Universa Medicina
type: channel
description: Universa Medicina (UnivMed) is an official scientific publication of the Faculty of Medicine Universitas Trisakti and is a peer-reviewed open-access journal. Universa Medicina is a four-monthly medical journal that publishes new research findings on a wide variety of topics of importance to biomedical science and clinical practice. Universa Medicina is a general medical journal that focuses on all aspects of human health. Accredited journal based on Ministerial Decree of the Minister of Research and Technology / Head of National Research and Innovation Agency of the Republic of Indonesia with First Grade (Peringkat 1, Sinta 1, Garuda) No. 148/M/KPT/2020 Volume 38 Number 3, 2019 to Volume 43 Number 2, 2024. The Univ Med journal has been indexed and abstracted and displayed in Clarivate Analytics Web of Science Core Collection Database (Emerging Source Citation Index) (Q4 JCR) 2023, 2024, Dimensions-Digital Science, CABI, ASEAN Citation Index, DOAJ, Chemical Abstract Services (CAS), ROAD, National Library of Medicine, ICMJE, ICI, and SINTA. Imprint information Author Guidelines Make a Submission
publisher: Faculty of Medicine, Universitas Trisakti
language: en
publication name: Universa Medicina
issn: 1907-3062
copyright: The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
items: Effect of brain endurance training on fatigue and physical endurance among stroke survivors: a non-blinded randomized controlled trial
items: The effect of war on displaced hemodialysis patients in Sudan
items: Microbiota as a reservoir of antibiotic resistance genes: relevance and urgency
items: Machine learning models for predicting 48-hour mortality in acute intracerebral hemorrhagic stroke
items: Role of global deoxyribonucleic acid methylation and molecular hypoxia changes in male infertility
items: Clinical significance of pre-operative prognostic nutritional index in predicting survival in patients with renal cell carcinoma
items: Effect of Muay Thai training frequency on VO2 max and muscle endurance in non-athletic adults: a randomized clinical trial
items: Hypoxic mesenchymal stem cell-derived secretome and alkaline water synergistically reduce apoptosis and insulin resistance in type 2 diabetes mellitus rat model
items: Bench to bedside and beyond: evolving trends in translational research
items: Application of international classification of functioning, disability and health in salat: a scoping review
items: Effect of cross-running polypropylene intradermal suture technique on keloid scar: a single-blind randomized controlled trial
items: Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center
items: An integrative review on the shadow of abuse in pediatric head trauma
items: Life satisfaction: a sustainable perspective in old age-physical and mental health
items: Fragrance preference of essential oil blends for reducing stress and sleep problems in adult women
items: Myosin heavy chain as biomarker in the prevention of sarcopenia
items: Angiogenesis in rheumatoid arthritis: epidemiology, pathogenesis, signal transduction pathways, and nano-targeted therapeutic strategies
items: Bortezomib in multiple myeloma management
items: High neutrophil-to-lymphocyte ratio is not a risk factor of severe dengue infection in children
items: Glucocorticoid-induced adrenal insufficiency after receiving intravenous methylprednisolone for Graves' ophthalmopathy: a case report
items: Foley catheter guided by semi-rigid ureterorenoscopy in the treatment of bladder diverticulum: a case report
items: The survival benefits of adjuvant radiotherapy for malignant meningioma: a retrospective cohort study
items: The effect of self-foot massage on anxiety and sleep quality in nursing students: A single-blind randomized controlled study
items: 24-hour movement guidelines: is there more to seek than time standards for health?
items: Predictors of persistent high disease activity after methotrexate treatment in rheumatoid arthritis patients
items: Retinoblastoma tumor suppressor protein is not a risk factor for the location of condyloma acuminatum among adults
items: Effectiveness of medium-chain triglyceride diet and low glycemic index therapy in drug-resistant childhood epilepsy: a systematic review, meta-analysis, and meta-regression
items: Analysis of serum levels of B cell activating factor and soluble B cell activating factor receptor with disease activity in systemic lupus erythematosus
items: Type 2 diabetes mellitus and recent treatment options in adolescents and young adults
items: Cavernous sinus thrombosis: a case series analysis

Effect of brain endurance training on fatigue and physical endurance among stroke survivors: a non-blinded randomized controlled trial
type: item
description: Background Post-stroke fatigue (PSF) is a multifactorial impairment characterized by persistent tiredness not relieved by rest, and affects nearly half of stroke survivors, leading to poor physical endurance which limits recovery and overall quality of life. Limited evidence suggests that combining cognitive and physical training might help in reducing fatigue. Brain endurance training (BET) involves both cognitive training and physical training, targeting PSF. The study aimed to evaluate the effect of BET on fatigue and physical endurance among stroke survivors. Methods A parallel group pilot randomized controlled trial was carried out in a private setting with 30 stroke survivors. Patients were randomized into two groups. Group A (n=15) received BET and group B (n=15) received conventional physiotherapy. Both groups underwent training for 65 minutes per day, thrice a week for eight weeks. Primary outcomes were Fatigue Severity Scale (FSS) and Six-Minute Walk Test (6MWT). Statistical analysis was performed using the chi-square test and independent t-test. Results At baseline, no significant differences were observed between groups for FSS and 6MWT (p>0.05). The BET group reported better reduction in fatigue (FSS: 5.39 ± 0.18 to 3.48 ± 0.16, p<0.001) and improvement in physical endurance (6MWT: 202.03 ± 4.35 to 273.35 ± 6.26, p<0.001) than the control group (FSS: 5.25 ± 0.10 to 4.19 ± 0.06) (6MWT: 200.53 ± 2.72 to 222.70 ± 3.64). Conclusion Brain endurance training is a feasible and safe approach for reducing fatigue and improving physical endurance among stroke survivors.
subject: Original Articles
  topic: section
subject: stroke
  topic: keywords
subject: fatigue
  topic: keywords
subject: physical endurance
  topic: keywords
subject: cognitive training
  topic: keywords
subject: physical exercises
  topic: keywords
subject: quality of life
  topic: keywords
subject: stroke
  topic: subjects
subject: fatigue
  topic: subjects
subject: physical endurance
  topic: subjects
subject: cognitive traininig
  topic: subjects
subject: physical exercises
  topic: subjects
subject: Quality of Life
  topic: subjects
subject: physiotherapy
  topic: disciplines
subject: physical medicine and rehabilitation
  topic: disciplines
subject: rehabilitation medicine
  topic: disciplines
subject: Health sciences
  topic: disciplines
subject: neuroscience
  topic: disciplines
creator: Jayasree Sai L
creator: Prathap Suganthirababu
creator: Dhanusia S
creator: Harika Valluri
rights: Copyright (c) 2026 Jayasree Sai L, Prathap Suganthirababu, Dhanusia S, Harika Valluri https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-04-01
publication date: 2026-04-01
starting page: 59
ending page: 67
doi: 10.18051/UnivMed.2026.v45.59-67

The effect of war on displaced hemodialysis patients in Sudan
type: item
description: BACKGROUND The Sudan war has severely disrupted healthcare services, particularly for patients with end-stage renal disease (ESRD) dependent on regular hemodialysis. Conflict-related displacement, damaged infrastructure, medication shortages, and financial hardship have compromised dialysis continuity and patient outcomes. This study assessed the impact of war-related displacement on dialysis care among Sudanese hemodialysis patients. METHODS This cross-sectional observational study included 101 displaced ESRD patients receiving maintenance hemodialysis. Data collection comprised demographic characteristics, causes of ESRD, dialysis access and adequacy, treatment interruptions, complications, medication availability, hospital admissions, and functional status before, during, and after the war. Comparisons of dialysis parameters and functional status before, during, and after the war were performed using Cochran’s Q test. RESULTS War-related displacement was associated with statistically significant worsening of dialysis care. Dialysis frequency decreased from two to 1.5 sessions per week, and session duration declined from four to three hours (both p<0.05). Patients missed a median of one dialysis session per week. Consequently, out-of-pocket payment for medications surged from 42 (41.6%) pre-war to 93 (92.1%) during the war and persisted at 89 (88.1% in the current period (p<0.0001). Erythropoietin use declined from 98 (97.1%) to 39 (38.6%) (both at p<0.001). Displacement was also associated with significantly increased complications, hospitalizations, reduced medication adherence, and marked fatigue (p < 0.05). CONCLUSION War-related displacement significantly reduced dialysis adequacy, medication access, and continuity of care, resulting in increased morbidity. Immediate humanitarian and health-system interventions are essential to prevent excess mortality among displaced hemodialysis patients.
subject: Original Articles
  topic: section
subject: Displacement
  topic: keywords
subject: Healthcare Disruption
  topic: keywords
subject: Hemodialysis Complications
  topic: keywords
subject: Humanitarian Aid
  topic: keywords
subject: Sudan-War
  topic: keywords
creator: Sara Mohamed Abdelgadir
creator: Sufian Khalid Mohamed
creator: Mohamed Osman Elamin
creator: Wahaj A. Khan
creator: Hatim O. Badri
creator: Abdullah Muhammad Alzhrani
creator: Osama Banah
creator: Ahmad Salah Alkathiri
creator: Ahmed A. Osman
creator: Fowzi O. Elamin
rights: Copyright (c) 2026 Sara Mohamed Abdelgadir, Sufian Khalid Mohamed, Mohamed Osman Elamin, Wahaj A. Khan, Hatim O. Badri, Abdullah Muhammad Alzhrani, Osama Banah, Ahmed Alkathiri, Ahmed A. Osman, Fowzi O. Elamin https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-02-10
publication date: 2026-02-10
starting page: 27
ending page: 38
doi: 10.18051/UnivMed.2026.v45.27-38

