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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 602 Documents
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Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center Farista, A. Deza; Rivianti, Nur; Bahar, Erial; Permata, Mega; Reagan, Muhammad; Indah, Crisnah; Artini, Ika
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.335-344

Abstract

BackgroundAs people age, skeletal muscle mass and strength decrease, leading to sarcopenia, diagnosed through calf circumference, muscle mass, strength, and physical performance. Uric acid (UA), with both pro-oxidant and antioxidant properties, is an indicator of oxidative stress and may contribute to sarcopenia. This study aimed to determine the correlation between serum uric acid levels and sarcopenia in elderly in a community health center. MethodsA cross-sectional study was conducted involving 42 subjects aged ≥60 years, consisting of 37 female and 5 male participants. We applied Asian Working Group for Sarcopenia (AWGS) 2019 criteria to define sarcopenia. Muscle mass was measured using skeletal muscle index (SMI) based on bioimpedance analysis (BIA). Handgrip strength (HGS), physical performance, calf circumference, and blood test data were collected. A backward regression analysis was performed to investigate the relationship between UA and SMI, HGS, physical performance, and calf circumference after adjusting for gender, smoking history, upper arm circumference, and body mass index.Results After adjusting for potential confounding variables, uric acid remained significantly associated with muscle strength (β=0.326; p=0.023) and calf circumference (β=0.264; p=0.010), but not with muscle mass (β=0.046; p=0.727) or physical performance (β=–0.171; p=0.279).ConclusionThere is a significant correlation between uric acid levels and muscle strength, physical performance, and calf circumference in sarcopenia among the elderly in the community health center. Higher uric acid serum levels might slow down the progression of sarcopenia.
Effect of cross-running polypropylene intradermal suture technique on keloid scar: a single-blind randomized controlled trial Wihastyoko, Herman Yosef Limpat; Rinhastyanti, Edith Sumaregita; Arviansyah, Arviansyah; Siswanto, Yudi; Agustina, Wilma; Sintaningrum, Elisabeth Prajanti
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.4-12

Abstract

BACKGROUNDKeloids are abnormal scars that present a therapeutic challenge. Various treatment modalities have been developed, including surgical excision. While cross-running intradermal sutures were previously created using absorbable polyglycolic acid, this study introduces a modification using a non-absorbable material. Therefore, this study aimed to evaluate the effect of the cross-running polypropylene intradermal suture (CR-PIS) technique compared to the simple interrupted suture technique on keloid repair. METHODSThis was a randomized controlled trial with a post-test-only design involving 30 male and female keloid patients aged 20-50 years. Participants were randomized into the treatment group (n=15) and the control group (n=15). Wound assessment using the Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS) was performed at 3, 6, and 9 months after surgery. Differences in VSS, MSS, and POSAS scores between the CR-PIS group and the simple knot group were analyzed using the Mann-Whitney U test. RESULTSStatistical analysis revealed a significant difference between the simple knot and CR-PIS groups (p<0.05). The median scores for each assessment (VSS, MSS, and POSAS) decreased significantly at 3, 6, and 9 months, with the control group's values being higher than those in the CR-PIS group (p<0.05). These results indicate that the control group developed moderate scars, whereas the treatment group exhibited good scars. CONCLUSIONSThe CR-PIS is more effective than the simple knot technique in improving keloid scars, as shown by changes in wound appearance, morphological function, topography, and patient and evaluator assessments.
Clinical significance of pre-operative prognostic nutritional index in predicting survival in patients with renal cell carcinoma Utama, Eldo Taufila Putra; Danarto, Raden
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.345-351

