Biomedical Journal of Indonesia

Evaluation of Serum Brain-Derived Neurotrophic Factor Levels in Patients with Ischemic and Hemorrhagic Stroke

2026-05-30T09:21:39+07:00

Introduction. Ischemic and hemorrhagic stroke arise from different vascular mechanisms and may therefore produce different neurobiological responses. Brain-Derived Neurotrophic Factor (BDNF) is involved in neuronal repair, synaptic remodeling, and recovery after brain injury. This study compared serum BDNF concentrations between ischemic and hemorrhagic stroke patients. Methods. A comparative cross-sectional study was conducted in 30 stroke patients recruited consecutively, with 15 participants in each diagnostic group. Eligibility included age 30-70 years, neuroimaging-confirmed stroke, onset between 6 and 48 days, MMSE score >18, and no other neurological comorbidity. Stroke severity was summarized using the National Institutes of Health Stroke Scale (NIHSS). Serum BDNF was quantified using an enzyme-linked immunosorbent assay (ELISA). Group differences were examined using an independent sample t-test after assessment of normality and homogeneity; ANCOVA was performed to adjust for age, onset, and NIHSS. Results. Serum BDNF was higher in hemorrhagic stroke than in ischemic stroke (1.549 ± 0.016 vs. 1.457 ± 0.024 ng/mL, mean ± SEM; p = 0.004). The mean difference was 0.092 ng/mL, with a large standardized effect (Cohen’s d = 1.15). After adjustment for age, onset, and NIHSS, stroke type remained significantly associated with serum BDNF (β = 0.093; 95% CI: 0.030-0.155; p = 0.005) Conclusion. Serum BDNF differed between stroke subtypes, with higher levels in hemorrhagic stroke. These findings support the potential relevance of BDNF as a complementary biological marker in stroke research, although larger longitudinal studies are required before clinical application.

Clinicopathological Characteristics of Nasopharyngeal Carcinoma Patients Based on WHO Classification at Dr. Mohammad Hoesin General Hospital Palembang 2020–2024

2026-06-20T12:08:28+07:00

Introduction. Nasopharyngeal carcinoma is one of the major head and neck cancers with a heavy burden of illness in Southeast Asia, especially in Indonesia. The World Health Organization (WHO) recognizes the three main types of nasopharyngeal carcinoma histopathologically as keratinizing squamous cell carcinoma, non-keratinizing squamous cell carcinoma, and basaloid squamous cell carcinoma. This article describes the clinicopathological features of nasopharyngeal carcinoma patients diagnosed at Dr. Mohammad Hoesin General Hospital (RSMH), Palembang, from 2020 to 2024. Methods. A retrospective descriptive observational study was conducted using total sampling method. Clinical and histopathological information was obtained from medical records and pathology archives from patients diagnosed from January 2020 through December 2024. Variables including age, sex, smoking history, clinical stage, operative procedure, and WHO histopathological classification were studied. Results. Out of the 138 cases, 56 were diagnosed in 2024 alone, the highest annual number. Majority of nasopharyngeal carcinoma patients were males (71%), less than 50 years old (50.7%), smokers (63%), and primarily presented with stage III (53.6%) disease. Biopsy dominated as the operative procedure with majority (79.7%) of the cases. Non-keratinizing squamous cell carcinoma was the main tumor type with the differentiated subtype being the most common histopathological identification. Conclusion. These results indicate that nasopharyngeal carcinoma at RSMH mostly involved male patients who had a history of smoking, most of them were diagnosed at an advanced clinical stage, with non-keratinizing squamous cell carcinoma subtype being the most common histological type.

A Pilot Comparative Study of Vocal and Instrumental Acoustic Stimulation on Early Embryonic Brain Morphology in Gallus gallus

2026-07-20T13:13:19+07:00

Introduction. Early embryonic brain development can respond to environmental factors, including sound. Sound waves create mechanical vibrations that affect cellular activity through mechano transduction. This study examined the effects of rhythmic vocal and harmonic instrumental acoustic stimulation on early brain development. Methods. We randomly assigned 20 fertilized chicken eggs to two groups: rhythmic vocal stimulation (Qur'anic recitation, n = 10) and harmonic instrumental stimulation (classical music, n = 10). We exposed the eggs to sound for 5 days, from embryonic day 1 to day 5. On day 5, we collected and examined the embryos. We assessed brain development based on embryo viability and the morphology of the primary brain vesicles. We used Fisher's Exact Test to compare developmental outcomes between the two groups. Results. Eight embryos (80%) developed in the rhythmic vocal group, while seven embryos (70%) developed in the harmonic instrumental group. The difference was not statistically significant (p > 0.05). However, Qualitative microscopic observation noted that primary brain vesicles appeared more clearly delineated in the rhythmic vocal group; however, this observation was descriptive and was not confirmed by quantitative morphometric measurement. Conclusion. Although the difference was not statistically significant, rhythmic vocal stimulation raise the hypothesis that rhythmic vocal stimulation may be associated with more distinct brain vesicle morphology. Because this was a pilot study with a small sample size, further studies using larger sample sizes and histological, biochemical, and molecular analyses are needed to better understand the biological effects of acoustic stimulation during embryonic development.