Microbiota as a reservoir of antibiotic resistance genes: relevance and urgency
type: item
description: 'Antimicrobial resistance' (AMR) is one of the top threats to global public health and developments.
subject: Editorial
  topic: section
subject: Antibiotic resistance
  topic: keywords
subject: Genes
  topic: keywords
subject: Microbiota
  topic: keywords
subject: Antibiotic resistance
  topic: subjects
subject: Genes
  topic: subjects
subject: Microbiota
  topic: subjects
subject: Human health
  topic: disciplines
creator: Naga Raju Maddela
rights: Copyright (c) 2026 Naga Raju Maddela https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-01-07
publication date: 2026-01-07
starting page: 1
ending page: 3
doi: 10.18051/UnivMed.2026.v45.1-3

Machine learning models for predicting 48-hour mortality in acute intracerebral hemorrhagic stroke
type: item
description: BACKGROUND Identifying patients with intracerebral hemorrhagic (ICH) at high risk of mortality is crucial for timely intervention. Machine learning (ML) offers novel methodologies for precise predictive models for ICH. Therefore, the aim of this study was to develop an ML-based predictive model for 48-hour mortality in patients with acute hemorrhagic stroke. METHODS A cross-sectional study was conducted using secondary data from 657 patients diagnosed with acute ICH. Demographic, clinical, laboratory, and radiological variables were extracted from medical records. Data preprocessing included cleaning, normalization, and class balancing using the Synthetic Minority Oversampling Technique (SMOTE). Three supervised algorithms—Random Forest, Decision Tree, and Gaussian Naïve Bayes—were developed and evaluated using stratified 5-fold cross-validation. Model performance was assessed using accuracy, sensitivity, specificity, precision, recall, F1-score, and AUC. RESULTS Random Forest achieved the best overall performance for predicting 48-hour mortality, with an accuracy of 84.77%, F1-score of 84.63%, and AUC of 80.51, outperforming Decision Tree (AUC 61.12) and Gaussian Naïve Bayes (AUC 82.94). Random Forest most accurately identified >48-hour survival, with high sensitivity (93.5%) and PPV (92.9%), while Naïve Bayes provided the most reliable positive classification for this category (PPV 99.0; specificity 94.2%). For ≤24-hour mortality, Naïve Bayes showed the best detection performance (sensitivity 85.4%; NPV 98.7%). CONCLUSIONS Machine learning, particularly the Random Forest algorithm, enables reliable prediction of 48-hour mortality in patients with acute ICH using basic clinical and radiological data available at admission. The model offers practical potential for early risk stratification in emergency and critical care settings.
subject: Original Articles
  topic: section
subject: Intracerebral hemorrhage
  topic: keywords
subject: machine learning
  topic: keywords
subject: early mortality
  topic: keywords
subject: predictive model
  topic: keywords
subject: 48-hour
  topic: keywords
creator: Intan Kemaladina
creator: Syahrul Syahrul
creator: Taufik Fuadi Abidin
creator: Nasrul Musadir
creator: Imran Imran
rights: Copyright (c) 2026 Intan Kemaladina, Syahrul Syahrul, Taufik Fuadi Abidin, Nasrul Musadir, Imran Imran https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-01-12
publication date: 2026-01-12
starting page: 13
ending page: 26
doi: 10.18051/UnivMed.2026.v45.13-26

Role of global deoxyribonucleic acid methylation and molecular hypoxia changes in male infertility
type: item
description: Infertility is recognized as a major global health issue and has become one of the primary challenges in reproductive health; its prevalence and incidence are steadily increasing worldwide. Recent research has highlighted the critical role of epigenetic dysregulation as a direct factor affecting male infertility. The objective of this review is to investigate the relationship between epigenetic modifications (specifically 5-methylcytosine and 5-hydroxymethylcytosine) and essential male reproductive outcomes, including the spermatogenesis process, testicular function, and semen quality parameters. Furthermore, this study explores the influence of micronutrients such as vitamin B12, homocysteine metabolism, and antioxidant capacity on DNA methylation and genomic stability. Significantly, this review establishes a novel link between infertility and cellular hypoxia focusing on the modulation of hypoxia-inducible factor (HIF-1α and HIF-2α) as a potential therapeutic strategy. Additionally, this work introduces the overlooked association between HIF-2α and infertility, offering novel insights since current findings regarding HIF-2α in male infertility are remarkably limited. A literature search was conducted on PubMed, ScienceDirect, Springer Link, Oxford Academic and Nature databases for sources published in English from 2015 to 2025, using the following keywords: male infertility, DNA methylation, hypoxia, HIF-1α, and immunity. Our work investigates the interruption of inflammatory cytokines and immunological markers by linking them with molecular factors, micronutrients and hypoxia pathways. This approach provides an integrated foundation for advanced diagnostic and therapeutic strategies. Ultimately, understanding these molecular signatures provides ways to enhance reproductive outcomes and improve success rates of assisted reproductive techniques.
subject: Review Article
  topic: section
subject: Male infertility
  topic: keywords
subject: DNA methylation
  topic: keywords
subject: vit. B12
  topic: keywords
subject: homocysteine
  topic: keywords
subject: hypoxia
  topic: keywords
subject: HIF-1α
  topic: keywords
subject: HIF-2α
  topic: keywords
subject: interleukin-41
  topic: keywords
creator: Zainab Abdul Jabbar
creator: Rakad Mohammed Khamas AL-Jumaily
rights: Copyright (c) 2026 Zainab Abdul Jabbar, Rakad Mohammed Khamas AL-Jumaily https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-03-06
publication date: 2026-03-06
doi: 10.18051/UnivMed.2026.v45.%p

Clinical significance of pre-operative prognostic nutritional index in predicting survival in patients with renal cell carcinoma
type: item
description: Background Renal cell carcinoma (RCC) is a prevalent urologic malignancy with heterogeneous outcomes even after surgery. Conventional prognostic factors are insufficient to capture host-related influences on survival. The prognostic nutritional index (PNI), derived from serum albumin and lymphocyte count, reflects nutritional and immunological status and has emerged as a potential prognostic biomarker. The objective of this study was to determine preoperative PNI in predicting survival outcomes of RCC patients. Methods This was a retrospective cohort study involving 107 RCC patients who underwent radical or partial nephrectomy. Patients were categorized into normal and low PNI. Associations between PNI and clinicopathological features were assessed, while survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Results Patients’ mean age was 53.1 ± 13.5 years, and 58.9% of the patients were male. Clear cell carcinoma was the most common histological type (69.2%). Low PNI was significantly associated with older age (p=0.04), metastatic disease (p<0.001), and advanced tumor stage (p=0.014). Kaplan–Meier analysis demonstrated significantly poorer survival in the low-PNI group (p<0.001). In the multivariate Cox model, PNI remained the strongest independent predictor of overall survival (HR = 0.29, 95% CI: 0.13–0.67, p=0.003), while metastasis also retained independent significance (HR = 2.04, 95% CI: 1.06–3.93, p=0.031). Conclusion The PNI is an independent, simple, and cost-effective prognostic factor for overall survival in RCC. Incorporating PNI into preoperative risk stratification may enhance clinical decision-making. Therefore, PNI could be used as an effective prognostic indicator in RCC.
subject: Original Articles
  topic: section
subject: Renal cell carcinoma
  topic: keywords
subject: prognostic nutritional index
  topic: keywords
subject: overall survival
  topic: keywords
subject: cancer prognosis
  topic: keywords
subject: immunological status
  topic: keywords
creator: Eldo Taufila Putra Utama
creator: Raden Danarto
rights: Copyright (c) 2025 Eldo Taufila Putra Utama, Raden Danarto https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-12-17
publication date: 2025-12-17
starting page: 345
ending page: 351
doi: 10.18051/UnivMed.2025.v44.345-351

