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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Published by Universitas Sriwijaya

ISSN : - EISSN : 25980580 DOI : -

Core Subject : Health, Science,

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 1,148 Documents

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From Antenatal Clue to Postnatal Cure: Surgical Management of a Symptomatic Jejunal Duplication Cyst in an Infant Agung Hartanto; Agung Aji Prasetyo; Agoes Wibisono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1461

Background: Alimentary tract duplication cysts represent a rare and challenging subset of congenital anomalies. Their non-specific symptomatology often leads to their misidentification as more common pediatric conditions, making a clear diagnostic pathway essential. With jejunal localization being particularly uncommon, these lesions can range from being asymptomatic to causing life-threatening abdominal emergencies. The evolution of high-resolution prenatal imaging, however, has fundamentally altered their management, enabling proactive postnatal intervention. Case presentation: A three-month-old female infant, with a history of a non-specific cystic intra-abdominal mass identified on a second-trimester antenatal ultrasound, was referred for progressive abdominal distension and non-bilious vomiting. Postnatal examination revealed a palpable right upper quadrant mass. A contrast-enhanced computed tomography (CT) scan confirmed a 3.9 x 3.9 x 3.3 cm thick-walled jejunal duplication cyst causing partial obstruction. The patient underwent a successful exploratory laparotomy with segmental jejunal resection and primary end-to-end anastomosis. The postoperative course was uneventful, with complete resolution of symptoms. Histopathology confirmed a benign jejunal duplication cyst without heterotopic mucosa. Conclusion: Jejunal duplication cysts are a critical, albeit rare, consideration in the differential diagnosis of an infant with an abdominal mass or intestinal obstruction. This case serves as a paradigm of modern perinatal care, where an antenatal clue facilitates a planned, definitive postnatal cure. Complete surgical resection remains the gold standard, preventing severe complications and ensuring an excellent long-term prognosis.

A Hierarchy of Harm: A Meta-analysis of Infection, Thrombosis, and Mortality Risks Across Central Catheters, Arteriovenous Grafts, and Fistulas Anak Agung Ngurah Gede Anggra Pramana; Anthony Wijaya; Putu Chandra Wibawa; I Gusti Agung Bagus Krisna Wibawa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1462

Background: Vascular access is a critical lifeline for patients with end-stage kidney disease requiring hemodialysis. The optimal choice among central venous catheters (CVCs), arteriovenous grafts (AVGs), and arteriovenous fistulas (AVFs) is a subject of intense debate, as each modality carries a distinct profile of risks. This meta-analysis was performed to establish a definitive, quantitative hierarchy of these risks to better inform clinical and policy decisions. Methods: A systematic search of PubMed, Scopus, and the Cochrane Library was conducted for studies published between January 2015 and September 2025 that compared complication rates among CVCs, AVGs, and AVFs in adult hemodialysis patients. Seven high-quality cohort studies met the inclusion criteria, encompassing 18,542 patients. Data on access-related bloodstream infections (ARBSI), access circuit thrombosis/dysfunction, and all-cause mortality were extracted. Pairwise meta-analyses using a random-effects model calculated pooled risk ratios (RR) and 95% confidence intervals (CI). Results: Central venous catheters were associated with a profoundly higher risk of ARBSI compared to both AVFs (RR 8.12, 95% CI 6.98–9.45, p < 0.001) and AVGs (RR 4.55, 95% CI 3.89–5.33, p < 0.001). Arteriovenous grafts demonstrated a markedly higher risk of access circuit thrombosis compared to AVFs (RR 2.78, 95% CI 2.41–3.21, p < 0.001). All-cause mortality was highest in patients with CVCs, showing a significantly increased risk compared to AVF users (RR 1.92, 95% CI 1.68–2.19, p < 0.001). Conclusion: This meta-analysis provides robust, contemporary quantitative evidence for a clear hierarchy of harm in hemodialysis access. CVCs pose the greatest risk for infection and mortality, AVGs present the highest risk for thrombosis, and AVFs represent the safest option. These data provide a powerful rationale for reinforcing systemic healthcare initiatives aimed at minimizing CVC exposure and promoting timely AVF placement.

