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Hardyanto Soebono
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INDONESIA
Indonesian Journal of Biomedicine and Clinical Sciences
Published by Universitas Gadjah Mada
ISSN : -     EISSN : 30323134     DOI : https://doi.org/10.22146/inajbcs.v56i01.11961
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
Indonesian Journal of Biomedicine and Clinical Sciences (InaJBCS) aims to promote the translational of basic research into clinical studies and of clinical evidence into practice. InaJBCS publishes studies that substantially enhance our standing of disease etiology and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments. InaJBCS invites authors to submit articles in the fields of biomedical sciences including biomedical genetics, bioinformatics, cardiovascular medicine, endocrinology, gastroenterology, geriatrics, infectious diseases, medical oncology, physiology, pharmacology and toxicology, and phytomedicine medicine.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 143 Documents
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Increasing quantitative estrogen receptor beta expression in meningioma after exogenous hormonal contraception exposure Dhimas Hari Sakti; Muhammad Bayu Sasongko; Suhardjo Pawiroranu; Didik Setyo Heriyanto; Indra Tri Mahayana; Datu Respatika; Idhayu Anggit Widhasari; Prima Sugesty Nurlaila; Agus Supartoto
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.19604

Abstract

Factors influencing estrogen receptor (ER) and progesterone receptor (PR) expression in meningioma are unclear. This study aimed to assess the expression of ER and PR in females with meningioma in relation to patient exogenous hormonal exposure. Cross-sectional study of females with meningioma in Yogyakarta, Indonesia, between 2010 to 2016 was conducted. Histories were obtained through interviews. Expressions of ERa, ERb, and PR were assessed from paraffin blocks containing patients’ meningioma tissue using real-time quantitative polymerase chain reaction (RT-qPCR). The study identified 28 female meningioma patients with a mean age of 45.6 ± 6.8 yr. Increased ERb expression was found in the ³10-yr group of hormonal contraception exposure duration (<10 yr vs ³10 yr = 7.63 (2.3-11.31) vs 12.56 (1.87-42.22), p=0.038). Positive correlation was found between ERb expression and the duration of hormonal contraception exposure (r=0.432; p=0.022), especially progesterone-only contraception (r=0.5; p=0.048), while no significant correlation was found between ERb expression and duration of progesterone-estrogen contraception exposure (r=0.382; p=0.22). No significant analyses were found in ERa and PR. In conclusion, expression of ERβ in meningioma increased in accordance with exogenous hormonal exposure duration, especially progesterone. This finding suggests the importance of ERβ in meningioma and warrants further study as a potential biomarker.
Association between serum endothelin-1 level and major adverse cardiovascular events following percutaneous coronary intervention in stable coronary artery disease Dian Herlusiatri Rahayu; Dyah Wulan Anggrahini; Anggoro Budi Hartopo
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.20513

Abstract

Coronary artery disease (CAD) affects greatly the global population, exhibits high mortality and morbidity rates. Major adverse cardiovascular events (MACE), such as stroke, myocardial infarction, heart failure, and death, are the focus of research due to their significant contribution to morbidity and mortality in patients with CAD. Endothelin-1 is identified as a CAD prognostic indicator, especially for heart failure outcome. This study aimed to investigate the association between serum endothelin-1 level and MACE within 1 yr observation in patients with CAD underwent percutaneous coronary intervention (PCI). It was a retrospective cohort study where conducted at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Subjects were patients with stable CAD who underwent elective PCI. Baseline serum endothelin-1 level was measured by ELISA at the time of elective PCI procedure. The outcome was MACE, which consisted of heart failure, acute coronary syndrome, stroke, and cardiac death, occurred within 1 yr after elective PCI. The ROC curve was designed to determine serum endothelin-1 cut-off value to predict MACE. Sixty-three subjects were enrolled and the endothelin-1 level in serum samples was analyzed. Out of these, 11 (17.5%) experienced MACE within 1 yr post elective PCI. Serum endothelin-1 cut-off value was 1.932 pg/mL, which determined based on ROC curve. There was no significant association between serum endothelin-1 and MACE. There was a trend of higher incidence of MACE, in subjects with above-cut-off endothelin-1 level (≥1.932 pg/mL) (MACE incidence: 23.1% vs. 8.3%; p=0.181). Above-cut-off endothelin-1 level significantly associated with incidence of heart failure (100% vs. 0%; p=0.039) for 1 yr follow-up after elective PCI. Higher serum endothelin-1 level had a trend of higher incidence of 1-yr MACE in patients with stable CAD undergone elective PCI. Among 1-yr MACE, higher serum endothelin-1 associated with increased incidence of heart failure.
When delays become lethal: A case report of a rare and fatal complication in traumatic carotid cavernous fistula Yuddy Imowanto; Dwiwardoyo Triyuliarto; Rico Wicaksana Putra; Fatah Abdul Yasir
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.20562

