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Folia Medica Indonesiana The Unit of Journal Consortium and Folia Medica Indonesiana Faculty of Medicine, Universitas Airlangga Jl. Prof. Dr. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, Jawa Timur 60132, Indonesia
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Folia Medica Indonesiana
Published by Universitas Airlangga
ISSN : 23558398     EISSN : 2599056X     DOI : https://doi.org/10.65346/2958-4515.2401
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Folia Medica Indonesiana, as indicated by its name, focuses on publishing good quality articles about research and education on health science and medicine in Indonesia. However, due to the fast growth of science and knowledge in these fields, we also welcome submitted articles from around the world, especially the ones that contain related matters from lower-middle income countries. Folia Medica Indonesiana is an open-access, peer-reviewed journal that is published online at least four times a year. The scope covers various aspects of basic medical sciences includes anatomy, physiology, pathology, microbiology, pharmacology, and molecular medicine) and clinical medicine (covers specialties like internal medicine, surgery, pediatrics, oncology, psychiatry, etc). We highlight the pathology and potential treatment of metabolic syndromes and infectious diseases. Folia Medica Indonesiana also encourages the publication of articles about health education. The scope includes, but is not limited to, articles that emphasize on preventive education on certain diseases in a community, also research report of various materials and/or methods to develop medical education. We recognize the importance of this type of articles to be published alongside the assigned topic in each of our yearly issues, to provide our readers with updated information in medical sciences’ research and education simultaneously.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
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Search results for , issue "Vol. 60, No. 3" : 10 Documents clear
Semen Analysis of Covid-19 Survivors and Uninfected Men: Examining the Motility, Concentration, Vitality, and Morphology Parameters of Spermatozoa Musta'ina, Sri; Siswidiyanto, Eko Budi; Narulita, Pety; Agustinus,; Hinting, Aucky; Atika,; Faizah, Zakiyatul
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. Spermatozoa can be affected by coronavirus disease 2019 (COVID-19) due to a disruption in spermatogenesis, leading to a decline in semen quality. 2. This study compared the semen quality of COVID-19 survivors and those who had not been infected with COVID-19, specifically on the first spermatogenesis cycle following the confirmation of COVID-19 infection. 3. This study is distinctive since no previous research in Indonesia has examined the semen quality parameters, such as the concentration, morphology, motility, and vitality of spermatozoa, in men who had a COVID-19 infection. Abstract Semen quality in COVID-19 patients shows inconsistencies and variations. This research was conducted considering that health is the main capital for humans in Indonesia's development, as outlined in Sustainable Development Goal 3. The purpose of this study was to compare the semen quality of COVID-19 survivors with non-COVID-19 men. This study was an analytical observational study with a cross-sectional design. Subjects were selected through consecutive sampling of up to 26 men of childbearing age who met the predetermined criteria. Semen quality assessment using the WHO Semen Analysis Guide 6th edition. Quantitative data were analyzed using SPSS. The data normality test was carried out using the Saphiro-Wilk test. Then, the data were tested by t-test from two unpaired samples and by the Mann-Whitney test. Data from semen analysis based on COVID-19 severity were tested using variant analysis (One-way ANOVA) and the Kruskal Wallis test. The normal morphology of spermatozoa in COVID-19 survivors was significantly lower (p=0.011) compared to uninfected men. Other semen quality parameters did not differ significantly, although they were lower in COVID-19 survivors. The results of the analysis also showed no significant difference in semen parameters related to COVID-19 severity (p=0.488 for progressive motility; p=0.372 for non-progressive motility; p=0.325 for total motility; p=0.707 for immotility; p=0.412 for vitality; p=0.324 for concentration; and p=0.334 for normal morphology). The study provides evidence that COVID-19 survivors have a lower normal spermatozoa morphology compared to uninfected men. However, the motility, vitality, and concentration of spermatozoa did not differ significantly between the two groups.
