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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 1,209 Documents

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The Nexus of Comorbid Thyroid Dysfunction, Developmental Trauma, and Marital Distress in Severe Depression: A Case Study of an Integrative Bio-Psycho-Social-Spiritual Approach I Putu Roni Mahendra Putra
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.v9i12.1471

Background: The management of major depressive disorder (MDD) is frequently complicated by the presence of medical comorbidities and profound psychosocial stressors. This complexity creates a significant risk for "diagnostic overshadowing," where one clinical issue may mask others, leading to incomplete treatment. This case report illustrates a systematic diagnostic and therapeutic pathway for a patient whose severe depression represents a confluence of biological, psychological, and social determinants. Case presentation: We present the case of a 50-year-old female with Severe Major Depressive Disorder, Recurrent Episode (F32.2), whose functional impairment was profound (GAF=40). A systematic diagnostic inquiry revealed a nexus of pathology: previously misidentified hypothyroidism (TSH > 100 µIU/mL), comorbid metabolic syndrome (BMI 31.2 kg/m², HbA1c 7.8%); a significant history of developmental trauma (Adverse Childhood Experiences Score ≥ 4); and acute, severe marital distress involving recurrent spousal infidelity. Informed consent was obtained after assessing her capacity, with family collaboration. Conclusion: The patient was managed using an integrative bio-psycho-social-spiritual framework. This multidimensional approach involved concurrent medical stabilization, psychopharmacological treatment (Sertraline), and a phase-oriented, trauma-informed psychotherapy. The integration of culturally congruent mind-body practices was essential for building the therapeutic alliance. This holistic strategy resulted in significant, quantifiable improvement in depressive symptoms (BDI-II score decreased from 32 to 18) and functional outcomes. This case underscores the necessity of a systematic, multi-domain assessment to avert clinical error and demonstrates a replicable methodology for treating complex presentations of severe depression.

Single-Dose Intralesional Bacillus Calmette-Guérin (BCG) Immunotherapy Induces Complete and Sustained Remission of Recalcitrant Anogenital Condylomata: A Mechanistic Case Series Azhar Arrosyid; Prasetyadi Mawardi; Endra Yustin Ellistasari; Ammarilis Murastami
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1472

Background: Anogenital condylomata acuminata caused by Human Papillomavirus (HPV) presents a significant therapeutic challenge due to high recurrence rates after conventional cytodestructive therapies. Intralesional immunotherapy aims to induce a host-mediated immune response, offering a promising alternative. This report investigates the efficacy, safety, and immunological rationale of a novel, single-dose Bacillus Calmette-Guérin (BCG) protocol in an immunologically primed population. Methods: In this prospective case series, three immunocompetent patients with extensive, therapy-refractory anogenital condylomata were enrolled. Following a standardized protocol, each patient received a single, calculated intralesional injection of BCG vaccine into the largest index lesion. The primary outcome was complete clinical and dermoscopic clearance. Patients were evaluated at regular intervals for efficacy and safety over a 12-month follow-up period. Result: All three patients achieved complete clinical and dermoscopic clearance of both the injected and distant, untreated lesions within a rapid timeframe of 6 to 10 weeks. The treatment was well-tolerated, with adverse events limited to anticipated and transient local inflammatory reactions. No recurrences were documented in any patient during the 12-month follow-up period. Conclusion: Single-dose intralesional BCG immunotherapy appears to be a highly effective, durable, and safe therapeutic strategy for recalcitrant anogenital condylomata. The observed pan-lesional clearance strongly suggests the induction of a systemic, cell-mediated anti-HPV immune response. These compelling preliminary findings provide a strong rationale for validation through larger, randomized controlled trials.

