Universa Medicina (UnivMed) is an official scientific publication of the Faculty of Medicine Universitas Trisakti and is a peer-reviewed open-access journal. Universa Medicina is a four-monthly medical journal that publishes new research findings on a wide variety of topics of importance to biomedical science and clinical practice. Universa Medicina is a general medical journal that focuses on all aspects of human health. Accredited journal based on Ministerial Decree of the Minister of Research and Technology / Head of National Research and Innovation Agency of the Republic of Indonesia with First Grade (Peringkat 1, Sinta 1, Garuda) No. 148/M/KPT/2020 Volume 38 Number 3, 2019 to Volume 43 Number 2, 2024. The Univ Med journal has been indexed and abstracted and displayed in Clarivate Analytics Web of Science Core Collection Database (Emerging Source Citation Index) (Q4 JCR) 2023, 2024, 2025, Dimensions-Digital Science, CABI, ASEAN Citation Index, DOAJ, Chemical Abstract Services (CAS), ROAD, National Library of Medicine, ICMJE, ICI, and SINTA. Imprint information Author Guidelines Make a Submission
Faculty of Medicine, Universitas Trisakti
The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
Strengthening clinical microbiology laboratories and prevention programs: a call to action for better infection control
The coronavirus disease 2019 (COVID-19) pandemic has revealed severe vulnerabilities in the global clinical laboratory systems, especially in low- and middle-income countries, where diagnostic capacity is still poor. As the world emerges from the acute phase of the pandemic, antimicrobial resistance (AMR) has re-emerged as the silent pandemic demanding urgent attention. Clinical microbiology laboratories are not just support services, they are the first line of defense against the disease outbreaks, healthcare-associated infections, and the increased risk of the drug-resistant pathogens. However, in most environments these laboratories are poorly funded, staffed and equipped. Enhancement of clinical microbiology laboratories should, therefore, be considered as one of the health priorities in the world.
Copyright (c) 2026 Abayeneh Girma https://creativecommons.org/licenses/by-nc-sa/4.0
Female university students’ attitude toward fertility and childbearing in Vietnam
Background Population aging and declining fertility rates are emerging concerns worldwide. In Vietnam, fertility rates have decreased rapidly in recent years. Understanding young women’s attitudes toward fertility and childbearing is important for developing appropriate reproductive and population policies. This study aimed to assess attitudes toward fertility and future childbearing among female students at the University of Medicine and Pharmacy, Vietnam National University, Hanoi. Methods A cross-sectional online survey was conducted among 187 nulliparous female students from September 2024 to March 2025. Data were collected using the Attitudes Toward Fertility and Childbearing Scale (AFCS). Descriptive statistics, chi-square tests, independent t-tests, and one-way analysis of variance were used to analyze the data. Results Overall, 66.3% of participants expressed a desire for future childbearing, 23.0% were uncertain, and 10.7% did not desire children. The desire for future childbearing was significantly higher among students aged >22 years compared with those aged ≤22 years (85.1% vs. 60.0%) and among participants in a relationship compared with single students (79.5% vs. 62.2%). The mean scores for the AFCS domains “Importance of fertility for the future,” “Childbearing as a hindrance at present,” and “Female identity” were 3.41 ± 0.97, 3.90 ± 0.74, and 2.96 ± 0.93, respectively. Greater importance placed on future fertility was associated with older age, rural residence, cohabiting parents, and desire for children (p<0.05). Conclusion Future childbearing intention among female students was relatively low and influenced by age and relationship status. Although fertility was considered important, childbearing was widely perceived as a present burden.
Copyright (c) 2026 Nguyen Thi Thu Ha, Hoang Thanh Luong, Thi Thu Phuong Pham https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical utility of artificial intelligence in prehospital emergency medical services : a systematic review and meta-analysis
Background The emergency medical services (EMS) sector presents substantial hurdles in providing excellent treatment while operating within limited resources. Artificial intelligence (AI) has significant potential in prehospital EMS, where rapid and accurate decision-making is essential. However, a comprehensive synthesis of AI’s effectiveness in this setting remains limited. The objective of this systematic review and meta-analysis was to evaluate AI’s predictive accuracy, compare its performance with human-based triage, and assess its feasibility in prehospital care. Methods Following PRISMA guidelines, PubMed, Cochrane Library, and Web of Science were searched up to February 20, 2025. Fourteen peer-reviewed studies reporting quantitative outcomes were included. Study quality was assessed using the Newcastle-Ottawa Scale (median score = 7). Random-effects meta-analyses in R were conducted to synthesize area under the curve (AUC), AI-human AUC differences, and feasibility outcomes. Results Across 14 studies involving 9,107,906 patients, AI demonstrated strong predictive performance with a pooled AUC of 0.874 (95% CI: 0.843–0.905). Individual study AUCs ranged from 0.805 to 0.997, with moderate heterogeneity (I²=52.3%). In eight studies, AI significantly outperformed human triage, showing a pooled AUC improvement of 0.074 (95% CI: 0.045–0.103; p<0.001), despite high heterogeneity due to varying human benchmarks. Feasibility analysis showed high clinical utility, with a pooled proportion of 0.929 and no heterogeneity (I²=0%). Funnel plots suggested slight asymmetry, but Egger’s tests indicated no significant publication bias. Conclusion Artificial intelligence demonstrated high predictive accuracy, slight superiority over human triage, and strong feasibility in prehospital care, supporting its integration into EMS with further validation and standardized reporting.
Copyright (c) 2026 Abdullah Alsamhari, Rafiulla Gilkaramenthi, Bader Hussain Alamer, Saad M. Mushawwah https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of using normal saline, alcohol and acetone on pain during removal of polyacrylate adhesive dressings in children aged 10–15 years: a pilot randomized controlled trial
Background Removing wound dressings containing polyacrylate adhesives can cause pain, especially in pediatric patients with more sensitive skin and lower pain thresholds. This study aimed to evaluate the effects of normal saline, alcohol, and acetone on pain during dressing removal in children and evaluate their associated side effects. Methods The study used a pilot randomized controlled trial involving 16 children aged 10-15 years at the Surgical Clinic of Dr. Saiful Anwar Regional General Hospital, Malang. Pain levels were measured using the Wong-Baker Faces Pain Scale, while side effects were assessed using the Skin Irritation Score and Itchyquant Score. The children's pain was assessed 1 min after the procedure. Kruskal-Wallis test, followed by Dunn's post hoc test were used for data analysis. Results The results demonstrated that acetone was significantly more effective than normal saline and alcohol in reducing pain during dressing removal (p<0.050). Normal saline and alcohol did not show significant differences compared to the control group, likely due to their limited ability to dissolve the polyacrylate adhesive. Mild irritation and temporary pruritus occurred in all groups, with acetone producing the least reaction. Acetone's effectiveness is attributed to its ability to disrupt van der Waals forces and polymer bonds within the adhesive, thereby reducing the force required for removal. Conclusions Acetone is the most effective agent for reducing pain during dressing removal, with minimal side effects compared to other solvents. Further research is necessary to determine optimal formulations and assess the stability of acetone for the development of acetone swab products.
