SCRIPTA SCORE Scientific Medical Journal
SCRIPTA SCORE Scientific Medical Journal is a medical student scientific journal from SCORE PEMA FK USU (Standing Committee on Research Exchange of Student Government Faculty of Medicine, University of North Sumatra). SCRIPTA SCORE Scientific Medical Journal is one of the SCORE PEMA FK USU icons that works together with many reviewers to support the quality and validity of a manuscript. Initially, in 2009, SCORE PEMA FK USU formed a medical student journal with the name of JIMKI (Indonesian Medical Student Scientific Journal). Then for some reason, the management of JIMKI has been moved to BAPIN-ISMKI authority (National Scientific Analysis and Development Agency-Indonesian Medical Student Senate Association). Subsequently, in 2011 a new journal was formed with the name of SCRIPTA by SCORE PEMA FK USU. Since 2016 until now, the SCRIPTA SCORE Scientific Medical Journal was published in 1 volume with 2 numbers every year in February and August that can be accessed here. SCRIPTA SCORE Scientific Medical Journal consists of 6-12 manuscripts with types of manuscripts such as research articles, review articles, and case reports in each volume. Publications from the SCRIPTA SCORE Scientific Medical Journal can be accessed offline (pISSN 2088-8686) on printed SCRIPTA SCORE Scientific Medical Journal magazine or online (eISSN 2686-0864) through the SCRIPTA SCORE Scientific Medical Journal (https://talenta.usu.ac.id/scripta) Journal title SCRIPTA SCORE Scientific Medical Journal Abbreviation SCRIPTA SCORE Sci Med J Initial SCRIPTA Frequency 2 (two) issues per year ISSN (Print) 2088-8686 ISSN (Online) 2686-0864 Digital Object Identifier (DOI) 10.32734 (Member of Crossref) Editor-in-Chief Juliandi Harahap Managing Editor Rina Amelia and Nenni Dwi Aprianti Lubis Publisher TALENTA Publisher, Universitas Sumatera Utara Citation Analysis Google Scholar Visitor Analysis Visitor Statistics (Sponsored by StatCounter)
Authors who publish with SCRIPTA SCORE Scientific Medical Journal agree to the following terms: Authors retain copyright and grant SCRIPTA SCORE Scientific Medical Journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in SCRIPTA SCORE Scientific Medical Journal. Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in SCRIPTA SCORE Scientific Medical Journal.
Copyright (c) 2026 scripta https://creativecommons.org/licenses/by-nc/4.0
Can Algorithms Improve Birth? A Meta-Analysis of AI-Enhanced Digital Antenatal Care on Fetal Wellness
Background: Traditional digital antenatal care (ANC) fails to sufficiently lower global maternal and neonatal mortality. Artificial Intelligence (AI) shifts this paradigm by enabling proactive prevention through predictive analytics and real-time, personalized risk assessments. Objectives: To systematically review and meta-analyze the impact of AI-enhanced digital monitoring and predictive alert systems on antenatal fetal wellness. Methods: Following PRISMA guidelines, a systematic search of PubMed, Scopus, and Web of Science was conducted. Studies evaluating AI-enhanced digital monitoring or predictive algorithms in antenatal and intrapartum care were included to assess fetal growth restriction (FGR)-mortality, spontaneous delivery, and congenital defects. Discussion: Ten studies were analyzed. AI-enhanced ANC demonstrated high diagnostic accuracy for FGR (AUC: 0.831–0.918) and outperformed standard cervical length assessment in predicting spontaneous preterm delivery (AUC 0.75 vs. 0.67; $p < 0.001$). AI-driven echocardiography boosted congenital heart defect detection sensitivity to 85% (vs. 34% clinically). Furthermore, graphical models revealed a 10-fold increased risk of perinatal morbidity when FGR combined with maternal diabetes (RR 9.8). AI also successfully identified delayed fetal brain maturation and predicted emergency Cesarean rates using heart rate variability. Overall, the models showed strong discriminative performance, yielding a pooled AUC of 0.858 (95% CI: 0.766–0.951). Conclusion: AI-enhanced digital ANC significantly improves the early detection of critical fetal complications, substantially strengthening antenatal surveillance and intrauterine intervention management. Keyword: Artificial intelligence, digital antenatal care, fetal growth restriction, fetal wellness, predictive analytics Latar Belakang: Perawatan antenatal (Antenatal Care/ANC) digital tradisional belum cukup mampu menurunkan angka kematian maternal dan neonatal global. Kecerdasan Buatan (AI) mengubah paradigma ini dengan mengaktifkan pencegahan proaktif melalui analitik prediktif dan penilaian risiko yang dipersonalisasi secara real-time. Tujuan: Meninjau secara sistematis dan melakukan meta-analisis terhadap dampak pemantauan digital berbasis AI dan sistem peringatan prediktif pada kesejahteraan janin selama masa antenatal. Metode: Berdasarkan pedoman PRISMA, pencarian sistematis dilakukan pada database PubMed, Scopus, dan Web of Science. Studi yang dievaluasi mencakup pemantauan digital berbasis AI atau algoritma prediktif dalam perawatan antenatal dan intrapartum untuk menilai hambatan pertumbuhan janin (Fetal Growth Restriction/FGR)-mortalitas, persalinan spontan, dan cacat bawaan. Pembahasan: Sepuluh studi dianalisis. ANC berbasis AI menunjukkan akurasi diagnostik yang tinggi untuk FGR (AUC: 0,831–0,918) dan mengungguli penilaian panjang serviks standar dalam memprediksi persalinan prematur spontan (AUC 0,75 vs. 0,67; $p < 0,001$). Ekokardiografi berbasis AI meningkatkan sensitivitas deteksi cacat jantung bawaan hingga 85% (dibandingkan standar klinis yang hanya 34%). Selain itu, model grafis menunjukkan peningkatan risiko morbiditas perinatal sebesar 10 kali lipat ketika FGR disertai dengan diabetes maternal (RR 9,8). AI juga berhasil mengidentifikasi keterlambatan pematangan otak janin dan memprediksi tingkat operasi sesar darurat menggunakan analisis variabilitas denyut jantung. Secara keseluruhan, model-model ini menunjukkan performa diskriminatif yang kuat, dengan nilai gabungan AUC sebesar 0,858 (95% CI: 0,766–0,951). Kesimpulan: ANC digital berbasis AI secara signifikan meningkatkan deteksi dini komplikasi janin yang kritis, serta memperkuat pengawasan antenatal dan manajemen intervensi dalam rahim. Kata kunci: Analitik prediktif, kecerdasan buatan, kesejahteraan janin, pelayanan antenatal digital, pertumbuhan janin terhambat
Copyright (c) 2026 M. Ari Irawan, Fauzan Azmi Hasti Habibi Samosir, Muhammad Ikhwan, Fildza Sabhrina,D, Kaniya Atsilah Samosir https://creativecommons.org/licenses/by-nc/4.0
Dynamic Digestive Health Surveillance System (DDHSS): A Conceptual Framework for Longitudinal Colorectal Cancer Surveillance
