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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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A Diagnostic Rarity: Apocrine Hidrocystoma Presenting as a Medial Canthal Mass in Adolescence Atika Syafendra; Mardijas Efendi; Ardizal Rahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1438

Background: Apocrine hidrocystomas are benign adnexal tumors of the glands of Moll, typically diagnosed in adults. Their presentation in adolescence is an exceptional clinical finding that challenges standard diagnostic paradigms for periocular masses in this age group, necessitating a broad and meticulous differential diagnosis. Case presentation: A 15-year-old female presented with a two-month history of a stable, asymptomatic, 7×5×1 mm cystic mass at the inferomedial canthus of the left eye. The patient's primary concern was cosmetic. A comprehensive ophthalmologic examination was unremarkable. Orbital computed tomography confirmed a simple, preseptal subcutaneous cyst. A complete excisional biopsy was performed, and histopathological analysis revealed a unilocular cyst lined by a double layer of epithelium with inner columnar cells demonstrating pathognomonic decapitation secretion, confirming an apocrine hidrocystoma. Conclusion: This case highlights the necessity of including apocrine hidrocystoma in the differential diagnosis of periocular masses in adolescents. The primary lesson is that a patient's age should broaden, not narrow, the diagnostic possibilities. Definitive diagnosis relies on histopathology, not demographic probability, and complete surgical excision remains the gold standard for both diagnosis and curative therapy, yielding an excellent prognosis.

Challenging the Paradigm: A Clinicopathological Case Series on the Discordance between Cutaneous Burn Severity and Airway Injury Following a Volcanic Pyroclastic Flow Exposure Adrifen Berti Akbar; Oea Khairsyaf; Russilawati Russilawati; Dimas Bayu Firdaus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1439

Background: Inhalation injury accompanying severe burns is a major driver of morbidity and mortality. The pathophysiology of injury from volcanic eruptions—a unique combination of extreme heat, abrasive particulates, and corrosive gases—is distinct from typical combustion smoke and not well-characterized. Flexible bronchoscopy is the gold standard for diagnosing and grading airway injury, yet its application in this context, particularly in relation to external burn severity, is unclear. Case presentation: We present a retrospective analysis of two climbers who were the sole survivors admitted to our tertiary center after exposure to the pyroclastic flow from the 2023 Mount Marapi eruption. A 19-year-old female with 40% Total Body Surface Area (TBSA) deep burns and a 20-year-old male with 30% TBSA deep burns both presented with signs concerning for inhalation injury. Despite the devastating extent of their cutaneous injuries, flexible bronchoscopy in both patients revealed only mild, Grade 1 endobronchial injury (mucosal erythema and edema) based on the Abbreviated Injury Score (AIS) classification. The first patient succumbed to septic shock from her burns, while the second patient showed significant respiratory improvement following therapeutic bronchial lavage and made a full recovery. Conclusion: This case series presents hypothesis-generating evidence suggesting that in victims of open-air volcanic pyroclastic flows, the severity of cutaneous burns may be a poor predictor of the degree of underlying endobronchial damage. These findings underscore the potential necessity of a low threshold for early flexible bronchoscopy to accurately diagnose, stratify, and therapeutically intervene in this unique patient population, irrespective of TBSA.

The Inflammatory Correlates of Hypothalamic-Pituitary-Gonadal Axis Dysfunction in Antiretroviral-Naïve Men with HIV: A Cross-Sectional Analysis of the TNF-α and Testosterone Relationship Hudari, Harun; Yulianto Kusnadi; Risfandi Ahmad Taskura
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1440

