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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Published by HM Publisher

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 1,518 Documents

135 136 137 138 139

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 (2026): 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 (2026): 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 (2026): 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 (2026): 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.

Efficacy and Safety of Adjunctive Corticosteroids in Non-HIV Pneumocystis jirovecii Pneumonia with Respiratory Failure: A Systematic Review and Meta-Analysis of Randomized and Observational Studies Reza Rahmadinata; Rohani Lasmaria
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1508

Background: Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised patients carries a mortality rate significantly higher than in the HIV-positive population. While adjunctive corticosteroids are the standard of care for HIV-associated pneumonia to prevent Immune Reconstitution Inflammatory Syndrome, their efficacy in non-HIV patients remains controversial due to differing immunopathogenesis. This study evaluated the efficacy and safety of adjunctive corticosteroids in non-HIV patients with respiratory failure, specifically addressing the discordance between historical observational data and recent randomized evidence. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching databases from January 2014 to July 2025. We included randomized controlled trials and observational studies of non-HIV adults with pneumonia receiving adjunctive corticosteroids. To address methodological heterogeneity, we performed stratified analyses separating randomized trial data from observational cohorts and conducted sensitivity analyses to account for outliers. Risk of bias was assessed using Cochrane RoB-2 and the Newcastle-Ottawa Scale. Results: Ten studies comprising 2,900 patients were analyzed. The randomized trial demonstrated no statistically significant reduction in 28-day mortality with corticosteroids (21.5% vs 32.4%, p=0.069). In the observational arm, initial pooled analysis suggested benefit, but sensitivity analysis removing a large administrative database study shifted the result to null. Crucially, higher cumulative steroid doses were associated with increased 90-day mortality (Hazard Ratio 1.01 per 100mg equivalent; p<0.05) and a significantly increased risk of secondary infections and hyperglycemia. Subgroup analysis revealed no benefit for pulse-dose regimens over standard dosing. Conclusion: Unlike in HIV, adjunctive corticosteroids do not confer a consistent survival benefit in non-HIV Pneumocystis pneumonia and are associated with dose-dependent toxicity. The routine use of corticosteroids should be abandoned in favor of a cautious approach restricted to severe, early hypoxemia using standard rather than pulse doses.

Impact of Co-existing Adenomyosis on Pain Recurrence Following Deep Endometriosis Excision: A Systematic Review and Meta-Analysis of Multivariate-Adjusted Observational Cohorts Ninda Frymonalitza
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1509

Background: Deep endometriosis (DE) represents a severe phenotype characterized by subperitoneal infiltration >5mm. While complete surgical excision is the gold standard, postoperative recurrence of pain and lesions remains clinically significant. Growing evidence implicates co-existing adenomyosis as a prognostic factor, yet its independent impact on DE surgery outcomes is debated. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2014 and 2025. Data were synthesized from seven high-quality studies involving 2,056 participants, focusing on those utilizing multivariate regression or propensity score matching. The primary outcomes were recurrence of pain (dysmenorrhea, dyspareunia), anatomical lesion recurrence, and surgical complications. Secondary outcomes included fertility. Results: The prevalence of adenomyosis in DE patients ranged from 35.6% to 49.05%. Patients with adenomyosis had significantly higher preoperative pain scores. Postoperatively, adenomyosis was an independent predictor of pain persistence and lesion recurrence. Extrinsic adenomyosis was associated with a 2.5-fold increased risk of early recurrence (OR 2.5; 95% CI 1.2–3.4). Survival analysis showed a 60% recurrence-free probability at 5 years for those with adenomyosis vs. 81% for those without. Surgical complications were significantly higher in the adenomyosis group (OR 4.56; 95% CI 1.90–11.30). Conclusion: Co-existing adenomyosis is a robust independent risk factor for failure of DE surgery, leading to persistent pain, lesion recurrence, and increased surgical morbidity. This supports the outside-in theory of pathogenesis. Preoperative screening for adenomyosis via TVS/MRI is mandatory for accurate counseling and surgical planning.

Fatal Disseminated Tuberculosis in Vaccinated Children with Failed BCG Scar Formation: A Clinical-Pathological Correlation and Immunological Review Delicia Rudy; Prisillia Brigitta; I Kadek Suarca
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1510

Background: The Bacillus Calmette-Guérin (BCG) vaccine remains the cornerstone of preventative strategies against severe pediatric tuberculosis (TB), specifically disseminated forms such as miliary TB and tuberculous meningitis (TBM). While the formation of a cutaneous scar is historically viewed as a surrogate marker for successful vaccine uptake and delayed-type hypersensitivity (DTH), its absence is often clinically overlooked. This study investigates the correlation between the lack of BCG scarring, immunological anergy, and fatal disseminated disease outcomes. Case presentation: We report a clinical-pathological analysis of two pediatric patients admitted to a tertiary care center in Indonesia. Case 1, an 11-month-old male vaccinated at birth, presented with status epilepticus and was diagnosed with Probable TBM Stage III. Despite vaccination, he lacked a BCG scar and exhibited Tuberculin Skin Test (TST) anergy (0 mm). Case 2, a 2-year-8-month-old female vaccinated at birth, presented with Type 1 respiratory failure due to severe miliary TB. She demonstrated profound wasting and TST anergy (0 mm). Both patients succumbed to the disease (Day 9 and Day 14, respectively) despite aggressive management. Conclusion: The absence of a BCG scar in vaccinated children serves as a critical clinical indicator of "immunological silence." It correlates with a failure to mount the Th1-mediated granulomatous response necessary for containing lymphohematogenous spread. We recommend that scar failure be treated as a risk factor requiring enhanced surveillance and a lower threshold for preventative therapy.

