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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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Efficacy and Safety of Adjunctive Corticosteroids in Non-HIV Pneumocystis jirovecii Pneumonia with Respiratory Failure: A Systematic Review and Meta-Analysis of Randomized and Observational Studies Reza Rahmadinata; Rohani Lasmaria
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1508

Background: Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised patients carries a mortality rate significantly higher than in the HIV-positive population. While adjunctive corticosteroids are the standard of care for HIV-associated pneumonia to prevent Immune Reconstitution Inflammatory Syndrome, their efficacy in non-HIV patients remains controversial due to differing immunopathogenesis. This study evaluated the efficacy and safety of adjunctive corticosteroids in non-HIV patients with respiratory failure, specifically addressing the discordance between historical observational data and recent randomized evidence. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching databases from January 2014 to July 2025. We included randomized controlled trials and observational studies of non-HIV adults with pneumonia receiving adjunctive corticosteroids. To address methodological heterogeneity, we performed stratified analyses separating randomized trial data from observational cohorts and conducted sensitivity analyses to account for outliers. Risk of bias was assessed using Cochrane RoB-2 and the Newcastle-Ottawa Scale. Results: Ten studies comprising 2,900 patients were analyzed. The randomized trial demonstrated no statistically significant reduction in 28-day mortality with corticosteroids (21.5% vs 32.4%, p=0.069). In the observational arm, initial pooled analysis suggested benefit, but sensitivity analysis removing a large administrative database study shifted the result to null. Crucially, higher cumulative steroid doses were associated with increased 90-day mortality (Hazard Ratio 1.01 per 100mg equivalent; p<0.05) and a significantly increased risk of secondary infections and hyperglycemia. Subgroup analysis revealed no benefit for pulse-dose regimens over standard dosing. Conclusion: Unlike in HIV, adjunctive corticosteroids do not confer a consistent survival benefit in non-HIV Pneumocystis pneumonia and are associated with dose-dependent toxicity. The routine use of corticosteroids should be abandoned in favor of a cautious approach restricted to severe, early hypoxemia using standard rather than pulse doses.

Impact of Co-existing Adenomyosis on Pain Recurrence Following Deep Endometriosis Excision: A Systematic Review and Meta-Analysis of Multivariate-Adjusted Observational Cohorts Ninda Frymonalitza
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1509

Background: Deep endometriosis (DE) represents a severe phenotype characterized by subperitoneal infiltration >5mm. While complete surgical excision is the gold standard, postoperative recurrence of pain and lesions remains clinically significant. Growing evidence implicates co-existing adenomyosis as a prognostic factor, yet its independent impact on DE surgery outcomes is debated. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2014 and 2025. Data were synthesized from seven high-quality studies involving 2,056 participants, focusing on those utilizing multivariate regression or propensity score matching. The primary outcomes were recurrence of pain (dysmenorrhea, dyspareunia), anatomical lesion recurrence, and surgical complications. Secondary outcomes included fertility. Results: The prevalence of adenomyosis in DE patients ranged from 35.6% to 49.05%. Patients with adenomyosis had significantly higher preoperative pain scores. Postoperatively, adenomyosis was an independent predictor of pain persistence and lesion recurrence. Extrinsic adenomyosis was associated with a 2.5-fold increased risk of early recurrence (OR 2.5; 95% CI 1.2–3.4). Survival analysis showed a 60% recurrence-free probability at 5 years for those with adenomyosis vs. 81% for those without. Surgical complications were significantly higher in the adenomyosis group (OR 4.56; 95% CI 1.90–11.30). Conclusion: Co-existing adenomyosis is a robust independent risk factor for failure of DE surgery, leading to persistent pain, lesion recurrence, and increased surgical morbidity. This supports the outside-in theory of pathogenesis. Preoperative screening for adenomyosis via TVS/MRI is mandatory for accurate counseling and surgical planning.