Background: In men with untreated Human Immunodeficiency Virus (HIV), the mechanisms underlying testosterone deficiency remain incompletely defined. Chronic inflammation is hypothesized to be a key factor in disrupting the hypothalamic-pituitary-gonadal (HPG) axis. This study aimed to investigate the association between the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-α) and the HPG axis and to assess this relationship while accounting for nutritional status in ART-naïve men. Methods: We conducted a cross-sectional study of 40 ART-naïve men with HIV in Palembang, Indonesia. We measured serum total testosterone, Luteinizing Hormone (LH), TNF-α, Interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). Hypogonadism was classified as primary (low testosterone, high LH) or secondary (low testosterone, low/normal LH). Spearman’s correlation was used to assess bivariate relationships. A multiple linear regression analysis was performed to determine the independent association of TNF-α and Body Mass Index (BMI) with testosterone levels. Results: All 40 participants (100%) presented with secondary (hypogonadotropic) hypogonadism, characterized by a median total testosterone of 6.48 pg/mL and an inappropriately normal median LH of 3.86 mIU/mL. Serum TNF-α was significantly elevated (median: 10.32 pg/mL). A moderate negative correlation was found between TNF-α and total testosterone (ρ = -0.411, p = 0.008). In the multivariate regression model, both higher TNF-α levels (β = -0.38, p = 0.011) and lower BMI (β = 0.45, p = 0.003) were significant, independent predictors of lower total testosterone. The model explained 34.6% of the variance in testosterone levels (Adjusted R² = 0.346). Conclusion: Our findings demonstrate a universal prevalence of secondary hypogonadism in ART-naïve men with HIV. This HPG axis dysfunction is strongly and independently associated with both the magnitude of systemic inflammation, marked by TNF-α, and the severity of malnutrition. These results suggest a complex interplay where inflammation and poor nutritional status act as distinct, synergistic contributors to the profound endocrine disruption seen in untreated HIV infection.

Evaluating Platelet-Large Cell Ratio (P-LCR) as an Accessible Biomarker for Myocardial Injury in Acute Coronary Syndrome Muhammad Riza Lubis; Dewi Indah Sari Siregar; Malayana Rahmita Nasution; Hana Fauziyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1441

Background: The accurate and timely diagnosis of acute coronary syndrome (ACS) in resource-limited healthcare settings is critically hampered by the high cost and limited availability of the gold-standard biomarker, Troponin I. This study aimed to conduct a preliminary evaluation of the association between two accessible platelet indices derived from the complete blood count—the platelet-large cell ratio (P-LCR) and the immature platelet fraction (IPF)—and the quantitative degree of myocardial injury in patients with ACS. Methods: An exploratory, cross-sectional study was conducted on 51 consecutive patients diagnosed with ACS at a tertiary referral hospital in Medan, Indonesia. The relationship between admission P-LCR, IPF, and Troponin I was assessed using a multi-faceted statistical approach, including Spearman's rank correlation, an exploratory multivariable linear regression model, and a Receiver Operating Characteristic (ROC) curve analysis. A post-hoc power analysis was performed to contextualize the findings. Results: The study was found to be statistically underpowered (power ≈ 60%) to reliably detect weak correlations. A statistically significant but weak positive correlation was observed between P-LCR and Troponin I levels (Spearman's ρ = 0.31, p = 0.026). This association remained significant after adjusting for age, gender, and ACS subtype, but the overall model demonstrated minimal explanatory power (Adjusted R² = 0.18). The ROC analysis for P-LCR in discriminating between normal and elevated Troponin I was poor (Area Under the Curve = 0.65; 95% CI: 0.50 - 0.79). No significant correlation was found between IPF and Troponin I (p = 0.093). Conclusion: P-LCR exhibits a weak, independent statistical association with the degree of myocardial injury in ACS patients. However, its poor discriminatory performance, coupled with the profound methodological limitations of this preliminary study, demonstrates that P-LCR is not a clinically useful biomarker for the identification or stratification of myocardial injury. These findings underscore the significant translational gap between a plausible biological hypothesis and a clinically viable diagnostic tool, highlighting the immense complexities that must be addressed in future, more robustly designed research.

UVB-Induced Oxidative Collapse and Melanogenic Activation in a Rat Model of Cutaneous Hyperpigmentation: A Multi-Parametric Analysis Sesia Pradestine; Endra Yustin Ellistasari; Nurrachmat Mulianto; Indah Julianto; Muhammad Eko Irawanto; Nugrohoaji Dharmawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1442

