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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

113 114 115 116 117

Loss of E-cadherin Expression Stratifies Aggressive versus Non-Aggressive Papillary Thyroid Carcinoma Dwi Yanti Fioni Putri; Yenita; Aswiyanti Asri; Tofrizal; Rony Rustam; Husna Yetti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1498

Background: Papillary thyroid carcinoma (PTC) is generally indolent, yet specific histological subtypes defined by the World Health Organization (WHO) are linked to aggressive behavior and poor prognosis. The loss of the cell-adhesion protein E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT), a process implicated in tumor aggression. However, its role in stratifying PTC subtypes versus its correlation with tumor stage remains a significant controversy in the literature. This study aimed to disentangle these two parameters by clarifying the relationship between E-cadherin expression and both histological phenotype and tumor stage. Methods: This was an observational, cross-sectional pilot study on 40 randomly selected, formalin-fixed, paraffin-embedded (FFPE) PTC cases from a 2024 cohort (N=74) at a tertiary hospital in Indonesia. All cases were re-evaluated and classified according to the WHO 5th Edition (2022) criteria as non-aggressive (n=34) or aggressive (n=6). E-cadherin expression was assessed by immunohistochemistry (IHC) using a standardized semi-quantitative scoring system (product of intensity and proportion) adapted from previous studies, with inter-rater reliability assessed (Cohen’s Kappa = 0.88). Scores were dichotomized as 'High' (n=25) or 'Low' (n=15). The association between E-cadherin expression and both histological subtype and AJCC 8th Edition tumor stage (Early: I/II [n=32] vs. Advanced: III/IV [n=8]) was analyzed using Fisher's Exact Test, with Odds Ratios (OR) and 95% Confidence Intervals (CI) calculated. Results: High E-cadherin expression was observed in 62.5% of cases. A statistically significant and strong association was found between E-cadherin expression and histological subtype (p=0.021; OR 12.0; 95% CI 1.2–118.9). Low E-cadherin expression was present in 83.3% (5 of 6) of aggressive-subtype tumors, versus only 29.4% (10 of 34) of non-aggressive subtypes. In contrast, no significant correlation was found between E-cadherin expression and advanced tumor stage (p=0.126; OR 3.67; 95% CI 0.7–18.6). Conclusion: Loss of E-cadherin expression is a significant biomarker associated with high-risk, aggressive histological phenotypes in PTC. Its lack of correlation with tumor stage, confirmed by an uncertain OR, suggests E-cadherin's role is indicative of an inherent tumor biological phenotype (aggressiveness) rather than a linear marker of tumor progression (stage). This dichotomy, likely reflecting EMT/MET plasticity, positions E-cadherin IHC as a powerful ancillary tool for pathological risk stratification.

The Oral-Skin Axis in Autoinflammation: A Case Report of Severe Refractory Generalized Pustular Psoriasis (GPP) Resolved by Comprehensive Periodontal Intervention Ni Putu Wina Widyastuti; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra; Handelia Phinari; Luh Putu Venny Cempaka Sari; Kevin Jonathan Djuanda; Mario Korwa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1499

Background: Generalized pustular psoriasis (GPP) is a severe, IL-36-driven autoinflammatory dermatosis, distinct from psoriasis vulgaris. Chronic periodontitis (CP) is a dysbiotic inflammatory disease sharing pathogenic pathways (IL-1, IL-17). An "oral-skin axis" has been hypothesized, but definitive clinical evidence of CP driving a GPP flare is scarce. Case presentation: We present a 37-year-old male with a history of plaque psoriasis who developed a severe, refractory GPP flare (GPPASI 35.8) with high-grade fever (38.9°C), profound neutrophilic leukocytosis (22.5 x 10³/µL), and markedly elevated CRP (150 mg/L). The flare was resistant to maintenance methotrexate. Workup revealed severe CP with multiple periapical abscesses, culture from which grew Porphyromonas gingivalis and Fusobacterium nucleatum. The patient underwent a comprehensive dental intervention, including emergency extractions and full-mouth debridement, with concurrent peri-operative Amoxicillin-Clavulanate therapy. This combined intervention led to a rapid resolution of fever, neutrophilia, and cutaneous pustulation within 72 hours, without any escalation of systemic immunomodulators. He achieved complete remission (GPPASI 1.0) at 3-month follow-up. Conclusion: This case provides a strong temporal association supporting the oral-skin axis, highlighting severe periodontitis as a potent trigger and amplifier for GPP. The rapid resolution following a combined surgical and antibiotic intervention suggests that targeting the oral inflammatory and microbial reservoir is a critical, actionable strategy. We strongly recommend consideration of a comprehensive dental/oral screening in patients with refractory GPP.