The Eye as a Window to Systemic Hemodynamics: A Novel Approach to Estimating Central Venous Pressure via Tonometry in Sepsis M. Irvan Noorrahman; Nopian Hidayat; Riki Sukiandra; Pratama Ananda
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1473

Background: Effective hemodynamic management in sepsis is critical, yet current practices are constrained by the risks and interpretive challenges of invasive central venous pressure (CVP) monitoring. The clinical utility of CVP is debated, fueling the search for safer alternatives. This study investigates a novel approach, exploring intraocular pressure (IOP) as a non-invasive surrogate for CVP, predicated on the direct anatomical link between the ocular venous drainage system and the central circulation. Methods: We conducted a prospective, single-center observational study in a tertiary intensive care unit, enrolling 20 adult patients with sepsis and indwelling central venous catheters. High-fidelity measurements of CVP via a pressure transducer and IOP via Perkins applanation tonometry were performed simultaneously. Data were collected at a baseline steady-state and again 15 minutes after a standardized fluid challenge (median volume 300 mL) to assess the dynamic relationship. The association was quantified using Pearson correlation and modeled with simple linear regression. Results: A strong, statistically significant positive correlation was observed between CVP and IOP at baseline (r=0.756, p=0.001). This physiological coherence was profoundly amplified following the fluid challenge, strengthening to a very strong correlation (r=0.947, p<0.001). The post-challenge data yielded a robust, preliminary predictive model, defined by the equation: CVP (mmHg) = -0.619 + (0.522 x IOP (mmHg)). The slope of this relationship was precisely estimated (95% CI: 0.435 to 0.609). The model demonstrated high predictive power, with post-challenge IOP accounting for 89% of the variance in CVP (R²=0.89). Conclusion: This pilot investigation provides compelling evidence for a strong and dynamic correlation between IOP and CVP in critically ill patients with sepsis. The findings suggest that ocular tonometry shows significant promise as a non-invasive method for assessing right-sided filling pressures and, more importantly, for tracking the dynamic response to fluid therapy, thereby offering a potential window into venous congestion. While intriguing, these results are from a small cohort. The derived formula is strictly hypothesis-generating and requires extensive validation in larger, more diverse clinical trials before any potential for clinical application can be considered.

Spontaneous Respiration Intubation as a Cornerstone of Multidisciplinary Management for Delayed Tracheoesophageal Fistula Repair in a Critically Ill Neonate Sulthoni; Dino Irawan; Novita Anggraeni; Nopian Hidayat; T Addi Saputra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1474

Background: The perioperative management of neonates with esophageal atresia and Type C tracheoesophageal fistula (EA/TEF) is exceptionally challenging, particularly in cases of delayed diagnosis complicated by aspiration pneumonia and congenital heart disease. The primary anesthetic risk is catastrophic gastric insufflation and hemodynamic collapse from positive pressure ventilation (PPV) before fistula control. This report details a successful multidisciplinary strategy centered on an airway technique that preserves spontaneous ventilation. Case presentation: A 16-day-old, 2.5 kg female neonate with Type C EA/TEF presented for surgical repair following a delayed referral. The case was critically complicated by severe aspiration pneumonia (cultures positive for Klebsiella pneumoniae), which was managed with targeted antibiotic therapy, and hemodynamically significant congenital heart defects (2.5 mm patent ductus arteriosus, 3 mm patent foramen ovale). After 48 hours of intensive cardiorespiratory and nutritional optimization in the neonatal intensive care unit (NICU), the patient underwent surgery. To circumvent the life-threatening risks of PPV, an inhalational induction with sevoflurane was performed, maintaining spontaneous ventilation. The airway was secured via direct laryngoscopy without neuromuscular blockade. A right extrapleural thoracotomy, fistula ligation, and primary esophageal anastomosis were successfully performed. Intraoperative lung retraction-induced desaturation was managed with coordinated surgeon-anesthetist maneuvers. The postoperative course was uneventful. Conclusion: In a high-risk neonate with delayed TEF presentation and profound cardiorespiratory compromise, securing the airway while maintaining spontaneous ventilation is a cornerstone of safe anesthetic practice. This approach, integrated within a comprehensive, multidisciplinary management plan, directly mitigates the risk of gastric perforation and cardiovascular collapse, thereby enabling a successful surgical repair and favorable outcome.

