Indonesian Journal of Biomedicine and Clinical Sciences

West Sumatera curd effect on fecal IgA and IgG in BALB/c mice colon inflammation induced by dextran sodium sulphate

Diah Dwi Utami — 2025-07-30

Curd, a fermented buffalo milk product from West Sumatra, is known for its probiotic content. Probiotics are recognized for their health benefits, including potential advantages for inflammatory bowel disease (IBD). Previous studies have confirmed the probiotic status of curd. However, the effects of curd on the immunoglobulin response in colon inflammation are still not well understood. This study employs an experimental design to investigate the impact of curd on the levels of total immunoglobulins A (IgA) and G (IgG) in feces and analyze the correlation between total IgA levels in feces and IL-10 expression in serum and feces and total IgG levels in feces and TNF-α expression in serum and feces of BALB/c with colon inflammation. In the normal group, curd administration significantly increased total IgA levels in feces, indicating a potential modulation of the immune response. Conversely, in the inflammatory group, curd reduced total IgA levels, though this effect was not statistically significant. Similarly, while curd reduced total IgG levels in feces for both the normal and inflammatory groups, the reduction was not statistically significant. No significant relationships were found between total IgA levels in feces and IL-10 expression in serum and feces, nor between total IgG levels in feces and TNF-α expression in serum and feces.

Genotyping F1534C mutation on dried Aedes aegypti preparation through direct PCR method: a proof of concept

Taufik Mulya Perdana — 2025-07-30

Aedes aegypti (Ae. aegypti) is the primary vector of dengue hemorrhagic fever (DHF). Various control strategies have been utilized to control its population, including the use of pyrethroid-based insecticides. However, the presence of mutations, such as the F1534C mutation, that confers resistance to pyrethroids has been increasingly reported. The increase of resistance-conferring mutation in Ae. aegypti population could potentially hinder DHF control measures. As such, monitoring the genotype of Ae. aegypti population is crucial. Mosquito rearing, DNA extraction, and PCR examination are usually employed to monitor the circulation of F1534C mutations. To simplify this process, we proposed a direct PCR workflow utilizing dried mosquito samples preserved on an in-house filter paper. To demonstrate the utility of our proposed workflow, we performed direct allele-specific PCR (AS-PCR) on 46 dried adult Ae. aegypti. As a comparator, conventional PCR was performed on 8 DNA extract from Ae. aegypti. Our results showed that direct AS-PCR successfully identified both wild-type (F allele) and mutant (C allele) genotypes from dried mosquitos with a success rate of 93.48%. These findings provide preliminary evidence supporting the use of cellulose-based in-house filter paper for genotyping insecticide-resistant mosquitoes. However, field testing must be performed before its implementation in real-world epidemiological and surveillance applications.

Genetic variation near the MC4R gene rs17782313 as a protective factor against high visceral fat: case control study in the Jambi Malay population

Alya Dwiva Juhari — 2025-08-01

Obesity is commonly assessed using the body mass index (BMI), which does not distinguish between fat and lean mass. Among fat distributions, visceral fat is more strongly associated with the risk of metabolic disease. Visceral or central obesity, characterized by excessive visceral fat accumulation, has become increasingly prevalent in recent years. Genetic factors, including rs17782313 polymorphism near the melanocortin 4 receptor (MC4R) gene, have been implicated in visceral fat accumulation. Previous studies reported varying effect sizes across different populations and inconsistent genotype-phenotype associations. However, no studies have investigated this association in the Jambi Malay Population. This case-control study aimed to evaluate the association between the MC4R rs17782313 polymorphism and visceral fat in the Jambi Malay population. A total of 110 Jambi Malay subjects participated in the study. Visceral fat was measured using bioelectrical impedance analysis (BIA), and genotyping was performed using the Tetra-ARMS PCR method. Bivariate and multivariate analyses were conducted to assess the association between genetic variation and visceral fat levels. Bivariate analysis showed that the TC genotype had a protective effect against high visceral fat compared to the TT genotype (p = 0.037; OR = 0.395). Similarly, the recessive model (CC+TC vs. TT) also indicated a protective effect (p = 0.022; OR = 0.375). In logistic regression model adjusted for calorie intake and physical activity, the protective effect persisted for both TC (p = 0.018; OR = 0.302) and the recessive model (p = 0.013; OR = 0.305). However, further adjustment for gender nullified the effect of the TC genotype, whereas the recessive model remained statistically significant, though the genetic effect was attenuated (p = 0.044; OR = 0.372). In conclusion, the TC genotype of MC4R rs17782313 is associated with a protective effect against visceral fat accumulation. This effect is influenced by calorie intake, physical activity, and gender.

