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Rachmat Hidayat
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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 1,509 Documents
Comparative Effectiveness of Channa micropeltes Albumin Extract Versus Human Albumin on Lactate and Central Venous Oxygen Saturation as Predictors of Mortality in Critically Ill Patients with Hypoalbuminemia: A Double-Blind Randomized Controlled Trial Purwoko; Bambang Novianto Putro; Juliana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (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.v10i8.1645

Abstract

Background: Hypoalbuminemia is highly prevalent in critically ill patients and is linked to impaired tissue perfusion and increased mortality. Human albumin is the gold-standard replacement but is costly and largely imported. Channa micropeltes (giant snakehead) albumin extract is a potential economical local alternative, yet comparative evidence on tissue-perfusion biomarkers—lactate and central venous oxygen saturation (ScvO2)—as predictors of mortality is scarce. Methods: A double-blind randomized controlled trial in the intensive care unit of Dr. Moewardi Regional General Hospital, Surakarta, enrolled 32 adults with serum albumin <2.8 g/dL randomized to oral Channa micropeltes extract 5 g every 12 h (n=16) or intravenous 20% human albumin (n=16) for three days. Lactate and ScvO2 were sampled via central venous catheter on day 0 and day 3; mortality was followed to day 4. Analyses included repeated-measures ANOVA, Cohen's d, ROC curves and multivariable logistic regression. Results: Lactate fell in both arms (Channa 5.29±1.32 to 3.52±1.00; human 5.31±0.94 to 3.63±1.09 mmol/L; both p<0.001; d≥1.5) and ScvO2 rose (Channa +10.53%; human +9.54%; both p<0.001), with no between-group difference (Δ lactate p=0.812; Δ ScvO2 p=0.620). Day-3 biomarker AUCs for mortality were 0.572 and 0.498. Albumin type was not associated with mortality (adjusted OR 0.354; 95% CI 0.067–1.862; p=0.220; NNT 16). No serious adverse events occurred. Conclusion: Channa micropeltes albumin extract was non-inferior to human albumin for restoring tissue-perfusion biomarkers, supporting its potential as an economical, locally available alternative in critically ill patients with hypoalbuminemia.
Early Individualized Medical Nutrition Therapy in Recurrent Luminal B Breast Cancer Complicated by Post-Chemotherapy Febrile Neutropenia and Pancytopenia with Moderate Malnutrition: A Case Report Arisita Andy Putri; Ni Made Dwi Asti Lestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (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.v10i8.1646

Abstract

Background: Breast cancer is the most common malignancy among women, and malnutrition affects approximately 30–50% of hospitalized patients with cancer, independently increasing treatment-related toxicity, prolonging hospitalization, and worsening survival. When cytotoxic chemotherapy precipitates febrile neutropenia and pancytopenia, reduced intake, systemic inflammation, and bone-marrow suppression converge, yet nutritional care is frequently deprioritized during the neutropenic nadir. Case presentation: A 58-year-old woman with recurrent left breast cancer (luminal B subtype), previously treated with mastectomy and three chemotherapy cycles, presented with two weeks of anorexia, fever (40.6 °C), vomiting, diarrhea, and 3 kg weight loss. Anthropometry showed a body mass index of 17.6 kg/m2 and a mid-upper-arm circumference of 23 cm; laboratory testing confirmed febrile neutropenia (absolute neutrophil count 0.05 ×103/µL) with pancytopenia and hypoalbuminemia (2.7 g/dL). She met three phenotypic and two etiologic Global Leadership Initiative on Malnutrition (GLIM) criteria, establishing moderate malnutrition. Alongside supportive care and granulocyte colony-stimulating factor, individualized medical nutrition therapy targeting 2,100 kcal/day and 90 g protein/day was delivered as a soft oral diet with a peptide-based oral nutritional supplement and vitamin B12. Oral intake rose from 50% or less to 86% by day three and 93% by day four; over six days, weight, appetite, physical function, and all hematologic indices recovered, and she was discharged stable. Conclusion: Early, individualized medical nutrition therapy initiated before severe malnutrition develops can support concurrent nutritional, immune, and hematologic recovery in breast cancer patients with post-chemotherapy hematologic toxicity. Routine nutritional screening and prompt, protein-focused intervention should be integrated into oncology care.
Mycological Culture Profile and Clinical Predictors of Culture Positivity in Dermatophytosis: A Four-Year Retrospective Study at a Tertiary Referral Hospital in Bali, Indonesia Ni Luh Putu Ratih Vibriyanti Karna; Antonio Orson Ongkowidjojo; Ida Ayu Ketut Ariningsih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (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.v10i8.1647

