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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 589 Documents
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Angiogenesis in rheumatoid arthritis: epidemiology, pathogenesis, signal transduction pathways, and nano-targeted therapeutic strategies Blin, Joan; Roduan, Mohd Rohaizad Md; Hamid, Roslida Abd
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.%p

Abstract

Angiogenesis is the formation of new blood vessels from existing vessels. In rheumatoid arthritis (RA), new blood vessels maintain a chronic inflammatory state by transporting inflammatory cells to the site of inflammation.  Rheumatoid arthritis is a chronic autoimmune disorder that affects approximately 1% of the global population, with a higher prevalence in women. It is characterized by synovial inflammation, hyperplasia, and angiogenesis, leading to joint destruction. Understanding the pathogenesis of RA, particularly the mechanisms driving synovial angiogenesis, is crucial for the development of targeted therapies. Fibroblast-like synoviocytes (FLS) and endothelial cells play key roles in RA pathogenesis by secreting pro-inflammatory cytokines and growth factors, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β, IL-6, and vascular endothelial growth factor (VEGF). These mediators activate multiple signaling pathways, including VEGF, nuclear factor kappa light chain enhancer of activated B cells (NF-κB), phosphatidylinositol-3 kinase (PI3K)/AKT, mitogen-activated protein kinase (MAPK), wingless-related integration site (Wnt), and the Janus kinase (JAK)/ signal transducer and activator of transcription (STAT), which contribute to synovial angiogenesis, inflammation, and joint damage. A literature search was conducted on PubMed, ScienceDirect, SpringerLink, and Google Scholar databases for sources published in English from 2015 to 2025, using the terms “nanotechnology rheumatoid arthritis,” “angiogenesis,” “synovial inflammation,” “pro-inflammatory cytokines,” “disease-modifying antirheumatic drugs,” and “signal transduction pathways”. Current treatments for RA include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs) (conventional synthetic, biological, and targeted synthetic). An informative overview of anti-angiogenic strategies for treating RA, which may provide new perspectives for developing nanoagents, is opening new horizons in the fight against RA. This review covers RA epidemiology, pathogenesis, and signal transduction, as well as current therapies and their limitations, highlighting the need to develop new treatment strategies that target angiogenesis in RA.
Prognostic factors of brain metastases affecting survival: an Indonesian cohort Koesbandono, Koesbandono; Muljadi, Rusli; Sutanto, Ratna; Hendriansyah, Lutfi; Kristiani, Erna; Faustina, Carissa; Christanti, Jessica
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.298-309

Abstract

BackgroundBrain metastases (BMs) most frequently originate from primary tumors of the lung and breast, and significantly impact cancer patient prognosis. Metastases can be detected synchronously along with the primary tumor or metachronously, following treatment of localized disease. The objective of this study was to identify key prognostic factors influencing survival in synchronous metastases (SM) and metachronous metastases (MM), focusing on metastatic duration, tumor volume response, and gamma knife radiosurgery. MethodsA retrospective cohort study was conducted involving 100 patients with brain metastases (48 synchronous, 52 metachronous). Age, gender, primary tumor, gamma knife status, metastasis location, peritumoral index group, volume reduction, metastatic duration, metastasis characteristics, and intensity pattern based on MRI. A Cox proportional hazards regression was used to analyze the data. Based on the Cox regression coefficients, a prognostic index was constructed. ResultsCalculated HR comprised MM (HR=0.49;95% CI :0.24–0.97], gamma knife treatment (HR = 0.15;95% CI: 0.07–0.29], and volume response (HR=0.40;95% CI: 0.16–0.99), all indicating a significantly reduced mortality risk. A prognostic index was calculated for all patients; those with scores ≤–1.513 were classified as low risk. Kaplan-Meier analysis showed that the low-risk group had a significantly longer mean survival period (75.52 months) compared to the high-risk group (31.43 months) (p<0.001). ConclusionMetachronous presentation, gamma knife therapy, and greater tumor volume reduction independently predict better survival. The developed prognostic index provides a clinically useful tool for personalized risk assessment and treatment planning in patients with brain metastases.
Bortezomib in multiple myeloma management Iqbal, Hrishik; Islam, Mohammad Nazmul; Chakravarthi, Srikumar; Jamali, Mohammad Chand; Mahedi, Rezwan Ahmed; Afrin, Sadia; Pujita Roy; Alam, Fahadul; Reza, Md.Shajalal; Syrmos, Νikolaos
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.%p

