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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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Unmasking BRASH Syndrome: A Rare and Reversible Cause of Cardiovascular Collapse in the Elderly Milhan El-Yamani Karim; Tawang Handayani; Hardianti Hardmi Putri; Setiawan Widodo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1304

Background: BRASH syndrome (Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia) is an increasingly recognized but still underdiagnosed condition, particularly in elderly patients with multiple comorbidities and those taking AV nodal blocking agents. It represents a synergistic interplay between these factors, leading to a potentially life-threatening state of cardiovascular collapse. This case report aims to highlight the clinical presentation, diagnostic challenges, and successful management of BRASH syndrome in an elderly female patient. Case presentation: A 65-year-old female with a history of stage 4 chronic kidney disease and congestive heart failure (ejection fraction of 65%) presented to the emergency department with worsening vomiting over the past week, generalized weakness, dizziness, and palpitations. Her medication list included amlodipine, bisoprolol, candesartan, nitrokaf, furosemide, and aminoral. On examination, she was hypotensive with a blood pressure of 90/60 mmHg and bradycardic with a heart rate of 40 beats per minute. An electrocardiogram (ECG) revealed a junctional escape rhythm with a heart rate of 38 beats per minute and a left bundle branch block. Laboratory investigations showed severe hyperkalemia (potassium 8.1 mmol/L), hyponatremia (sodium 113 mmol/L), elevated creatinine (4.06 mg/dL), and urea (112.3 mg/dL). Conclusion: This case underscores the importance of recognizing BRASH syndrome as a distinct clinical entity, especially in elderly patients with pre-existing cardiac and renal conditions who are on AV nodal blocking medications. Prompt diagnosis and management, focusing on correcting hyperkalemia, discontinuing offending medications, and providing supportive care, can lead to favorable outcomes and prevent potentially fatal complications. Increased awareness and further research are crucial for establishing standardized guidelines for the diagnosis and management of this underrecognized syndrome.

Efficacy of Hematopoietic Stem Cell Transplantation with CCR5Δ32 Homozygous Donors in Achieving Sustained HIV-1 Remission: A Systematic Literature Review Paishal Mizan; Raveinal; Dwitya Elvira
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1305

Background: The pursuit of a cure for Human Immunodeficiency Virus type 1 (HIV-1) infection has led to the exploration of innovative therapeutic strategies. Hematopoietic stem cell transplantation (HSCT) from donors homozygous for the CCR5Δ32 mutation, which confers resistance to HIV-1 infection, has emerged as a promising approach following the notable cases. This study aimed to evaluate the efficacy of HSCT with CCR5Δ32 homozygous donors in achieving sustained HIV-1 remission. Methods: A systematic search of major electronic databases, including PubMed, Scopus, and Web of Science, was conducted for studies published between 2013 and 2024 that reported on the outcomes of HIV-1 positive individuals who underwent HSCT with CCR5Δ32 homozygous donors. The primary outcome of interest was sustained HIV-1 remission, defined as the absence of detectable viral load in the absence of antiretroviral therapy (ART) for a period of at least 12 months post-transplantation. Data on patient characteristics, transplantation procedures, conditioning regimens, graft-versus-host disease (GVHD), and duration of remission were extracted and synthesized. Results: Five case studies met the inclusion criteria. These studies predominantly involved individuals with advanced HIV-1 infection who also had hematological malignancies necessitating HSCT. All patients received allogeneic HSCT from donors with the CCR5Δ32/Δ32 genotype. Conditioning regimens varied but generally included chemotherapy with or without total body irradiation. Graft-versus-host disease was a common complication, ranging from mild to severe. Sustained HIV-1 remission, defined by the interruption of ART with undetectable viral load, was achieved in most reported cases for varying durations. Data, based on the patterns observed in these five cases, suggested that approximately 60-80% of patients receiving HSCT from CCR5Δ32 homozygous donors might achieve at least 12 months of ART-free HIV-1 remission, with a smaller subset achieving long-term remission beyond 5 years. Conclusion: HSCT with CCR5Δ32 homozygous donors demonstrated a significant potential for achieving sustained HIV-1 remission in a select group of individuals, primarily those with hematological malignancies.

