Indonesian Journal of Biomedicine and Clinical Sciences

The activity antibiofilm of betadine leaf (Jatropha multifida Linn) juice on urinary catheters

Rada Tania — 2025-03-19

Biofilm formation can reduce the efficacy of antibiotics against pathogenic microorganisms. Flavonoids are proven to have antibiofilm activity. Betadine leaf (Jatrophas multifida Linn) contains abundant flavonoids. This study aimed to evaluate the biofilm activity of the betadine leaf juice on urinary catheters. Biofilm forming Escherichia coli was isolated from a urinary catheter. The betadine leaf juice was prepared by harvesting, washing, drying, juicing, centrifuging, and sterilizing the juice. Phytochemical analysis was performed to identify the presence of steroids, alkaloids, flavonoids, and phenols. Biofilm and antibiofilm assays were conducted by incubating thioglycolate medium with varying concentrations of the betadine leaf juice and E. coli suspension, with bacterial growth and biofilm formation assessed based on turbidity observations. Alkaloids, steroids, flavonoids, and phenolic compounds have been found in the sterilized betadine leaf juice. Bacterial growth was observed in all tubes containing different dilutions of the betadine leaf juice. However, turbidity levels increased as the juice concentration decreased. Additionally, the weight of the urinary catheter was significantly greater in tubes with lower juice concentrations (p=0.02). In conclusion, the J. multifida Linn leaf juice has potential antibiofilm activity against E. coli in urinary catheters.

Antihyperlipidemic activity of kaffir lime leaf extract (Citrus hystrix DC) on hypercholesterolemic model mice

Ade Giriayu Anjani — 2025-06-10

Kaffir lime (Citrus hystrix DC) is rich in various bioactive substances like flavonoids, tannins, saponins, hesperidin, and several monoterpenes, which are believed to have antihyperlipidemic activity. Hyperlipidemia is a metabolic issue that can lead to high blood pressure and weight gain. This condition is the result of an imbalance in cholesterol levels, including total cholesterol, elevated LDL, and reduced HDL. This study aimed to investigate the antihyperlipidemic activity of kaffir lime leaf extract (C. hystrix DC) on hypercholesterolemic model mice. It was pre- and post-control group design study. Tweenty-five male mice (Mus musculus) weighing 16-21g at 12 wk of age were used in this study. Five mice as normal control mice group (Group 1) were only administered 1% CMC-Na solution and 20 mice were administered an atherogenic diet to induce hyperlipidemic model. The hyperlipidemic mice were then randomly divided into four groups i.e. positive control mice group (Group 2) were administered simvastatin suspendet in 1% CMC-Na at dose of 0.03 mg/g BW, treatment mice group (Group 3-5) were administered C. hystrix DC leaf extract suspendet in 1% CMC-Na at doses of 0.21; 0.28; and 0.35 mg/g BW, respectively. The interventions were administered one daily for 14 d. Blood sampling from the retroorbital plexus of the mice was conducted before and 14 d after the intervention for lipid profile analysis. The serum total cholesterol, LDL, HDL, and triglyceride levels were measured by the CHOD-PAP (cholesterol oxidase-phenyl amino phyrazolone) enzymatic method. A significant decrease in total cholesterol, LDL, triglycerides levels, and a significant increase in the HDL level were observed in the treatment group at doses of 0.28; 0.35 mg/g BW compared to the normal control group (p<0.05). The maximal antihyperlipidemic activity was observed at dose of 0.28 mg/g BW. In conclusion, the C. hystrix DC leaf extract has antihyperlipidemic model mice.

Biofilm detection of clinical isolates of Klebsiella pneumoniae from Pontianak, West Kalimantan

Joycely Anggie — 2025-06-11

Klebsiella pneumoniae (K. pneumoniae) belongs to the Enterobacteriaceae family, which is known as Gram-negative, encapsulated, and non-motile bacteria. One of its most important virulence factors of K. pneumoniae is the ability to form biofilms. A high percentage of K. pneumoniae as biofilm formation is associated with a high incidence of antibiotic resistance, leading to higher morbidity and mortality. This study aimed to evaluate biofilm formation of clinical isolates of K. pneumonia from Pontianak, West Kalimantan. A total of 24 K. pneumoniae clinical isolates from various specimens were subjected to biofilm formation detection. The biofilm formation was detected by crystal violet formation at wavelength of 570 nm as indicator using microtiter plate assay. As control of biofilm formation was Staphylococcus aureus ATCC 25923, and as control of non-biofilm formation was Staphylococcus epidermidis ATCC 12228. Data on biofilm formation of the isolates from various specimens were analyzed using Fisher’s exact test with SPSS Ver. 26. All the K. pneumoniae clinical isolates were biofilm producer consisting of 19 isolates were strong biofilm producer, four were moderate biofilm producer, and one isolates was weak biofilm producer. No association between biofilm formation and specimen type was observed (p=0.541). In conclusion, all K. pneumoniae clinical isolates from Pontianak, West Kalimantan are identified as biofilm producer.