Abstract

BackgroundRenal cell carcinoma (RCC) is a prevalent urologic malignancy with heterogeneous outcomes even after surgery. Conventional prognostic factors are insufficient to capture host-related influences on survival. The prognostic nutritional index (PNI), derived from serum albumin and lymphocyte count, reflects nutritional and immunological status and has emerged as a potential prognostic biomarker. The objective of this study was to determine preoperative PNI in predicting survival outcomes of RCC patients.MethodsThis was a retrospective cohort study involving 107 RCC patients who underwent radical or partial nephrectomy. Patients were categorized into normal and low PNI. Associations between PNI and clinicopathological features were assessed, while survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression.ResultsPatients’ mean age was 53.1 ± 13.5 years, and 58.9% of the patients were male. Clear cell carcinoma was the most common histological type (69.2%). Low PNI was significantly associated with older age (p=0.04), metastatic disease (p<0.001), and advanced tumor stage (p=0.014). Kaplan–Meier analysis demonstrated significantly poorer survival in the low-PNI group (p<0.001). In the multivariate Cox model, PNI remained the strongest independent predictor of overall survival (HR = 0.29, 95% CI: 0.13–0.67, p=0.003), while metastasis also retained independent significance (HR = 2.04, 95% CI: 1.06–3.93, p=0.031).ConclusionThe PNI is an independent, simple, and cost-effective prognostic factor for overall survival in RCC. Incorporating PNI into preoperative risk stratification may enhance clinical decision-making. Therefore, PNI could be used as an effective prognostic indicator in RCC.
Machine learning models for predicting 48-hour mortality in acute intracerebral hemorrhagic stroke Kemaladina, Intan; Syahrul, Syahrul; Abidin, Taufik Fuadi; Musadir, Nasrul; Imran, Imran
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.13-26

Abstract

BACKGROUNDIdentifying patients with intracerebral hemorrhagic (ICH) at high risk of mortality is crucial for timely intervention. Machine learning (ML) offers novel methodologies for precise predictive models for ICH.  Therefore, the aim of this study was to develop an ML-based predictive model for 48-hour mortality in patients with acute hemorrhagic stroke.  METHODSA cross-sectional study was conducted using secondary data from 657 patients diagnosed with acute ICH. Demographic, clinical, laboratory, and radiological variables were extracted from medical records. Data preprocessing included cleaning, normalization, and class balancing using the Synthetic Minority Oversampling Technique (SMOTE). Three supervised algorithms—Random Forest, Decision Tree, and Gaussian Naïve Bayes—were developed and evaluated using stratified 5-fold cross-validation. Model performance was assessed using accuracy, sensitivity, specificity, precision, recall, F1-score, and AUC. RESULTSRandom Forest achieved the best overall performance for predicting 48-hour mortality, with an accuracy of 84.77%, F1-score of 84.63%, and AUC of 80.51, outperforming Decision Tree (AUC 61.12) and Gaussian Naïve Bayes (AUC 82.94). Random Forest most accurately identified >48-hour survival, with high sensitivity (93.5%) and PPV (92.9%), while Naïve Bayes provided the most reliable positive classification for this category (PPV 99.0; specificity 94.2%). For ≤24-hour mortality, Naïve Bayes showed the best detection performance (sensitivity 85.4%; NPV 98.7%).  CONCLUSIONSMachine learning, particularly the Random Forest algorithm, enables reliable prediction of 48-hour mortality in patients with acute ICH using basic clinical and radiological data available at admission. The model offers practical potential for early risk stratification in emergency and critical care settings.
Microbiota as a reservoir of antibiotic resistance genes: relevance and urgency Maddela, Naga Raju
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.1-3

Abstract

'Antimicrobial resistance' (AMR) is one of the top threats to global public health and developments.
Glucocorticoid-induced adrenal insufficiency after receiving intravenous methylprednisolone for Graves' ophthalmopathy: a case report Pradwi Efendi, Yanne; Aprilia, Dinda; Decroli, Eva
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.%p

