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Contact Name
Rachmat Hidayat
Contact Email
dr.rachmat.hidayat@gmail.com
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Journal Mail Official
dr.rachmat.hidayat@gmail.com
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Kab. ogan ilir,
Sumatera selatan
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 1,258 Documents
Short-Term Efficacy Versus Long-Term Maintenance of Pelvic Floor Muscle Training for Perinatal Urinary Incontinence: A Meta-Analysis of Randomized Controlled Trials Qonita Prasta Agustia; Rahajeng
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1597

Abstract

Background: Postpartum urinary incontinence remains a prevalent, profoundly debilitating complication following childbirth, significantly reducing maternal physical function and psychosocial quality of life. Pelvic floor muscle training is globally established as a conservative first-line treatment. However, the stark contrast between its immediate postnatal efficacy and its long-term maintenance remains inadequately synthesized in the current literature. The aim was to evaluate this chronological divergence. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Data were extracted from eligible trials assessing pregnant and postpartum women undergoing pelvic floor muscle training compared to standard care. Primary outcomes included the prevalence and severity of urinary incontinence evaluated at short-term (under one year) and long-term (over one year) intervals. Data were pooled utilizing a random-effects model, calculating risk ratios for dichotomous prevalence data and standardized mean differences for continuous severity scores. Results: Eight randomized controlled trials encompassing over two thousand participants were included. Short-term analysis demonstrated a highly significant reduction in urinary incontinence prevalence among women receiving the intervention (Pooled Risk Ratio 0.65, 95% Confidence Interval 0.52 to 0.81, P < 0.001) and a significant improvement in severity scores (Standardized Mean Difference -0.72, 95% Confidence Interval -0.95 to -0.49, P < 0.001). Conversely, long-term follow-up data evaluated at the seven-year milestone showed a completely diminished effect, with no statistically significant difference in urinary incontinence prevalence between the prior intervention and control groups (Pooled Risk Ratio 0.92, 95% Confidence Interval 0.78 to 1.08, P = 0.45). Conclusion: Structured pelvic floor muscle training provided substantial, rapid short-term efficacy in preventing and treating perinatal urinary incontinence. However, the initial anatomical and neuromuscular gains did not translate into long-term maintenance, highlighting a critical drop-off in behavioral adherence and the necessity for lifelong continuous booster interventions.
Efficacy and Safety of Intensive Blood Pressure Lowering on Cardiovascular Outcomes and Orthostatic Hypotension in Frail vs. Non-Frail Elderly Patients: A Systematic Review and Meta-Analysis Dian Arfan As Bahri; Rose Dinda Martini; Roza Mulyana; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1598

Abstract

Background: The management of hypertension in the older adult population presents a complex clinical challenge, particularly regarding the balance between cardiovascular risk reduction and the provocation of adverse events such as orthostatic hypotension. Frailty status complicates this dynamic, creating uncertainty regarding the optimal blood pressure target. Methods: A systematic review and meta-analysis investigated the efficacy and safety of intensive versus standard blood pressure lowering in frail compared to non-frail older adults. Databases were systematically searched for randomized controlled trials and their secondary analyses reporting cardiovascular outcomes and orthostatic hypotension stratified by frailty. Data were extracted and synthesized using a random-effects model, calculating pooled risk ratios and standardized mean differences to assess primary cardiovascular events and safety outcomes. Results: Ten primary studies met the inclusion criteria. Intensive blood pressure lowering significantly reduced the incidence of major cardiovascular events in both non-frail and frail cohorts. Surprisingly, intensive treatment did not increase the risk of orthostatic hypotension in frail patients and was associated with a protective effect against orthostatic hypotension in specific subsets. The risk of bias was generally low across the included trials. Conclusion: Intensive blood pressure control provides substantial cardiovascular benefits for older adults, irrespective of baseline frailty status. Furthermore, the aggressive lowering of blood pressure does not exacerbate the risk of orthostatic hypotension, challenging previous clinical hesitations. These findings support the cautious but deliberate implementation of intensive targets in the geriatric population, monitored closely by comprehensive geriatric assessments.
Clinicopathological Profiling and Skeletal Tropism of Bone Metastases in Breast Cancer: A 5-Year Retrospective Institutional Analysis in Central Java Gana Adyaksa; Benny Rizkillah Pratamayoga
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): 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.v10i6.1599

