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Rachmat Hidayat
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INDONESIA
Bioscientia Medicina : Journal of Biomedicine and Translational Research
Published by Universitas Sriwijaya
ISSN : -     EISSN : 25980580     DOI : -
Core Subject : Health, Science,
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
Beta-Blocker Therapy in Older (≥75 Years) and Frail Patients with Heart Failure: A Systematic Review and Meta-Analysis Nurhayani Fatimah; Wahyudi; Taufik Rizkian Asir
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1433

Abstract

Background: Beta-blockers are a cornerstone of therapy for heart failure with reduced ejection fraction (HFrEF), but their efficacy and safety in the burgeoning population of very elderly and frail patients, particularly those with preserved ejection fraction (HFpEF), remain uncertain. This population is characterized by unique pathophysiological features, including altered pharmacokinetics, heightened inflammation, and autonomic dysregulation, which may modulate the treatment effect. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. We searched MEDLINE, Embase, and CENTRAL for randomized controlled trials (RCTs) and observational studies published between 2015-2025 that evaluated beta-blockers versus placebo or standard care in patients aged ≥75 years or defined as frail with heart failure. The primary efficacy outcome was all-cause mortality. The primary safety outcome was treatment discontinuation due to adverse events. Results: Eight studies (three RCTs, five observational) involving 8,512 patients were included. In the overall population, beta-blocker therapy was associated with a reduction in all-cause mortality (Hazard Ratio: 0.88; 95% CI: 0.79−0.98), but with significant heterogeneity (I2=68%). Subgroup analysis revealed this benefit was confined to patients with HFrEF (HR: 0.72; 95% CI: 0.63−0.83), with no benefit observed in HFpEF (HR: 1.09; 95% CI: 0.95−1.25). In frail patients with HFpEF, a trend towards harm was noted (HR: 1.21; 95% CI: 0.98−1.49). Beta-blockers significantly increased treatment discontinuation (Odds Ratio: 2.15; 95% CI: 1.55−2.98), driven primarily by bradycardia. Conclusion: Beta-blocker therapy reduces mortality in elderly patients with HFrEF, consistent with findings in younger populations. However, in elderly and frail patients with HFpEF, beta-blockers offer no mortality benefit and may be associated with harm, likely due to a pathophysiological mismatch between the drug's mechanism and the disease state.
A Masquerading Giant: Unprecedented Sebaceous Gland Carcinoma with Massive Orbito-facial Invasion and the Diagnostic and Therapeutic Challenges of an Extreme Presentation Rizki Dwayana Putra; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1434

Abstract

Background: Sebaceous gland carcinoma (SGC) is a rare, aggressive adnexal malignancy of the eyelid, notorious for masquerading as benign inflammatory conditions. Presentations involving massive, destructive orbito-facial invasion are exceptionally rare and pose profound diagnostic and therapeutic challenges, often reflecting a confluence of biological aggression and systemic delays in care. Case presentation: A 68-year-old male presented with a one-year history of a progressively enlarging mass on his left upper eyelid, which had evolved into a giant, 15 x 15 x 7 cm fungating tumor, causing complete destruction of the orbital contents and extensive invasion into adjacent facial structures. An initial incisional biopsy was paradoxically interpreted as benign sebaceous hyperplasia. Due to the stark clinico-pathological discordance, a repeat, deeper biopsy was performed. The subsequent histopathological examination revealed a high-grade carcinoma, and the diagnosis was definitively confirmed by a panel of immunohistochemical stains, including strong positivity for Epithelial Membrane Antigen (EMA) and Cytokeratin 7 (CK7). The disease was staged as T4dN1M0 and deemed unresectable. Conclusion: This case documents a catastrophic outcome of SGC, resulting from a combination of delayed patient presentation and initial diagnostic error. It highlights that giant SGC, while rare, must be considered in the differential of destructive facial tumors and underscores that immunohistochemistry is mandatory for resolving clinico-pathological paradoxes in ocular adnexal pathology. This case serves as a call to action for improved public health awareness and enhanced diagnostic acumen to prevent such devastatingly advanced presentations.
The Unseen Danger: A Meta-Analysis of Bystander Injuries in Firework-Related Ocular Trauma Rania Ayu Permata Putri Kornia; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1409

