Introduction: People with HIV/AIDS (PLHIV) frequently suffer from psychosocial issues like anger rejection and de-pression as a result of their illness. It is hoped that under these circumstances people living with HIV will be able to find the strength to overcome obstacles. To enhance physical and mental health which is linked to a higher quality of life and the ability to adapt to illness individuals must develop and preserve resilience. The purpose of this study was to examine how PLHIV quality of life and resilience are related. Methods: This research used a correlational design on 185 PLHIV that registered in AIDS Commission (KPA) in Tulungagung Regency, East Java, who were selected using a simple random sampling technique. Research variables in the form of resilience and quality of life were mea-sured using Resilience Scale for Adults (RSA) and The World Health Organization Quality of Life (WHOQoL) and analyzed using spearman correlation. Results: The results showed that there was a significant relation
Introduction: Baby with cleft lip and palate are underweight due to inadequate nutritional status, which puts their physical growth at risk. This can have an impact on malnutrition. The research aims to determine the relationship between the type of cleft palate and the weight of cleft-lip and palate aged 0-5 years, as well as to map the general picture and find out the research themes that have been researched in nutrition and cleft studies which can strength-en the research findings. Methods: A cross-sectional study design with a total sample of 110 based on data at Paru Jember Hospital Indonesia. Analysis uses Spearman's rho and z score statistics. Later, the bibliometric analysis was performed based on the Google Scholar and Scopus data based. Results: Statistical tests (p=0.755), correlation co-efficient (0.30). The z score for cleft type on body weight (1.759 ± 1-5). The bibliometric analysis of 980 articles contained 4 main keywords, one of which was "nutritional" AND "cleft lip and palate" which had 7
Introduction: Groundwater is the most widely used source of potable water worldwide. However, the presence of enteropathogenic bacteria in drinking-water systems poses a growing public health concern, particularly in develop-ing regions. This study aimed to assess the bacteriological quality of domestic groundwater in Jember, East Java, and to identify the presence of waterborne pathogens associated with gastrointestinal infection. Methods: A total of 42 groundwater samples were collected from household dug wells and analysed for total coliform counts. The presence of Escherichia coli and Salmonella sp. was confirmed using selective culture media and standard microbiological procedures in accordance with WHO drinking-water quality guidelines. Results: Only 3 of the 42 samples (7.1%) complied with the WHO standard of zero coliforms per 100 mL. In contrast, 29 samples (69%) were contaminated with enteropathogenic bacteria, predominantly E. coli and Salmonella sp., indicating faecal pollution and a poten-tial risk of waterborne disease transmission. Conclusion: These findings highlight the need for improved household water treatment, enhanced sanitation practices, and routine microbiological monitoring. Strengthening public health interventions is essential to ensure safe groundwater consumption and to reduce the risk of gastrointestinal infections in the Jember community.
Introduction: Tuberculosis is a chronic infectious disease caused by M.tuberculosis. BCG is currently the only type of tuberculosis vaccine recognized by the WHO. BCG vaccine has limited protection. The vaccines currently being developed can be derived from the secretory protein of a pathogen. One of the secretory proteins found in M.tu-berculosis is the Ag85 complex. Proteins Ag85 complex binds to integrin β2 receptor in M.tuberculosis virulence. Therefore, this study aims to determine the potential for binding between the complex Ag85 protein and the receptor β2 integrin as an in-silico development of a secretory protein-based TB vaccine. Methods: This study is exploratory research with in silico testing. This study utilized the ClusPro website to perform molecular docking based on the binding energy values and the resulting binding interaction models. We obtained the structures of the Ag85 protein complex and integrin β2 via the Protein Data Bank website and visualized the binding interaction model using PyMOL software. Results: In this study, the binding energy values obtained for the three bonds between the Ag85 complex proteins with integrin β2 were negative, and all hydrogen bonds showed that the bonds formed were strong and stable. The lowest value is observed in the interaction between Ag85 B protein and β2 integrin. Conclusion: Ag85B-β2 integrin bond exhibits the most stable and spontaneous binding, as indicated by lowest binding energy. This interaction occurs at the active site of the amino acid.