Abstract

Carotid cavernous fistula (CCF) is a rare complication that can be easily missed after blunt traumatic brain injury. It is defined as an abnormal arteriovenous shunt between the carotid artery or its branches with the cavernous sinus. Most cases are traumatic in origin and although not typically life-threatening, carry a risk of serious complications. One of the most fatal complications is spontaneous intracerebral haemorrhage (ICH), occurring only 0.9-2.6% of cases. We report a rare case of a 27 yo female, who sustained traumatic brain and craniofacial injuries in a motor vehicle accident 25 d earlier. She presented with gradual loss of consciousness following ophthalmic symptoms that began 5 d prior to admission. Imaging confirmed the presence of ICH as a complication of traumatic CCF. This case highlights the diagnostic challenges of traumatic CCF and its potential complications. Diagnosis is challenging due to its rare occurrence with variable time interval for symptoms to develop (ranging from several hours to years after the initial injury), non-specific symptoms that may mimic other conditions, and delays in seeking care. Delayed diagnosis can be fatal, leading to visual loss, cerebral infarction, and haemorrhagic events. Rapid recognition and prompt management of traumatic CCF are crucial for preventing complications and achieving complete resolution with low rates of morbidity and mortality.
Umbilical cord mesenchymal stem cells and their secretome in peripheral nerve regeneration: a narrative review promising therapeutic strategy Tito Sumarwoto; Seti Aji Hadinoto; Romaniyanto; Sholahudin Rhatomy; Pamudji Utomo; Mujaddid Idulhaq; Asep Santoso; Heri Suroto
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.24055

Abstract

The injuries of peripheral nerves remain a substantial clinical challenge because of their limited regenerative capacity, the complexity of nerve repair, and limitations of current treatment strategies. Umbilical cord mesenchymal stem cells (UC-MSCs) and their secretome have shown promise as regenerative treatments due to their distinct biological characteristics. This review explores the possibility of UC-MSCs and their secretome in promoting peripheral nerve regeneration, by their action mechanisms, therapeutic applications, and current preclinical - clinical evidence. UC-MSCs have proven to be capable of support Wallerian degeneration, improving axonal growth, reducing inflammation, and improving functional recovery in both animal models and early clinical studies. Their secretome has been shown to promote neuroprotection and functional repair, avoiding the risks of receiving a direct stem cell transplant. Challenges remain in standardizing UC-MSC-based therapies, ensuring long-term safety, and enhancing delivery strategies. Further clinical trials are needed to determine the efficacy, safety, and scalability of UC-MSC therapies for widespread clinical use. UC-MSCs and their secretome provide a unique, cell-free and cell-based strategy to peripheral nerve regeneration. Future advancements in biomaterial integration, gene editing, and personalized medicine will be essential to implementing these treatments in clinical settings.
Modulation of inflammatory pathways in ischemic stroke rats by hypoxia-primed umbilical cord mesenchymal stem cells (UC-MSCs): Implications for IFN-γ and IL-10 signaling Rakha Fahreza; Eko Setiawan; Setyo Trisnadi; Agung Putra; Nurul Hidayah; Fikriya Novita Sari; Sugeng Ibrahim
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.24529

Abstract

Ischemic stroke is a major global cause of disability and mortality. Inflammation plays a central role in its pathogenesis, characterized by elevated pro-inflammatory cytokines such as IFN-γ and reduced anti-inflammatory cytokines like IL-10. Mesenchymal stem cells (MSCs), especially those derived from the umbilical cord (UC-MSCs), exhibit enhanced immunomodulatory potential when preconditioned under hypoxia. This study aims to evaluate the effect of hypoxic-preconditioned UC-MSCs administration on IFN-γ and IL-10 levels in an ischemic stroke rat model. This in vivo experimental study employed a randomized posttest-only control group design with four groups of male Wistar rats (n=6 each), ranging from healthy controls, untreated group to stroke-induced groups treated with hypoxic UC-MSCs at different doses (1.5x106 and 3x106). IFN-γ and IL-10 levels in brain tissue of each group were measured via ELISA. Significant reduction in IFN-γ and elevation in IL-10 were observed in UC-MSC-treated groups, particularly at the 3×10⁶ cell dose compared to the untreated ischemic group (p<0.05). Hypoxic UC-MSCs reduce post-stroke inflammation by lowering IFN-γ and enhancing IL-10, indicating a promising immunomodulatory potential.
Effect of oyster mushroom powder on total leukocyte during inflammatory and proliferative phases of the wound healing process of third-degree burns model in Wistar rat (Rattus norvegicus) Ulfa Elfiah; Mochammad Amrun Hidayat; Elly Nurus Sakinah; Candra Agung Wibisana; Alfiyah Ramadhani; Hudayah Apryanita
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.24919