The Differential Risk of Intraoperative Floppy Iris Syndrome (IFIS) with Tamsulosin versus Other α1-Adrenergic Antagonists: A Systematic Review and Comparative Meta-Analysis Muhammad Adithia; Boy Tri Janpiter; Ashabul Anhar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1463

Background: α1-adrenergic antagonists are a cornerstone therapy for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Their association with intraoperative floppy iris syndrome (IFIS) during cataract surgery is well-established, yet the comparative risk between the highly α1A-selective agent tamsulosin and other α1-blockers has not been adequately quantified in a meta-analysis. This study aimed to synthesize the evidence to determine the magnitude of this differential risk. Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, and the Cochrane Library through September 2025. We included comparative studies reporting IFIS incidence in adults on α1-blockers undergoing cataract surgery. Data were independently extracted by two reviewers. The primary outcome was the pooled Odds Ratio (OR) for IFIS, calculated using a random-effects model. Heterogeneity was assessed with the I² statistic. Results: The search yielded 1,218 records, with six studies comprising 10,878 patients meeting the inclusion criteria. The incidence of IFIS was 18.7% in the tamsulosin group versus 2.9% in the comparator group (other α1-blockers or control). Tamsulosin was associated with a significantly greater risk of IFIS (Pooled OR = 4.28, 95% CI: 2.91–6.31, p < 0.00001). This corresponds to an absolute risk increase of 15.8% and a Number Needed to Harm (NNH) of 7, suggesting one additional case of IFIS occurs for every seven patients treated with tamsulosin instead of a different agent. Moderate heterogeneity was noted (I² = 62%). Conclusion: This meta-analysis provides robust evidence that tamsulosin carries a more than four-fold increased odds of IFIS compared to other α1-blockers. This substantial and clinically meaningful risk, highlighted by an NNH of 7, mandates a risk-stratified approach to BPH management. A patient's present or future ophthalmological needs must be a central factor in the shared decision-making process when selecting an α1-blocker.

Baseline Visual Acuity as an Independent Predictor of Therapeutic Outcomes in HIV-Associated Cytomegalovirus Retinitis: A Three-Year Cohort Study in Indonesia Anak Agung Ayu Putri Prematura Sri Anasary; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1464

Background: Cytomegalovirus (CMV) retinitis is a severe opportunistic infection causing irreversible blindness in patients with advanced human immunodeficiency virus (HIV). In the modern era of highly active antiretroviral therapy (HAART), understanding the key determinants of visual prognosis is critical for effective patient management, particularly in resource-limited settings. This study aimed to evaluate the clinical spectrum of CMVR and identify independent predictors of short-term visual outcomes in a cohort of HIV-positive patients in Indonesia. Methods: A retrospective cohort study was conducted on HIV-positive patients diagnosed with CMV retinitis between January 2021 and December 2023 at a tertiary referral hospital in Bali, Indonesia. Data on demographics, clinical features, CD4+ T-cell counts, HAART status, and visual acuity (VA) at baseline and three months were collected. Visual acuity was converted to the Logarithm of the Minimum Angle of Resolution (LogMAR) for analysis. A multivariable linear regression model was employed to identify independent predictors of three-month visual outcomes. Results: The study included 26 patients (38 eyes). The cohort was predominantly male (61.5%) with a mean age of 36.73 years. Severe immunosuppression was common, with 65.4% of patients having a CD4+ count below 50 cells/mm³. Posterior uveitis was the most frequent presentation (68.4%). In the multivariable linear regression analysis, baseline LogMAR VA was the only significant independent predictor of three-month LogMAR VA (β = 0.71, p < 0.001) after adjusting for age, CD4+ count, and HAART status. The baseline CD4+ T-cell count was not a significant independent predictor of visual outcome (p = 0.841). Conclusion: Baseline visual acuity, a direct functional measure of existing retinal damage, is the most powerful independent predictor of short-term visual prognosis in patients with HIV-associated CMV retinitis. This finding highlights the irreversible nature of retinal necrosis and underscores that the opportunity to save sight lies in preemptive action. We advocate for the urgent integration of routine ophthalmological screening into the care protocols for high-risk HIV populations to detect and treat CMVR before significant vision loss occurs.