Introduction: Androgenetic alopecia (AGA) is a progressive condition driven by dihydrotestosterone (DHT)-medi-ated inhibition of the Wnt/β-catenin signaling pathway. While topical minoxidil is the first-line therapy, its efficacy is often limited by follicular sulfotransferase activity and patient non-response. The specific therapeutic potential of platelet-rich plasma (PRP) bioactive nanocarriers, such as PRP-derived small extracellular vesicles (sEVs) remains un-derexplored in combination protocols. This study aims to investigates whether the combination of PRP-derived sEVs and 5% minoxidil exerts a synergistic effect in a testosterone-induced AGA mouse model. Methods: An experimental study was conducted using 14 male BALB/c mice. AGA was induced via subcutaneous injection of testosterone (0.5 mg/day) for 10 days. Mice were randomized into two groups (n=7): Group A received topical 5% minoxidil twice daily, while Group B received topical minoxidil combined with weekly intradermal injections of PRP-derived sEVs (1 x 109 particles/mL) on days 11, 18, and 25. sEVs were isolated from calcium chloride-activated PRP using size-exclu-sion chromatography (SEC) and characterized by Nanoparticle Tracking Analysis (NTA). Histopathological analysis of hair follicle density (HFD) and anagen-to-telogen (A:T) ratio was performed on day 21. Results: The combination treatment (Group B) yielded a higher hair follicle density (120.82 ± 57.14 vs. 40.14 ± 11.69 follicles/mm²; p < 0.001) and a superior anagen-to-telogen ratio (0.54 vs. 0.22; p < 0.001) compared to minoxidil monotherapy. Conclusion: PRP-derived sEVs potentiate the hair-growth-promoting effects of minoxidil. This synergistic effect is likely mediated by the dual action of minoxidil-induced vascular support and sEV-mediated Wnt pathway activation.
Introduction: Malaria remains a major global health concern, and increasing resistance to current antimalarial drugs highlights the need to explore alternative therapies. Goat bile (GB) has traditionally been used by some In-donesian communities to improve stamina and treat malaria. This study aimed to investigate the effects of GB on parasitemia and immune responses, particularly interleukin-12 (IL-12) and interleukin-6 (IL-6) levels, in mice infected with Plasmodium berghei ANKA. Methods: Fifty male BALB/c mice were divided into healthy and P. berghei-infected groups. Both groups received either 50% goat bile (GB50) or no treatment. GB50 was adminis-tered orally at 0.5 mL per 20 g body weight for four consecutive days, starting three days post-infection. A positive control group received dihydroartemisinin–piperaquine at 187.2 mg/kg body weight. Parasitemia was monitored daily, while serum IL-6 and IL-12 levels were measured after treatment using ELISA. Data were analyzed using Kruskal–Wallis, Mann–Whitney post hoc, and Spearman’s correlation tests. Results: GB50 significantly reduced parasitemia in P. berghei-infected mice (p < 0.05). GB50 treatment increased IL-6 levels in both healthy and in-fected mice. In contrast, IL-12 levels were significantly lower in the Pb+GB50 group than in the untreated infect-ed group. A similar pattern of increased IL-6 and reduced IL-12 was observed in healthy mice receiving GB50. Conclusion: GB50 demonstrated antiparasitic and immunomodulatory effects by reducing parasitemia, increasing IL-6, and decreasing IL-12 levels. These findings suggest that GB50 may regulate immune responses while reducing parasite burden.