Background: Ultraviolet B (UVB) radiation is a primary driver of cutaneous hyperpigmentation disorders, with oxidative stress recognized as a key pathogenic mechanism. However, a comprehensive, multi-level characterization of the causal link between chronic UVB exposure and the resulting oxidative, histological, and melanogenic responses is needed. This study aimed to quantitatively validate a preclinical model of UVB-induced hyperpigmentation by characterizing the reciprocal regulation of key oxidative stress biomarkers and correlating these changes with objective histological evidence of hyperpigmentation. Methods: This controlled in vivo experimental study used 14 male Sprague Dawley rats, divided into a control group (KN; n=7) and a UVB-exposed group (KP; n=7). The KP group received chronic UVB radiation (300 mJ/cm² daily, 5 days/week for 4 weeks). Dorsal skin tissue was harvested for analysis. Oxidative stress was assessed by quantifying malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) levels via ELISA. Hyperpigmentation was objectively validated and quantified using Fontana-Masson staining for melanin deposition and immunohistochemistry for microphthalmia-associated transcription factor (MITF). Results: Chronic UVB exposure induced significant hyperpigmentation, confirmed by a 5.8-fold increase in epidermal melanin content (p < 0.001) and a 4.1-fold increase in the number of MITF-positive melanocytes (p < 0.001) in the KP group. This was accompanied by a profound oxidative imbalance: MDA levels increased by 7.5-fold (p < 0.001), while the activities of SOD, CAT, and GPx decreased by 80.5%, 65.2%, and 71.4%, respectively (all p < 0.001). A strong negative correlation was observed between MDA and all antioxidant enzymes, particularly SOD (r = -0.985, p < 0.001). Conclusion: Chronic UVB exposure directly triggers a collapse of the cutaneous antioxidant network, leading to severe lipid peroxidation. This state of profound oxidative stress is causally linked to melanocyte activation and excessive melanin synthesis, driving the hyperpigmentation phenotype. This robustly validated preclinical model provides a powerful platform for investigating the molecular pathophysiology of UVB-induced pigmentary disorders and for evaluating novel therapeutic interventions.

Beyond 'Blunt': A Pathophysiology-Guided Framework for Managing High-Risk Pediatric Foreign Body Ingestion Fatmala Haningtyas; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1443

Background: Foreign body ingestion is a significant cause of pediatric morbidity. The traditional "blunt" classification is insufficient for risk stratification, as objects like magnets and impacted items pose distinct threats based on their intrinsic properties. This study analyzes how a pathophysiology-based approach, distinguishing active (magnetic) from passive (mechanical) injury mechanisms, guides clinical decision-making. Methods: We conducted a retrospective, descriptive case series at a tertiary pediatric surgical center, reviewing cases from January 2022 to December 2024. Five illustrative cases of high-risk blunt foreign body ingestion were selected to demonstrate the spectrum of management based on the object's potential for harm. Results: The series included five children (aged 3-7 years). A 7-year-old with a single gastric magnet retained for five days developed mucosal injury and required urgent endoscopic removal. A 5-year-old with a recently ingested solitary gastric magnet and a 3-year-old with an impacted pyloric pendant also underwent urgent endoscopic removal. A 6-year-old with a gastric coin had elective endoscopy due to socioeconomic factors. In contrast, a 5-year-old with a coin that passed the pylorus was managed conservatively with spontaneous passage. All patients had successful outcomes. Conclusion: The management of pediatric foreign body ingestion should be dictated by the object's pathophysiological potential for injury, not its shape. Understanding the difference between active magnet-induced pressure necrosis and passive mechanical impaction is paramount for applying guidelines effectively and preventing severe complications. This framework supports a necessary shift from shape-based to mechanism-based risk assessment.

The Vesicovaginal Fistula Repair Dilemma: A Systematic Review and Meta-Analysis of Transabdominal versus Transvaginal Surgical Approaches Al Kahfi Harifudin; Ali Husein
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1444