Plastic Reconstructive and Aesthetic Surgery
Copyright (c) 2026 Edith Sumaregita Rinhastyanti, Herman Wihastyoko, Tommy Alfandy Nazwar https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence and risk factors of Entamoeba histolytica and Giardia lamblia infection among patients with gastrointestinal complaints
Background Intestinal parasitic infections remain a significant public health problem in developing regions, primarily driven by inadequate hygiene and sanitation standards. The most prevalent protozoan parasites causing gastrointestinal illness are Entamoeba histolytica and Giardia lamblia. This study aimed to investigate the prevalence of these infections and evaluate their association with socio-demographic factors and clinical stool consistency. Methods A total of 122 subjects aged 1-60 years were involved in this cross-sectional study. Data was collected via direct interviews and parasitological diagnosis using standard laboratory protocols to identify the presence of cysts or trophozoites. Data were stratified by age group, gender, and stool consistency, and a Chi-square test was used for data analysis. Results The findings revealed a high overall prevalence, with E. histolytica being the main parasite at 84.42% (103/122) compared to G. lamblia at 15.57% (19/122). Age-specific data showed that the 31-40 year age group had the highest infection rate for E. histolytica (92.31%), while the 21-30 year age group showed the highest occurrence of G. lamblia (25.81%). Gender-wise, males exhibited a significantly higher infection rate for E. histolytica (91.93%) compared to females (76.66%) (p=0.038). Regarding stool consistency, a highly significant association was observed (p<0.001). Conclusion The study highlights a substantial burden of protozoan infections, particularly E. histolytica. The significant association between stool consistency and parasite type emphasizes the importance of clinical presentation in diagnostic suspicion. Enhanced community-level health education and improved sanitation infrastructure are urgently needed to mitigate the transmission of these intestinal parasites.
Copyright (c) 2026 Hussein A. Sadeq, Shivan O. Haydar, Ghanem M. Jaafar, Mohammad I. Alberfkani https://creativecommons.org/licenses/by-nc-sa/4.0
Trends of early-onset colorectal cancer biomarkers from 1985 to 2024 : a bibliometric analysis
Early-onset colorectal cancer (EOCRC) is increasingly recognized as a global public health concern. Biomarker research in EOCRC has expanded across hereditary, molecular, epigenetic, liquid biopsy, microbiome, and multi-omics domains, but the overall research landscape remains fragmented. This study aimed to map global research trends and identify prominent and underdeveloped topics in EOCRC biomarker research. A bibliometric analysis was conducted using publications on EOCRC biomarkers retrieved on October 27, 2024. Eligible documents were limited to English-language articles, reviews, and conference proceedings, with a final publication stage and no restriction on publication year. After screening, 134 relevant documents published between 1985 and 2024 were included. Bibliometric indicators, including publication trends, leading contributors, influential publications, topic evolution, and keyword co-occurrence patterns, were analyzed using Biblioshiny (Bibliometrix R package v4.1.3) and VOS viewer (v1.6.18). Early-onset colorectal cancer biomarker research showed steady growth, with an annual growth rate of 7.54% and a publication peak in 2023. The dataset included 134 documents from 92 sources and involved 1,121 authors, with international collaboration observed in 20.9% of publications. Earlier studies focused mainly on hereditary predisposition, Lynch syndrome, mismatch repair genes, and microsatellite instability. More recent research shifted toward molecular profiling, epigenetic alterations, liquid biopsy, gut microbiota, tumor microenvironment, and multi-omics approaches. Underdeveloped areas included diagnostic biomarker validation, screening implementation, gut microbiota, risk factors, and machine learning-based biomarker discovery. Overall, EOCRC biomarker research has evolved from a hereditary-centered focus toward a broader precision oncology framework, but further work is needed to strengthen validation, translational relevance, and clinical applicability across diverse populations.
Copyright (c) 2026 Hamzah Haryo Prakoso, Andre Setiawan, Nur Rahadiani https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of brain endurance training on fatigue and physical endurance among stroke survivors: a non-blinded randomized controlled trial
Background Post-stroke fatigue (PSF) is a multifactorial impairment characterized by persistent tiredness not relieved by rest, and affects nearly half of stroke survivors, leading to poor physical endurance which limits recovery and overall quality of life. Limited evidence suggests that combining cognitive and physical training might help in reducing fatigue. Brain endurance training (BET) involves both cognitive training and physical training, targeting PSF. The study aimed to evaluate the effect of BET on fatigue and physical endurance among stroke survivors. Methods A parallel group pilot randomized controlled trial was carried out in a private setting with 30 stroke survivors. Patients were randomized into two groups. Group A (n=15) received BET and group B (n=15) received conventional physiotherapy. Both groups underwent training for 65 minutes per day, thrice a week for eight weeks. Primary outcomes were Fatigue Severity Scale (FSS) and Six-Minute Walk Test (6MWT). Statistical analysis was performed using the chi-square test and independent t-test. Results At baseline, no significant differences were observed between groups for FSS and 6MWT (p>0.05). The BET group reported better reduction in fatigue (FSS: 5.39 ± 0.18 to 3.48 ± 0.16, p<0.001) and improvement in physical endurance (6MWT: 202.03 ± 4.35 to 273.35 ± 6.26, p<0.001) than the control group (FSS: 5.25 ± 0.10 to 4.19 ± 0.06) (6MWT: 200.53 ± 2.72 to 222.70 ± 3.64). Conclusion Brain endurance training is a feasible and safe approach for reducing fatigue and improving physical endurance among stroke survivors.
