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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Published by Universitas Sriwijaya

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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

BioScientia Medicina is an open access international scholarly journal in the field of biomedicine and translational research aimed to publish a high-quality scientific paper including original research papers, reviews, short communication, and technical notes. This journal welcomes the submission of articles that offering a sensible transfer of basic research to applied clinical medicine. BioScientia Medicina covers the latest developments in various fields of biomedicine with special attention to medical sciences, Traditional Herb, genetics, immunology, environmental health, toxicology, bioinformatics and biotechnology as well as multidisciplinary studies. The views of experts on current advances in nanotechnology and molecular/cell biology will be also considered for publication as long as they have a direct clinical impact on human health.

Arjuna Subject : Kedokteran - Anatomi

Articles 1,209 Documents

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The Triad of Risk: Advanced Age, Female Gender, and High BMI in Patients Requiring Total Knee Replacement for Osteoarthritis at a Tertiary Indonesian Hospital Muhammad Kelvin Rizaldy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1346

Background: Knee osteoarthritis (OA) imposes a substantial global burden, leading to significant disability, particularly within the elderly demographic. Total Knee Replacement (TKR) stands as the definitive surgical intervention for advanced knee OA cases that have proven refractory to comprehensive conservative management. A thorough understanding of the multifaceted characteristics of patients undergoing TKR is paramount for the development and implementation of targeted, effective healthcare strategies and resource allocation. This study aimed to meticulously identify and describe these characteristics in a cohort of patients receiving TKR at a tertiary referral hospital located in Bali, Indonesia. Methods: This investigation employed a descriptive quantitative cross-sectional study design. It involved a retrospective analysis of medical records pertaining to 54 patients who underwent primary TKR for diagnosed knee OA at Prof. Dr. I.G.N.G. Ngoerah General Hospital. The data collection period spanned from November 2023 to November 2024. The primary variables assessed included chronological age at the time of surgery, biological sex, body mass index (BMI) calculated from recorded height and weight, and the documented incidence of postoperative periprosthetic joint infection (PJI). All collected data were subjected to descriptive statistical analysis. Results: The demographic analysis revealed that the vast majority of patients were female, accounting for 85.2% (n=46) of the cohort. The predominant age group for TKR procedures was between 50 and 69 years, encompassing 85.1% of patients; specifically, the 50–59 years category included 44.4% (n=25), and the 60–69 years category included 40.7% (n=22). A notably high prevalence of overweight or obesity was observed, with 70.3% of patients falling into these BMI classifications (overweight: 37.0%, n=11; obesity class I: 27.8%, n=15; obesity class II: 9.3%, n=5). Periprosthetic joint infection, a significant postoperative complication, was documented in 5.6% of the patients (n=3) within this cohort. Conclusion: The findings of this study strongly indicate that advanced age, female gender, and an elevated body mass index collectively constitute a significant triad of risk characteristics among patients undergoing TKR for severe knee OA within this specific Balinese hospital setting. These observations underscore the critical necessity for focused preventive measures and tailored management strategies, particularly directed towards older women with increased BMI, to potentially mitigate the progression of OA and optimize the outcomes following TKR.

Menthol-Camphor-Thymol-Eucalyptus Compound as a Novel Adjuvant Therapy in Fluconazole-Treated Candida parapsilosis Onychomycosis: A Case Report Nurrachmat Mulianto; Nurul Hidayati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1348