Background: Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide. Although fecal immunochemical tests (FIT) and colonoscopy effectively detect precancerous lesions and early-stage CRC, current screening strategies remain predominantly age-based and episodic. Such approaches inadequately capture longitudinal changes in individual risk profiles. Recent advances in electronic health records (EHRs), longitudinal healthcare databases, and artificial intelligence (AI) provide opportunities for more adaptive CRC surveillance. Objectives: This review evaluated the limitations of conventional CRC screening and the potential role of longitudinal healthcare data integration and AI-assisted risk stratification in adaptive CRC surveillance. Methods: A structured narrative review was conducted. Literature searches were performed in PubMed and Scopus for studies published between 2016 and 2026 using keywords related to CRC screening, longitudinal surveillance, healthcare informatics, and artificial intelligence. Relevant literature on CRC screening performance, predictive modeling, and AI-assisted surveillance systems was synthesized to develop a conceptual framework. Discussion: CRC susceptibility evolves under biological, metabolic, genetic, and environmental influences. Integration of cumulative healthcare information with predictive analytical models may improve the continuity and precision of CRC surveillance compared with conventional age-based screening. However, translational barriers, including data interoperability, algorithmic bias, and limited longitudinal validation, remain important challenges. Based on the synthesized evidence, the Dynamic Digestive Health Surveillance System (DDHSS) is proposed as a conceptual framework for population-level CRC surveillance. Conclusion: Integration of longitudinal healthcare data and AI-driven analytics may support more personalized and adaptive CRC surveillance beyond conventional age-based screening. Keyword: artificial intelligence, colorectal cancer, population surveillance, risk stratification, screening Latar Belakang: Kanker kolorektal (CRC) tetap menjadi salah satu penyebab utama morbiditas dan mortalitas akibat kanker di seluruh dunia. Meskipun tes imunokimia feses (FIT) dan kolonoskopi efektif dalam mendeteksi lesi prakanker serta CRC stadium awal, strategi skrining saat ini masih didominasi pendekatan berbasis usia dan dilakukan secara episodik. Pendekatan tersebut belum sepenuhnya menangkap perubahan risiko individu dari waktu ke waktu. Kemajuan rekam medis elektronik (EHR), data kesehatan longitudinal, dan kecerdasan buatan (AI) membuka peluang pengembangan pemantauan risiko CRC yang lebih adaptif. Tujuan: Tinjauan ini mengevaluasi keterbatasan skrining CRC konvensional serta potensi integrasi data longitudinal dan stratifikasi risiko berbantuan AI dalam surveilans CRC adaptif. Metode: Kajian naratif terstruktur dilakukan melalui penelusuran PubMed, Scopus, dan ScienceDirect untuk publikasi tahun 2016–2026. Sebanyak 38 publikasi memenuhi kriteria dan disintesis secara naratif. Pembahasan: Risiko CRC bersifat dinamis dan dipengaruhi faktor biologis, metabolik, genetik, lingkungan, serta riwayat skrining. Bukti yang ditinjau menunjukkan masih adanya risiko residual setelah hasil skrining negatif, heterogenitas lintasan risiko pascaskrining, serta potensi integrasi hasil FIT, temuan endoskopi sebelumnya, variabel klinis, dan data kesehatan rutin untuk mendukung pemantauan risiko yang lebih adaptif. Namun, model prediktif yang ada masih dibatasi oleh kurangnya validasi prospektif, ketidakpastian kalibrasi, bias algoritma, keterbatasan interoperabilitas data, dan belum cukupnya bukti utilitas klinis di dunia nyata. Berdasarkan bukti yang disintesis, DDHSS diusulkan sebagai kerangka konseptual untuk pemantauan risiko CRC longitudinal dan dukungan rujukan. Kesimpulan: DDHSS merupakan kerangka integratif yang bersifat hipotesis-generatif dengan menghubungkan data kesehatan longitudinal, analitik prediktif, stratifikasi risiko, dan umpan balik surveilans. DDHSS perlu dipahami sebagai arsitektur surveilans konseptual, bukan sistem klinis tervalidasi, sehingga nilai tambahnya dibandingkan jalur skrining, diagnostik, dan surveilans yang telah ada masih memerlukan evaluasi prospektif. Kata kunci: kanker kolorektal, kecerdasan buatan, surveilans populasi, skrining, stratifikasi risiko
Copyright (c) 2026 Aisyah Aulia Az-Zahra Ikhsan, Akmal Hisyam, Raihansyah Harris Nasution, Muhammad Zain Ardiansyah https://creativecommons.org/licenses/by-nc/4.0
Evolving Paradigms in Video-Assisted Thoracoscopic Surgery for Lung Cancer: Techniques, Outcomes, and Emerging Technologies
Background: Video-Assisted Thoracoscopic Surgery (VATS) has transformed lung cancer management by enabling minimally invasive approaches with improved perioperative outcomes. However, rapid advancements in surgical techniques and integration with emerging technologies necessitate a comprehensive synthesis of current evidence. Objectives: This review aims to evaluate the evolving paradigms of VATS in lung cancer, including comparisons between uniportal and multiportal techniques, assessment against robotic-assisted thoracic surgery (RATS), and analysis of clinical outcomes and technological innovations. Methods: A narrative review was conducted using a structured literature search across major databases, including retrospective studies, prospective trials, meta-analyses, and consensus reports published over the past two decades. Relevant studies were selected based on predefined inclusion criteria and analyzed qualitatively. Results and Discussions: Evidence indicates that uniportal VATS is increasingly adopted, offering reduced postoperative pain, shorter hospital stays, and comparable oncological outcomes to multiportal VATS and open surgery. RATS demonstrates enhanced surgical precision and improved lymph node dissection with favorable recovery profiles, although associated with higher costs and technical demands. Overall, minimally invasive approaches reduce perioperative complications and improve recovery, but limitations persist regarding technical complexity, cost-effectiveness, and long-term outcomes. Conclusion: VATS continues to evolve as a safe and effective modality in lung cancer surgery. Integration with advanced technologies enhances surgical performance; however, further standardized protocols and high-quality studies are required to optimize clinical implementation. Keyword: lung cancer, minimally invasive surgery, robotic-assisted thoracic surgery, surgical outcomes, VATS Latar Belakang: Video-Assisted Thoracoscopic Surgery (VATS) telah merevolusi penatalaksanaan kanker paru melalui pendekatan invasif minimal yang memberikan hasil perioperatif yang lebih baik. Namun, perkembangan teknik bedah dan integrasi teknologi baru menuntut sintesis bukti yang komprehensif. Tujuan: Tinjauan ini bertujuan untuk mengevaluasi perkembangan VATS dalam kanker paru, termasuk perbandingan teknik uniportal dan multiportal, evaluasi terhadap robotic-assisted thoracic surgery (RATS), serta analisis luaran klinis dan inovasi teknologi. Metode: Literature review dilakukan melalui pencarian terstruktur pada berbagai database yang mencakup studi retrospektif, uji prospektif, meta-analisis, dan laporan konsensus dalam dua dekade terakhir. Studi yang relevan dipilih berdasarkan kriteria inklusi dan dianalisis secara kualitatif. Pembahasan: Uniportal VATS menunjukkan peningkatan penggunaan dengan keunggulan berupa nyeri pascaoperasi lebih rendah, lama rawat lebih singkat, serta luaran onkologis yang sebanding dengan teknik multiportal dan operasi terbuka. RATS memberikan presisi bedah yang lebih tinggi dan diseksi kelenjar getah bening yang lebih optimal, namun dengan biaya lebih tinggi dan kebutuhan pelatihan khusus. Secara keseluruhan, pendekatan invasif minimal menurunkan komplikasi perioperatif dan mempercepat pemulihan, meskipun masih terdapat keterbatasan dalam kompleksitas teknik, efektivitas biaya, dan data jangka panjang. Kesimpulan: VATS merupakan metode yang aman dan efektif dalam pembedahan kanker paru yang terus berkembang. Integrasi teknologi meningkatkan performa bedah, namun diperlukan standarisasi protokol dan penelitian berkualitas tinggi untuk optimalisasi implementasi klinis. Kata kunci: bedah invasif minimal, kanker paru, luaran bedah, RATS