Total Plate Count Analysis and Food-Contaminating Bacterial Identification of Smoked Tatihu (Thunnus albacares) Sold in Several Traditional Markets in Ambon, Indonesia Haurissa, Evangelista Risalia; Yunita, Melda; Sulfiana, Sulfiana
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This research provides important information regarding the food safety of smoked tatihu (yellowfin tuna) sold in several traditional markets in Ambon, Indonesia. 2. We find that smoked tatihu fish samples examined at 2 of 3 traditional markets in Ambon city are unsafe for consumption according to the Indonesian National Standard due to bacterial contamination. 3. The findings indicate that smoked fish can be contaminated by Gram-positive bacteria, such as Staphylococcus gallinarum, Staphylococcus sciuri, Rothia kristinae, and Staphylococcus pseudintermedius. Abstract The large marine area and abundant fish resources of Maluku Province, Indonesia, are in contrast to the poor hygiene of its traditional markets, which can cause microbial contamination and taint processed products, such as smoked tatihu (yellowfin tuna). In Ambon city, Maluku, Indonesia, no research had been conducted concerning total plate count analysis and food-contaminating bacterial identification that could guarantee the microbiological safety of smoked tatihu. Therefore, this study aimed to assess the microbiological quality of smoked tatihu according to Indonesian National Standards (INS 2725:2013) and to identify any presence of food-contaminating bacteria. This research was a quantitative descriptive study with a true experimental laboratory approach. The samples used were smoked tatihu collected from three traditional markets in Ambon, Indonesia. The spread plate method was used in the isolation process, while the total plate count analysis was performed to estimate the quantity of colonies on each petri dish. Bacterial identification was carried out macroscopically and microscopically. The microscopic identification involved Gram staining to determine the shape and color of the bacteria. Additionally, the bioMérieux VITEK 2 Compact system was utilized for biochemical identification to ascertain the species of bacteria present. The results revealed that the colony counts in smoked tatihu from the Mardika market and Hative Kecil market were 1.1 x 104 CFU/g and 8.2 x 106 CFU/g, respectively. However, smoked tatihu from the Batu Meja market had an excessive number of colonies that were difficult to quantify. The contaminating bacteria were identified as Staphylococcus gallinarum, Staphylococcus sciuri, Rothia kristinae, and Staphylococcus pseudintermedius. In conclusion, smoked tatihu fish from the Mardika market are considered safe for consumption as the microbiological parameters do not exceed the Indonesian National Standards, whereas those obtained from the Hative Kecil and Batu Meja markets are unsafe for consumption due to the excessive presence of food-contaminating bacteria.
Antibacterial Potential of Endemic Medicinal Plants of the Maluku Islands, Indonesia, against Urinary Tract Infection Pathogens Astuty, Eka; Luhulima, Vinsa Delia; Ariwicaksono, Stefanus Cahyo
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights:1. Clove, cinnamon, and eucalyptus have found to be able to providing antibacterial agents for urinary tract infection (UTI).2. Ethanol extracts derived from clove leaves, cinnamon bark, and eucalyptus leaves can inhibit pathogenic bacteria responsible for UTI, indicating their potential as sources of bioactive compounds for UTI medication development. AbstractMedicinal plants possess antimicrobial properties that have been believed to be efficacious for treating various diseases. However, antimicrobial-based medicinal plants remain an untapped source of potential pharmaceuticals. This study aimed to evaluate the antibacterial properties of ethanolic extracts derived from several medicinal plants endemic to Maluku, Indonesia, specifically regarding their antibacterial activity against isolates of pathogenic bacteria found in the urine samples of urinary tract infection (UTI) patients. This was a true experimental research with a posttest-only control group design. The medicinal plant extraction was conducted using the maceration method. The pathogens were isolated using the dilution method. Following the pathogen isolation, the isolates were identified according to the colony morphology, Gram staining, and biochemical test results. The antibacterial activity was determined through the Kirby-Bauer disc diffusion test. The results indicated that five selected isolates (i.e., 0A1, 0A2, 0A3, 0A4, and 0A5) had a round shape with flat edges. Isolates 0A2 and 0A4 exhibited a solid white color, whereas isolates 0A1 and 0A3 displayed an off-white color, and isolate 0A5 showed a yellow color. Isolates 0A1, 0A2, and 0A4 were Gram-positive bacteria, while isolates 0A3 and 0A5 demonstrated Gram-negative characteristics. The biochemical testing revealed that the five selected isolates were identified as Staphylococcus warneri, Staphylococcus haemolyticus, Enterobacter aerogenes, Enterococcus faecium, and Escherichia coli. The ethanol extracts of clove (Syzygium aromaticum) leaves, cinnamon (Cinnamomum burmannii) bark, and eucalyptus (Melaleuca leucadendra) leaves demonstrated the ability to inhibit pathogenic bacteria responsible for UTI. Clove leaf ethanol extract exhibited the highest average clear zone compared to the other two ethanol extracts. This study concluded that medicinal plants from Maluku, Indonesia, the clove, cinnamon, and eucalyptus, have antibacterial potential that may be effective in treating UTI. Further investigation is necessary to fully comprehend the mechanisms of action, detection, and description of bioactive compounds, particularly against human pathogens.
