Biomedical Journal of Indonesia

Promama Complementary Therapy: Impact on Hemoglobin, Weight, Anxiety, Nausea and Vomiting of Pregnancy (NVP)

2025-09-28T14:34:36+07:00

Introduction. Nausea and vomiting are among the most common discomforts experienced by pregnant women in the first trimester, often leading to decreased nutritional intake, weight loss, and anemia, which may ultimately affect maternal and fetal health. Various complementary interventions, including acupressure, moxibustion, and ginger aromatherapy, have been developed as supportive therapies to reduce these symptoms. This aimed to analyze the effectiveness of PROMAMA is a combined intervention of acupressure, moxibustion, and ginger aromatherapy for nausea and vomiting of pregnancy in reducing nausea, vomiting, anxiety, and anemia, as well as improving weight gain. Methods. This quasi-experimental study employed a pre-test-post-test control group design with 120 first-trimester pregnant women who met the inclusion criteria. Participants were divided into three groups: control, Standard, and intensive intervention. Data were collected using the PUQE-24 (Pregnancy-Unique Quantification of Emesis and Nausea), GAD-7 (Generalized Anxiety Disorder-7), hemoglobin measurements, and maternal weight records. Statistical analyses included One-Way ANOVA, ANCOVA, and Independent Sample T-Test. Results. The findings revealed significant differences between the groups in reducing nausea and vomiting, anxiety, and hemoglobin levels at post-test 1 and post-test 2 (p < 0.05). Intensive interventions combining acupressure, moxibustion, and ginger aromatherapy showed greater effectiveness compared to Standard and control groups. However, no significant differences were observed in weight gain across the groups (p > 0.05). Conclusion. Acupressure, moxibustion, and ginger aromatherapy are effective for managing nausea, vomiting, anxiety, and anemia in first-trimester pregnant women. These interventions can be recommended as non-pharmacological approaches to improve maternal well-being and pregnancy outcomes.

Effect of Penta Herbs Forte on Antioxidant Capacity and Cardiac Protein Carbonyl Levels in a Hypoxia-Induced Rat Model

2026-01-18T07:42:17+07:00

Introduction. Hypoxia, a state of inadequate oxygen supply in tissues, can induce the generation of reactive oxygen species (ROS), leading to oxidative stress and damage to biomolecules such as proteins. This damage can be quantified by measuring protein carbonyl levels. Penta Herbs Forte (PHF), a polyherbal formulation composed of Andrographis paniculata, Blumea balsamifera, Phyllanthus urinaria, Zingiber officinale, and Curcuma xanthorrhiza, is rich in bioactive compounds with known antioxidant properties. This study aimed to evaluate the antioxidant activity of PHF extract and its effects on cardiac protein carbonyl levels in hypoxia-induced rats. Methods. This experimental study included 32 male Sprague-Dawley rats, divided into eight groups: control and treatment groups under normoxia, 1-day hypoxia, 7-day hypoxia, and 14-day hypoxia, either with or without PHF extract administration. Antioxidant capacity was determined using the ABTS and DPPH assays, and cardiac protein carbonyl levels were measured using a spectrophotometer. Results. PHF extract showed an antioxidant activity yielding LC₅₀ values of 22.135 μg/mL (ABTS) and 105.04 μg/mL (DPPH), indicating strong antioxidant potential. PHF-treated groups exhibited lower cardiac protein carbonyl levels than their respective controls across all hypoxic durations. Conclusion. Administration of PHF extract reduced cardiac protein carbonyl levels via its antioxidant activity, suggesting its potential as an exogenous antioxidant source to protect against hypoxia-induced oxidative damage.