Background: Onychomycosis, a fungal infection of the nail apparatus, presents a therapeutic challenge due to its recalcitrant nature and the limitations of current antifungal regimens, including potential side effects and prolonged treatment durations. Candida parapsilosis is an increasingly recognized, yet less commonly reported, yeast pathogen in onychomycosis, particularly in immunocompromised individuals or those with specific comorbidities. The exploration of effective, safe, and accessible adjuvant therapies is crucial to enhance treatment outcomes. This report details the use of an over-the-counter menthol-camphor-thymol-eucalyptus compound as an adjuvant to oral fluconazole. Case presentation: A 69-year-old male, a gold washer by occupation with a two-month history of rheumatoid arthritis (RA) treated with methotrexate, hydroxychloroquine, methylprednisolone, and celecoxib, presented with a four-month history of yellowish-brown discoloration, uneven texture, and brittleness of both thumb nails. Dermatological examination revealed onychodystrophy, subungual hyperkeratosis, and yellowish-brown discoloration of the bilateral thumb nail plates. Dermoscopy confirmed these findings. Fungal culture of nail clippings identified Candida parapsilosis. The patient was treated with oral fluconazole 150 mg weekly for three months and twice-daily topical application of menthol-camphor-thymol-eucalyptus compound under plastic occlusion. Significant clinical improvement in nail color and texture, with no onycholysis, was observed at the 6-week follow-up. At the 3-month evaluation, fungal culture was negative, and liver function tests remained within normal limits. Conclusion: This case demonstrates the successful use of a menthol-camphor-thymol-eucalyptus compound as an adjuvant to oral fluconazole in treating Candida parapsilosis onychomycosis in an elderly patient with RA. The combination therapy was well-tolerated and led to clinical and mycological resolution, suggesting a promising, accessible, and cost-effective adjunctive therapeutic strategy.

High-Flow Nasal Cannula versus Non-Invasive Positive Pressure Ventilation in Adults with Acute Hypoxemic (Type 1) Respiratory Failure: A Meta-Analysis of Efficacy, Intubation Rates, and Mortality Muhammad Reza Arifin; Indra Yovi; Sri Indah Indriani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1349

Background: Acute hypoxemic respiratory failure (AHRF), or Type 1 respiratory failure, is a common life-threatening condition characterized by severe impairment in arterial oxygenation. High-flow nasal cannula (HFNC) and Non-Invasive Positive Pressure Ventilation (NIPPV) are two widely used non-invasive respiratory support strategies. However, their comparative effectiveness in adults with Type 1 AHRF remains a subject of ongoing investigation. This meta-analysis aimed to compare the efficacy, intubation rates, and mortality associated with HFNC versus NIPPV in this patient population. Methods: A systematic search of PubMed, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted for randomized controlled trials (RCTs) published between January 2014 and December 2024. Studies comparing HFNC with NIPPV in adult patients with Type 1 AHRF were included. The primary outcomes were the rate of endotracheal intubation and all-cause mortality (hospital or 28-day). Secondary outcomes included improvement in oxygenation (such as change in PaO2/FiO2 ratio) and length of hospital stay. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias tool. Meta-analyses were performed using a random-effects model, and results were expressed as Risk Ratios (RR) with 95% Confidence Intervals (CI) for dichotomous outcomes and Mean Differences (MD) for continuous outcomes. Heterogeneity was assessed using the I² statistic. Results: Six RCTs involving a total of 1850 patients (920 in the HFNC group and 930 in the NIPPV group) met the inclusion criteria. The overall risk of bias in the included studies was moderate. There was no statistically significant difference between HFNC and NIPPV in the rate of endotracheal intubation (RR 0.92, 95% CI 0.75-1.13; I²=28%; 6 studies) or all-cause mortality (RR 0.88, 95% CI 0.69-1.12; I²=15%; 6 studies). For oxygenation improvement, assessed by the change in PaO2/FiO2 ratio at 24 hours, data from four studies showed no significant difference between the two groups (MD 5.8 mmHg, 95% CI -8.5 to 20.1 mmHg; I²=45%). Hospital length of stay was also comparable. Subgroup analyses based on underlying etiology (such as pneumonia) did not reveal significant interactions. Conclusion: In adult patients with Type 1 acute hypoxemic respiratory failure, this meta-analysis found no significant difference between HFNC and NIPPV in terms of intubation rates, mortality, or improvement in oxygenation. Both modalities appear to be viable initial non-invasive respiratory support options. The choice between HFNC and NIPPV may depend on patient tolerance, local expertise, resource availability, and specific clinical contexts. Further large-scale, high-quality RCTs are warranted to confirm these findings and explore effects in specific patient subgroups.