Perioperative Blood Glucose Levels as a Predictor of Hospital Length of Stay in Complicated Appendicitis: A Prospective Cohort Study Trengginas, Satrio Sarwo; Ida Bagus Budhi Surya Adnyana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1306

Background: Complicated appendicitis presents significant management challenges. Perioperative blood glucose levels are emerging as potential prognostic indicators in surgery. This study aimed to evaluate the correlation between perioperative blood glucose levels and hospital length of stay in patients with complicated appendicitis. Methods: This prospective cohort study was conducted at Dr. Moewardi General Hospital, Indonesia, from October 2020 to October 2021. We enrolled 49 adult patients with complicated appendicitis. Preoperative and postoperative blood glucose levels were measured. The primary outcome was hospital length of stay. Spearman’s correlation and ROC curve analyses were performed. Results: Significant positive correlations were found between hospital length of stay and preoperative blood glucose (r=0.324, p=0.023), postoperative blood glucose (r=0.484, p=0.000), age (r=0.324, p=0.023), and surgical site infection (r=0.360, p=0.011). Postoperative blood glucose showed the strongest correlation. ROC analysis identified a postoperative blood glucose level >123 mg/dL as a cut-off for prolonged hospitalization (>3 days), with 65.2% sensitivity and 65.4% specificity (AUC=0.71). Conclusion: Perioperative blood glucose levels significantly correlate with hospital length of stay in complicated appendicitis, with postoperative levels showing the strongest association. Monitoring postoperative blood glucose may help predict and potentially reduce the duration of hospitalization.

Traumatic Femoral Arteriovenous Fistula Mimicking Chronic Venous Insufficiency with Concurrent Iliac and Femoral Artery Aneurysms: A Case Report Tommy Kuswara; Ramzi Azrial; Tania Nugrah Utami
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1307

Background: Traumatic arteriovenous fistulas (AVFs), constituting approximately 2.5% of emergency vascular cases, present diagnostic challenges due to their obscure nature. This report describes two cases of traumatic AVFs caused by gunshot wounds. Case presentation: A 61-year-old male presented with right lower extremity pain and swelling, following a gunshot wound four months prior. Clinical findings included discoloration, edema, vein swelling, and pain from the femoral to pedis regions. CT angiography revealed multiple aneurysms from the lower abdominal aorta to the right common iliac arteries, stenosis in the right external iliac artery, and reduced blood perfusion. Additional findings were tubular aneurysms in the external and internal right iliac arteries and a combination saccular-tubular aneurysm in the right femoral artery. A second, separate case also involved a traumatic AVF from a gunshot wound. Conclusion: Traumatic AVFs, particularly those resulting from gunshot wounds, can be difficult to diagnose early due to their rarity and obscure presentation. Early diagnosis is crucial to prevent disease progression and improve clinical outcomes. Open surgical SFA bypass has a good outcome, proven by ultrasound examination that there is good blood flow in the distal artery.

The Efficacy of NeuroAid™ (MLC601) in Modulating NF-κB Expression and Improving Outcomes in Traumatic Brain Injury: A Preclinical Study Dedy Chandra Hariyono; Hanis Setyono; Ida Bagus Budhi Surya Adnyana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1309

Background: Traumatic brain injury (TBI) represents a significant global health concern, leading to substantial mortality and long-term disability. The intricate pathophysiology of TBI involves primary mechanical damage followed by a cascade of secondary injury events, including neuroinflammation, apoptosis, and oxidative stress. The nuclear factor kappa B (NF-κB) signaling pathway plays a pivotal role in orchestrating the inflammatory response post-TBI and has emerged as a potential therapeutic target. This preclinical study aimed to investigate the efficacy of NeuroAid™ (MLC601), a traditional herbal medicine, in modulating NF-κB expression and improving outcomes in a rat model of TBI. Methods: This study employed a true experimental in vivo design with a post-test only control group. Male Wistar rats (n=18) were randomly divided into two groups: a control group (n=9) subjected to TBI via a weight-drop method, and an experimental group (n=9) subjected to the same TBI procedure followed by intraperitoneal administration of NeuroAid™ (MLC601) at a dose of 2.5 mg/kg body weight at 5 minutes, 8 hours, and 16 hours post-injury. NF-κB expression in brain tissue samples collected 1 hour after the final dose was assessed using immunohistochemistry and quantified by an immunoreactivity score considering both the intensity and percentage of NF-κB expression. Results: Immunohistochemical analysis revealed the presence of NF-κB expression in both the nucleus and cytoplasm of neurons in both the control and experimental groups. While the experimental group treated with NeuroAid™ (MLC601) exhibited a lower average immunoreactivity score (0.93) compared to the control group (1.29), the difference in NF-κB expression between the two groups was not statistically significant (p = 0.122). Conclusion: In this preclinical study using a Wistar rat model of TBI, the administration of NeuroAid™ (MLC601) did not result in a statistically significant reduction in NF-κB expression compared to the untreated control group. Although a trend towards lower NF-κB expression was observed in the NeuroAid™-treated group, further research with larger sample sizes, different dosages, and extended treatment durations is warranted to fully elucidate the potential therapeutic effects of NeuroAid™ (MLC601) in the management of traumatic brain injury.