Abstract

Background: The skeletal system is the most frequent site of distant metastasis in breast cancer, precipitating severe skeletal-related events. Characterizing histological subtypes, molecular profiles, and precise skeletal distribution is essential for targeted surveillance. Methods: A retrospective analytical cohort study of 200 consecutive patients with radiologically documented bone metastasis was conducted at Dr. Kariadi General Hospital, Semarang, Central Java (2021–2025). Diagnosis required definitive confirmation via CT-scan or bone scintigraphy; clinical-only diagnoses were excluded. Primary metastatic burden was objectively defined by the largest lesion volume on imaging. World Health Organization (WHO) criteria were applied, subsuming invasive ductal carcinoma (IDC) into invasive breast carcinoma of no special type (NST). Immunohistochemical profiling and demographic data were extracted. Inferential statistics included Pearson Chi-Square and multivariate logistic regression to identify independent predictors of anatomical tropism, reporting Adjusted Odds Ratios (aOR) with 95% Confidence Intervals (CI). Results: The cohort was predominantly female (n=199, 99.5%), with a mean age of 54.2 (SD ± 8.5) years. Following WHO consolidation, NST comprised 90.0% (n=180) and Invasive Lobular Carcinoma (ILC) 10.0% (n=20). The axial skeleton harbored the primary burden in 82.5% of cases. ILC demonstrated a significantly distinct tropism, showing 50.0% appendicular involvement compared to 13.9% in NST. Multivariate logistic regression confirmed ILC as an independent predictor for appendicular metastasis (aOR 4.21, 95% CI 1.85–9.60, p=0.012). Conclusion: While NST exhibits a strong predilection for the axial skeleton, ILC uniquely favors appendicular dissemination. These findings mandate histology-specific diagnostic algorithms and targeted orthopedic surveillance.
Beyond PD-1/PD-L1: A Systematic Review and Meta-Analysis of LAG-3, TIGIT, and TIM-3 as Prognostic Biomarkers and Therapeutic Targets in Breast Cancer Dinar Kukuh Prasetyo; Widyanti Soewoto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1600

Abstract

Background: The therapeutic paradigm for breast cancer advanced significantly with programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) inhibitors. However, adaptive immune resistance, driven by compensatory upregulation of alternative checkpoints—Lymphocyte-activation gene 3 (LAG-3), T-cell immunoreceptor with Ig and ITIM domains (TIGIT), and T-cell immunoglobulin and mucin-domain containing-3 (TIM-3)—limits durable responses. This study aimed to quantitatively synthesize the prognostic significance, tumor microenvironment interactions, and translational surgical implications of these biomarkers in breast cancer. Methods: A systematic literature search (PubMed, Embase, Cochrane) identified original research evaluating LAG-3, TIGIT, and TIM-3 expression in breast cancer cohorts. Data extraction focused on overall survival (OS) hazard ratios (HR), standardized mean differences (SMD) for tumor-infiltrating lymphocyte (TIL) density, and pathological complete response (pCR) rates. Random-effects meta-analyses generated forest plots, assessed heterogeneity (I-squared), and evaluated publication bias via funnel plots. Results: Eight major cohorts comprising over 7,200 patients were included. High LAG-3 expression on TILs in triple-negative breast cancer (TNBC) was significantly associated with improved OS (Pooled HR 0.88, 95% CI 0.81-0.95, p=0.002) and higher pCR rates following neoadjuvant chemotherapy. Conversely, elevated TIGIT expression in primary tumors correlated with poorer OS (Pooled HR 1.58, 95% CI 1.18-2.11, p=0.004) and increased locoregional recurrence risk. TIM-3 demonstrated dual prognostic value: favorable in basal-like subtypes but detrimental in luminal subtypes. Funnel plots indicated minimal publication bias. Conclusion: LAG-3, TIGIT, and TIM-3 function as distinct, non-redundant biomarkers. LAG-3 signifies a primed, actionable immune response, whereas TIGIT and TIM-3 indicate severe immune exhaustion. Mapping these profiles provides critical translational value for optimizing personalized surgical timing, predicting neoadjuvant downstaging, and selecting adjuvant immunotherapies.
The Clinical Trade-off between Rapid Hemodynamic Stabilization and Respiratory Morbidity in Pediatric Dengue Shock Syndrome: A Meta-Analysis of Colloid versus Crystalloid Resuscitation Ni Nyoman Putri Widyastiti; I Nyoman Putra Arcana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1601