Abstract

Background: Dermatophytosis is the commonest superficial mycosis, yet the aetiological spectrum in eastern Indonesia and the determinants of a positive fungal culture remain poorly characterised. We aimed to describe the mycological culture profile and identify predictors of culture positivity at a tertiary referral centre in Bali. Methods: This STROBE-compliant retrospective cross-sectional study analysed 214 consecutively sampled patients with dermatophytosis at the Dermatology and Venereology clinic of Ngoerah Hospital, Denpasar, between January 2020 and December 2023. Potassium-hydroxide (KOH) microscopy and Sabouraud culture data were extracted from records. Proportions carried 95% Wilson confidence intervals (CI); associations were assessed by chi-square/Fisher tests with odds ratios and Cramér's V, followed by multivariable logistic regression (adjusted odds ratio [aOR], Nagelkerke R²) and receiver-operating-characteristic analysis. Results: Mean age was 42.7 years and the male-to-female ratio 1.68:1; Fitzpatrick phototype IV predominated (51.9%). Culture was positive in 138 patients (64.5%; 95% CI 57.9–70.6). Trichophyton rubrum was the leading isolate (50.0%; 95% CI 41.8–58.2), followed by the T. mentagrophytes complex (15.9%) and Microsporum canis (10.1%); anthropophilic species comprised 81.2%. KOH positivity (aOR 5.20; 95% CI 2.27–11.87; p<0.001) independently predicted culture positivity, whereas prior antifungal use was protective (aOR 0.30; 95% CI 0.13–0.65; p=0.002); the model discriminated well (AUC 0.785; 95% CI 0.715–0.855). Conclusion: Dermatophytosis in Bali is dominated by anthropophilic T. rubrum, and culture yield is governed chiefly by prior antifungal exposure and KOH status, supporting a stewardship-oriented diagnostic pathway in which culture is prioritised for KOH-positive, treatment-naive and recalcitrant presentations.
When Bleeding Stops but Organs Fail: Fatal Multiple Organ Dysfunction Syndrome Following Massive Atonic Postpartum Haemorrhage in a Young Primipara — A Case Report Rina Gustuti; Arianti Arifin; Yusrawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1648

Abstract

Background: Postpartum haemorrhage from uterine atony can precipitate profound haemorrhagic shock within minutes, and in resource-constrained referral systems the interval between the onset of bleeding and definitive source control is frequently the decisive determinant of survival. Objective: To document, in granular day-by-day detail, the evolution of fatal multiple organ dysfunction syndrome following massive atonic postpartum haemorrhage in a young woman with no antecedent organ disease, and to translate that trajectory into transferable lessons for haemorrhage systems in resource-limited settings. Case presentation: We describe a 28-year-old primipara referred four hours after a vacuum-assisted vaginal delivery of twins complicated by severe pre-eclampsia. On arrival she was stuporous, hypotensive (70/68 mmHg), tachycardic (142 beats/min) and oliguric, with active vaginal bleeding and a haemoglobin of 2.4 g/dL. Resuscitation and haemorrhage control proceeded in parallel: high-flow oxygen, dual large-bore access, crystalloid and colloid loading, tranexamic acid, balanced blood-component transfusion, bimanual compression, intubation and emergency laparotomy. A flaccid, bluish, atonic uterus and a fourth-degree perineal tear were identified; subtotal hysterectomy with sphincteroplasty and perineorrhaphy achieved haemostasis. Despite massive transfusion and intensive care, prolonged hypoperfusion evolved into ischaemic hepatitis, severe coagulopathy, stage III acute kidney injury requiring haemodialysis, hospital-acquired pneumonia with drug-resistant sepsis, acute pulmonary oedema and upper gastrointestinal bleeding. Progressive multiple organ dysfunction syndrome culminated in asystolic cardiac arrest on postoperative day 15. Conclusion: This case illustrates a principle easily overlooked: definitive surgical haemostasis does not reverse organ injury already committed during the pre-operative shock interval. Objective cumulative blood-loss measurement, immediate haemorrhage-bundle and massive-transfusion protocol activation, explicitly documented uterotonic therapy, rapid balanced resuscitation and structured post-haemostasis organ surveillance are the interventions most likely to interrupt the lethal trajectory.
Higher Ictal EEG Amplitude Predicts Greater PANSS Improvement in Schizophrenia Patients Undergoing Electroconvulsive Therapy: A Two-Group Analytical Study in Surakarta, Indonesia Cindy Berlian Sulaeman; Debree Septiawan; Adriesti Herdaetha
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1649