Effect of Muay Thai training frequency on VO2 max and muscle endurance in non-athletic adults: a randomized clinical trial
type: item
description: Background Urban lifestyles have become increasingly sedentary, contributing to reduced physical fitness. Muay Thai, a high-intensity martial art, has been proposed as an effective exercise modality to improve aerobic capacity and muscle endurance. This study aimed to evaluate the effects of different weekly Muay Thai training frequencies on VO₂ max and muscle endurance in non-athletic adults. Methods A randomized experimental study with a pre-test–post-test design was conducted involving 40 non-athletic adults (aged 20–25 years). Participants were randomly allocated into two groups: training twice weekly (MT2X) or four times weekly (MT4X) for eight weeks. Outcomes included VO₂ max and upper, abdominal, and lower body muscle endurance. Baseline characteristics were described descriptively. Between-group differences in post-intervention outcomes were analyzed using analysis of covariance (ANCOVA), with baseline values included as covariates. Results At baseline, VO₂ max, abdominal, and lower body muscle endurance were higher in the MT4X group. After adjustment for baseline values using ANCOVA, the MT4X group demonstrated significantly higher post-intervention VO₂ max compared with the MT2X group (adjusted mean difference, p<0.001). Significantly greater improvements favoring the MT4X group were also observed for upper body muscle endurance (push-ups, p<0.001), abdominal muscle endurance (sit-ups, p<0.001), and lower body muscle endurance (squats, p=0.018). Conclusion A higher frequency Muay Thai training program is effective in significantly improving participants' aerobic capacity and muscle endurance. Practitioners are able to choose their training frequency preference, since both frequencies provide similar adaptation.
subject: Original Articles
  topic: section
subject: Cardiovascular fitness
  topic: keywords
subject: Muay Thai
  topic: keywords
subject: muscle endurance
  topic: keywords
subject: sedentary lifestyle
  topic: keywords
subject: VO₂ max
  topic: keywords
creator: Al Husni Hadi Pasca Putra
creator: Julia Windi Gunadi
creator: Yenni Limyati
creator: Oeij Anindita Adhika
rights: Copyright (c) 2026 Al Husni Hadi Pasca Putra, Julia Windi Gunadi, Yenni Limyati, Oeij Anindita Adhika https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-03-17
publication date: 2026-03-17
starting page: 46
ending page: 58
doi: 10.18051/UnivMed.2026.v45.46-58

Hypoxic mesenchymal stem cell-derived secretome and alkaline water synergistically reduce apoptosis and insulin resistance in type 2 diabetes mellitus rat model
type: item
description: BACKGROUND Type 2 Diabetes Mellitus (T2DM) is characterized by chronic inflammation and insulin resistance. These factors contribute to pancreatic β-cell apoptosis, reducing insulin production and impairing glucose homeostasis. This study aims to evaluate the protective effects of hypoxic mesenchymal stem cell-derived secretome (HMSCS) and alkaline water on inflammation, apoptosis, and insulin resistance in a T2DM rat model. METHODS An experimental study was conducted involving 24 male Wistar T2DM model rats (aged 6-8 weeks, 200-250g). They were randomized into four groups: T2DM rats only as negative control (K-), T2DM rats with metformin as positive control (K+), HMSCS treatment (P1), and HMSCS plus alkaline water group (P2). Caspase-3 expression was measured to assess apoptosis levels using RT-PCR, while homeostatic model assessment for insulin resistance (HOMA-IR) was measured using ELISA. One way ANOVA followed by a post hoc LSD test were used to analyse the data. RESULTS The P1 group (3.03 ± 1.26 a.u) and P2 group (2.93 ± 0.52 a.u.) had significantly lower caspase-3 expression compared to K- group (6.66 ± 2.76 a.u.) (p<0.05), but were not significantly different from K+ group (3.83 ± 1.61 a.u.) (p>0.05). Additionally, P2 group (6.76 ± 0.96) had a significantly lower HOMA-IR than K- group (18.92 ± 2.63) and K+ group (10.85 ± 1.39) (p<0.05), and similarly the P1 (7.71 ± 0.53) group also showed significant difference from K- and K+ groups (p<0.05). CONCLUSION Higher doses of HMSCS and alkaline water are associated with reduced pancreatic β-cell apoptosis and improved insulin sensitivity, highlighting its potential as a novel therapeutic approach for T2DM.
subject: Original Articles
  topic: section
subject: Caspase-3
  topic: keywords
subject: HOMA-IR
  topic: keywords
subject: inflammation
  topic: keywords
subject: insulin resistance
  topic: keywords
subject: HMSCS
  topic: keywords
subject: T2DM
  topic: keywords
subject: rats
  topic: keywords
creator: Melisa Septi Mawarini
creator: Eko Setiawan
creator: Agung Putra
rights: Copyright (c) 2025 Melissa Septi Mawarini, Eko Setiawan, Agung Putra https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-11-11
publication date: 2025-11-11
starting page: 310
ending page: 317
doi: 10.18051/UnivMed.2025.v44.310-317

Bench to bedside and beyond: evolving trends in translational research
type: item
subject: Editorial
  topic: section
creator: Juhi Aggarwal
rights: Copyright (c) 2025 Juhi Aggarwal https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-10-12
publication date: 2025-10-12
starting page: 285
ending page: 287
doi: 10.18051/UnivMed.2025.v44.285-287

Application of international classification of functioning, disability and health in salat: a scoping review
type: item
description: Background Salat has been linked to physical, cognitive, emotional and psychological health benefits. This scoping review classifies the health benefits of salat based on the International Classification of Functioning, Disability, and Health (ICF) conceptual framework. The ICF illustrates how Salat may be used as a multi-modal and multidisciplinary framework to rehabilitate clients with different conditions tailored to their clinical, psychosocial and environmental contexts. Purpose To conduct a scoping review on the health benefits of salat (muslim prayer) based on the ICF conceptual framework. Methods A literature review was conducted from February to April 2023 using PubMed, EBSCO, and the Scopus Library databases. Articles published between 2012 and 2023 were retrieved using the following keywords: "impact" OR "effect" OR "health benefit" OR "functional outcome" AND "shalat" OR "Muslim prayer" OR "Salat”. Health benefits of salat were subsequently categorised into five domains of the ICF. Results A total of 596 articles were identified through PubMed (404), EBSCO (124), and Scopus (68). Thirty-one records met the predefined inclusion criteria: 21 original articles, two systematic reviews, five literature reviews, one case study, one case series, and one short report. Salat had positive benefits on the cardiorespiratory, haematological, immunological, mental and neuromuscular functions. Salat may serve as a coping mechanism to reduce stress and depression. The frequency and duration of salat had positive associations with maintaining employment, social support and better quality of life. Conclusion Salat is associated with many health benefits, which can be categorised systematically and summarised using the ICF conceptual framework.
subject: Review Article
  topic: section
subject: Functional outcome
  topic: keywords
subject: health benefit
  topic: keywords
subject: muslim prayer
  topic: keywords
subject: salat
  topic: keywords
subject: International Classification of Functioning
  topic: keywords
subject: disability
  topic: keywords
subject: health
  topic: keywords
creator: Irma Ruslina Defi
creator: Intan Sabrina Mohamad
creator: Nuzula Chafidh Al Barqi
creator: Adziqa Ammara Qiantori
creator: Andri Qiantori
rights: Copyright (c) 2025 Irma Ruslina Defi, Intan Sabrina Mohamad, Nuzula Chafidh Al Barqi, Adziqa Ammara Qiantori, Andri Qiantori https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-12-04
publication date: 2025-12-04
starting page: 406
ending page: 418
doi: 10.18051/UnivMed.2025.v44.406-418

