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INDONESIA
Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 851 Documents
 82   83   84   85   86 
Sagittal Knee Alignment Is Associated with Reduced Knee Flexion Range of Motion in Asymptomatic Elderly: A Cross-Sectional Study Mustamsir, Edi; Putra, Domy Pradana; Aji, Aulia Pandu; Firladi, Haidar Abror; Auzan, Asyrafly; Sasongko, Armabar Dwipantara; Tegar, Bintang Taqwa Nan
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.1

Abstract

Knee alignment affects lower limb biomechanics and functional knee movement. However, the relationship between knee alignment and knee flexion range of motion (ROM) in healthy populations, particularly across different age groups, remains unclear. To compare coronal and sagittal knee alignment and knee flexion ROM between healthy young adults and elderly individuals, and to examine the association between knee alignment and knee flexion ROM using clinical goniometric assessment. This cross-sectional study included 64 healthy participants (32 young adults aged 20–24 years and 32 elderly individuals aged ≥60 years). Coronal and sagittal knee alignment and active knee flexion ROM were measured using a goniometer. Group differences were analyzed using independent t-tests and Chi-square tests, and associations between alignment categories and knee flexion ROM were assessed using the Kruskal-Wallis test. Elderly participants showed a higher prevalence of coronal varus alignment and sagittal flexion contracture compared with young adults. Mean knee flexion range of motion was significantly lower in elderly participants than in young adults (127.4±4.7° vs 137.6±4.4°, p<0.001). Coronal knee alignment was not significantly associated with knee flexion ROM in either young adults (p=0.056) or elderly participants (p=0.476). In contrast, sagittal knee alignment demonstrated a significant association with knee flexion ROM in elderly participants (p=0.017), whereas no significant association was observed in the young adult group (p=0.922). Sagittal knee alignment, rather than coronal alignment, correlates with reduced knee flexion range of motion in healthy elderly individuals. A straightforward clinical evaluation of sagittal alignment may assist in detecting early functional deterioration in ageing populations.
Comparison of Outcomes between HIV-Positive and HIV-Negative Tuberculous Meningitis: A Retrospective Study Badrul Munir; Hasibuan, M Effendy Nugraha
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.8

Abstract

Tuberculous meningitis (TBM) is a form of extrapulmonary tuberculosis characterized by neurological complications and high mortality. HIV co-infection further elevates this risk. Clinical presentations and outcomes vary significantly between HIV-positive and HIV-negative patients, yet data from Indonesia remain limited. This study aimed to compare the clinical characteristics, presenting symptoms, and outcomes of HIV-positive and HIV-negative TBM patients at Dr. Saiful Anwar General Hospital, Malang, Indonesia. This retrospective study used electronic medical records of TBM patients treated from June to December 2023, including demographics, clinical symptoms, and outcomes. Inclusion criteria required age >18 years, a probable or confirmed TBM diagnosis by the Marais Score, and documented HIV status; exclusion criteria included incomplete records and other CNS infections. Statistical analysis included frequency distribution, Fisher's exact test, odds ratio, and multivariable logistic regression. Among 36 patients, the majority were male (72.2%) and aged 15–30 years (33%). Common symptoms included fever, seizures, decreased consciousness, headache, meningeal signs, and pulmonary tuberculosis. Overall mortality was 47.2%, with higher crude mortality in HIV-positive than HIV-negative patients (80% vs. 42%; OR 5.54, p=0.12). After adjustment, BMRC disease severity emerged as the strongest independent predictor of mortality (p=0.004), while HIV status was no longer significant. These findings suggest that disease severity at presentation, rather than HIV status itself, largely explains the excess mortality, though HIV-positive patients still appeared to have worse clinical outcomes overall. Early diagnosis and severity-based triage remain important regardless of HIV status, and larger studies are needed to confirm these findings.
Correlation Analysis of STOP-BANG Score and VOC Components in COPD and High-Risk COPD Patients in Malang City Djajalaksana, Susanthy; Wardoyo, Arinto Yudi Pomco; Sari, Fitri Indah; Anggraeni, Rizki Diah; Setiadi, Satya
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.3