Abstract

Multiple myeloma (MM) is a hematologic malignancy characterized by the uncontrolled proliferation of plasma cells, leading to complications such as bone lesions, renal dysfunction, and immune suppression. Over the past three decades, its incidence has risen significantly, attributed to factors such as aging populations and improved diagnostic methods. Treatment strategies have evolved considerably, transitioning from alkylating agents and high-dose chemotherapy to targeted therapies, including proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs). Bortezomib, a first-in-class PI, has revolutionized MM management by inhibiting proteasome activity, thereby inducing apoptosis in malignant plasma cells. This review evaluates the efficacy, safety, and clinical applications of bortezomib, both as monotherapy and in combination with dexamethasone, IMiDs, and conventional chemotherapies. Key clinical trials, such as VISTA and SUMMIT, demonstrate its superiority over traditional regimens, improving response rates and survival outcomes. However, its use is associated with adverse effects, including peripheral neuropathy, hematologic toxicities, and gastrointestinal disturbances, necessitating dose modifications and supportive care. Emerging combinations with monoclonal antibodies and novel agents further enhance therapeutic potential, though optimal sequencing remains under investigation. Systematic literature search was performed using PubMed and Cochrane to identify relevant studies on the applications of bortezomib. The search was inclusive of all publications up to May 2025, without restriction by publication year, to ensure a thorough review of research on bortezomib. Studies focusing on multiple myeloma (MM) and the efficacy of bortezomib were prioritized. A broad set of keywords was employed reflecting the diverse applications of bortezomib in MM treatment. The search strategy was designed to capture a wide range of relevant studies. By synthesizing evidence from 77 studies, this review highlights bortezomib’s pivotal role in MM treatment while addressing challenges in toxicity management. Future research should focus on refining combination strategies and minimizing side effects to maximize long-term patient outcomes.
Type 2 diabetes mellitus and recent treatment options in adolescents and young adults Bari, Md Nadeem; Ansari, Md Rizwan; Anwar, Mohammad; Mohammad, Imran
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.%p

Abstract

Although type 2 diabetes mellitus (T2DM) has historically been thought of as a disease that mostly affects adults, its incidence among adolescents and young people has been rising in tandem with the rising rates of childhood obesity. There is no evidence to support the best course of treatment for T2DM in this age group despite the undeniable benefits of lifestyle adjustment for obese kids. Early diabetes start is linked to extended exposure to the disease and a greater likelihood of chronic issues, which impact more individuals during their working years and highlight the negative social effects of the condition. Additionally, there is mounting evidence that juvenile diabetes cohorts exhibit an aggressive phenotype that contributes to the early onset of problems that negatively affect life quality and negatively impact long-term results, increasing the possibility of a future public health emergency. Relevant studies were identified through a systematic search of PubMed, ScienceDirect, and Google Scholar for articles published between 2019 and 2025 using the keyword “Adolescents and (T2DM or Insulin Resistance)”. Type 2 diabetes in young people is a serious global public health issue now. Many significant obstacles must be overcome to treat T2DM that develops in young people, including a lack of effective treatment alternatives and limitations in carrying out therapeutic research. The US Food and Drug Administration has approved metformin, glimepiride (Amaryl), and insulin as treatments for teenagers and young adults with type 2 diabetes, despite therapeutic medication studies. Given modified pharmaceutical laws, it is probable that further anti-diabetic drugs will be included in the arsenal of treatment choices available to teenagers and young adults with T2DM. The epidemiology and current understanding of the pathophysiology, risk factors, consequences, and therapy of T2DM in adolescents and young adults are discussed in this review. 
Hypoxic mesenchymal stem cell-derived secretome and alkaline water synergistically reduce apoptosis and insulin resistance in type 2 diabetes mellitus rat model Mawarini, Melisa Septi; Setiawan, Eko; Putra, Agung
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.310-317