Abstract

Background: Firework-related ocular trauma represents a significant, preventable cause of severe vision loss, with incidence rates peaking during global cultural and national festivals. While the risks to active firework users are well-established, the burden of injury sustained by passive spectators, or bystanders, remains poorly quantified. This study aimed to synthesize global data to define the magnitude of this unseen danger. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Scopus, EMBASE, and Web of Science were searched for studies published between January 2015 and December 2025 that reported separable data on firework-related ocular injuries in bystanders and operators. A random-effects model calculated the pooled proportion of bystander injuries. Secondary outcomes included pooled odds ratios (ORs) for open globe injury (OGI) and severe vision loss (SVL; Visual Acuity <3/60). Results: Eleven studies, encompassing 2,440 patients, met the inclusion criteria. This meta-analysis, despite significant heterogeneity in the source data (I² = 89%), suggests that nearly half of all victims were bystanders, with a pooled proportion of 47.5% (95% CI: 41.8%–53.2%). Bystanders had significantly lower odds of sustaining an OGI compared to operators (pooled OR: 0.72, 95% CI: 0.58–0.90). However, the odds of suffering permanent SVL were not statistically different between the two groups (pooled OR: 0.91, 95% CI: 0.73–1.14), indicating a comparable risk of blinding injury. Conclusion: These findings must be interpreted with caution due to high inter-study heterogeneity and unmeasured clinical confounders. Nonetheless, the analysis strongly suggests that the risk to bystanders is unacceptably high and that public health paradigms focused solely on operator safety are insufficient. This study underscores the urgent need for prospective, standardized data collection and a shift in prevention strategies toward protecting passive spectators.
Impaired Stimulated Pancreatic β-Cell Responsiveness is a Dominant Feature of Bisphenol A-Associated Metabolic Dysfunction in Type 2 Diabetes: A Cross-Sectional Analysis of Adjusted Associations in an Indonesian Cohort Yulianto Kusnadi; Ardianto Ardianto; Ratna Maila Dewi Anggraini; Sudarto Sudarto; Imran Imran
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1410

Abstract

Background: Exposure to the endocrine-disrupting chemical bisphenol A (BPA) is a suspected contributor to the type 2 diabetes mellitus (T2DM) pandemic. This study aimed to move beyond simple correlation and investigate the adjusted association between urinary BPA and the dual pathophysiological defects of T2DM—insulin resistance and pancreatic β-cell failure—with a novel emphasis on contrasting basal versus stimulated β-cell function in an understudied Indonesian cohort. Methods: In a cross-sectional study, 40 patients with T2DM were recruited from a tertiary hospital in Palembang, Indonesia. Urinary BPA was quantified by liquid chromatography–mass spectrometry (LCMS). Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). β-cell function was evaluated using the C-peptide index (CPI) at fasting and 1-hour post-75g oral glucose tolerance test (OGTT). Multivariable linear regression models were constructed to determine the association between urinary BPA (log-transformed) and metabolic indices, adjusting for age, gender, and body mass index (BMI). Results: After adjusting for confounders, higher log-urinary BPA remained a significant independent predictor of higher log-HOMA-IR (β = 0.58, 95% CI: 0.31-0.85, p < 0.001). BPA was also independently associated with poorer β-cell function, showing a significant inverse association with the fasting CPI (β = -0.45, 95% CI: -0.73 to -0.17, p = 0.003). Critically, this association was markedly stronger and more profound with the 1-hour stimulated CPI (β = -0.79, 95% CI: -0.99 to -0.59, p < 0.001). The variance in stimulated CPI explained by the model (R2) was substantially higher than for other indices. Conclusion: Higher environmental BPA exposure is independently associated with both heightened insulin resistance and compromised β-cell function in T2DM. The distinctly stronger association with impaired stimulated β-cell secretion, even after adjusting for key confounders, identifies a critical mechanism by which BPA may accelerate functional β-cell exhaustion, the pivotal event in T2DM progression.
Ocular Parasitoses in the Globally Mobile Population: A Systematic Review of Etiology, Pathophysiology, and Clinical Management Ervan Suryanti Umbu Lapu; I Made Ady Wirawan; I Gusti Ayu Made Julari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1411

