrative review aims to synthesize the current evidence on abusive head trauma in pediatric patients by identifying distinguishing diagnostic criteria, clinical patterns, and risk factors, in order to support early recognition, accurate diagnosis, and effective intervention strategies by healthcare professionals. Methods This integrative review aimed to systematically include studies published between 2020-2025 and the literature search was conducted in April-June 2025. The databases searched included PubMed and Web of Science. The keywords included in the search were "Abusive head trauma", "child abuse", "non-accidental head injury", "health care professional", "pediatric head trauma". The methodological quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Results The findings were synthesized under four main themes: diagnostic indicators and differentiation, epidemiological risk factors, short-term clinical outcomes, and long-term developmental effects. Elevated glucose levels (>300 mg/dL), the diagnostic “triad” (subdural hematoma, retinal hemorrhage, and encephalopathy), and increased plasma osteopontin levels were identified as critical diagnostic clues. Additionally, household composition and caregiver characteristics emerged as significant risk factors. Conclusion This integrative review highlights the necessity of identifying high-risk environments and implementing preventive strategies. The evidence presented offers practical, evidence-based insights to support healthcare professionals in accurately diagnosing and managing AHT. It also underscores the need for multidisciplinary prevention efforts and post-trauma monitoring. Ultimately, this study seeks to enhance clinical awareness and improve early identification and intervention strategies for children suffering from abuse-related head trauma.

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