Novel Application of a Modified Small T-Plate as an Internal Joint Stabilizer for Chronic Elbow Instability: Technique and Two-Year Results Wiria Aryanta; Satria Putra Wicaksana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1310

Background: Chronic elbow instability, particularly following neglected or recurrent dislocations, presents a significant treatment challenge. Restoring stability while preserving functional motion is difficult, especially when standard internal joint stabilizers (IJS) are unavailable. We explored the use of a readily available small T-plate, modified intraoperatively, as a temporary internal hinge stabilizer. Case presentation: A 33-year-old male presented with chronic left elbow instability and functional impairment persisting for 14 years after an initial injury. Previous treatments, including traditional bone setting and K-wire fixation, had failed, resulting in recurrent dislocations. Surgical exploration revealed significant fibrosis and compromised ligamentous structures. Open reduction was performed, followed by stabilization using a modified small T-plate contoured to act as an internal hinge, maintaining the ulnohumeral joint space. The implant was removed after 4 weeks. At the 24-month follow-up, the patient exhibited excellent functional outcomes, with a stable elbow, substantial improvement in range of motion (Flexion-extension: 4.2°-129.2°; Pronation-supination: 80°), and an excellent Broberg-Morrey score, enabling pain-free daily activities. Conclusion: This case demonstrated that a modified small T-plate can serve as an effective, low-cost internal hinge joint stabilizer for managing complex chronic elbow instability, particularly in resource-limited settings. It facilitated early controlled motion, promoted stable fibrous tissue healing, and resulted in excellent long-term functional outcomes. This technique presents a viable alternative when standard IJS devices are not accessible.

Programmed Intermittent Epidural Bolus (PIEB) Versus Patient-Controlled Epidural Analgesia (PCEA) with Continuous Basal Infusion for Labor Analgesia: A Meta-Analysis Nopian Hidayat; Novita Anggraeni; Ricko Yorinda Putra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1311

Background: Maintaining effective labor epidural analgesia while optimizing maternal satisfaction and minimizing drug consumption remains a key objective in obstetric anesthesia. Programmed intermittent epidural bolus (PIEB) techniques have emerged as an alternative to traditional continuous epidural infusion (CEI) combined with patient-controlled epidural analgesia (PCEA). This meta-analysis aimed to compare the efficacy, local anesthetic (LA) consumption, and maternal satisfaction between PIEB regimens (typically combined with PCEA for rescue) and PCEA regimens supplemented with a continuous basal infusion (PCEA+Basal). Methods: A systematic literature search was conducted for PubMed, EMBASE, and the Cochrane Library for randomized controlled trials (RCTs) published between January 2013 and December 2024 comparing PIEB (+/- PCEA) with PCEA+Basal for labor analgesia. Primary outcomes were hourly LA consumption, maternal satisfaction (rated as high/excellent), and need for clinician rescue analgesia (breakthrough pain). Secondary outcomes included pain scores (Visual Analog Scale - VAS), mode of delivery, duration of labor stages, motor blockade incidence, and neonatal outcomes (Apgar scores). Data were extracted from suitable studies identified through the search. A random-effects model was used for meta-analysis using RevMan software. Mean Differences (MD) or Odds Ratios (OR) with 95% Confidence Intervals (CI) were calculated. Heterogeneity was assessed using the I² statistic. Results: Five studies involving a total of 1158 parturients met the inclusion criteria. The pooled analysis indicated that PIEB regimens were associated with a trend towards lower hourly LA consumption compared to PCEA+Basal (MD: -1.2 mL/hour; 95% CI: -2.5 to 0.1; P=0.07; I²=78%), although heterogeneity was high. Maternal satisfaction rated as 'high' or 'excellent' was significantly more frequent in the PIEB group (OR: 1.85; 95% CI: 1.20 to 2.85; P=0.005; I²=35%). The need for clinician rescue analgesia was numerically lower with PIEB, but the difference did not reach statistical significance (OR: 0.70; 95% CI: 0.45 to 1.10; P=0.12; I²=45%). No significant differences were noted in VAS pain scores during established labor, mode of delivery, or Apgar scores. Incidence of motor block appeared potentially lower with PIEB regimens. Conclusion: Based on this meta-analysis, PIEB regimens appear promising for labor analgesia, potentially offering comparable efficacy to PCEA+Basal while possibly reducing local anesthetic consumption and enhancing maternal satisfaction. However, significant heterogeneity was observed for some outcomes. High-quality, large-scale RCTs directly comparing optimized PIEB+PCEA protocols with PCEA+Basal infusion are crucial to definitively establish the relative benefits and risks of these techniques.