Precipitation of Occult Lymphomatous Hemorrhage by Early Initiation of Factor Xa Inhibitors: A Pharmacovigilance Case Study and Critical Reappraisal of DOAC Safety Kadek Cahya Adwitya; I Putu Bayu Triguna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1511

Background: The concurrent management of cancer-associated thrombosis (CAT) and active malignancy represents a precarious clinical equilibrium, particularly when the neoplasm involves occult extranodal gastrointestinal (GI) sites. While direct oral anticoagulants (DOACs) have largely supplanted low-molecular-weight heparin (LMWH) as the standard of care for CAT, emerging pharmacovigilance data suggest a specific vulnerability in patients with luminal GI malignancies. Case presentation: We report the case of a 76-year-old frail female presenting with extensive left iliofemoral deep vein thrombosis (DVT). Diagnostic evaluation identified a perfect storm of pathology: Stage IV diffuse large B-cell lymphoma (DLBCL) with bulky retroperitoneal lymphadenopathy encasing the inferior vena cava (IVC) and a suspicious infiltrative mass in the proximal jejunum. Following standard guidelines, the patient was initiated on rivaroxaban. However, this intervention precipitated a catastrophic upper GI hemorrhage (hemoglobin drop to 6.5 g/dL) within 96 hours. A retrospective pharmacokinetic audit revealed critical predisposing factors: severe hypoalbuminemia (1.6 g/dL) increasing the free drug fraction, and an estimated glomerular filtration rate (eGFR) <30 mL/min, suggesting the patient was effectively overdosed relative to her physiological clearance. Conclusion: The empiric use of rivaroxaban in elderly patients with uncharacterized abdominal masses, renal impairment, and cachexia carries unacceptable hemorrhagic risks. We advocate for a systematic bleed-risk stratification protocol, prioritizing LMWH or Apixaban, and the judicious use of IVC filters as bridging therapies in high-risk phenotypes.

Tear Reservoir Thickness and Vector-Resolved Refractive Outcomes in Indonesian Corneal Ectasia: A Scleral Lens Pilot Study Anak Agung Ayu Putri Prematura Sri Anasary; Ariesanti Tri Handayani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1512

Background: Corneal ectasia is characterized by high-order aberrations and irregular astigmatism, presenting significant optical challenges. Scleral lenses neutralize these irregularities via a post-lens tear reservoir. However, the precise optical contribution of the tear reservoir thickness itself to residual refractive error remains under-characterized, particularly in Southeast Asian populations where aggressive ectasia phenotypes are common. This study aimed to determine if tear reservoir thickness correlates with residual refractive error using vector analysis. Methods: This retrospective pilot study analyzed 12 eyes of 8 patients with severe corneal ectasia fitted with scleral lenses in Indonesia. Refractive outcomes were converted to Thibos power vectors (M, J0, J45). To account for bilateral eye correlations, linear mixed models (LMM) were employed with Patient ID as a random effect. A theoretical thick-lens model compared predicted versus observed over-refraction. Results: The cohort (mean age 28 ± 10.2 years) achieved significant visual improvement (LogMAR 0.35 to 0.17; p = 0.005). The mean tear reservoir thickness was 263.33 ± 80.92 μm. LMM analysis revealed no statistically significant correlation between fluid thickness and Spherical Equivalent (M) (beta = -0.001, p = 0.72) or Blur Strength (p = 0.68). The theoretical model indicated that residual error was driven by uncorrected posterior corneal astigmatism rather than fluid depth. Conclusion: In this Indonesian cohort, optical efficacy was driven by refractive index matching at the corneal interface, not reservoir thickness. Clinical fitting should prioritize physiological clearance over refractive manipulation.

Psoriasiform Digital Bowen’s Disease: A Diagnostic Challenge and Short-Term Response to Liquid Nitrogen Cryotherapy Putu Resika Melarosa; Ketut Kwartantaya Winaya; Lettisia Amanda Ruslan; Made Sri Adnyasitarini; Putu Ayu Paramitha Saraswaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1513

Background: Bowen’s disease (BD), or squamous cell carcinoma in situ, classically presents as a slowly enlarging erythematous plaque on sun-exposed skin. However, digital Bowen’s disease represents a distinct and rare clinical subset that frequently poses a significant diagnostic dilemma. Due to its unique anatomical location and morphological variability, digital BD often masquerades as benign inflammatory dermatoses, particularly psoriasis or chronic eczema, leading to dangerous therapeutic delays. Case presentation: We report the case of a 46-year-old male presenting with a solitary, rough, erythematous plaque on the dorsal aspect of the left index finger that had persisted for one year. The lesion was initially misdiagnosed and treated as an inflammatory condition without success. Detailed dermoscopic evaluation revealed a specific "psoriasiform" vascular pattern characterized by clustered glomerular vessels and surface scaling, raising suspicion for malignancy. Histopathological analysis confirmed the diagnosis of Bowen’s disease, demonstrating full-thickness epidermal atypia with psoriasiform hyperplasia. Notably, the presence of histological koilocytic atypia suggested a potential synergistic etiology involving Human Papillomavirus (HPV) infection alongside chronic ultraviolet exposure. The patient was treated with a tissue-sparing protocol of liquid nitrogen cryotherapy to preserve digital function. Conclusion: Complete clinical resolution of the lesion was observed at the three-week follow-up interval, resulting in a hypopigmented macule with full preservation of joint mobility. This case highlights the critical necessity of distinguishing "psoriasiform" malignancies from true inflammatory diseases through the recognition of specific vascular arrangements in dermoscopy. Furthermore, it suggests that cryotherapy is a pragmatic, function-sparing alternative to surgical excision for digital malignancies, provided that rigorous long-term surveillance is maintained to monitor for recurrence.

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Rachmat Hidayat

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Contact Name Rachmat Hidayat

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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

Abstract

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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