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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
Bioscientia Medicina : Journal of Biomedicine and Translational Research
Published by HM Publisher
ISSN : -     EISSN : 25980580     DOI : https://doi.org/10.37275/bsm
Core Subject : Health, Science,
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.
Articles 1,518 Documents
Mycobacterium marinum Co-infection Masquerading as Treatment-Resistant Chromoblastomycosis: A Diagnostic and Therapeutic Challenge in Cutaneous Co-infection Stefanus Soewito Sutanto; Ni Luh Putu Ratih Vibriyanti Karna; Herman Saputra; Robert Thiodorus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (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.v10i7.1624

Abstract

Background: Co-infection of chromoblastomycosis and Mycobacterium marinum (fish tank granuloma) within a single cutaneous lesion is exceptionally rare and presents a formidable diagnostic challenge owing to overlapping clinical and histopathologic features. The chronic verrucous or nodular morphology, predilection for distal extremities, and aquatic exposure history common to both conditions can lead to misdiagnosis, prolonged ineffective therapy, and patient morbidity. Case presentation: A 31-year-old Indonesian male with a fishkeeping hobby presented with a persistent erythematous plaque on the right middle finger, present since 2022, following a puncture injury sustained while collecting mosquito larvae and water fleas as fish food. He was initially diagnosed with chromoblastomycosis (Phialophora spp. on culture) in September 2023 and treated with itraconazole 200 mg daily and topical miconazole 2% for 48 weeks without resolution. Repeat biopsy in 2024 demonstrated negative periodic acid-Schiff and Ziehl-Neelsen stains but revealed non-caseating tuberculoid granulomas. Considering the patient's aquatic exposure, antifungal failure, and granulomatous histopathology, a diagnosis of fish tank granuloma due to M. marinum co-infection was established. Combination antimycobacterial therapy with rifampicin 600 mg and ethambutol 1500 mg daily produced clinical resolution at six-month follow-up. Conclusion: This case underscores the necessity of considering M. marinum in patients with antifungal-refractory chronic skin lesions and aquatic exposure, and highlights the diagnostic value of repeat histopathology with directed staining when initial therapy fails.
Membranous β-Catenin Expression Inversely Correlates with WHO/ISUP Grading in Clear Cell Renal Cell Carcinoma: An Indonesian Cross-Sectional H-Score Study Rifka Ulfa Rosyida; Kenty Wantri Anita; Ihda Dian Kusuma; Eviana Norahmawati; Rachmad Sarwo Bekti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (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.v10i7.1625

Abstract

Background: Clear cell renal cell carcinoma (ccRCC) is the most common adult renal malignancy and exhibits heterogeneous clinical behavior that is currently stratified by the WHO/ISUP nuclear grading system. β-catenin, the terminal effector of canonical Wnt signaling and an integral component of the cadherin–catenin adhesion complex, has been implicated in epithelial–mesenchymal transition (EMT) and tumor progression, but its quantitative relationship with WHO/ISUP grade in Indonesian ccRCC has not been reported. Methods: This analytic observational cross-sectional study examined 73 archived formalin-fixed, paraffin-embedded ccRCC specimens collected at the Anatomical Pathology Installation of Dr. Saiful Anwar Regional General Hospital Malang between January 2019 and May 2025. Immunohistochemistry for β-catenin (Dako Clone 14, dilution 1:200) was scored independently and blindly by two anatomical pathologists using the H-score methodology across ten 400× high-power fields per case. Results: The overall mean H-score was 236.4 ± 50.6 (range 20–295). Spearman rank correlation revealed a strong, statistically significant inverse association between membranous β-catenin H-score and WHO/ISUP grade (ρ = –0.664; 95% CI –0.778 to –0.503; p < 0.001). Mean H-scores declined monotonically from Grade 1 (285 ± 28) through Grade 2 (270 ± 32), Grade 3 (228 ± 30), to Grade 4 (175 ± 32), and Receiver Operating Characteristic analysis distinguished high-grade (G3–G4) from low-grade (G1–G2) tumors with an area under the curve of 0.84. Conclusion: These findings support membranous β-catenin H-score as a biologically grounded, accessible immunohistochemical adjunct to WHO/ISUP grading and motivate further translational evaluation of the Wnt/β-catenin pathway as a stratification and therapeutic target in ccRCC.
Dose-Dependent Anti-Fibrotic Effect of Thymoquinone on Renal TGF-β1 Expression in Wistar Rats with Unilateral Ureteral Obstruction M Zulfikar Abadi; Suprapti; Muhammad Irsan Saleh; Zulkhair Ali; Novadian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (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.v10i7.1626