Exploring Associations Lipid Profiles, Body Composition, Anthropometry, and Osteoarthritis Index

2025-12-22T09:21:57+07:00

Introduction. Osteoarthritis (OA) is a joint disorder and is considered one of the leading causes of disability worldwide. It is commonly associated with aging and characterized by chronic pain, joint stiffness, and limitations in daily activities. This study aimed to evaluate the association between lipid profile and body composition with the severity of OA, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Methods. This cross-sectional study involved 67 community-dwelling older adults. Assessments included fasting lipid profiles (HDL, LDL, total cholesterol, Apo A, Apo B, and triglycerides), body fat distribution and muscle mass, anthropometric measurements (body mass index, waist circumference, and hip circumference), and handgrip strength. Associations between variables were analyzed using Spearman’s correlation test with a significance level of 5%. Results. Correlation analysis demonstrated associations between lipid profile levels and worsening OA symptoms. Higher Apo B levels were associated with increased trunk fat (r=0.47, p<0.001) and greater joint pain (r=0.35, p=0.004). Lower HDL levels were associated with increased visceral fat (r=−0.37, p=0.002) and greater joint stiffness (r=0.26, p=0.038). Greater upper extremity muscle mass was associated with less severe pain (r=−0.38, p<0.001), while higher body mass index and waist circumference were associated with higher WOMAC scores (r=0.32, p=0.009). Conclusion. These findings support the concept that OA is a systemic condition influenced by metabolic and biomechanical pathways. OA management should therefore include metabolic control, optimization of body composition, and routine monitoring of lipid profiles and anthropometric indices as part of non-pharmacological therapy and preventive strategies.

Optimization of Duplex Real-time PCR to Detect Corynebacterium ulcerans and C. pseudotuberculosis from Patients with Suspected Diphtheria in Jakarta

2026-01-18T07:48:16+07:00

Introduction. Diphtheria infection remains a serious public health problem in many countries with low vaccine coverage. Molecular detection plays an important role in controlling disease dissemination. Among more than 122 Corynebacterium species, only three are potentially toxigenic: C. diphtheriae, C. ulcerans, and C. pseudotuberculosis. Infections caused by C. ulcerans and C. pseudotuberculosis in humans usually involve close animal contact. Due to the many difficulties in identifying C. ulcerans and C. pseudotuberculosis, this study aimed to optimize Duplex Real-time PCR for rapid and precise detection. Method. Duplex real-time PCR was performed by using 2 pairs of primers and a probe to detect C. ulcerans and C. pseudotuberculosis. All parameters were optimized to maximize PCR amplification. Then, the primer set's specificity was tested against some microorganisms. The sensitivity test of DNA was conducted to get the detection limit. Results: Optimization of real-time PCR was conducted to achieve optimal amplification conditions. Annealing temperature 57 °C, Optimization of primer and probe concentration of 0.45 μM and 0.50 μM for C. ulcerans, Primer and probe concentrations of 0.35 μM for C. pseudotuberculosis yielded optimal results. The detection limit of DNA of duplex real-time PCR for C. ulcerans was 4.49 DNA copy number and 1.06 DNA copy number for C. pseudotuberculosis. Conclusion. Duplex Real-time PCR optimization result can be used as a detection of C. ulcerans and C. pseudotuberculosis for effective control of dissemination in the population. PCR results showed that all 108 clinical specimens suspect diphtheria were negative for C. ulcerans and C. pseudotuberculosis.

Shared Mattresses, Combs, and Residential Sanitation Associated with Pediculosis Capitis in Orphanages

2026-01-19T20:40:59+07:00

Introduction. Head lice infestation (pediculosis capitis) continues to be a widespread health issue among children, especially in orphanages. Pediculosis capitis often occurs due to sharing personal items and poor residential sanitation conditions. Methods. This study applied an observational analytic design using a cross-sectional approach, conducted across nine orphanages in South Sumatra Province. Independent variables included sharing personal items and residential sanitation factors such as occupancy density, ventilation, lighting, temperature, and humidity, while the dependent variable was pediculosis capitis occurrence. Results. Pediculosis capitis prevalence reached 37.7%. Sharing mattresses (p = 0.038) and combs (p = 0.016) showed a significant association with pediculosis capitis, while sharing bed sheets, blankets, pillows, towels, headscarves, prayer garments, and caps was not significantly associated. In terms of residential sanitation, occupancy density (p = 0.002), ventilation (p < 0.001), and lighting (p < 0.001) were significantly related to the occurrence of pediculosis capitis. Meanwhile, temperature (p = 0.678) and humidity (p = 0.585) did not show a significant relationship. Conclusion. Pediculosis capitis occurrence is linked to sharing certain personal items and various residential sanitation factors.