Fatal Disseminated Tuberculosis in Vaccinated Children with Failed BCG Scar Formation: A Clinical-Pathological Correlation and Immunological Review Delicia Rudy; Prisillia Brigitta; I Kadek Suarca
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1510

Background: The Bacillus Calmette-Guérin (BCG) vaccine remains the cornerstone of preventative strategies against severe pediatric tuberculosis (TB), specifically disseminated forms such as miliary TB and tuberculous meningitis (TBM). While the formation of a cutaneous scar is historically viewed as a surrogate marker for successful vaccine uptake and delayed-type hypersensitivity (DTH), its absence is often clinically overlooked. This study investigates the correlation between the lack of BCG scarring, immunological anergy, and fatal disseminated disease outcomes. Case presentation: We report a clinical-pathological analysis of two pediatric patients admitted to a tertiary care center in Indonesia. Case 1, an 11-month-old male vaccinated at birth, presented with status epilepticus and was diagnosed with Probable TBM Stage III. Despite vaccination, he lacked a BCG scar and exhibited Tuberculin Skin Test (TST) anergy (0 mm). Case 2, a 2-year-8-month-old female vaccinated at birth, presented with Type 1 respiratory failure due to severe miliary TB. She demonstrated profound wasting and TST anergy (0 mm). Both patients succumbed to the disease (Day 9 and Day 14, respectively) despite aggressive management. Conclusion: The absence of a BCG scar in vaccinated children serves as a critical clinical indicator of "immunological silence." It correlates with a failure to mount the Th1-mediated granulomatous response necessary for containing lymphohematogenous spread. We recommend that scar failure be treated as a risk factor requiring enhanced surveillance and a lower threshold for preventative therapy.

Precipitation of Occult Lymphomatous Hemorrhage by Early Initiation of Factor Xa Inhibitors: A Pharmacovigilance Case Study and Critical Reappraisal of DOAC Safety Kadek Cahya Adwitya; I Putu Bayu Triguna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1511

Background: The concurrent management of cancer-associated thrombosis (CAT) and active malignancy represents a precarious clinical equilibrium, particularly when the neoplasm involves occult extranodal gastrointestinal (GI) sites. While direct oral anticoagulants (DOACs) have largely supplanted low-molecular-weight heparin (LMWH) as the standard of care for CAT, emerging pharmacovigilance data suggest a specific vulnerability in patients with luminal GI malignancies. Case presentation: We report the case of a 76-year-old frail female presenting with extensive left iliofemoral deep vein thrombosis (DVT). Diagnostic evaluation identified a perfect storm of pathology: Stage IV diffuse large B-cell lymphoma (DLBCL) with bulky retroperitoneal lymphadenopathy encasing the inferior vena cava (IVC) and a suspicious infiltrative mass in the proximal jejunum. Following standard guidelines, the patient was initiated on rivaroxaban. However, this intervention precipitated a catastrophic upper GI hemorrhage (hemoglobin drop to 6.5 g/dL) within 96 hours. A retrospective pharmacokinetic audit revealed critical predisposing factors: severe hypoalbuminemia (1.6 g/dL) increasing the free drug fraction, and an estimated glomerular filtration rate (eGFR) <30 mL/min, suggesting the patient was effectively overdosed relative to her physiological clearance. Conclusion: The empiric use of rivaroxaban in elderly patients with uncharacterized abdominal masses, renal impairment, and cachexia carries unacceptable hemorrhagic risks. We advocate for a systematic bleed-risk stratification protocol, prioritizing LMWH or Apixaban, and the judicious use of IVC filters as bridging therapies in high-risk phenotypes.

Tear Reservoir Thickness and Vector-Resolved Refractive Outcomes in Indonesian Corneal Ectasia: A Scleral Lens Pilot Study Anak Agung Ayu Putri Prematura Sri Anasary; Ariesanti Tri Handayani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1512

Background: Corneal ectasia is characterized by high-order aberrations and irregular astigmatism, presenting significant optical challenges. Scleral lenses neutralize these irregularities via a post-lens tear reservoir. However, the precise optical contribution of the tear reservoir thickness itself to residual refractive error remains under-characterized, particularly in Southeast Asian populations where aggressive ectasia phenotypes are common. This study aimed to determine if tear reservoir thickness correlates with residual refractive error using vector analysis. Methods: This retrospective pilot study analyzed 12 eyes of 8 patients with severe corneal ectasia fitted with scleral lenses in Indonesia. Refractive outcomes were converted to Thibos power vectors (M, J0, J45). To account for bilateral eye correlations, linear mixed models (LMM) were employed with Patient ID as a random effect. A theoretical thick-lens model compared predicted versus observed over-refraction. Results: The cohort (mean age 28 ± 10.2 years) achieved significant visual improvement (LogMAR 0.35 to 0.17; p = 0.005). The mean tear reservoir thickness was 263.33 ± 80.92 μm. LMM analysis revealed no statistically significant correlation between fluid thickness and Spherical Equivalent (M) (beta = -0.001, p = 0.72) or Blur Strength (p = 0.68). The theoretical model indicated that residual error was driven by uncorrected posterior corneal astigmatism rather than fluid depth. Conclusion: In this Indonesian cohort, optical efficacy was driven by refractive index matching at the corneal interface, not reservoir thickness. Clinical fitting should prioritize physiological clearance over refractive manipulation.