Association of sleep quality and body mass index (BMI) with metabolic syndrome risk factors among medical students

Yuliana — 2025-08-07

Sleep quality reflects an individual’s satisfaction with the sleep process, which is essential for cognitive, psychological, metabolic, and cardiovascular health. Poor sleep quality is prevalent among medical students and may elevate their risk of metabolic syndrome. This study investigated the association between sleep quality and body mass index (BMI) with metabolic syndrome risk factors in medical students. This was a cross-sectional study involving 98 first- to third-year preclinical medical students. Sleep quality was assessed by using the Pittsburgh sleep quality index (PSQI) questionnaire, BMI was measured from body weight and height, and metabolic syndrome risk factors were evaluated through waist circumference, blood pressure, fasting blood glucose, and high-density lipoprotein (HDL) cholesterol levels. Data was analyzed using Chi square and Fisher’s exact test. Results showed that 54.08% of students had good sleep quality and 42.86% had a normal BMI. However, 59.18% of students exhibited at least one metabolic syndrome risk factor, including central obesity (51.02%), hypertension (20.41%), dyslipidemia (13.27%), and high fasting blood glucose (1.02%). There was no association between sleep quality and metabolic syndrome risk factors. The BMI showed no association with fasting blood glucose and HDL cholesterol level. However, BMI showed a significant association with waist circumference (p<0.001) and blood pressure (p = 0.005). These findings emphasize the importance of addressing the MBI in mitigating metabolic syndrome risks among medical students.

The potential of short-chain fatty acids-producing probiotics as a treatment for liver disease: a systematic review

Nur Azizah — 2025-08-08

Recent insights reveal that liver diseases influence not only hepatic function but also disrupt gut microbial balance through the gut–liver axis. The gut–liver axis establishes a bidirectional relationship between the intestines and the liver, allowing microbial by-products such as short-chain fatty acids (SCFAs) to influence liver function and health. Short-chain fatty acids are known to maintain intestinal epithelial integrity, reduce inflammation, and support liver function. Probiotic bacteria including Lactobacillus, Bifidobacterium, and Clostridium, are natural SCFA producers and may offer therapeutic potential for liver disease by targeting the gut-liver axis. This systematic review was conducted using the PRISMA 2020 methodology to identify and evaluate preclinical studies examining the impact of SCFA-producing probiotics on liver disease. We searched PubMed, Scopus, and Google Scholar from August to October 2023, using predefined inclusion criteria based on the PICO framework. The SYRCLE risk of bias tool was employed to evaluate potential biases. A total of 14 animal studies fulfilled the inclusion criteria and were incorporated into the final analysis. The included studies demonstrated that SCFA-producing probiotics improved liver function by reducing serum liver enzymes (ALT, AST), increasing tight junction proteins (occluding, ZO-1), modulating pro-inflammatory cytokines (IL-1β, IL-6, TNF-α,), and improving lipid metabolism. These outcomes were mediated by increases in SCFA levels and improved gut barrier integrity in models of NAFLD, ALD, NASH, and autoimmune hepatitis. These findings support the promising potential of SCFA-producing probiotics as adjunctive therapies for liver disease through modulation of the microbiota-gut-liver axis. Yet, continued research is needed to determine strain-specific efficacy, optimal dosage, long-term safety, and clinical applicability. Future research should also explore personalized probiotic strategies and the integration of probiotic therapy into standard liver disease management.

