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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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ISSN : - EISSN : 25980580 DOI : https://doi.org/10.37275/bsm

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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 : 1.Rhemumatology 2.Molecular aspect of Indonesia Traditional Herb 3.Cardiology and Cardiovascular diseases 4.Genetics 5.Immunology 6.Environmental health 7.Toxicology 8. Neurology 9. Pharmacology 10. Oncology 11. Other multidisciplinary studies related medicine. 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 - Kedokteran (Lain-Lain)

Articles 1,165 Documents

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Hyperthyroidism-Induced Myocardial Ischemia: Quantification and Correlation with fT4 via 99mTc-Sestamibi Scintigraphy Daniel Chung; Achmad Hussein Sundawa Kartamihardja; Raden Erwin Affandi Soeriadi Koesoemah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1336

Background: Hyperthyroidism exerts significant detrimental effects on the cardiovascular system, increasing the risk of major adverse cardiac events (MACE). While associations with atrial fibrillation and cardiomyopathy are well-documented, the incidence and characteristics of myocardial ischemia, particularly assessed by functional imaging, remain less explored. This study aimed to investigate the incidence of myocardial ischemia in hyperthyroid patients using Technetium-99m Sestamibi (⁹⁹ᵐTc-Sestamibi) myocardial perfusion scintigraphy (MPS) and correlate findings with thyroid hormone levels. Methods: This prospective preliminary study enrolled fifteen consecutive patients with confirmed hyperthyroidism and no prior history of ischemic heart disease between January and April 2024. All subjects underwent thyroid function tests (TSH, fT4, T3) and a one-day rest/adenosine-stress ⁹⁹ᵐTc-Sestamibi MPS protocol. Myocardial ischemia presence, reversibility, severity (Summed Stress Score, SSS), and extent (total ischemic segments) were assessed using the AHA 17-segment model. Spearman correlation was used to analyze the relationship between hormone levels and MPS parameters. Results: Fifteen subjects (93.3% female, mean age 34 ± 11 years) were included. Myocardial ischemia was detected in 14/15 subjects (93.3%). Among those with ischemia, 12 (80% of total subjects, 85.7% of ischemic subjects) exhibited reversible defects. Free thyroxine (fT4) levels showed a strong positive correlation with SSS (rs = 0.64, p = 0.01) and the total number of ischemic segments (rs = 0.65, p = 0.01). Conclusion: This preliminary study revealed a high incidence of myocardial ischemia, predominantly reversible, in patients with hyperthyroidism detected by ⁹⁹ᵐTc-Sestamibi MPS. The severity and extent of ischemia demonstrated a significant positive correlation with fT4 levels. These findings underscore the potential utility of MPS in cardiovascular risk assessment and suggest the need for comprehensive cardiac evaluation in hyperthyroid patients, particularly those with higher fT4 levels.

Differential Roles of CD117 and Ki67 in Gastrointestinal Stromal Tumors: Diagnostic Utility Versus Prognostic Power Fitri Nur Handriyani; Noza Hilbertina; Henny Mulyani; Loli Devianti; Avit Suchitra; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1337

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the digestive tract, primarily driven by mutations in KIT or PDGFRA genes. CD117 (c-KIT) expression is a key diagnostic marker, while the Ki67 labeling index reflects cellular proliferation. Risk stratification, often using modified NIH criteria based on tumor size, mitotic rate, and location, guides prognosis and treatment. This study investigated the distinct roles of CD117 and Ki67 expression in relation to risk stratification in GIST patients. Methods: This cross-sectional analytical study examined 27 GIST cases diagnosed between January 2021 and December 2024 from three Indonesian hospitals. Formalin-fixed paraffin-embedded tissues were analyzed using immunohistochemistry for CD117 (clone YR145) and Ki67 (clone K2). CD117 positivity was defined as ≥5% tumor cell staining, and high Ki67 expression as >10% nuclear staining. Risk stratification utilized the modified NIH criteria. The Chi-square test assessed correlations (p<0.05 significance). Results: The cohort predominantly comprised patients >50 years (66.7%), males (59.3%), with gastric tumors (51.9%), large tumor size (>5cm in 96.3%), spindle cell morphology (77.8%), and high mitotic rates (74.1%). Most cases (85.2%) were classified as high-risk. CD117 was positive in 81.5% (22/27) of cases but showed no significant correlation with risk stratification (p=0.561). High Ki67 expression was found in 74.1% (20/27) of cases and demonstrated a significant positive correlation with high-risk stratification (p=0.002). The combination of CD117 and Ki67 status also showed a significant association with risk stratification (p=0.001). Conclusion: While CD117 expression remains a cornerstone for GIST diagnosis and targeted therapy selection, it did not correlate significantly with risk stratification in this cohort. Conversely, a high Ki67 labeling index was significantly associated with high-risk GIST, underscoring its potential as a valuable prognostic marker alongside established risk stratification parameters.