Copyright (c) 2026 Jayasree Sai L, Prathap Suganthirababu, Dhanusia S, Harika Valluri https://creativecommons.org/licenses/by-nc-sa/4.0
The effect of war on displaced hemodialysis patients in Sudan
BACKGROUND The Sudan war has severely disrupted healthcare services, particularly for patients with end-stage renal disease (ESRD) dependent on regular hemodialysis. Conflict-related displacement, damaged infrastructure, medication shortages, and financial hardship have compromised dialysis continuity and patient outcomes. This study assessed the impact of war-related displacement on dialysis care among Sudanese hemodialysis patients. METHODS This cross-sectional observational study included 101 displaced ESRD patients receiving maintenance hemodialysis. Data collection comprised demographic characteristics, causes of ESRD, dialysis access and adequacy, treatment interruptions, complications, medication availability, hospital admissions, and functional status before, during, and after the war. Comparisons of dialysis parameters and functional status before, during, and after the war were performed using Cochran’s Q test. RESULTS War-related displacement was associated with statistically significant worsening of dialysis care. Dialysis frequency decreased from two to 1.5 sessions per week, and session duration declined from four to three hours (both p<0.05). Patients missed a median of one dialysis session per week. Consequently, out-of-pocket payment for medications surged from 42 (41.6%) pre-war to 93 (92.1%) during the war and persisted at 89 (88.1% in the current period (p<0.0001). Erythropoietin use declined from 98 (97.1%) to 39 (38.6%) (both at p<0.001). Displacement was also associated with significantly increased complications, hospitalizations, reduced medication adherence, and marked fatigue (p < 0.05). CONCLUSION War-related displacement significantly reduced dialysis adequacy, medication access, and continuity of care, resulting in increased morbidity. Immediate humanitarian and health-system interventions are essential to prevent excess mortality among displaced hemodialysis patients.
Copyright (c) 2026 Sara Mohamed Abdelgadir, Sufian Khalid Mohamed, Mohamed Osman Elamin, Wahaj A. Khan, Hatim O. Badri, Abdullah Muhammad Alzhrani, Osama Banah, Ahmed Alkathiri, Ahmed A. Osman, Fowzi O. Elamin https://creativecommons.org/licenses/by-nc-sa/4.0
Microbiota as a reservoir of antibiotic resistance genes: relevance and urgency
'Antimicrobial resistance' (AMR) is one of the top threats to global public health and developments.
Copyright (c) 2026 Naga Raju Maddela https://creativecommons.org/licenses/by-nc-sa/4.0
Gamma-oryzanol as a potential intervention for normalizing insulin secretion and pancreatic β-cell function
The bioactive substance gamma-oryzanol (GO), which is mostly present in rice bran oil, has attracted a lot of interest due to its possible therapeutic application in metabolic conditions like diabetes mellitus. The effects of GO on insulin secretion and pancreatic β-cell function are examined in this study. Gamma-oryzanol improves β-cell viability, lowers oxidative stress, and modifies intracellular signaling pathways linked to glucose metabolism, all of which increase insulin secretion, according to experimental and clinical evidence. Additionally, GO's anti-inflammatory and antioxidant qualities shield β-cells from dysfunction and apoptosis brought on by hyperglycemia and lipid toxicity. Relevant studies were identified through a systematic search of PubMed, ScienceDirect, and Google Scholar for articles published between 2017 and 2026 using the keyword “gamma-oryzanol”, “insulin secretion”, ‘pancreatic β-cell function”. Additionally, the substance seems to support glucose homeostasis and pancreatic function by upregulating important genes involved in insulin synthesis and secretion. All things considered, GO shows great promise as a natural agent for maintaining β-cell integrity and increasing insulin secretion, providing a novel complementary approach to managing diabetes. Gamma-oryzanol is frequently linked to anti-inflammatory, anti-cancer, anti-diabetic, and cholesterol-lowering properties. Because Orz reduces insulin activity, cholesterol metabolism, and associated chronic inflammation, its potential to treat metabolic diseases has recently been investigated. After apoptosis and increased endoplasmic reticulum (ER) stress were decreased, oral GO administration increased glucose-stimulated insulin secretion in islets from diabetic mice fed a high-fat diet. We also examined the effects of GO on low-dose streptozotocin-induced diabetic mice, which demonstrated elevated ER stress and consequent β-cell apoptosis. Furthermore, γ-oryzanol improved glucose dysmetabolism in this model by lowering the mRNA levels of genes linked to apoptotic signaling and ER stress in islets. All things considered, GO shows encouraging potential as a natural agent for enhancing insulin secretion and maintaining the integrity of β-cells, providing a new complementary strategy for controlling and preventing diabetes.
Mamoun Abdelwahab Mohammed Elamin Alfaki
Copyright (c) 2026 Mamoun Abdelwahab Mohammed Elamin Alfaki, Md Nadeem Bari, Md Rizwan Ansari, Imran Mohammad, Mohammad Anwar https://creativecommons.org/licenses/by-nc-sa/4.0
Machine learning models for predicting 48-hour mortality in acute intracerebral hemorrhagic stroke
BACKGROUND Identifying patients with intracerebral hemorrhagic (ICH) at high risk of mortality is crucial for timely intervention. Machine learning (ML) offers novel methodologies for precise predictive models for ICH. Therefore, the aim of this study was to develop an ML-based predictive model for 48-hour mortality in patients with acute hemorrhagic stroke. METHODS A cross-sectional study was conducted using secondary data from 657 patients diagnosed with acute ICH. Demographic, clinical, laboratory, and radiological variables were extracted from medical records. Data preprocessing included cleaning, normalization, and class balancing using the Synthetic Minority Oversampling Technique (SMOTE). Three supervised algorithms—Random Forest, Decision Tree, and Gaussian Naïve Bayes—were developed and evaluated using stratified 5-fold cross-validation. Model performance was assessed using accuracy, sensitivity, specificity, precision, recall, F1-score, and AUC. RESULTS Random Forest achieved the best overall performance for predicting 48-hour mortality, with an accuracy of 84.77%, F1-score of 84.63%, and AUC of 80.51, outperforming Decision Tree (AUC 61.12) and Gaussian Naïve Bayes (AUC 82.94). Random Forest most accurately identified >48-hour survival, with high sensitivity (93.5%) and PPV (92.9%), while Naïve Bayes provided the most reliable positive classification for this category (PPV 99.0; specificity 94.2%). For ≤24-hour mortality, Naïve Bayes showed the best detection performance (sensitivity 85.4%; NPV 98.7%). CONCLUSIONS Machine learning, particularly the Random Forest algorithm, enables reliable prediction of 48-hour mortality in patients with acute ICH using basic clinical and radiological data available at admission. The model offers practical potential for early risk stratification in emergency and critical care settings.
