Medical Profession Journal of Lampung

Innovation of β-Thalassemia Treatment Strategies

Komang Ria Yuliana Santhi — 2025-12-20

β-thalassemia is an inherited blood disorder caused by mutations in the β-globin gene that reduce or eliminate β-globin chain synthesis, leading to hypochromic microcytic anemia and significant morbidity worldwide. The disorder is prevalent in South Asia, Southeast Asia, the Mediterranean, the Middle East, India, and Africa, with approximately 1.5% of the global population identified as carriers. Severe complications, including iron overload, skeletal deformities, heart failure, and multi-organ damage, contribute to its substantial global health burden. This narrative literature review synthesizes evidence from PubMed, Cochrane, and Google Scholar to examine conventional and emerging therapeutic strategies for β-thalassemia, with particular emphasis on recent advances in gene therapy. Standard management relies on regular blood transfusions and iron chelation, which remain supportive and are associated with long-term complications. Hematopoietic stem cell transplantation is the only established curative treatment, especially effective in pediatric patients with matched HLA donors, although its availability is limited. Novel pharmacologic agents, such as luspatercept and mitapivat, have demonstrated reductions in transfusion requirements and improvements in hemoglobin production. Additional approaches, including fetal hemoglobin induction and modulation of iron metabolism, show encouraging potential. A major breakthrough is CRISPR-based gene therapy using exagamglogene autotemcel (Casgevy), approved by the FDA and EMA in 2024, with phase 3 trials reporting transfusion independence in more than 90% of patients and significant quality-of-life improvements. Despite persistent challenges related to cost, access, and long-term safety, these advances indicate a paradigm shift toward precision medicine with curative potential for β-thalassemia.

The Relationship Between BMI and Blood Sugar Levels in Patients with Type 2 Diabetes Mellitus: A Literature Review

Ighra Afifah — 2025-12-20

Type 2 diabetes mellitus is a chronic metabolic disease with a steadily increasing prevalence globally, including in Indonesia. One of the main risk factors contributing to the development and severity of type 2 diabetes is obesity, clinically measured by Body Mass Index (BMI). Increased BMI is closely associated with impaired glucose metabolism and insulin resistance, which play a key role in the pathogenesis of type 2 diabetes. This study used a literature review approach by examining various studies analyzing the relationship between BMI and blood glucose levels. The results showed that increased BMI is positively correlated with fasting blood glucose, random blood glucose, and HbA1c levels. Individuals with a higher BMI tend to experience more severe glycemic control disorders. Pathophysiologically, increased adipose tissue, especially visceral fat, produces various inflammatory mediators such as TNF-α and IL-6, which disrupt the insulin signaling pathway, reduce glucose uptake by muscle tissue, and trigger hyperglycemia. Furthermore, dysfunction of adipokine hormones such as decreased adiponectin and resistance to leptin contribute to worsening insulin sensitivity

Phytochemical-Based Ovicidal Activity of Selected Plant Extracts against Aedes aegypti for Sustainable Dengue Vector Control

Linda Septiani — 2025-12-20

Dengue Hemorrhagic Fever (DHF) remains a major public health concern, with Aedes aegypti serving as the primary vector. The continuous use of synthetic insecticides has led to resistance development and environmental concerns, highlighting the need for safer and sustainable alternatives. This review aims to evaluate the ovicidal potential of selected plant extracts against Aedes aegypti as an early-stage vector control strategy. A literature review was conducted using relevant national and international publications focusing on plant-based ovicides. The findings indicate that extracts from Piper nigrum L., Ocimum basilicum, Syzygium myrtifolium Walp., Tithonia diversifolia, Acorus calamus L., Solanum lycopersicum, and Euphorbia hirta L. effectively reduce egg hatchability of Aedes aegypti. The ovicidal activity is associated with secondary metabolites such as flavonoids, alkaloids, saponins, tannins, terpenoids, polyphenols, and essential oils, which disrupt egg membranes and inhibit embryonic development in a concentration-dependent manner. These findings suggest that plant extracts possess promising potential as natural ovicides and may serve as a basis for further pharmaceutical development and formulation in sustainable dengue vector control.