Effect of cross-running polypropylene intradermal suture technique on keloid scar: a single-blind randomized controlled trial
type: item
description: BACKGROUND Keloids are abnormal scars that present a therapeutic challenge. Various treatment modalities have been developed, including surgical excision. While cross-running intradermal sutures were previously created using absorbable polyglycolic acid, this study introduces a modification using a non-absorbable material. Therefore, this study aimed to evaluate the effect of the cross-running polypropylene intradermal suture (CR-PIS) technique compared to the simple interrupted suture technique on keloid repair. METHODS This was a randomized controlled trial with a post-test-only design involving 30 male and female keloid patients aged 20-50 years. Participants were randomized into the treatment group (n=15) and the control group (n=15). Wound assessment using the Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS) was performed at 3, 6, and 9 months after surgery. Differences in VSS, MSS, and POSAS scores between the CR-PIS group and the simple knot group were analyzed using the Mann-Whitney U test. RESULTS Statistical analysis revealed a significant difference between the simple knot and CR-PIS groups (p<0.05). The median scores for each assessment (VSS, MSS, and POSAS) decreased significantly at 3, 6, and 9 months, with the control group's values being higher than those in the CR-PIS group (p<0.05). These results indicate that the control group developed moderate scars, whereas the treatment group exhibited good scars. CONCLUSIONS The CR-PIS is more effective than the simple knot technique in improving keloid scars, as shown by changes in wound appearance, morphological function, topography, and patient and evaluator assessments.
subject: Original Articles
  topic: section
subject: CR-PIS
  topic: keywords
subject: intradermal suture
  topic: keywords
subject: keloid
  topic: keywords
subject: polypropylene
  topic: keywords
creator: Herman Yosef Limpat Wihastyoko
creator: Edith Sumaregita Rinhastyanti
creator: Arviansyah Arviansyah
creator: Yudi Siswanto
creator: Wilma Agustina
creator: Elisabeth Prajanti Sintaningrum
rights: Copyright (c) 2026 Herman Yosef Limpat Wihastyoko, Edith Sumaregita Rinhastyanti, Arviansyah Arviansyah, Yudi Siswanto, Wilma Agustina, Elisabeth Prajanti Sintaningrum https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-01-12
publication date: 2026-01-12
starting page: 4
ending page: 12
doi: 10.18051/UnivMed.2026.v45.4-12

Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center
type: item
description: Background As people age, skeletal muscle mass and strength decrease, leading to sarcopenia, diagnosed through calf circumference, muscle mass, strength, and physical performance. Uric acid (UA), with both pro-oxidant and antioxidant properties, is an indicator of oxidative stress and may contribute to sarcopenia. This study aimed to determine the correlation between serum uric acid levels and sarcopenia in elderly in a community health center. Methods A cross-sectional study was conducted involving 42 subjects aged ≥60 years, consisting of 37 female and 5 male participants. We applied Asian Working Group for Sarcopenia (AWGS) 2019 criteria to define sarcopenia. Muscle mass was measured using skeletal muscle index (SMI) based on bioimpedance analysis (BIA). Handgrip strength (HGS), physical performance, calf circumference, and blood test data were collected. A backward regression analysis was performed to investigate the relationship between UA and SMI, HGS, physical performance, and calf circumference after adjusting for gender, smoking history, upper arm circumference, and body mass index. Results After adjusting for potential confounding variables, uric acid remained significantly associated with muscle strength (β=0.326; p=0.023) and calf circumference (β=0.264; p=0.010), but not with muscle mass (β=0.046; p=0.727) or physical performance (β=–0.171; p=0.279). Conclusion There is a significant correlation between uric acid levels and muscle strength, physical performance, and calf circumference in sarcopenia among the elderly in the community health center. Higher uric acid serum levels might slow down the progression of sarcopenia.
subject: Original Articles
  topic: section
subject: Sarcopenia
  topic: keywords
subject: uric acid levels
  topic: keywords
subject: muscle mass
  topic: keywords
subject: physical performance
  topic: keywords
subject: calf circumference
  topic: keywords
creator: A. Deza Farista
creator: Nur Rivianti
creator: Erial Bahar
creator: Mega Permata
creator: Muhammad Reagan
creator: Crisnah Indah
creator: Ika Artini
rights: Copyright (c) 2025 A. Deza Farista, Nur Rivianti https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-12-15
publication date: 2025-12-15
starting page: 335
ending page: 344
doi: 10.18051/UnivMed.2025.v44.335-344

An integrative review on the shadow of abuse in pediatric head trauma
type: item
description: Introduction Abusive head trauma (AHT) is a significant public health issue that can lead to severe neurological damage or death in childhood. Often difficult to detect, AHT carries long-term consequences and requires high diagnostic vigilance. This integrative review aims to synthesize the current evidence on abusive head trauma in pediatric patients by identifying distinguishing diagnostic criteria, clinical patterns, and risk factors, in order to support early recognition, accurate diagnosis, and effective intervention strategies by healthcare professionals. Methods This integrative review aimed to systematically include studies published between 2020-2025 and the literature search was conducted in April-June 2025. The databases searched included PubMed and Web of Science. The keywords included in the search were "Abusive head trauma", "child abuse", "non-accidental head injury", "health care professional", "pediatric head trauma". The methodological quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Results The findings were synthesized under four main themes: diagnostic indicators and differentiation, epidemiological risk factors, short-term clinical outcomes, and long-term developmental effects. Elevated glucose levels (>300 mg/dL), the diagnostic “triad” (subdural hematoma, retinal hemorrhage, and encephalopathy), and increased plasma osteopontin levels were identified as critical diagnostic clues. Additionally, household composition and caregiver characteristics emerged as significant risk factors. Conclusion This integrative review highlights the necessity of identifying high-risk environments and implementing preventive strategies. The evidence presented offers practical, evidence-based insights to support healthcare professionals in accurately diagnosing and managing AHT. It also underscores the need for multidisciplinary prevention efforts and post-trauma monitoring. Ultimatel…
subject: Review Article
  topic: section
subject: Abusive head trauma
  topic: keywords
subject: child abuse
  topic: keywords
subject: non-accidental head injury
  topic: keywords
subject: health care professional
  topic: keywords
subject: pediatric head trauma
  topic: keywords
creator: Semra SÖNGÜT
rights: Copyright (c) 2025 Semra SÖNGÜT https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-08-24
publication date: 2025-08-24
starting page: 257
ending page: 269
doi: 10.18051/UnivMed.2025.v44.257-269

Life satisfaction: a sustainable perspective in old age-physical and mental health
type: item
description: Life satisfaction is a subjective concept that reflects individuals’ overall evaluation of their life. It is closely associated with the physical and mental health of older adults. The sustainability of life satisfaction among the elderly is important for both individual happiness and societal well-being for public health. This literature study aims to provide a sustainable perspective by examining the factors influencing life satisfaction in old age through both physical and mental dimensions. This study, designed as a literature review, was prepared by scanning studies published in the last five years (2021-2025) in PubMed, Scopus and Science Direct databases. Older adults with high life satisfaction tend to form healthier relationships with their surroundings, access health services more consciously, and interact more actively with society. In this context, addressing life satisfaction in old age from a physical and mental health perspective contributes to achieving sustainable well-being at both the individual and societal levels. The literature demonstrates that life satisfaction in older adults is directly related to their physical and mental health status. The majority of participants reported that the presence of chronic diseases, mobility limitations, and loss of independence in daily activities negatively affected their life satisfaction. In terms of mental health, symptoms of depression, social isolation, and feelings of loneliness emerge as significant determinants of reduced life satisfaction. The review found that protective factors such as regular health check-ups, an active lifestyle, the presence of social support systems, and support for psychological well-being significantly enhance life satisfaction. Additionally, developing a positive attitude towards aging and having meaningful life goals play a vital role in ensuring sustainable life satisfaction. Based on the literature review, developing policies, practices, and supportive services aimed at …
subject: Review Article
  topic: section
subject: Life satisfaction
  topic: keywords
subject: sustainability
  topic: keywords
subject: elderly health
  topic: keywords
subject: mental health
  topic: keywords
subject: physical health
  topic: keywords
subject: public health
  topic: keywords
creator: Ayşe ÇALMAZ
creator: Gülay YILMAZEL
rights: Copyright (c) 2025 Ayşe ÇALMAZ, Gülay YILMAZEL https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-12-17
publication date: 2025-12-17
starting page: 419
ending page: 426
doi: 10.18051/UnivMed.2025.v44.419-426

Fragrance preference of essential oil blends for reducing stress and sleep problems in adult women
type: item
description: Background Aromatherapy with a blend of essential oils is an alternative treatment for stress and sleep disturbances, providing stress relief and sleep enhancement, while increasing the efficacy and scent appeal. This study aimed to formulate an essential oil blend with the potential to reduce stress and enhance sleep quality, and to identify the most preferred blend based on participant satisfaction. Methods A cross-sectional study was conducted involving 63 female volunteers aged 25 - 50 years. Three formulations (A, B, and C) of essential oil blends were developed, each with a distinct scent profile—floral, unisex, and aromatic. A preference test was conducted using a sensory evaluation method, assessing participants’ satisfaction of the blends through inhalation. Preferences were quantified using a structured scoring system. Formula B was the most popular and was further refined into two recipes, B1 and B2. B2 emerged as the preferred option, and its primary component was identified using gas chromatography-mass spectrometry (GC–MS). Results Formulation B, rich in bergamot oil, received significantly higher hedonic ratings than Formulation A (p<0.05) and was the most preferred in interviews. Participants recommended a milder, more balanced scent for relaxation and sleep. While B1 and B2 showed no significant differences, B2 was chosen for its higher bergamot content, fresher unisex profile, and reduced floral notes. GC–MS analysis identified limonene, menthol, and linalool as its main components. Conclusion This study demonstrated that an essential oil blend predominantly composed of bergamot oil was most favored by the volunteers, indicating its potential benefits for promoting relaxation.
subject: Original Articles
  topic: section
subject: Essential oil blend
  topic: keywords
subject: sleep
  topic: keywords
subject: sleep problem
  topic: keywords
subject: stress
  topic: keywords
subject: preference
  topic: keywords
subject: women
  topic: keywords
creator: Kanchanapa Sathirachawan
creator: Kosum Chansiri
creator: Deeprom Sirikate
creator: Phakkharawat Sittiprapaporn
creator: Ruttachuk Rungsiwiwut
creator: Somrudee Saiyudthong
rights: Copyright (c) 2025 Kanchanapa Sathirachawan, Kosum Chansiri, Deeprom Sirikate , Phakkharawat Sittiprapaporn, Ruttachuk Rungsiwiwut, Somrudee Saiyudthong https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-08-05
publication date: 2025-08-05
starting page: 162
ending page: 171
doi: 10.18051/UnivMed.2025.v44.162-171