Abstract

BACKGROUNDType 2 Diabetes Mellitus (T2DM) is characterized by chronic inflammation and insulin resistance. These factors contribute to pancreatic β-cell apoptosis, reducing insulin production and impairing glucose homeostasis. This study aims to evaluate the protective effects of hypoxic mesenchymal stem cell-derived secretome (HMSCS) and alkaline water on inflammation, apoptosis, and insulin resistance in a T2DM rat model. METHODSAn experimental study was conducted involving 24 male Wistar T2DM model rats (aged 6-8 weeks, 200-250g). They were randomized into four groups: T2DM rats only as negative control (K-), T2DM rats with metformin as positive control (K+), HMSCS treatment (P1), and HMSCS plus alkaline water group (P2). Caspase-3 expression was measured to assess apoptosis levels using RT-PCR, while homeostatic model assessment for insulin resistance (HOMA-IR) was measured using ELISA. One way ANOVA followed by a post hoc LSD test were used to analyse the data. RESULTSThe P1 group (3.03 ± 1.26 a.u) and P2 group (2.93 ± 0.52 a.u.) had significantly lower caspase-3 expression compared to K- group (6.66 ± 2.76 a.u.) (p<0.05), but were not significantly different from K+ group (3.83 ± 1.61 a.u.) (p>0.05). Additionally, P2 group (6.76 ± 0.96) had a significantly lower HOMA-IR than K- group (18.92 ± 2.63) and K+ group (10.85 ± 1.39) (p<0.05), and similarly the P1 (7.71 ± 0.53) group also showed significant difference from K- and K+ groups (p<0.05). CONCLUSIONHigher doses of HMSCS and alkaline water are associated with reduced pancreatic β-cell apoptosis and improved insulin sensitivity, highlighting its potential as a novel therapeutic approach for T2DM.
Cavernous sinus thrombosis: a case series analysis Nusanti, Syntia; Andini, Nadia Delima; Eldinia, Lourisa Ruth
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.%p

Abstract

BackgroundAlthough uncommon, cavernous sinus thrombosis (CST) is a serious and potentially life-threatening condition that often presents with nonspecific signs and symptoms. Cavernous sinus thrombosis is associated with high morbidity and mortality, estimated at approximately 15% and 11% respectively. The complex diagnostic and treatment processes pose a challenge for healthcare providers, considering its elevated mortality and morbidity. We present four cases with varying clinical presentations and outcomes to provide valuable insights into the manifestations and management of CST. Case descriptionOur case series explored CST across age groups, including a case involving a pregnant woman. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment, and clinical outcomes were analyzed. All cases were associated with one or more ophthalmic symptoms. All patients exhibited eye symptoms, with proptosis occurring unilaterally or bilaterally. Etiologies ranged from infections stemming from pimples and tooth cavities to an initially non-septic cause. Of the four cases presented, two proved fatal: one due to severe sepsis in a young man and the other initially aseptic but later progressing into sepsis in a geriatric man. The remaining two cases exhibited septic complications with complete recovery after prompt treatment. ConclusionSeverity and clinical courses of CST varied, emphasizing the need for careful consideration and tailored management strategies in CST cases. The prognosis of CST has improved with the advancement in treatment, but complications are not infrequent. Raising awareness regarding the potential for severe complications, such as cavernous sinus thrombosis, initiated by a common infection, is strongly encouraged.
Retinoblastoma tumor suppressor protein is not a risk factor for the location of condyloma acuminatum among adults Primisawitri, Pratiwi Prasetya; Mulianto, ⁠Nurrachmat; Ellistasari, Endra Yustin; Poncorini, Eti; Kariosentono, ⁠⁠Harijono; Widhiati, Suci; Wasita, Brian; Setyawan, Novan Adi; Yudhistira, Muhammad Yurizar
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.343-349