Investigating the Landscape of Programmed Death-Ligand 1 (PD-L1) in Thymic Tumors: Implications for Histopathological Classification and Staging Rio Hendra; Noza Hilbertina; Henny Mulyani; Tofrizal; Afriani; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1338

Background: Thymic epithelial tumors (TETs) are uncommon malignancies originating in the mediastinum, characterized by considerable histopathological diversity and variable clinical trajectories. Programmed Death-Ligand 1 (PD-L1), an immune checkpoint protein, is implicated in mechanisms of tumor immune evasion. This study aimed to investigate the correlation between PD-L1 immunoexpression and distinct histopathological types, as well as the Masaoka-Koga stage, in TETs. Methods: This cross-sectional investigation analyzed 29 archival cases of TETs diagnosed between January 2019 and December 2024 at the Anatomical Pathology Laboratory of Dr. M. Djamil General Hospital Padang. Samples were procured via consecutive sampling from formalin-fixed paraffin-embedded (FFPE) tumor tissues. Histopathological classification was reassessed according to the WHO 2021 criteria. PD-L1 expression was evaluated immunohistochemically and quantified using the Tumor Proportion Score (TPS). Masaoka-Koga staging was determined from clinical records. Statistical analysis of correlations was performed using the Chi-square test. Results: PD-L1 immunoexpression was detected in the preponderance of cases. Low positive PD-L1 expression (TPS 1-49%) was observed in 82.8% of TETs, while high positive expression (TPS ≥50%) was noted in 10.3%. Thymic carcinoma constituted the most prevalent histopathological category (51.7%), and the majority of patients (91.7%) presented at an advanced Masaoka-Koga stage. Statistical analysis did not demonstrate a significant correlation between PD-L1 expression levels and histopathological type (p=0.195). Furthermore, no significant association was identified between PD-L1 expression and Masaoka-Koga stage (p=0.800). Conclusion: This study indicated that while PD-L1 is frequently expressed in TETs within this cohort, its expression level did not exhibit a significant correlation with specific histopathological subtypes or the Masaoka-Koga clinical stage. Further investigations incorporating larger sample sizes are warranted to delineate the precise role of PD-L1 within the complex biological spectrum of thymic neoplasms.

Harnessing the Power of Nature: Ananas comosus Extract Gel as an Alternative Topical Treatment for Grade 2 Burn Wounds Kharmi Juni Yanti; Diah Adriani Malik; Novi Kusumaningrum
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1339

Background: Burn injuries remain a significant global health challenge, often leading to complications such as infection and delayed healing. Conventional treatments can be costly and may have side effects, prompting exploration into natural therapeutic alternatives. Ananas comosus (pineapple), rich in the enzyme bromelain, has demonstrated anti-inflammatory and wound-healing properties, suggesting its potential as a topical agent for burn wounds. This study aimed to evaluate the efficacy of a topical gel formulated from Ananas comosus extract in promoting the healing of grade 2 burn wounds in a Wistar rat model by assessing its impact on wound diameter and the levels of pro-inflammatory cytokines Interleukin-1 beta (IL-1β) and Interleukin-6 (IL-6). Methods: A true experimental study with a post-test only control group design was conducted using 30 male Wistar rats. Grade 2 burn wounds were induced on the dorsum of the rats. The rats were randomly assigned to six groups (n=5 per group): a normal control (KN, no treatment), negative control (K-), a positive control (K+, silver plus alginate hydrogel), and three treatment groups receiving topical Ananas comosus extract gel at concentrations of 15% (P1), 20% (P2), and 25% (P3) twice daily for 14 days. Wound diameter was measured on days 1, 3, 6, 9, 12, and 14 using the ImageJ application. On day 15, tissue samples were collected for IL-1β and IL-6 quantification via ELISA. Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests for wound diameter, and One-Way ANOVA with LSD post-hoc test for cytokine levels, with p<0.05 considered significant. Results: Significant differences in burn wound diameter and levels of IL-1β and IL-6 were observed among the groups (p<0.05). The P2 group (20% pineapple extract gel) exhibited the most significant reduction in wound diameter compared to the negative control and was comparable to the positive control group. This group also showed a marked decrease in IL-1β and IL-6 levels, with IL-1β levels similar to the positive control and IL-6 levels significantly lower than the untreated group and approaching those of the positive control. Conclusion: Topical application of 20% Ananas comosus extract gel effectively accelerated the healing of grade 2 burn wounds and reduced the levels of pro-inflammatory cytokines IL-1β and IL-6 in Wistar rats. These findings support the potential use of pineapple extract as an alternative herbal topical therapy for burn injuries. Further research is warranted to explore optimal formulations and clinical applications in humans.