Relationship of Resting Heart Rate Variability to Physical Fitness Levels in Adolescents

2026-01-25T09:08:51+07:00

Introduction. Physical fitness is an important indicator of adolescent health, closely related to cardiovascular function and the body's ability to perform physical activity. One physiological parameter reflecting cardiovascular system regulation is resting heart rate variability, which has the potential to serve as an objective indicator of physical fitness. This study aimed to examine the relationship between resting heart rate variability and physical fitness levels in adolescents. Methods. This study used a quantitative approach with a cross-sectional correlational design. Fifty-eight students from SMP Negeri 3 Gowa were selected using a purposive sampling technique. Resting heart rate variability was measured using a digital heart rate monitor, while physical fitness levels were assessed using the Cooper test. Data were analyzed descriptively and inferentially using the Pearson correlation test with SPSS version 25 at a significance level of 0.05. Results. The findings revealed a positive and significant relationship between resting heart rate variability and physical fitness levels (r = 0.462; p = 0.001). Adolescents with better resting heart rate variability tended to demonstrate higher levels of physical fitness. Conclusion. Resting heart rate variability is significantly associated with physical fitness levels in adolescents and shows potential as an objective physiological indicator for monitoring physical fitness.

Comparison of FEV3 and FEV3/FVC Ratio Between Smokers and Non-Smokers Who Engage in Regular Exercise

2026-04-28T10:09:33+07:00

Introduction. Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). In the early stages of disease, these pathological processes predominantly affects the small airways, known as Small Airway Disease (SAD), which is often clinically silent. FEV3 and FEV3/FVC ratio have been proposed as potential indicators of SAD. Regular exercise has been suggested to attenuate smoking-related pulmonary decline. However, evidence regarding its effect on small airway function in smokers in human studies, particularly among physically active individuals, remains limited. This study aimed to compare FEV3 and FEV3/FVC ratio between smokers and non-smokers who regularly engage in physical exercise. Methods. 30 adult male with regular exercise (18 smokers and 12 non-smokers) were included in this cross-sectional comparative study. Spirometric parameters, including percentage predicted values of Forced Expiratory Volume in three seconds (FEV3), and FEV3/FVC were measured and compared between groups using the independent samples t-test. Welch’s t-test was applied as a more robust method. Statistical analysis was computerized using Jamovi 2.3.28 software. Results. Non-smokers showed higher mean percentage predicted FEV3 and FVC compared with smokers. However, no significant differences in FEV3 (p= 0.608; effect sizes=-0.1870; 95% CI -0.911 to 0.555) and FEV3/FVC ratio (p= 0.100; effect sizes=0; 95% CI -0.487 to 0.984) between groups. Conclusion. This study found no significant differences in FEV3 or FEV3/FVC ratio between smokers and non-smokers with regular exercise. Further studies are needed to clarify the relationship between smoking, exercise, and early small airway impairment.

The Association Between Stress Levels and Nutritional Status Among Preclinical Medical Students at The State University of Gorontalo

2026-01-19T20:40:17+07:00

Introduction. Malnutrition remains a global public health concern with significant implications for young adults, including medical students who are exposed to high academic demands that may induce persistent stress and subsequently affect eating behavior and nutritional status. This study aimed to identify stress levels and nutritional status and to analyze the relationship between the two among preclinical medical students at the Faculty of Medicine, Gorontalo State University. Methods. An observational analytical study with a cross-sectional design was conducted involving 191 respondents selected through total sampling. Stress levels were assessed using the Medical Student Stressor Questionnaire (MSSQ), while nutritional status was determined based on Body Mass Index (BMI) obtained from standard anthropometric measurements. Data were analyzed using Spearman’s correlation test. Results. The results showed that most students experienced moderate stress levels (51.8%), with academic-related stressors being the most dominant, and the majority of respondents had normal nutritional status (56.5%). Bivariate analysis demonstrated no significant correlation between stress levels and nutritional status (r = −0.131; p = 0.071). Conclusion. In conclusion, stress levels were not significantly associated with nutritional status among preclinical medical students. Other factors, such as daily calorie intake, physical activity, sleep duration, and genetic or family history, may play a more prominent role in determining nutritional status. Nevertheless, stress management interventions and the promotion of healthy lifestyles remain important to support the overall well-being of medical students.