A rare case of syringocystadenoma papilliferum: clinical and histopathological insights

Raden Roro Rini Andayani — 2025-08-11

Syringocystadenoma papilliferum (SCAP) is a rare benign adnexal neoplasm originating from apocrine or eccrine sweat glands, first reported by Stokes in 1917. Clinically, SCAP manifests in various forms such as nodules, plaques, or warts, predominantly affecting the scalp in adolescents or children. Histopathologically, it is characterized by papillary and ductal invaginations lined with a two-layered epithelium. This condition can be present at birth or emerge during puberty. We present a 19-year-old female with a congenital, pinkish-brown, wart-like lesion on her scalp that progressively enlarged and spread to the face. Physical examination revealed a verrucous plaque with central erosion, extending from the temporal scalp to the lateral face. Dermoscopy showed papillary structures with defined lesion borders, while histopathological findings confirmed SCAP. The patient underwent surgical excision, and no new lesions were detected during a 3 mo follow-up. Syringocystadenoma papilliferum is often confused with other neoplasms such as sebaceous nevus or verruca vulgaris, but its definitive diagnosis relies on histopathology. The tumor’s characteristic features include cystic invaginations into the dermis with a two-layered epithelium, differentiating it from other conditions. Surgical excision remains the treatment of choice to prevent potential malignant transformation and improve cosmetic outcomes. Syringocystadenoma papilliferum, though rare, can be effectively managed through timely diagnosis and surgical excision. In this case, the patient’s postoperative outcome was favorable, with no recurrence of the lesion. Histopathological evaluation is crucial for accurate diagnosis and guiding treatment strategies.

Histopathology as a key to identify Sezary syndrome in patient with clinical erythroderma

Sonia Diovani — 2025-08-13

Sezary syndrome (SS) is a rare and aggressive variant of cutaneous T-cell lymphoma (CTCL), characterized by clonal proliferation of malignant T lymphocytes with skin erythroderma. The incidence of CTCL in the United States from 2000 to 2010 reached 10 cases per million people per year, accounts for only 3% of all cases of cutaneous lymphoma. In Indonesia, lymphoma ranks sixth in terms of malignancies, alongside Hodgkin lymphoma and leukemia. We reported a case of 56 y.o. woman presented with blistering lesions that turned into wounds all over her body. Skin biopsy examination revealed characteristic histopathological features, including basket weave-type orthokeratosis, focal parakeratosis, focal acanthosis, and epidermotropism of atypical lymphoid cells with cerebriform nuclei (Sezary cells). Immunohistochemical examination using CD3, CD4, and CD8 showed positive staining in the membrane and cytoplasm of tumor cells within the dermis and epidermis. Sezary syndrome is characterized by clonal expansion of T-helper memory cells in the skin. Histopathology and immunohistochemistry could not differentiate SS from mycosis fungoides. However, histopathological examination could distinguish SS from other differential diagnoses. The diagnosis of SS can be established based on the triad of 1) generalized exfoliative dermatitis involving more than 80% of the body surface area, 2) lymphadenopathy, and 3) the presence of 5% or more malignant T-cells with cerebriform nuclei (Sezary or Lutzner cells) in peripheral blood lymphocytes. In conclusion, we present a case of SS, diagnosed based on the patient's history, physical examination, peripheral blood examination, histopathology, and immunohistochemistry.