Unraveling the Angiogenic Landscape in Endometrioid Endometrial Carcinoma: VEGF Expression, Histopathological Differentiation, and Lymphovascular Invasion as Key Players Mustika Sari; Aswiyanti Asri; Tofrizal; Henny Mulyani; Syamel Muhammad; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1340

Background: Endometrioid endometrial carcinoma (EEC) is a prevalent gynecological malignancy whose prognosis is influenced by factors including histopathological grade and lymphovascular invasion (LVI). Angiogenesis, crucial for tumor growth and metastasis, is significantly mediated by vascular endothelial growth factor (VEGF). This study aimed to investigate the expression of VEGF in EEC and its correlation with histopathological differentiation and LVI. Methods: This observational analytical study employed a cross-sectional design using 36 archival paraffin block samples of EEC diagnosed between January 2022 and December 2024 at the Anatomical Pathology Laboratory of Dr. M. Djamil General Hospital Padang. Cases were selected via simple random sampling from a population of 59. Histopathological grade (Grade 1, 2, or 3 based on FIGO architectural and nuclear criteria) and LVI (negative, focal, or substantial) were re-evaluated from Hematoxylin-Eosin (H&E) stained slides. VEGF expression was assessed by immunohistochemistry, scored semiquantitatively based on the percentage of positive tumor cells and staining intensity, and categorized as low or high. Data were analyzed using Chi-square tests, with p<0.05 considered statistically significant. Results: The mean age of patients was 54.36 years, with the highest prevalence in the 51-60 age group (41.7%). Grade 3 tumors were most common (38.9%), followed by Grade 2 (33.3%) and Grade 1 (27.8%). LVI was present in 47.2% of cases, predominantly focal (38.9%). High VEGF expression was observed in 58.3% of EEC cases. A statistically significant association was found between high VEGF expression and higher histopathological grade (p=0.000), with 66.7% of Grade 3 tumors showing high VEGF expression. No significant association was found between VEGF expression and LVI (p=0.080). Conclusion: High VEGF expression significantly correlated with higher histopathological grades in EEC, suggesting its role in tumor aggressiveness and dedifferentiation. However, a significant association with LVI was not established in this cohort. VEGF expression warrants further investigation as a potential prognostic biomarker and therapeutic target in EEC.

Beyond the Scar: A Case Report on the Clinical Presentation, Diagnostic Nuances, and Surgical Management of Type I Cesarean Scar Pregnancy Pradnyana, I Wayan Agus Surya; Anak Agung Ngurah Jaya Kusuma; Gde Bagus Rizky Kornia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1341

Background: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy where the gestational sac implants within the fibrous tissue of a previous cesarean section scar. Its incidence is rising in parallel with increasing cesarean delivery rates, posing significant risks of maternal morbidity, including uterine rupture and severe hemorrhage. Type I CSP, or endogenic CSP, involves implantation on a healed scar with growth primarily towards the uterine cavity. Early and accurate diagnosis, relying heavily on ultrasonographic nuances, is crucial for appropriate management and fertility preservation. Case presentation: We present the case of a 36-year-old woman, G7P3033, with a history of two prior cesarean sections, who presented at 6-7 weeks of gestation with vaginal discharge. Transabdominal ultrasonography revealed a gestational sac implanted on the anterior uterine wall within the cesarean scar area, with a thin myometrium between the sac and the bladder, consistent with a Type I (endogenic, COS-1, Grade II) Cesarean Scar Pregnancy. The patient also had Stage II hypertension. After thorough evaluation and counseling, the patient underwent a laparotomy with wedge resection of the CSP and scar revision, along with bilateral fimbriectomy as per her request for sterilization. Conclusion: This case highlights the importance of high clinical suspicion for CSP in pregnant women with previous cesarean sections presenting with early pregnancy symptoms. Detailed ultrasonography is paramount for accurate diagnosis, classification, and guiding management. Surgical management, specifically laparotomy with wedge resection and scar repair, proved to be an effective treatment for this Type I CSP, allowing for removal of the ectopic pregnancy and reinforcement of the uterine wall, while addressing the patient's desire for permanent contraception. Timely intervention is key to preventing life-threatening complications and preserving future reproductive options if desired.