Abstract

Background: Schizophrenia frequently responds incompletely to antipsychotics, and electroconvulsive therapy (ECT) remains an important somatic augmentation for severe or treatment-resistant disease; however, the neurophysiological determinants of ECT response are shifting from seizure duration toward ictal electroencephalographic (EEG) quality, of which peak ictal amplitude is a putative but under-tested marker. Objective: To determine whether peak ictal EEG amplitude predicts the magnitude of symptomatic improvement, measured by the Positive and Negative Syndrome Scale (PANSS), in schizophrenia patients undergoing electroconvulsive therapy. Methods: This analytical two-group study at RSJD dr. Arif Zainuddin, a tertiary psychiatric hospital in Surakarta, Central Java, Indonesia, enrolled 36 consecutively sampled inpatients (18 per group) with DSM-5-TR/ICD-11-confirmed schizophrenia undergoing ECT, reported per STROBE. Peak ictal EEG amplitude was dichotomised at 1000 µV; the Positive and Negative Syndrome Scale (PANSS), applied by trained raters using the validated Indonesian adaptation, was measured before and after the ECT course. Analyses included paired and independent t-tests, correlation, receiver-operating-characteristic (ROC) analysis, and multivariable linear and penalised logistic regression. Results: Both groups improved (both paired p<0.001), but the ≥1000 µV group achieved markedly greater total-PANSS reduction (34.7±9.2 vs 23.2±8.5 points; mean difference 11.5, 95% CI 5.5–17.5; t(34)=3.90; p=0.0004; Cohen d=1.30) and higher ≥30% response (72.2% vs 16.7%). Continuous amplitude correlated with PANSS reduction (r=0.73, p<0.001), the adjusted odds ratio for response was 4.85 (95% CI 1.56–15.06), and amplitude discriminated responders well (AUC 0.88; Youden cut-off ~1093 µV; sensitivity 81%, specificity 90%). Conclusion: Higher ictal EEG amplitude independently predicts greater symptomatic improvement in schizophrenia, supporting routine intra-procedural amplitude monitoring to optimise therapeutic seizure quality, particularly in resource-constrained psychiatric practice.
Admission Systemic Immune-Inflammation Index and Its Association with High Thrombus Burden and No-Reflow in ST-Segment Elevation Myocardial Infarction: A Retrospective Cohort Study Wayan Ardyana Prastara; Hendy Wirawan; I Kadek Susila Surya Darma; I Made Junior Rina Artha; I Made Putra Swi Antara; I Wayan Gede Artawan Eka Putra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1650