Abstract

BACKGROUNDGraves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease and can significantly impair visual function and quality of life. High-dose intravenous methylprednisolone (IVMP) is recommended as first-line therapy for moderate-to-severe active GO due to its superior efficacy and tolerability compared with oral glucocorticoids. However, IVMP therapy may be associated with rare but potentially serious adverse effects, including suppression of the hypothalamic–pituitary–adrenal (HPA) axis leading to GI adrenal insufficiency (GI-AI). Case descriptionWe report the case of a 38-year-old man with Graves’ disease who developed AI following IVMP therapy for moderate-to-severe GO. The patient received five weekly doses of IVMP 500 mg (cumulative dose 2.5 g) for progressive ocular symptoms. He subsequently presented with fatigue, weight gain, moon face, and buffalo hump. Laboratory evaluation revealed a markedly low morning serum cortisol level of 1 mcg/dL, confirming adrenal insufficiency. Patient was diagnosed with GI-AI accompanied by features of iatrogenic Cushing’s syndrome. Management consisted of hydrocortisone replacement therapy at a dose of 20 mg/day along with ongoing antithyroid treatment using methimazole. Serial monitoring of cortisol levels demonstrated gradual recovery of HPA axis function, accompanied by clinical improvement. ConclusionThis case highlights that glucocorticoid-induced adrenal insufficiency can occur on IVMP used for GO. Clinicians should maintain a high index of suspicion and perform appropriate adrenal function monitoring during and after IVMP therapy to ensure early detection and safe management of this potentially life-threatening complication.
High neutrophil-to-lymphocyte ratio is not a risk factor of severe dengue infection in children Desita, Saskia Ratna; Prasetyo, Risky Vitria; Irwanto, Irwanto
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.39-45

Abstract

BackgroundDengue infection in children globally shows a significant increasing trend in incidence and remains a heavy public health burden. Dengue infection can progress rapidly to death, especially in children. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that represents an immune response to the disease. This study investigated NLR as a risk factor of dengue infection severity in children. MethodsA cross-sectional study was conducted involving 237 children, (110 girls and 127 boys) aged 1-18 years with dengue infection. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF) according to WHO 2011 criteria. Demographic characteristics, clinical manifestations, and hematological parameters, including hemoglobin (Hb), leukocyte count, thrombocyte count, hematocrit (HCT), and NLR, were extracted. Bivariate and multivariate logistic regression analysis were used to analyze the data. ResultsThe study demonstrated that 59.9% of cases were classified as DF and 40.1% as DHF, with a mean age of 9.99 ± 4.84 years. The mean NLR was 0.99 ± 0.98 in DHF and 1.51 ± 1.38 in DF. Univariate regression analysis stated that NLR≥2 was associated with dengue severity. However, multivariate regression analysis stated that NLR was not a risk factor of dengue severity, adjusted from demographic characteristics and hematologic parameters. Hemoglobin and platelets are the independent factors of dengue severity. ConclusionNeutrophil-to-lymphocyte ratio is a simple biomarker but not a risk factor of dengue fever severity in children. There is evidence suggesting that the relationship between NLR and dengue fever severity is complex, with varying trends in different phases of the disease.
Myosin heavy chain as biomarker in the prevention of sarcopenia Sari, Desy Nofita; Goenarjo, Roman Ardian; Sianipar, Imelda Rosalyn; Lim, Chin Leong
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.%p

Abstract

Sarcopenia, or the age-related loss of skeletal muscle mass and function, can reduce total muscle contractile capacity and increase the likelihood of physical disability in older adults. The loss of muscle mass and contractile performance is generally thought to be multifactorial, with as possible contributing factor an age-related shift in the expressed amounts of myosin heavy chain (MyHC) isoforms. The composition of adult human skeletal muscle consists of a mixture of three distinct MyHC isoforms (I, IIA, and IIX). This literature review aimed to explore studies focused on the signs of sarcopenia, the early detection of initial symptoms, and awareness among the aging population. We aimed to understand the molecular changes in muscle fibers as people age and to help inform the early intervention approach to prevent sarcopenia. The literature search was conducted in several databases between 2020 to 2025, including PubMed, ScienceDirect, and SpringerLink. The search terms consisted of “sarcopenia”, “muscle mass”, “early detection”, and “myosin heavy chain”. Inclusion criteria included original full-text English-language studies on the cellular and molecular physiology of sarcopenia. Molecular changes in myosin heavy chain vary across different age groups, suggesting the potential for early detection of muscle aging. The review is limited by the variability in the definition and measurement of sarcopenia across different studies, which may affect the generalizability of the findings. This review highlights the potential significance of identification and sarcopenia management in elderly individuals. The findings would be helpful for clinicians, researchers, and policymakers to improve elderly care and quality of life.
The effect of war on displaced hemodialysis patients in Sudan Abdelgadir, Sara Mohamed; Mohamed, Sufian Khalid; Elamin, Mohamed Osman; Khan, Wahaj A.; Badri, Hatim O.; Alzhrani, Abdullah Muhammad; Banah, Osama; Alkathiri, Ahmad Salah; Osman, Ahmed A.; Elamin, Fowzi O.
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.27-38