Abstract

Background: Renal fibrosis is the final common pathway of chronic kidney disease (CKD), regulated by the pro-fibrotic cytokine Transforming Growth Factor-β1 (TGF-β1). Thymoquinone, the principal bioactive constituent of Nigella sativa, has antioxidant, anti-inflammatory and anti-fibrotic activity in pre-clinical models, but its dose-response profile in obstructive nephropathy is incompletely characterised. Methods: This in-vivo experimental study used a post-test-only with control-group design in 30 male Wistar rats (200–250 g) randomised into six groups (n=5): sham + olive-oil; UUO + olive-oil; UUO without olive-oil; and UUO with intra-peritoneal thymoquinone at 5, 10 or 20 mg/kg body-weight daily for 14 days. The primary outcome was renal cortical TGF-β1 mRNA expression by RT-PCR; secondary outcomes were IL-6 expression, serum urea and creatinine, Sirius-red percentage of positively-stained area (PSA) and a PAS-stained tubular injury score. Results: UUO produced renal injury: urea rose from 41.3 ± 6.2 to 57.7 ± 7.6 mg/dL (p=0.003) and TGF-β1 expression rose from 473,500 ± 32,797 to 679,922 ± 27,998 densitometric units (p=0.001). Thymoquinone reduced TGF-β1 dose-dependently to 644,571 ± 25,457, 612,143 ± 23,822 and 581,571 ± 24,128 a.u. at 5, 10 and 20 mg/kg (ANOVA p=0.004); the 20 mg/kg dose was superior to lower doses (p<0.05). PSA and tubular injury improved in parallel and correlated strongly with TGF-β1 (r=0.85). Conclusion: Thymoquinone exerts a dose-dependent anti-fibrotic effect via TGF-β1 down-regulation in obstructive nephropathy, supporting its evaluation as a complementary anti-fibrotic adjunct in CKD.
Adjuvant Resveratrol Reduces Albuminuria and Serum Transforming Growth Factor-β Without Improving Glomerular Filtration Rate in Diabetic Kidney Disease: A 12-Week Randomized Controlled Trial Eva Julita; Zulkhair Ali; Yulianto Kusnadi; Legiran
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1627

Abstract

Background: Diabetic kidney disease (DKD) progresses through inflammation and fibrosis, with transforming growth factor-β (TGF-β) as the principal profibrotic mediator and albuminuria as a clinical surrogate of glomerular injury. Methods: We conducted a 12-week, double-blind, placebo-controlled randomized trial at Dr. Mohammad Hoesin General Hospital, Palembang, between October 2025 and January 2026 to evaluate adjuvant resveratrol on serum TGF-β, urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). Results: Of 61 randomized adults with DKD on standard care, 54 were analyzed (resveratrol n=27 received 25 mg twice daily, derived from Polygonum cuspidatum in 95% lecithin; placebo n=27). Within the resveratrol group, serum TGF-β fell from 123.7 to 77.1 pg/mL (p=0.008) and UACR from 94.1 to 89.8 mg/g (p=0.017); within placebo, UACR rose from 81.9 to 112 mg/g (p=0.029) while TGF-β change was non-significant (p=0.428). Between-group ΔUACR was significant (p<0.001), whereas ΔTGF-β (p=0.303) and ΔeGFR (p=0.567) were not. Multivariable linear regression identified resveratrol as an independent predictor of UACR reduction (B=−394.12 mg/g; 95% CI −659.53 to −128.71; p=0.004; adjusted R²=0.129). Baseline TGF-β was the dominant predictor of ΔTGF-β (B=−0.81; p<0.001; adjusted R²=0.701), and baseline LFG stage predicted ΔeGFR (B=−4.76; p=0.021). Mild bloating was reported in 14.8% of resveratrol versus 11.1% of placebo recipients; no serious adverse events occurred. Conclusion: Adjuvant low-dose resveratrol reduces albuminuria and serum TGF-β over 12 weeks in DKD without short-term improvement in eGFR, supporting an antifibrotic biomarker signal that warrants longer trials.
Efficacy and Safety of Travoprost Intraocular Implants in Open-Angle Glaucoma and Ocular Hypertension: A Systematic Review and Meta-Analysis Jovita Jutamulia; Agnestya Christine Zely Raule
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1628