Abstract

Background: ST-segment elevation myocardial infarction (STEMI) is a thrombo-inflammatory emergency, and successful epicardial recanalisation during primary percutaneous coronary intervention (PCI) does not always restore myocardial perfusion. The Systemic Immune-Inflammation Index (SII), derived from routine platelet, neutrophil and lymphocyte counts, may reflect thrombo-inflammatory risk. Objective: This study evaluated the association of admission SII with high thrombus burden and no-reflow in STEMI patients undergoing primary PCI. Methods: This STROBE-compliant retrospective cohort study consecutively sampled 118 STEMI patients at Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar. High thrombus burden was defined as TIMI thrombus grade 4-5 and no-reflow as post-procedural TIMI flow grade =2. The optimal SII cut-off was derived by receiver operating characteristic analysis (Youden index); associations were assessed with chi-square/Fisher tests and modified Poisson regression with robust standard errors. Results: High thrombus burden occurred in 99 patients (83.9%) and no-reflow in 16 (13.6%). High SII was associated with high thrombus burden (90.8% vs 75.5%; relative risk 1.203, 95% CI 1.013-1.428; p=0.025) and no-reflow (20.0% vs 5.7%; relative risk 3.53, 95% CI 1.062-11.753; p=0.024), persisting after adjustment (adjusted relative risk 1.194 and 3.226, respectively). Discrimination was weak-to-modest (AUC 0.597 and 0.674). Conclusion: Admission SII was independently associated with high thrombus burden and no-reflow but had insufficient accuracy for standalone prediction, supporting its role as a simple adjunctive marker rather than a definitive predictor.
Synergistic Reduction of TNF-α by Combined Ursodeoxycholic Acid and Multi-Strain Probiotics in a Rat Model of Cholestasis Muhammad Hasbi Nur; Erik Prabowo; Sigit Adi Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1651

Abstract

Background: Cholestasis is a complex hepatobiliary disorder in which impaired bile flow provokes a sustained inflammatory response, with tumor necrosis factor-alpha (TNF-α) acting as a central pro-inflammatory mediator. Ursodeoxycholic acid (UDCA) is the first-line therapy, but a substantial subset of patients responds incompletely, motivating adjunctive strategies that target extrahepatic, gut-derived drivers of inflammation through the gut–liver axis. Objective: To evaluate whether multi-strain probiotics potentiate the anti-inflammatory (TNF-α–lowering) effect of ursodeoxycholic acid (UDCA) in experimental cholestasis. Methods: This randomised, post-test-only controlled experimental study was reported in accordance with ARRIVE 2.0 guidelines. Thirty-five male Sprague-Dawley rats were randomised into seven groups (n=5): healthy control (K1), disease control (K2), UDCA monotherapy (K3), probiotic monotherapy (K4), and three UDCA plus dose-escalating probiotic combinations (K5–K7). Cholestasis was induced by common bile duct ligation; interventions ran for 21 days. Serum TNF-α was quantified by ELISA and analysed with one-way ANOVA, Tukey HSD and Games-Howell post hoc tests, effect sizes, and dose-response regression. Results: TNF-α differed markedly across groups (F(6,28)=783.5, p<0.001, η²=0.994). Ligation raised TNF-α from 5.69±0.25 pg/mL (K1) to 17.88±0.43 pg/mL (K2; p<0.001, Cohen's d=34.7). Both monotherapies reduced TNF-α (K3 14.91±0.49; K4 12.50±0.32; both p<0.001), but combination therapy achieved significantly greater suppression, lowest in K7 (7.91±0.18 pg/mL; 55.8% reduction; 81.8% normalisation toward healthy). A significant dose-dependent decline occurred across combination groups (slope=−0.113 pg/mL per mg, r=−0.94, R²=0.89, p<0.001). Conclusion: Combined UDCA and probiotics produce a synergistic, dose-dependent reduction of TNF-α in experimental cholestasis, supporting probiotics as a rational adjunct targeting the gut–liver axis and warranting translational evaluation in cholestatic patients.
Laser Haemorrhoidoplasty versus Stapled Haemorrhoidopexy for Grade II–III Haemorrhoidal Disease: A Systematic Review and Meta-Analysis of Postoperative Pain and Perioperative Outcomes Ricky Dwi Nur Tyastono; Muhammad Fahmi Salafuddin
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1652