Copyright (c) 2026 Vika Kyneissia Gliselda https://creativecommons.org/licenses/by-nc/4.0
Mitochondrial Dysfunction Induced by Hyperglycemia as a Key Mechanism in Metabolic Disorders
Background: Hyperglycemia is a major feature of metabolic disorders and is closely associated with mitochondrial dysfunction through oxidative stress, impaired bioenergetics, and altered mitochondrial regulation. Plant-derived bioactive compounds have also attracted interest for their potential to modulate these mitochondrial and redox pathways. Objectives: This review aimed to synthesize published evidence on hyperglycemia-induced mitochondrial dysfunction as a central mechanism in metabolic disorders and to summarize the potential role of plant-derived compounds in modulating mitochondrial pathways. Methods: This study was conducted as a narrative literature review. Articles were searched through PubMed, SAGE Journals, and ScienceDirect databases for publications from 2015 to 2025. The search terms included combinations of hyperglycemia, mitochondrial dysfunction, oxidative stress, PGC-1α, Nrf2, mitochondrial biogenesis, mitochondrial dynamics, metabolic disorders, and plant-derived extracts. Eligible articles included original studies and review papers discussing mitochondrial alterations under hyperglycemic conditions in in vitro, animal, or human studies. The data were synthesized qualitatively and organized into thematic categories without meta-analysis. Discussion: Hyperglycemia increases reactive oxygen species (ROS) production, impairs electron transport chain efficiency, and reduces adenosine triphosphate (ATP) generation. It may also disturb mitochondrial quality control by promoting excessive fission and suppressing PGC-1α-mediated mitochondrial biogenesis. Oxidative stress–responsive pathways, including Nrf2, contribute to mitochondrial redox homeostasis under metabolic stress. Polyphenols, flavonoids, and curcumin may modulate these pathways by activating Nrf2-dependent antioxidant responses and supporting mitochondrial biogenesis-related signaling. Conclusion: Hyperglycemia contributes to mitochondrial dysfunction through oxidative stress, impaired energy metabolism, and altered mitochondrial regulatory pathways. Plant-derived compounds may offer potential protective effects, although many studies remain limited by the lack of direct mitochondrial functional assessment. Keyword: hyperglycemia; mitochondrial dysfunction; Nrf2; oxidative stress; PGC-1α Latar Belakang: Hiperglikemia merupakan ciri utama gangguan metabolik dan berhubungan erat dengan disfungsi mitokondria melalui stres oksidatif, gangguan bioenergetika, dan perubahan regulasi mitokondria. Senyawa bioaktif berbasis tanaman juga mendapat perhatian karena berpotensi memodulasi jalur mitokondria dan redoks tersebut. Tujuan: Tinjauan ini bertujuan untuk menyintesis bukti ilmiah mengenai disfungsi mitokondria akibat hiperglikemia sebagai mekanisme penting pada gangguan metabolik, serta merangkum potensi senyawa berbasis tanaman dalam memodulasi jalur mitokondria. Metode: Studi ini disusun sebagai narrative literature review. Penelusuran artikel dilakukan melalui basis data PubMed, SAGE Journals, dan ScienceDirect untuk publikasi tahun 2015 hingga 2025. Kata kunci yang digunakan mencakup kombinasi hyperglycemia, mitochondrial dysfunction, oxidative stress, PGC-1α, Nrf2, mitochondrial biogenesis, mitochondrial dynamics, metabolic disorders, dan plant-derived extracts. Artikel yang memenuhi kriteria meliputi penelitian asli dan artikel review yang membahas perubahan mitokondria pada kondisi hiperglikemia berdasarkan studi in vitro, hewan coba, maupun manusia. Data disintesis secara kualitatif dan disusun dalam kategori tematik tanpa meta-analisis. Pembahasan: Hiperglikemia meningkatkan produksi reactive oxygen species (ROS), menurunkan efisiensi rantai transpor elektron, dan mengurangi pembentukan adenosine triphosphate (ATP). Kondisi ini juga dapat mengganggu kontrol kualitas mitokondria dengan meningkatkan fisi berlebihan dan menekan biogenesis mitokondria yang dimediasi PGC-1α. Jalur respons stres oksidatif, termasuk Nrf2, berperan dalam menjaga homeostasis redoks mitokondria selama stres metabolik. Senyawa fitokimia seperti polifenol, flavonoid, dan kurkumin berpotensi memodulasi jalur tersebut melalui aktivasi respons antioksidan bergantung Nrf2 dan dukungan terhadap regulasi biogenesis mitokondria. Kesimpulan: Hiperglikemia berkontribusi terhadap disfungsi mitokondria melalui stres oksidatif, gangguan metabolisme energi, dan perubahan jalur regulasi mitokondria. Senyawa berbasis tanaman berpotensi memberikan efek protektif, meskipun banyak studi masih terbatas karena belum mengevaluasi fungsi mitokondria secara langsung. Kata kunci: disfungsi mitokondria; hiperglikemia; Nrf2; PGC-1α; stres oksidatif
Copyright (c) 2026 Josephine Gloriana, Sry Suryani Widjaja, Firzan Nainu https://creativecommons.org/licenses/by-nc/4.0
Multi-Omics Integration and Artificial Intelligence for Dynamic Risk Stratification of Hepatocellular Carcinoma in MASLD: Toward Precision Surveillance and Personalized Immunotherapy
Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and remains a major cause of cancer-related mortality worldwide. Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as an important driver of hepatocarcinogenesis, characterized by heterogeneous disease progression and the development of HCC even in non-cirrhotic patients, thereby challenging conventional surveillance strategies. Objectives: This review aimed to evaluate the role of multi-omics integration and artificial intelligence (AI) in the early detection and dynamic risk stratification of MASLD-related HCC, synthesize evidence regarding the association between multi-layer biomarkers, biological heterogeneity, and immunotherapy response prediction, and formulate a conceptual framework for dynamic risk stratification based on longitudinal molecular trajectories as a foundation for precision surveillance and personalized therapeutic strategies. Methods: A structured narrative literature review using a conceptual synthesis approach was conducted. Literature searches were performed in PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2021 and 2026. Studies investigating genomics, transcriptomics, proteomics, metabolomics, or epigenomics integrated with AI-based approaches for HCC detection, risk stratification, or therapeutic response prediction were qualitatively synthesized. Discussion: Current evidence suggests that multi-omics integration provides a more comprehensive understanding of molecular heterogeneity and hepatocarcinogenic trajectories than single-biomarker approaches. AI facilitates the