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Rachmat Hidayat
Contact Email
dr.rachmat.hidayat@gmail.com
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Kab. ogan ilir,
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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
The Anicteric Giant: A Rare Case of Giant Choledocholithiasis and Multiple Cholelithiasis Presenting with Paradoxically Normal Bilirubin Profiles Sujek Miko Eka Putra; Mochammad Riskie Aditya Putra
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.v10i2.1518

Abstract

Background: Giant choledocholithiasis, defined as common bile duct (CBD) calculi exceeding 15 mm, typically presents with Charcot’s triad or marked biochemical cholestasis. The phenomenon of silent or anicteric giant stones remains a dangerous diagnostic blind spot. We present a rare case of a massive biliary stone burden presenting with paradoxically normal bilirubin and liver enzyme profiles, challenging standard screening algorithms. Case presentation: A 61-year-old female presented with a 12-month history of intermittent epigastric pain and nausea, initially misdiagnosed as gastritis. Despite the chronicity, she denied jaundice or fever. Biochemical analysis revealed a Total Bilirubin of 0.39 mg/dL (Reference: 0.1–1.2 mg/dL) and normal gamma-glutamyl transferase (GGT) levels, indicating an absence of biochemical obstruction. Magnetic resonance cholangiopancreatography (MRCP) identified multiple cholelithiasis and a solitary giant CBD stone. Intraoperative exploration confirmed a CBD dilated to 22 mm containing a calculus measuring 28 mm × 22 mm. Due to the massive ductal dilation and risk of recurrent stasis, the patient underwent a retrograde cholecystectomy followed by biliary reconstruction via Roux-en-Y choledochojejunostomy. Conclusion: Giant choledocholithiasis can exist in a silent phase due to ductal compliance and the ball-valve mechanism, rendering bilirubin an unreliable screening tool. This case underscores the necessity of cross-sectional imaging in chronic abdominal pain, even when biochemical markers are normal. Roux-en-Y reconstruction remains the definitive management for giant stones in significantly dilated ducts to prevent recurrence and sump syndrome.
Metabolic and Inflammatory Signatures of Neurotrauma: Correlating Early Glycemic and Leukocytic Shifts with Glasgow Coma Scale Scores Ni Wayan Lisa Suasti; Roland Sidabutar; Agung Budi Sutiono; Guata Naibaho
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1519

Abstract

Background: Traumatic brain injury (TBI) precipitates a profound systemic physiological stress response, often termed the sympathetic storm, characterized by neuroendocrine dysregulation and widespread inflammation. While admission biomarkers such as White Blood Cell (WBC) count and Blood Glucose levels are routinely measured, their comparative utility in stratifying injury severity—particularly in distinguishing between moderate and severe phenotypes—remains under-characterized. This study aimed to evaluate the discriminatory power of these markers, hypothesizing that metabolic and immune responses exhibit distinct saturation kinetics relative to the Glasgow Coma Scale (GCS). Methods: We conducted a retrospective analytical observational study at Dr. Hasan Sadikin General Hospital (RSHS), a level I trauma center in Bandung, Indonesia. From an annual pool of admitted neurotrauma patients (January–December 2021), a stratified sample of 238 patients aged 18-60 years was analyzed. Strict exclusion criteria were applied to minimize confounders, including a history of metabolic disease and alcohol intoxication. TBI severity was stratified into mild (GCS 13-15), moderate (GCS 9-12), and severe (GCS 3-8). Statistical analysis utilized the Kruskal-Wallis and Mann-Whitney tests to assess non-parametric relationships. Results: The cohort was predominantly male (82.8%) and young (18-40 years, 68.9%). Both biomarkers correlated with overall severity; however, their trajectories diverged significantly. WBC counts exhibited a threshold effect, rising significantly from Mild (17.50 ± 6.56 x10³/µL) to Moderate (18.81 ± 5.27 x10³/µL) severity, but plateauing between moderate and severe groups (p>0.05), suggesting a saturation of the demargination response. Conversely, blood glucose displayed a graded linear escalation: Mild (133.11 ± 34.53 mg/dL), moderate (158.35 ± 49.59 mg/dL), and severe (226.14 ± 105.61 mg/dL) (p<0.001), with significant discrimination across all severity pairings. Conclusion: Admission hyperglycemia serves as a superior, graded biomarker for stratifying TBI severity compared to leukocytosis, which functions primarily as a binary threshold marker. The observed immune plateau contrasts with the linear metabolic scaling, highlighting stress-induced hyperglycemia as a critical indicator of severe neuro-metabolic derangement.
The Hepatotoxicity and Adherence Advantage of Short-Course Rifapentine/Isoniazid (3HP) over Stratified Isoniazid Monotherapy (6H/9H): A Systematic Review and Meta-Analysis Agus Subhan; Rohani Lasmaria
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1520