Serum Albumin and Globulin Levels in Pulmonary and Extrapulmonary Tuberculosis: A Cross-Sectional Study in Palembang

2026-04-14T20:27:59+07:00

Introduction. Alterations in serum albumin and globulin reflect inflammatory responses in tuberculosis (TB), but evidence linking them to TB type remains inconsistent. This study investigated the association between serum albumin, globulin, albumin/globulin (A/G) ratio, and TB type (pulmonary [PTB] vs. extrapulmonary [EPTB]) in adult patients at Dr. Mohammad Hoesin Hospital, Palembang. Methods. A cross-sectional study was conducted among adult TB patients with measured serum albumin and globulin levels. TB type was categorized as PTB or EPTB. Associations were analyzed using chi-square tests, and prevalence ratios (PR) were calculated to quantify the strength of associations. Results. Among 251 patients, low serum albumin was more frequent in EPTB (41.7%) than in PTB (28.4%) (p = 0.006; PR = 1.802; 95% CI: 1.178–2.757), indicating EPTB patients were 1.8 times more likely to have low albumin. No significant association was observed for globulin: high globulin occurred in 56.7% of EPTB vs. 52.9% low-to-normal in PTB (p = 0.323; PR = 1.471; 95% CI: 0.682–3.174). Similarly, the A/G ratio showed no significant difference: low A/G ratio in 50% of PTB vs. 42.1% of EPTB (p = 0.676; PR = 1.376; 95% CI: 0.641–2.954). Conclusion. Lower serum albumin is significantly associated with EPTB compared to PTB, whereas globulin and the A/G ratio are not. Albumin may have potential as a supplementary clinical indicator of inflammatory status and disease manifestation in TB, though further longitudinal studies are warranted.

The Effectiveness of Awareness-Based SBCC Through Parenting Patterns and Intensive Nutrition in Handling Stunting in Ropang Subdistrict

2026-04-02T13:11:48+07:00

Introduction. Stunting is a public health indicator that reflects the quality of human resources and remains a significant challenge in various regions of Indonesia, including Ropang District, Sumbawa Regency. This study aims to evaluate the effectiveness of an awareness-based Social Behavioral Change Communication (SBCC) approach through improved parenting and intensive nutrition in efforts to address stunting. Methods. The study used a mixed-method design with a quasi-experimental pretest-posttest approach involving 12 mothers with stunted children. The intervention was conducted over two months through face-to-face education, printed and digital educational media, and a community-based approach. Quantitative data analysis used the Wilcoxon test and paired t-test, while qualitative data was obtained from in-depth interviews and field observations. Results. The results showed a significant increase in parenting patterns (p=0.046) and eating patterns (p=0.025), while the increase in nutritional knowledge was not significantly different (p=0.564). Anthropometrically, there were significant differences in height (p=0.014) and weight (p=0.037) between the pre- and post-intervention periods. Conclusion. This improvement indicates that changes in parenting behavior and feeding practices, delivered through the SBCC approach, contributed to improvements in children's nutritional status.

Profile of Hearing Loss and Related Risk Factors among Geriatric Patients at RSUD Prof. Dr. H. Aloei Saboe