integration of multidimensional data through complex modeling, enabling dynamic risk stratification, improving early detection, and predicting immunotherapy response. Conclusion: Multi-omics and AI have the potential to transform risk-based surveillance and personalized management of MASLD-related HCC. However, prospective multicenter validation, standardized integration strategies, and adequate healthcare infrastructure are required for broader clinical implementation. Keyword: artificial intelligence; hepatocellular carcinoma; MASLD; multi-omics; precision hepatology Latar Belakang: Karsinoma hepatoseluler (hepatocellular carcinoma/HCC) merupakan keganasan hati primer tersering dan masih menjadi penyebab utama mortalitas terkait kanker di seluruh dunia. Metabolic dysfunction-associated steatotic liver disease (MASLD) telah berkembang sebagai determinan penting dalam hepatokarsinogenesis dengan karakteristik progresi penyakit yang heterogen serta kemampuan berkembang menjadi HCC bahkan pada pasien tanpa sirosis, sehingga menantang strategi surveilans konvensional. Tujuan: Tinjauan ini bertujuan mengevaluasi peran integrasi multi-omics dan kecerdasan buatan (artificial intelligence/AI) dalam deteksi dini dan stratifikasi risiko dinamis HCC terkait MASLD, mensintesis bukti mengenai hubungan biomarker multi-lapis dengan heterogenitas biologis dan prediksi respons imunoterapi, serta merumuskan kerangka konseptual stratifikasi risiko dinamis berbasis trajektori molekuler longitudinal sebagai dasar pengembangan surveilans presisi dan strategi terapi yang dipersonalisasi. Metode: Tinjauan literatur naratif terstruktur dengan pendekatan sintesis konseptual dilakukan melalui pencarian literatur pada PubMed, Scopus, ScienceDirect, dan Google Scholar terhadap studi yang dipublikasikan pada tahun 2021–2026. Studi yang mengevaluasi integrasi genomik, transkriptomik, proteomik, metabolomik, atau epigenomik dengan pendekatan berbasis AI untuk deteksi HCC, stratifikasi risiko, atau prediksi respons terapi dianalisis secara kualitatif. Pembahasan: Bukti terkini menunjukkan bahwa integrasi multi-omics memberikan pemahaman yang lebih komprehensif mengenai heterogenitas molekuler dan trajektori hepatokarsinogenesis dibandingkan pendekatan biomarker tunggal. AI memungkinkan integrasi data multidimensi melalui pemodelan kompleks untuk mendukung stratifikasi risiko dinamis, meningkatkan deteksi dini, serta memprediksi respons imunoterapi. Kesimpulan: Integrasi multi-omics dan AI berpotensi mentransformasi surveilans berbasis risiko dan tata laksana personalisasi HCC terkait MASLD. Namun, validasi prospektif multisenter, standardisasi strategi integrasi data, serta kesiapan infrastruktur kesehatan masih diperlukan untuk implementasi klinis yang lebih luas. Kata kunci: kecerdasan buatan; karsinoma hepatoseluler; MASLD; multi-omics; hepatologi presisi
Copyright (c) 2026 Muhammad Zain Ardiansyah, Muhammad Yahri Zacky, Aisyah Aulia Az-Zahra Ikhsan, Akmal Hisyam https://creativecommons.org/licenses/by-nc/4.0
Potensi CRISPR-Cas9 Terkonjugasi Sistem Pengantar Vesikel Ekstraseluler sebagai Strategi Terapeutik Penyakit HIV dengan Metode Genome Editing untuk Pengobatan Masa Depan Penyakit HIV
Background: Human Immunodeficiency Virus (HIV) remains a major global health challenge with high morbidity and mortality rates. Although antiretroviral therapy (ART) effectively suppresses viral replication, it is unable to eradicate latent HIV reservoirs, preventing complete viral clearance. Advances in genome editing technologies, particularly Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated protein 9 (CRISPR-Cas9), have created new opportunities for HIV treatment through the targeted elimination of integrated viral genetic material. Objective: This study aimed to review the potential of CRISPR-Cas9 conjugated with extracellular vesicle delivery systems as a therapeutic strategy for HIV based on current scientific evidence. Methods: A literature review was conducted using scientific articles retrieved from PubMed, ScienceDirect, NCBI, and other relevant scientific databases. Relevant studies were critically reviewed and synthesized to evaluate its therapeutic potential for HIV treatment. Discussion: The findings indicate that CRISPR-Cas9 can target multiple stages of the HIV life cycle, including disruption of viral entry coreceptors, inhibition of viral replication, and elimination of latent proviral DNA integrated within host genomes. Furthermore, extracellular vesicles offer several advantages as delivery vehicles, including high biocompatibility, low immunogenicity, and efficient intracellular delivery of CRISPR-Cas9 components. Several studies have demonstrated that the combination of CRISPR-Cas9 and extracellular vesicle-based delivery systems can reduce HIV proviral expression and prevent the reactivation of latent viral reservoirs. Conclusion: CRISPR-Cas9 conjugated with extracellular vesicle delivery systems represents a promising therapeutic approach for HIV treatment. However, further studies are required to evaluate its safety, efficacy, and clinical applicability in humans. Keywords: CRISPR-Cas9, extracellular vesicles, gene therapy, genome editing, HIV. Latar Belakang: Human Immunodeficiency Virus (HIV) masih menjadi tantangan kesehatan global dengan angka morbiditas dan mortalitas yang tinggi. Meskipun terapi antiretroviral (ART) efektif dalam menekan replikasi virus, terapi ini belum mampu mengeliminasi reservoir laten HIV sehingga belum dapat memberikan kesembuhan secara menyeluruh. Perkembangan teknologi genome editing, khususnya Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated protein 9 (CRISPR-Cas9), membuka peluang baru dalam terapi HIV melalui eliminasi materi genetik virus yang terintegrasi pada genom inang. Tujuan: Mengkaji potensi CRISPR-Cas9 yang dihantarkan menggunakan vesikel ekstraseluler sebagai strategi terapeutik HIV berdasarkan bukti ilmiah terkini. Metode: Penelitian ini menggunakan metode literature review dengan menelaah berbagai artikel ilmiah yang diperoleh dari PubMed, ScienceDirect, NCBI, dan sumber ilmiah relevan lainnya. Artikel yang relevan ditelaah secara kritis dan disintesis untuk mengevaluasi potensi terapeutik pendekatan tersebut dalam pengobatan HIV. Pembahasan: Kajian menunjukkan bahwa CRISPR-Cas9 mampu menargetkan berbagai tahap siklus hidup HIV, termasuk menghambat koreseptor masuknya virus, mengganggu replikasi virus, serta mengeliminasi provirus laten yang terintegrasi dalam genom sel inang. Selain itu, vesikel ekstraseluler memiliki keunggulan sebagai sistem penghantar karena bersifat biokompatibel, memiliki imunogenisitas rendah, serta mampu meningkatkan efisiensi pengiriman komponen CRISPR-Cas9 ke sel target. Beberapa penelitian menunjukkan bahwa kombinasi CRISPR-Cas9 dan vesikel ekstraseluler mampu menurunkan ekspresi provirus HIV dan menghambat aktivasi ulang reservoir laten. Kesimpulan: CRISPR-Cas9 yang dihantarkan menggunakan vesikel ekstraseluler berpotensi menjadi strategi terapeutik inovatif untuk HIV. Meskipun demikian, penelitian lebih lanjut masih diperlukan untuk mengevaluasi keamanan, efikasi, dan aplikasinya pada manusia. Keyword: CRISPR-Cas9, HIV, penyuntingan genom, terapi gen, vesikel ekstraseluler.