The clinical outcomes and quality of life in patients with Guillain- Barré syndrome: a literature review

Rosa De Lima Renita Sanyasi — 2025-08-15

Guillain-Barre syndrome (GBS) is an immune-mediated condition that targets the roots of the spinal cord and peripheral nerves. While most patients with GBS can achieve complete recovery with appropriate management, some may experience long-term sequelae that adversely impact their quality of life (QoL). Clinical outcomes are measured variables in research to evaluate the effects of interventions or exposures on a particular population’s health. Patients with GBS may experience suboptimal clinical outcomes due to post-GBS disabilities, which may result from complications or residual symptoms of the syndrome. These disabilities can impede daily functioning and significantly lower QoL, often requiring patients to alter their lifestyles, work, and social interactions. Quality of life is a subjective assessment of how individuals perceive their circumstances in relation to their goals, influenced by their cultural and value systems. Various tools are available to assess the quality of life for GBS patients. The clinical outcomes and QoL for post-GBS patients are diverse and shaped
by various factors. Through the early identification of these factors, clinicians can enhance management strategies to improve both clinical outcomes and the overall QoL for individuals recovering from GBS.

The role of VEGF in predicting progression-free survival (PFS) and overall survival (OS) for ovarian carcinoma patients

Moh Nailul Fahmi — 2025-08-15

Vascular endothelial growth factor (VEGF) plays a pivotal role in highly vascularized tumors such as ovarian cancer. It can be detected in serum and ascitic fluid. This study aimed to determine the difference between VEGF in the blood serum level and ascitic fluid in predicting progression-free survival (PFS) and overall survival (OS) in patients with ovarian cancer. A prospective cohort study was conducted between 2018 and 2021 at Dr Sardjito General Hospital, Yogyakarta, Indonesia. The study included patients who underwent primary surgery for epithelial ovarian cancer. VEGF levels in both serum and ascitic fluid were measured using the human cytokine magnetic 10-plex panel for Luminex (Invitrogen commercial kit), based on the enzyme-linked
immunosorbent assay (ELISA). PFS and OS were monitored until the end of the study period. A total of 40 patients were enrolled, with a median follow-up duration of 24 mo. Among participants, 22 patients (55%) experienced disease progression, and 50% survived. The median VEGF levels in serum and ascitic fluid were 720 and 1925 pg/mL, respectively. Receiver operating characteristic (ROC) curve analyses of PFS and OS revealed that VEGF levels in ascitic fluid had better predictive value than serum VEGF levels. The area under the curve
(AUC) of ascites vs serum was 0.646 vs 0.567, with sensitivity of 83.3% vs 100% for PFS, whereas the AUC of ascites vs serum was 0.565 vs 0.548, with sensitivity of 50.0% vs 93.8% for OS. However, no statistical significance was observed (p>0.05). In conclusion, both VEGF ascites and serum failed to predict PFS and OS in ovarian cancer patients.

Role of nuclear factor-κB (NFκB) in microglial polarization in correlation with neuroinflammatory mechanism at the hippocampal cornu ammonis (CA) 1 region after acute and chronic phase of global ischemic brain injury in rats

Dian Prasetyo Wibisono — 2025-08-15

Ischemic brain injuries can result in hippocampal injury due to its vulnerability to ischemia, specifically the CA1 region. Ischemic injury to this region alters nerve cells, synapses, and non-neural hippocampal tissue and causes hippocampal sclerosis. This injury could be mediated by microglia via the neuroinflammation pathway. However, the neuroinflammatory mechanism underlying hippocampal ischemic injury is still unclear. This study aimed to investigate the role of NF-κB in microglia polarization which affects the hippocampal area after ischemic injury. We conducted a quasi-experimental study, using 24 male Sprague Dawley rats aged 4 wk old and weighing 100 g. The rats were grouped into 4 different groups (CL1 as acute, CL3 as subacute, CL7 as chronic, and SO as control groups) and performed bilateral common carotid artery ligation to induce global ischemic injury in the brain. The difference in microglial activation was tested using immunohistochemistry for CD68. Moreover, polymerase chain reaction (PCR) was utilized to assess mRNA expression differences in IL1β, IL6, TNFα, and NF-κB. An increase in the number of positive CD68 fraction areas in CL1, CL3, and CL7 compared to the SO group (p=0.002) was shown after bilateral common carotid artery ligation. Such ligation also induced a significantly higher mRNA expression of IL1β (p=0.004), IL6 (p=0.028), TNFα (p=0.028), and NF-κB (p=0.002) in the CL1, CL3, and CL7 groups, compared to the SO group. In conclusion, NF-κB is the key player in hippocampal injury in the CA1 region following ischemic event by differentiating microglia into M1 phenotype form and initiates the neuroinflammatory cascade via IL1β, IL6, and TNFα in all phases.