Copyright (c) 2026 Intan Kemaladina, Syahrul Syahrul, Taufik Fuadi Abidin, Nasrul Musadir, Imran Imran https://creativecommons.org/licenses/by-nc-sa/4.0
Role of global deoxyribonucleic acid methylation and molecular hypoxia changes in male infertility
Infertility is recognized as a major global health issue and has become one of the primary challenges in reproductive health; its prevalence and incidence are steadily increasing worldwide. Recent research has highlighted the critical role of epigenetic dysregulation as a direct factor affecting male infertility. The objective of this review is to investigate the relationship between epigenetic modifications (specifically 5-methylcytosine and 5-hydroxymethylcytosine) and essential male reproductive outcomes, including the spermatogenesis process, testicular function, and semen quality parameters. Furthermore, this study explores the influence of micronutrients such as vitamin B12, homocysteine metabolism, and antioxidant capacity on DNA methylation and genomic stability. Significantly, this review establishes a novel link between infertility and cellular hypoxia focusing on the modulation of hypoxia-inducible factor (HIF-1α and HIF-2α) as a potential therapeutic strategy. Additionally, this work introduces the overlooked association between HIF-2α and infertility, offering novel insights since current findings regarding HIF-2α in male infertility are remarkably limited. A literature search was conducted on PubMed, ScienceDirect, Springer Link, Oxford Academic and Nature databases for sources published in English from 2015 to 2025, using the following keywords: male infertility, DNA methylation, hypoxia, HIF-1α, and immunity. Our work investigates the interruption of inflammatory cytokines and immunological markers by linking them with molecular factors, micronutrients and hypoxia pathways. This approach provides an integrated foundation for advanced diagnostic and therapeutic strategies. Ultimately, understanding these molecular signatures provides ways to enhance reproductive outcomes and improve success rates of assisted reproductive techniques.
Copyright (c) 2026 Zainab Abdul Jabbar, Rakad Mohammed Khamas AL-Jumaily https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical significance of pre-operative prognostic nutritional index in predicting survival in patients with renal cell carcinoma
Background Renal cell carcinoma (RCC) is a prevalent urologic malignancy with heterogeneous outcomes even after surgery. Conventional prognostic factors are insufficient to capture host-related influences on survival. The prognostic nutritional index (PNI), derived from serum albumin and lymphocyte count, reflects nutritional and immunological status and has emerged as a potential prognostic biomarker. The objective of this study was to determine preoperative PNI in predicting survival outcomes of RCC patients. Methods This was a retrospective cohort study involving 107 RCC patients who underwent radical or partial nephrectomy. Patients were categorized into normal and low PNI. Associations between PNI and clinicopathological features were assessed, while survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Results Patients’ mean age was 53.1 ± 13.5 years, and 58.9% of the patients were male. Clear cell carcinoma was the most common histological type (69.2%). Low PNI was significantly associated with older age (p=0.04), metastatic disease (p<0.001), and advanced tumor stage (p=0.014). Kaplan–Meier analysis demonstrated significantly poorer survival in the low-PNI group (p<0.001). In the multivariate Cox model, PNI remained the strongest independent predictor of overall survival (HR = 0.29, 95% CI: 0.13–0.67, p=0.003), while metastasis also retained independent significance (HR = 2.04, 95% CI: 1.06–3.93, p=0.031). Conclusion The PNI is an independent, simple, and cost-effective prognostic factor for overall survival in RCC. Incorporating PNI into preoperative risk stratification may enhance clinical decision-making. Therefore, PNI could be used as an effective prognostic indicator in RCC.
Copyright (c) 2025 Eldo Taufila Putra Utama, Raden Danarto https://creativecommons.org/licenses/by-nc-sa/4.0
Association of toxoplasmosis with risk factors among adults in Duhok Province, Kurdistan Region, Iraq
BACKGROUND Toxoplasma gondii is a widespread zoonotic parasite that infects approximately one-third of the global population. Humans become infected mainly by consumption of undercooked meat or water or fruits and vegetables contaminated with oocysts. This study aimed to investigate the seroprevalence of toxoplasmosis and associated risk factors in adults from Duhok province, Iraq. Methods A cross-sectional study was conducted with 600 participants (ages 22–60 years, both genders) from Duhok. Variables included age, gender, occupation, interaction with cats, and hygiene practices were collected. Blood samples were analyzed for anti-Toxoplasma IgM and IgG antibodies, using ELISA. Multiple logistic regressions were used to identify risk factors for toxoplasmosis. Results The overall seroprevalence was 39.17% (IgG: 31.67%, IgM: 7.5%). Both IgM and IgG prevalence were significantly associated with gender (p<0.001). IgG was more prevalent in participants aged 31–40 years (p<0.001). Key risk factors included cat contact (aOR=4.50, 95% C.I.: [2.10, 9.50], p<0.001), drinking tap water (aOR=3.00, 95% C.I.: [1.50, 6.00], p=0.005), consuming undercooked meat (aOR=3.20, 95% C.I.: [2.00, 5.30], p<0.001), eating unwashed vegetables (aOR=2.50, 95% C.I.: [1.50, 4.30], p<0.001), eating outside home (aOR=2.50, 95% C.I.: [1.50, 4.00], p<0.001), and a history of arthritis (aOR=3.00, 95% C.I.: [2.00, 4.50], p<0.001), hygiene practices, such as handwashing (aOR=0.30, 95% C.I.: [0.15, 0.60], p=0.001) and hygienic measures (aOR=0.35, 95% C.I.: [0.20, 0.60], p<0.001), reduced risk former Covid-19 (aOR=7.00, 95% C.I.: [3.50, 14.00], p<0.001). Conclusions Toxoplasmosis in Duhok is associated with dietary habits, sanitation, and cat contact. Enhancing hygiene and food safety can reduce the disease burden, particularly in immunocompromised individuals.
Copyright (c) 2026 Mustafa Riadh Hussein, Wijdam Mero https://creativecommons.org/licenses/by-nc-sa/4.0
Umbilical cord mesenchymal stem cells and their secretome: a new frontier in orthopedic medicine
Umbilical cord mesenchymal stem cells (UC-MSCs) have gained significant attention in regenerative medicine due to their unique biological properties, including high proliferation capacity, low immunogenicity, and potent immunomodulatory effects. These characteristics make UC-MSCs particularly promising for orthopedic applications, where the repair and regeneration of musculoskeletal tissues such as bone, cartilage, tendons, ligaments, and nerves are critical for restoring function. The secretome of UC-MSCs—comprising bioactive molecules such as exosomes, cytokines, and growth factors—offers a powerful, cell-free therapeutic option through paracrine signaling, further enhancing their therapeutic potential. A literature search was conducted in major databases (PubMed, ScienceDirect, SpringerLink, Google Scholar) for English articles from 2010–2025 using keywords related to UC‑MSCs and orthopedic regeneration. This review explores the role of UC-MSCs and their secretome in orthopedic tissue repair, focusing on their application in bone healing, cartilage regeneration, tendon-ligament repair, and nerve regeneration with their innovative delivery. Despite the promising potential of UC-MSC therapies, several challenges remain, including regulatory hurdles, long-term safety concerns, and the scalability of cell-based and secretome-based therapies for widespread clinical use. Although umbilical cord MSCs are not yet widely applied in clinical practice, increasing evidence suggests that they offer significant therapeutic potential, especially in the treatment of autoimmune and neurodegenerative diseases. The UC-MSCs and their secretome represent a transformative approach in orthopedics, offering new avenues for treating complex musculoskeletal injuries and degenerative diseases. Ongoing advancements in this field will likely unlock their full potential, making them viable options for clinical use in the near future.