Copyright (c) 2026 Muhammad Rizky Hidayatullah, Salwa Adilah Ningtiyas, Adinda Nezma Meidina, Awwa Chaga Qambara Taqwa https://creativecommons.org/licenses/by-nc/4.0
Quadriceps Tendon versus Bone–Patellar Tendon–Bone Autograft for Primary ACL Reconstruction: A Systematic Review and Meta-analysis of Complications and Patient-Reported Outcomes
Background: Bone–patellar tendon–bone has long been regarded as a benchmark graft for primary anterior cruciate ligament reconstruction, although donor-site morbidity remains a relevant limitation. Quadriceps tendon has emerged as an increasingly adopted alternative, but its comparative role remains to be clearly defined. Objectives: This systematic review and meta-analysis aimed to compare quadriceps tendon and bone–patellar tendon–bone autografts in primary anterior cruciate ligament reconstruction, particularly regarding patient-reported outcomes, graft failure, and postoperative complications. Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. PubMed, Scopus, Web of Science, and Cochrane CENTRAL were searched for comparative studies evaluating quadriceps tendon versus bone–patellar tendon–bone autografts in primary anterior cruciate ligament reconstruction. Discussion: Six comparative studies met the eligibility criteria. Pooled analyses showed no significant differences between grafts in International Knee Documentation Committee subjective score, Tegner activity score, Lysholm score, or graft failure. In contrast, quadriceps tendon was associated with a lower rate of arthrofibrosis. A lower risk of contralateral anterior cruciate ligament tear was also observed, although this finding should be interpreted cautiously because of sparse event counts. Conclusion: Quadriceps tendon offers clinical effectiveness comparable to bone–patellar tendon–bone, with a potentially more favorable complication profile, supporting its use as a dependable alternative graft for primary anterior cruciate ligament reconstruction. Keyword: anterior cruciate ligament reconstruction, autograft, bone–patellar tendon–bone, quadriceps tendon, systematic review Latar belakang: Bone–patellar tendon–bone merupakan graft acuan pada rekonstruksi ligamentum krusiatum anterior primer, tetapi morbiditas donor-site tetap menjadi perhatian. Quadriceps tendon semakin banyak digunakan sebagai alternatif, namun efektivitas dan profil komplikasinya masih perlu dipertegas. Tujuan: Systematic review dan meta-analysis ini bertujuan membandingkan autograft quadriceps tendon dan bone–patellar tendon–bone pada rekonstruksi ligamentum krusiatum anterior primer, terutama terkait luaran pasien, kegagalan graft, dan komplikasi pascaoperasi. Metode: Studi ini dilakukan sesuai Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Scopus, Web of Science, dan Cochrane CENTRAL digunakan untuk mencari studi komparatif yang mengevaluasi quadriceps tendon versus bone–patellar tendon–bone pada rekonstruksi ligamentum krusiatum anterior primer. Pembahasan: Enam studi komparatif memenuhi kriteria inklusi. Analisis gabungan menunjukkan tidak ada perbedaan bermakna pada International Knee Documentation Committee subjective score, Tegner activity score, Lysholm score, maupun kegagalan graft. Sebaliknya, quadriceps tendon berhubungan dengan angka arthrofibrosis yang lebih rendah. Penurunan risiko robekan ligamentum krusiatum anterior kontralateral juga ditemukan, tetapi perlu ditafsirkan hati-hati karena jumlah kejadian yang terbatas. Kesimpulan: Quadriceps tendon memberikan efektivitas klinis yang sebanding dengan bone–patellar tendon–bone, dengan potensi profil komplikasi yang lebih menguntungkan, sehingga dapat digunakan sebagai alternatif graft yang andal pada rekonstruksi ligamentum krusiatum anterior primer. Kata kunci: autograft; bone–patellar tendon–bone; quadriceps tendon; rekonstruksi ligamentum krusiatum anterior; systematic review
Copyright (c) 2026 Oktavio Jalu Kuncoro Jati, Ryan Rainier Rasman, Seva Ajisma, Jordaniel Setiabudi, Rafell Tantyo https://creativecommons.org/licenses/by-nc/4.0
Therapeutic Potential of Moringa oleifera Leaf Extract and Nigella sativa as Herbal Therapy in Diabetes Mellitus: A Literature Review
Background: Diabetes mellitus (DM) is a metabolic disorder characterized by elevated blood glucose concentrations resulting from impaired insulin production, reduced insulin responsiveness, or a combination of both conditions. Increasing evidence indicates that oxidative imbalance and persistent inflammatory responses contribute substantially to the onset and progression of type 2 diabetes mellitus (T2DM). Consequently, medicinal plants with antioxidant and anti-inflammatory activities have gained attention as potential supportive interventions. Objective: This review aimed to evaluate published evidence regarding the antidiabetic properties of Moringa oleifera and Nigella sativa, particularly their influence on glucose metabolism, oxidative damage, and inflammatory pathways. Methods: A narrative review was performed using articles retrieved from PubMed, ScienceDirect, SpringerLink, Google Scholar, and accredited scientific journals. Publications from 2015–2024 were screened according to predefined eligibility criteria. Of 87 records initially identified, 17 studies were selected for analysis. Results: Available studies indicate that Moringa oleifera may assist glucose regulation through enzyme inhibition, improvement of insulin responsiveness, and enhancement of endogenous antioxidant defenses. Meanwhile, Nigella sativa and its principal bioactive constituent, thymoquinone, demonstrate glucose-lowering, antioxidant, and anti-inflammatory activities through modulation of oxidative stress and inflammatory mediators. Both plants have also shown protective effects against tissue damage associated with diabetes. Conclusion: Current findings support the potential role of Moringa oleifera and Nigella sativa as adjunctive approaches in diabetes management. Nevertheless, additional well-designed clinical investigations are required to establish their therapeutic effectiveness and long-term safety. Keyword: diabetes mellitus, inflammation, Moringa oleifera, Nigella sativa, oxidative stress Latar Belakang: Diabetes melitus (DM) merupakan gangguan metabolik kronis yang ditandai oleh peningkatan kadar glukosa darah akibat gangguan sekresi insulin, penurunan sensitivitas insulin, atau kombinasi keduanya. Selain hiperglikemia, stres oksidatif dan inflamasi kronis diketahui berkontribusi terhadap perkembangan serta progresivitas diabetes melitus tipe 2 (DMT2). Oleh karena itu, tanaman obat yang memiliki aktivitas antioksidan dan antiinflamasi semakin banyak diteliti sebagai terapi pendamping dalam pengelolaan diabetes. Tujuan: Tinjauan pustaka ini bertujuan mengevaluasi bukti ilmiah mengenai potensi antidiabetik Moringa oleifera dan Nigella sativa, khususnya terkait pengaruhnya terhadap metabolisme glukosa, stres oksidatif, dan jalur inflamasi. Metode: Penelitian dilakukan menggunakan metode narrative literature review. Artikel diperoleh dari basis data PubMed, ScienceDirect, SpringerLink, Google Scholar, dan jurnal ilmiah terakreditasi. Publikasi tahun 2015–2024 diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan. Dari 87 publikasi yang teridentifikasi, sebanyak 17 artikel memenuhi kriteria dan dianalisis. Hasil: Hasil kajian menunjukkan bahwa Moringa oleifera berpotensi membantu pengendalian glukosa melalui penghambatan enzim pencernaan karbohidrat, peningkatan sensitivitas insulin, serta penguatan sistem antioksidan endogen. Sementara itu, Nigella sativa, terutama melalui kandungan thymoquinone, menunjukkan aktivitas antihiperglikemik, antioksidan, dan antiinflamasi melalui modulasi stres oksidatif dan mediator inflamasi. Kedua tanaman juga berpotensi memberikan efek protektif terhadap kerusakan jaringan akibat diabetes. Kesimpulan: Moringa oleifera dan Nigella sativa memiliki potensi sebagai terapi komplementer pada diabetes melitus. Namun, penelitian klinis yang lebih terstandarisasi masih diperlukan untuk memastikan efektivitas dan keamanan penggunaannya dalam jangka panjang. Keyword: diabetes melitus, inflamasi, Moringa oleifera, Nigella sativa, stres oksidatif