Background: The optimal surgical approach for repairing a vesicovaginal fistula (VVF) remains a subject of significant clinical debate. Both transabdominal and transvaginal techniques have distinct advantages and disadvantages, leading to a dilemma in surgical decision-making. This systematic review and meta-analysis aims to provide a comprehensive, evidence-based comparison of the two approaches, focusing on surgical success, complications, and perioperative outcomes. Methods: This review was conducted and reported in accordance with the PRISMA 2020 guidelines. A systematic search of PubMed, Scopus, and Web of Science was performed for comparative studies published between January 2015 and August 2025. We included studies directly comparing transabdominal and transvaginal VVF repair. The primary outcome was surgical success (fistula closure). Secondary outcomes included overall complications, mean operative time, and length of hospital stay. A random-effects model was used for meta-analysis to calculate pooled Odds Ratios (OR) and Mean Differences (MD) with 95% Confidence Intervals (CI). Results: From 1,284 articles identified, seven comparative studies involving 678 patients (335 transvaginal, 343 transabdominal) were included. The meta-analysis revealed no statistically significant difference in surgical success rates between the transvaginal and transabdominal approaches (OR 1.12, 95% CI 0.68,1.85, p=0.65; I²=21%). However, the transvaginal approach was associated with a significantly lower rate of overall complications (OR 0.45, 95% CI 0.28,0.73, p=0.001; I²=0%). Furthermore, the transvaginal approach demonstrated significantly shorter mean operative times (MD -58.45 minutes, 95% CI−75.60,−41.30, p<0.00001; I²=88%) and a shorter mean length of hospital stay (MD -3.15 days, 95% CI −4.01,−2.29, p<0.00001; I²=92%). Conclusion: While both surgical approaches yield comparable fistula closure rates, the transvaginal technique offers a superior safety and efficiency profile, with significantly fewer complications, shorter operative times, and reduced hospitalization. These findings suggest that the transvaginal route should be considered the preferred approach for anatomically suitable fistulas, though surgeon expertise and fistula characteristics remain paramount in resolving the VVF repair dilemma.

A Retrospective Analysis of Clinical Characteristics and Neutrophil-to-Lymphocyte Ratio in Hospitalized Indonesian Patients with Pemphigus Vulgaris and Bullous Pemphigoid: A Single-Center Experience Azhar Arrosyid; Nurrachmat Mulianto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1445

Background: Comprehensive clinical-epidemiological data on severe autoimmune bullous diseases (ABDs) from Southeast Asian populations are notably scarce. Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are the most common ABDs, and understanding their presentation in diverse ethnic and geographic contexts is crucial for global health equity. This study’s primary aim was to characterize a cohort of hospitalized ABD patients in Central Java, Indonesia, and to secondarily explore the behavior of the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker within this real-world clinical setting. Methods: A retrospective, cross-sectional study was conducted at a tertiary referral hospital in Surakarta, Indonesia. The study included all patients admitted with a final diagnosis of PV or BP between January 2019 and December 2023. Comprehensive data on demographics, documented comorbidities, duration of hospitalization, and admission hematological parameters were extracted from medical records. Clinical characteristics were compared, and the non-parametric Mann-Whitney U test was used to analyze the difference in NLR. A post-hoc power analysis was performed to contextualize the hematological findings. Results: This study provides a detailed clinical profile of 30 hospitalized ABD patients. The PV cohort (n=17) was characterized by a younger age of onset (mean age 54.29 ± 14.83 years) and a strong female predominance (70.6%). In contrast, the BP cohort (n=13) was older (mean age 63.08 ± 22.01 years) with a balanced gender distribution. A key finding was that patients with PV had a significantly longer duration of hospitalization than those with BP (13.24 vs. 10.15 days, p < 0.05). The mean NLR was descriptively higher in BP (10.56 ± 7.22) than in PV (9.43 ± 6.14), but this difference was not statistically significant (p = 0.770), a finding consistent with the study’s critically low statistical power of 9.8%. Conclusion: This study presents a valuable clinical and epidemiological snapshot of hospitalized patients with PV and BP in an underrepresented Indonesian population, highlighting a significantly greater clinical burden for PV as quantified by length of stay. The exploratory analysis of the NLR was inconclusive and should not be interpreted as definitive evidence against its utility. Instead, it serves as a powerful illustration of how the effects of low statistical power and overwhelming, unmeasured confounding from disease severity and corticosteroid treatment present profound challenges to the validation of non-specific biomarkers in complex, real-world clinical scenarios.

