Evidence-based Case Report Research Articles

Potassium-Competitive Acid Blocker sebagai Alternatif Penghambat Pompa Proton untuk Mengatasi Gejala Gastroesophageal Reflux Disease: Sebuah Laporan Kasus Berbasis Bukti

Gastric acid suppression is one of the main pillars of gastroesophageal reflux disease (GERD) treatment. Proton pump inhibitor (PPI) is the most used drug for suppressing gastric acid in GERD patients currently. Potassium- acid competitive acid blocker (PCAB) is a new class of drug which can be used as an alternative drug for suppressing gastric acid, so hypothetically, this drug could be an alternative of PPI for relieving GERD symptoms. However, the ability of PCAB for relieving GERD symptoms was not established, so this study was aimed to elucidate the ability of PCAB as an alternative drug of PPI for relieving GERD symptoms. Comprehensive literature searching was conducted in several databases such as PubMed, Embase, Cochrane, EBSCO, and Proquest with keywords “GERD”, “PCAB”, “PPI” dan “symptoms” on September 16-20, 2023. Early literature searching comprised 229 articles then selected based on clinical question and eligibility criteria to get 3 articles to be appraised critically. Vonoprazan, one of PCAB, was using as the main therapy in all of selected studies. Two randomized control trial (RCT) studies showed the non-inferiority of vonoprazan compared to PPI for relieving GERD symptoms. On the other hand, one systematic review and meta-analysis study showed that vonoprazan was superior than PPI for relieving GERD symptoms. This evidence-based case report (EBCR) shows that vonoprazan is non-inferior, even superior, compared to PPI for relieving GERD symptoms. Further, extensive, and larger researches is still needed to support this evidence and the using of PCAB as main and routine treatment for GERD patients.

Ichthyosis vulgaris successfully treated with individualised homoeopathic medicine Dulcamara 200C – An evidence-based case report

Ichthyosis vulgaris successfully treated with individualised homoeopathic medicine Dulcamara 200C – An evidence-based case report

Lichen planus an autoimmune disease treated using Homoeopathic medicine – An evidence-based case report

Lichen planus an autoimmune disease treated using Homoeopathic medicine – An evidence-based case report

The Effect of Endorphine Massage to Reduce Pain During the First Stage of Labor: Evidence Based Case Report

Background: Labor is a physiological process that every pregnant woman will experience in her reproductive cycle. The changes that occur in the body to prepare for childbirth often cause pain in the mother. Physical changes will also affect the emotional and psychological condition of the birthing mother, such as stress and anxiety. One non-pharmacological methods to reduce pain during labor is endorphine massage. This massage aims to make the mother comfortable and calm by helping to release endorphin hormones which play a role in increased analgesic response during labor. Endorphine massage is performed by giving a light touch to the back area to help release the hormones endorphins and oxytocin during the first stage of labor. Purpose: To determine the effect of endorphin massage on reducing pain in the first stage of labor. Method: Evidence based case report (EBCR) by searching several articles via Google Scholar and Portal Garuda. Result: There was a decrease in pain intensity of first stage of labor from severe to moderate pain after being given endorphins massage for 5 minutes every hour. Conclusion: The results of the case report show that endorphin massage can reduce pain in the first stage of labor.

Exercise to Improve Asthma Control and Lung Function in Stable Asthma: An Evidence-based Case Report

Exercise to Improve Asthma Control and Lung Function in Stable Asthma: An Evidence-based Case Report

Examining The Relationship between Shift Work and Diabetes Mellitus among Nurses: An Evidence-based Case Report