Abstract

Background: Postoperative pain and delayed recovery are the principal drawbacks of excisional haemorrhoid surgery, and two minimally invasive alternatives — laser haemorrhoidoplasty (LH) and stapled haemorrhoidopexy (SH) — are increasingly used to overcome them. Although each has repeatedly been compared with conventional haemorrhoidectomy, the direct head-to-head evidence comparing LH with SH has never been pooled quantitatively. Objective: This systematic review and meta-analysis compared the perioperative, early postoperative pain and safety outcomes of LH and SH in adults with symptomatic haemorrhoidal disease. Methods: PubMed, Scopus-indexed journals, Crossref and Google Scholar were searched systematically for randomised and comparative studies directly comparing LH with SH. Ten studies were included and seven contributed poolable data. Random-effects models (DerSimonian–Laird, with Hartung–Knapp–Sidik–Jonkman intervals for inference on continuous outcomes) generated risk ratios (RR) for dichotomous outcomes and standardised mean differences (SMD, Hedges g) for continuous outcomes; raw mean differences were reported for interpretability. Risk of bias was appraised with RoB 2 and ROBINS-I, and the certainty of evidence was rated for each outcome. Results: Laser haemorrhoidoplasty was associated with a significantly shorter operative time (SMD −1.65, 95% CI −2.47 to −0.84; p<0.001; approximately 8 minutes shorter on average), a shorter hospital stay (SMD −3.07, 95% CI −5.58 to −0.55; p=0.017) and a non-significant trend toward less intraoperative blood loss (SMD −2.30, 95% CI −4.74 to 0.13; p=0.064). Early postoperative pain (≤24 h) did not differ significantly on pooling (SMD −0.66, 95% CI −1.95 to 0.63; p=0.32; I² 98%); this reflected a time-dependent crossover in which LH was less painful in the first hours but SH became less painful from 24 hours onward. Overall complications favoured LH numerically but not significantly (RR 0.58, 95% CI 0.25 to 1.30; p=0.18), an advantage confined to short-follow-up studies and reversed in the single 24-month trial. Recurrence, bleeding, anal stenosis and urinary retention were comparable. The certainty of evidence was low to very low for all outcomes. Conclusion: Laser haemorrhoidoplasty offered consistent intraoperative advantages over stapled haemorrhoidopexy, whereas early pain and safety were comparable and duration of follow-up was the dominant effect-modifier. Both are reasonable minimally invasive options; technique selection should be individualised pending adequately powered long-term trials.
Surgical Outcomes and Recurrence in Adult Abdominal Cocoon (Sclerosing Encapsulating Peritonitis): A Systematic Review and Meta-Analysis of Pooled Proportions Eko Nur Febrianto; Zuldi Erdiansyah; Reno Rudiman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (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.v10i9.1653

Abstract

Background: Abdominal cocoon, also termed sclerosing encapsulating peritonitis (SEP) or encapsulating peritoneal sclerosis (EPS), is a rare cause of intestinal obstruction in which the small bowel is encased within a fibrocollagenous membrane, producing the prototypical frozen abdomen. Its surgical outcomes had never been pooled quantitatively. Objective: To quantitatively pool the surgical outcomes of adult abdominal cocoon — peri-operative mortality, morbidity, recurrence and pre-operative diagnostic yield — in patients undergoing operative management. Methods: PubMed, Scopus, the Cochrane Library and Google Scholar were searched for observational studies reporting the operative management and outcomes of adult abdominal cocoon. Ten case series (179 operated patients) were included. As all studies were single-arm, proportions were pooled with the Freeman–Tukey transformation under a DerSimonian–Laird random-effects model; robustness was tested with a logit-normal model, leave-one-out analysis and the Egger test, and quality with the Joanna Briggs Institute checklist. Results: Pooled peri-operative mortality was 4.5% (95% CI 0.2–12.1%; k=7); because zero-event studies influence the double-arcsine transformation, a logit-normal model gave 13.1% and the crude proportion 7.9%, so mortality is best summarised as low-to-moderate. Pooled morbidity was 19.5% (95% CI 5.9–36.9%; k=5), recurrence 3.3% (95% CI 0.0–21.8%; k=3) and pre-operative diagnostic yield 19.1% (95% CI 6.0–36.0%; k=4). Leave-one-out kept mortality between 3.0% and 8.5%. Conclusion: Surgery for adult abdominal cocoon achieved low-to-moderate mortality and acceptable morbidity with infrequent recurrence, supporting membrane excision and adhesiolysis in selected patients, while the low pre-operative diagnostic rate signals a need for greater awareness.

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