Abstract

Background: Open-angle glaucoma (OAG) and ocular hypertension (OHT) are leading causes of irreversible visual impairment and require lifelong reduction of intraocular pressure (IOP). Topical prostaglandin analogues are the standard first-line therapy, yet their effectiveness is constrained by poor adherence. The travoprost 75 µg intracameral implant has emerged as a sustained-release alternative designed to bypass these adherence barriers. The present systematic review and meta-analysis quantitatively synthesised the efficacy and safety of this device in adults with OAG or OHT. Methods: PubMed was searched in accordance with the PRISMA 2020 statement. Original research articles evaluating the travoprost 75 µg intracameral implant in adults with OAG or OHT were eligible. Two reviewers screened, extracted data, and independently appraised risk of bias using Cochrane RoB 2.0 (RCTs) or the Newcastle–Ottawa Scale (non-randomised). Standardised mean changes in IOP were synthesised as Hedges' g under a DerSimonian–Laird random-effects model with Knapp–Hartung adjustment. Pre-specified sensitivity, leave-one-out, alternative-pool, and design sub-group analyses were performed. The funnel plot was inspected; Egger's test was deferred because k < 10. Results: Of 30 PubMed records, 10 original research studies were eligible and 6 contributed to the primary quantitative synthesis (2,152 total enrolled participants; 1,525 implant-arm participants pooled in the within-group synthesis). The pooled within-group Hedges' g for IOP reduction was 4.35 (95% CI 3.14 to 5.56; p = 0.0002). Heterogeneity was very high (I² = 96.1%, τ² = 1.121, Q = 53.64, p < 0.0001). The 95% prediction interval, derived from the same model, spanned approximately 1.13 to 7.56. The randomised-controlled-trial-only pool (k = 4) yielded a more conservative pooled estimate of g = 3.76 (95% CI 2.94 to 4.58; I² = 88.6%). Leave-one-out analyses confirmed robustness (g range 3.98–4.56). Serious ocular adverse events were rare (one endophthalmitis in the slow-eluting arm of the GC-010 phase 3 trial, with no further cases in the remaining cohorts); transient ocular hyperemia, iritis, and elevated IOP were the most common, broadly consistent with the topical-travoprost class profile. Conclusion: The travoprost 75 µg intracameral implant produced a large and consistent reduction in IOP across designs and follow-up windows, with a safety profile non-inferior to topical timolol 0.5%. The substantial heterogeneity, near-uniform sponsor footprint, and limited head-to-head comparisons against topical prostaglandin monotherapy temper the certainty of the evidence and warrant pragmatic, independent, multi-ethnic trials. Within these limits, the implant is a clinically meaningful addition to interventional glaucoma therapy, particularly for patients in whom topical adherence is the dominant driver of disease progression.
Topical Allium cepa Ethanol Extract Restores SOD and VEGF Without Increasing Hair Length in UV-B-Exposed Wistar Rats Ajeng Hana Anjani Djajaatmadja; I Made Winarsa Ruma; Ida Ayu Dewi Wiryanthini; Agung Nova Mahendra; Bagus Komang Satriyasa; I Wayan Sugiritama
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1629

Abstract

Background: Ultraviolet B (UV-B) accelerates hair photoaging by depleting cutaneous superoxide dismutase (SOD) and dysregulating vascular endothelial growth factor (VEGF). Red onion (Allium cepa) is rich in flavonoids and organosulfur precursors of hydrogen sulphide that may enhance both antioxidant defenses and pro-angiogenic signaling. This study evaluated topical Allium cepa ethanol extract on cutaneous SOD, VEGF, and hair length in UV-B-exposed Wistar rats. Methods: Twenty male Wistar rats (3–4 months, 180–200 g) were randomly allocated to five groups (n=4): normal control without UV-B (KN), placebo with UV-B and base preparation (K-), and three groups receiving topical Allium cepa ethanol extract at 1% (P1), 2% (P2), and 4% (P3). UV-B was administered at 65 mJ/cm² thrice weekly for 21 days. SOD and VEGF were measured by ELISA; hair length by digital calipers. Data were analyzed by one-way ANOVA with Tukey post-hoc tests. Results: UV-B reduced SOD by 77.2% and VEGF by 61.7% versus normal. Topical Allium cepa restored both dose-dependently: SOD reached 13.85±0.27 U/mL and VEGF reached 43.00±1.13 ng/L at 4%, with 4% VEGF exceeding normal by 33% (p<0.001). The 2% concentration restored VEGF to physiological levels (p=0.493). Hair length did not differ across groups (p=0.394). The cross-group SOD–VEGF correlation was strongly positive (Pearson r=0.804). Conclusion: Topical Allium cepa ethanol extract is a potent dose-dependent enhancer of cutaneous SOD and VEGF in UV-B-exposed rats. The dissociation between robust biochemical recovery and the unchanged hair-length endpoint supports Allium cepa as an antioxidant and pro-angiogenic adjunct for hair photoaging warranting extended-duration translational studies.
Single-Stage Bilateral Sinusectomy with Methylene Blue Tract Delineation for Familial Classic Preauricular Sinus Following Right-Sided Abscess Control: A Case Report Jihan Mudrika Rahmi; Al Hafiz
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1630