Management Strategies and Outcomes for Bilateral Pulmonary Hydatid Cysts: A Systematic Review and Meta-Analysis Berliana Islamiyarti Hydra; Irvan Medison; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1342

Background: Bilateral pulmonary hydatid disease presents a complex therapeutic challenge, necessitating careful consideration of surgical timing, approach, and adjuvant medical therapy to optimize patient outcomes while minimizing morbidity. This systematic review and meta-analysis aimed to evaluate the different management strategies and their associated outcomes in patients with bilateral pulmonary hydatid cysts. Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science databases was conducted for studies published between January 2014 and December 2024, reporting on management strategies (one-stage bilateral surgery, two-stage bilateral surgery, medical therapy) and outcomes (postoperative complications, recurrence, mortality, length of hospital stay) in patients with bilateral pulmonary hydatid cysts. Studies were selected based on predefined inclusion and exclusion criteria. Data were extracted by two independent reviewers, and quality assessment was performed using a modified Newcastle-Ottawa Scale. Pooled proportions for outcomes were calculated using random-effects models. Heterogeneity was assessed using the I2 statistic. Results: Seven studies, encompassing a total of 305 patients with bilateral pulmonary hydatid cysts, met the inclusion criteria. The studies varied in design, including retrospective cohorts and prospective case series. Management predominantly involved surgical intervention, with 148 patients (48.5%) undergoing one-stage bilateral surgery and 127 patients (41.6%) undergoing two-stage procedures. Perioperative albendazole was administered to 245 patients (80.3%). The pooled overall postoperative complication rate was 28.7% (95% CI: 21.5%-36.8%; I2=78%). Major complications occurred in 12.1% (95% CI: 8.0%-17.9%; I2=65%). The pooled recurrence rate at a mean follow-up of 38.5 months was 8.5% (95% CI: 5.1%-13.8%; I2=55%). Overall mortality was 2.1% (95% CI: 0.9%-4.5%; I2=0%). Patients undergoing one-stage surgery exhibited a trend towards higher overall complication rates (33.1% vs. 25.2% for two-stage) but shorter total hospital stays. Adjuvant albendazole therapy was associated with a trend towards lower recurrence rates. Conclusion: Surgical management, whether one-stage or two-stage, remains the cornerstone of treatment for bilateral pulmonary hydatid disease, achieving acceptable morbidity and mortality with good long-term control in most patients. Postoperative complications are relatively common, highlighting the complexity of these cases. While one-stage surgery may shorten overall hospital stay, it might be associated with a higher risk of immediate complications. Adjuvant albendazole appears beneficial in reducing recurrence. The choice of surgical strategy should be individualized based on patient status, cyst characteristics, and surgical expertise. Further prospective, comparative studies are needed to delineate optimal management pathways.

Thoracic Epidural Anesthesia Facilitating Upper Abdominal Surgery in the Presence of Malignant Pleural Effusion and Hepatic Metastases: A Case Report Faisal Irwanda; Andre Azhar; Dino Irawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1343

Background: Upper abdominal surgery in patients with advanced metastatic cancer, particularly with significant pulmonary and hepatic involvement, presents substantial perioperative challenges. Malignant pleural effusion (MPE) and hepatic metastases compromise cardiorespiratory reserve, increasing the risks associated with general anesthesia and surgical stress. Thoracic epidural anesthesia (TEA) offers potential benefits by providing effective analgesia, reducing pulmonary complications, and attenuating the surgical stress response. Case presentation: We report the case of a 65-year-old male patient with metastatic breast cancer involving the lungs, liver, and spine, complicated by recurrent malignant pleural effusion. He presented with dyspnea and abdominal pain, requiring a laparotomy for liver biopsy to guide further oncological management. Given his ASA III status, significant pulmonary compromise (pre-operative SpO2 93-94% on room air, effusion requiring drainage), and the nature of the surgery, TEA was chosen as the primary anesthetic technique. An epidural catheter was successfully placed at the T9-T10 interspace, achieving a T4 sensory block using ropivacaine 0.5%. The laparotomy and liver biopsy proceeded with stable intraoperative hemodynamics and adequate surgical conditions. Conclusion: TEA provided effective anesthesia and analgesia for upper abdominal surgery in this high-risk patient with extensive metastatic disease and compromised pulmonary function. This approach facilitated the procedure while maintaining hemodynamic stability and avoiding the potential respiratory complications associated with general anesthesia and tracheal intubation. TEA should be considered a viable anesthetic option in carefully selected high-risk patients undergoing abdominal oncological surgery.