2026-01-11T15:55:37+07:00

Introduction. Hearing loss is a common health problem in the geriatric population and significantly affects quality of life and independence. This condition is multifactorial, involving interactions between natural degenerative processes, comorbid conditions, environmental factors, and lifestyle factors. This study aims to describe the factors that influence hearing loss among geriatric patients at RSUD (Regional General Hospital) Prof. Dr. H. Aloei Saboe, Gorontalo City. Methods. This study employed a quantitative descriptive survey method involving 63 geriatric respondents at the Internal Medicine Polyclinic who were selected using purposive sampling. Data were collected through questionnaires and physical examinations (Rinne-Weber test at 512 Hz) and were analyzed using univariate analysis with SPSS to determine the frequency distribution of each variable. Results. The majority of respondents (57.1%) experienced sensorineural hearing loss, were aged 60-69 years (79.4%), and were female (74.6%). The dominant comorbid factors were hypertension (42.9%) and a combination of hypertension and diabetes mellitus (22.2%). Regarding environmental factors, 49.2% of respondents lived near sources of noise, while 11.1% reported occupational noise exposure. In terms of lifestyle factors, obesity was found in 25.4% of respondents, while the prevalence of smoking (27%) and alcohol consumption (9.5%) was relatively low. Conclusion. The study site’s geriatric patients experience predominantly sensorineural hearing loss, with a high proportion of vascular comorbidities among affected patients.

Clinical and Histopathological Profile of Breast Cancer Based on HER2 Stratification ASCO/CAP 2018: Analysis of HER2-Positive, Negative, Low, and Ultralow

2026-03-19T20:34:09+07:00

Introduction. The emerging classification of HER2-low and HER2-ultralow breast cancer subtypes has important treatment implications, especially after the introduction of trastuzumab deruxtecan, which is effective in tumors exhibiting low levels of HER2 expression. However, data from Indonesia are still limited. This study aimed to characterize the clinicopathological features of Invasive Breast Cancer (IBC) according to the ASCO/CAP 2018 HER2 classification and to determine the proportion of HER2-negative patients who can be further categorized as HER2-low or HER2-ultralow. Methods. This retrospective descriptive-analytical study involved 50 patients diagnosed with IBC who underwent HER2 immunohistochemical evaluation at Mohammad Hoesin General Hospital, Palembang, in February 2023. The variables analyzed were age, ER/PR status, Ki-67 index, tumor-infiltrating lymphocytes (TILs), lymphovascular invasion (LVI), histological grade, and tumor subtype. Results. Of the 50 patients, 16 (32%) were categorized as HER2-positive and 34 (68%) were categorized as HER2-negative. Among the HER2-negative group, 10 patients (35.7%) were HER2-low and 5 patients (17.8%) were HER2-ultralow. The majority of patients were aged 40 years or older and ER-positive. A high Ki-67 index was observed in 84% of cases. Most tumors were grade II–III and of the NST subtype. No significant differences were observed between the HER2-low and HER2-ultralow groups (p>0.05). Conclusion. A considerable proportion of HER2-negative IBCs are categorized as HER2-low or HER2-ultralow. These findings highlight the importance of accurate HER2 assessment to identify patients who may benefit from antibody–drug conjugate therapy and to advance precision medicine in breast cancer management in Indonesia.

Association of Biofilm Formation with Fluconazole Susceptibility in Candida Urinary Isolates

2026-04-10T09:25:03+07:00

Introduction. This study aims to investigate the association between biofilm formation by Candida spp. and in vitro fluconazole susceptibility in urinary isolates from intensive care unit (ICU) patients with indwelling urinary catheters, while characterising species distribution, biofilm formation, and susceptibility patterns. Methods. This cross-sectional study included 44 Candida spp. isolates recovered from urine samples of ICU patients catheterised for more than 48 hours. Species identification and fluconazole susceptibility testing were performed using the VITEK 2 system, and biofilm formation was assessed using a microtiter plate assay. Demographic characteristics, comorbidities, and catheterisation duration were obtained from medical records. Results. Candida albicans was the most frequent species (40.9%), followed by Candida tropicalis (25.0%), Candida glabrata (20.5%), and Candida parapsilosis (13.6%). Half of the isolates (22/44) formed biofilms, predominantly weak, with only a small proportion demonstrating moderate biofilm formation. Fluconazole susceptibility was observed in 16 of 22 (72.7%) biofilm-forming isolates and 17 of 22 (77.3%) non-biofilm-forming isolates, while resistance was identified in 6 of 22 (27.3%) and 5 of 22 (22.7%), respectively. No significant association was found between biofilm formation and fluconazole susceptibility (χ² = 0.121; p = 0.728). Conclusion. In this single-centre ICU cohort, biofilm formation among urinary Candida isolates was common but predominantly weak and was not significantly associated with in vitro fluconazole susceptibility. These findings should be interpreted cautiously, given the cross-sectional design and in vitro nature of the study. Larger multicentre studies are warranted to clarify the clinical relevance of Candida biofilm formation in candiduria.