Introduction: Nutrients intake from complementary feeding during breastfeeding period greatly important in sup-plying energy and nutrient for children’s growth. This study aimed to evaluate the physical growth of stunted and non-stunted children aged 12-24 months olds who given innovative bean cookies complementary foods interven-tion for once snack in 30 days, in the highest prevalence stunting villages, Arjasa subdistrict, Jember district, Indo-nesia. Methods: The research stages included: 1) preparation of the bean cookies 2) obtaining ethical clearance, determining subjects, and obtaining informed consent; 3) evaluating subjects' dietary patterns and height-for-age of subject; 4) administering the bean cookies; and 5) measuring the height-for-age after the intervention. This ethical approved cross-sectional-single-blind design study was involving 22 non-stunted and 18 stunted children aged 12-24 months who fulfilled subject’s criteria. The subjects physical growth (height-for-age) was evaluated using WHO
Teratoma is a rare condition but represents the most common germ cell tumor in pediatric patients. Ovarian germ cell tumors account for approximately 27% of cases, while mesenteric teratomas are extremely uncommon, compris-ing only 1%. Early recognition is essential to ensure appropriate management and reduce morbidity and mortality. We report two pediatric cases presenting with abdominal enlargement. The first case involved a 6-year-old girl with a large abdominal mass and elevated alpha-fetoprotein (AFP) level. Imaging revealed a well-defined cystic lesion with solid components and calcifications in the right ovary. She underwent right oophorectomy, and histopathology confirmed an immature teratoma. The second case involved a 15-year-old girl with a large heterogeneous abdominal mass and normal AFP levels. Complete surgical resection was performed, and histopathology confirmed a mature teratoma. Clinical examination, imaging, and serum markers are essential for diagnosis, while complete surgical resection r
Hunter’s syndrome (MPS II) is a rare X-linked recessive disorder caused by a deficiency of the lysosomal enzyme iduronate-2-sulfatase, with an estimated incidence of 1 in 162,000 live male births. It affects only males due to its inheritance pattern and leads to glycosaminoglycan (GAG) accumulation in various organs, resulting in clinical man-ifestations including severe bone abnormalities. Complications may include hydrocephalus, short stature, and car-diomyopathy. We report a 15-year-old male with MPS II presenting with limited joint mobility, bone deformity, and growth delay. Symptoms began at age 1, but diagnosis was delayed until age 4 due to limited resources. Radiological evaluation showed dysostosis multiplex, including coarse facial features, widened sella, and J-shaped sella turcica. The patient is currently receiving calcium and vitamin D3 supplementation. This case highlights the importance of early recognition of skeletal abnormalities and the role of multidisciplinary care in improving outcomes in MPS II.
Choledochal cyst is a congenital disorder causing dilation of bile ducts. It results from abnormal bile duct devel-opment and manifests in jaundice, abdominal discomfort, and masses. Procedure management involves external drainage, cyst removal, and bile duct reconstruction. We reported a 1-year-old female with choledochal cyst type I. The patient came with complaints of vomiting. The diagnosis was confirmed through ultrasound and magnetic resonance cholangiopancreatography (MRCP). Laboratory examination showed elevated liver enzymes. The patient underwent intraoperative cholangiography followed by single-step cyst excision with cholecystectomy, the cyst was found in the proximal CBD measuring 12 x 8 x 6 cm. This procedure was followed by Roux-en-Y hepaticojejunosto-my. Postoperatively, the patient received antibiotics and medication, showing improvement in liver enzyme levels. After seven days in the hospital, she was discharged with a closed surgical wound, indicating a successful recovery from the procedur
Congenital adhesion band is a rare finding in neonates and may cause obstruction at any age. Only a few case reports exist regarding the finding. Here we present a 6-days-old boy, referred to our institution with complaints of repeated bilious vomiting; abdominal distention was not found and the child was still able to defecate. Babygram showing double bubble was performed at the previous hospital. Upper GI series was then done at our institution showing windsock appearance at the 2nd part of duodenum suggesting duodenal web, elective laparotomy was done with findings of midgut volvulus and adhesion of the jejunum to the ascending colon..