Fatal Feline Rabies: A Case Report of Encephalitis Following a Cat Scratch in an Endemic Indonesian Region Gede Tamblang Baswara Putra; I Made Mahardika Yasa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1344

Background: Rabies, a viral zoonosis caused by Lyssavirus, remains a significant public health threat, particularly in Asia and Africa, with an almost invariably fatal outcome once clinical symptoms manifest. While dogs are the primary vector, transmission via cats, especially through scratches, is an under-recognized risk in endemic areas like Indonesia. Delayed post-exposure prophylaxis (PEP) and gaps in surveillance contribute to ongoing fatalities. Case presentation: We report the case of a 45-year-old Indonesian male from a rural, rabies-endemic area in Jembrana Regency, Bali, who developed fatal encephalitis. Approximately one month prior to symptom onset, he sustained a superficial scratch on his right hand from a free-roaming domestic cat. He did not seek immediate medical attention or PEP. His illness commenced with prodromal symptoms of fever and headache, rapidly progressing to agitation, dysphagia, severe hydrophobia, and aerophobia. Neurological examination revealed fluctuating consciousness, hyperactive reflexes, and marked autonomic dysfunction. Despite intensive supportive care in an isolation unit, his condition deteriorated, leading to death two days after admission. A clinical diagnosis of rabies encephalitis was made based on the characteristic symptoms, a clear history of exposure to a potential vector, and the epidemiological context. Conclusion: This case underscores the critical importance of recognizing cats as significant vectors for rabies transmission, even via non-bite exposures like scratches, particularly in endemic settings. It highlights the urgent need for increased public awareness regarding prompt wound management and PEP for all potential rabies exposures, including those from felines. Furthermore, comprehensive rabies control strategies must incorporate feline vaccination and improved surveillance to effectively mitigate this fatal disease in regions like Indonesia.

The Landscape of Condyloma Acuminata and Concomitant STIs in Denpasar: A Retrospective Analysis with Implications for Public Health Strategies Ni Putu Wina Widyastuti; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Aditya Permana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1345

Background: Condylomata acuminata (CA) is a prevalent sexually transmitted infection (STI). Research into the risk factors and characteristics associated with CA is crucial for developing effective prevention strategies. This study aimed to determine the prevalence and characteristics of CA patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital in Denpasar, Bali, Indonesia. Methods: A retrospective cross-sectional study was conducted using medical records of CA patients attending the STI and Dermatology Clinic at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from January 2021 to December 2023. Data collected included patient visit status, age, gender, occupation, education, concomitant STIs, sexual orientation, marital status, and use of protective measures. Data were processed descriptively. Results: Of 284 CA patients, 69.7% were male and 30.3% were female. The mean age was 28.99 ± 11.38 years. Married individuals constituted 41.5% of cases. Private employees were the predominant occupation (34.2%). Fifty percent of patients had no concomitant STIs, while HIV was present in 37.7% of the total sample (75.4% of those with any concomitant STI). A significant proportion (49%) reported not using protective measures during sexual intercourse. Conclusion: The prevalence of CA at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, was 40 per 1000 visits during the study period. CA was predominantly observed in adult males who were married, heterosexual, had completed high school, worked as private employees, and did not use protective measures during sexual intercourse. These findings underscore the need for targeted public health interventions.

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Contact Name Rachmat Hidayat

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Editorial Address Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang

Location Kota palembang, Sumatera selatan INDONESIA

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Contact Name
Rachmat Hidayat

Contact Email
dr.rachmat.hidayat@gmail.com

Phone
+6281949581088

Journal Mail Official
editor.bioscmed@gmail.com

Editorial Address
Jl. Sirna Raga no 99, 8 Ilir, Ilir Timur 3, Palembang

Location
Kota palembang,

Sumatera selatan

INDONESIA