Optimization of Vulvovaginal Candidiasis Induction in Rattus norvegicus using Estradiol Benzoate: A Preliminary Study

2026-06-20T11:37:04+07:00

Introduction. Approximately 75% of women of reproductive age have opportunistic vaginal infection with Candida albicans at least once in their lifetime, which is known as vulvovaginal candidiasis (VVC). The increasing global prevalence and emergence of antifungal agents underscore the importance of research into effective prevention and treatment. In vivo studies using rats are commonly conducted, as they provide valuable knowledge on reproductive diseases in humans such as VVC. Methods. Pseudoestrus was induced in wistar rats by subcutaneous injection of estradiol benzoate at doses of 0.1 and 0.2 mg/rat/week. Cytologic observation using vaginal smear staining is used to detect cornified epithelial cells and leukocytes. VVC was induced by intravaginal administration of Candida albicans ATCC10231 (0.5 and 1.0 McFarland) daily for 5 consecutive days. VVC confirmation by microscopic detection of Candida albicans pseudohyphae from vaginal swabs, supported by viability testing of vaginal lavage cultures. Results. Pseudoestrus induction was optimal at a dose of 0.2 mg/rat/week, as both animals were maintained in this phase for 3 consecutive days. Furthermore, an inoculum of 1.3×10⁷CFU/mL (McFarland standard 1.0) administered for 5 days successfully induced VVC in both animals. Microscopic confirmation revealed intracellular pseudohyphae, supported by the growth of viable Candida albicans from vaginal lavage cultures. Conclusion. The optimal estradiol benzoate protocol for pseudoestrus induction was 0.2 mg/rat/week, and pseudoestrus was maintained for 3 days without ovariectomy. The optimal VVC rat model was established using intravaginal Candida albicans at 1.3×10⁷CFU/mL for 5 days, with viability from lavage cultures of 1.3×10²CFU/mL and 0.3×10²CFU/mL.

Comparative Effects of Monday–Thursday and Daud Fasting Regimens on Serum Testosterone Levels in Male Wistar Rats (Rattus norvegicus)

2026-01-25T09:01:13+07:00

Introduction. Intermittent fasting has attracted increasing attention because of its metabolic and endocrine benefits. However, evidence regarding the effects of non-daily fasting regimens, particularly Monday–Thursday fasting and Daud fasting, on male reproductive hormones remains limited. This study compared the effects of these regimens on serum testosterone levels in male Wistar rats. Methods. A true experimental study with a post-test-only control group design was conducted using 27 healthy male Wistar rats (Rattus norvegicus). Animals were randomly assigned to a control group, a Monday–Thursday fasting group, or a Daud fasting group (n = 9/group). The fasting groups underwent 12-hour daily feeding restriction (18:00–06:00) for 21 days, comprising six and ten fasting days, respectively. Serum testosterone levels were measured using ELISA and analyzed by one-way ANOVA followed by Tukey's post hoc test. Results. Mean serum testosterone concentrations were 15.003 ± 3.55 mg/dL in the control group, 11.682 ± 3.05 mg/dL in the Monday–Thursday fasting group, and 8.501 ± 1.31 mg/dL in the Daud fasting group. Significant differences were observed among groups (p < 0.001). Both fasting groups showed significantly lower testosterone levels than the control group (p = 0.049 and p < 0.001), whereas no significant difference was found between the two fasting regimens (p = 0.061). Conclusion. Both Monday–Thursday fasting and Daud fasting for 21 days were associated with reduced serum testosterone levels in male Wistar rats. Further studies should control energy intake and evaluate hormonal and metabolic biomarkers to clarify the underlying mechanisms.