Systematic Literature Review: Cryptographic Protocols for Securing Genomic Data and Privacy

Angga Wijaya — 2025-12-20

Advances in Next-Generation Sequencing (NGS) technology have enabled large-scale genomic data digitalization to support precision medicine. However, the static, sensitive, and hereditary nature of genomic data poses significant privacy risks for individuals and their families. This study aims to conduct a systematic literature review of modern cryptographic protocols designed to secure genomic data. The research applies a Systematic Literature Review (SLR) approach by analyzing relevant scientific publications from 2018 to 2026 across multiple reputable databases. The findings indicate that Homomorphic Encryption (HE) enables computation on encrypted data without decryption, ensuring strong privacy protection, but faces challenges related to computational efficiency. Secure Multi-party Computation (SMPC) supports secure collaboration across institutions without exposing raw data, although it requires substantial communication and bandwidth resources. Meanwhile, Differential Privacy (DP) provides a more efficient approach but may compromise data accuracy, particularly in clinical decision-making contexts. In addition, hybrid approaches, selective encryption strategies, and the integration of post-quantum cryptography are emerging as promising solutions to address scalability and long-term security challenges in genomic big data. Alignment with regulatory frameworks such as Indonesia’s Personal Data Protection Law is also critical for practical implementation. Therefore, developing adaptive, efficient, and sustainable genomic data security systems is essential to support a secure, ethical, and trustworthy national health data ecosystem.

Relationship Between Hypertension and Coronary Artery Disease (CAD) : A Literature Review

Avis Meyvika Worocahyo — 2025-12-20

Coronary Artery Disease (CAD) remains a leading cause of morbidity and mortality worldwide, including in Indonesia, where its prevalence continues to increase alongside the high burden of hypertension. Hypertension is recognized as a major cardiovascular risk factor due to its role in accelerating atherosclerosis and inducing structural and functional alterations in the cardiovascular system. This study aims to analyze the relationship between hypertension and CAD through a literature review of national studies conducted in Indonesia. Relevant articles were obtained from online scientific databases and selected based on predefined inclusion criteria, focusing on studies that examined hypertension as a risk factor for CAD. The findings consistently demonstrate a statistically significant association between hypertension and CAD incidence, with most studies reporting p-values < 0.05. Individuals with hypertension have more than a twofold increased risk of developing CAD compared to normotensive individuals. From a pathophysiological perspective, chronic hypertension contributes to endothelial dysfunction, hemodynamic disturbances, activation of the renin–angiotensin–aldosterone system, and cardiac remodeling, all of which accelerate coronary atherosclerosis and increase the risk of myocardial ischemia. In addition, prolonged elevated blood pressure promotes plaque formation and instability, which may lead to acute coronary events. In conclusion, hypertension plays a critical role in the development of CAD. Early detection, optimal blood pressure control, and lifestyle modification are essential strategies to reduce cardiovascular risk and lower the overall burden of coronary artery disease in Indonesia.

Correlation Between Ferritin Levels and ALT in Beta-Thalassemia Major Patients: A Literature Review

Mutiara Maharani — 2025-12-20

Beta thalassemia major is an autosomal recessive genetic blood disorder caused by mutations in the globin gene, resulting in impaired globin chain synthesis. It represents the most severe form of thalassemia and is characterized by chronic anemia, regular blood transfusions, and a high risk of iron overload. The global prevalence of beta thalassemia major continues to increase, including in Indonesia and the Lampung region. Excess iron is primarily stored as ferritin, which becomes toxic to hepatic tissue at high levels and is reflected by increased alanine transaminase (ALT) levels. This study aimed to analyze the relationship between ferritin and ALT levels in patients with beta thalassemia major through a literature review approach. Relevant scientific publications from reputable databases and accredited national journals were reviewed, focusing on studies that evaluated the association between these two parameters. The results demonstrated a statistically significant positive correlation (p < 0.05), in which elevated ferritin levels were consistently associated with increased ALT levels. These findings indicate a close relationship between iron overload and hepatocellular damage. However, the interpretation of ferritin and ALT levels should consider confounding factors such as inflammation, infection, and other clinical conditions that may influence laboratory results. Pathophysiologically, repeated blood transfusions lead to excessive iron accumulation that exceeds storage capacity, triggering oxidative stress, hepatocyte injury, and subsequent ALT release into circulation. Therefore, regular monitoring of ferritin and ALT levels is essential for early detection and prevention of hepatic complications in patients with beta thalassemia major.