Psoriasiform Digital Bowen’s Disease: A Diagnostic Challenge and Short-Term Response to Liquid Nitrogen Cryotherapy Putu Resika Melarosa; Ketut Kwartantaya Winaya; Lettisia Amanda Ruslan; Made Sri Adnyasitarini; Putu Ayu Paramitha Saraswaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1513

Background: Bowen’s disease (BD), or squamous cell carcinoma in situ, classically presents as a slowly enlarging erythematous plaque on sun-exposed skin. However, digital Bowen’s disease represents a distinct and rare clinical subset that frequently poses a significant diagnostic dilemma. Due to its unique anatomical location and morphological variability, digital BD often masquerades as benign inflammatory dermatoses, particularly psoriasis or chronic eczema, leading to dangerous therapeutic delays. Case presentation: We report the case of a 46-year-old male presenting with a solitary, rough, erythematous plaque on the dorsal aspect of the left index finger that had persisted for one year. The lesion was initially misdiagnosed and treated as an inflammatory condition without success. Detailed dermoscopic evaluation revealed a specific "psoriasiform" vascular pattern characterized by clustered glomerular vessels and surface scaling, raising suspicion for malignancy. Histopathological analysis confirmed the diagnosis of Bowen’s disease, demonstrating full-thickness epidermal atypia with psoriasiform hyperplasia. Notably, the presence of histological koilocytic atypia suggested a potential synergistic etiology involving Human Papillomavirus (HPV) infection alongside chronic ultraviolet exposure. The patient was treated with a tissue-sparing protocol of liquid nitrogen cryotherapy to preserve digital function. Conclusion: Complete clinical resolution of the lesion was observed at the three-week follow-up interval, resulting in a hypopigmented macule with full preservation of joint mobility. This case highlights the critical necessity of distinguishing "psoriasiform" malignancies from true inflammatory diseases through the recognition of specific vascular arrangements in dermoscopy. Furthermore, it suggests that cryotherapy is a pragmatic, function-sparing alternative to surgical excision for digital malignancies, provided that rigorous long-term surveillance is maintained to monitor for recurrence.

Selective Suppression of Prevotella and Modulation of Oral Dysbiosis in Stunted Children: The Role of Systemic Zinc as a Biological Adjuvant to Mechanical Therapy Nila Kasuma; Dewa Made Wedagama; Thifla Rafifa Wirza; Dedi Sumantri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1514

Background: Gingivitis in stunted children represents a unique pathological entity driven by a compromised mucosal barrier and systemic zinc deficiency. These children exhibit a phenotype of acquired immunodeficiency, where standard mechanical debridement often fails to resolve inflammation, leading to a phenomenon known as dysbiotic rebound. This study investigated the biomolecular efficacy of systemic Zinc supplementation combined with scaling and root planing (SRP) in modulating the oral microbiome of nutritionally vulnerable children. Methods: A randomized, single-blind, pre-post test controlled clinical trial was conducted in Padang, Indonesia, involving 30 stunted children (Height-for-age Z-score < -2 SD) diagnosed with generalized gingivitis. Participants were randomized into a Control group (SRP + Placebo, n=15) and an Intervention group (SRP + 20mg Zinc Sulfate Monohydrate daily, n=15) for a duration of 14 days. Microbial profiling was performed on unstimulated saliva utilizing high-throughput 16S rRNA gene sequencing (V3–V4 region). Bioinformatics processing utilized the DADA2 pipeline to generate Amplicon Sequence Variants (ASVs). Results: Results indicated that SRP alone resulted in a pathogenic recolonization dominated by Firmicutes (+49.6%). Conversely, Zinc supplementation induced a significant Gram-negative crash, reducing Proteobacteria by 50.6%. Most notably, the key periodontal pathogen Prevotella was suppressed to undetectable levels in the Zinc group (p<0.05). Conclusion: Systemic zinc acts as a potent biological scaffold in the enterosalivary cycle, likely repairing the epithelial barrier and starving hemin-dependent pathogens. It is strongly recommended as a therapeutic adjuvant to prevent the ecological recurrence of gingivitis in nutritionally vulnerable pediatric populations.