Beyond Tumor Grade: Investigating the Heterogeneity of PD-L1 Expression in Soft Tissue Sarcomas and the Need for Subtype-Specific Analysis Hamka Muhammad Nasir Laitupa; Eviana Norahmawati; RA Rose Khasana Dewi; Rachmad Sarwo Bekti; Diah Prabawati Retnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1350

Background: Soft tissue sarcomas (STS) represent a diverse group of malignant mesenchymal neoplasms with considerable histological variety and differing degrees of malignancy. Programmed Death-Ligand 1 (PD-L1) expression is a crucial immunotherapy target in various cancers, but its role and expression patterns in STS, particularly within the Indonesian population, remain inadequately defined. This study aimed to investigate the differences in PD-L1 expression between low-grade and high-grade STS and to determine the correlation between PD-L1 expression and histological grading in an Indonesian cohort. Methods: This analytical observational study utilized a cross-sectional design, incorporating 29 archival paraffin-embedded tissue blocks from STS patients diagnosed at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. PD-L1 expression was assessed immunohistochemically using the monoclonal antibody clone 22c3, and scoring was performed using the Combined Positive Score (CPS). Statistical analyses, including the Mann-Whitney U test and Spearman correlation, were employed to evaluate differences and correlations. Results: The majority of STS cases (89.7%) exhibited negative PD-L1 expression. The mean PD-L1 CPS was 0.1429 in low-grade STS and 0.233 in high-grade STS. No statistically significant difference in PD-L1 expression was observed between the low-grade and high-grade groups (p=0.620). Furthermore, Spearman correlation analysis revealed no significant association between PD-L1 expression (numeric CPS and categorical positivity) and histological grade (r=0.094, p=0.629 for CPS; r=0.102, p=0.600 for interpretation). Conclusion: This study found no significant difference in PD-L1 expression between low-grade and high-grade soft tissue sarcomas, nor a significant correlation with histological grade in the investigated Indonesian patient cohort. These findings suggest that PD-L1 expression, when assessed independently, may not be a reliable prognostic biomarker based solely on tumor grading in STS. Further research with larger sample sizes, encompassing diverse histological subtypes and incorporating additional immune biomarkers, is warranted.

Non-Operative Management Accelerates Recovery: Reduced Length of Hospital Stay in Partial Small Bowel Obstruction with Virgin Abdomens Aryani, Prathita Amanda; Abdul Mughni
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1351

Background: Small bowel obstruction (SBO) represents a formidable challenge in surgical practice. Partial SBO (PSBO) in individuals without a history of abdominal surgery, termed "virgin abdomens," introduces distinct diagnostic and therapeutic considerations. While non-operative management (NOM) has become a cornerstone for adhesive SBO, comprehensive data elucidating its impact on PSBO in virgin abdomens, especially concerning the length of hospital stay (LOS), are not extensively available. This study was designed to meticulously compare the LOS between NOM and operative interventions in patients diagnosed with PSBO affecting virgin abdomens, specifically within a tertiary care setting in Indonesia. Methods: A retrospective analytic observational methodology, utilizing a cross-sectional design, was implemented at Dr. Kariadi General Hospital, Semarang, covering patients admitted from January through December 2024. The study included patients over 18 years of age with a confirmed diagnosis of PSBO in a virgin abdomen. Exclusion criteria encompassed total SBO, obstructions located in the colon, or any record of prior abdominal surgical procedures. The principal outcome measure, LOS, was rigorously compared between the cohort managed non-operatively and the cohort that underwent surgical procedures. Statistical analysis was performed using appropriate tests, with a p-value below 0.05 established as the threshold for statistical significance. Results: The study cohort comprised 167 eligible patients. For the 112 patients (67.1%) subjected to surgical intervention, the mean LOS was recorded at 13.2±8.72 days. Conversely, the 55 patients (32.9%) managed conservatively demonstrated a markedly shorter mean LOS of 7.74±6.12 days. This observed difference in LOS was statistically highly significant (p < 0.001). The mean age of the participants was 50.60±14.94 years, with females constituting 52.1% of the group. Conclusion: In clinically stable patients presenting with partial small bowel obstruction in virgin abdomens, non-operative management was associated with a significantly diminished length of hospital stay when compared to surgical intervention. This conservative strategy proves to be an effective and advantageous approach in appropriately selected patient populations, offering the potential to lessen hospital burden and enhance recovery timelines.