Abstract

BACKGROUNDThe Sudan war has severely disrupted healthcare services, particularly for patients with end-stage renal disease (ESRD) dependent on regular hemodialysis. Conflict-related displacement, damaged infrastructure, medication shortages, and financial hardship have compromised dialysis continuity and patient outcomes. This study assessed the impact of war-related displacement on dialysis care among Sudanese hemodialysis patients. METHODSThis cross-sectional observational study included 101 displaced ESRD patients receiving maintenance hemodialysis. Data collection comprised demographic characteristics, causes of ESRD, dialysis access and adequacy, treatment interruptions, complications, medication availability, hospital admissions, and functional status before, during, and after the war. Comparisons of dialysis parameters and functional status before, during, and after the war were performed using Cochran’s Q test. RESULTSWar-related displacement was associated with statistically significant worsening of dialysis care. Dialysis frequency decreased from two to 1.5 sessions per week, and session duration declined from four to three hours (both p<0.05). Patients missed a median of one dialysis session per week. Consequently, out-of-pocket payment for medications surged from 42 (41.6%) pre-war to 93 (92.1%) during the war and persisted at 89 (88.1% in the current period (p<0.0001). Erythropoietin use declined from 98 (97.1%) to 39 (38.6%) (both at p<0.001). Displacement was also associated with significantly increased complications, hospitalizations, reduced medication adherence, and marked fatigue (p < 0.05). CONCLUSIONWar-related displacement significantly reduced dialysis adequacy, medication access, and continuity of care, resulting in increased morbidity. Immediate humanitarian and health-system interventions are essential to prevent excess mortality among displaced hemodialysis patients.
Role of global deoxyribonucleic acid methylation and molecular hypoxia changes in male infertility Abdul Jabbar, Zainab; AL-Jumaily, Rakad Mohammed Khamas
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.%p

Abstract

Infertility is recognized as a major global health issue and has become one of the primary challenges in reproductive health; its prevalence and incidence are steadily increasing worldwide. Recent research has highlighted the critical role of epigenetic dysregulation as a direct factor affecting male infertility. The objective of this review is to investigate the relationship between epigenetic modifications (specifically 5-methylcytosine and 5-hydroxymethylcytosine) and essential male reproductive outcomes, including the spermatogenesis process, testicular function, and semen quality parameters. Furthermore, this study explores the influence of micronutrients such as vitamin B12, homocysteine metabolism, and antioxidant capacity on DNA methylation and genomic stability. Significantly, this review establishes a novel link between infertility and cellular hypoxia focusing on the modulation of hypoxia-inducible factor (HIF-1α and HIF-2α) as a potential therapeutic strategy. Additionally, this work introduces the overlooked association between HIF-2α and infertility, offering novel insights since current findings regarding HIF-2α in male infertility are remarkably limited. A literature search was conducted on PubMed, ScienceDirect, Springer Link, Oxford Academic and Nature databases for sources published in English from 2015 to 2025, using the following keywords: male infertility, DNA methylation, hypoxia, HIF-1α, and immunity. Our work investigates the interruption of inflammatory cytokines and immunological markers by linking them with molecular factors, micronutrients and hypoxia pathways. This approach provides an integrated foundation for advanced diagnostic and therapeutic strategies. Ultimately, understanding these molecular signatures provides ways to enhance reproductive outcomes and improve success rates of assisted reproductive techniques.

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