Abstract

Background. Preauricular sinus is a congenital anomaly arising from incomplete fusion of the auricular hillocks of the first and second branchial arches. The condition shows marked ethnic variation, with bilateral presentations strongly associated with hereditary transmission. Surgical excision remains the only definitive treatment for symptomatic or recurrently infected lesions, yet operative recurrence rates of up to 42% have been historically reported. Case presentation. A 24-year-old Indonesian Minangkabau male presented with bilateral preauricular openings present since birth and a recent right preauricular abscess that had been treated with incision and drainage twenty days prior. His father had a unilateral left-sided preauricular pit, consistent with familial transmission. Examination confirmed bilateral classic-type preauricular fistulae anterior to the ascending helix without active discharge, and a quiescent right post-incision wound. Preoperative blood work, renal and hepatic profiles, and chest radiography were within normal limits. The patient underwent simultaneous bilateral preauricular sinusectomy under general anesthesia using methylene blue tract delineation, elliptical skin incision, complete tract dissection with adjacent granulation removal, and primary closure over a small-calibre drain. Postoperative recovery was uneventful; the drain was removed on day three, sutures were removed on day ten, and the surgical wound remained quiescent without recurrence or hypertrophic scarring at the 39-day follow-up. Conclusion. Simultaneous single-stage bilateral sinusectomy combined with methylene blue tract delineation, prior infection control, and closed-system drainage produced excellent early outcomes in an adult with familial bilateral classic preauricular sinus.
Determinants of In-hospital Mortality in Preterm Neonates Admitted to a Tertiary Indonesian NICU: A One-Year Retrospective Cohort of 209 Infants Komang Okky Maharani Ciptana Putri; Putu Mas Vina Paramitha Cempaka; I Made Kardana; Made Sukmawati; Putu Junara Putra; I Wayan Dharma Artana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1631

Abstract

Background. Preterm birth is the largest single contributor to global neonatal mortality, and Southeast Asia carries a disproportionate burden, yet contemporary multivariable data from Indonesian tertiary neonatal intensive care units (NICUs) remain limited. We aimed to identify maternal, perinatal and neonatal determinants of in-hospital mortality among preterm neonates at the NICU of Prof. I.G.N.G Ngoerah Hospital, Denpasar, Bali. Methods. In a single-centre retrospective cohort, 209 preterm neonates (gestational age <37 weeks and birth weight <2500 g) admitted between September 2024 and September 2025 were enrolled by total sampling. Bivariate logistic regression with p<0.25 inclusion threshold was followed by multivariable binary logistic regression; intermediate-outcome variables (RDS and surfactant therapy) were excluded a priori to avoid over-adjustment bias. Results. In-hospital mortality was 42.1% (88/209) and decreased monotonically across birth-weight strata, from 75.0% in infants <1000 g to 41.9% in 1000–1499 g and 22.9% in ≥1500 g (Cochran–Armitage trend p<0.001). Sepsis (56.8%) and respiratory distress syndrome (30.7%) accounted for 87.5% of deaths. In the multivariable model, birth weight 1000–1499 g (adjusted odds ratio [aOR] 0.36, 95% CI 0.15–0.90; p=0.029) and ≥1500 g (aOR 0.17, 95% CI 0.06–0.51; p=0.001) and each 1-point increment in 5-minute Apgar score (aOR 0.81, 95% CI 0.67–0.98; p=0.031) were independently associated with lower mortality. Maternal urinary tract infection trended toward higher mortality (aOR 2.85, 95% CI 0.97–8.35; p=0.057). Conclusion. Birth weight and 5-minute Apgar score are independent, immediately measurable predictors of in-hospital preterm mortality in this Indonesian tertiary NICU. Combining bedside risk stratification with antenatal corticosteroid coverage audit and universal antenatal urine-culture screening offers a translational pathway to reduce neonatal mortality in resource-constrained Southeast Asian settings.
Incidence of Intraocular Inflammation, Retinal Vasculitis, and Retinal Vascular Occlusion Following Intravitreal Brolucizumab in Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis Ida Ayu Laksmi Devi; Sari Marina; Putu Daivi Prakriti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1632