Combinatorial Efficacy of Human Mesenchymal Stem Cell Secretome and Ursodeoxycholic Acid in Ameliorating Renal Dysfunction: A Synergistic Approach in a Rat Model of Cholestatic Injury Mariani Devi; Parish Budiono; Gana Adyaksa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1515

Background: Cholestatic nephropathy, historically termed cholemic nephropathy, represents a critical intersection of hepatic and renal pathology where the systemic retention of nephrotoxic cholephiles induces severe acute kidney injury. The pathophysiological cascade involves direct tubular epithelial toxicity, mitochondrial oxidative stress, and intraluminal cast formation driven by hydrophobic bile acids and bilirubin. While ursodeoxycholic acid (UDCA) serves as the standard pharmacological intervention to displace toxic bile salts, its efficacy in reversing established secondary renal injury is limited. The secretome of human mesenchymal stem cells (Hu-MSC-S) has emerged as a potent regenerative agent, rich in trophic factors capable of mitigating inflammation and promoting tissue repair. This study investigates the synergistic potential of combining standard UDCA therapy with Hu-MSC-S to preserve renal excretory function in a surgically induced model of extrahepatic cholestasis. Methods: A randomized experimental study was conducted using 24 male Wistar rats. Extrahepatic cholestasis was induced via common bile duct ligation (CBDL). Following a 2-week induction period to establish significant hepatic and secondary renal injury, rats were randomized into four groups (n=6): Control (untreated cholestasis), UDCA Monotherapy (4.5 mg/200g body weight orally), Hu-MSC-S Monotherapy (0.2 ml/kg intraperitoneally), and combination therapy (UDCA + Hu-MSC-S). Treatments were administered weekly for four weeks. Renal function was rigorously assessed through serum Urea (Urease-GLDH method) and Creatinine (Kinetic Jaffe method) levels. Results: The study demonstrated a marked renoprotective gradient across the treatment groups. The untreated Control group exhibited severe renal dysfunction with a mean Urea of 42.60 mg/dL and Creatinine of 3.18 mg/dL. Both monotherapies significantly attenuated these markers compared to controls. However, the Combination group achieved superior efficacy, restoring renal parameters to near-physiological levels (Urea: 13.08 mg/dL; Creatinine: 1.32 mg/dL). Delta analysis confirmed that the combination therapy yielded the highest magnitude of recovery for both markers. Conclusion: The concurrent administration of Hu-MSC-S and UDCA exerts a potent synergistic effect, significantly ameliorating renal dysfunction in cholestatic rats. The findings suggest that Hu-MSC-S acts as a crucial adjuvant, repairing tubular injury via paracrine mechanisms while UDCA mitigates the primary cholestatic insult, offering a novel multi-target therapeutic strategy for cholemic nephropathy.

Therapeutic Potential of Curcumin in Modulating the HMGB1/TLR4/NF-κB Axis in Polymicrobial Peritonitis: A Systematic Review and Dose-Response Meta-Analysis Leonardo Aaron Hartanto; Neni Susilaningsih; Erik Prabowo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1516