Angiofibroma Beyond the Nasopharynx: Diagnostic Challenges and Endoscopic Management of Two Atypical Cases Arising from the Ethmoid and Sphenoid Sinuses Dolly Irfandy; Bestari Jaka Budiman; Jihan Mudrika Rahmi; Auzy Yoana Khalisha; Hippocrates Kam
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1500

Background: Angiofibroma is a histologically benign but locally aggressive vascular neoplasm almost exclusively associated with the nasopharynx of adolescent males (Juvenile Nasopharyngeal Angiofibroma, JNA). Extranasopharyngeal angiofibroma (ENA) is an exceptionally rare variant that originates outside the sphenopalatine foramen, posing significant diagnostic and management challenges due to its atypical locations, age of presentation, and clinical mimicry of other sinonasal pathologies. Case presentation: We present two sophisticated cases of ENA managed at our tertiary center. Case 1: A 35-year-old male presented with unilateral nasal obstruction. Endoscopy and imaging revealed a hypervascular mass centered in the posterior ethmoid sinus, destroying the basal lamella and abutting the skull base. Histopathological analysis was initially confounded by features resembling a solitary fibrous tumor (SFT), requiring a comprehensive immunohistochemical panel (IHC) including STAT6 and nuclear beta-catenin to confirm the diagnosis of angiofibroma. Case 2: A 17-year-old male presented with symptoms and imaging (non-contrast CT) highly suggestive of a benign sphenochoanal polyp. An initial attempt at routine endoscopic removal was aborted due to unexpected, profuse hemorrhage. Subsequent advanced imaging (CTA/MRI) revealed a hypervascular sphenoid-based angiofibroma. Both patients underwent preoperative superselective embolization followed by successful, purely endoscopic tumor resection with no recurrence at 12 and 18-month follow-up, respectively. Conclusion: ENA is a critical, albeit rare, diagnostic consideration for any vascular sinonasal mass, regardless of patient age or tumor location. These cases underscore the unreliability of "classic" clinical and radiological signs, the diagnostic pitfalls of histopathological mimics like SFT and polyps, and the critical role of advanced IHC (nuclear beta-catenin) for definitive diagnosis. A modern, multidisciplinary approach combining preoperative embolization with endoscopic resection offers a safe and effective pathway to cure.

Divergent Inflammatory Trajectories: Independent Predictive Value of Admission Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratios for Acute Ischemic Stroke Severity in a Southeast Asian Cohort Kadek Kristian Dwi Cahya; I Ketut Sumada; Desie Yuliani; Ni Made Kurnia Dwi Jayanthi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1501

Background: Systemic sterile inflammation acts as a critical pathophysiological driver in the acute phase of ischemic stroke, mediating secondary brain injury through blood-brain barrier disruption and microvascular thrombosis. While the Neutrophil-to-Lymphocyte Ratio (NLR) and Lymphocyte-to-Monocyte Ratio (LMR) have emerged as potential biomarkers in Western populations, their independent prognostic utility and specific diagnostic thresholds within Southeast Asian populations remain under-explored. This region presents unique challenges due to potential variations in baseline hematological profiles driven by genetic polymorphisms and environmental factors. This study aims to elucidate the association between admission NLR and LMR levels and the severity of Acute Ischemic Stroke (AIS) and to determine optimal population-specific prognostic cut-offs. Methods: We conducted a retrospective cross-sectional comparative study involving 128 patients with confirmed AIS admitted to Wangaya Regional General Hospital, Indonesia, between January 2025 and August 2025. Patients were stratified based on admission National Institutes of Health Stroke Scale (NIHSS) scores into a Mild Group (NIHSS ≤ 6, n=64) and a Moderate-Severe Group (NIHSS > 6, n=64). Infection was strictly excluded using clinical and radiological criteria independent of admission leukograms to prevent circular bias. Receiver Operating Characteristic (ROC) curve analysis was performed to determine diagnostic accuracy and identify optimal cut-offs. To address potential multicollinearity between NLR and LMR, two separate multivariate binary logistic regression models were constructed to determine independent predictors of severity. Results: The study population had a mean age of 60.5 years. The Moderate-Severe Group exhibited significantly higher NLR (6.12 ± 3.41 vs. 2.85 ± 1.20; p < 0.001) and lower LMR (2.15 ± 0.92 vs. 4.22 ± 1.50; p < 0.001) compared to the Mild Group. ROC analysis identified optimal cut-offs of ≥ 4.82 for NLR (AUC: 0.782; Sensitivity: 76.6%) and ≤ 2.89 for LMR (AUC: 0.724; Sensitivity: 71.9%). In the multivariate analysis Model 1, NLR ≥ 4.82 remained an independent predictor of severity (Adjusted Odds Ratio [aOR]: 4.12; 95% CI: 1.78–9.54; p = 0.001). In the separate Model 2, LMR ≤ 2.89 was also confirmed as an independent predictor (aOR: 2.85; 95% CI: 1.24–6.55; p = 0.014). Conclusion: Elevated NLR and reduced LMR at admission are robust, independent indicators of stroke severity in this Indonesian cohort. These accessible hematological biomarkers reflect the divergent trajectories of post-ischemic neuroinflammation—innate immune hyperactivity and adaptive immune exhaustion. They provide a cost-effective method for risk stratification in resource-limited settings, warranting their integration into routine initial assessment protocols.