Background : Work shifts could cause numerous health problems, such as sleep disorders, weight gain disorders, and unhealthy food intake consumption, leading to obesity and changes in blood glucose levels, that eventually lead to diabetes mellitus. This evidence-based case report aims to provide an evidence of association between shift work and the risk of diabetes mellitus among nurses. Methods : We performed a literature searching from Pubmed, Embase, Cochrane, Scopus, and Google Scholar in September 2023 using keywords ‘shift work’ AND ‘diabetes’ AND ‘nurse’. We included studies that assessed the association between shift work and diabetes among nurses using observational studies, meta-analysis, and systemic review as their study design. The outcome variable was the odd ratio or the relative risk of developing diabetes. We excluded cross-over studies, clinical trials, and cross-sectional studies. In addition, quality assessment was conducted according to The Oxford Center for Evidence-Based Medicine (OCEBM). Results : After title and abstract screening, we found seven out of twenty articles with a total of 689,273 participants. Among these articles, there were three cohort studies which found an increased relative risk (1.08 to 2.60) of diabetes among nurses who worked night and rotating shifts compared to those who did not. Another evidence from two cohort studies and one meta-analysis identified that nurses who worked in full shifts had an increased risk of diabetes (1.05 to 3.60) than those who worked non-shifts. Factors affecting the risk of diabetes were gender, unhealthy lifestyle, sleep disorders, and shift work duration (≥10 years). Conclusions : Shift work in nurses has a significant association with the risk of diabetes mellitus. Nurses had been working shift work for more than 10 years, particularly on night shift, had a higher risk compared to those who had been working for less than 10 years without night shift. Additional factors such as obesity, smoking, lack of physical activity, unhealthy diet, and sleep disorders would increase the risk of diabetes mellitus.

McKenzie Exercise for Reducing Low Back Pain Complaints in Office Worker: An Evidence-based Case Report

Background: Low back pain (LBP) is pain that is felt in the lower back area, namely between the corners of the lowest ribs and the lower buttocks (lumbar or lumbo-sacral area) and can be local pain or radiate to the upper thighs/legs or both. Low back pain is a 10% debilitating condition that results in a change in life expectancy due to disability. Low back pain is not a malignancy and is a self-limiting condition, but patients always seek treatment to reduce the severity of their symptoms. Chronic Low Back Pain can alter lifestyle and increase the rate of prolonged absenteeism at work resulting in physical limitations. Discomfort due to chronic low back pain is a sign that requires immediate treatment. Methods: The purpose of this evidence-based case report is to get the right answer about McKenzie exercise in reducing low back pain in office workers. Article searches were conducted through PubMed, Embase and Cochrane Library. Inclusion criteria were Systematic Review, Meta-Analysis, Randomized Control Trial (RCT), Adult or Productive Age, Non Specific Chronic Low Back Pain and McKenzie Exercise. Then critically reviewed using Oxford CEBM criteria for intervention-therapy studies Results: 1 research article was obtained that met the inclusion criteria with the type of Randomized Control Trial (RCT). Conclusion:. The critical review showed that McKenzie exercise can reduce complaints of low back pain at 5 weeks of treatment, but this exercise did not show a clinical effect in the form of a reduction in complaints of low back pain after being implemented for 3,6 and 12 months.

Cutaneous warts treated with a single dose of the homoeopathic medicine Carcinosin 200C: An evidence-based case report

Cutaneous warts treated with a single dose of the homoeopathic medicine Carcinosin 200C: An evidence-based case report

OXYTOCIN RELEASED FROM BACK MASSAGE EXTENDS CONTRACTIONS IN THE FIRST STAGE OF LABOR: EVIDENCE-BASED CASE REPORT (EBCR)

Introduction: Maternal health is a key indicator of community welfare as measured by the Maternal Mortality Rate (MMR). One of the problems with maternal mortality is caused by prolonged labor. Non-pharmacological action in the form of back massage is an important consideration in health services that can be utilized more optimally. This evidence-based case report aims to find out the effectiveness of back massage to increase contractions in the active phase of the first stage of labor. Method: Article search using Pubmed and Google Scholar databases. Found 2 articles chosen one according to the inclusion and exclusion criteria and has been screened previously, then reviewed critically. Result: Based on studies by Kursih Sulastriningsih, et al and Adinda Putri Sari Dewi, et al, it was found that back massage is effective in increased contractions in the first stage of labor in the active phase. Conclusion: Back massage will speed up the work of the parasympathetic nerves in stimulating the posterior pituitary to release oxytocin which can have a relaxing effect. The relaxation experienced by the mother stimulates the brain to reduce levels of the hormone adrenaline and increase the production of oxytocin, which is a factor in producing adequate uterine contractions. Having adequate contractions can cause the cervix to flatten and open. Back massage has been suggested as an effective, inexpensive, non-pharmacological way to induce labor and increase contractions to speed up the progress of labor.