Myosin heavy chain as biomarker in the prevention of sarcopenia
type: item
description: Sarcopenia, or the age-related loss of skeletal muscle mass and function, can reduce total muscle contractile capacity and increase the likelihood of physical disability in older adults. The loss of muscle mass and contractile performance is generally thought to be multifactorial, with as possible contributing factor an age-related shift in the expressed amounts of myosin heavy chain (MyHC) isoforms. The composition of adult human skeletal muscle consists of a mixture of three distinct MyHC isoforms (I, IIA, and IIX). This literature review aimed to explore studies focused on the signs of sarcopenia, the early detection of initial symptoms, and awareness among the aging population. We aimed to understand the molecular changes in muscle fibers as people age and to help inform the early intervention approach to prevent sarcopenia. The literature search was conducted in several databases between 2020 to 2025, including PubMed, ScienceDirect, and SpringerLink. The search terms consisted of “sarcopenia”, “muscle mass”, “early detection”, and “myosin heavy chain”. Inclusion criteria included original full-text English-language studies on the cellular and molecular physiology of sarcopenia. Molecular changes in myosin heavy chain vary across different age groups, suggesting the potential for early detection of muscle aging. The review is limited by the variability in the definition and measurement of sarcopenia across different studies, which may affect the generalizability of the findings. This review highlights the potential significance of identification and sarcopenia management in elderly individuals. The findings would be helpful for clinicians, researchers, and policymakers to improve elderly care and quality of life.
subject: Review Article
  topic: section
subject: Early detection
  topic: keywords
subject: muscle aging
  topic: keywords
subject: myosin heavy chain
  topic: keywords
subject: sarcopenia
  topic: keywords
creator: Desy Nofita Sari
creator: Roman Ardian Goenarjo
creator: Imelda Rosalyn Sianipar
creator: Chin Leong Lim
rights: Copyright (c) 2026 Desy Nofita Sari, Imelda Rosalyn Sianipar, Roman Ardian Goenarjo https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-02-23
publication date: 2026-02-23
doi: 10.18051/UnivMed.2026.v45.%p

Angiogenesis in rheumatoid arthritis: epidemiology, pathogenesis, signal transduction pathways, and nano-targeted therapeutic strategies
type: item
description: Angiogenesis is the formation of new blood vessels from existing vessels. In rheumatoid arthritis (RA), new blood vessels maintain a chronic inflammatory state by transporting inflammatory cells to the site of inflammation. Rheumatoid arthritis is a chronic autoimmune disorder that affects approximately 1% of the global population, with a higher prevalence in women. It is characterized by synovial inflammation, hyperplasia, and angiogenesis, leading to joint destruction. Understanding the pathogenesis of RA, particularly the mechanisms driving synovial angiogenesis, is crucial for the development of targeted therapies. Fibroblast-like synoviocytes (FLS) and endothelial cells play key roles in RA pathogenesis by secreting pro-inflammatory cytokines and growth factors, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β, IL-6, and vascular endothelial growth factor (VEGF). These mediators activate multiple signaling pathways, including VEGF, nuclear factor kappa light chain enhancer of activated B cells (NF-κB), phosphatidylinositol-3 kinase (PI3K)/AKT, mitogen-activated protein kinase (MAPK), wingless-related integration site (Wnt), and the Janus kinase (JAK)/ signal transducer and activator of transcription (STAT), which contribute to synovial angiogenesis, inflammation, and joint damage. A literature search was conducted on PubMed, ScienceDirect, SpringerLink, and Google Scholar databases for sources published in English from 2015 to 2025, using the terms “nanotechnology rheumatoid arthritis,” “angiogenesis,” “synovial inflammation,” “pro-inflammatory cytokines,” “disease-modifying antirheumatic drugs,” and “signal transduction pathways”. Current treatments for RA include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs) (conventional synthetic, biological, and targeted synthetic). An informative overview of anti-angiogenic strategies for treating RA, which may provide new perspectives for …
subject: Review Article
  topic: section
subject: Nanotechnology rheumatoid arthritis
  topic: keywords
subject: angiogenesis
  topic: keywords
subject: synovial inflammation
  topic: keywords
subject: pro-inflammatory cytokines
  topic: keywords
subject: disease-modifying antirheumatic drugs
  topic: keywords
subject: signal transduction pathways
  topic: keywords
creator: Joan Blin
creator: Mohd Rohaizad Md Roduan
creator: Roslida Abd Hamid
rights: Copyright (c) 2025 Joan Blin, Mohd Rohaizad Md Roduan, Roslida Abd Hamid https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-10-14
publication date: 2025-10-14
starting page: 359
ending page: 379
doi: 10.18051/UnivMed.2025.v44.359-379

Bortezomib in multiple myeloma management
type: item
description: Multiple myeloma (MM) is a hematologic malignancy characterized by the uncontrolled proliferation of plasma cells, leading to complications such as bone lesions, renal dysfunction, and immune suppression. Over the past three decades, its incidence has risen significantly, attributed to factors such as aging populations and improved diagnostic methods. Treatment strategies have evolved considerably, transitioning from alkylating agents and high-dose chemotherapy to targeted therapies, including proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs). Bortezomib, a first-in-class PI, has revolutionized MM management by inhibiting proteasome activity, thereby inducing apoptosis in malignant plasma cells. This review evaluates the efficacy, safety, and clinical applications of bortezomib, both as monotherapy and in combination with dexamethasone, IMiDs, and conventional chemotherapies. Key clinical trials, such as VISTA and SUMMIT, demonstrate its superiority over traditional regimens, improving response rates and survival outcomes. However, its use is associated with adverse effects, including peripheral neuropathy, hematologic toxicities, and gastrointestinal disturbances, necessitating dose modifications and supportive care. Emerging combinations with monoclonal antibodies and novel agents further enhance therapeutic potential, though optimal sequencing remains under investigation. Systematic literature search was performed using PubMed and Cochrane to identify relevant studies on the applications of bortezomib. The search was inclusive of all publications up to May 2025, without restriction by publication year, to ensure a thorough review of research on bortezomib. Studies focusing on multiple myeloma (MM) and the efficacy of bortezomib were prioritized. A broad set of keywords was employed reflecting the diverse applications of bortezomib in MM treatment. The search strategy was designed to capture a wide range of relevant studies. By synthesizing evidence f…
subject: Review Article
  topic: section
subject: Proteasome Inhibitors
  topic: keywords
subject: Multiple Myeloma
  topic: keywords
subject: Immunomodulatory Drugs
  topic: keywords
subject: Hematologic Toxicities
  topic: keywords
subject: Gastrointestinal Disturbances
  topic: keywords
creator: Hrishik Iqbal
creator: Mohammad Nazmul Islam
creator: Srikumar Chakravarthi
creator: Mohammad Chand Jamali
creator: Rezwan Ahmed Mahedi
creator: Sadia Afrin
creator: Pujita Roy
creator: Fahadul Alam
creator: Md.Shajalal Reza
creator: Νikolaos Syrmos
rights: Copyright (c) 2025 Hrishik Iqbal, Mohammad Nazmul Islam, Srikumar Chakravarthi, Mohammad Chand Jamali, Rezwan Ahmed Mahedi, Sadia Afrin, Pujita Roy, Fahadul Alam, Md.Shajalal Reza, Νikolaos Syrmos https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-10-20
publication date: 2025-10-20
starting page: 380
ending page: 393
doi: 10.18051/UnivMed.2025.v44.380-393