Therapeutic Plasma Exchange as Adjuvant Rescue Therapy for Weil’s Disease-Associated Acute Liver Failure in a Hemodialysis-Dependent Patient: A Case Report Ardana Tri Arianto; Aura Ihsaniar; Lichte Christian Purbono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1502

Background: Weil’s disease, the severe form of leptospirosis, manifests as a triad of jaundice, renal failure, and hemorrhage. In patients with pre-existing end-stage renal disease (ESRD), the management of superimposed acute liver failure (ALF) is exceptionally challenging due to altered pharmacokinetics, fluid intolerance, and the inability of standard hemodialysis to clear protein-bound hepatic toxins. Case presentation: We present a 32-year-old anuric male with ESRD on maintenance hemodialysis who presented with fever, jaundice, and altered mental status following floodwater exposure. He developed severe metabolic encephalopathy (GCS E2V2M4), profound coagulopathy (INR 6.04), and hyperbilirubinemia (Total Bilirubin 18.31 mg/dL). Following the failure of broad-spectrum antibiotics and sustained low-efficiency dialysis (SLED) to halt clinical deterioration, two sessions of therapeutic plasma exchange (TPE) were initiated as salvage therapy. The intervention utilized 100% fresh frozen plasma (FFP) replacement to address hemostatic failure. TPE resulted in rapid biochemical clearance and clinical stabilization. Post-intervention, the INR decreased from 6.04 to 1.57 (74% reduction), Total bilirubin declined from 18.31 to 5.57 mg/dL (69.5% reduction), and platelet counts recovered from 45,000 to 142,000/µL. Neurological status normalized (GCS 15) within 48 hours of the second session. Conclusion: TPE served as an effective bridge to recovery by clearing albumin-bound toxins and restoring coagulation factors in a high-risk patient where standard renal replacement was insufficient.

Nuclear β-Catenin Accumulation Correlates with Poor Survival in Undifferentiated Nasopharyngeal Carcinoma: A Retrospective Cohort Study in an Endemic Region Ayu Aksara; Awal Prasetyo; Devia Eka Listiana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1503

Background: Nasopharyngeal carcinoma (NPC) is highly endemic in Indonesia, characterized by a prevalence of undifferentiated subtypes and late-stage presentation. While the Epstein-Barr virus (EBV) is a primary driver, the limitations of TNM staging in predicting individual outcomes necessitate the identification of molecular biomarkers. This study investigates the prognostic utility of aberrant Wnt/β-catenin signaling, specifically nuclear accumulation, in predicting overall survival (OS). Methods: A retrospective cohort study was conducted on 44 patients diagnosed with undifferentiated NPC at Dr. Kariadi General Hospital, Indonesia, between 2020 and 2024. Immunohistochemistry (IHC) for β-catenin was performed, with scoring specifically targeting nuclear and cytoplasmic reactivity (excluding physiological membranous staining) using the Allred system. Clinicopathological variables, including TNM staging (AJCC 8th edition), were analyzed. Survival analysis utilized Kaplan-Meier curves and multivariate Cox Proportional Hazards regression. Results: The cohort exhibited advanced disease, with 81.8% of patients presenting at Stage III or IV. Nuclear β-catenin overexpression (moderate-to-strong) was observed in 97.7% of cases. Strong nuclear expression was significantly associated with advanced T-stage (p=0.032) and distant metastasis (p=0.045). Kaplan-Meier analysis revealed a significant reduction in 5-year overall survival for the strong expression group (0%) compared to the weak/moderate group (p < 0.001). In multivariate analysis adjusted for age and TNM stage, strong β-catenin expression remained a significant predictor of mortality (Hazard Ratio: 2.15; 95% CI: 1.05–4.42; p=0.036), alongside Stage IV disease. Conclusion: Nuclear accumulation of β-catenin is a prevalent molecular event in Indonesian NPC and serves as a significant prognostic biomarker independent of tumor stage. These findings suggest potential utility for risk stratification and targeted Wnt-inhibitor therapies.