Abstract

Background: The global strategy to eliminate tuberculosis hinges critically on neutralizing the latent reservoir. For decades, the standard of care has been daily Isoniazid monotherapy for 6 or 9 months. However, the effectiveness of this regimen is historically compromised by poor adherence due to its duration and significant rates of hepatotoxicity, particularly in older adults. The 3-month once-weekly regimen of Rifapentine plus Isoniazid offers a promising alternative, yet a consolidated high-level analysis comparing it specifically against stratified Isoniazid monotherapy across diverse high-risk groups was necessary to justify global policy shifts. Methods: We conducted a systematic review and meta-analysis of eight pivotal studies, including large-scale randomized controlled trials and programmatic surveillance studies. Outcomes included prevention of active tuberculosis, Grade 3/4 hepatotoxicity, and treatment completion. Data were pooled using a random effects model to account for clinical heterogeneity. Subgroup analyses stratified comparators by duration and administration method. Results: The analysis of over 10,000 participants revealed that the short-course regimen was non-inferior to isoniazid monotherapy for tuberculosis prevention (Pooled Risk Ratio 0.54; 95% CI 0.30–0.97). Crucially, the Rifapentine-based regimen demonstrated a profound reduction in grade 3/4 hepatotoxicity compared to Isoniazid monotherapy (Pooled Risk Ratio 0.16; 95% CI 0.08–0.32), with the benefit most pronounced in elderly populations. Treatment completion was significantly higher in the short-course group (Pooled Risk Ratio 1.25; 95% CI 1.15–1.36), with programmatic data confirming adherence exceeding 85% even under self-administration. Conclusion: The 3-month Rifapentine/Isoniazid regimen offers a superior safety profile and significantly higher treatment completion rates compared to Isoniazid monotherapy while maintaining equivalent efficacy. The regimen’s ability to minimize liver injury while maximizing adherence supports its adoption as a preferred standard of care, particularly for older adults.
The Uncoupling Phenomenon: Dissociation Between Albuminuria and Glomerular Filtration Rate in an Advanced Diabetic Kidney Disease Phenotype Naufal Fathi Ashari; Harun, Harnavi; Russilawati; Dinda Aprilia; SM Rezvi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1521

Abstract

Background: The classical paradigm of diabetic kidney disease (DKD) assumes a synchronous, linear trajectory where increasing albuminuria predicts the decline of glomerular filtration rate (GFR). However, emerging epidemiology suggests these markers may dissociate in advanced disease stages, particularly under modern renoprotective pharmacotherapy. We aimed to investigate this uncoupling phenomenon by evaluating the correlation between urine albumin creatinine ratio (UACR) and estimated GFR (eGFR) in a specific cohort of advanced DKD patients in Indonesia. Methods: We conducted a cross-sectional analytic study from January to November 2025 at Dr. M. Djamil General Hospital Padang, a tertiary referral center. The study population comprised 30 patients with established DKD, predominantly in CKD Stages 3b and 4. The primary outcome was the Spearman rank correlation (r) between UACR and eGFR, reported with 95% Confidence Intervals (CI). An exploratory sub-analysis compared trends in patients receiving SGLT2 inhibitors (n=12) versus standard care (n=18). Results: The cohort was elderly (mean age 61.93 years) with critical renal reserve depletion (median eGFR 32.50 mL/min/1.73 m²). Median UACR was 403.90 mg/g, yet exhibited massive heterogeneity (IQR: 170.82–1779.27). Spearman analysis revealed a complete lack of linear correlation between albuminuria and filtration function (r = 0.041; 95% CI: -0.322 to 0.395; p = 0.830). While SGLT2 inhibitor users (n=12) demonstrated numerically lower median UACR than non-users (n=18), the dissociation from eGFR persisted in both subgroups. Conclusion: We demonstrate a distinct dissociation between albuminuria severity and filtration function in advanced DKD. This uncoupling suggests that in late-stage nephropathy, structural glomerulosclerosis and tubulointerstitial fibrosis progress independently of permeability changes. Consequently, albuminuria cannot serve as a sole surrogate for disease progression in this phenotype, supporting a dual-biomarker strategy where UACR and eGFR are monitored as independent risk factors.
Sporadic Coexistence of Multiple Trichoepitheliomas and Solitary Neurofibroma: Mimicking Brooke–Spiegler Syndrome Rivano Frits Henry Pandaleke; Shienty Gaspersz; Ferra Olivia Mawu; Tara Sefanya Kairupan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1522