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that causes long-term airflow limitation, and its burden continues to increase worldwide. Volatile Organic Compounds (VOC) found within exhaled breath have been studied as possible biomarkers for this condition. Obstructive Sleep Apnea (OSA) is one comorbidity that receives attention because it can be related to more frequent exacerbations and poorer outcomes within COPD. This cross-sectional observational study describes STOP-BANG score patterns among confirmed COPD patients and people with high COPD risk from three primary health care centers within Malang City. It also examines the relationship between STOP-BANG score and VOC components within both groups. Data were collected using the STOP-BANG (Snoring, Tiredness, Observed apnea, Pressure, BMI, Age, Neck circumference, Gender) questionnaire and VOC examination. A total of 102 patients were included, consisting of 49 men and 53 women. STOP-BANG score showed weak to moderate relationships with several VOC components, including carbon dioxide (CO2; r=0.286; p=0.014), ammonia (NH3; r=0.286; p=0.039), and benzene (C6H6; r=-0.253; p=0.033). Among patients with moderate-high OSA risk within the high-risk COPD group, the STOP-BANG score had a significant relationship with CO2, acetone (C3H6O; r=0.347; p=0.023), and propylene (C3H6; r=0.347; p=0.023). Smoking history was also significantly related to C6H6 (r=0.282; p=0.017) within the high-risk COPD group and carbon monoxide (CO; r=0.73; p=0.025) within the COPD group. Since findings remain exploratory, further confirmation using polysomnography is needed before VOC profiling can be used as an additional method for OSA risk screening within primary health care.
Integration of Molecular Factors Influencing VCAM-1 Expression in Vascular Inflammation and Atherosclerosis: A Systematic Review of In Vitro Studies Asini, Nur; Indrajaya, Taufik; Irfannuddin, Irfannuddin; Putri, Siti Sarahdeaz Fazzaura
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.12

Abstract

Vascular Cell Adhesion Molecule-1 (VCAM-1) is a vascular adhesion molecule that plays a crucial role in vascular inflammation, endothelial dysfunction, and the development of atherosclerosis. Increased VCAM-1 expression occurs in response to various inflammatory stimuli and cellular stressors that involve the activation of specific molecular signaling pathways. Various factors such as chronic inflammation, oxidative stress, activation of the Nuclear Factor-kappa B (NF-κB) pathway, the Janus Kinase-Signal Transducer and Activator of Transcription (JAK-STAT) pathway, obesity, leptin resistance, genetic factors, and changes in vascular hemodynamics are known to contribute to increased VCAM-1 expression. This study aims to analyze various factors that influence VCAM-1 changes molecularly using a narrative review method. Article searches were conducted through the PubMed, Scopus, and Google Scholar databases using the keywords "VCAM-1", "NF-κB", "oxidative stress", "LEPR", "leptin resistance", "endothelial dysfunction", and "atherosclerosis". The articles used were published between 2020 and 2026, relevant to the research topic, and available in full text. The review results indicate that NF-κB activation is the primary mechanism of VCAM-1 elevation triggered by pro-inflammatory cytokines, increased reactive oxygen species (ROS), leptin resistance, and LEPR activation via the JAK-STAT pathway. Furthermore, genetic factors such as LEPR polymorphisms and epigenetic mechanisms also contribute to increased vascular inflammation and VCAM-1 expression. Thus, VCAM-1 has great potential as a biomarker of vascular inflammation and a therapeutic target in cardiovascular disease, particularly atherosclerosis.
Cardiometabolic Risk Factors and Hypertension Modelling in the Elderly at Puskesmas Industri, Gresik Regency Ariyani, Nila; Umbul Wahyuni, Chatarina; Peristiowati, Yuly
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.7

Abstract

In older adults, residing near industrial settings confers multifaceted health risk associated with metabolic dysregulation and other underlying conditions. Using local public health screening records, we developed a risk-prediction model to predict late-life hypertension. Data were acquired from 278 older people (age ≥60 years) selected through a complete-case analysis approach based on clinical record completeness from the 966 registered residents at Puskesmas Industri, Gresik Regency. Routine anthropometric measurements (BMI, waist circumference), daily lifestyle habits, and glucose history were assessed. Independent t-tests, chi-square analyses, and multivariable binary logistic regression were conducted to determine the above factors. In bivariate analysis, hypertensive status was closely associated with high BMI, abdominal obesity, low physical activity, active smoking and diabetes mellitus (p values <0.05). The last regression model has an excellent final fit with empirical data (Hosmer-Lemeshow test, p = 0.785) and it explained 45.7% of the total variance (Nagelkerke R Square). Continuous waist circumference was found the most important independent risk factor among all tested factors (Wald=14.542; p=0.000). The odds of clinical hypertension increased independently by 1.079 times (OR=1.079; 95% CI=1.038–1.122) for every one-centimeter increase in waist measurement. The results suggest that the amount of visceral fat is an important physical predictor of high blood pressure in older adults. Primary care clinics should treat digital screening databases as tools for clinical risk stratification, not just administrative logs.
Effect of Strobilanthes crispa (Keji Beling) Ethanol Extract (EESC) on Body Weight in High-Fat Diet-Induced Wistar Rats Suandy; Sun, Michelle Angelia; Ana Fresia
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.4