The Pointed Challenge: Endoscopic Management of an Ingested Sharp Foreign Body and a Synthesis of Modern Techniques Sindhu Nugroho Mukti; Sigit Adi Prasetyo; Bernardus Parish Budiono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1465

Background: The ingestion of sharp-pointed foreign bodies constitutes a high-acuity medical emergency, distinguished from other ingested objects by its significant potential for severe complications, including visceral perforation and hemorrhage. While flexible endoscopy has emerged as the cornerstone of management, its successful application hinges on a systematic, protocol-driven approach. This manuscript presents a case of an ingested straight pin and uses it as the framework for a critical synthesis of modern diagnostic and therapeutic strategies. Case presentation: A 40-year-old female presented to the emergency department, hemodynamically stable and completely asymptomatic, two hours after accidentally swallowing a straight pin. A benign abdominal examination belied the potential danger. Plain radiography confirmed a single, sharp metallic object in the gastric antrum. An urgent esophagogastroduodenoscopy under general anesthesia was performed. The pin was securely grasped with rat-tooth forceps and extracted without incident. The patient's recovery was uneventful, and she was discharged on the first postoperative day. Conclusion: This case provides a high-fidelity validation of current international guidelines, demonstrating that a protocol-driven approach—encompassing rapid triage, definitive imaging, and urgent therapeutic endoscopy—is both safe and maximally effective for upper gastrointestinal sharp foreign bodies. The successful outcome underscores the critical importance of this management algorithm in preventing progression to life-threatening complications. This case-driven synthesis reinforces that adherence to a rigorous, evidence-based protocol is the most effective strategy to navigate this pointed clinical challenge and consistently achieve optimal patient outcomes.

Balancing Efficacy and Tolerability: A Prospective Cohort Study of Oral and Intravenous Methylprednisolone for Active Graves' Ophthalmopathy in an Indonesian Tertiary Care Center Mardijas Efendi; Hendriati; Pattih Primasakti; Yolanda Wulandari Erwen
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1466

Background: In managing active, moderate-to-severe Graves' Ophthalmopathy (GO), a notable gap often exists between treatment efficacy in controlled trials and effectiveness in real-world practice. High-dose corticosteroids are standard, but the choice between intravenous (IV) and oral routes involves a complex trade-off between efficacy, tolerability, and practicality, particularly in diverse populations. Methods: This single-center, pragmatic, prospective cohort study was conducted at a tertiary hospital in Indonesia from March 2023 to March 2024. Thirty-six GO patients were treated with either IV pulse or daily oral methylprednisolone based on a shared clinical decision-making process. The primary outcome was the change in proptosis. To address the non-randomized design and control for selection bias, a propensity score-adjusted Analysis of Covariance (ANCOVA) was used to compare treatment effectiveness. Results: Baseline analysis revealed that patients selected for IV therapy had significantly more severe proptosis. Both unadjusted and adjusted analyses showed that each regimen resulted in a significant reduction in proptosis from baseline (p < 0.01). In the primary, propensity score-adjusted analysis, no statistically significant difference was detected in the degree of proptosis reduction between the IV and oral groups. However, the tolerability profiles were profoundly different; patients in the oral group experienced a significantly higher incidence of adverse events, including dyspepsia (66.7%) and Cushingoid features (55.6%), compared to a single case of transient hypokalemia in the IV group. Conclusion: In this real-world setting, after statistically controlling for baseline severity, both IV and oral methylprednisolone demonstrated comparable effectiveness in reducing proptosis. However, the intravenous route was associated with a vastly superior safety profile. These findings underscore the critical importance of tolerability in clinical decision-making and support the continued recommendation of IV pulse therapy as the first-line treatment.