Abstract

Background: The simultaneous presentation of multiple adnexal tumors and neural sheath tumors on the face typically heralds a genodermatosis, most notably Brooke–Spiegler syndrome (BSS) or neurofibromatosis type 1 (NF1). The sporadic, non-syndromic coexistence of these entities in the same anatomical region is a diagnostic pitfall that challenges the principle of parsimony. Case presentation: We report the case of a 24-year-old Asian female presenting with a 12-month history of 18 disseminated, skin-colored papules restricted to the centrofacial region, followed by the rapid development of a 3.0 cm solitary tumor on the right buccal region. Dermoscopic evaluation revealed a dichotomy in tumor morphology: the papules exhibited ivory-white backgrounds with multiple rosette signs and milia-like cysts, while the buccal tumor displayed a structureless pink pattern with absence of pigment networks. Detailed physical examination ruled out cutaneous stigmata of NF1. Histopathological analysis confirmed the diagnosis of multiple trichoepitheliomas and a solitary localized neurofibroma based on characteristic morphological features, including papillary mesenchymal bodies and mast cell presence. Immunohistochemistry was not utilized due to setting-specific resource limitations. Conclusion: This case underscores the potential for sporadic benign tumors to mimic syndromic phenotypes (phenocopies). It highlights the critical importance of recognizing key hematoxylin and eosin morphological markers and clinical signs to establish accurate diagnoses in resource-limited settings where molecular genetics and immunohistochemical staining are unavailable.
The Silent Saboteur: Chronic Refractory Erythema Nodosum Leprosum Perpetuated by Neglected Odontogenic Foci in a Post-RFT Borderline Lepromatous Patient Antonio Orson Ongkowidjojo; Luh Made Mas Rusyati; Stefanus Soewito Sutanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1523

Abstract

Background: Erythema nodosum leprosum (ENL) is a severe, immune-complex mediated complication of lepromatous leprosy that can manifest before, during, or after multidrug therapy (MDT). While the primary etiology involves the release of Mycobacterium leprae antigens, the chronicity of ENL is frequently driven by secondary, often occult, triggers. Focal infections, particularly of odontogenic origin, are frequently overlooked in standard dermatological assessments, leading to refractory clinical courses. Case presentation: We report the case of a 32-year-old male with a history of borderline lepromatous (BL) leprosy who had achieved release from treatment (RFT). The patient presented with severe, chronic, and recurrent ENL characterized by painful erythematous nodules, high-grade fever, and acute neuritis, occurring more than one year post-RFT. Laboratory evaluation revealed significant inflammatory markers, including a C-Reactive Protein level of 172.7 mg/L and leukocytosis. Crucially, intraoral examination identified neglected chronic dental caries (gangrene radix) and generalized periodontal inflammation. Despite medical advice, the patient refused dental intervention. The reactional state was managed with a combination of intravenous methylprednisolone and high-dose oral clofazimine. While cutaneous symptoms improved, the persistence of the focal infection poses a substantial risk for further recurrence. Conclusion: This case highlights the critical and often underestimated role of odontogenic focal infections as perpetuating factors in chronic ENL. It underscores the necessity for a multidisciplinary approach integrating dentistry and dermatology. We propose that recalcitrant ENL in post-RFT patients should trigger mandatory screening for occult dental infections to disrupt the cycle of systemic inflammation.
Biallelic versus Monoallelic TP53 Inactivation in Hematologic Malignancies: A Comparative Meta-Analysis of Lymphoid and Plasma Cell Disorders Atika Indah Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1524