High neutrophil-to-lymphocyte ratio is not a risk factor of severe dengue infection in children
type: item
description: Background Dengue infection in children globally shows a significant increasing trend in incidence and remains a heavy public health burden. Dengue infection can progress rapidly to death, especially in children. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that represents an immune response to the disease. This study investigated NLR as a risk factor of dengue infection severity in children. Methods A cross-sectional study was conducted involving 237 children, (110 girls and 127 boys) aged 1-18 years with dengue infection. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF) according to WHO 2011 criteria. Demographic characteristics, clinical manifestations, and hematological parameters, including hemoglobin (Hb), leukocyte count, thrombocyte count, hematocrit (HCT), and NLR, were extracted. Bivariate and multivariate logistic regression analysis were used to analyze the data. Results The study demonstrated that 59.9% of cases were classified as DF and 40.1% as DHF, with a mean age of 9.99 ± 4.84 years. The mean NLR was 0.99 ± 0.98 in DHF and 1.51 ± 1.38 in DF. Univariate regression analysis stated that NLR≥2 was associated with dengue severity. However, multivariate regression analysis stated that NLR was not a risk factor of dengue severity, adjusted from demographic characteristics and hematologic parameters. Hemoglobin and platelets are the independent factors of dengue severity. Conclusion Neutrophil-to-lymphocyte ratio is a simple biomarker but not a risk factor of dengue fever severity in children. There is evidence suggesting that the relationship between NLR and dengue fever severity is complex, with varying trends in different phases of the disease.
subject: Original Articles
  topic: section
subject: Dengue infection
  topic: keywords
subject: Clinical manifestation
  topic: keywords
subject: Hematological profile
  topic: keywords
subject: Neutrophil-to-lymphocyte ratio
  topic: keywords
creator: Saskia Ratna Desita
creator: Risky Vitria Prasetyo
creator: Irwanto Irwanto
rights: Copyright (c) 2026 Saskia Ratna Desita, Risky Vitria Prasetyo, Irwanto Irwanto https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-02-15
publication date: 2026-02-15
starting page: 39
ending page: 45
doi: 10.18051/UnivMed.2026.v45.39-45

Glucocorticoid-induced adrenal insufficiency after receiving intravenous methylprednisolone for Graves' ophthalmopathy: a case report
type: item
description: BACKGROUND Graves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease and can significantly impair visual function and quality of life. High-dose intravenous methylprednisolone (IVMP) is recommended as first-line therapy for moderate-to-severe active GO due to its superior efficacy and tolerability compared with oral glucocorticoids. However, IVMP therapy may be associated with rare but potentially serious adverse effects, including suppression of the hypothalamic–pituitary–adrenal (HPA) axis leading to GI adrenal insufficiency (GI-AI). Case description We report the case of a 38-year-old man with Graves’ disease who developed AI following IVMP therapy for moderate-to-severe GO. The patient received five weekly doses of IVMP 500 mg (cumulative dose 2.5 g) for progressive ocular symptoms. He subsequently presented with fatigue, weight gain, moon face, and buffalo hump. Laboratory evaluation revealed a markedly low morning serum cortisol level of 1 mcg/dL, confirming adrenal insufficiency. Patient was diagnosed with GI-AI accompanied by features of iatrogenic Cushing’s syndrome. Management consisted of hydrocortisone replacement therapy at a dose of 20 mg/day along with ongoing antithyroid treatment using methimazole. Serial monitoring of cortisol levels demonstrated gradual recovery of HPA axis function, accompanied by clinical improvement. Conclusion This case highlights that glucocorticoid-induced adrenal insufficiency can occur on IVMP used for GO. Clinicians should maintain a high index of suspicion and perform appropriate adrenal function monitoring during and after IVMP therapy to ensure early detection and safe management of this potentially life-threatening complication.
subject: Case Report
  topic: section
subject: Graves' ophthalmopathy
  topic: keywords
subject: adrenal insufficiency
  topic: keywords
subject: intravenous glucocorticoid
  topic: keywords
subject: HPA axis
  topic: keywords
subject: methylprednisolone
  topic: keywords
creator: Yanne Pradwi Efendi
creator: Dinda Aprilia
creator: Eva Decroli
rights: Copyright (c) 2026 Yanne Pradwi Efendi, Dinda Aprilia, Eva Decroli https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2026-02-13
publication date: 2026-02-13
doi: 10.18051/UnivMed.2026.v45.%p

Foley catheter guided by semi-rigid ureterorenoscopy in the treatment of bladder diverticulum: a case report
type: item
description: Background A bladder diverticulum can be the consequence of a congenital abnormality or acquired as a result of trauma, infection, or outlet obstruction. Despite advancements in laparoscopic techniques, to date, precise intraoperative identification of diverticula remains a significant challenge. The aim of this case report was to offer an alternative technique using a foley catheter guided by semi-rigid ureterorenoscopy to facilitate bladder diverticulum identification during laparoscopic diverticulectomy. Case description A 77-year-old male patient presented with complaints of burning sensation during urination and reported frequent episodes of urinary tract infection over the past several months. Cystographic imaging revealed a large diverticulum located on the left posterior bladder wall. Non-contrast abdominal computed tomography (CT) scan identified a 10×10 mm calculus in the left inferior renal calyx. The patient was diagnosed with a bladder diverticulum. Subsequently, laparoscopic transperitoneal diverticulectomy was performed using a foley catheter guided by semi-rigid ureterorenoscopy for diverticulum identification and excision. The procedure commenced with cystoscopy to localize the diverticulum. Four trocars were inserted: two 12 mm and two 5 mm. A pneumoperitoneum pressure of 14 mmHg was maintained throughout the surgery. The diverticulum was clearly visualized during the operation, and excised successfully without injuring adjacent structures. Postoperative recovery was uneventful. Conclusion The use of a foley catheter guided by semi-rigid ureterorenoscopy may serve as an effective alternative for intraoperative identification of bladder diverticula, particularly in laparoscopic and resource-limited settings.
subject: Case Report
  topic: section
subject: Bladder diverticulum
  topic: keywords
subject: foley catheter
  topic: keywords
subject: laparoscopic
  topic: keywords
subject: diverticulectomy
  topic: keywords
subject: semi-rigid ureterorenoscopy
  topic: keywords
subject: elderly male
  topic: keywords
creator: Made Kresna Yudhistira Wiratma
creator: Ahmad Zulfan Hendri
creator: Eko Subekti
rights: Copyright (c) 2025 Made Kresna Yudhistira Wiratma, Ahmad Zulfan Hendri, Eko Subekti https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-06-30
publication date: 2025-06-30
starting page: 201
ending page: 207
doi: 10.18051/UnivMed.2025.v44.201-207

The survival benefits of adjuvant radiotherapy for malignant meningioma: a retrospective cohort study
type: item
description: Background Malignant meningiomas (MM) are rare aggressive tumors associated with poor survival outcomes. Due to their rarity, there is limited data on the outcomes and prognostic factors of MM patients, particularly on adjuvant radiotherapy roles in this tumor population. This study aims to investigate the clinical characteristics, prognostic factors, and survival outcomes of MM with focus on survival benefits of adjuvant radiotherapy. Methods This retrospective cohort study analyzed 19 MM patients, who were initially subjected to postoperative radiotherapy, at Dr. Kariadi General Hospital, Semarang, from 2013 to 2023. Kaplan-Meier analysis was used to estimate survival rates at 1, 2, and 5 years. Univariate and multivariate Cox regression analyses were performed to identify factors associated with overall survival (OS). Variables with a p-value ≤ 0.25 in univariate analysis were included in the multivariate models. Results The median OS was 16 months (95% CI 0.0–40.2), with estimated 1-year, 2-year, and 5-year survival rates of 52.6%, 42.1%, and 15.8%, respectively. Adjuvant radiotherapy (RDT) was associated with a significantly improved OS (p<0.001). However, sex, age, tumor location, and extent of resection did not show a significant association with OS. Cox regression showed that RDT had no statistically significant effect on OS in the multivariate model (HR = 0, 95% CI 0–1.8, p=0.923). Conclusion Adjuvant radiotherapy is critical for improving OS in MM patients, and gross-total resection (GTR) alone does not guarantee better long-term outcomes. Further studies with larger cohorts and molecular analysis are necessary to refine treatment strategies for MM.
subject: Original Articles
  topic: section
subject: Adjuvant radiotherapy
  topic: keywords
subject: malignant meningioma
  topic: keywords
subject: prognostic factor
  topic: keywords
subject: survival outcome
  topic: keywords
creator: Yuriz Bakhtiar
creator: Fariz Eka Setiawan
creator: Rafi Ilmansyah
creator: Krisna Tsaniadi Prihastomo
creator: Dody Priambada
creator: Faiza Rizky Aryani Septarina
creator: Muhamad Thohar Arifin
creator: Zainal Muttaqin
rights: Copyright (c) 2025 Yuriz Bakhtiar, Fariz Eka Setiawan, Rafi Ilmansyah, Krisna Tsaniadi Prihastomo, Dody Priambada, Faiza Rizky Aryani Septarina, Muhamad Thohar Arifin, Zainal Muttaqin https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-11-27
publication date: 2025-11-27
starting page: 318
ending page: 327
doi: 10.18051/UnivMed.2025.v44.318-327