The Diagnostic Accuracy of IgG Avidity Testing for Differentiating Acute from Chronic Toxoplasmosis in Pregnant Women: A Meta-Analysis Hermalina Sherli Utami; Rohayat Bilmahdi; Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1467

Background: Differentiating acute from chronic Toxoplasma gondii infection during pregnancy is a critical diagnostic challenge. Persistent Immunoglobulin M (IgM) antibodies create ambiguity, complicating clinical management. The IgG avidity test serves as a key tool to estimate infection timing. This meta-analysis aimed to systematically evaluate and quantify the diagnostic accuracy of the IgG avidity test for identifying acute toxoplasmosis in pregnant women. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, EMBASE, and LILACS for studies published between January 2015 and December 2025 evaluating the IgG avidity test's diagnostic accuracy in pregnant women. Included studies required data for a 2x2 contingency table. The QUADAS-2 tool was used for bias assessment. A bivariate random-effects model was used to pool sensitivity, specificity, likelihood ratios (PLR, NLR), and the diagnostic odds ratio (DOR). Results: Seven studies, comprising 1,250 pregnant women, were included. The pooled sensitivity was 0.96 (95% Confidence Interval [CI]: 0.92–0.98), and the pooled specificity was 0.97 (95% CI: 0.94–0.99). The pooled PLR was 32.5 (95% CI: 15.1–69.8), the NLR was 0.04 (95% CI: 0.02–0.08), and the DOR was 785 (95% CI: 289–2134). The area under the SROC curve was 0.99 (95% CI: 0.97–1.00). Substantial heterogeneity was observed across studies. A sensitivity analysis excluding one study with a high risk of bias did not significantly alter the results, and Deeks' test showed no evidence of publication bias (p=0.21). Conclusion: The IgG avidity test demonstrated excellent pooled diagnostic accuracy for differentiating acute from chronic toxoplasmosis in pregnancy. However, significant heterogeneity across studies underscores that a single performance estimate is not universally applicable. The test is a powerful tool for resolving diagnostic uncertainty, but results must be interpreted based on assay-specific performance and in the context of the complete clinical picture.

Erythema Nodosum Leprosum as a Harbinger of Relapse in Multibacillary Leprosy: A Clinico-Histopathological Case Study Benedikta Lauda; Nurrachmat Mulianto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1468

Background: Leprosy, a chronic granulomatous disease caused by Mycobacterium leprae, presents formidable long-term management challenges. In the post-elimination era, differentiating a true bacteriological relapse from a late-onset Erythema Nodosum Leprosum (ENL) reaction in patients who have completed multidrug therapy (MDT) is a critical diagnostic dilemma. Misdiagnosis can lead to inappropriate treatment, risking disease progression and irreversible nerve damage. Case presentation: A 30-year-old male presented with a severe, systemic inflammatory illness two years after completing MDT for lepromatous leprosy. His symptoms included crops of painful, erythematous nodules, fever, and arthralgia. While clinically suggestive of a severe ENL reaction, a slit-skin smear revealed a paradoxically high bacterial index (BI) of +5 with a morphological index (MI) of 0%. A skin biopsy was performed for definitive diagnosis. Histopathology revealed a dual pathology: a diffuse infiltrate of foamy macrophages typical of lepromatous leprosy, alongside a dense neutrophilic panniculitis characteristic of ENL. Crucially, Fite-Faraco staining demonstrated vast numbers of intact, solid-staining acid-fast bacilli, providing unequivocal evidence of active bacterial proliferation. Conclusion: This case demonstrates that a diagnostic algorithm integrating a high index of clinical suspicion with comprehensive bacteriological and histopathological methods is essential for accurately identifying relapse masked by ENL. The presence of viable bacilli confirms that ENL can be a direct clinical harbinger of relapse, mandating a dual therapeutic strategy that combines aggressive anti-inflammatory treatment with the immediate re-initiation of MDT.