Abstract

Background: Fluid resuscitation is the cornerstone therapy for pediatric Dengue Shock Syndrome (DSS), a condition defined by profound endothelial hyperpermeability. The choice between crystalloids and colloids presents a clinical paradox. Crystalloids are standard first-line therapies, whereas colloids offer rapid intravascular expansion for refractory shock. This study quantifies the trade-off between the rapid hemodynamic stabilization provided by colloids and the subsequent iatrogenic risk of respiratory morbidity in pediatric DSS. Methods: Following PRISMA guidelines, a systematic review and meta-analysis were conducted. We searched MEDLINE, Scopus, and Cochrane databases for original randomized controlled trials (RCTs) and cohort studies comparing crystalloid and colloid regimens in pediatric DSS. To address methodological heterogeneity, efficacy outcomes (time to hemodynamic stabilization) from RCTs and safety outcomes (respiratory morbidity) from observational cohorts were analyzed separately. Standardized mean differences (SMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models. Results: Seven studies encompassing 2,477 pediatric patients were included. Meta-analysis of RCTs demonstrated that colloid-containing regimens achieved significantly faster initial hemodynamic stabilization compared to crystalloid-only regimens (SMD -0.62, 95% CI -0.85 to -0.39). Conversely, meta-analysis of cohort data revealed that mixed or colloid-heavy regimens were associated with a markedly increased risk of respiratory morbidity and mechanical ventilation requirements (OR 2.45, 95% CI 1.68 to 3.57). Overall shock recovery was prolonged in mixed-fluid groups. Conclusion: A definitive clinical trade-off exists in pediatric DSS management. Colloids rapidly restore early hemodynamics but significantly increase late-stage respiratory morbidity and ventilation requirements. This supports a restrictive, crystalloid-first resuscitation strategy. Future randomized trials are urgently needed to specifically evaluate the safety of natural colloids, such as 5% albumin, versus synthetic starches and gelatins.
Serum Neurofilament Light Chain as a Discriminatory Biomarker and Predictor of Disease Trajectory in Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis Cindy Permata Sari; I Ketut Sumada; Desie Yuliani; Ni Made Kurnia Dwi Jayanthi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): 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.v10i6.1602

Abstract

Background: Amyotrophic lateral sclerosis is a rapidly progressive, fatal neurodegenerative disorder characterized by the deterioration of upper and lower motor neurons. Diagnostic delays are frequently caused by phenotypic overlap with various mimic disorders. Serum neurofilament light chain has emerged as a promising biomarker; however, its precise discriminatory capacity against mimics and its utility in predicting disease trajectory necessitate rigorous quantitative evaluation. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of MEDLINE/PubMed, Embase, Cochrane Central, and Scopus was conducted. Eight high-quality primary research articles met the strict inclusion criteria for data extraction. Studies evaluating diagnostic utility (amyotrophic lateral sclerosis versus mimic disorders) and prognostic value (survival hazard ratios) were included. Random-effects models calculated pooled standardized mean differences for diagnostic accuracy and pooled hazard ratios for overall survival. Results: The meta-analysis analyzed data from 8 cohorts. Serum neurofilament light chain levels were significantly elevated in amyotrophic lateral sclerosis patients compared to mimic disorders, yielding a pooled standardized mean difference of 1.43 (95% confidence interval: 1.15 to 1.71, p < 0.001). High heterogeneity was observed (I-squared = 82%). For prognostic evaluation, a pilot quantitative synthesis of two cohorts demonstrated that higher baseline concentrations correlated with increased mortality risk, showing a pooled hazard ratio of 1.95 (95% confidence interval: 1.58 to 2.41, p < 0.001). Conclusion: Serum neurofilament light chain is a robust discriminatory biomarker capable of distinguishing amyotrophic lateral sclerosis from confounding mimic disorders. Furthermore, baseline concentrations offer prognostic value for survival outcomes. These findings support the cautious integration of this biomarker into clinical algorithms, though broader multi-center prognostic studies are required.
Diagnostic Accuracy of the Triglyceride-Glucose (TyG) Index for Identifying Advanced Chronic Kidney Disease in Type 2 Diabetes: A Cross-Sectional Analysis Mathias Wahyu Manumpak Lumbantobing; Nindia Sugih Arto; Sylvia Youvella; Ricke Loesnihari; Mohammad Riza Lubis; Ranti Permata Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i6.1604