Abstract

Obesity is a growing global health concern and a major risk factor for metabolic diseases. Pharmacological therapies have limitations and adverse effects. Strobilanthes crispa has demonstrated pharmacological activities. However, its ethanol extract has not been extensively evaluated for body weight effects in high-fat diet (HFD)-induced rats. This study aimed to evaluate the effect of Strobilanthes crispa ethanol extract (EESC) on body weight in HFD-induced Wistar rats. In this pretest–posttest experimental study, following a 12-week HFD induction, rats were randomly assigned to four groups (n = 6/group): vehicle control, atorvastatin (20 mg/kg BW), EESC-400 (400 mg/kg BW), and EESC-600 (600 mg/kg BW). Treatments were administered orally for 28 days, and body weight was recorded on Days 0, 7, 14, 21, and 28. Repeated measures ANOVA revealed significant effects of time (F = 28.316, p < 0.001, partial η² = 0.586) and time × group interaction (F = 17.163, p < 0.001, partial η² = 0.720), whereas the main effect of group was not significant (F = 1.983, p = 0.149). The greatest mean reduction in Δ body weight was observed in the EESC-400 group (−8.33 g), followed by the EESC-600 group (−6.67 g). The Kruskal–Wallis test demonstrated significant differences in Δ body weight among the experimental groups (H = 16.187, p = 0.001). Bonferroni-adjusted pairwise comparisons revealed significant differences between the vehicle group and the EESC-400 (p = 0.002) and EESC-600 (p = 0.006) groups. In conclusion, EESC may reduce body weight in HFD-induced Wistar rats.
Stem Cells and Exosomes Delivery via Collagen-Based Platform for Advanced Wound Healing: A Systematic Review of In Vivo Studies Ratih Paramita Suprapto; Raras, Tri Yudani Mardining; Kusuma, Ihda Dian
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.11

Abstract

Chronic wounds remain a global health challenge due to persistent inflammation and impaired cellular function that delay healing. Collagen-based hydrogels are promising delivery platforms for enhancing the therapeutic efficacy of mesenchymal stem cells (MSCs) and exosomes. This review aimed to evaluate the efficacy and molecular mechanisms of MSCs and/or their derived exosomes delivered in collagen-based hydrogels in accelerating wound healing in vivo. This review was managed following PRISMA 2020 guidelines. Literature searches were conducted in PubMed, Scopus, and Europe PMC for original studies published between 2020 and 2025. Eligible studies provided sufficient data describing in vivo chronic wound models treated with collagen scaffolds loaded with MSCs or exosomes. Three in vivo studies using murine burn, diabetic rat, and diabetic rabbit models were included. Each of them used pullulan-collagen seeded with Adipocyte Stem Cells (ASCs), stem cell-derived exosomes combined with recombinant human collagen-methacrylate, and MSC-derived extracellular vesicles (EVs) loaded into collagen hydrogel. All platforms significantly accelerated wound closure versus controls. Histological analyses confirmed enhanced neovascularization, organized collagen deposition, mature granulation tissue formation, and re-epithelization. These effects were mediated by M1-to-M2 macrophage polarization and downregulation of pro-inflammatory cytokines. Cell-free exosome therapy loaded in collagen hydrogels represents a promising approach for chronic wound management.
The Association between Age and Sex with Rectal Cancer Metastasis Occurrence Dhiya Nazhifah Putri; Ivan Kurniawan Bassar; Rita Halim; Moh. Rizal Syafiie; Harahap, Huntari
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.5