Umbilical cord-mesenchymal stem cells (UC-MSCs)
Copyright (c) 2026 Tito Sumarwoto, Romaniyanto, Sholahuddin Rhamtomy, Mujaddid Idulhaq, Asep Santoso https://creativecommons.org/licenses/by-nc-sa/4.0
Validity of core needle biopsy in diagnosing primary thyroid lymphoma: a systematic-review and meta-analysis
Background Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, accounting for less than 5% of thyroid malignancies. The prognosis of PTL depends on the histologic subtype and stage of disease at diagnosis, hence an effective diagnostic method is needed to ensure prompt treatments. Fine needle aspiration (FNA) is the first test for microscopic examination of a rapidly enlarging thyroid mass, but its limitations and low sensitivity have been observed. After the often “inconclusive” result is known, core-needle biopsy (CNB) should be performed as the natural next diagnostic step. This systematic review and meta-analysis aimed to evaluate the diagnostic value of core needle biopsy (CNB) in diagnosing PTL. Methods This systematic review and meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A PubMed and Embase database search was performed in August 2025. Populations included were patients with final diagnosis of PTL. Pooled sensitivity was calculated using a random-effects model. Results This systematic review and meta-analysis of 12 studies comprised a total of 1091 patients. Core needle biopsy proved to be highly effective, with a pooled sensitivity of 91.6% (95% CI: 82.1%–96.3%). The development of tumor-cell seeding following CNB has been a major concern, but this complication is extremely rare. Other potential complications include bleeding and infection. Conclusion Core needle biopsy demonstrates high diagnostic sensitivity and a favorable safety profile in diagnosing primary thyroid lymphoma, supporting its role as a valuable diagnostic modality, particularly when PTL is clinically suspected or FNA results are inconclusive.
Copyright (c) 2026 Kevin Varian Marcevianto, Nadira Prajnasari Sanjaya, Indira Saraswati Sanjaya, Kelvin Kohar, Hayatun Nufus https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Muay Thai training frequency on VO2 max and muscle endurance in non-athletic adults: a randomized clinical trial
Background Urban lifestyles have become increasingly sedentary, contributing to reduced physical fitness. Muay Thai, a high-intensity martial art, has been proposed as an effective exercise modality to improve aerobic capacity and muscle endurance. This study aimed to evaluate the effects of different weekly Muay Thai training frequencies on VO₂ max and muscle endurance in non-athletic adults. Methods A randomized experimental study with a pre-test–post-test design was conducted involving 40 non-athletic adults (aged 20–25 years). Participants were randomly allocated into two groups: training twice weekly (MT2X) or four times weekly (MT4X) for eight weeks. Outcomes included VO₂ max and upper, abdominal, and lower body muscle endurance. Baseline characteristics were described descriptively. Between-group differences in post-intervention outcomes were analyzed using analysis of covariance (ANCOVA), with baseline values included as covariates. Results At baseline, VO₂ max, abdominal, and lower body muscle endurance were higher in the MT4X group. After adjustment for baseline values using ANCOVA, the MT4X group demonstrated significantly higher post-intervention VO₂ max compared with the MT2X group (adjusted mean difference, p<0.001). Significantly greater improvements favoring the MT4X group were also observed for upper body muscle endurance (push-ups, p<0.001), abdominal muscle endurance (sit-ups, p<0.001), and lower body muscle endurance (squats, p=0.018). Conclusion A higher frequency Muay Thai training program is effective in significantly improving participants' aerobic capacity and muscle endurance. Practitioners are able to choose their training frequency preference, since both frequencies provide similar adaptation.
Copyright (c) 2026 Al Husni Hadi Pasca Putra, Julia Windi Gunadi, Yenni Limyati, Oeij Anindita Adhika https://creativecommons.org/licenses/by-nc-sa/4.0
Hypoxic mesenchymal stem cell-derived secretome and alkaline water synergistically reduce apoptosis and insulin resistance in type 2 diabetes mellitus rat model
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is characterized by chronic inflammation and insulin resistance. These factors contribute to pancreatic β-cell apoptosis, reducing insulin production and impairing glucose homeostasis. This study aims to evaluate the protective effects of hypoxic mesenchymal stem cell-derived secretome (HMSCS) and alkaline water on inflammation, apoptosis, and insulin resistance in a T2DM rat model. METHODS An experimental study was conducted involving 24 male Wistar T2DM model rats (aged 6-8 weeks, 200-250g). They were randomized into four groups: T2DM rats only as negative control (K-), T2DM rats with metformin as positive control (K+), HMSCS treatment (P1), and HMSCS plus alkaline water group (P2). Caspase-3 expression was measured to assess apoptosis levels using RT-PCR, while homeostatic model assessment for insulin resistance (HOMA-IR) was measured using ELISA. One way ANOVA followed by a post hoc LSD test were used to analyse the data. RESULTS The P1 group (3.03 ± 1.26 a.u) and P2 group (2.93 ± 0.52 a.u.) had significantly lower caspase-3 expression compared to K- group (6.66 ± 2.76 a.u.) (p<0.05), but were not significantly different from K+ group (3.83 ± 1.61 a.u.) (p>0.05). Additionally, P2 group (6.76 ± 0.96) had a significantly lower HOMA-IR than K- group (18.92 ± 2.63) and K+ group (10.85 ± 1.39) (p<0.05), and similarly the P1 (7.71 ± 0.53) group also showed significant difference from K- and K+ groups (p<0.05). CONCLUSION Higher doses of HMSCS and alkaline water are associated with reduced pancreatic β-cell apoptosis and improved insulin sensitivity, highlighting its potential as a novel therapeutic approach for T2DM.