Abstract

Burn wounds are challenging to treat because they often heal slowly and are susceptible to complications. The inflammatory phase plays an essential role in the repair process. However, prolonged inflammation can delay tissue healing. The total leukocyte count is an important parameter to evaluate the process, as it reflects the balance between inflammation and the initiation of tissue regeneration. Oyster mushrooms (Pleurotus ostreatus) contain β-glucans and phenolic compounds with anti-inflammatory and antioxidant properties, which may help regulate leukocyte activity and promote wound healing. This study aimed to evaluate the effect of oyster mushroom powder on total leukocyte counts during burn wound healing in Rattus norvegicus. Twenty-seven healthy male rats aged 2-3 mo were randomly divided into 3 groups, with 9 rats in each group. The negative control group received aquadest, the positive control group received bovine serum albumin, and the treatment group received 10% oyster mushroom powder. All groups received identical topical wound management with 1% silver sulfadiazine ointment to prevent infection and maintain a moist wound environment during healing. Blood samples were collected on days 0, 4, 8, and 12 after burn induction, and leukocyte counts were measured. The results showed that the treatment group consistently had lower leukocyte counts compared with control groups. On day 0, the treatment group had significantly lower leukocyte levels compared with the negative control (p = 0.019). On day 8, leukocyte counts in the treatment group were also significantly lower than the positive control (p = 0.030). By day 12, all groups showed a decrease, but the treatment group demonstrated the most gradual and stable reduction over time. In conclusion, oyster mushroom powder reduces leukocyte levels and supported a more controlled inflammatory phase, allowing faster progression to proliferation and improved burn wound healing.
Secondary syphilis psoriasiform in HIV-infected patients: A case series Katia Fitriani; Alessandro Alfieri; Nurwestu Rusetiyanti; Devi Artami Susetiati; Niken Trisnowati; Satiti Retno Pudjiati
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.26999

Abstract

Psoriasiform secondary syphilis is an uncommon and diagnostically challenging variant of secondary syphilis that can closely mimic psoriasis vulgaris, particularly in people with HIV. This case series adds to the limited literature from resource-limited settings by illustrating how psoriasiform secondary syphilis may be misinterpreted as psoriasis both clinically and histopathologically, and how repeated clinicopathologic correlation is essential to avoid inappropriate immunosuppression. We reported three HIV-infected male patients who presented with generalized psoriasiform erythematous scaly plaques, some with palmoplantar involvement, initially diagnosed as psoriasis. One patient had been treated with methotrexate for severalmonths without clinical improvement. Serologic testing in all cases demonstrated active syphilis with reactive nontreponemal and treponemal tests, including a very high venereal disease research laboratory (VDRL) titer in one patient, and all were confirmed HIV-positive. Initial histopathologic examinations variably suggestedsecondary syphilis or psoriasis; in two patients, repeat biopsy or deeper sectioning was required to reveal plasma cell–rich perivascular infiltrates and vascular changes consistent with secondary syphilis, while one case was ultimately considered to represent coexistence of psoriasis and syphilis. All patients received intramuscularbenzathine penicillin G according to syphilis stage, with additional topical or systemic antiinflammatory therapy when indicated, and showed clinical improvement. In conclusion, psoriasiform secondary syphilis should be routinely considered in the differential diagnosis of psoriasiform eruptions in individuals with sexuallytransmitted infection risk or known HIV infection, and that discrepant clinical, serologic, and histopathologic findings warrant repeat biopsy, deeper sectioning, and multidisciplinary review.
Clinical profile, manifestation, and treatment of dermatophytosis patients at Ngoerah Hospital Bali in 2021-2023 Kevin Jonathan Djuanda; I.G.A.A. Dwi Karmila; Kevin Jonathan Djuanda
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 3 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i3.27749