Laparoscopic Cholecystectomy is Associated with Superior Clinical Outcomes in Pediatric Cholelithiasis: A 6-Year Comprehensive Surgical Outcome Analysis from Semarang, Indonesia Natasha Hartanto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1469

Background: The incidence of pediatric cholelithiasis is increasing globally, driven primarily by the childhood obesity epidemic. In a nation of over 270 million people like Indonesia, with rising obesity rates, understanding the optimal surgical management is a national health priority. This study provides the first detailed, comparative surgical outcome analysis for pediatric cholecystectomy from a major Indonesian referral center. Methods: A retrospective cohort study of all pediatric patients (≤18 years) undergoing cholecystectomy from January 2019 to December 2024 was conducted. Data on preoperative demographics, clinical presentation, intraoperative variables (operative time, blood loss, conversion rate), and postoperative outcomes (length of stay, 30-day complications graded by Clavien-Dindo) were extracted. Laparoscopic (LC) and open cholecystectomy (OC) groups were compared using Mann-Whitney U and Fisher’s exact tests. Results: The cohort of 30 patients (70% female, mean age 12.0 years) had a 60% prevalence of overweight or obesity. Laparoscopy was the initial approach in 25 cases (83.3%), with one conversion to open surgery (4%). Compared to the OC group (n=6), the definitive LC group (n=24) demonstrated significantly superior outcomes: median operative time was shorter (72 vs. 115 minutes, p=0.004), median estimated blood loss was lower (15 vs. 80 mL, p<0.001), and median postoperative length of stay was significantly reduced (3 vs. 5 days, p=0.002). The postoperative complication rate was lower in the LC group (8.3% vs. 33.3%, p=0.14), with all complications being minor (Clavien-Dindo Grade I-II). Conclusion: Laparoscopic cholecystectomy is a safe, effective, and efficient procedure that provides superior clinical outcomes compared to the open approach in the Indonesian pediatric population. These findings provide robust local evidence to establish LC as the unequivocal standard of care and justify investment in minimally invasive surgical training and infrastructure to meet the rising burden of this disease.

The Clinical and Pathological Landscape of Pediatric Appendicitis in Central Java, Indonesia: A Retrospective Cohort Study Highlighting a High Burden of Delayed Diagnosis Dimas Susilo Waridiarto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1470

Background: The timely diagnosis of pediatric appendicitis is a global challenge, particularly in low- and middle-income countries where health system barriers can lead to significant delays and increased morbidity. This study aimed to characterize the clinical and pathological presentation patterns of pediatric appendicitis at a major Indonesian referral center to identify evidence of diagnostic delay and to analyze associated surgical management trends. Methods: A retrospective cohort study was conducted at Dr. Kariadi General Hospital on all pediatric patients (n=52) who underwent appendectomy between January 2022 and December 2024. Data on demographics, definitive histopathological diagnoses, and surgical approaches were collected and analyzed. The manuscript was prepared in accordance with the STROBE guidelines for observational studies. Results: The cohort was predominantly male (63.4%), with a peak incidence in the 6–10 year age group (42.3%). The most striking finding was the histopathological diagnosis: a remarkable 48.0% of patients were diagnosed with chronic appendicitis with acute exacerbation, a strong indicator of delayed presentation. Minimally invasive surgery was performed in 48.0% of cases. While a significant association was observed between laparoscopic surgery and a shorter postoperative length of stay (p < 0.001), this finding was subject to significant confounding by indication. Conclusion: The exceptionally high prevalence of chronic exacerbated appendicitis is the principal finding of this study, serving as a powerful public health signal for systemic delays in the pediatric acute care pathway in this region. While minimally invasive surgery is associated with faster recovery, the more pressing priority is addressing the upstream factors—including public awareness and primary care referral systems—that lead to late surgical presentation and increased cumulative morbidity.

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