Navigating a Rare Entity: Pancreatic Lipomatosis in a 34-Year-Old Female Without Classical Risk Factors – A Case Report Ezra Gunadi; Ari Adrianto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1352

Background: Pancreatic lipomatosis (PL), characterized by the replacement of pancreatic acinar tissue with mature adipose cells, is an uncommon condition with an etiology that is often not fully understood. It is frequently identified incidentally during imaging studies. The aim of this case report is to contribute to and advance the clinical understanding of this exceedingly rare and atypical presentation of pancreatic lipomatosis. Case presentation: This report details the case of a 34-year-old female who presented for evaluation of nonspecific, intermittent epigastric discomfort. Her medical history was devoid of significant illnesses, alcohol abuse, or known genetic conditions predisposing to pancreatic disorders. Comprehensive laboratory evaluations, encompassing serum amylase, lipase, liver function tests, lipid profile, and HbA1c, yielded results entirely within normal parameters. Abdominal computed tomography (CT) imaging revealed a striking diffuse, homogeneous fatty replacement of the entire pancreatic parenchyma, a hallmark of total pancreatic lipomatosis. Importantly, there was no evidence of pancreatic ductal dilatation, calcifications, or any discrete pancreatic masses. The patient's management was conservative, involving lifestyle counseling and scheduled periodic monitoring for the potential, though infrequent, development of complications such as exocrine pancreatic insufficiency or secondary diabetes mellitus. Conclusion: This case distinctly illustrates the occurrence of extensive pancreatic lipomatosis in a young, otherwise healthy female lacking classical risk factors. The pivotal role of cross-sectional imaging, specifically CT, in accurately diagnosing this benign condition is emphasized, which is crucial for averting misdiagnosis and precluding unnecessary invasive interventions. Enhanced awareness among clinicians is vital for appropriate patient counseling, the implementation of conservative management strategies, and diligent long-term monitoring for any potential metabolic or functional sequelae.

Navigating Frontal Lobe Arteriovenous Malformation Resection: A Case Report on TIVA with Propofol-Remifentanil TCI for Hemodynamic Stability and ICP Control I Gede Catur Wira Natanagara; I Putu Pramana Suarjaya; Ida Bagus Krisna Jaya Sutawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1353