Achieving Resectability in Giant Primary Breast Leiomyosarcoma Via Transarterial Chemoembolization: A Novel Neoadjuvant Strategy Alfred Hamonangan L Toruan; Kiki A Rizki
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1504

Background: Primary leiomyosarcoma (LMS) of the breast is an exceptionally rare and aggressive non-epithelial malignancy, constituting less than 0.1% of all breast neoplasms. Due to the scarcity of cases, no standardized consensus exists regarding neoadjuvant protocols. Large, locally advanced tumors often present with chest wall fixation, rendering upfront resection difficult or impossible without extensive morbidity. This study explores the novel application of Transarterial Chemoembolization (TACE)—traditionally reserved for hepatic malignancies—as a neoadjuvant strategy to downstage a giant breast LMS. Case presentation: We present the case of a 40-year-old female presenting with a rapidly enlarging, painless, giant mass in the right breast measuring 19 x 18 x 15 cm. Clinical and radiological evaluation (CT Thorax) revealed a heterogeneous, hypervascular mass fixed to the pectoralis major muscle, classified as BIRADS 5. Core needle biopsy confirmed high-grade Leiomyosarcoma. Due to the tumor’s size and fixation to the chest wall, the patient underwent preoperative TACE using 35 mg Doxorubicin followed by embolization of the supplying branches of the right internal mammary and thoracoacromial arteries. Post-procedure, the tumor volume significantly decreased (downsized to approx. 15 cm), and critically, the mass detached from the chest wall, becoming mobile. The patient subsequently underwent a successful total mastectomy with clear margins (R0 resection). Conclusion: TACE offers a promising, minimally invasive neoadjuvant alternative for hypervascular, giant breast sarcomas. By inducing tumor necrosis and reducing vascularity, TACE can facilitate resectability in initially fixed tumors, potentially converting inoperable cases into candidates for R0 resection while minimizing intraoperative blood loss.

The Sandwich Dual-Tissue Salvage: Synergistic Anteriorly-Based Tongue Flap and Autologous Dermofat Graft for Recalcitrant Pittsburgh Class V-VI Palatal Fistulas Anak Agung Gde Rama Kaesara; Putu Trisna Utami
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1505

Background: Recurrent palatal fistulas following cleft palate repair, particularly Pittsburgh Class V and VI defects, represent a distinct reconstructive challenge characterized by tissue ischemia, scarring, and volumetric deficiency. The "failure of failure" in these cases often precludes the use of local mucoperiosteal flaps due to the poor quality of the recipient bed. This study evaluates a standardized "dual-tissue" salvage protocol combining an anteriorly-based dorsal tongue flap with an autologous dermofat graft. Case presentation: A 21-year-old female with a recurrent, symptomatic Pittsburgh Class V-VI fistula measuring 15 mm by 12 mm underwent a two-stage reconstruction. The surgical protocol involved three distinct layers: (1) nasal lining closure via turnover flaps; (2) interposition of an inguinal dermofat graft oriented with the fatty surface facing the nasal layer to obliterate dead space; and (3) oral coverage using an anteriorly-based tongue flap. Speech outcomes were quantified using the Pittsburgh Weighted Speech Scale (PWSS) by an independent, blinded Speech-Language Pathologist. The procedure successfully achieved complete closure with no evidence of necrosis, dehiscence, or donor site morbidity. The total operative time was 145 minutes. Quantitative assessment revealed a robust improvement in speech resonance; the PWSS score improved from a severe 18/30 pre-operatively to a clinically competent 4/30 at 6 months post-operatively. The dermofat graft maintained volumetric stability, preventing the concave collapse often observed in single-layer repairs. Conclusion: The sandwich technique potentially reduces recurrence risk in high-grade fistulas by addressing the triad of failure: tension, ischemia, and dead space. The vascularized tongue flap protects the underlying graft, while the dermofat graft acts as a biological spacer and source of adipose-derived stem cells. This protocol offers a reproducible solution for complex craniofacial defects where local tissues are exhausted.