Copyright (c) 2026 Tiffany Anggun Prasetyo, Mutiara Indah Sari, Tri Widyawati https://creativecommons.org/licenses/by-nc/4.0
Vaksin Berbasis Messenger Ribonucleic Acid (mRNA) untuk Pencegahan Human Immunodeficiency Virus (HIV): Perkembangan Teknologi dan Bukti Klinis Terkini
Background: Human Immunodeficiency Virus (HIV) remains a major global public health challenge. According to the World Health Organization (WHO), in 2025, approximately 41 million people were living with HIV, with an estimated 570,000 deaths attributable to HIV-related causes and 1.2 million new HIV infections. These figures underscore the importance of effective HIV prevention strategies. Messenger ribonucleic acid (mRNA)-based vaccines represent a promising platform for HIV prevention because they enable flexible delivery and expression of HIV immunogens. Objective: To evaluate the development and potential of mRNA-based vaccines for HIV prevention. Methods: A narrative literature review was conducted using the Cochrane Library, Europe PMC, PubMed, ScienceDirect, Semantic Scholar, SpringerLink, Wiley Online Library, and Google Scholar for publications from 2021 to 2026. A total of 17 peer-reviewed articles were included and narratively synthesized. Results: Preclinical studies and phase I trials demonstrated that mRNA-LNP vaccines can induce HIV-specific humoral and cellular immune responses. In macaques, one candidate reduced the risk of heterologous SHIV infection by 79% per exposure. In humans, IAVI G002 and G003 demonstrated activation and early maturation of VRC01-class bnAb precursors, while HVTN 302 induced autologous tier 2 neutralizing antibodies in 80% of recipients receiving membrane-anchored Env trimers compared with 4% receiving soluble trimers. However, current evidence has not demonstrated that mRNA vaccines can prevent HIV acquisition in humans, induce broad and durable bnAb responses, or provide protection against viral diversity. Conclusion: mRNA-based HIV vaccines demonstrate biological feasibility and promising early clinical immunogenicity, but their protective efficacy has not yet been established. Further clinical studies are warranted to optimize delivery systems, dosing, durability of immune responses, and long-term safety. Keyword: antibodies; HIV prevention; immunogenicity; mRNA vaccine Latar Belakang: Human Immunodeficiency Virus (HIV) masih menjadi masalah kesehatan masyarakat global. Menurut World Health Organization (WHO), pada tahun 2025 diperkirakan terdapat 41 juta orang yang hidup dengan HIV, dengan sekitar 570.000 kematian akibat penyebab terkait HIV dan 1,2 juta infeksi baru. Hal ini menunjukkan pentingnya pencegahan HIV. Vaksin berbasis messenger ribonucleic acid (mRNA) merupakan salah satu platform yang berpotensi dikembangkan untuk pencegahan HIV karena memungkinkan penghantaran dan ekspresi imunogen secara fleksibel. Tujuan: Mengevaluasi perkembangan dan potensi vaksin berbasis mRNA untuk pencegahan HIV. Metode: Penelitian ini menggunakan narrative literature review. Pencarian literatur dilakukan melalui Cochrane Library, Europe PMC, PubMed, ScienceDirect, Semantic Scholar, SpringerLink, Wiley Online Library, dan Google Scholar terhadap publikasi tahun 2021–2026. Sebanyak 17 artikel ilmiah peer-reviewed yang memenuhi kriteria inklusi disintesis secara naratif. Hasil: Penelitian praklinis dan uji fase I menunjukkan bahwa mRNA-LNP dapat menginduksi respons imun humoral dan seluler spesifik HIV. Pada kera, salah satu kandidat menurunkan risiko infeksi SHIV heterolog sebesar 79% per pajanan. Pada manusia, IAVI G002 dan G003 menunjukkan aktivasi serta pematangan awal prekursor bnAb kelas VRC01, sedangkan HVTN 302 menghasilkan antibodi penetral tier 2 autolog pada 80% penerima trimer Env membrane-anchored dibandingkan 4% pada trimer terlarut. Namun, bukti yang tersedia belum menunjukkan kemampuan vaksin mRNA dalam mencegah akuisisi HIV pada manusia, menghasilkan respons bnAb yang luas dan persisten, atau memberikan perlindungan terhadap keragaman virus. Kesimpulan: Vaksin HIV berbasis mRNA menunjukkan kelayakan biologis dan imunogenisitas klinis awal, tetapi efikasi protektifnya belum terbukti. Diperlukan uji klinis lebih lanjut untuk mengoptimalkan sistem penghantaran, dosis, durabilitas, dan keamanan jangka panjang. Kata kunci: antibodi; pencegahan HIV; respons imun; vaksin mRNA.
Copyright (c) 2026 Muhammad Rizky Hidayatullah, Adinda Nezma Meidina, Salwa Adilah Ningtiyas, Awwa Chaga Qambara Taqwa https://creativecommons.org/licenses/by-nc/4.0
Assessing Visual Health Awareness: Knowledge, Attitude, and Behavior Towards Refractive Errors at SMP Harapan 2 Medan
Background: Uncorrected refractive errors are a leading cause of visual impairment globally, significantly impacting students' learning capacity and academic performance. Junior high school students are particularly vulnerable to this condition due to increasing digital device usage and prolonged screen time. Objective: This study aimed to investigate the relationship between the level of knowledge, attitudes, and behaviors regarding eye health and the prevalence of refractive errors among students at SMP Harapan 2 Medan. Methods: This analytical observational study utilized a cross-sectional design. A total sampling technique was employed, involving all students at SMP Harapan 2 Medan. Data were collected through validated questionnaires and visual acuity examinations. Statistical analysis was performed using Somers’ D bivariate test to evaluate the correlations between variables. The study received institutional ethical approval. Results: Among the 50 respondents, the majority demonstrated good levels of knowledge (66.0%) and positive attitudes (70.0%) toward refractive errors. However, only 38.0% exhibited good health behaviors, while 54.0% displayed moderate behavioral patterns. Statistical analysis revealed significant associations between refractive errors and students' knowledge levels (p = 0.020), attitudes (p = 0.032), and behaviors (p = 0.001). Conclusion: There are statistically significant associations between the levels of knowledge, attitudes, and behaviors and the prevalence of refractive errors among students at SMP Harapan 2 Medan. These findings underscore the importance of targeted educational interventions to improve health-seeking behaviors and mitigate the progression of refractive errors in adolescent populations. Keyword: Attitude, behavior, knowledge, junior high school students, and Refractive error Latar Belakang : Kelainan refraksi yang tidak terkoreksi merupakan penyebab utama gangguan penglihatan di tingkat global dan dapat berdampak serius pada kemampuan belajar serta prestasi akademik siswa. Siswa Sekolah Menengah Pertama (SMP) sangat rentan terhadap kondisi ini akibat peningkatan penggunaan perangkat digital dan durasi waktu layar yang tinggi. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat pengetahuan, sikap, dan perilaku siswa di SMP Harapan 2 Medan. Metode: Penelitian ini menggunakan desain observasional analitik dengan pendekatan cross-sectional. Penelitian ini menggunakan teknik total sampling yang dilakukan pada siswa di SMP Harapan 2 Medan. Data dikumpulkan melalui kuesioner dan pemeriksaan tajam penglihatan (visus), kemudian dianalisis menggunakan uji statistik bivariat Somers' D untuk mengevaluasi hubungan antar variabel. Penelitian ini telah mendapatkan izin etik. Hasil: Dari total 50 responden, ditemukan bahwa mayoritas siswa memiliki tingkat pengetahuan yang baik (66,0%) dan sikap yang baik (70,0%) terhadap kelainan refraksi. Namun, hanya 38,0% siswa yang menunjukkan perilaku yang baik, sementara 54,0% memiliki perilaku yang cukup. Hasil uji statistik menunjukkan adanya hubungan yang signifikan antara tingkat pengetahuan siswa dengan kelainan refraksi mata (p = 0,020). Hubungan yang signifikan juga ditemukan antara tingkat sikap dengan kelainan refraksi mata (p = 0,032). Selain itu, terdapat hubungan yang kuat antara tingkat perilaku siswa dengan kelainan refraksi mata (p = 0,001). Kesimpulan: Terdapat hubungan yang signifikan secara statistik antara tingkat pengetahuan, sikap, dan perilaku siswa di SMP Harapan 2 Medan dengan prevalensi kelainan refraksi mata. Kata kunci: Kelainan refraksi, pengetahuan, perilaku, sikap, dan siswa sekolah menengah pertama.