Neurovascular Inflammation and Oxidative Stress Markers in Chronic Migraine: Is Nitric Oxide the Key Link to Severity? Aulia Noza; Restu Susanti; Yuliarni Syafrita; Syarif Indra; Lydia Susanti; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1312

Background: Nitric oxide (NO), a ubiquitous signaling molecule, has been implicated in migraine pathophysiology through mechanisms including vasodilation, neurogenic inflammation, and oxidative stress. However, its specific relationship with the clinical severity of chronic migraine required further elucidation. This study aimed to investigate the association between serum NO levels and the severity of chronic migraine in a cohort of female patients. Methods: An observational study employing a cross-sectional design was conducted between July 2024 and November 2024 at Neurology Clinics and Community Healthcare Centers in Padang City, Indonesia. Fifty-one female chronic migraineurs, diagnosed according to ICHD-3 criteria, were enrolled using consecutive sampling. Patients with specific comorbidities, pregnancy, breastfeeding, or Medication Overuse Headache (MOH) were excluded. Migraine severity during an ictal phase was assessed using the Migraine Severity Scale (MIGSEV). Venous blood samples were collected during migraine attacks (ictal phase), and serum NO levels were quantified using a colorimetric method. The association between NO levels and MIGSEV scores was analyzed using the Kruskal-Wallis test, followed by post-hoc Mann-Whitney U tests. Statistical significance was set at p < 0.05. Results: The study included 51 female chronic migraineurs with a median age of 33 years. Migraine severity distribution was: 10 (19.6%) mild, 26 (51.0%) moderate, and 15 (29.4%) severe. The overall median serum NO level was 74.8 nmol/ml (range: 32.20 - 169.15 nmol/ml). Median NO levels demonstrated a positive gradient with increasing migraine severity: mild group 47.31 nmol/ml (range: 34.85 - 67.15), moderate group 88.45 nmol/ml (range: 32.20 - 167.45), and severe group 96.71 nmol/ml (range: 65.45 - 169.15). The Kruskal-Wallis test revealed a statistically significant difference in NO levels across the severity groups (p < 0.01). Post-hoc analyses confirmed significant differences between the mild and moderate groups (p < 0.01) and between the mild and severe groups (p < 0.01). Conclusion: This study demonstrated a significant positive association between serum Nitric Oxide levels, measured during the ictal phase, and the severity of chronic migraine in female patients. Higher NO levels were correlated with greater migraine severity, suggesting NO may play a crucial role in the mechanisms underlying migraine intensity and potentially serve as a biomarker reflecting the clinical burden of chronic migraine.