Conjoined twins are a rare congenital anomaly caused by incomplete division of a monozygotic embryo. Ompha-lopagus twins, joined at the anterior abdominal wall, represent 10–18% of cases and are relatively compatible with postnatal survival. We report two serial cases of female omphalopagus twins diagnosed after birth. The first case involved full-term twins with partial hepatic fusion and shared upper abdominal viscera. The second case involved preterm twins with minimal soft tissue fusion and largely separate organ systems, except for a small secundum atrial septal defect in one twin. Antenatal ultrasonography in both cases failed to establish a definitive diagnosis. Postnatal evaluation using contrast-enhanced computed tomography, barium studies, and echocardiography provided de-tailed delineation of organ sharing. These findings guided neonatal intensive care and surgical planning. The cases emphasize the importance of thorough postnatal imaging and multidisciplinary management to assess operability and optimize outcomes, particularly in settings with limited antenatal diagnostic resources.
Laparoscopic cholecystectomy (LC) is a minimally invasive procedure widely used to treat gallbladder diseases, including cholelithiasis, in pediatric patients. A 10-year-old boy presented with a one-year history of intermittent right upper quadrant abdominal pain, worsened by fatty food intake, accompanied by nausea and vomiting without fever or jaundice. Ultrasonography and magnetic resonance cholangiopancreatography (MRCP) confirmed multiple gallstones, the largest measuring 0.5 cm, with no evidence of biliary obstruction. Due to persistent symptoms and risk of complications, laparoscopic cholecystectomy was performed. The procedure was completed successfully without intraoperative complications, and the patient had an uneventful recovery with significant symptom resolution. He was discharged within 48 hours. This case highlights the safety and effectiveness of laparoscopic cholecystectomy in managing symptomatic pediatric cholelithiasis. Preoperative MRCP played an important role in clarifying anatomy and
Liver abscess is rare in pediatric patients, and delayed presentation following blunt abdominal trauma is unusual. Diagnosis can be challenging because symptoms are nonspecific and the interval between trauma and infection may be prolonged. A 12-year-old girl presented with one month of progressive epigastric pain, nausea, vomiting, and early satiety, without fever or jaundice. Laboratory studies showed mild leukocytosis and elevated inflammatory markers, with normal liver function tests. Ultrasonography and contrast-enhanced computed tomography revealed a large abscess in liver segment VII. Detailed history-taking identified blunt abdominal trauma three years earlier that had been managed conservatively. Broad-spectrum intravenous antibiotics were initiated, and laparoscopic drainage was attempted. Owing to a thick abscess wall and dense adhesions limiting safe evacuation, conversion to open laparotomy was required. Approximately 500 mL of fluid, including purulent material, was drained. The patient recovered uneventfully and was discharged on postoperative day seven. This case underscores delayed liver abscess as a rare post-traumatic complication and highlights the importance of thorough history-taking, imaging, and timely surgical management.
Neonatal gastric perforation (NGP) is a rare but life-threatening condition, most commonly affecting preterm and very low birth weight infants, and remains associated with high mortality despite advances in neonatal care. We report a male extremely preterm twin born at 25 weeks and 2 days of gestation with a birth weight of 685 g who developed progressive abdominal distension on day 6 of life. Radiologic evaluation revealed pneumoperitoneum. Emergency exploratory laparotomy identified multiple perforations involving both the anterior and posterior walls of the stomach. Primary repair was performed with creation of a feeding jejunostomy. Despite intensive postoperative support, the neonate developed sepsis, disseminated intravascular coagulation, and acute kidney injury, and died on postoperative day 8. This case highlights the severe and rapidly progressive nature of NGP in extremely preterm infants. Early recognition, prompt imaging, and timely surgical intervention are critical, although prognosis remains p
Duplication cysts of the gastrointestinal tract are rare congenital anomalies that can present with intestinal obstruc-tion in children, requiring early diagnosis and surgical management to prevent complications. We report a pediatric case presenting with recurrent vomiting, abdominal distension, and a history of abdominal massage. The vomitus was bilious with milk particles, and the patient passed mucus occasionally mixed with blood, without fever or ab-dominal tenderness. Nasogastric decompression yielded bilious content. Ultrasound excluded intussusception but suggested bowel obstruction, which was confirmed by barium follow-through demonstrating distal small bowel blockage. Exploratory laparotomy revealed a 2×2 cm cystic lesion at the ileocecal junction resembling adjacent mucosa. Complete resection with end-to-end anastomosis and mesenteric lymph node excision was performed. Histopathological examination confirmed a duplication cyst. The patient had an uneventful recovery. This case em-phasizes considering duplication cysts in pediatric obstruction and highlights surgical excision as definitive treatment with excellent outcomes.