The effect of self-foot massage on anxiety and sleep quality in nursing students: A single-blind randomized controlled study
type: item
description: Background Anxiety and poor sleep quality have always caused problems for nursing students. Today, self-foot massage is considered adjunctive therapy for reducing anxiety and improving sleep quality. This study aimed to evaluate the effects of self-foot massage on anxiety levels and sleep quality among nursing students with high anxiety. Methods An experimental study with pre-test and post-test control groups, included 40 first-year nursing students who met the inclusion criteria (intervention= 20, control= 20). The students were randomized into intervention and control groups using block randomization. A block size of four was employed to maintain equal group sizes. State Anxiety Inventory (SAI) and Pittsburgh Sleep Quality Index (PSQI) were used to collect the data. In the self-foot massage group, subjects attended foot massage sessions at the same time every day for 10 days. Independent t-test and Chi-square method was used to analyze the data. Results The intervention group performing self-foot massage demonstrated significantly lower mean scores for PSQI (7.70 ± 1.5) and SAI (34.10 ± 4.82) compared to the control group, whose mean scores were 8.00 ± 2.65 and 38.80 ± 3.04, respectively (p=0.03; p=0.021). These differences indicate improved sleep quality and reduced anxiety in the intervention group. Subjective sleep quality was also found to be better among participants in the intervention group. However, no significant differences were observed between the groups in the PSQI subcomponents (p>0.05). Conclusion Self-foot massage can be considered as a potential therapeutic intervention that improves sleep quality and reduces anxiety among nursing students with high level anxiety.
subject: Original Articles
  topic: section
subject: Foot massage
  topic: keywords
subject: state anxiety
  topic: keywords
subject: sleep quality
  topic: keywords
subject: nurses
  topic: keywords
subject: nursing students
  topic: keywords
creator: Kezban KORAŞ SÖZEN
creator: Songül GÜNGÖR
rights: Copyright (c) 2025 Kezban KORAŞ SÖZEN, Songül GÜNGÖR https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-10-06
publication date: 2025-10-06
starting page: 288
ending page: 297
doi: 10.18051/UnivMed.2025.v44.288-297

24-hour movement guidelines: is there more to seek than time standards for health?
type: item
subject: Editorial
  topic: section
creator: Leandro Dragueta Delfino
rights: Copyright (c) 2025 Leandro Dragueta Delfino https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-06-02
publication date: 2025-06-02
starting page: 129
ending page: 130
doi: 10.18051/UnivMed.2025.v44.129-130

Predictors of persistent high disease activity after methotrexate treatment in rheumatoid arthritis patients
type: item
description: Background Methotrexate (MTX) is the firstline therapy for rheumatoid arthritis (RA). However, 30–40% of RA patients exhibit poor response. Identifying early factors associated with persistent disease activity is critical to guide treatment. This study aimed to identify predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. Methods A retrospective cohort study was conducted involving 204 RA patients who had completed six months of MTX therapy. The primary outcome was DAS28-ESR score at six months. Independent variables included baseline erythrocyte sedimentation rate (ESR), cumulative doses of MTX and low-dose methylprednisolone (LDM), and rheumatoid factor (RF) status. Simple and multiple logistic regression was used to analyze the data. Results Significant differences in ESR and cumulative MTX dose were observed between low and high disease activity groups. Multivariate analysis identified four independent predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy: disease duration >11 months (AOR =0.45; 95% CI 0.23–0.89; p=0.025); age at onset >50 years (AOR 0.48; 95% CI 0.24–0.94; p=0.038); cumulative MTX dose >85 mg (AOR 4.75; 95% CI 1.55–14.64; p=0.006); ESR >66 mm/hr (AOR 2.32; 95% CI 1.11–4.89; p=0.026). Conclusion Greater cumulative methotrexate dose (>85 mg) was the most influential predictor of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. These findings may assist clinicians in identifying patients at risk for poor MTX response and support timely therapeutic adjustments.
subject: Original Articles
  topic: section
subject: Persistent disease activity
  topic: keywords
subject: rheumatoid arthritis
  topic: keywords
subject: methotrexate
  topic: keywords
subject: DAS28-ESR
  topic: keywords
subject: predictors
  topic: keywords
creator: Ayu Paramaiswari
creator: Nyoman Kertia
creator: Deddy Achadiono
creator: Armin Sinarta
creator: Dhite Nugroho
rights: Copyright (c) 2025 Ayu Paramaiswari, Nyoman Kertia, Deddy Achadiono, Armin Sinarta, Dhite Nugroho https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-07-04
publication date: 2025-07-04
starting page: 141
ending page: 151
doi: 10.18051/UnivMed.2025.v44.141-151

Retinoblastoma tumor suppressor protein is not a risk factor for the location of condyloma acuminatum among adults
type: item
description: Background Condylomata acuminata (CA) are sexually transmitted infections primarily caused by low-risk HPV types 6 and 11. Retinoblastoma protein (pRb) interacts with HPV oncoproteins, leading to destabilization, genomic instability, and carcinogenesis. This study aimed to determine whether variations in pRb expression and sexual orientation are risk factors of the anatomical location of CA lesions and to compare differences in pRb expression by sexual orientation. Methods A cross-sectional study was conducted among 33 patients aged >18 years with clinically and histopathologically confirmed CA. Demographic data, pRb expression assessed via excision biopsy and immunohistochemistry, and relevant risk factors were collected. Statistical analyses including Simple and multiple binary logistic regression were used to analyze the data, with model fit assessed using the Hosmer–Lemeshow test. Results Weak pRb expression predominated in anal lesions (92.3%; p=0.018) and among homosexual/bisexual individuals (57.9%; p=0.031), while moderate expression was more common in genital lesions (66.7%; p=0.018) and heterosexual individuals (57.1%; p=0.011). Simple logistic regression analysis showed that HIV status (OR=11.88; p=0.025), sexual orientation (OR=13.33; p=0.001), and moderate-to-strong pRb expression (OR=24.00; p=0.008; OR=12.00; p=0.048) were associated with lesion location. In the multivariate model, pRb expression was excluded due to multicollinearity. Sexual orientation remained the only independent predictor of lesion location (Adj OR=8.89; p=0.023), with heterosexual individuals more likely to present with genital lesions. Conclusion The expression of pRb was not a risk factor of the anatomical location of CA, and differed between genital and anal CA. However, sexual orientation emerged as the dominant independent factor associated with lesion location.
subject: Original Articles
  topic: section
subject: Condylomata acuminata
  topic: keywords
subject: HPV infection
  topic: keywords
subject: malignancy
  topic: keywords
subject: retinoblastoma protein
  topic: keywords
subject: sexual orientation
  topic: keywords
creator: Pratiwi Prasetya Primisawitri
creator: ⁠Nurrachmat Mulianto
creator: Endra Yustin Ellistasari
creator: Eti Poncorini
creator: ⁠⁠Harijono Kariosentono
creator: Suci Widhiati
creator: Brian Wasita
creator: Novan Adi Setyawan
creator: Muhammad Yurizar Yudhistira
rights: Copyright (c) 2025 Pratiwi Prasetya Primisawitri, ⁠Nurrachmat Mulianto, Endra Yustin Ellistasari, Eti Poncorini, ⁠⁠Harijono Kariosentono, Suci Widhiati, Brian Wasita, Novan Adi Setyawan, Muhammad Yurizar Yudhistira https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-12-03
publication date: 2025-12-03
starting page: 328
ending page: 334
doi: 10.18051/UnivMed.2025.v44.343-349