A Neuroinflammatory Biomarker Profile Associated with Neuropathic Pain in Hansen's Disease: A Systematic Review and Meta-Analysis of S100B, TNF-α, and IL-6 Dian Rizki Fitria; I Putu Eka Widyadharma; Ni Made Susilawathi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1475

Background: Neuropathic pain (NP) is a severe, chronic complication of Hansen's disease (HD), persisting after antimicrobial therapy and profoundly diminishing quality of life. Its pathophysiology is driven by persistent, complex neuroinflammatory processes within the peripheral nervous system. Circulating biomarkers, especially the glial-derived protein S100B, offer a potential objective window into this underlying pathology. This study aimed to meta-analyze the association between circulating S100B, TNF-α, and IL-6 and the presence of NP in patients with HD. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted for observational studies published between January 2015 and December 2025 that compared biomarker levels in HD patients with and without NP, diagnosed using validated screening instruments. Data from eligible studies were extracted independently, and methodological quality was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to compute the pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) for each biomarker. Results: Seven studies, comprising 812 patients (405 with NP, 407 without NP), met the inclusion criteria. The meta-analysis revealed that serum S100B levels were significantly elevated in HD patients with NP compared to those without (SMD = 1.28, 95% CI [0.95, 1.61], p < 0.001). This finding was accompanied by very high statistical heterogeneity (I² = 78%). Concurrently, the analysis demonstrated significantly higher circulating levels of TNF-α (SMD = 0.89, 95% CI [0.62, 1.16]) and IL-6 (SMD = 0.75, 95% CI [0.48, 1.02]) in the NP group. Conclusion: This meta-analysis establishes a strong statistical association between a distinct neuroinflammatory biomarker profile—characterized by elevated circulating S100B, TNF-α, and IL-6—and the presence of neuropathic pain in Hansen's disease. S100B, as a marker of Schwann cell distress, is a particularly relevant component of this profile. These findings underscore the pivotal role of neuroinflammation in HD-related NP, although the high heterogeneity and non-specific nature of these systemic markers necessitate a cautious interpretation regarding their immediate clinical applicability.

Dynamic Coupling of Systemic and Intratumoral Estradiol in HER2-Positive and Triple-Negative Breast Cancer: A Validation Study of a Non-Invasive Surrogate Nadhim Muhammad Askar; Widyanti Soewoto; Brian Wasita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1476

Background: The role of estradiol in the tumor microenvironment (TME) of estrogen receptor (ER)-negative breast cancers is increasingly recognized. Direct measurement of intratumoral estradiol is invasive, creating a barrier to clinical research. This study aimed to determine if circulating plasma estradiol can serve as a high-fidelity, non-invasive surrogate for intratumoral concentrations in HER2-positive (HER2+) and triple-negative breast cancer (TNBC). Methods: This retrospective, cross-sectional study included 60 women with primary operable HER2+ (n=21) and TNBC (n=39) who underwent mastectomy. Paired pre-operative plasma and post-operative tumor tissue samples were analyzed. Estradiol concentrations were quantified using a validated high-performance liquid chromatography-radioimmunoassay (HPLC-RIA) protocol. Clinicopathological data, including Body Mass Index (BMI), were collected. The primary outcome was the correlation between plasma and intratumoral estradiol, assessed by Spearman's rank correlation. Paired concentrations were compared using the Wilcoxon signed-rank test. Results: Baseline clinicopathological characteristics, including BMI, were well-balanced between the HER2+ and TNBC cohorts. A highly significant, strong positive correlation was found between plasma and intratumoral estradiol concentrations across the entire cohort (Spearman's ρ = 0.78, p < 0.001). This correlation remained robust in subgroup analyses of menopausal status and tumor grade. Interestingly, median intratumoral estradiol levels (30.0 pg/mL; IQR: 10.0-65.0) were significantly lower than paired median plasma levels (132.0 pg/mL; IQR: 40.0-225.0) (p < 0.001). Conclusion: Plasma estradiol demonstrates a strong and direct correlation with intratumoral estradiol in HER2+ and TNBC, validating its use as a reliable, non-invasive surrogate. This provides a crucial tool to explore the pathophysiology of the TME. The finding that intratumoral levels are lower than systemic circulation, yet tightly coupled, suggests a dynamic equilibrium that warrants further investigation into local estradiol metabolism and signaling in ER-negative disease.