Background: Arteriovenous malformations (AVMs) located within the frontal lobe present considerable anesthetic challenges. These challenges arise from the critical functions governed by this brain region and the inherent risks associated with intracranial surgery, notably hemodynamic instability and the potential for elevated intracranial pressure (ICP). The utilization of Total Intravenous Anesthesia (TIVA) through Target-Controlled Infusion (TCI) systems for propofol and remifentanil provides a sophisticated strategy for achieving precise control over anesthetic depth and maintaining physiological homeostasis. This report offers a detailed account of such a case. Case presentation: A 25-year-old male patient, classified as ASA III, presented with a right frontal lobe Spetzler-Martin Grade I AVM and was scheduled for elective microsurgical resection. The anesthetic management centered on a TIVA approach, employing propofol administered via an Eleveld TCI model (target concentration range: 2-5 µg/mL) and remifentanil via a Minto TCI model (target concentration range: 4-6 ng/mL). Comprehensive intraoperative monitoring included invasive arterial blood pressure and central venous pressure. Pharmacological adjuncts included mannitol, dexamethasone, and tranexamic acid. Throughout the procedure, stable intraoperative hemodynamics (target Mean Arterial Pressure [MAP] 70-90 mmHg) were successfully maintained, and intracranial pressure was effectively controlled, thereby facilitating the complete AVM resection. The patient was extubated in the post-operative period, demonstrated a stable neurological status, and was subsequently managed in the Intensive Care Unit (ICU). Conclusion: A meticulously planned and executed TIVA-TCI regimen, featuring propofol and remifentanil, when integrated with thorough invasive monitoring and proactive pharmacological interventions, demonstrated effectiveness in preserving crucial hemodynamic stability and fostering optimal intracranial conditions. This comprehensive anesthetic strategy was instrumental in the successful surgical resection of a frontal lobe AVM and contributed to a favorable neurological outcome for the patient.

Beyond Co-Expression: Unraveling the Complex Relationship Between PD-L1 and Tumor-Infiltrating Lymphocytes in Basal Cell Carcinoma Subtypes Fitria Mayasari; Kenty Wantri Anita; Diah Prabawati Retnani; Rachmad Sarwo Bekti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1354

Background: Basal cell carcinoma (BCC) is the most prevalent non-melanoma skin cancer, characterized by high recurrence rates. Immunotherapy, particularly targeting the Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) axis, offers a promising therapeutic avenue. The interplay between PD-L1 expression on tumor and immune cells and the nature of Tumor-Infiltrating Lymphocytes (TILs) is crucial for immune response, yet their relationship in BCC, especially across diverse histological subtypes, remains incompletely understood. This study aimed to investigate the correlation between PD-L1 expression and TILs density in various BCC subtypes, seeking to elucidate the complexities of their interaction within the tumor microenvironment. Methods: This analytical observational study utilized a cross-sectional design, analyzing 20 archived paraffin-embedded BCC tissue samples from Dr. Saiful Anwar Regional General Hospital Malang. PD-L1 expression was assessed by immunohistochemistry using the 22c3 clone and evaluated via the Combined Positive Score (CPS). TILs were semi-quantitatively assessed as percentage infiltration and categorized into low, moderate, and high grades. Histological subtypes of BCC were documented. Spearman correlation was used to analyze the relationship between PD-L1 expression and TILs. Results: Of the 20 BCC cases, 55% exhibited PD-L1 positivity (CPS ≥ 1). TILs infiltration was predominantly moderate (70%), with 25% high and 5% low. The cohort included nodular (40%), infiltrating (35%), and basosquamous (25%) as the main subtypes, with specific variants also analyzed. Basosquamous BCC consistently showed positive PD-L1 expression (100% of its cases positive), while nodular and infiltrating subtypes displayed varied PD-L1 expression. TILs distribution also varied across subtypes, with nodular BCC exhibiting the full range from low to high TILs. Overall, no significant correlation was observed between PD-L1 expression and TILs density (Spearman's r = -0.077, p = 0.747). Conclusion: This study confirms PD-L1 expression and TILs presence in BCC but reveals no direct linear correlation between them across the cohort, even when considering broad subtypes. Basosquamous BCC consistently expressed PD-L1. The lack of overall correlation suggests a complex, potentially subtype-specific interplay within the BCC tumor microenvironment, warranting further investigation into functional TILs subsets and other immune modulators.