Analysis of Risk Factors Associated with the Incidence of Placenta Accreta at an Indonesian Tertiary Hospital Cahyani, Aisha Grayli; Sandhika, Willy; Hardianto, Gatut
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. The increased incidence of placenta accreta is contributed significantly by parity classification, a history of cesarean section, body mass index, and interbirth interval. 2. The findings of this study can be used as an additional reference in determining the risk of placenta accreta in pregnant women, specifically as an input in screening and antenatal care programs for pregnant women to provide early detection and appropriate management. Abstract The incidence of placenta accreta during pregnancy constitutes a serious problem in reproductive health. This complication has increased significantly over the last few decades, especially in developed countries where cesarean deliveries have also risen. Placenta accreta spectrum can cause very severe bleeding and potentially lead to other serious complications. The purpose of this study was to analyze the risk factors associated with the incidence of placenta accreta in women giving birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This quantitative study used an analytical observational research design, specifically the case-control approach. The study sample was all mothers who gave birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, between 2019 and 2023. In addition to a univariate analysis, the data were subjected to bivariate analysis using a two-sample independent t-test or Mann-Whitney test for ordinal data and for nominal data using the Chi-square test as well as multivariate analysis using logistic regression (p<0.05). The results showed that parity, a history of cesarean section, body mass index, and interbirth interval were the variables identified as significantly associated with placenta accreta. According to the logistic regression analysis, parity, a history of cesarean section, and a history of curettage were identified as the primary determinants of placenta accreta incidence. The classification of parity was found to have the most significant relationship to the incidence of placenta accreta. This study concluded that parity classification, a history of cesarean section, body mass index, and interbirth interval are the significant risk factors contributing to the increased incidence of placenta accreta at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
The Neurogenic Effects of Pasak bumi (Eurycoma longifolia Jack) and Seluang Fish (Rasbora spp.) in Malnutrition-Induced Rat Sanyoto, Didik Dwi; Triawanti,; Noor, Meitria Syahadatina; Airlangga, Dimas Ikhsan
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study analyzed the effects of using locally sourced pasak bumi extract and seluang fish on the parameters of neurogenesis in malnourished rat models. 2. It promotes further exploration into modified treatments for malnutrition, emphasizing nutritional strategies that harness locally available natural resources. Abstract Early developmental malnutrition exerts adverse effects on the structural, neurochemical, and neurophysiological maturation of cerebral cells by disrupting the process of neurogenesis. Pasak bumi (Eurycoma longifolia Jack) and seluang fish (Rasbora spp.), two indigenous natural resources of South Kalimantan, Indonesia, are believed to harbor nutritional components capable of mitigating these deleterious effects. We aimed to assess the impact of administering pasak bumi, seluang fish, and pure docosahexaenoic acid (DHA) on the neurogenesis process in malnourished rat models. The Rattus norvegicus specimens were partitioned into seven distinct cohorts, each consisting of five rats: healthy rats in the negative control group (KN), while malnourished rats in the positive control (KP) and treatment groups (P1, P2, P3, P4, and P5). Both the KP and KN groups received a placebo and a standard feed. The treatment groups received different interventions for five weeks: standard feed alongside pasak bumi extract for the P1 group, standard feed and DHA for the P2 group, standard feed in combination with pasak bumi extract and DHA for the P3 group, seluang fish for the P4 group, and pasak bumi extract and seluang fish for the P5 group. The doses determined for the pasak bumi extract and DHA were 15 and 1 mg/kg bw, respectively. The parameters evaluated consisted of the levels of brain-derived neurotrophic factor (BDNF), neural progenitor cell β-tubulin 3 (Tuj-1) expression, and peroxisome proliferator-activated receptor gamma (PPARγ). The data were subjected to analysis through the Kruskal-Wallis test and analysis of variance (ANOVA) at a 95% confidence level. A value of p<0.05 was considered significant. Statistically significant differences were observed in the BDNF levels (p=0.00) and Tuj-1 expressions (p=0.01) across all groups. In conclusion, the combined administration of pasak bumi and seluang fish demonstrates the capacity of enhancing neurogenesis in malnourished rats, as evidenced by elevated BDNF levels and Tuj-1 expressions.