Abstract

BackgroundCondylomata acuminata (CA) are sexually transmitted infections primarily caused by low-risk HPV types 6 and 11. Retinoblastoma protein (pRb) interacts with HPV oncoproteins, leading to destabilization, genomic instability, and carcinogenesis. This study aimed to determine whether variations in pRb expression and sexual orientation are risk factors of the anatomical location of CA lesions and to compare differences in pRb expression by sexual orientation. MethodsA cross-sectional study was conducted among 33 patients aged >18 years with clinically and histopathologically confirmed CA. Demographic data, pRb expression assessed via excision biopsy and immunohistochemistry, and relevant risk factors were collected. Statistical analyses including Simple and multiple binary logistic regression were used to analyze the data, with model fit assessed using the Hosmer–Lemeshow test. ResultsWeak pRb expression predominated in anal lesions (92.3%; p=0.018) and among homosexual/bisexual individuals (57.9%; p=0.031), while moderate expression was more common in genital lesions (66.7%; p=0.018) and heterosexual individuals (57.1%; p=0.011). Simple logistic regression  analysis showed that HIV status (OR=11.88; p=0.025), sexual orientation (OR=13.33; p=0.001), and moderate-to-strong pRb expression (OR=24.00; p=0.008; OR=12.00; p=0.048) were associated with lesion location. In the multivariate model, pRb expression was excluded due to multicollinearity. Sexual orientation remained the only independent predictor of lesion location (Adj OR=8.89; p=0.023), with heterosexual individuals more likely to present with genital lesions. ConclusionThe expression of pRb was not a risk factor of the anatomical location of CA, and differed between genital and anal CA. However, sexual orientation emerged as the dominant independent factor associated with lesion location.   
The survival benefits of adjuvant radiotherapy for malignant meningioma: a retrospective cohort study Bakhtiar, Yuriz; Eka Setiawan, Fariz; Ilmansyah, Rafi; Prihastomo, Krisna Tsaniadi; Priambada, Dody; Rizky Aryani Septarina, Faiza; Arifin, Muhamad Thohar; Muttaqin, Zainal
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.318-327

Abstract

BackgroundMalignant meningiomas (MM) are rare aggressive tumors associated with poor survival outcomes. Due to their rarity, there is limited data on the outcomes and prognostic factors of MM patients, particularly on adjuvant radiotherapy roles in this tumor population. This study aims to investigate the clinical characteristics, prognostic factors, and survival outcomes of MM with focus on survival benefits of adjuvant radiotherapy. MethodsThis retrospective cohort study analyzed 19 MM patients, who were initially subjected to postoperative radiotherapy, at Dr. Kariadi General Hospital, Semarang, from 2013 to 2023. Kaplan-Meier analysis was used to estimate survival rates at 1, 2, and 5 years. Univariate and multivariate Cox regression analyses were performed to identify factors associated with overall survival (OS). Variables with a p-value ≤ 0.25 in univariate analysis were included in the multivariate models. ResultsThe median OS was 16 months (95% CI 0.0–40.2), with estimated 1-year, 2-year, and 5-year survival rates of 52.6%, 42.1%, and 15.8%, respectively. Adjuvant radiotherapy (RDT) was associated with a significantly improved OS (p<0.001). However, sex, age, tumor location, and extent of resection did not show a significant association with OS. Cox regression showed that RDT had no statistically significant effect on OS in the multivariate model (HR = 0, 95% CI 0–1.8, p=0.923). ConclusionAdjuvant radiotherapy is critical for improving OS in MM patients, and gross-total resection (GTR) alone does not guarantee better long-term outcomes. Further studies with larger cohorts and molecular analysis are necessary to refine treatment strategies for MM.
Application of international classification of functioning, disability and health in salat: a scoping review Defi, Irma Ruslina; Mohamad, Intan Sabrina; Al Barqi, Nuzula Chafidh; Qiantori, Adziqa Ammara; Qiantori, Andri
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.%p

Abstract

BackgroundSalat has been linked to physical, cognitive, emotional and psychological health benefits. This scoping review classifies the health benefits of salat based on the International Classification of Functioning, Disability, and Health (ICF) conceptual framework. The ICF illustrates how Salat may be used as a multi-modal and multidisciplinary framework to rehabilitate clients with different conditions tailored to their clinical, psychosocial and environmental contexts.PurposeTo conduct a scoping review on the health benefits of salat (muslim prayer) based on the ICF conceptual framework.MethodsA literature review was conducted from February to April 2023 using PubMed, EBSCO, and the Scopus Library databases. Articles published between 2012 and 2023 were retrieved using the following keywords: "impact" OR "effect" OR "health benefit" OR "functional outcome" AND "shalat" OR "Muslim prayer" OR "Salat”. Health benefits of salat were subsequently categorised into five domains of the ICF.ResultsA total of 596 articles were identified through PubMed (404), EBSCO (124), and Scopus (68).  Thirty-one records met the predefined inclusion criteria: 21 original articles, two systematic reviews, five literature reviews, one case study, one case series, and one short report. Salat had positive benefits on the cardiorespiratory, haematological, immunological, mental and neuromuscular functions. Salat may serve as a coping mechanism to reduce stress and depression. The frequency and duration of salat had positive associations with maintaining employment, social support and better quality of life.ConclusionSalat is associated with many health benefits, which can be categorised systematically and summarised using the ICF conceptual framework. 

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