Optimizing Sunburn Prevention in Children: A Meta-Analysis of the Efficacy of Sunscreen Application, Protective Apparel, and Shade-Seeking Behaviors Ellistasari, Endra Yustin; Suci Widhiati; Sesia Pradestine
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1355

Background: Childhood sunburn significantly elevates lifelong skin cancer risk, underscoring the need for effective prevention. While sunscreen, protective apparel, and shade-seeking are advocated, a quantitative synthesis of their efficacy in children is crucial. This meta-analysis aimed to consolidate and quantify the evidence on the effectiveness of these core sun protection strategies in preventing pediatric sunburn. Methods: A systematic search of PubMed/MEDLINE, Scopus, Cochrane CENTRAL, and Web of Science (January 2014 - December 2024) identified randomized controlled trials and cohort studies evaluating sunscreen, protective apparel, or shade-seeking behaviors for sunburn prevention in individuals aged 0-18 years. Data on sunburn incidence were extracted, study quality assessed, and pooled Risk Ratios (RR) with 95% confidence intervals (CI) calculated using a random-effects model. Results: Six studies (two RCTs, four cohort studies) involving 8,500 children were included. Regular sunscreen use (SPF ≥30) significantly reduced sunburn incidence (RR 0.65, 95% CI 0.55-0.77). Protective apparel use also demonstrated substantial protection (RR 0.70, 95% CI 0.60-0.82). Enhanced shade provision and shade-seeking behaviors effectively lowered sunburn risk (RR 0.75, 95% CI 0.62-0.90). Multi-component strategies combining these approaches showed consistent protective benefits. Conclusion: This meta-analysis provides robust quantitative evidence that diligent sunscreen application, consistent use of protective apparel, and active shade-seeking are all significantly effective in reducing sunburn incidence in children. These findings strongly support multifaceted public health initiatives emphasizing comprehensive sun protection to safeguard pediatric skin health.

The Shadow of Deficiency: Vitamin D Status as a Critical Determinant of Antithyroid Drug Efficacy in Graves’ Disease – Insights from an Indonesian Cohort Ratna Maila Dewi Anggraini; Intan Fajrin Karimah; Eddy Yuristo; Yulianto Kusnadi; Erwin Sukandi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1356

Background: Graves' disease (GD), an autoimmune hyperthyroid condition, presents significant management challenges, particularly concerning variable remission rates with antithyroid drugs (ATDs). Vitamin D, with its established immunomodulatory properties, is hypothesized to influence autoimmune processes, including those in GD. However, its precise impact on ATD treatment outcomes in diverse populations, especially in regions like Indonesia with high vitamin D deficiency prevalence, remains insufficiently elucidated. Methods: This retrospective cohort study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, analyzing data from 73 newly diagnosed adult GD patients (diagnosed January 2022 - December 2023). Patients had confirmed GD based on hyperthyroidism with orbitopathy or positive TRAb and were followed until May 2025. Baseline serum 25-hydroxyvitamin D [25(OH)D], free T4 (fT4), and TSH levels were recorded. Vitamin D deficiency (VDD) was defined as <20 ng/mL. The primary outcome was non-remission after ATD therapy, defined as failure to achieve stable euthyroidism for ≥6 months on minimal ATD doses. Multivariate Poisson regression was used to assess predictors of non-remission. Results: Of 73 patients (mean age 36.2 years; 62% female), 55 (75.3%) exhibited VDD. Multivariate analysis identified VDD as a significant independent predictor of non-remission (adjusted Relative Risk [aRR] 11.81; 95% CI 1.88–74.20; p=0.008). Elevated baseline fT4 levels (≥5 ng/dL; aRR 4.61; 95% CI 1.13–18.70; p=0.032) and older age (>48 years; aRR 0.078; 95% CI 0.06–0.95, indicating a protective effect of older age against non-remission) were also significant predictors. Conclusion: Baseline vitamin D deficiency is a potent independent risk factor for non-remission in Indonesian Graves' disease patients receiving antithyroid drug therapy. These findings underscore the potential importance of assessing and addressing vitamin D status in the management of Graves' disease to optimize therapeutic outcomes.

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Rachmat Hidayat

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Kab. ogan ilir,

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