Copyright (c) 2026 Rafi Anggia Hogantara Tambunan, Fauzan Azmi Hasti Habibi Samosir, Ramadhan Bestari, Ichwan Alamsyah Lubis , Dody Firmanda, Ahmad Rauf Tondi Tambunan https://creativecommons.org/licenses/by-nc/4.0
Gambaran Tingkat Pengetahuan, Pemilihan dan Penggunaan Kosmetik Pemutih pada Mahasiswi Fakultas Kedokteran Universitas Sumatera Utara
Background: Beauty standards in Indonesia are often described with an ideal body shape, clear and fair skin. This response was driven by the development of media such as advertising media and social media. This has led to the increasing use of whitening cosmetics among young adult women with the aim of beautifying themselves and increasing self-confidence. Objectives: This study aimed to describe the knowledge, attitudes toward selecting, and practices related to the use of whitening cosmetics among female medical students at Universitas Sumatera Utara. Methods: A descriptive study with cross-sectional design and the sampling technique used was stratified random sampling. The data was collected using an online questionnaire in the form of Google Form which contained 26 questions. The collected data were then processed using a computer program and tabulated. Results: The results showed that FK USU students had high (31.3%), moderate (55.6%), and low (13.2%) levels of knowledge. The respondents' attitudes toward selecting whitening cosmetics were categorized as capable (77.1%), quite capable (22.2%), and not capable (0.7%). The level of practice was good (55.6%), moderate (42%) and less (2.5%). Discussion: Knowledge about whitening cosmetics can help students in choosing and using whitening cosmetics. Conclusion: The description of female students’ level of knowledge is in the medium category, level of attitudes in choosing is in the capable category and action in using is in the good category. Keyword: Female students, knowledge, selection, use, whitening cosmetics Latar Belakang: Standar kecantikan di Indonesia dideskripsikan sebagai bentuk badan ideal, kulit bersih dan putih. Tanggapan ini didorong oleh perkembangan media seperti media iklan dan media sosial. Hal ini menyebabkan semakin meningkatnya penggunaan kosmetik pemutih di kalangan wanita dewasa muda dengan tujuan untuk mempercantik diri dan meningkatkan kepercayaan diri. Tujuan: Tujuan penelitian ini adalah untuk mengetahui gambaran pengetahuan, sikap memilih, dan tindakan penggunaan mahasiswi FK USU tentang kosmetik pemutih. Metode: Penelitian deskriptif dengan rancangan cross-sectional dan teknik pengambilan sampel berupa stratified random sampling. Pengumpulan data dilakukan menggunakan kuesioner online berupa Google Form yang berisikan 26 pertanyaan. Data yang dikumpulkan kemudian diolah menggunakan program komputer dan ditabulasi. Hasil: Hasil penelitian menunjukkan bahwa tingkat pengetahuan mahasiswi FK USU sebagian besar berada pada kategori sedang (55,6%), diikuti kategori tinggi (31,3%) dan kategori rendah (13,2%). Sikap mahasiswi dalam memilih kosmetik pemutih didominasi oleh kategori mampu (77,1%), diikuti kategori cukup mampu (22,2%), dan kategori tidak mampu (0,7%). Sementara itu, tindakan mahasiswi dalam menggunakan kosmetik pemutih sebagian besar berada pada kategori baik (55,6%), diikuti kategori sedang (42,0%) dan kategori kurang (2,5%). Pembahasan: Pengetahuan mengenai kosmetik pemutih dapat membantu mahasiswi dalam memilih dan menggunakan kosmetik pemutih. Kesimpulan: Gambaran tingkat pengetahuan mahasiswi berada pada kategori sedang, gambaran tingkat sikap pemilihan berada pada kategori mampu dan gambaran tindakan penggunaan berada pada kategori baik. Kata Kunci: Kosmetik pemutih, mahasiswi, pemilihan, pengetahuan, penggunaan
Copyright (c) 2026 Choirunnisa Fauzi, Dina Arwina Dalimunthe https://creativecommons.org/licenses/by-nc/4.0
Pulmonary Tuberculosis Case Before and During Pandemic COVID-19: Prevalence and Frequency Distribution Differences at Arifin Achmad General Hospital, Riau Province
Background: The COVID-19 pandemic severely disrupted tuberculosis (TB) control efforts, leading to a global "diagnostic deficit." Objectives: This study aimed to compare the incidence and frequency distribution of new pulmonary TB cases before and during the pandemic at Arifin Achmad General Hospital, Riau Province. Methods: Adhering to STROBE guidelines, this observational cross-sectional study analyzed 343 medical records from March 2018 to March 2022. Comparison was made between the pre-pandemic (2018–2020) and pandemic (2020–2022) periods using Chi-square analysis and Odds Ratios. Results: New pulmonary TB case notifications significantly declined by 33.5%, falling from 206 cases (60.1%) pre-pandemic to 137 cases (39.9%) during the pandemic. Of the total cases, 291 (84.8%) were drug-sensitive (DS-TB) and 52 (15.2%) were drug-resistant (DR-TB). Bivariate analysis revealed highly significant associations (p < 0.001) between the pandemic period and both smoking history and a history of COVID-19 infection. Significant associations were also found with comorbidities, including Diabetes Mellitus and HIV (p = 0.01). Conclusion: The observed decline reflects a diagnostic deficit driven by healthcare disruptions and reduced health-seeking behavior rather than a true reduction in incidence. The biological synergy between SARS-CoV-2 and Mycobacterium tuberculosis likely catalyzed active disease in vulnerable groups. Healthcare systems must prepare for a "time lag" phenomenon, where undiagnosed community transmission leads to a future surge in advanced TB presentations. Intensified active case-finding is essential to mitigate the pandemic's long-term epidemiological impact. Keyword: COVID-19 Pandemic, Incidence, Time Lag, Tuberculosis Latar Belakang: Pandemi COVID-19 telah sangat mengganggu upaya pengendalian tuberkulosis (TB), yang mengakibatkan terjadinya “defisit diagnosis” secara global. Tujuan: Penelitian ini bertujuan untuk membandingkan insidensi dan distribusi frekuensi kasus TB paru baru sebelum dan selama pandemi di Rumah Sakit Umum Arifin Achmad, Provinsi Riau. Metode: Sesuai dengan pedoman STROBE, studi observasional cross-sectional ini menganalisis 343 rekam medis dari Maret 2018 hingga Maret 2022. Perbandingan dilakukan antara periode pra-pandemi (2018–2020) dan pandemi (2020–2022) menggunakan analisis Chi-square dan Odds Ratios. Hasil: Laporan kasus TB paru baru menurun secara signifikan sebesar 33,5%, dari 206 kasus (60,1%) pada periode pra-pandemi menjadi 137 kasus (39,9%) selama pandemi. Kesimpulan: Penurunan yang diamati mencerminkan kekurangan dalam diagnosis yang disebabkan oleh gangguan layanan kesehatan dan berkurangnya perilaku mencari perawatan kesehatan, bukan penurunan insiden yang sesungguhnya. Sinergi biologis antara SARS-CoV-2 dan Mycobacterium tuberculosis kemungkinan besar memicu penyakit aktif pada kelompok rentan. Sistem layanan kesehatan harus bersiap menghadapi fenomena “time lag”, di mana penularan di masyarakat yang tidak terdiagnosis akan menyebabkan lonjakan kasus TB stadium lanjut di masa depan. Peningkatan upaya pencarian kasus secara aktif sangat penting untuk memitigasi dampak epidemiologis jangka panjang dari pandemi ini. Kata kunci: Insidensi, Pandemi COVID-19, Time Lag, Tuberkulosis
Copyright (c) 2026 Arya Maganda Simanjuntak, Indra Yovi, Suyanto, Zarfiardy Aksa Fauzy https://creativecommons.org/licenses/by-nc/4.0
Relationship Between Levels of Physical Activity and The Incidence of Constipation in Medical Students of The Faculty of Medicine Universitas Andalas