Abstract

Background: The tumor suppressor protein p53, encoded by the TP53 gene on chromosome 17p13.1, functions as the central guardian of genomic stability. In hematologic malignancies, including multiple myeloma (MM), chronic lymphocytic leukemia (CLL), and myelodysplastic syndromes (MDS), p53 dysfunction acts as a universal marker of chemoresistance and disease progression. Current clinical staging systems frequently conflate chromosomal deletion, or del(17p), with somatic mutation, thereby failing to distinguish between monoallelic (single-hit) and biallelic (double-hit) inactivation. This lack of granularity obscures the distinct biological consequences of these two states. This study aims to resolve the prognostic discordance between genomic subgroups in the context of modern therapeutic interventions. Methods: We conducted a comparative meta-analysis of nine pivotal studies comprising 4,125 patients, selected through a stringent protocol requiring paired cytogenetic (FISH) and molecular sequencing data. Patients were stratified into three genomic subgroups: Wild type, monoallelic disruption (isolated deletion or isolated mutation), and biallelic disruption (deletion plus mutation). Data were synthesized using a random-effects model to calculate pooled hazard ratios (HR) for Overall Survival (OS), with specific subgroup analyses performed for Plasma Cell versus Lymphoid malignancies to account for lineage heterogeneity. Results: The analysis revealed a profound prognostic dichotomy. In Multiple Myeloma, biallelic inactivation conferred a catastrophic prognosis with a pooled hazard ratio for death of 3.82 compared to Wild Type. Conversely, isolated del(17p) carried a significantly lower risk (HR 1.82), suggesting functional compensation by the residual allele. In CLL and Waldenström's Macroglobulinemia, TP53 mutations acted as independent drivers of poor survival (HR 2.80) even in the absence of deletion, consistent with a dominant-negative mechanism. The double hit phenotype was consistently associated with a median survival reduction exceeding fifty percent compared to monoallelic cases across all lineages. Conclusion: The prognostic weight of TP53 abnormalities is defined by allelic dosage. Biallelic inactivation represents a distinct, high-risk biological entity requiring novel therapeutic approaches, whereas monoallelic alterations often exhibit intermediate outcomes. Clinical guidelines must mandate sequencing alongside FISH to prevent misstratification and overtreatment.
Rapid Correction of Hypoalbuminemia and Promotion of Granulation Tissue in Pediatric Deep Partial-Thickness Burns via Targeted Immunonutrition: A Case Report Ni Kadek Ari Puji Astiti; Christian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1525

Abstract

Background: Pediatric burns induce a profound hypermetabolic and hypercatabolic state, distinct from adults due to limited physiological reserves and high growth demands. The rapid onset of negative nitrogen balance and hypoalbuminemia significantly impairs wound healing and immune function. Case presentation: We report the case of a 7-year-old male with pre-existing malnutrition (StrongKids Medium Risk) presenting with 23% total body surface area (TBSA) Grade IIB scald burns affecting the posterior humerus, lumbosacral, gluteus, and femoral regions. The patient exhibited acute hypoalbuminemia (2.3 g/dL) and anorexia due to pain. A specialized medical nutrition therapy (MNT) protocol was implemented using the Curreri Junior formula, targeting 2,500 kcal/day and 105 g protein/day. The intervention utilized a stepwise escalation of polymeric enteral nutrition enriched with immunonutrients (Glutamine, Zinc, and Vitamin C). Despite the severity of the injury, the patient demonstrated rapid nutritional rehabilitation. By day 5 of hospitalization, albumin levels normalized to 3.1 g/dL, and significant granulation tissue formation was observed. The patient achieved a weight gain of 0.4 kg during the acute phase, countering the expected catabolic weight loss. Conclusion: Early, aggressive, and calculated nutritional support incorporating specific immunonutrients can reverse the catabolic effects of thermal injury in pediatric patients. This case highlights the efficacy of the Curreri Junior formula combined with Glutamine and Zinc in accelerating wound closure and correcting biochemical markers in resource-limited settings.
Prevalence and Etiology of Ocular Morbidity in Maritime Environments: A Systematic Review and Meta-Analysis of Passenger and Crew Data Iska Novi Udayani; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita; I Made Ady Wirawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1526