Abstract

Background: The unprecedented scale of global travel has amplified the diagnostic challenge of ocular parasitoses in non-endemic regions. These infections, while rare, can cause severe visual morbidity and are often misdiagnosed. This systematic review synthesizes the current evidence on parasitic eye infections in international travelers to create a comprehensive, state-of-the-art resource for clinicians. Methods: A systematic literature search was conducted in PubMed, Scopus, ProQuest, and the Cochrane Library in accordance with the PRISMA 2020 guidelines. The search included terms for parasitic eye diseases and international travelers. All case reports, case series, and observational studies published in English detailing confirmed ocular parasitic infections in patients with a history of international travel were eligible. Data on demographics, travel, clinical presentation, diagnosis, and management were extracted from all eligible studies, and their methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist. A qualitative narrative synthesis of the findings was performed. Results: From an initial 1,408 records, 19 studies met the full inclusion criteria and were included in the final synthesis. These studies detailed infections from a wide range of helminthic and protozoan pathogens, including Loa loa, Dirofilaria spp., Thelazia callipaeda, Gnathostoma spp., Onchocerca volvulus, Toxoplasma gondii, Trypanosoma cruzi, Acanthamoeba spp., and Taenia solium (cysticercosis). Infections were acquired across Africa, Asia, and the Americas. Clinical presentations were highly diverse, ranging from migrating subconjunctival worms to sight-threatening chorioretinitis, keratitis, and intraocular cysts. Diagnosis consistently relied on a combination of high-magnification biomicroscopy, advanced serological and molecular assays like PCR, and targeted imaging. Management was pathogen-specific, involving microsurgical extraction for accessible helminths and tailored antimicrobial therapy for protozoan and systemic infections. Conclusion: Ocular parasitoses represent a critical diagnostic challenge in returning travelers. A detailed travel and exposure history is the single most important tool to guide the differential diagnosis. Effective management requires a high index of suspicion and a collaborative, interdisciplinary approach to prevent irreversible vision loss.
Optic Neuritis After Viral Vector versus mRNA COVID-19 Vaccines: A Systematic Review and Comparative Meta-Analysis Tiara Alexander; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1412

Abstract

Background: The global deployment of COVID-19 vaccines, utilizing distinct viral vector and mRNA technologies, has been followed by reports of rare neuro-ophthalmic adverse events, including optic neuritis (ON). This study aimed to systematically compare the clinical phenotypes, autoimmune serological profiles, and visual outcomes of ON cases with onset in temporal association with viral vector versus mRNA COVID-19 vaccination. Methods: A systematic review was conducted across PubMed, Scopus, and EMBASE databases for case reports and case series published up to August 2025 detailing ON after COVID-19 vaccination. Data were extracted on clinical presentation, MRI findings, serostatus for aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) antibodies, treatments, and visual outcomes. Separate meta-analyses of proportions and comparative odds ratios (OR) were calculated for key outcomes, including distinct analyses for NMOSD and MOGAD. Results: Our analysis of published reports included 20 studies, comprising 90 patients (40 viral vector, 50 mRNA). Cases associated with viral vector vaccines had significantly higher odds of presenting with bilateral disease (OR 4.31, 95% CI [1.67, 11.11]). This platform was also associated with markedly increased odds of AQP4-IgG positivity (NMOSD) (OR 5.15, 95% CI [1.35, 19.61]) and MOG-IgG positivity (MOGAD) (OR 4.58, 95% CI [1.09, 19.21]). Consequently, these patients had higher odds of requiring aggressive immunotherapy and of suffering incomplete visual recovery (OR 3.41, 95% CI [1.14, 10.21]). Conclusion: Our analysis of published case reports suggests that while ON following COVID-19 vaccination is a very rare event, its clinical phenotype may differ based on the vaccine platform. Cases associated with viral vector vaccines appear more likely to manifest as a severe, bilateral, antibody-mediated condition characteristic of NMOSD or MOGAD. These findings, which do not establish causality, underscore the critical importance of prompt autoantibody testing to guide appropriate management. The established benefits of vaccination continue to overwhelmingly outweigh the exceptionally low absolute risk of such adverse events.
Navigating Surgical Strategies for Symptomatic Tarlov Cysts: A Case Report of Successful Microsurgical Excision and Imbrication Arip Heru Tripana; Tondi Maspian Tjili; Afdal; Ismar; Eko Setiawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1413