Rehabilitation Impact of Vivifrail Exercise Program Type C on the Cognitive Function of Pre-Frail Elderly People in the Community Soenarti, Sri; Lestari, Dwi Indriani; Nugroho, Muhammad Barlian; Lestari, Harien
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study emphasizes the importance of providing physical exercises to pre-frail elderly individuals, especially in a community setting. 2. This study establishes a foundation for future research to explore the relationship between physical exercise, particularly the Vivifrail Type C Protocol, and cognitive function in pre-frail elderly individuals. Abstract Frailty is a clinical syndrome that increases vulnerability, potentially leading to disability or death. The pre-frail phase is ideal for preventing frailty and improving quality-adjusted life years, particularly through physical exercises that reduce the risk of dementia and cognitive impairment. Multicomponent exercises, such as the Vivifrail Exercise Program, may enhance cognitive function and daily independence by preventing and mitigating frailty through tailored routines. However, its impact on cognitive function in pre-frail elderly people had not been well studied. This study aimed to determine the effect of the Vivifrail Exercise Program Type C on the cognitive function of pre-frail elderly people. This study was a quasi-experiment with a non-randomized control group pretest-posttest design. The sample was chosen by the quota sampling method. Twenty-seven subjects were analyzed, comprising 16 individuals in the exercise group and 11 individuals in the control group. The exercise group participated in the Vivivfrail Type C Exercise Program, with 45-minute sessions conducted biweekly for 12 weeks. The evaluated parameters included the Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The statistical analysis utilized the Kruskal-Wallis test, followed by the post-hoc Mann-Whitney test and independent t-test (p<0.05). A path analysis was performed using simple linear regression. The subjects' average ages were 72.2 years in the control group and 67.47 years in the exercise group. The Vivifrail Exercises Program Type C significantly improved the MoCA-INA scores from 20.25 to 24.06. It also increased the LOTCA scores in several domains, i.e., thinking operations and visual perception. The exercise group demonstrated more improvement than the control group (p=0.032). An enhancement in cognitive function was particularly observed in elderly women with pre-frailty. In conclusion, the Vivifrail Exercise Program Type C can help improve the cognitive function of the elderly within the community.
Larvicidal Effect of Breadfruit (Artocarpus altilis) Flower Extract Against Aedes aegypti Winianti, Ni Wayan; Budi Apsari, Putu Indah; Jayanti, Ni Kadek Meta
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study attempted an experiment on the novel invention of a naturally sourced larvacide, specifically breadfruit (Artocarpus atilis) flower extract, against Aedes aegepti. 2. The findings of this study suggest that breadfruit flower extract can serve as an effective larvacide, as evident by an increased mortality rate of Aedes aegepti larvae. Abstract Dengue hemorrhagic fever remains a major problem in Indonesia. The mosquito that spreads this disease is the Aedes aegypti species. The use of larvicides is a viable method to inhibit the growth of larvae into adult mosquitoes. The flowers of breadfruits (Artocarpus atilis) have long been used as a natural mosquito killer. The objectives of this study were to determine the lethal dose 50 (LC50) of breadfruit flower extract and to analyze its potential as a larvicide against stage 2–3 instar Aedes aegypti larvae. In this true experimental research, each of four treatment groups was administered with breadfruit flower extracts at concentrations of 25, 50, 75, and 90 ppm, respectively. The positive control group was treated with temephos (Abate), while the negative control group received no treatment. Larval mortality was recorded at 1 hour, 2 hours, 3 hours, 4 hours post-intervention. The observed larval deaths were compared among the groups. Quantitative data encompassing the larval mortality in each group were analyzed using the repetitive analysis of variance (ANOVA) and the probit test with minimum p value <0.05. The results indicated that the LC50 value of breadfruit flower extract was 52.67–54.12 ppm. The doses of 50 ppm, 75 ppm and 90 ppm were effective in killing Aedes aegypti larvae. In conclusion, breadfruit flower extract of 50 ppm and higher can effectively kill Aedes aegypti larvae.