Abstract

Background: The maritime environment constitutes a unique epidemiological enclosure characterized by isolation, specific occupational hazards, and distinct environmental stressors including hyper-salinity and high ultraviolet (UV) albedo. While gastrointestinal and respiratory outbreaks at sea are well-documented, the burden of ocular morbidity remains under-quantified. This study aims to determine the prevalence and etiology of ocular emergencies, stratifying risks between industrial seafarers (crew) and recreational travelers (passengers). Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Data were extracted from eight observational studies (2014–2024) covering expedition cruises, commercial shipping, and leisure voyages. To address population heterogeneity, a stratified analysis was performed: Track A analyzed occupational trauma in crew, while track B analyzed environmental morbidity in passengers. A random-effects model was used to calculate pooled proportions with 95% Confidence Intervals (CI), accompanied by a leave-one-out sensitivity analysis. Results: The dataset represented a combined population of over 5,000 maritime subjects. The pooled prevalence of ocular involvement in maritime trauma cases was 18.4% (95% CI: 12.1%–25.5%). Etiological analysis of crew injuries revealed a dominance of mechanical trauma, specifically metallic foreign bodies (40.5%), followed by chemical burns (26.2%). In contrast, passenger morbidity was driven by environmental factors (photokeratitis, dry eye) and infectious conjunctivitis. Conclusion: Ocular emergencies represent a significant, preventable burden in maritime travel, with distinct risk profiles for crew and passengers. The high rate of occupational trauma suggests a failure in personal protective equipment (PPE) compliance, while the environmental burden reflects the dry ship phenomenon. Mandatory protective eyewear policies and the integration of anterior-segment tele-ophthalmology are critical interventions.
Unmasking Organic Pathology in Pediatric Recurrent Abdominal Pain: Diagnostic Yield, Histopathological Discordance, and the Asian Enigma in a Tertiary Indonesian Setting Doni Andika Putra; Yusri Dianne Jurnalis
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (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.v10i3.1527

Abstract

Background: Recurrent abdominal pain (RAP) in children presents a complex diagnostic dichotomy between functional disorders and organic pathology. In Southeast Asia, this challenge is compounded by the Asian Enigma of variable Helicobacter pylori prevalence. This study evaluated the diagnostic yield of Esophagogastroduodenoscopy (EGD) and the correlation between macroscopic and histopathological findings in an Indonesian tertiary pediatric cohort. Methods: A retrospective, analytical cross-sectional study was conducted on 108 pediatric patients aged 1 to 18 years fulfilling Rome IV criteria for RAP between January 2022 and July 2025. EGD was performed, with biopsies taken based on macroscopic abnormalities or clinical suspicion (n=65). Diagnostic yield was calculated, and H. pylori prevalence was subjected to sensitivity analysis to account for non-biopsied patients. Multivariate logistic regression identified predictors of organic findings. Results: The cohort was predominantly female (65.7%) and adolescent (48.1%). The overall diagnostic yield for macroscopic abnormalities was 77.8%, dominated by macroscopic gastritis (39.8%). H. pylori infection was confirmed in 26.9% of the total cohort, rising to 44.6% (95% Confidence Interval: 32.5%–57.3%) among biopsied patients. Sensitivity analysis estimated the true prevalence range between 26.9% and 48.0%. Notably, in a subset of patients with normal macroscopic mucosa (n=10), 30% exhibited microscopic inflammation, indicating endoscopic-histologic discordance. Independent predictors of organic pathology included age over 10 years (adjusted Odds Ratio 2.41) and vomiting (adjusted Odds Ratio 3.12). Conclusion: EGD reveals a high burden of organic disease in Indonesian children with RAP, challenging the functional paradigm in this setting. The significant rate of H. pylori and potential microscopic inflammation in normal-appearing mucosa suggest that biopsy should be considered routine rather than targeted to avoid verification bias.

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