Abstract

Rectal cancer, a subtype of colorectal cancer, has shown a rising incidence; however, local epidemiological data from Jambi Province remain limited. This study aimed to determine the association between age and sex and the occurrence of metastasis among rectal cancer patients at Raden Mattaher Regional General Hospital, Jambi, from 2023 to 2025. An analytical observational study with a retrospective cross-sectional design was conducted using total sampling of 252 medical records, of which 147 subjects met the inclusion and exclusion criteria. Bivariate analysis using the Pearson Chi-square test assessed associations between variables, and multivariable Poisson regression with robust variance estimation determined the independent associations of age and sex with metastasis occurrence. Most subjects were aged 45–60 years (46.9%), male (68%), and had stage 2 disease (32.7%). Metastasis was identified in 31.3% of subjects. A significant association was found between age and metastasis (p = 0.008), with subjects aged 45–60 years showing a significantly higher prevalence ratio than the < 45-year group (PR 2.87, 95% CI 1.22–6.72). Metastasis was also significantly associated with sex (p = 0.011), with males having a 2.2-fold higher prevalence of metastasis than females (95% CI, 1.13–4.41). In the multivariable analysis, participants aged 45–60 years remained independently associated with metastasis occurrence (adjusted prevalence ratio [aPR] 2.72, 95% CI 1.17–6.30; p = 0.020). Male sex also remained independently associated with metastasis (aPR 2.09, 95% CI 1.06–4.08; p = 0.032). Conclusion: Both age and sex remained independently associated with metastasis occurrence in rectal cancer after adjustment in the multivariable analysis.
Effectiveness of Loading-Dose Intravitreal Anti-VEGF for Wet Age-Related Macular Degeneration Syuhada, Arya Putra; Artha Dewi, Nadia
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.9

Abstract

Wet age-related macular degeneration (AMD) is a major cause of irreversible visual impairment in older adults. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the standard treatment, and current guidelines recommend three consecutive monthly loading-dose injections before maintenance therapy. This study involved evaluating the clinical effectiveness of intravitreal ranibizumab in loading doses for improving visual acuity and anatomical outcomes of wet AMD patients, as a retrospective study on 22 patients with wet AMD who received treatment between 2022 and 2024. All patients had received three monthly loading doses of intravitreal ranibizumab, and their medical records indicated their clinical characteristics. Assessment of best-corrected visual acuity (BCVA) used a Snellen chart, whereas measurement of central retinal thickness (CRT) and total macular volume (TMV) used optical coherence tomography. Data analysis used the Chi-square and Mann-Whitney U tests. Following the loading-dose regimen, CRT decreased by a mean of 52 μm (p = 0.038) and TMV by 1.8 μm (p = 0.047). In 59% of patients, their visual acuity improved, and younger individuals had significantly greater improvement (p = 0.029). Earlier disease onset had a significant association with greater reductions in CRT and TMV (p = 0.026). These findings indicated that both anatomical and functional outcomes in patients with wet AMD improved effectively following the loading-dose regimen of intravitreal ranibizumab, with reductions in retinal thickness and macular volume as well as improvements in visual acuity. Younger age and earlier treatment initiation become important prognostic factors in association with better treatment responses
Multidomain Lifestyle Factors and a Preliminary Composite Lifestyle Score in Patients with Acute Coronary Syndrome: A Pilot Case-Control Study Ermin Rachmawati; Riskiyah Riskiyah; Muhammad Ramadhani Aurino Disastranegara; Firdausiyatul Ulya; Ufaira Ramadhanti Majid; Rifki Zidan Nugraha; Indra Wahyu Saputra; Indra Hidayah Ramadhan; Larasati Sekar Kinasih
Jurnal Kedokteran Brawijaya Vol. 34 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.02.10

Abstract

In recent years, the incidence of Acute Coronary Syndrome (ACS) has been increasing worldwide. Although modified risk factors are well established, the combined contribution of lifestyle factors to ACS has not been extensively studied. This study aimed to examine multidomain lifestyle factors associated with ACS by developing a preliminary lifestyle composite. A pilot case-control study was conducted using data from 55 ACS cases and 55 healthy controls. Lifestyle factors were assessed using a questionnaire including the Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scales (DASS-21), Food Habits Questionnaire (FHQ), Night Eating Diagnostic Questionnaire (NEDQ), and the Global Physical Activity Questionnaire (GPAQ). The hypothesis was analyzed using a bivariate test, followed by binary logistic regression. Bivariate analysis identified educational level (p=0.019), comorbidities (p<0.001), body mass index (p=0.037), stress level (p=0.001), sleep quality (p=0.004), night eating patterns (p<0.001), fat consumption, and physical activity (p<0.000) associated with ACS incidence. A preliminary composite lifestyle score was constructed and was strongly associated with ACS incidence (p<0.001). Multivariable logistic regression further confirmed that preliminary composite lifestyle risk, comorbidities, age, and BMI independently predicted ACS occurrence, with comorbidities (OR=16.69; 95% CI:4.05-68.67) and lifestyle risk (Wald X2=17.2), followed by BMI (OR=3.15; 95% CI:1.21-8.22) and age (OR=2.82; 95% CI:1.46-5.45). The preliminary composite lifestyle score demonstrated a strong association with ACS Status, and warrants validation in larger, prospective cohorts before clinical application.

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