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Misdiagnosis rate of endometriosis and strategies employed to identify endometriosis by analyzing patient characteristics in low-resource settings

Misdiagnosis rate of endometriosis and strategies employed to identify endometriosis by analyzing patient characteristics in low-resource settings

50

Authors
Ruswana Anwar1, Aditya Utomo1, Dina Marlina1, Megawati Al’badly Ponco Dewi Poernomo2, Putri Nadhira Adinda Adriansyah3, Beni Samsul Amri4, Artha Falentin Putri Susilo1, Mulyanusa Amarullah Ritonga1 and Anita Rachmawati1

Affiliations

1Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin Hospital, Bandung, Indonesia 2Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia 3Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia 4Department of Obstetrics and Gynecology, Universitas Jenderal Soedirman, Purwokerto, Indonesia

Background

• Endometriosis affects about 10% of women of reproductive age worldwide, yet no curative treatment exists.

• Diagnosis is often delayed due to a lack of non-invasive tests, especially in low-resource settings.

Methods

• Descriptive study at Prof. Dr. Margono Soekarjo General Hospital, Indonesia, of all patients referred as suspected endometriosis to the fertility endocrinology clinic from 2020 to 2024.

• All participants underwent surgery, and diagnosis was confirmed by histopathology; patient characteristics were analysed to identify predictive features.

Key Results

• 46.87% of suspected cases were ultimately found to be non-endometriosis, reflecting a high misdiagnosis rate.

• Dysmenorrhea, early onset of dysmenorrhea, and high menstrual volume were significantly associated with histologically confirmed endometriosis.

Discussion & Conclusion

• Nearly half of suspected endometriosis cases were misdiagnosed, contributing to diagnostic delays and delayed treatment.

• Specific symptoms such as dysmenorrhea, its early onset, and heavy menstrual volume may help identify true cases earlier, especially where diagnostic access is limited.

Related SDGs

SDG 3: Good Health and Well-Being – Reducing diagnostic delays in women’s reproductive health

SDG 10: Reduced Inequalities – Improving care access in low-resource settings

Journal Information

Journal: Sage Open Medicine

DOI: https://doi.org/10.1177/20503121261420031

Integrative Computational and Transcriptional Analysis of NF-κB and HIF-1α Modulation Following Doxorubicin Treatment in Triple-Negative Breast Cancer Cells

Integrative Computational

Autors
Nurul Utami 1,2, Arif Setiawansyah3, Muhammad Hasan Bashari 4, Hermin Aminah Usman 5, Raden Yohana Azhar 6, Astrid Feinisa Khairani 4

Affiliations

1Doctoral Program in Medical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Anatomy, Anatomical Pathology, and Histology, Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia; 3Pharmacy Diploma Program, Akademi Farmasi Cendikia Farma Husada, Bandar Lampung, Indonesia; 4Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 5Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital, Bandung, Indonesia; 6Division of Oncology Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr Hasan Sadikin General Hospital, Bandung, Indonesia

Background

• Triple-negative breast cancer (TNBC) is aggressive and has limited targeted treatment options.

• Doxorubicin remains a cornerstone treatment, but its molecular effects beyond direct cytotoxicity are not fully understood.

Methods

• Network pharmacology analysis, molecular docking, and molecular dynamics simulations explored doxorubicin’s potential links to NF-κB and HIF-1α signaling.

• In vitro validation used MTT cytotoxicity assays in MDA-MB-231 TNBC cells, with IC50 determined and RT-qPCR measuring NF-κB and HIF-1α expression.

Key Results

• Computational analyses suggested potential associations between doxorubicin and NF-κB/HIF-1α-related pathways.

• In vitro assays showed concentration-dependent cytotoxicity, with IC50 values of 2.34 µM (DMEM) and 1.07 µM (RPMI-1640).

• RT-qPCR showed downregulation of both NF-κB and HIF-1α mRNA after doxorubicin treatment.

Discussion & Conclusion

• The findings provide transcriptional-level evidence for NF-κB- and HIF-1α-related pathway involvement in TNBC cells’ response to doxorubicin.

• Combining computational predictions with early experimental validation generates hypotheses for further mechanistic study, supporting foundational cancer research toward SDG 3.

Related SDGs

SDG 3: Good Health and Well-Being – Advancing breast cancer treatment research

Journal Information

Journal: Journal of Experimental Pharmacology

DOI: https://doi.org/10.2147/JEP.S576572

The Uncommon Coexistence of Mid-Borderline Leprosy and Generalized Pustular Psoriasis

The Uncommon Coexistence of Mid-Borderline Leprosy and Generalized Pustular Psoriasis

49

Authors
Hendra Gunawan 1, Risa Miliawati Nurul Hidayah 1, Reiva Farah Dwiyana 1,Trustia Rizqandaru 1, Reti Hindritiani 1, Hermin Aminah Usman 2, Ranisa Larasati 1

Affiliations

1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 2Department of Pathological Anatomy, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

Background

• Leprosy is a chronic disease affecting the skin and nerves, while generalized pustular psoriasis (GPP) is a rare, severe autoimmune skin condition.