Incidence rate of depression and factors affecting children and adolescents with type 1 diabetes mellitus (T1DM) in Semarang, Central Java

Fadia Raihani Aprilia Herenda — 2025-08-21

Type 1 diabetes mellitus (T1DM) is characterized by pancreatic ß-cell damage due to an autoimmune process that causes a lack of endogenous insulin production. In 2018, 1,220 children with T1DM was reported in Indonesia. Children and adolescents with T1DM require lifelong insulin treatment leading to diabetes distress and depression. Type 1 diabetes mellitus and psychological problems are bidirectionally interconnected. This study aimed to determine the incidence of depression and influencing factors in children and adolescents with T1DM in Semarang City, Indonesia. This analytical observational study with a crosssectional design was conducted from March to October 2023 at Diponegoro National Hospital and Dr. Kariadi General Hospital, Semarang, using consecutive sampling. The inclusion criteria were children aged 7–17 years diagnosed with T1DM and receiving treatment. Parents of respondents provided informed consent before their children completed the Children’s Depression Inventory (CDI) questionnaire to assess depression. A CDI score of ≥13 was classified as indication of depression. The data were analyzed descriptively and bivariately using Chi-square and Fisher’s exact tests. Among 27 respondents, 8 children were diagnosed with depression and 19 respondents scored on the guilt subscale of the CDI questionnaire, indicating moderate depressive symptoms. Approximately 30% of children and adolescents with T1DM were diagnosed with depression. The most influential factor associated with this depression was a history of chronic disease in children.

Delayed diagnosis of bilateral iatrogenic ureteric injury presenting with life-threatening pseudo-acute kidney injury after hysterectomy: a case report

Ryuu Damara Parisudha — 2025-08-22

Bilateral ureteric injury after pelvic surgeries, particularly hysterectomy, carries a substantial risk of life-threatening conditions such as severe respiratory distress related to pseudo-acute kidney injury (pseudo-AKI) and sepsis due to peritonitis. A 47 y.o. woman presented with anuria 9 d after hysterectomy. She exhibited severe dyspnea requiring intubation, reduced level of consciousness, tachycardia and abdominal distension. Laboratory results revealed rapid increment of urea and creatinine post operatively requiring serial hemodialysis, leukocytosis, hyperkalemia and metabolic acidosis. Imaging identified bilateral hydronephrosis and ascites. An emergency laparotomy was performed, draining 2.7 L of intraperitoneal urine and revealing bilateral distal ureteral ligation with perforations. Subsequent bilateral ureteroneocystostomy was conducted resulting in significant improvements in clinical status as well as normalization of the renal function within 48 hr postoperatively. Bilateral iatrogenic ureteric injury with concurrent urinary ascites is an uncommon but serious complication of gynaecologic surgeries, particularly hysterectomies. This condition significantly increases the risk of renal failure and other life-threatening complications. Delayed diagnosis, as seen in this case, exacerbates these risks. Immediate surgical laparotomy with subsequent ureteroneocystostomy is critical for renal recovery and resolution of urinary ascites. Although rare, bilateral ureteric injury with urinary ascites necessitates prompt recognition and urgent surgical management to prevent severe renal impairment and other life-threatening outcomes. Careful preoperative planning and intraoperative ureteral visualization are essential in reducing the risk of such injuries.