Exercise During Work Hours Improves Fitness: An Evidence-Based Case Report

Relatively tight working hours are problems for employees in urban areas, affecting less time for physical activities. About 59% of office workers in Jakarta are classified as sedentary. The high number of sedentary workers can cause productivity problems due to low fitness. Appropriate interventions are needed to overcome it. We have done literature searches from 7 journal databases in the last 20 years, including ScienceDirect, EBSCOhost, PubMed, ProQuest, Scopus, ClinicalKey, and Cochrane. Inclusion criteria include research design in the form of systematic review/meta-analysis/randomized controlled trials, outcomes in the form of physical fitness or work performance, and interventions in the form of workplace exercise or stretching. Three selected articles showed a significant relationship (p-value <0.05) between programmed physical exercise at work and several fitness factors, such as decreased body fat and fat mass, increased lean mass, and increased sit-up and push-up fitness test results. Physical activity at work decreased cardiovascular risk as assessed by VO2max. In conclusion, physical activity during working hours effectively improves health-related fitness. The minimal intervention types needed are aerobics, strength training, and muscle endurance. We recommend providing interventions for workplace fitness and education programs (WFEP).

Tranexamic Acid in the Management of Non-variceal Upper Gastrointestinal Bleeding

Background: Non-variceal upper gastrointestinal bleeding (UGIB) is a common case of emergency in daily clinical practice with a fairly high mortality rate. The use of tranexamic acid, which has been recommended in managing trauma bleeding, may serve as an alternative pharmacological therapy to manage bleeding in non-variceal UGIB. This evidence-based case report aims to evaluate the impact of tranexamic acid on managing bleeding, risk of mortality, and thromboembolic event in non-variceal UGIB patients.Methods: A systematic literature search was conducted on 4 databases: CDSR, EMBASE, PubMed, and Scopus for meta-analyses. Studies were selected based on inclusion and exclusion criteria formulated a-priori with subsequent critical appraisal according to the OCEBM critical appraisal tools. Result: Meta analyses by Kamal, et al (2020) and Twum-Barimah, et al (2020) were included in our report. Kamal, et al shows no significant difference in mortality in tranexamic acid use compared to placebo (RR 0.84; 95%CI 0.63–1.11; I2=2%). Similarly, although Twum-Barimah reported tranexamic acid reduced risk of mortality compared to placebo (RR 0.45; 95%CI 0.23–0.88; p=0.02; I2 = 0%), none of the RCTs included shows significant result when observed individually. In addition, Kamal, et al also reported increased risk of vein thromboembolic events in high-dose tranexamic acid administration (RR 2.21; 95%CI 1.32–3.69; I2=0%) compared to low-dose administration, in UGIB patients.Conclusion: Tranexamic acid is not recommended to be used in managing bleeding in patients non-variceal UGIB patients and may increase the risk of thromboembolic event.

Management of Geographic Tongue with Individualized Homeopathy: An Evidence-Based Case Report

AbstractGeographic tongue, also known as benign migratory glossitis, is a common and benign condition characterized by distinct features on the tongue's surface. Typically, it affects the tip, lateral borders, and dorsum of the tongue, with occasional extension to the ventral surface. Indeed, geographic tongue commonly starts in childhood and has a global prevalence estimated at around 1 to 2.5% of the general population. In the pediatric population, the prevalence ranges from 0.37 to 14.3%, indicating that it can vary significantly among different age groups. The age group of 20 to 29 years seems to have the highest prevalence, with approximately 39.4% of individuals affected by geographic tongue. This suggests a peak incidence during early adulthood. This case report explores the potential benefits of homeopathic medicines in management of geographic tongue. A 17-year-old adolescent girl experiencing whitish discoloration of the tongue accompanied by intense burning sensation with history of recurrent tonsillitis and increased sweating in her palms and soles since early childhood presented in the OPD of Regional Research Institute for Homoeopathy, Shimla. Upon examination of her oral cavity, white patches were observed on her tongue, which did not resolve despite trying various medications. The primary diagnosis was geographic tongue, confirmed by physical examination. Following homeopathic treatment, the patient experienced marked improvement in symptomatology, including relief from the burning sensation, and the lesion from the tongue completely disappeared. This evidence-based case report highlights the potential beneficial role of homeopathy in the treatment of geographic tongue.