Abstract

Background. Brolucizumab is a humanized single-chain anti-VEGF antibody fragment licensed for neovascular age-related macular degeneration (nAMD). Post-marketing surveillance identified intraocular inflammation (IOI), retinal vasculitis (RV), and retinal vascular occlusion (RVO) as adverse events of special interest, sometimes causing irreversible visual loss. Published incidence estimates range from below 1% to above 10%. We aimed to estimate the pooled cumulative incidence of these events and characterize heterogeneity drivers. Methods. PubMed/MEDLINE, Cochrane CENTRAL, and Google Scholar were searched for phase 3 randomized controlled trials (RCTs), phase IIIb prospective studies, and retrospective/registry studies (≥30 eyes) reporting IOI, RV, or RVO incidence after intravitreal brolucizumab 6 mg in nAMD. A DerSimonian–Laird random-effects model with Freeman–Tukey arcsine transformation was applied; REML, Paule–Mandel, and GLMM (logit link) estimators were used in sensitivity analyses. Results. Ten independent datasets (33,280 brolucizumab-treated eyes; 1,130 events) were included. Pooled cumulative incidence of any IOI/RV/RVO was 5.54% (95% CI 4.23–7.02%; I² = 94.0%; Q = 150.48). Prospective studies yielded higher pooled incidence (8.42%, 95% CI 4.12–14.04%) than retrospective/registry studies (4.35%, 95% CI 3.28–5.56%). Leave-one-out sensitivity ranged 4.98–6.19%. Funnel-plot asymmetry was detected (Egger t = 3.27; p = 0.011). More than 75% of events occurred within six months of the first injection. Conclusion. Cumulative incidence of IOI/RV/RVO after brolucizumab 6 mg in nAMD approached 5.5%, with markedly higher rates under independent adjudication. These findings support careful patient selection, baseline screening for prior IOI history, and intensified monitoring after brolucizumab initiation.
Occupational and Environmental Ultraviolet–Sunlight Exposure, Including Outdoor Agricultural Work, and the Risk of Cataract: A Systematic Review and Meta-Analysis of Observational Studies Kadek Diah Pramesti Ken Wardana; Sari Marina; Putu Daivi Prakriti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1633

Abstract

Background.Cataract remains the leading cause of avoidable blindness worldwide, and occupational sunlight exposure is suspected as a modifiable risk factor among outdoor workers, including agricultural workers in tropical low- and middle-income countries (LMICs) such as Indonesia. Previous quantitative syntheses pooled mixed exposure-contrast metrics into a single estimate and obtained heterogeneity in excess of I2 = 95%, providing limited interpretable guidance for clinicians and policy makers. Methods.A systematic search of PubMed/MEDLINE was conducted and supplemented by citation tracing and translated search strings for Scopus, Embase, Web of Science and Cochrane CENTRAL. Eligible studies were observational analyses of adults reporting an OR, HR or relative risk with a 95% CI for occupational or environmental UV-sunlight exposure and cataract. Risk of bias was assessed using the Newcastle-Ottawa Scale. Effect estimates were pooled using DerSimonian-Laird random-effects models with REML and Hartung-Knapp-Sidik-Jonkman sensitivity estimators. Results.Seven observational studies (combined n approximately 60,000) met the inclusion criteria. Pooled OR from four extreme high-vs-low contrast studies: 6.52 (95% CI 4.12-10.33; I2 = 67%). Three modest per-unit/ever-vs-never studies pooled at OR/HR 1.09 (95% CI 1.04-1.14; I2 = 0%). The contrast-type moderator explained approximately 45% of between-study heterogeneity (p < 0.001). Conclusion.Occupational and environmental UV-sunlight exposure is associated with a clinically significant increase in cataract risk. The magnitude depended on the exposure contrast. The findings support targeted ocular-protection programmes for outdoor agricultural workers in high-insolation LMICs such as Indonesia.

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