Abstract

Background: Symptomatic Tarlov (perineural) cysts are a rare but debilitating cause of chronic radicular pain, arising from cerebrospinal fluid (CSF) accumulation within the nerve root sheath. The diagnostic journey is often complex, requiring a definitive link between the lesion and the patient's symptoms, and the optimal surgical strategy remains a subject of considerable debate. Case presentation: A 56-year-old male presented with a six-month history of intractable right S2 radiculopathy (VAS 8/10) and severe functional impairment (Oswestry Disability Index 78%), which had failed a comprehensive trial of conservative management. Magnetic resonance imaging revealed a large cystic lesion at the right S2 level, with features characteristic of a Tarlov cyst, causing severe nerve root compression. Following a thorough discussion of the risks and benefits, the patient underwent an S2 laminectomy with microsurgical partial cyst excision and wall imbrication. Postoperative histopathology confirmed the diagnosis of a perineural cyst, identifying nerve fibers within the fibroconnective tissue of the cyst wall. Conclusion: The patient experienced immediate and sustained resolution of his radicular pain (VAS 0/10) and a profound improvement in functional status (ODI 12%) at one-year follow-up, with radiological confirmation of successful cyst obliteration. This case highlights the potential of a direct microsurgical approach, guided by a strong clinical-radiological correlation and confirmed by histopathology, to provide a durable and life-altering cure for patients disabled by symptomatic Tarlov cysts.
The Efficacy of Phyllanthus niruri Linn in Modulating Inflammatory and Cancer Stem Cell Markers in Colorectal Cancer: A Stratified Systematic Review and Meta-Analysis Nurul Ahmad Isnaini; Albertus Ari Adrianto; Udadi Sadhana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1415

Abstract

Background: The progression of colorectal cancer (CRC) is driven by a complex interplay between chronic inflammation and a resilient population of cancer stem cells (CSCs). Phyllanthus niruri Linn (PNL), a medicinal plant with established immunomodulatory effects, presents a promising adjuvant therapeutic strategy. This study aimed to move beyond qualitative summaries to quantitatively assess PNL's efficacy by synthesizing evidence on its modulation of key inflammatory and CSC biomarkers. Methods: Following PRISMA guidelines, a systematic search of PubMed, ScienceDirect, Google Scholar, and Scopus (2015–2025) was conducted. Studies quantifying the effects of PNL on Interleukin-8 (IL-8), Cyclooxygenase-2 (COX-2), or CD133 in CRC models were included. Recognizing the profound biological differences between experimental systems, a stratified meta-analysis was performed. Data were pooled using a random-effects model, stratified by study type (in vitro vs. in vivo) and intervention (monotherapy vs. combination therapy). The Standardized Mean Difference (SMD) was the primary effect measure. Results: Seven studies met the inclusion criteria. In a stratified analysis of in vivo models, PNL monotherapy significantly reduced COX-2 (SMD -2.11; 95% CI [-3.10, -1.12]) and IL-8 (SMD -1.95; 95% CI [-3.01, -0.89]). The effect on the CSC marker CD133 was most pronounced in vitro (SMD -2.98; 95% CI [-4.87, -1.09]), while still significant in in vivo models (SMD -2.15; 95% CI [-3.45, -0.85]). The analysis revealed that the biological context (in vitro vs. in vivo) is a significant determinant of the observed effect size. Conclusion: This stratified meta-analysis provides robust, context-specific evidence of PNL's ability to suppress key inflammatory and CSC markers in CRC. The findings reveal that PNL's potent anti-CSC activity observed in vitro is translated into a significant, though attenuated, effect in vivo, highlighting the critical influence of the tumor microenvironment and pharmacokinetics. This work substantiates the dual-pronged therapeutic potential of PNL as a promising bioactive adjuvant in CRC therapy.
High-Dose Sucralfate as a Mucosal-Protective Cornerstone in the Organ-Sparing Management of Pediatric Grade 2A Corrosive Gastroduodenitis: A Case Report and Pathophysiological Review Wely Wahyura; Yusri Dianne Jurnalis; Ade Nofendra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1416