Sleep Quality and Health-Related Quality of Life in Hemodialysis Patients With and Without Restless Legs Syndrome

2026-08-29T14:34:03+07:00

Introduction. Restless legs syndrome (RLS) is a frequent complication in people with chronic kidney disease (CKD), especially in maintenance hemodialysis. Its frequency among hemodialysis patients is far above that of the general population, with estimates spanning widely from 5%-70%. For patients on long-term dialysis, RLS can disrupt sleep and lower quality of life. This study aimed to contrast sleep quality and health-related quality of life (HRQOL) between maintenance hemodialysis patients who have RLS and those who do not. Methods. A cross-sectional design was applied to patients on maintenance hemodialysis. RLS status was established using the diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and health-related quality of life with the Kidney Disease Quality of Life-36 (KDQOL-36). Results. Among 61 participants, 31% fulfilled the criteria for RLS. In exploratory unadjusted comparisons, the two groups differed in age, proportion with type 2 diabetes mellitus, and serum potassium. Patients with RLS slept significantly worse, with a median global PSQI score of 9 (IQR 6–10.5) against 4.5 (IQR 2.25–7) in those without RLS (p<0.001). KDQOL-36 scores were likewise significantly lower in the RLS group on the symptom/problem list (73.35 vs 84.27; p=0.011), effects of kidney disease (61.35 vs 74.70; p=0.009), and burden of kidney disease (24.34 vs 41.51; p=0.002). Conclusion. RLS was frequent in maintenance hemodialysis patients. Those with RLS slept worse and reported lower HRQOL across several kidney disease–specific domains than those without it.

Short Eyes, Blurred Vision: A Case of Axial High Hyperopia and Suspected Amblyopia in Childhood

2026-09-27T08:57:45+07:00

Introduction. Hypermetropia is a common refractive error in children that, when significant, may impair visual function and increase the risk of amblyopia and strabismus. Amblyopia is a developmental visual disorder characterized by reduced best-corrected visual acuity due to abnormal visual experience during childhood. Early identification and appropriate refractive correction are important for maximizing visual development. Such cases may have reduced visual acuity despite initial refractive correction. This report describes the management of high hypermetropia with suspected bilateral ametropic amblyopia and aims to improve best-corrected visual acuity through proper correction. Methods. An 8-year-old student presenting with bilateral blurred vision for two months, aggravated by reading and mobile phone use, underwent ophthalmological assessment, including visual acuity measurement, pinhole testing, cycloplegic refraction, and crowding testing. Symptoms, daily screen exposure, spectacle prescription, and visual acuity at one-month follow-up were documented. Results. The patient reported no diplopia, squinting, redness, or watering of the eyes. The mother reported mobile phone use exceeding six hours daily without breaks. Initial visual acuity was 6/30 in both eyes, improving to 6/21 with pinhole testing. Cycloplegic refraction revealed +5.25 D spherical in both eyes, improving visual acuity to 6/18 and to 6/15 on crowding testing. The patient was prescribed +5.00 D spherical spectacles bilaterally. At one month, best-corrected visual acuity improved from 6/18 to 6/15. Conclusion. High hypermetropia with suspected bilateral ametropic amblyopia requires appropriate refractive correction and regular follow-up. Improved visual acuity after spectacle correction demonstrates potential visual benefit. Continued monitoring remains important to assess visual development.

Comparison of NLR, PLR, SII, and SIRI for Discriminating Severe Primary Open-Angle Glaucoma in a Cross-Sectional Study

2026-10-18T22:52:53+07:00

Introduction. Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness, with a 3.0% national blindness prevalence. Chronic low-grade inflammation is increasingly implicated in POAG, but few studies compare how these indices track severity rather than detect it. Objective. To compare the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) in discriminating severe from mild/moderate POAG. Methods. This cross-sectional study enrolled 45 patients (90 eyes) at Dr. Mohammad Hoesin Hospital. Severity was staged by the Hodapp-Parrish-Anderson classification and dichotomized as severe (48 eyes) versus mild/moderate (42 eyes), with the four indices derived from complete blood counts. Analyses used generalized estimating equations (GEE) for within-patient eye clustering. Results. Patients averaged 57.4±10.3 years, 60.0% female, with 53.3% of eyes (48/90) severe. All four indices remained associated with severity under GEE (p<0.05; SIRI p=0.043, the narrowest margin). On non-clustered ROC analysis, SII showed the highest AUC (0.803) and accuracy (80.0%), ahead of NLR (0.785), PLR (0.729), and SIRI (0.622). Bootstrap validation (500 replications) confirmed these cut-offs and AUCs; only the NLR-SIRI AUC gap reached significance (p=0.032–0.052), with SII-SIRI borderline (p=0.044–0.060). Conclusion. All four indices remained associated with severity after clustering adjustment, with SIRI's margin consistently the narrowest. SII showed the highest apparent discriminative performance, and bootstrap validation supports a real AUC disadvantage for SIRI versus NLR; broader superiority among the other three remains unestablished pending external validation. None of the four markers should replace intraocular pressure measurement or structural-functional evaluation.