Catastrophic Zone I Open Globe Injury: Pathophysiological Insights and Staged Surgical Triumphs in a Case of Corneal Rupture, Lens Extrusion, and "Blackball" Hyphema Harrie Kurnia Rahman; Fitratul Ilahi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1477

Background: Complex open globe injuries (OGIs) involving the simultaneous destruction of multiple anterior segment structures represent a formidable challenge in ophthalmic traumatology. These injuries necessitate a staged surgical approach to restore ocular integrity and optimize the potential for visual rehabilitation. Case presentation: A 44-year-old male presented with a severe Zone I OGI in the left eye from a high-velocity projectile stone. His initial best-corrected visual acuity was limited to light perception. Examination revealed an 8-mm corneal rupture with uveal prolapse, complete anterior extrusion of the crystalline lens, and a Grade IV "blackball" hyphema. The Ocular Trauma Score (OTS) was calculated as 1, predicting a very poor visual outcome. Immediate primary repair involved anterior vitrectomy, lensectomy, hyphema evacuation, and corneal suturing. After a six-month stabilization period, a secondary scleral-fixated intraocular lens (IOL) was implanted using a double-needle Yamane technique. Conclusion: Despite the devastating nature of the initial injury and a grim prognosis as per the OTS, a principled, staged surgical strategy resulted in a final best-corrected visual acuity of 20/50. This case highlights that adherence to damage-control principles—prioritizing anatomical restoration in the primary surgery and deferring refractive correction—can lead to unexpectedly favorable functional outcomes in the most severe categories of ocular trauma.

Temporal Dynamics of Postoperative Enterocolitis in Hirschsprung Disease: A Comparative Analysis of Earlier Onset After TAERPT versus the Duhamel Procedure Anisa Ika Pratiwi; Nunik Agustriani; Suwardi; Ida Bagus Budhi Surya Adnyana; Henky Agung Nugroho
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1478

Background: Hirschsprung-associated enterocolitis (HAEC) remains the most formidable cause of morbidity in surgically corrected Hirschsprung disease (HD). While the transanal endorectal pull-through (TAERPT) and the Duhamel procedure are standard treatments, a critical knowledge gap exists regarding the timing of postoperative HAEC onset associated with each technique. This study aimed to investigate and compare the temporal dynamics of HAEC presentation following these distinct surgical reconstructions. Methods: This single-center, retrospective cohort study reviewed 64 HD patients who underwent either TAERPT (n=32) or a modified Duhamel procedure (n=32) between January 2022 and January 2023 at a tertiary referral hospital. The primary outcome was the incidence of severe HAEC (HAEC score ≥10). The principal secondary outcome was the time to onset of the first episode of mild-to-moderate HAEC (score <10). Due to the non-normal distribution of onset data, the Mann-Whitney U test was used for statistical comparison. Results: Baseline demographic and clinical characteristics were comparable between the two cohorts. The incidence of severe HAEC was 0% in both the TAERPT and Duhamel groups. All recorded complications were mild-to-moderate and managed non-surgically. A statistically significant and clinically profound difference in the timing of these complications was observed. The median onset of HAEC in the TAERPT group was 6.0 months (Interquartile Range [IQR], 3.0-6.0), which was significantly earlier than the median onset of 8.5 months (IQR, 3.0-24.0) in the Duhamel group (p < 0.001). The mean onset times were 5.50 ± 1.90 months and 16.09 ± 16.33 months, respectively. Conclusion: Although both TAERPT and the Duhamel procedure demonstrated excellent safety profiles regarding severe HAEC, their associated temporal patterns of mild-to-moderate enterocolitis are markedly different. The significantly earlier onset of complications following TAERPT suggests that postoperative surveillance strategies should be procedure-specific, with intensified clinical vigilance during the first postoperative year for TAERPT patients.