Necrotizing Fasciitis in Neonates: an evidence-based case report

Necrotizing Fasciitis in Neonates: an evidence-based case report

Aplikasi Citicoline dalam Pengobatan Stroke Hemoragik

Background: Choline-containing phospholipids, citicoline, and choline alphoscerate have been proposed as adjuvants in acute stroke treatment. An evidence-based case report (EBCR) was conducted to examine the benefits of citicoline in hemorrhagic stroke (SH) patients. Method: Search for articles published from October 2019-2023 from PubMed, Cochrane, Google Scholar, and ProQuest sources using the keywords “Citicoline”, “Hemorrhagic Stroke”, “Choline”, and “Intracerebral Hemorrhage”. The search results were evaluated using inclusion and exclusion criteria. Selected full-text studies were evaluated. The final selection results were critically reviewed based on validity, importance, and applicability by the three authors. Results: One study was considered valid, important, and applicable. The quality of this study is very high based on the literature review. Conclusion: The study shows that citicoline has the potential as an adjuvant therapy to improve clinical outcomes in SH patients, although it does not sufficiently improve neurological or functional outcomes.

Pengaruh Citicoline terhadap Tingkat Keparahan dan Status Fungsional Pasien Stroke Iskemik

Background: Stroke is a cause of long-term mortality, morbidity, and disability. Neuroprotectors, such as citicoline, are a choice for patients not eligible for rTPA. This evidence-based case report aims to look at the association of citicoline with the severity and functional status of ischemic stroke. Method: The search is based on the database Scopus. A total of 191 studies were reviewed, and 3 articles were chosen for critical review: Ghosh, et al, (2015), Martynov, et al, (2013), and Mehta, et al, (2019). Results: Significant differences in functional status measured by the Barthel index and modified Rankin Scale (mRS) and severity measured by the NIHSS. Conclusion: Citicoline has a significant effect on the functional status and severity of an ischemic stroke.

Non-Healing Abscess of Myositis Cured with Homoeopathy Treatment: An Evidence-Based Case Report

AbstractMyositis is an infectious disease that affects skeletal muscle and may appear as a diffuse inflammation or a rapidly progressive myonecrotic process that often results in abscess development. It is most common in thigh muscles. Staphylococcus aureus is the most common microorganism, accounting for 90% of cases. Pyomyositis diagnosis can be challenging due to neglect of initial symptoms, and usually presents with fever and muscle pain. Standard antibiotic treatment is the mainstay. However, it can be effectively treated with homoeopathic medicines by considering local pathology and other individualised characteristics. A 58-year-old male patient consulted with a non-healing abscess of myositis with multi-morbid conditions. Initially treated in outpatient department without any positive change, he was later admitted to inpatient department of National Homoeopathy Research Institute in Mental Health, Kottayam, and treated for 45 days. Merc. sol. 0/1 was given as the first prescription and repeated as required in the follow-up visits. Syphilinum 200 was given as an intercurrent remedy to address predominant syphilitic miasm. Abscess of myositis was cured, and diabetes and hypertension were under control. There was an improvement in sensorineural deafness in both ears, and his craving for alcohol was also reduced. The changes in outcome and causal attribution were assessed using the Modified Naranjo Criteria. The score was +9, close to the maximum (13), showing positive relationship between homoeopathic intervention and the outcome. This case proves the positive role of homoeopathic medicines intervention in treating non-healing abscess of myositis associated with multimorbidities.