Abstract

Background: Accidental corrosive ingestion is a formidable pediatric emergency that can lead to severe gastrointestinal injury and long-term sequelae. Sulfuric acid, a common agent, induces coagulative necrosis, primarily affecting the stomach. The optimal management for moderate-grade injuries (Zargar Grade 2A) is debated, with a focus on preventing stricture formation. This report details a case managed with an aggressive pharmacotherapeutic protocol centered on high-dose sucralfate. Case presentation: A 2-year-10-month-old boy was admitted following accidental ingestion of battery acid. His presentation was atypical, with vomiting but no oropharyngeal lesions. Initial investigations revealed a significant systemic inflammatory response (leukocytosis: 19,220/mm³; thrombocytosis: 581,000/mm³) and aspiration pneumonitis. Despite a 12-day delay in endoscopy due to parental refusal, an aggressive conservative regimen was initiated upon admission. This protocol included high-dose, frequent-interval sucralfate (80 mg/kg every 2 hours), intensive intravenous acid suppression (omeprazole and ranitidine), and prophylactic antibiotics. The endoscopy on day 12 confirmed Zargar Grade 2A burns in the gastric fundus, pylorus, and proximal duodenum, with the esophagus spared. The patient improved rapidly, tolerated an oral diet by day 11, and was discharged on day 14. Conclusion: Follow-up endoscopy at 6 weeks and 6 months confirmed complete mucosal healing without any evidence of stricture or gastric outlet obstruction. This case suggests that an immediate, aggressive, non-surgical protocol featuring high-dose sucralfate can be effective in managing pediatric Grade 2A corrosive gastroduodenal burns, promoting complete healing and preventing long-term complications. The findings underscore the potential of this pharmacotherapeutic strategy and warrant further investigation.
The Hidden Hazard of Celebration: A Meta-Analysis of Ocular Morbidity from Colored Powder Festivals and Implications for Global Travel Medicine Frangklin Refelino Jotlely; I Made Ady Wirawan; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1417

Abstract

Background: The globalization of colored powder festivals, such as Holi, has exposed millions, including international tourists, to significant ocular health risks from synthetic industrial dyes that have replaced traditional organic powders. This study was conducted to quantify the prevalence of acute ocular morbidities from these festivals, providing an evidence base to inform clinical practice and public health policy, particularly within travel medicine. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Google Scholar, ScienceDirect, and ProQuest for observational studies published up to July 2024. Studies reporting ocular complications from colored powder exposure were included. Data were extracted by two independent reviewers, and methodological quality was assessed using JBI checklists. A random-effects model was used to calculate pooled prevalence for key ocular injuries. Heterogeneity was investigated using sensitivity analyses, and publication bias was assessed with funnel plots. Results: Six studies from India, encompassing 189 patients, met the inclusion criteria for quantitative analysis. The patient population was predominantly young males (mean age 20-30 years). The meta-analysis revealed a high pooled prevalence of key ocular morbidities. The prevalence for chemical conjunctivitis was 95% (95% CI: 87%-100%), though with substantial but anticipated heterogeneity (I²=82%). The prevalence for corneal epithelial defects was 37% (95% CI: 23%-53%; I²=45%), and for superficial punctate keratopathy was 75% (95% CI: 57%-90%; I²=0%). Most injuries were bilateral. Conclusion: Participation in colored powder festivals, based on extensive evidence from Holi in India, presents a quantifiable and significant risk of acute ocular morbidity. The high prevalence of chemical-induced ocular surface disease necessitates urgent recognition of this "hidden hazard." Proactive, evidence-based preventive strategies, including tiered recommendations for protective eyewear and updated pre-travel health advisories, are imperative to safeguard the vision of millions of celebrants worldwide.

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