The relationship between the degree of low back pain and concentration levels among RICCI Catholic High School Jakarta students during the COVID-19 pandemic

Putu Radhya Kirana Karmanita — 2025-03-19

The COVID-19 pandemic has shifted most learning activities to an online format, leading to increased sitting time and a higher risk of low back pain (LBP). Low back pain can be a factor that causes changes in concentration during learning. This study aimed to evaluate the relationship between the degree of LBP and the level of learning concentration in high school students. It was a cross-sectional study conducted at RICCI Catholic High School Jakarta, involving students from grades 10, 11, and 12. Data were collected using a questionnaire that was distributed online with Google forms. The Chi-square method for data analysis was used with a significance level of 0.05. A total of 121 students participated in this study, with 66.9% did not experience LBP, 30.6% had LBP with a slight degree of pain, and 2.5% had LBP . There were no students with severe LBP. The results for low, moderate and high concentration levels were 8.3%, 70.2%, and 21.5%, respectively. The bivariate analysis between LBP and learning concentration level using was 0.062 (p>0.05). In conclusion, there is no significant relationship between the degree of LBP and the level of concentration in high school students.

Computational study of active compounds of Citrullus lanatus Linn peel extract as potential antidiabetics

Shinta Dewi Permata Sari — 2025-06-11

Diabetes mellitus (DM) is one of the metabolic diseases that have emerged as a global health problem. Type 2 diabetes mellitus (T2DM), which affect 90-95% of DM, is caused by reduced insulin sensitivity and insulin resistance in peripheral tissues. Oral antidiabetics have resulted side effects, prompting an investigation for a natural-based antidiabetic agent as an alternative treatment. Using network pharmacology, we investigated the mechanism of phytochemical substances of Citrulus lanatus Linn. peel extract and their interactions with target proteins in the DM pathogenesis pathway. Cytoscape 3.6.1 software has created a network of extract compound-protein targets. Investigation of protein interaction, target gene function enrichment, and signal pathway performed via DAVID, STRING database, and the KEGG pathway database. The computational study identified 90 target proteins associated with T2DM based on protein-protein interactions. In addition, Cytoscape analysis and DAVID enrichment revealed the network of extract compound's target and generated proteins such as INS, TNF-α, IL-6, and AKT2. The KEGG pathway analysis presented the crucial role of insulin resistance and AGE-RAGE signaling pathways. This pathway correlated with lower glucose activity in obesity and hyperglycemia. It indicates that the active constituents of C. lanatus Linn peel extract can lower blood sugar levels by interacting with selected proteins. This study's findings will be carried out in further research of in vitro trials.

Combining square-stepping exercise and strengthening exercise improve frailty status in pre-frail community-dwelling older adults

Ira Adventia — 2025-06-18

Frailty is a complex syndrome affecting older people, characterized by unintentional weight loss, low muscle strength, feelings of exhaustion, reduced physical activity capacity, and slow walking speed. A decrease of muscle strength has been shown to be a major cause of frailty. The studies further agreed that frailty is a treatable condition. Intervention at the pre-frail state may offer the best opportunity to prevent, delay, or reverse existing symptoms of physical frailty. The evidence that multicomponent exercise (particularly resistance exercise) can have marked effects on frailty and sarcopenia is now forceful. Thus, we combine strengthening exercise and square-stepping exercise (SSE), a popular balance exercise, in community-dwelling pre-frail older adults. To evaluate the effectiveness of additional lower extremity strengthening exercise on frailty phenotype scores in pre-frail older adults who receive SSE. This study used an experimental, randomized control trial on pre-frail older adults aged between 60 and 70 yr. The participants were divided into 2 groups of 19 people each. The control group received SSE 3 x /wk, while the treatment group received SSE 3 x /wk plus lower extremity strengthening exercises 2 x /wk for 6 wk. The analysis of each group revealed an improvement in frailty phenotype scores in both the treatment and control groups. Ten participants (55.56%) in the control group experienced an improvement in the frailty phenotype status to robust (non-frail). Eleven participants (64.71%) in the treatment group experienced an improvement in frailty phenotype status to robust (non-frail). These findings suggest that SSE can improve frailty phenotype scores in pre-frail older adults, and that adding lower extremity strengthening exercises to SSE significantly improves frailty phenotype score compared to SSE alone.