Copyright (c) 2025 Melissa Septi Mawarini, Eko Setiawan, Agung Putra https://creativecommons.org/licenses/by-nc-sa/4.0
Association between homicide and myocardial infarction mortality: a population-level analysis in Mexico from 2000 to 2019
Background Globally, violent deaths represent a serious public health issue, and Mexico has shown an increase in homicides. Exposure to violence has been linked to adverse mental and physical health outcomes, including cardiovascular disease. However, population-level evidence linking homicide mortality to myocardial infarction (MI) mortality remains limited. This study assesses the association between homicides and mortality from myocardial infarction in Mexico from 2000 to 2019. Methods This ecological time-series study used national mortality data from the Mexican National Institute of Statistics and Geography (INEGI). Adjusted annual mortality rates were calculated. Mortality trends were evaluated using Joinpoint software. The association between homicides and other causes of mortality was analyzed using Pearson correlation and univariate and multivariate regression analyses. Results During the study period, the average adjusted mortality rates were 16.8/100,000 for homicides and 67.4/100,000 for myocardial infarction. Both homicide and MI mortality rates increased significantly over time. In simple linear regression, homicides only showed significant associations with myocardial infarction (B=0.55, p<0.05). In multivariate regression analyses, homicide mortality remained significantly associated with MI mortality after adjustment for unemployment, gross domestic product per capita (GDP-PC), and diabetes mortality, although the association was attenuated when suicide mortality was included in the model. Conclusion At the population level, from 2000 to 2019 both homicide and MI mortality rates increased significantly, while homicides were positively associated with myocardial infarction mortality in Mexico. Elevated homicide rates act as a population-level stressor that coincides with higher mortality from heart attacks.
Copyright (c) 2026 Omar González-Santiago https://creativecommons.org/licenses/by-nc-sa/4.0
Bench to bedside and beyond: evolving trends in translational research
Copyright (c) 2025 Juhi Aggarwal https://creativecommons.org/licenses/by-nc-sa/4.0
Application of international classification of functioning, disability and health in salat: a scoping review
Background Salat has been linked to physical, cognitive, emotional and psychological health benefits. This scoping review classifies the health benefits of salat based on the International Classification of Functioning, Disability, and Health (ICF) conceptual framework. The ICF illustrates how Salat may be used as a multi-modal and multidisciplinary framework to rehabilitate clients with different conditions tailored to their clinical, psychosocial and environmental contexts. Purpose To conduct a scoping review on the health benefits of salat (muslim prayer) based on the ICF conceptual framework. Methods A literature review was conducted from February to April 2023 using PubMed, EBSCO, and the Scopus Library databases. Articles published between 2012 and 2023 were retrieved using the following keywords: "impact" OR "effect" OR "health benefit" OR "functional outcome" AND "shalat" OR "Muslim prayer" OR "Salat”. Health benefits of salat were subsequently categorised into five domains of the ICF. Results A total of 596 articles were identified through PubMed (404), EBSCO (124), and Scopus (68). Thirty-one records met the predefined inclusion criteria: 21 original articles, two systematic reviews, five literature reviews, one case study, one case series, and one short report. Salat had positive benefits on the cardiorespiratory, haematological, immunological, mental and neuromuscular functions. Salat may serve as a coping mechanism to reduce stress and depression. The frequency and duration of salat had positive associations with maintaining employment, social support and better quality of life. Conclusion Salat is associated with many health benefits, which can be categorised systematically and summarised using the ICF conceptual framework.
International Classification of Functioning
Copyright (c) 2025 Irma Ruslina Defi, Intan Sabrina Mohamad, Nuzula Chafidh Al Barqi, Adziqa Ammara Qiantori, Andri Qiantori https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of cross-running polypropylene intradermal suture technique on keloid scar: a single-blind randomized controlled trial
BACKGROUND Keloids are abnormal scars that present a therapeutic challenge. Various treatment modalities have been developed, including surgical excision. While cross-running intradermal sutures were previously created using absorbable polyglycolic acid, this study introduces a modification using a non-absorbable material. Therefore, this study aimed to evaluate the effect of the cross-running polypropylene intradermal suture (CR-PIS) technique compared to the simple interrupted suture technique on keloid repair. METHODS This was a randomized controlled trial with a post-test-only design involving 30 male and female keloid patients aged 20-50 years. Participants were randomized into the treatment group (n=15) and the control group (n=15). Wound assessment using the Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS) was performed at 3, 6, and 9 months after surgery. Differences in VSS, MSS, and POSAS scores between the CR-PIS group and the simple knot group were analyzed using the Mann-Whitney U test. RESULTS Statistical analysis revealed a significant difference between the simple knot and CR-PIS groups (p<0.05). The median scores for each assessment (VSS, MSS, and POSAS) decreased significantly at 3, 6, and 9 months, with the control group's values being higher than those in the CR-PIS group (p<0.05). These results indicate that the control group developed moderate scars, whereas the treatment group exhibited good scars. CONCLUSIONS The CR-PIS is more effective than the simple knot technique in improving keloid scars, as shown by changes in wound appearance, morphological function, topography, and patient and evaluator assessments.
Copyright (c) 2026 Herman Yosef Limpat Wihastyoko, Edith Sumaregita Rinhastyanti, Arviansyah Arviansyah, Yudi Siswanto, Wilma Agustina, Elisabeth Prajanti Sintaningrum https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of astaxanthin supplementation on oxidative stress in adult women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials
Background Polycystic ovary syndrome (PCOS) can cause significant morbidity through fertility disorders and most often found in the productive age. Recent research suggests that oxidative stress plays an important role in the pathogenesis of PCOS. Astaxanthin (AST) has broad protective effects, particularly in the regulation of antioxidant and anti-inflammatory activity. The objective of this systematic review and meta-analysis was to evaluate the efficacy of AST supplementation on PCOS management. Methods A systematic literature search was conducted in PubMed, Scopus, Science Direct, and Cochrane Library from January 2020 to March 2025. Randomized controlled trials (RCTs) assessing astaxanthin supplementation in adult women with PCOS were included. Outcomes of interest were malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAC). Data were analyzed using Review Manager (RevMan) version 5.4.1. Pooled effects were calculated as mean differences (MDs) with 95% confidence intervals (CIs). Results Four RCTs involving 194 participants were included. Astaxanthin supplementation significantly reduced MDA levels (MD −0.670; 95% CI −1.070 to −0.270; p = 0.001; I² = 93%) and significantly increased TAC levels (MD 0.030; 95% CI 0.000 to 0.060; p = 0.030; I² = 76%). No significant effect was observed on SOD levels (MD 0.025; 95% CI −0.850 to 1.350; p = 0.660; I² = 57%). The overall risk of bias across included studies was low. Conclusion This systematic review shows that AST supplementation significantly reduced lipid peroxidation in women with PCOS. These findings suggest that AST may serve as potential adjuvant antioxidant therapy in PCOS management.