Sexual Abuse and Neglect during Childhood are Associated with an Increased Prevalence of Mental Health Problems among University Students in Surakarta, Indonesia Putu Dian Apriandary, Ni; Muthmainah,; Setyaningrum, Rohmaningtyas Hidayah; Septiawan, Debree
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights:1. This study reiterates the long-term negative impact of childhood trauma on young adults' mental health.2. This study contributes to the prevention of mental disorders through the identification of risk factors associated with mental health problems. AbstractThe prevalence of mental health problems is a global public health concern. Young adults, such as university students, are highly vulnerable to the onset of mental health problems due to biological, psychological, and social factors. In particular, abusive and traumatic experiences during childhood may increase the risk of developing mental health problems during adulthood. The prevalence of child abuse cases in Indonesia is concerning. This abuse includes physical, emotional, and sexual abuse, in addition to neglect. This study aimed to assess the relationship between the occurrence of mental disorder symptoms during young adulthood and the preceding child abuse. A total of 191 undergraduate students in Surakarta, Indonesia, participated in this study. The participants completed the Child Abuse and Trauma Scale (CATS) for the evaluation of maltreatment experienced during childhood and adolescence as well as the Self-Reporting Questionnaire-20 (SRQ-20) for the measurement of mental health problem symptoms. The association of the degree of child abuse and trauma with mental health problems was analyzed using a logistic regression test, which was selected because the dependent variable (mental health problems) had binary outcomes. The level of statistical significance was set at p<0.05. We found that 33% of the participants reported mental health problems. In addition, sexual abuse and neglect were found to be associated with mental health problems. The analysis of the sexual abuse variable revealed a statistically significant value of p=0.03, an odds ratio (OR) of 1.39, and a 95% confidence interval (CI) of 1.03-1.88. Additionally, the analysis of the neglect variable yielded comparable results with values of p=0.03, OR=1.26, and 95% CI=1.02-1.55. Our findings suggest that child abuse, particularly sexual abuse and neglect, may have a long-term deleterious impact on an individual’s mental health.
Bacterial Profiles and Antibiotic Resistance in Chronic Obstructive Pulmonary Disease Patients with Exacerbation and Type 2 Respiratory Failure at Adam Malik General Hospital Annisa, Lia Mutia; Syarani, Fajrinur; Pradana, Andika; Mutiara, Erna
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study provides a comprehensive analysis of various factors such as age, sex, education, occupation, BMI, and comorbidities, and their relationship with bacterial infections in COPD patients experiencing exacerbation and type 2 respiratory failure. 2. While the COPD patients experiencing exacerbation did not exhibit resistance to linezolid and vancomycin, they demonstrated specific antibiotic resistance patterns characterized by high resistance rates to commonly used antibiotics such as meropenem and amikacin. 3. The findings enhance the understanding of the complex interplay of factors influencing infection patterns in this patient population. Abstract Chronic obstructive pulmonary disease (COPD) is a prevalent condition characterized by persistent respiratory symptoms and airflow limitation. Bacterial infections may trigger COPD exacerbations, leading to more severe symptoms as well as increased morbidity and mortality rates. This study aimed to investigate the bacterial profiles and antibiotic resistance in COPD patients who had experienced exacerbation and type 2 respiratory failure at Adam Malik Central General Hospital, Medan, Indonesia. This retrospective study utilized medical records spanning from January 1, 2020, to December 1, 2022. The sample included patients aged 40–90 years who had experienced COPD exacerbation and type 2 respiratory failure. The exclusion criteria were patients who had received antibiotic therapy within 48 hours before admission, were severely immunocompromised, and had severe malignancy. The analysis results were presented in the form of means, standard deviations, and frequency distributions. Additionally, an analysis of the relationship between the categorical variables was performed using the Chi-squared test (p<0.05). The study analyzed 25 subjects with an average age of 63.6 years, primarily consisting of men (84%). It was shown that severe exacerbations were prevalent (92%), accompanied by the presence of common comorbidities including pneumonia (52%), diabetes mellitus (32%), and other non-communicable diseases (44%). Bacterial growth was observed in 76% of the subjects, predominantly involving Gram-negative bacteria (89.4%). Klebsiella pneumoniae (26.3%) and Pseudomonas aeruginosa (21.1%) were the most frequently isolated species. The antibiotic resistance patterns indicated that meropenem and amikacin had the highest resistance rates (100%). Cefepime, ertapenem, and gentamicin exhibited notable resistance rates of 66.7%, 66.7%, and 75.0%, respectively. This study highlights the high prevalence of Gram-negative bacteria and significant antibiotic resistance in COPD patients who exhibit exacerbation and type 2 respiratory failure.