• Their coexistence is extremely rare due to very different genetic and immune profiles.

Methods

• Case report of a 28-year-old woman presenting with both mid-borderline leprosy and severe generalized pustular psoriasis.

• Diagnosis combined slit-skin smear, Gram staining, and histopathology of both anesthetic patches and pustular lesions.

Key Results

• Slit-skin smear showed a bacterial index of 1+, and Gram staining of pustules showed no bacteria.

• Histopathology confirmed leprosy granulomas in one set of lesions and features of generalized pustular psoriasis in another.

• She was treated with WHO multidrug therapy for leprosy plus systemic corticosteroids, with marked improvement within 47 days.

Discussion & Conclusion

• This case highlights the importance of recognizing rare coexisting skin conditions with very different underlying mechanisms.

• A comprehensive diagnostic approach and prompt combined management led to a favourable outcome.

Related SDGs

SDG 3: Good Health and Well-Being – Improving diagnosis of complex, overlapping skin diseases

Journal Information

Journal: Clinical Cosmetic and Investigational Dermatology

DOI: https://doi.org/10.2147/CCID.S599655

The Uncommon Coexistence of Mid-Borderline Leprosy and Generalized Pustular Psoriasis

The Uncommon Coexistence of Mid-Borderline Leprosy and Generalized Pustular Psoriasis

48

Authors

Hendra Gunawan1, Risa Miliawati Nurul Hidayah1, Reiva Farah Dwiyana1, Trustia Rizqandaru1, Reti Hindritiani1, Hermin Aminah Usman2, Ranisa Larasati1

Affiliations

1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 2Department of Pathological Anatomy, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

Background

• Leprosy is a chronic disease affecting the skin and nerves, while generalized pustular psoriasis (GPP) is a rare, severe autoimmune skin condition.

• Their coexistence is extremely rare due to very different genetic and immune profiles.

Methods

• Case report of a 28-year-old woman presenting with both mid-borderline leprosy and severe generalized pustular psoriasis.

• Diagnosis combined slit-skin smear, Gram staining, and histopathology of both anesthetic patches and pustular lesions.

Key Results

• Slit-skin smear showed a bacterial index of 1+, and Gram staining of pustules showed no bacteria.

• Histopathology confirmed leprosy granulomas in one set of lesions and features of generalized pustular psoriasis in another.

• She was treated with WHO multidrug therapy for leprosy plus systemic corticosteroids, with marked improvement within 47 days.

Discussion & Conclusion

• This case highlights the importance of recognizing rare coexisting skin conditions with very different underlying mechanisms.

• A comprehensive diagnostic approach and prompt combined management led to a favourable outcome.

Related SDGs

SDG 3: Good Health and Well-Being – Improving diagnosis of complex, overlapping skin diseases

Journal Information

Journal: Clinical Cosmetic and Investigational Dermatology

DOI: https://doi.org/10.2147/CCID.S599655

Managing concurrent nephrotic syndrome, spontaneous bacterial peritonitis, and herpes zoster in an immunocompromised child: Diagnostic difficulties and treatment outcomes

Managing concurrent nephrotic syndrome, spontaneous bacterial peritonitis, and herpes zoster in an immunocompromised child: Diagnostic difficulties and treatment outcomes

47

Authors

Riyadi Adrizain a,*69946c28 40eb 44f4 a6b1 ac6e6f16c28d, Ismiana Modjaningrat c, Winyarti c, Fadila Dyah Trie Utami a, Wilson Surya Lesmana d, Vita Indriasari b, Dedi Rachmadi Sjambas a

Affiliations

a Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia b Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia c Pediatric Resident, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia d Pediatric Surgery Resident, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia

Background

• Nephrotic syndrome (NS) involves heavy protein loss in urine, and poorly controlled disease can lead to serious infectious complications.

• Immunocompromised children with NS face added risk from opportunistic infections.

Methods

• Case report of a 9-year-old boy with a history of nephrotic syndrome since age 7, poorly controlled due to irregular medication use.

• He presented with worsening abdominal pain, fever, and facial oedema, and was managed through hospitalization with imaging, lavage drainage, and antibiotic therapy.

Key Results

• The patient was diagnosed with spontaneous bacterial peritonitis and septic shock related to uncontrolled nephrotic syndrome.

• During hospitalization he developed herpes zoster skin lesions linked to his immunocompromised state.

• He improved with antibiotics and supportive care and was discharged with outpatient follow-up.

Discussion & Conclusion

• This case highlights the importance of early, aggressive intervention in immunocompromised children with nephrotic syndrome facing multiple infectious complications.

• Regular medication adherence is critical to preventing this kind of double infectious burden.

Related SDGs

SDG 3: Good Health and Well-Being – Improving care for children with complex kidney disease

Journal Information

Journal: Idcases

DOI: https://doi.org/10.1016/j.idcr.2026.e02489

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