Presumed Polymyositis in Chronic Hepatitis C: Navigating Diagnostic Uncertainty and Therapeutic Imperatives in Recurrent Myopathy I Ketut Wardika; Pande Ketut Kurniari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (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.v9i12.1446

Background: Polymyositis (PM) is a cell-mediated inflammatory myopathy for which viral triggers, particularly the Hepatitis C virus (HCV), are increasingly recognized. The convergence of these conditions creates a formidable clinical scenario, often compelling urgent therapeutic intervention despite incomplete diagnostic data. This report explores the management of such a case, highlighting the pragmatic decision-making required when definitive investigations are deferred. Case presentation: A 48-year-old male with untreated chronic HCV infection (Genotype 1b, viral load 2.8 x 10⁶ IU/mL) presented with a debilitating relapse of severe, symmetric proximal muscle weakness, three years after a similar episode. He exhibited profound weakness (Medical Research Council grade 2/5 in hip flexors) and marked myonecrosis (Creatine Kinase 8,572 U/L). Although comprehensive myositis-specific autoantibodies were negative, a strong clinical and biochemical profile led to a presumptive diagnosis of an acute PM exacerbation. Definitive diagnostics, including muscle biopsy, were deferred by the patient. Empirical treatment with high-dose corticosteroids and azathioprine was initiated, predicated on a careful risk-benefit analysis concerning immunosuppression in active viral infection. This strategy resulted in rapid and significant clinical and biochemical improvement. The patient was subsequently scheduled for direct-acting antiviral therapy to address the underlying viral trigger. Conclusion: This case underscores the critical challenge of managing severe, presumed autoimmune disease in the face of diagnostic ambiguity. It demonstrates that a therapeutic strategy guided by strong clinical evidence can be effective for controlling acute, disabling flares. Furthermore, it champions a necessary dual-paradigm approach: acute immunomodulation to preserve function, followed by targeted antiviral therapy to eradicate the probable etiological trigger, thereby aiming to prevent future recurrence and achieve durable remission.

Gonococcal and Non-Gonococcal Urethritis in a Global Travel Hub: A Retrospective Analysis of Syndromic Management, Suboptimal Cefixime Monotherapy, and the Public Health Crisis of Patient Retention in Bali, Indonesia Andrew Wicaksono; I Gusti Ayu Agung Elis Indira; Ni Made Dwi Puspawati; Aditya Permana; Nyoman Suryawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1447

Background: The inexorable rise of antimicrobial resistance (AMR) in Neisseria gonorrhoeae represents a formidable threat to global public health, jeopardizing the efficacy of last-line treatments for gonococcal urethritis (GO). Southeast Asia is a recognized epicenter for the emergence and dissemination of AMR, yet granular surveillance data from many high-risk localities remain critically sparse. This study aimed to provide a comprehensive characterization of the clinical epidemiology, frontline management practices, and patient outcomes of male urethritis at a tertiary referral center in Bali, Indonesia—a major international crossroads for tourism and migration. Methods: A retrospective, cross-sectional analysis was conducted on the medical records of male patients diagnosed with urethritis at the Dermatology and Venereology Polyclinic of Ngoerah Hospital between January 1st, 2021, and December 31st, 2024. A rigorous screening process of 215 initial records was undertaken to identify eligible cases. Data on sociodemographics, behavioral risk factors, clinical presentation, syndromic diagnosis, prescribed pharmacotherapy, and follow-up adherence were systematically extracted and analyzed using descriptive and comparative statistics. Results: From the initial cohort, 58 male patients met the final inclusion criteria. The cohort was predominantly diagnosed with GO (n=39, 67.2%) over non-gonococcal urethritis (NGO) (n=19, 32.8%). Patients were primarily of productive age (25–44 years, 58.6%) and reported high-risk behaviors, including multiple sexual partners (65.5%). A critical deviation from international treatment guidelines was identified: 97.4% (38/39) of GO patients received oral cefixime 400 mg monotherapy, a regimen no longer recommended for first-line use due to AMR concerns. Furthermore, a profound fracture in the care cascade was evident, with an overall loss-to-follow-up rate of 58.6% (34/58). This failure was most pronounced in the GO cohort, where 76.9% (30/39) of patients did not return for scheduled follow-up, a rate significantly higher than the 21.1% (4/19) observed in the NGO cohort (p<0.001). Conclusion: The clinical management of gonorrhoea at this major Indonesian referral center is defined by two systemic failures: the routine prescription of a suboptimal antimicrobial monotherapy and a near-total collapse of patient follow-up. This combination, situated in a high-transience international hub, creates an unmonitored, high-risk environment for the selection, amplification, and global dissemination of antimicrobial-resistant N. gonorrhoeae. These findings signal an urgent imperative to align local therapeutic protocols with evidence-based global standards and to implement robust, innovative strategies to ensure patient retention and verify the cure.

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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