Abstract

Dermatophytosis is a common superficial fungal infection of keratinized tissues, caused by the fungal family of Microsporum, Epidermophyton, and Trichophyton. It is highly prevalent in tropical regions due to favorable environmental conditions. Local hospital-based data are still needed to describe the clinical pattern of dermatophytosis in Bali. This study aimed to describe the clinical profile, manifestations, laboratory findings, and treatment of dermatophytosis patients treated at the Dermatology and Venereology Outpatient Clinic of Ngoerah Hospital Bali. This descriptive observational study utilized a cross-sectional retrospective design, analyzing medical records of dermatophytosis patients treated since January 2021 to December 2023, and the data were analyzed descriptively. A total of 135 patients were included, with a mean patient age of 30.4 ± 17.5 years old (range 1–73 years old), most cases occurring in females (53.3%), students (35.6%), and showed high prevalence in the 25-44 age group. The majority of patients live in private residences (57%) with the primary transmission route being intrafamilial contact (39.3%). Based on 153 clinical presentations, the most frequent type was tinea corporis (39.2%), followed by tinea cruris (19.0%), tinea unguium (19.0%), and tinea capitis (18.3%). The potassium hydroxide (KOH) examination was documented in 124 patients and fungal culture results were available in 99 patients. Dermatophytosis remains a significant health concern, with tinea corporis as the predominant type in our study. Antifungal systemic and topical treatment were used in this study. Awareness and early diagnosis are essential for effective disease control.
Brief cognitive behavioral therapy for chronic insomnia in a primary care setting: a case report Dellma Anggini; Mualimin
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 3 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i3.28287

Abstract

Chronic insomnia with anxiety disorders is a common non-specialist mental health condition frequently encountered in primary care. Although the WHO Mental Health Gap Action Programme (mhGAP) recommends psychosocial interventions at this level, skepticism persists regarding the feasibility of implementing brief psychotherapy within the high-volume workflow of Indonesian community health centers. This case report aims to illustrate the clinical application and operational feasibility of Brief Cognitive Behavioral Therapy (BCBT) in a primary health center setting. We report a 40-year-old female with chronic insomnia accompanied by somatic symptoms, including palpitations and tachycardia, without underlying medical comorbidities. The patient exhibited significant cognitive distortion in the form of sleep state misperception. As the primary treatment modality, a four-session BCBT intervention was conducted every two weeks (30–45 minutes per session). The curriculum included autonomic, behavioral, and cognitive (ABC) model psychoeducation, cognitive restructuring, scheduled worry period, behavioral activation, relaxation, lifestyle modification, and relapse prevention. Evaluation was performed using the insomnia severity index (ISI), subjective units of distress scale (SUDS), and collaborative patient-reported outcome measures (PROM) encompassing three domains: sleep duration, frequency, and anxiety levels. The collaborative goal setting (CGS) of at least 5 hours of sleep, 5 days a week without anxiety, was fully achieved by the third session and remained stable until thereafter. This case illustrates that structured psychotherapy such as BCBT is potentially feasible within a busy PHC workflow, provided there is institutional commitment from facility leadership, a dedicated psychotherapy schedule for trained mental health providers at least once a week, and functional early detection within general outpatient services. While these results are promising for this individual case, further studies are needed to evaluate the scalability and standardized implementation of this model across diverse primary care settings in Indonesia.
The relationship between psychological stress, salivary cortisol levels, and psoriasis severity Nyoman Suryawati; Ketut Kwartantaya Winaya; I Gusti Ayu Agung Praharsini; I Nyoman Wande
Indonesian Journal of Biomedicine and Clinical Sciences Vol 58 No 3 (2026)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v58i3.29208

Abstract

Psychological stress has been associated with psoriasis, possibly through neuroendocrine pathways involving the hypothalamic-pituitary-adrenal axis. However, evidence on salivary cortisol levels in psoriasis vulgaris remains inconsistent, and data from Indonesian populations remain limited. This analytical cross-sectional study was conducted at Ngoerah Hospital, Bali, Indonesia, from July to October 2024. The study included 44 patients with psoriasis vulgaris and 41 non-psoriasis controls. Psychological stress was assessed using the Perceived Stress Scale; psoriasis severity was evaluated using the Psoriasis Area and Severity Index; and salivary cortisol levels were measured using an enzyme-linked immunosorbent assay. Between-group comparisons and correlation analyses were performed to evaluate the relationship between psychological stress, salivary cortisol levels, and psoriasis severity. Psychological stress scores and salivary cortisol levels did not differ significantly between the psoriasis and non-psoriasis groups. In the psoriasis group, salivary cortisol levels were not correlated with psychological stress. However, salivary cortisol levels showed a weak negative correlation with psoriasis severity, as measured by the PASI score (r=-0.33; p=0.03). This study found no significant correlation between salivary cortisol levels and psychological stress, but revealed a weak negative correlation between salivary cortisol levels and psoriasis severity.

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