Background: Physical activity refers to all body movements produced by skeletal muscle contractions that substantially increase energy expenditure. Constipation is a gastrointestinal disorder characterized by infrequent bowel movements, hard stools, painful defecation, excessive straining, and a sensation of incomplete evacuation. Reduced physical activity is considered one of the contributing factors to constipation. Objectives: This study aimed to determine the relationship between physical activity level and the occurrence of constipation among medical students of Universitas Andalas, class of 2020. Methods: This quantitative study used a cross-sectional design involving 68 respondents conducted in September until October 2023 at the Faculty of Medicine, Universitas Andalas. Respondents were selected using simple random sampling. Physical activity levels were assessed using the Global Physical Activity Questionnaire (GPAQ), while constipation was evaluated using the Constipation Scoring System questionnaire. Data analysis was performed using the Pearson chi-square test to determine the relationship between physical activity level and constipation occurrence. Results: The results showed that nearly half of the respondents (45.6%) had a moderate level of physical activity. Constipation was more frequently observed among female respondents and was most common at the age of 21 years. Statistical analysis demonstrated no significant relationship between physical activity level and the occurrence of constipation among medical students of Universitas Andalas, class of 2020 (p=0.052). Conclusions: There was no significant association between physical activity level and constipation occurrence among medical students of Universitas Andalas, class of 2020. Keywords: constipation scoring system; global physical activity questionnaire; physical activity Latar Belakang: Aktivitas fisik merupakan seluruh gerakan tubuh yang dihasilkan oleh kontraksi otot rangka dan berperan dalam meningkatkan pengeluaran energi. Konstipasi adalah gangguan gastrointestinal yang ditandai dengan penurunan frekuensi buang air besar, tinja keras, nyeri saat defekasi, kesulitan pengeluaran tinja, mengejan berlebihan, rasa tersumbat pada area anorektal, serta sensasi evakuasi yang tidak tuntas. Kurangnya aktivitas fisik diduga menjadi salah satu faktor yang berkontribusi terhadap terjadinya konstipasi. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat aktivitas fisik dan kejadian konstipasi pada mahasiswa kedokteran Universitas Andalas angkatan 2020. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain cross-sectional yang melibatkan 68 responden dan dilakukan pada dari September sampai Oktober 2023 di Fakultas Kedokteran Universitas Andalas. Pengambilan sampel dilakukan menggunakan metode simple random sampling. Tingkat aktivitas fisik diukur menggunakan kuesioner Global Physical Activity Questionnaire (GPAQ), sedangkan kejadian konstipasi dinilai menggunakan Constipation Scoring System. Analisis hubungan antara tingkat aktivitas fisik dan kejadian konstipasi dilakukan menggunakan uji chi-square Pearson. Hasil: Hasil penelitian menunjukkan bahwa hampir setengah responden (45,6%) memiliki tingkat aktivitas fisik sedang. Kejadian konstipasi lebih banyak ditemukan pada responden perempuan dan paling sering terjadi pada usia 21 tahun. Analisis statistik menunjukkan tidak terdapat hubungan yang signifikan antara tingkat aktivitas fisik dan kejadian konstipasi pada mahasiswa kedokteran Universitas Andalas angkatan 2020 (p=0,052). Kesimpulan: Tidak terdapat hubungan yang signifikan antara tingkat aktivitas fisik dan kejadian konstipasi pada mahasiswa kedokteran Universitas Andalas angkatan 2020. Kata Kunci : aktivitas fisik; konstipasi; kuesioner aktivitas fisik global
Copyright (c) 2026 Ghifari Aulia Dzakwan, Husnil Kadri, Havriza Vitresia, Rauza Sukma Rita, MIftah Irrahmah, Selfi Renita Rusjdi https://creativecommons.org/licenses/by-nc/4.0
The Effect of Zingiber officinale var. rubrum Extract on IL-6 Cytokine Levels in Pneumonia-Induced by Streptococcus pneumoniae on Rattus norvegicus
Background: Pneumonia remains a leading cause of death from infectious diseases, often associated with elevated levels of proinflammatory cytokines such as Interleukin-6 (IL-6). Zingiber officinale var. rubrum (red ginger) contains bioactive compounds with potential anti-inflammatory effects. Objectives: To evaluate the effect of red ginger extract on IL-6 expression in the lung tissue of Wistar rats induced with Streptococcus pneumoniae, either as monotherapy or in combination with azithromycin. Methods: An experimental study was conducted using 30 male Wistar rats divided into five groups (n = 6 each): K1 (negative control), K2 (positive control), K3 (red ginger extract 400 mg/kgBW), K4 (azithromycin 11 mg/kgBW), and K5 (combination of red ginger extract and azithromycin). Pneumonia was induced intratracheally using a suspension of S. pneumoniae. Treatments were administered once daily for seven days. IL-6 expression in lung tissue was analyzed using immunohistochemistry and evaluated semi-quantitatively based on staining intensity and distribution. Results: The Kruskal-Wallis test showed a significant difference in IL-6 expression among groups (p < 0.05). Post hoc analysis revealed that K4 and K5 had significantly lower IL-6 expression than K2. No significant difference was found between K4 and K5, nor between K3 and K2, indicating that red ginger extract alone was not effective in significantly reducing IL-6 expression. Conclusion: Azithromycin, both alone and in combination with red ginger extract, effectively reduced IL-6 expression in rats with pneumonia. Red ginger extract alone did not show a significant anti-inflammatory effect in this model. Keywords: Azithromycin, IL-6, Pneumonia, Rattus norvegicus, Zingiber officinale var. rubrum Latar Belakang: Pneumonia masih menjadi salah satu penyebab utama kematian akibat penyakit infeksi, sering dikaitkan dengan peningkatan kadar sitokin proinflamasi seperti Interleukin-6 (IL-6). Zingiber officinale var. rubrum (jahe merah) mengandung senyawa bioaktif yang berpotensi memiliki efek antiinflamasi. Tujuan: Mengetahui pengaruh ekstrak jahe merah terhadap ekspresi IL-6 pada jaringan paru tikus Wistar yang diinduksi Streptococcus pneumoniae, baik sebagai monoterapi maupun dalam kombinasi dengan azitromisin. Metode: Penelitian eksperimental dilakukan menggunakan 30 ekor tikus Wistar jantan yang dibagi menjadi lima kelompok (n = 6 setiap kelompok), yaitu K1 (kontrol negatif), K2 (kontrol positif), K3 (ekstrak jahe merah 400 mg/kgBB), K4 (azitromisin 11 mg/kgBB), dan K5 (kombinasi ekstrak jahe merah dan azitromisin). Pneumonia diinduksi secara intratrakeal menggunakan suspensi S. pneumoniae. Perlakuan diberikan satu kali sehari selama tujuh hari. Ekspresi IL-6 pada jaringan paru dianalisis menggunakan pemeriksaan imunohistokimia dan dinilai secara semi-kuantitatif berdasarkan intensitas serta distribusi pewarnaan. Hasil: Uji Kruskal-Wallis menunjukkan adanya perbedaan bermakna ekspresi IL-6 antar kelompok (p < 0,05). Analisis post hoc menunjukkan bahwa kelompok K4 dan K5 memiliki ekspresi IL-6 yang secara signifikan lebih rendah dibandingkan kelompok K2. Tidak ditemukan perbedaan bermakna antara K4 dan K5 maupun antara K3 dan K2, yang menunjukkan bahwa ekstrak jahe merah saja tidak efektif dalam menurunkan ekspresi IL-6 secara signifikan. Kesimpulan: Azitromisin, baik sebagai monoterapi maupun dalam kombinasi dengan ekstrak jahe merah, efektif menurunkan ekspresi IL-6 pada tikus dengan pneumonia. Ekstrak jahe merah sebagai monoterapi tidak menunjukkan efek antiinflamasi yang signifikan pada model penelitian ini. Kata kunci: Azitromisin, IL-6, Pneumonia, Rattus norvegicus, Zingiber officinale var. rubrum
Copyright (c) 2026 Karina, Sri Rezeki Arbaningsih, Pinta Pudiyanti Siregar https://creativecommons.org/licenses/by-nc/4.0