Effect of L-Citrulline on Creatine Kinase MM (CK-MM) Isoenzymes in Mice: An In Vivo Study Focusing on Immunohistochemistry Analysis Ghozali, Dhoni Akbar; Rahma, Annisa Aghnia; Hanifa, Shafira Nur; Ilyas, Muhana Fawwazy
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study elucidates the effect of L-citrulline supplementation on creatine kinase MM (CK-MM) expression post-eccentric exercise, offering novel insights into its potential role in mitigating muscle damage. 2. The findings demonstrate that L-citrulline administration significantly reduces CK-MM expression levels in skeletal muscle tissue, suggesting its therapeutic potential in enhancing muscle recovery and performance following exercise-induced damage. 3. This study contributes valuable insights into the multifaceted benefits of L-citrulline supplementation for supporting overall muscle health and performance by identifying its protective effects under different mechanisms, including improved blood flow, antioxidant activity, enhanced mitochondrial function, and promotion of muscle protein synthesis.   Abstract Eccentric exercise often induces muscle injuries in athletes, resulting in impaired performance and prolonged recovery time. Creatine kinase MM (CK-MM) is a biomarker for assessing muscle damage, with elevated levels indicating injury. L-citrulline, an amino acid, has shown promise in enhancing performance and reducing recovery time. However, its specific effect on CK-MM remains unclear. This study utilized immunohistochemistry analysis to investigate the effect of L-citrulline supplementation on CK-MM expression post-eccentric exercise in male BALB/c mice. This in vivo study was conducted with a post-test-only design. A total of 25 mice were divided into two control groups (normal/C1 and negative/C2) and three treatment groups (T1, T2, and T3), each containing five mice. The T1, T2, and T3 groups were daily administered 250, 500, and 1,000 mg/kg bw of L-citrulline for seven days, respectively. All mice, except the C1 group, performed a downhill running procedure. The CK-MM expression in skeletal muscle tissue post-eccentric exercise was assessed using immunohistochemistry analysis. The statistical analysis included the Shapiro-Wilk test for data distribution and the Kruskal-Wallis and Mann-Whitney post-hoc tests for significant differences (p<0.05). The results showed that CK-MM expression in the C2 group (91.00±2.24%) was significantly higher (p=0.008) than that of the C1 group (70.00±10.0%). Subsequently, the T1 (68.00±9.08%, p=0.008), T2 (72.00±7.58%, p=0.008), and T3 (67.00±9.75%, p=0.008) groups exhibited significantly lower expressions than the C2 group. These results were consistent with the role of CK-MM as a marker for muscle damage, and they indicated that L-citrulline might have a protective effect against muscle damage post-eccentric exercise. However, no significant differences were observed among the C1, T1, T2, and T3 groups. In conclusion, L-citrulline supplementation demonstrates promise in attenuating muscle damage following eccentric exercise, as evidenced by reduced CK-MM expression levels. These findings highlight the potential therapeutic role of L-citrulline in enhancing muscle recovery and performance.

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