Copyright (c) 2026 Donna Pratiwi, Agustinus I Wayan Harimawan, I Wayan Weta, Ni Ketut Sumartini, Syuma Adhy Awan, I Wayan Gede Sutadarma https://creativecommons.org/licenses/by-nc-sa/4.0
Andrographis paniculata: a review of pharmacology and clinical efficacy
Andrographis paniculata is widely regarded as one of the most important medicinal plants due to its broad therapeutic value and global use in traditional medicine. Commonly known as Kalmegh, creat, or green chirayata, the plant has been an integral part of Ayurvedic, Siddha, Unani, and other traditional healing systems for centuries. It has traditionally been consumed to manage a variety of ailments, particularly those related to the liver, respiratory system, and immune health. Phytochemical investigations have revealed that Andrographis paniculata is rich in diverse bioactive constituents. Among these, andrographolide, neoandrographolide, and didehydroandrographolide are the most prominent diterpenoid lactones. Andrographolide, in particular, is recognized as the principal active compound and has been extensively studied for its wide pharmacological spectrum. Research indicates that andrographolide exhibits strong hepatoprotective, antioxidant, anti-inflammatory, immunomodulatory, antibacterial, antipyretic, anti-diabetic, and anti-cancer activities. These properties contribute to the plant’s reputation as a versatile therapeutic agent. In this review, we systematically searched and analyzed articles published in English from 2019 to 2025, using PubMed, ScienceDirect, Springer Link, and Google Scholar. Relevant search terms included “Andrographis paniculata”, pharmacology”, “clinical efficacy”, “safety”, etc. Given its chemical richness and diverse pharmacological actions, Andrographis paniculata continues to attract scientific attention. Numerous studies support its potential in managing chronic diseases, enhancing immune function, and mitigating oxidative stress. This review aims to provide a concise yet comprehensive overview of the plant’s therapeutic relevance, highlighting its major chemical constituents and summarizing key findings from pharmacological evaluations and clinical safety and efficacy reported in the scientific literature. By synthesizing existing knowledge, this review emphasises the significance of Andrographis paniculata as a promising natural resource in herbal medicine and modern pharmacotherapy.
Copyright (c) 2026 Sangita Boro, Manisha Chirania, Deepjyoti boro, Bhriganka Bharadwaj, Mitali Baruah, Minakshi Bhattacharjee https://creativecommons.org/licenses/by-nc-sa/4.0
Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center
Background As people age, skeletal muscle mass and strength decrease, leading to sarcopenia, diagnosed through calf circumference, muscle mass, strength, and physical performance. Uric acid (UA), with both pro-oxidant and antioxidant properties, is an indicator of oxidative stress and may contribute to sarcopenia. This study aimed to determine the correlation between serum uric acid levels and sarcopenia in elderly in a community health center. Methods A cross-sectional study was conducted involving 42 subjects aged ≥60 years, consisting of 37 female and 5 male participants. We applied Asian Working Group for Sarcopenia (AWGS) 2019 criteria to define sarcopenia. Muscle mass was measured using skeletal muscle index (SMI) based on bioimpedance analysis (BIA). Handgrip strength (HGS), physical performance, calf circumference, and blood test data were collected. A backward regression analysis was performed to investigate the relationship between UA and SMI, HGS, physical performance, and calf circumference after adjusting for gender, smoking history, upper arm circumference, and body mass index. Results After adjusting for potential confounding variables, uric acid remained significantly associated with muscle strength (β=0.326; p=0.023) and calf circumference (β=0.264; p=0.010), but not with muscle mass (β=0.046; p=0.727) or physical performance (β=–0.171; p=0.279). Conclusion There is a significant correlation between uric acid levels and muscle strength, physical performance, and calf circumference in sarcopenia among the elderly in the community health center. Higher uric acid serum levels might slow down the progression of sarcopenia.
Copyright (c) 2025 A. Deza Farista, Nur Rivianti https://creativecommons.org/licenses/by-nc-sa/4.0
An integrative review on the shadow of abuse in pediatric head trauma
Introduction Abusive head trauma (AHT) is a significant public health issue that can lead to severe neurological damage or death in childhood. Often difficult to detect, AHT carries long-term consequences and requires high diagnostic vigilance. This integrative review aims to synthesize the current evidence on abusive head trauma in pediatric patients by identifying distinguishing diagnostic criteria, clinical patterns, and risk factors, in order to support early recognition, accurate diagnosis, and effective intervention strategies by healthcare professionals. Methods This integrative review aimed to systematically include studies published between 2020-2025 and the literature search was conducted in April-June 2025. The databases searched included PubMed and Web of Science. The keywords included in the search were "Abusive head trauma", "child abuse", "non-accidental head injury", "health care professional", "pediatric head trauma". The methodological quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Results The findings were synthesized under four main themes: diagnostic indicators and differentiation, epidemiological risk factors, short-term clinical outcomes, and long-term developmental effects. Elevated glucose levels (>300 mg/dL), the diagnostic “triad” (subdural hematoma, retinal hemorrhage, and encephalopathy), and increased plasma osteopontin levels were identified as critical diagnostic clues. Additionally, household composition and caregiver characteristics emerged as significant risk factors. Conclusion This integrative review highlights the necessity of identifying high-risk environments and implementing preventive strategies. The evidence presented offers practical, evidence-based insights to support healthcare professionals in accurately diagnosing and managing AHT. It also underscores the need for multidisciplinary prevention efforts and post-trauma monitoring. Ultimately, this study seeks to enhance clinical awareness and improve early identification and intervention strategies for children suffering from abuse-related head trauma.
Copyright (c) 2025 Semra SÖNGÜT https://creativecommons.org/licenses/by-nc-sa/4.0
Life satisfaction: a sustainable perspective in old age-physical and mental health
Life satisfaction is a subjective concept that reflects individuals’ overall evaluation of their life. It is closely associated with the physical and mental health of older adults. The sustainability of life satisfaction among the elderly is important for both individual happiness and societal well-being for public health. This literature study aims to provide a sustainable perspective by examining the factors influencing life satisfaction in old age through both physical and mental dimensions. This study, designed as a literature review, was prepared by scanning studies published in the last five years (2021-2025) in PubMed, Scopus and Science Direct databases. Older adults with high life satisfaction tend to form healthier relationships with their surroundings, access health services more consciously, and interact more actively with society. In this context, addressing life satisfaction in old age from a physical and mental health perspective contributes to achieving sustainable well-being at both the individual and societal levels. The literature demonstrates that life satisfaction in older adults is directly related to their physical and mental health status. The majority of participants reported that the presence of chronic diseases, mobility limitations, and loss of independence in daily activities negatively affected their life satisfaction. In terms of mental health, symptoms of depression, social isolation, and feelings of loneliness emerge as significant determinants of reduced life satisfaction. The review found that protective factors such as regular health check-ups, an active lifestyle, the presence of social support systems, and support for psychological well-being significantly enhance life satisfaction. Additionally, developing a positive attitude towards aging and having meaningful life goals play a vital role in ensuring sustainable life satisfaction. Based on the literature review, developing policies, practices, and supportive services aimed at improving life satisfaction in older adults is of great importance for promoting healthy and active aging.