Neuroinflammation and Sleep Dysfunction in Epilepsy: The Role of High Sensitivity C-Reactive Protein Akmal Irsyadi Iswan; Restu Susanti; Lydia Susanti; Syarif Indra; Fanny Adhy Putri; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1313

Background: Emerging evidence suggests a bidirectional relationship between systemic inflammation and both epilepsy and sleep dysfunction. High-sensitivity C-reactive protein (Hs-CRP), a sensitive marker of low-grade systemic inflammation, is elevated in response to pro-inflammatory cytokines. However, the specific link between Hs-CRP levels and subjective sleep quality within the epilepsy population required further investigation. This study aimed to investigate the relationship between serum Hs-CRP levels and sleep quality in patients diagnosed with epilepsy. Methods: A cross-sectional study was conducted involving 40 patients diagnosed with epilepsy attending the neurology clinic at Dr. M. Djamil General Hospital, Padang, Indonesia, between January and February 2025. Patients aged over 17 years diagnosed by a neurologist were included. Serum Hs-CRP levels were quantified using an enzyme-linked immunosorbent assay (ELISA). Sleep quality over the preceding month was assessed using the validated Indonesian version of the Pittsburgh Sleep Quality Index (PSQI). Mann-Whitney U test was employed to analyze the difference in median Hs-CRP levels between patients with good and poor sleep quality. Relationships between baseline characteristics and sleep quality were assessed using Chi-square/Fisher's exact tests for categorical variables and the Mann-Whitney U test for continuous variables. Results: Forty epilepsy patients (median age 25.5 years, range 17-50; 52.5% female) were enrolled. The median duration of epilepsy was 10 years (range 1-35). A majority of patients exhibited uncontrolled seizures (75%) and were receiving AED polytherapy (60%). Based on PSQI scores, 24 patients (60%) were classified as poor sleepers, while 16 (40%) were good sleepers. A significant difference was observed in median serum Hs-CRP levels between the two groups: patients with good sleep quality had significantly lower median Hs-CRP levels compared to those with poor sleep quality (1,271.50 ng/ml [range 58–5,837] vs. 2,771.50 ng/ml [range 509–27,187], p=0.027). Poor sleep quality was significantly associated with younger age (median 23 vs. 36 years, p=0.039) and AED polytherapy (75% vs. 25%, p=0.018). Conclusion: This study demonstrated a significant association between elevated serum Hs-CRP levels and poor subjective sleep quality in patients with epilepsy. Epilepsy patients experiencing poor sleep exhibited significantly higher levels of this inflammatory biomarker. These findings underscore the potential role of systemic inflammation in the complex interplay between epilepsy and sleep disturbances, suggesting Hs-CRP could serve as a potential biomarker linking these conditions.

Kawasaki Disease in a Preschooler: A Case Study on Timely Diagnosis and IVIG (Intravenous Immunoglobulin) Intervention Fitriana Wibowo; Didik Hariyanto; Farid I Hussein
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (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.v9i6.1314

Background: Kawasaki disease (KD) is an acute, systemic vasculitis predominantly affecting young children and represents the leading cause of acquired heart disease in developed nations. Diagnostic challenges, particularly in resource-limited settings like Indonesia, contribute to underdiagnosis and delayed treatment. Case presentation: We report the case of a 3-year-8-month-old Indonesian male who presented with a five-day history of high-grade fever, polymorphous rash, bilateral non-purulent conjunctival injection, oropharyngeal changes (strawberry tongue, dry cracked lips), and unilateral cervical lymphadenopathy. These features fulfilled the classic diagnostic criteria for KD. Laboratory investigations revealed mild normocytic anemia and a markedly elevated erythrocyte sedimentation rate (ESR). Initial electrocardiogram showed sinus tachycardia without conduction abnormalities. Echocardiography performed during the acute phase was essential for baseline assessment and monitoring. The patient received timely administration of high-dose intravenous immunoglobulin (IVIG) (2 g/kg) and high-dose aspirin within the optimal treatment window. Conclusion: This case underscores the paramount importance of early clinical recognition based on established criteria and prompt initiation of IVIG therapy in mitigating the risk of CAA in children with KD. Despite successful treatment in this instance, the challenges of underdiagnosis and variable clinical presentations, including incomplete forms, persist globally, particularly in regions like Indonesia. Continued research into KD pathogenesis, improved diagnostic markers, management of IVIG resistance, and long-term cardiovascular surveillance protocols are crucial for optimizing patient outcomes.

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Rachmat Hidayat

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Kab. ogan ilir,

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INDONESIA