Peran Citicoline Oral Sebagai Terapi Tambahan dalam Pengobatan Glaukoma

Glaucoma is the second-leading global cause of blindness. Lowering intraocular pressure can prevent the worsening of open-angle glaucoma, but alternative neuroprotective therapies are needed; citicoline is supposed to have neuroprotective potential. This evidence-based case report was to review the effectiveness of oral citicoline as an adjunct therapy for glaucoma. From 22 studies identified through PubMed, Scopus, Cochrane, EBSCO Host, and Google Scholar, three articles were selected for critical review. Lanza M. found the RNFL and GCC of the citicoline group 500 mg were significantly higher, 70.39 and 71.19 Pm, p<0,01 compared to controls, after 12 months. Sahin A, et al, showed that the RNFL was significantly higher in the third month than baseline in the oral citicoline 250 mg group, p = 0.038. Putri VC, et al, found that after 60 days, based on sub-group analysis, there was a significant difference in RNFL and GCIPL thickness changes after citicoline 500 mg intervention in the mild glaucoma group and after citicoline 1,000 mg in the moderate-severe glaucoma group. Oral citicoline supplementation prevents significant worsening of glaucoma, it can be given as an adjunct therapy.

Effect of oral vitamin E supplementation on lipid profile in diabetes mellitus: evidence based case report

Introduction: Diabetes mellitus, a prominent non-communicable disease, presents as a chronic condition associated with various complications, including heart disease, nerve damage, chronic kidney disease, and dyslipidemia. A pivotal abnormality in diabetic dyslipidemia is insulin resistance, which stimulates the production of Hepatic VLDL1 (very-low-density lipoprotein 1). The resulting overproduction of VLDL1 is metabolically linked to an abundance of small, dense LDL (low-density lipoprotein) particles and a reduction in large, cholesterol-rich HDL2 (high-density lipoprotein). Conversely, vitamin E, known for its antioxidant and anti-inflammatory properties, acts as a remover of peroxyl radicals, preventing lipid oxidation and safeguarding polyunsaturated fatty acids (PUFA) within cells and plasma lipoproteins.
 Method: This study investigates the impact of oral vitamin E supplementation on the lipid profile in diabetic patients. Employing advanced search techniques on databases like PubMed, Cochrane Library, and Google Scholar, we conducted a comprehensive literature search using MeSH terms, advanced search methods, and specific eligibility criteria. The results yielded one systematic review with a meta-analysis and two randomized controlled trials (RCTs) that met the predefined PICO and eligibility criteria.
 Results: The systematic review and meta-analysis, along with one RCT, reported no significant reduction in lipid profiles with oral vitamin E supplementation in diabetic patients. In contrast, the other RCT observed an improvement in lipid profiles among diabetic patients receiving oral vitamin E supplementation.
 Conclusion: Supplementing with oral vitamin E does not enhance the lipid profile of individuals with diabetes mellitus.

Polycystic Ovarian Syndrome Treated by Homoeopathy: An Evidence-Based Case Report

Abstract Background Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive women. Cardinal manifestations of PCOS include hyperandrogenism, oligo/anovulation and/or polycystic ovarian morphology. Affected women often display notable metabolic co-morbidities. Plenty of evidence on PCOS favouring homoeopathy is available in the literature. In this case, also individualised medicine portrayed a favourable response within a short span of time. Case Summary A case of PCOS with the complaint of irregular, delayed menses, acne on the face and dark pigmentation on the neck for the last 3 years is presented here. The outcome was assessed by using two validated measurement scales. After 4 months of follow-up, the case was markedly improved on the Outcome Related to Impact on Daily Living (ORIDL) scale (+4) as per the patient's perspective. Clinical improvement was correlated with objective evidence from the ultrasonography report. Modified Naranjo criteria for Homeopathy (MONARCH) score recorded at the final visit (+8 on the ‘−6 to 13’ scale) is suggestive of a high likelihood of improvement by homoeopathic intervention. Conclusion The case report presented here has produced significant evidence of the effect of individualised homoeopathic medicine in the treatment of PCOS within a short time.

Prognosis of COVID-19 on Workers with History of Asthma: An Evidence-Based Case Report

Prognosis of COVID-19 on Workers with History of Asthma: An Evidence-Based Case Report