The efficacy of combination of oral antioxidants and topical retinoic acid versus topical retinoic acid monotherapy in mild acne vulgaris patients

Ferra Olivia Mawu — 2025-06-04

Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous follicle with multifactorial pathogenesis and pleiomorphic clinical manifestations constituting comedones, papules, pustules, nodules, and cysts. Oxidative stress has been reported to contribute in AV pathogenesis. This phenomenon rationalizes antioxidant supplementation as an adjuvant therapy for AV management. Four cases of 22 to 23 yo women with complaints of worsening facial acne for 1 to 6 mo. Initially, acne lesions appeared as skin-colored papules, which increased in number, became reddish papules and pustules, and extended to the jaw and chin. Lesions were accompanied by temporary itching and pain. Dermatological examination revealed multiple circumscribed discrete erythematous papules, miliar to lenticular in size, comedones (+), and pustules (+), with total lesions <30. According to the Lehmann criteria, patients were diagnosed as mild AV. All patients were treated with 0.025% topical retinoic acid cream, while the other two patients received additional oral antioxidant supplementations (zinc and ɑ-lipoic acid) and were followed up every two weeks. Two cases who received additional oral antioxidant supplementations (Group A) exhibited an earlier and higher clinical improvement, characterized by a reduction in the number of lesions on each follow up, till the current report. Oxidative stress in AV pathogenesis causes microenvironment alteration that favours colonization of Cutibacterium acnes. Together with the increase in sebum production, it stimulates the release of pro-inflammatory cytokines, such as interleukin (IL)-1α, IL-8, and tumor necrosis factor-α (TNF α), contributing to the inflammatory response. Antioxidant supplementation plays a role in suppressing the process of lipid peroxidation and inhibiting the expression of pro-inflammatory cytokines. Comprehensive management of AV is based on pathogenesis and the role of oxidative stress. An earlier and higher clinical improvement reduction was noted in Group A, patients who received a combination of 0.025% topical retinoic acid cream and oral antioxidant supplementation.

The role of bisphosphonate and bone morphogenetic proteins in congenital pseudoarthrosis of the tibia management: a literature review

Panji Sananta — 2025-03-20

Congenital pseudoarthrosis of the tibia (CPT) is a rare medical condition characterized by a congenital absence of union in the tibia, which causes the leg to flex anterolaterally. Despite the use of several surgical techniques for the treatment of CPT, there is still a significant risk of failure with surgical interventions. Recent studies have shown that bisphosphonates (BP) and bone morphogenetic proteins (BMP) can be effective adjuncts to surgical procedures, increasing the success rate of bone union and reducing the chance of re-fracture. This review aimed to evaluate the role of BP and BMP in CPT. In this review, a comprehensive literature evaluation was conducted using the PRISMA method. The databases used to search for information included PubMed, ScienceDirect, and Google Scholar for the past 10 years. Six articles were included in this review. The results showed that using pharmacological agents such as BMP and BP is considered safe for pediatric patients as an adjunctive treatment to surgery. This combination can effectively increase the speed of bone union and prevent re-fractures. The small sample size, different protocols, and different doses may have impacted the study results, which should be thoroughly explained.