Hypospadias is one of the most common congenital anomalies in males, with an estimated prevalence of 1 in 250–300 live births, and is classified into distal and proximal types based on the location of the urethral meatus. We report a 1-year-old boy who had not urinated from the tip of the penis since birth. Physical examination revealed a urethral opening at the penoscrotal region, significant chordee, and bilaterally descended testes. The patient was diagnosed with proximal hypospadias and underwent staged surgical management including chordectomy, scrotoplasty, and penile transposition. Postoperatively, the patient recovered well and was discharged in good condition with satis-factory wound healing. Proximal hypospadias represents a severe form requiring complex reconstruction. Surgical management aims to achieve penile straightening, functional urethral reconstruction, and acceptable cosmetic out-comes. This case highlights the importance of early diagnosis and appropriate surgical planning in managing severe hypospadias to optimize both functional and aesthetic results in pediatric patients.
Hypospadias is a common congenital anomaly in males, with severity increasing as the urethral meatus is located more proximally. A 13-year-old boy presented with an abnormal urinary stream and malformed genitalia since birth. He had a history of perineal voiding and underwent chordectomy at 5 years old, followed by scrotoplasty, penoscro-tal transposition, and urethroplasty at 11 years old, with persistent symptoms. Examination revealed a scrotal urethral meatus with a deep urethral plate, and the glans–urethral–meatus–shaft (GMS) score indicated severe hypospadias. A multi-staged urethroplasty using a U-incision technique was performed to reposition the meatus. Postoperatively, the patient achieved improved urinary function and satisfactory cosmetic outcomes without fistula formation. Severe perineal hypospadias requires a complex, staged surgical approach. This case highlights the importance of careful planning and staged reconstruction in achieving favorable functional and cosmetic results in patients with
Esophageal atresia (EA) with tracheoesophageal fistula (TEF) remains a challenging neonatal condition, particularly in resource-limited secondary hospitals, where morbidity and mortality continue to be significant despite improving survival. We report the first successful management of EA in a 2-day-old male infant presenting with hypersalivation, choking during feeding, and inability to pass a nasogastric tube. Initial stabilization included gastrostomy decom-pression and jejunostomy feeding on day 9 of life. Definitive repair was performed two weeks later via thoracotomy, confirming type C EA. The procedure involved distal TEF ligation and primary end-to-end esophageal anastomosis with chest tube placement. Postoperatively, the patient required ventilatory support in the NICU, later transitioned to nasal continuous positive airway pressure (NCPAP) on postoperative day 4. Suspected anastomotic leak occurred following saliva drainage through the chest tube, prompting cessation of NCPAP and conservative management. The patient improved, was weaned to room air by postoperative day 30, and discharged in stable condition. Noninvasive ventilation may increase anastomotic leak risk after EA repair.
A 14-year-old male with a history of intermittent headaches since age 8 was diagnosed with right adrenal pheochro-mocytoma at 11 years after presenting with severe headaches and sustained hypertension up to 200 mmHg. Imaging revealed a right suprarenal mass, and debulking surgery was performed in 2021, with histopathology confirming pheochromocytoma. Three years later, he presented with recurrent headaches, palpitations, syncope, and systolic hypertension of 180 mmHg. Imaging demonstrated a large hypervascular solid–cystic mass in the left suprarenal region, without residual tumor on the right. The patient underwent laparotomy with complete excision of a well-en-capsulated left adrenal mass, and histopathology again confirmed pheochromocytoma measuring 10 cm. This case highlights metachronous contralateral recurrence following initial debulking surgery in a pediatric patient. It under-scores the limitations of incomplete resection, the importance of early recognition of recurrent symptoms, and the need for li