Abstract

Background: Chronic kidney disease (CKD) is a debilitating microvascular complication of type 2 diabetes mellitus (T2DM), fundamentally exacerbated by systemic insulin resistance and glucolipotoxicity. The triglyceride-glucose (TyG) index is emerging as a practical surrogate for insulin resistance. This study aims to evaluate the diagnostic accuracy of the TyG index in identifying advanced CKD among adults with T2DM. Methods: A cross-sectional analysis was conducted on 44 adult T2DM patients with CKD at a tertiary referral hospital. To establish an adequate diagnostic threshold, advanced CKD was explicitly defined as an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 (Stages IV and V). Patients were statistically stratified into three equal tertiles based on their TyG index. Diagnostic performance was evaluated using the Receiver Operating Characteristic (ROC) curve analysis. Results: The median eGFR demonstrated a severe, statistically significant decline across increasing TyG tertiles (Tertile I: 54.09; Tertile II: 36.42; Tertile III: 19.12 mL/min/1.73 m2; p < 0.001). ROC analysis revealed a strong diagnostic profile for identifying advanced CKD, yielding an Area Under the Curve (AUC) of 0.756 (95% CI: 0.595–0.916, p = 0.002). An optimal cut-off value of 8.81 provided a sensitivity of 89.5% (95% CI: 66.9–98.7%), a specificity of 60.0% (95% CI: 38.7–78.9%), a positive predictive value of 63.0% (95% CI: 42.4–80.6%), and a negative predictive value of 88.2% (95% CI: 63.6–98.5%). Conclusion: The TyG index is strongly associated with renal decline in T2DM. It serves as a highly accessible, adjunctive screening tool to stratify patients at risk for severe renal impairment.
The Paradoxical Prognostic Value of Endogenous Melatonin in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Mild-to-Moderate versus Malignant Infarctions Merry Angeline; Desak Ketut Indrasari Utami; Kumara Tini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 6 (2026): 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.v10i6.1607

Abstract

Background: Acute ischaemic stroke (AIS) is a leading global cause of morbidity and mortality. While endogenous melatonin is widely proposed as a neuroprotectant, recent clinical evidence suggests a paradoxical, severity-dependent prognostic relationship. This meta-analysis synthesises evidence regarding this paradox and its prognostic implications. Methods: A systematic search of major databases through March 2026 identified observational studies correlating endogenous melatonin levels with AIS clinical outcomes. Data were stratified by stroke severity phenotype, and standardised mean differences were calculated using random-effects meta-regression models. Results: Ten observational studies comprising 847 AIS patients were included. A striking paradox emerged: in patients with mild-to-moderate stroke, lower melatonin concentrations were associated with poor clinical outcomes. Conversely, in malignant middle cerebral artery infarctions, higher melatonin concentrations were paradoxically linked to worse clinical outcomes, including increased mortality. Extreme overall heterogeneity (I²=97.85%) was substantially resolved (I²=0%) upon proper severity stratification. Conclusion: The prognostic implications of endogenous melatonin fundamentally differ according to stroke severity phenotype. This severity-dependent paradox likely reflects context-dependent alterations in melatonin signalling pathway efficacy. Mechanistic investigations and well-designed prospective trials are urgently warranted to elucidate the underlying pathophysiology.

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