Intraoperative Endoscopy as a Navigational Adjunct in Laparoscopic Heller Myotomy for Achalasia: A Consecutive Case Series Jonathan Alvin Nugraha Halim; Ahmad Fathi Fuadi; Dimas Erlangga Nugrahadi; Agung Aji Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1479

Background: Laparoscopic Heller myotomy (LHM) is a primary surgical treatment for esophageal achalasia. Achieving a complete myotomy while avoiding mucosal perforation is paramount for success, yet intraoperative challenges persist. Intraoperative endoscopy (IOE) is recommended by guidelines but remains underutilized. This study aims to illustrate the methodological application and clinical utility of a standardized IOE protocol in LHM. Methods: This study was a retrospective analysis of a prospectively maintained database of a consecutive series of patients who underwent LHM with routine IOE for achalasia at our institution in 2023. We present three consecutive cases. Preoperative evaluation included esophagography, upper endoscopy, and high-resolution manometry (HRM). The primary outcomes were the adequacy of myotomy, incidence of mucosal perforation, and postoperative symptomatic relief measured by the Eckardt score at three months. Results: Three female patients (aged 19, 30, and 65) with achalasia (Type I and II) underwent LHM with IOE. The mean preoperative Eckardt score was 9.3 ± 1.5. IOE was successfully used in all cases to: (1) precisely identify the gastroesophageal junction (GEJ) via transillumination, (2) facilitate submucosal dissection through controlled insufflation, (3) confirm mucosal integrity with an air leak test, and (4) verify a patulous GEJ post-myotomy. No mucosal perforations occurred. At three-month follow-up, the mean Eckardt score significantly improved to 0.3 ± 0.6 (p < 0.05). All patients reported resolution of dysphagia and significant improvement in nutritional status. Conclusion: Our experience with this consecutive series supports the utility of systematic IOE during LHM. It appears to be a valuable tool for enhancing procedural safety, ensuring myotomy adequacy, and achieving optimal short-term functional outcomes. These findings reinforce existing guidelines and should encourage wider adoption of this critical surgical adjunct.

Ultrasound-Guided Neuraxial Precision in a High-Risk Adolescent Parturient: Navigating Anesthetic Management in the Confluence of Nephrotic Syndrome, Diastolic Heart Failure, and Anasarca Made Bagus Cahya Maha Putra; Tjokorda Gde Agung Senapathi; I Gusti Ngurah Mahaalit Aribawa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (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.v10i1.1480

Background: Anesthetic management for cesarean delivery in parturients with concurrent nephrotic syndrome and decompensated heart failure presents a profound clinical challenge. Severe anasarca can obliterate anatomical landmarks, while complex cardiorenal pathophysiology creates a state of extreme hemodynamic fragility. This case report describes a systematic, ultrasound-guided approach to overcome these obstacles. Case presentation: A 15-year-old primigravida at 33 weeks gestation, with new-onset nephrotic syndrome and decompensated heart failure (NYHA Class III), required an emergency cesarean section. Clinical examination revealed severe anasarca, rendering lumbar spinal landmarks impalpable. A systematic pre-procedural lumbar ultrasound examination was performed using a low-frequency curvilinear transducer. This allowed for precise identification of the L3-L4 interspace and an accurate skin-to-dura depth measurement of 4.6 cm. A single-attempt subarachnoid block was successfully performed with a reduced dose (10 mg) of hyperbaric bupivacaine. An adequate T4 sensory block was achieved for surgery. The patient remained remarkably hemodynamically stable throughout the procedure, with no episodes of hypotension requiring vasopressor support. A healthy infant was delivered, and both maternal and neonatal outcomes were excellent. Conclusion: This case demonstrates that a systematic pre-procedural ultrasound protocol is an indispensable tool for enhancing the safety and success of neuraxial anesthesia in high-risk obstetric patients. By enabling precise anatomical localization and informed dose reduction, it mitigates procedural risk and supports hemodynamic stability in the face of distorted anatomy and severe cardiorenal comorbidities.

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Rachmat Hidayat

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Kab. ogan ilir,

Sumatera selatan

INDONESIA