Secondhand smoke exposure and its role in the pathogenesis of preeclampsia: a narrative review of molecular and epidemiological perspectives

Yenny Febriany — 2025-06-18

Preeclampsia (PE) is a pregnancy complication characterized by hypertension after 20 wk of gestation, often accompanied by proteinuria or organ dysfunction. This condition is linked to genetic, environmental factors, and exposure to secondhand smoke (SHS). This study explores the relationship between SHS exposure and PE risk through a narrative literature review. Epidemiological and molecular studies data demonstrate that SHS exposure increases PE risk via oxidative stress, inflammation, and angiogenic disruptions. The analysis reveals that SHS exposure enhances reactive oxygen species (ROS) production, triggers systemic inflammation through the NF-κB pathway, and impairs angiogenic function by lowering the PlGF/sFlt-1 ratio. The risk significantly increases with exposures ≥2 hr/d or weekly frequencies ≥4 d, particularly in poorly ventilated domestic and occupational settings. Biomarkers such as cotinine and carbon monoxide (CO) are employed to assess exposure levels, providing robust evidence that duration and intensity of exposure are pivotal in PE pathogenesis. These findings highlight the importance of preventive strategies, including smoking bans, public health education, and integration of biomarker-based assessments into prenatal care. Future research should aim to clarify the molecular and epigenetic mechanisms involved and explore therapeutic interventions to mitigate SHS-induced damage.

The role of flaxseed (Linum usitatissimum) in improving plasma lipid profiles: a literature review

Marzha Marcella — 2025-06-05

Several major risk factors contribute to cardiovascular diseases. One of these is dyslipidemia, an imbalance of plasma lipids such as total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), and high-density lipoprotein (HDL). While medications to lower lipids are widely used to improve lipid profiles, they have some limitations. Flaxseed is rich in ɑ-linolenic acid, phytosterols, and lignans, which can improve lipid profiles. This study aimed to review the potential effects of flaxseed on lipid metabolism. Data was gathered from research databases such as Google Scholar, PubMed, Science Direct, and Springer for the past 5 yr. About 1,527 scientific articles were found, but after eliminating duplicates and screening of title and abstract, only 45 full-text articles were assessed, with 16 selected. The result showed that ɑ-linolenic acid, phytosterols, lignans, and fibers in flaxseed improve TC, LDL, TG, and HDL through various mechanisms. In conclusion, flaxseed shows promise as a natural therapy for dyslipidemia, improving TC, LDL, VLDL, and TG levels, though HDL effects vary. Disparities are linked to demographics, form, dosage, and duration, highlighting the need for standardized research.

Association between undernutrition and language delay in children under 5 years old: a systematic review

Lulus Hardiyanti — 2025-06-03

In 2022, global statistics of the WHO (World Health Organization) reported 148.1 million children under 5 y.o. were too short for their age (stunting), 45.0 million were too thin for their height (wasting), and 37.0 million were too heavy for their height (overweight). Solving the problem of undernutrition is included in the second goal of the Sustainable Development Goals. Language skills are one of the important aspects of development in children. This study aimed to assess the association between undernutrition and language delay in children under 5 y.o. We searched PubMed, Scopus, and Web of Science for relevant studies published in 2014-2024. We identified studies that analyzed children under 5 y.o. with undernutrition and screenings for language delay, full-text, Indonesia, and English language studies, used cross-sectional study, case-control study, cohort study, and RCT study designs. The risk of bias was assessed using the ROBINS-E tool. There were 4,865 articles of search results in 3 databases consisting of PubMed, Web of Science, and Scopus. A total of 16 articles, including 11 cross-sectional studies and 5 cohorts, were analyzed. An association was observed between undernutrition and language delay. Other factors that significantly influenced language delay were paternal education, maternal education, and stimulation. Most studies report that the more severe the conditions of wasting, stunting and underweight will cause more severe conditions of language delay.

Effectiveness of disinfectants against methicillin resistant Staphylococcus aureus (MRSA) contamination in hospital: a review

Arviansyah — 2025-06-03

Methicillin-resistant Staphylococcus aureus (MRSA) contamination is still widely reported in various hospital areas. Despite routine cleaning and preventive measures in places such as hospitals, the prevalence of MRSA is still increasing worldwide, especially in Asia. This review aimed to evaluate the effectiveness of disinfectants against MRSA contamination in hospitals. Articles were searched from PubMed, ScienceDirect, Cochrane, and Google Scholar databases using specific keywords and boolean operators. Journal selection from these databases was based on inclusion criteria, exclusion criteria, and PICOS framework. Studies that did not fit the topic or study design and had paid access and duplication were excluded. A total of five valid and reliable articles found that some disinfectants, such as JUC Polymer, a combination of hydrogen peroxide (H₂O₂) and silver cations (Ag), have effectiveness in eradicating germs or inhibiting the growth of MRSA germs. The application of disinfectants in MRSA also showed benefits in terms of cost. However, the use of disinfectants needs to be considered because they can cause tolerance and resistance. In conclusion, MRSA disinfectants are still proven effective with various methods and precautions. In addition, disinfectants are beneficial in terms of prevention and health financing.