Copyright (c) 2025 Ayşe ÇALMAZ, Gülay YILMAZEL https://creativecommons.org/licenses/by-nc-sa/4.0
Fragrance preference of essential oil blends for reducing stress and sleep problems in adult women
Background Aromatherapy with a blend of essential oils is an alternative treatment for stress and sleep disturbances, providing stress relief and sleep enhancement, while increasing the efficacy and scent appeal. This study aimed to formulate an essential oil blend with the potential to reduce stress and enhance sleep quality, and to identify the most preferred blend based on participant satisfaction. Methods A cross-sectional study was conducted involving 63 female volunteers aged 25 - 50 years. Three formulations (A, B, and C) of essential oil blends were developed, each with a distinct scent profile—floral, unisex, and aromatic. A preference test was conducted using a sensory evaluation method, assessing participants’ satisfaction of the blends through inhalation. Preferences were quantified using a structured scoring system. Formula B was the most popular and was further refined into two recipes, B1 and B2. B2 emerged as the preferred option, and its primary component was identified using gas chromatography-mass spectrometry (GC–MS). Results Formulation B, rich in bergamot oil, received significantly higher hedonic ratings than Formulation A (p<0.05) and was the most preferred in interviews. Participants recommended a milder, more balanced scent for relaxation and sleep. While B1 and B2 showed no significant differences, B2 was chosen for its higher bergamot content, fresher unisex profile, and reduced floral notes. GC–MS analysis identified limonene, menthol, and linalool as its main components. Conclusion This study demonstrated that an essential oil blend predominantly composed of bergamot oil was most favored by the volunteers, indicating its potential benefits for promoting relaxation.
Copyright (c) 2025 Kanchanapa Sathirachawan, Kosum Chansiri, Deeprom Sirikate , Phakkharawat Sittiprapaporn, Ruttachuk Rungsiwiwut, Somrudee Saiyudthong https://creativecommons.org/licenses/by-nc-sa/4.0
Myosin heavy chain as biomarker in the prevention of sarcopenia
Sarcopenia, or the age-related loss of skeletal muscle mass and function, can reduce total muscle contractile capacity and increase the likelihood of physical disability in older adults. The loss of muscle mass and contractile performance is generally thought to be multifactorial, with as possible contributing factor an age-related shift in the expressed amounts of myosin heavy chain (MyHC) isoforms. The composition of adult human skeletal muscle consists of a mixture of three distinct MyHC isoforms (I, IIA, and IIX). This literature review aimed to explore studies focused on the signs of sarcopenia, the early detection of initial symptoms, and awareness among the aging population. We aimed to understand the molecular changes in muscle fibers as people age and to help inform the early intervention approach to prevent sarcopenia. The literature search was conducted in several databases between 2020 to 2025, including PubMed, ScienceDirect, and SpringerLink. The search terms consisted of “sarcopenia”, “muscle mass”, “early detection”, and “myosin heavy chain”. Inclusion criteria included original full-text English-language studies on the cellular and molecular physiology of sarcopenia. Molecular changes in myosin heavy chain vary across different age groups, suggesting the potential for early detection of muscle aging. The review is limited by the variability in the definition and measurement of sarcopenia across different studies, which may affect the generalizability of the findings. This review highlights the potential significance of identification and sarcopenia management in elderly individuals. The findings would be helpful for clinicians, researchers, and policymakers to improve elderly care and quality of life.
Copyright (c) 2026 Desy Nofita Sari, Imelda Rosalyn Sianipar, Roman Ardian Goenarjo https://creativecommons.org/licenses/by-nc-sa/4.0
Angiogenesis in rheumatoid arthritis: epidemiology, pathogenesis, signal transduction pathways, and nano-targeted therapeutic strategies
Angiogenesis is the formation of new blood vessels from existing vessels. In rheumatoid arthritis (RA), new blood vessels maintain a chronic inflammatory state by transporting inflammatory cells to the site of inflammation. Rheumatoid arthritis is a chronic autoimmune disorder that affects approximately 1% of the global population, with a higher prevalence in women. It is characterized by synovial inflammation, hyperplasia, and angiogenesis, leading to joint destruction. Understanding the pathogenesis of RA, particularly the mechanisms driving synovial angiogenesis, is crucial for the development of targeted therapies. Fibroblast-like synoviocytes (FLS) and endothelial cells play key roles in RA pathogenesis by secreting pro-inflammatory cytokines and growth factors, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β, IL-6, and vascular endothelial growth factor (VEGF). These mediators activate multiple signaling pathways, including VEGF, nuclear factor kappa light chain enhancer of activated B cells (NF-κB), phosphatidylinositol-3 kinase (PI3K)/AKT, mitogen-activated protein kinase (MAPK), wingless-related integration site (Wnt), and the Janus kinase (JAK)/ signal transducer and activator of transcription (STAT), which contribute to synovial angiogenesis, inflammation, and joint damage. A literature search was conducted on PubMed, ScienceDirect, SpringerLink, and Google Scholar databases for sources published in English from 2015 to 2025, using the terms “nanotechnology rheumatoid arthritis,” “angiogenesis,” “synovial inflammation,” “pro-inflammatory cytokines,” “disease-modifying antirheumatic drugs,” and “signal transduction pathways”. Current treatments for RA include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs) (conventional synthetic, biological, and targeted synthetic). An informative overview of anti-angiogenic strategies for treating RA, which may provide new perspectives for developing nanoagents, is opening new horizons in the fight against RA. This review covers RA epidemiology, pathogenesis, and signal transduction, as well as current therapies and their limitations, highlighting the need to develop new treatment strategies that target angiogenesis in RA.
Copyright (c) 2025 Joan Blin, Mohd Rohaizad Md Roduan, Roslida Abd Hamid https://creativecommons.org/licenses/by-nc-sa/4.0