Effectiveness of medium-chain triglyceride diet and low glycemic index therapy in drug-resistant childhood epilepsy: a systematic review, meta-analysis, and meta-regression
type: item
description: Background Drug-resistant epilepsy (DRE) challenges clinical management, with many patients failing to find relief. Medium-chain triglyceride diet (MCTD) and low glycemic index therapy (LGIT) are emerging variants of the ketogenic diet. MCTD and LGIT show promise but lack clear efficacy data. The purpose of this systematic review was to evaluate and compare the efficacy of MCTD and LGIT in the management of pediatric patients with DRE. Methods Four databases were searched (PubMed, Embase, Scopus, and Cochrane Library) from November 2024 to February 2025. Two independent reviewers meticulously screened titles, abstracts, and full texts, ensuring adherence to predefined criteria. Data extraction encompassed study characteristics, participant demographics, intervention details, and outcomes, including seizure frequency, percentage reduction, and adverse events. Statistical analyses were performed using R 4.2.2 software, assessing heterogeneity with Cochrane Q and I² and utilizing random-effects and common-effects models. Results From 1489 articles found, 487 duplicates were removed, 897 were excluded based on title and abstract screening, and of the 47 full-text articles assessed for eligibility, 31 articles were excluded, resulting in 16 articles (9 MCTD and 7 LGIT) included in this review. The pooled estimates for the proportion of children achieving seizure freedom, ≥90% seizure reduction, and ≥50% seizure reduction following the intervention were comparable between the MCTD and LGIT groups. Based on the random-effects model, the overall success proportion of MCTD in reducing seizure frequency was 0.20 [95 % Confidence Interval (CI), 0.14-0.27] (p<0.01). Meanwhile, in the LGIT group, the overall success proportion was 0.27 [95% CI,0.14- 0.45] (p<0.01). Conclusion Both MCTD and LGIT demonstrate comparable efficacy, and no definitive conclusion can be drawn regarding the superiority of one diet over the other.
subject: Review Article
  topic: section
subject: Childhood epilepsy
  topic: keywords
subject: drug resistant epilepsy
  topic: keywords
subject: medium-chain triglyceride diet
  topic: keywords
subject: low glycemic index therapy
  topic: keywords
subject: seizure freedom
  topic: keywords
subject: seizure reduction
  topic: keywords
creator: Elbert Wiradarma
creator: Herlyani Khosama
creator: Finny Warouw
creator: Windy M. V. Wariki
creator: Seilly Yunita Jehosua
creator: Junita Maja Pertiwi
rights: Copyright (c) 2025 Elbert Wiradarma, Herlyani Khosama, Finny Warouw, Windy M. V. Wariki, Seilly Yunita Jehosua, Junita Maja Pertiwi https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-08-21
publication date: 2025-08-21
starting page: 245
ending page: 256
doi: 10.18051/UnivMed.2025.v44.245-256

Analysis of serum levels of B cell activating factor and soluble B cell activating factor receptor with disease activity in systemic lupus erythematosus
type: item
description: Background Systemic lupus erythematosus (SLE) is caused by B-cell hyperactivity, which stimulates the production of autoantibodies, leading to the formation of immune complexes and resulting in tissue damage. Increased B-cell activation is associated with disease activity in SLE. The cytokine B-cell Activating Factor (BAFF) and its soluble BAFF receptor (sBAFF-R) play a crucial role in B-cell activation and survival. Their serum levels may serve as potential biomarkers for SLE severity. This study aimed to compare serum levels of BAFF and sBAFF-R between SLE patients with mild, moderate, and severe disease activity. Methods A cross-sectional study was conducted involving 33 female SLE patients. Subjects were divided into mild, moderate, and severe disease activity groups. Disease activity was assessed using Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) scores. Serum BAFF and sBAFF-R levels were measured using ELISA. Data were analyzed using the Kruskal–Wallis and Mann-Whitney tests. A p-value < 0.05 was considered statistically significant. Results The median serum BAFF level in SLE patients was 0.51 ng/mL, and 4.66 ng/mL in sBAFF-R level.There was a statistically significant difference in serum BAFF and sBAFF-R levels between mild, moderate, and severe disease activity among SLE patients (p<0.0001). Conclusion Increased serum levels of BAFF and sBAFF-R may influence disease activity in SLE. Serum concentrations of BAFF and sBAFF-R were found to be associated with disease severity, including mild, moderate, and severe categories. These findings suggest that serum BAFF and sBAFF-R levels may serve as potential biomarkers for assessing SLE activity.
subject: Original Articles
  topic: section
subject: B-cell activating factor
  topic: keywords
subject: biomarker
  topic: keywords
subject: MEX-SLEDAI
  topic: keywords
subject: receptor
  topic: keywords
subject: systemic lupus erythematosus
  topic: keywords
creator: Raveinal Raveinal
creator: Dwitya Elvira
creator: Muhamad Delfin
rights: Copyright (c) 2025 Raveinal Raveinal, Dwitya Elvira, Muhamad Delfin https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-08-23
publication date: 2025-08-23
starting page: 181
ending page: 189
doi: 10.18051/UnivMed.2025.v44.181-189

Type 2 diabetes mellitus and recent treatment options in adolescents and young adults
type: item
description: Although type 2 diabetes mellitus (T2DM) has historically been thought of as a disease that mostly affects adults, its incidence among adolescents and young people has been rising in tandem with the rising rates of childhood obesity. There is no evidence to support the best course of treatment for T2DM in this age group despite the undeniable benefits of lifestyle adjustment for obese kids. Early diabetes start is linked to extended exposure to the disease and a greater likelihood of chronic issues, which impact more individuals during their working years and highlight the negative social effects of the condition. Additionally, there is mounting evidence that juvenile diabetes cohorts exhibit an aggressive phenotype that contributes to the early onset of problems that negatively affect life quality and negatively impact long-term results, increasing the possibility of a future public health emergency. Relevant studies were identified through a systematic search of PubMed, ScienceDirect, and Google Scholar for articles published between 2019 and 2025 using the keyword “Adolescents and (T2DM or Insulin Resistance)”. Type 2 diabetes in young people is a serious global public health issue now. Many significant obstacles must be overcome to treat T2DM that develops in young people, including a lack of effective treatment alternatives and limitations in carrying out therapeutic research. The US Food and Drug Administration has approved metformin, glimepiride (Amaryl), and insulin as treatments for teenagers and young adults with type 2 diabetes, despite therapeutic medication studies. Given modified pharmaceutical laws, it is probable that further anti-diabetic drugs will be included in the arsenal of treatment choices available to teenagers and young adults with T2DM. The epidemiology and current understanding of the pathophysiology, risk factors, consequences, and therapy of T2DM in adolescents and young adults are discussed in this review.
subject: Review Article
  topic: section
subject: Type 2 diabetes mellitus
  topic: keywords
subject: treatment option
  topic: keywords
subject: physical lifestyle
  topic: keywords
subject: obesity
  topic: keywords
subject: pathophysiology
  topic: keywords
subject: adolescent
  topic: keywords
subject: insulin
  topic: keywords
creator: Md Nadeem Bari
creator: Md Rizwan Ansari
creator: Mohammad Anwar
creator: Imran Mohammad
rights: Copyright (c) 2025 Md Nadeem Bari; Md Rizwan Ansari; Mohammad Anwar, Imran Mohammad https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-10-28
publication date: 2025-10-28
starting page: 394
ending page: 405
doi: 10.18051/UnivMed.2025.v44.394-405

Cavernous sinus thrombosis: a case series analysis
type: item
description: Background Although uncommon, cavernous sinus thrombosis (CST) is a serious and potentially life-threatening condition that often presents with nonspecific signs and symptoms. Cavernous sinus thrombosis is associated with high morbidity and mortality, estimated at approximately 15% and 11% respectively. The complex diagnostic and treatment processes pose a challenge for healthcare providers, considering its elevated mortality and morbidity. We present four cases with varying clinical presentations and outcomes to provide valuable insights into the manifestations and management of CST. Case description Our case series explored CST across age groups, including a case involving a pregnant woman. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment, and clinical outcomes were analyzed. All cases were associated with one or more ophthalmic symptoms. All patients exhibited eye symptoms, with proptosis occurring unilaterally or bilaterally. Etiologies ranged from infections stemming from pimples and tooth cavities to an initially non-septic cause. Of the four cases presented, two proved fatal: one due to severe sepsis in a young man and the other initially aseptic but later progressing into sepsis in a geriatric man. The remaining two cases exhibited septic complications with complete recovery after prompt treatment. Conclusion Severity and clinical courses of CST varied, emphasizing the need for careful consideration and tailored management strategies in CST cases. The prognosis of CST has improved with the advancement in treatment, but complications are not infrequent. Raising awareness regarding the potential for severe complications, such as cavernous sinus thrombosis, initiated by a common infection, is strongly encouraged.
subject: Case Report
  topic: section
subject: Cavernous sinus thrombosis
  topic: keywords
subject: proptosis
  topic: keywords
subject: septic thrombosis
  topic: keywords
subject: aseptic thrombosis
  topic: keywords
subject: infection-related thrombosis
  topic: keywords
creator: Syntia Nusanti
creator: Nadia Delima Andini
creator: Lourisa Ruth Eldinia
rights: Copyright (c) 2025 Syntia Nusanti, Nadia Delima Andini, Lourisa Ruth Eldinia https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-11-28
publication date: 2025-11-28
starting page: 352
ending page: 358
doi: 10.18051/UnivMed.2025.v44.352-358