Managing diagnostic problem of syphilis manifested as chronic colitis and enteropathic arthritis in a 29 yo male: a case report

Kamila Auliya — 2025-06-17

Syphilis is a chronic sexually transmitted infection caused by Gram-negative bacterium, Treponema pallidum, known for its ability to mimic other diseases, leading to misdiagnosis and delayed treatment. We present a case of a 29 yo male with recurrent acute diarrhea, accompanied by fever, nausea, vomiting, prolonged mouth ulcers, and weight loss for the last three months. He was hospitalized multiple times due to the same recurrent problems. He was initially suspected for immunodeficiency diseases and was screened for HIV and hepatitis B, but both results came out negative. The patient was then suspected with malignancy of the gastrointestinal tract and underwent several examinations including; hematology workup, abdominal X-ray, gastroduodenoscopy, colonoscopy and biopsy. However, the result of all abdominal X-ray, biopsy and colonoscopy ruled out malignancy. The examinations discovered intraluminal ileocecal mass that is consist of lymphocytic cells, therefore the patient was diagnosed with chronic colitis and ileitis. The patient went to the clinic as scheduled with a new chief complain of other symptoms; painful spine and hip join movement, which added to his new diagnose of enterophatic arthritis and he was hospitalized for further diagnosis. During hospitalization, the patient was screened for another venereal disease i.e. syphilis, due to the everchanging symptomatology. He was being screened with VDRL, and later TPHA test. This case encompasses the complexity and challenges of diagnostic workup in non-suggestive findings of the disease syphilis as the Great Imitator.

Penile squamous cell carcinoma related to high risk HPV infection

Erliana Tantri Harsono — 2025-06-20

Penile cancer is an uncommon form of malignancy, with squamous cell carcinoma (SCC) being the most common subtype. Human papillomavirus (HPV) infection is strongly associated with the development of penile SCC, particularly strains 16 and 18. This report presents two cases of penile SCC related to HPV type 18 infection and discusses the diagnosis and role of HPV in penile cancer. It aims to illustrate the clinical presentation and diagnostic challenges of penile SCC, with emphasis on the role of HPV infection. Case 1 involves a 41 yo man with a verrucous mass on the glans penis, diagnosed as well-differentiated SCC, with HPV type 18 detected. Case 2 is a 54 yo man presenting with multiple ulcerative plaques on the distal glans, also diagnosed as SCC with HPV type 18. Penile SCC can be classified into HPV-associated and non-HPV-associated subtypes. The HPV-associated SCC, more commonly seen in younger patients, is driven by viral oncogenes E6 and E7, which disrupt tumor suppressor proteins. The pathogenesis is similar to that seen in cervical cancer. Diagnosis is confirmed through histopathology and genotyping, while treatment involves surgical excision, with possible radiotherapy and chemotherapy depending on lymph node involvement. Early detection and diagnosis of penile SCC are critical for effective treatment. The HPV infection plays a significant role in the pathogenesis of penile SCC, highlighting the importance of HPV vaccination in prevention. Multidisciplinary management is essential for improving patient outcomes

Response of narrowband ultraviolet-B phototherapy combined with superoxide dismutase antioxidant cream in the management of non-segmental vitiligo

Muchamad Apriyanto — 2025-06-16

Vitiligo is a skin depigmentation disorder characterized by the loss of melanocyte function. The oxidative stress theory plays a role in the occurrence of vitiligo. Narrow band ultraviolet B (NB-UVB) phototherapy can be combined with other therapies to accelerate skin repigmentation. A 47 yo woman presented to the dermatology and venereology outpatient clinic in Dr. Sardjito General Hospital, Yogyakarta with a chief complaint of white patches on her face, neck, chest, and hands that had persisted for 11 yr. The patient had previously received NB-UVB phototherapy and a calcineurin inhibitor cream, but the symptoms persisted. Significant repigmentation of the lesion area was achieved after NB-UVB phototherapy combined with superoxide dismutase (SOD) antioxidant cream. NB-UVB phototherapy plays a role in immunomodulation, biostimulation, and reducing oxidative stress. The SOD helps clear superoxide radicals, preventing damage to melanocytes. The combination of NB-UVB phototherapy and antioxidant cream can be considered a treatment option for vitiligo.