Background: Polymicrobial peritonitis and its systemic sequela, sepsis, represent a catastrophic dysregulation of the host immune response to infection, leading to multiple organ dysfunction syndrome and high mortality rates. The pathophysiology is driven by a hyperinflammatory cytokine storm followed by immunoparalysis, governed centrally by the high mobility group box 1 (HMGB1)/toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling axis. Curcumin, a polyphenolic compound derived from Curcuma longa, has demonstrated potent immunomodulatory properties. However, its specific regulatory effects on this molecular axis, particularly regarding dose-dependency and novel cell death pathways like ferroptosis and lactylation, require systematic synthesis. Methods: A systematic review and meta-analysis were conducted on preclinical and clinical studies published between 2014 and 2025. Ten pivotal manuscripts meeting strict inclusion criteria were analyzed, comprising rodent models of sepsis (Cecal Ligation and Puncture, Zymosan, Lipopolysaccharide) and human clinical trials. Primary outcomes included quantitative expression levels of HMGB1, TLR4, and NF-κB, alongside organ injury scores and survival rates. Secondary outcomes analyzed downstream cytokines (TNF-α, IL-6, IL-1β) and oxidative stress markers. Data were stratified by dosage to evaluate dose-response relationships. Results: The analysis included data from 218 subjects. curcumin administration significantly attenuated the activation of the HMGB1/TLR4/NF-κB axis across all models. Quantitative analysis revealed a dose-dependent reduction in serum HMGB1 levels and a significant inhibition of NF-κB p65 nuclear translocation (p < 0.001). High-dose curcumin (100–200 mg/kg) exhibited superior efficacy in mitigating multi-organ injury compared to low-dose regimens. Novel mechanisms identified included the suppression of ferroptosis via the upregulation of the ACSL4/GPX4 axis and the inhibition of protein lactylation through p300 downregulation. Clinical data demonstrated that nano-curcumin formulations significantly reduced SOFA scores and inflammatory markers in septic patients, confirming enhanced bioavailability. Conclusion: Curcumin functions as a robust, pleiotropic inhibitor of the HMGB1/TLR4/NF-κB axis in polymicrobial peritonitis. Its therapeutic efficacy is dose-dependent and involves the regulation of emerging epigenetic and cell death pathways. These findings support the clinical integration of nano-curcumin as an adjuvant therapy for surgical sepsis.

Longitudinal Observational Analysis of Traumatic Brain Injury Epidemiology and Pre-Hospital Intervals During the COVID-19 Pandemic in a West Java Tertiary Center Ni Wayan Lisa Suasti; Akhmad Imron; Guata Naibaho
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1517

Background: The COVID-19 pandemic necessitated large-scale social restrictions (PSBB) in Indonesia, drastically altering population mobility and, consequently, the landscape of neurotrauma. While the reduction in road traffic Incidents (RTIs) during lockdowns is well-documented, the collateral impact on the golden hour—the critical pre-hospital interval for traumatic brain injury (TBI) resuscitation—remains under-researched in lower-middle income countries (LMICs). This study analyzes the longitudinal shifts in TBI epidemiology, injury mechanisms, and hospital admission intervals across pre-pandemic, pandemic, and relaxation phases. Methods: This retrospective observational study analyzed 1,519 TBI patients admitted to the Emergency Department of Dr. Hasan Sadikin General Hospital (RSHS), a tertiary referral center in West Java, from January 2019 to December 2021. The cohort was stratified into three phases: Pre-Pandemic (2019), Pandemic/PSBB (2020), and Relaxation (2021). Variables included demographics, injury mechanisms, Glasgow Coma Scale (GCS), loss of consciousness (LOC), and Hospital Admission Interval (MRS). Results: Total TBI admissions exhibited a sharp V-shaped trend, decreasing by 75% in 2020 compared to 2019, driven by a collapse in RTI volume (490 to 107 cases). Admissions rebounded in 2021 (n=705). Males (78.4%) and young adults (15-24 years) constituted the majority, with RTI accounting for 74.78% of all mechanisms. While pediatric (0-4 years) and geriatric (≥65 years) groups were prone to falls, the most critical finding concerned pre-hospital delays. Despite reduced traffic density, only 3.23% of patients arrived within the golden hour (<1 hour). The majority (40.42%) arrived between 5-12 hours, and a significant cohort (17.44%) experienced delays exceeding 12 hours, indicating persistent systemic barriers to rapid care regardless of road conditions. Conclusion: The pandemic successfully suppressed TBI volume through mobility restrictions but failed to improve pre-hospital admission times. The persistence of significant delays (>5 hours) for the vast majority of patients highlights that the barriers to the golden hour in Indonesia are structural rather than traffic-dependent. Future trauma systems must address these pre-hospital inefficiencies to improve outcomes.

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Rachmat Hidayat

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Kab. ogan ilir,

Sumatera selatan

INDONESIA