Masquerading as an Orbital Malignancy: A Rare Presentation of Pott’s Puffy Tumor with Intraorbital Extension in a Diabetic Adult Suhery; Mardijas Efendi; Silvia Roza; Hesty Lidya Ningsih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1506

Background: Pott’s puffy tumor (PPT) is a rare, life-threatening clinical entity characterized by frontal bone osteomyelitis and subperiosteal abscess, typically resulting from untreated frontal sinusitis. While predominantly a pediatric diagnosis, adult presentation is exceptionally rare and often associated with immunocompromised states. The clinical mimicry of PPT, particularly when presenting with bone destruction and orbital extension, frequently leads to misdiagnosis as a malignant neoplasm. This study aims to report a rare and instructive case of Pott’s puffy tumor in a 52-year-old diabetic female. Case presentation: We report a case of a 52-year-old female with uncontrolled Type 2 Diabetes Mellitus presenting with progressive left ocular proptosis, globe displacement, and blurred vision persisting for two months. Imaging revealed a heterogeneous mass in the frontoethmoidal sinus with extensive osteolytic destruction of the orbital roof and frontal bone, initially raising strong suspicion of a sinonasal malignancy or metastasis. The patient underwent a bicoronal craniectomy and debridement. Intraoperative findings revealed a purulent subperiosteal collection and necrotic bone, confirming the diagnosis of PPT with intraorbital extension. The defect was repaired via craniofacial reconstruction using bone cement. Post-operative culture analysis confirmed a polymicrobial infection. Conclusion: This case underscores the necessity of maintaining a high index of suspicion for PPT in diabetic adults presenting with proptosis and osteolytic radiographic findings. Although rare, PPT can masquerade as a malignancy. Early recognition and a multidisciplinary approach combining aggressive surgical debridement with targeted antibiotic therapy are imperative to prevent catastrophic intracranial and orbital complications.

Diagnostic Value of Platelet-to-Lymphocyte Ratio Versus Neutrophil-to-Lymphocyte Ratio in Early-Onset Neonatal Sepsis: A Retrospective Analysis in a Limited-Resource Setting Delicia Rudy; Nova Damayanti; Putu Siska Suryaningsih; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1507

Background: Early-onset neonatal sepsis remains a critical cause of mortality in developing nations. Blood culture, the gold standard, suffers from delay and low sensitivity. While hematologic indices such as neutrophil-to-lymphocyte ratio (NLR) are used in adults, their utility in the first 72 hours of life is confounded by physiological instability. This study evaluates the diagnostic accuracy of the platelet-to-lymphocyte ratio (PLR) compared to NLR, mean platelet volume (MPV), and red cell distribution width (RDW) in early-onset neonatal sepsis. Methods: A retrospective observational study was conducted on 55 neonates (25 septic, 30 symptomatic non-septic controls) at a tertiary center in Indonesia. Sepsis was defined by clinical criteria and C-reactive protein positivity, independent of complete blood count parameters, to avoid incorporation bias. Diagnostic performance was assessed using Mann-Whitney U tests, receiver operating characteristic curve analysis, and multivariable logistic regression to control for confounders, including asphyxia. Results: The median PLR was significantly lower in the sepsis group compared to controls (32.6 [IQR 3.4–100.4] versus 71.1 [IQR 45.3–82.9]; p = 0.016). Conversely, NLR (p = 0.80), MPV (p = 0.163), and RDW (p = 0.422) showed no significant discrimination. PLR yielded an area under the curve of 0.724. At a cut-off of equal to or less than 40.5, determined by the Youden Index, PLR demonstrated a sensitivity of 68.0%, specificity of 73.3%, positive likelihood ratio of 2.55, and negative likelihood ratio of 0.44. Multivariable regression confirmed PLR as an independent predictor (Adjusted Odds Ratio 0.96; 95% CI 0.93–0.99; p = 0.038) after adjusting for birth asphyxia. Conclusion: PLR demonstrates superior discriminative ability over NLR for early-onset sepsis in this cohort. The distinct inverse PLR phenomenon reflects sepsis-induced thrombocytopenia and bone marrow suppression. While not a standalone diagnostic tool, PLR serves as a valuable, zero-cost adjunctive marker for risk stratification in resource-limited settings.

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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