Evidence-based Report Research Articles

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.

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

Effectiveness of Proton Pump Inhibitor Therapy in Children with Chronic Otitis Media: an Evidence-Based Case Report

Introduction: In Indonesia, 82% of children with otitis media have experienced chronic otitis media (COM). COM has a high recurrency rate and is multifactorial, one of which is caused by acid reflux. Proton pump inhibitor (PPI) therapy has been used to treat acid reflux and gives excellent result. Purpose: Reporting one case of a child with COM and laryngopharyngeal reflux (LPR) who received PPI therapy. An evidence-based literature review was done to evaluate the effectiveness of PPI therapy in patient with COM and LPR.Methods: Literature searching was done through 3 databases. Critical appraisal based on the Oxford Center for Evidence Based Medicine Checklists 2011.Results: After we sorted out duplications and screened articles according to our inclusion and exclusion criteria, we retrieved one article. This article is valid and applicable, yet PPI therapy did not give significant clinical improvement because of some reasons.Conclusion: From the literature review, PPI therapy on patient with COM did not give significant clinical improvement such as to stop middle ear discharge, yet in our case, PPI therapy could produce a clinical improvement and in line with previous experimental studies. Therefore, PPI therapy could still be considered given in children with COM.

Role of Homoeopathy in Diabetic Ulcer: An Evidence-Based Case Report

Role of Homoeopathy in Diabetic Ulcer: An Evidence-Based Case Report

Molluscum contagiosum treated with Bromium 30C Homoeopathic medicine using Boericke’s repertory as a reference: An evidence-based case report

Molluscum contagiosum treated with Bromium 30C Homoeopathic medicine using Boericke’s repertory as a reference: An evidence-based case report

The Effectiveness of Oral Citicoline Administration as a Therapy for Memory Enhancement in Post-COVID-19 Patients: An Evidence-Based Case Report

Background: Coronavirus Disease 2019 can cause both acute and chronic neurological problems, including cognitive impairment, which can develop at various times post-exposure and persist indefinitely. Citicoline is an alternative treatment option that can function as a neuroprotector. Objective: To determine the effectiveness of oral Citicoline administration as a therapy for memory enhancement in post-COVID-19 patients. Methods: A search was conducted on PubMed, Cochrane, EBSCOhost, Scopus, and Google Scholar for review articles and original studies. Researchers found only three studies linking Citicoline, COVID-19, and memory. Results: Turana et al. (2021) stated that Citicoline combats COVID-19-related cognitive decline through anti-inflammatory, antiviral, neuroprotective, neurorestorative, and acetylcholine neurotransmitter synthesis mechanisms. Al-Kuraishy (2022) concluded that Citicoline improves memory through mechanisms involving neural energy, neurogenesis, anti-inflammatory, antioxidant, and silent information regulator 1 (SIRT1). Zueva et al. (2021) reported that 18 (75%) COVID-19 patients with cognitive impairment who received Citicoline 1000 mg/day in an oral solution (100 mg / 1 ml) for 14 days showed significant memory improvement with p <0.05. This study reported that administering Citicoline 500 mg tablets every 12 hours for two months improved MoCA-INA scores by 16 points and MMSE scores by 13 points. Conclusion: Citicoline can be a significant consideration in memory therapy for post-COVID-19 patients.

Treatment of Varicose Veins with Individualized Homoeopathic Medicine - A Case Report

Varicose veins a common vascular condition affecting millions worldwide presents with symptoms ranging from cosmetic concerns to discomfort and complications. While conventional treatments such as compression stockings and surgery exist interest in complementary and alternative therapies like homeopathy has surged. This case report documents the efficacy of individualized homeopathic medicine in treating varicose veins through an evidence-based approach. A 42-year-old male presented with bilateral lower limb varicose veins causing pain swelling. Conventional treatments had provided limited relief. An individualized homeopathic remedy was prescribed based on his unique symptomatology focusing on modalities concomitant symptoms and constitutional characteristics. The patient was followed up for six months during which the progression of symptoms pain intensity and quality of life were assessed using standardized measures. Significant improvement in symptoms was observed within weeks of initiating homeopathic treatment. Pain and swelling reduced progressively. Quality of life scores improved notably reflecting the overall well-being of the patient. No adverse effects were reported throughout the treatment duration. This evidence-based case report highlights the potential of individualized homeopathic medicine as an effective and safe treatment modality for varicose veins. Further research incorporating larger sample size and rigorous methodologies is warranted to validate these findings and elucidate the underlying mechanisms of action. Integrating homeopathy into comprehensive management strategies for varicose veins may offer personalized holistic care options for patients seeking alternative approaches to conventional treatments.

Bridging the engineering skill gap in Nigeria: Preliminary findings and recommendations of the E4I survey

The paper presents the key findings and recommendations of an evidence-based survey report on the engineering skill gap among young engineering graduates in Nigeria. The outcome of the study highlighted the lack of technical, problem-solving, research and development, and management skills in the country’s young engineering graduates. Integrating emerging technologies like artificial intelligence, additive manufacturing, virtual reality, computer programming, computer-aided manufacturing, and computer-aided design into the curriculum was strongly recommended for the training of young engineering students in Nigerian higher education institutions. Other recommendations for skill augmentation include; enabling young graduates to develop their optimisation, modelling, simulation, design, creativity, technical, practical, machining, operation, and management skills to boost their hands-on engineering proficiencies. Strong emphasis was also on the importance of a one-year post-graduation internship program to upskill all young engineering graduates and provide a head-start in industrial settings. Lastly, adopting an outcome-based education (OBE) engineering training curriculum was recognised as crucial for addressing the skills gap.

Unleashing The Curative Power of Homoeopathy Through Treatment of Allergic Rhinitis an Evidence-Based Case Report.

Unleashing The Curative Power of Homoeopathy Through Treatment of Allergic Rhinitis an Evidence-Based Case Report.

Type 2 Diabetes in Non-Sedentary Workers with Long Working Hours “An Evidence-Based Case Report”

Background: Type 2 diabetes mellitus is a serious threat to public health and the economy. Several reviews suggested that working long hours has a negative effect on health, especially metabolic disorders.Objective: To determine whether long working hours increase the incidence of diabetes mellitus in non-sedentary workers.Methods: A literature search using PubMed, Scopus, and Proquest was conducted based on the clinical question. Selected studies were critically reviewed for their validity using Oxford University’s Center for Evidence-Based Medicine’s etiological study criteria.Result: Three relevant studies were found. A cohort study found that non-clerical workers and shift workers with long working hours had a significantly higher risk of developing diabetes with a Hazard Ratio (HR) of 2.28 (95% Confidence Interval [CI] 1.13-4.82). However, the dominant risk factor that may have influenced the outcomes could not be clearly identified. In contrast, a cross-sectional study found no significant association (p>0.05) between working overtime and diabetes prevalence among field workers. Another cross-sectional study showed that blue-collar workers with long working hours had a higher likelihood of prediabetes with an adjusted Odds Ratio (aOR) of 1.54 (95% CI 1.15-2.06). However, since this is a cross-sectional study, the causal relationship is uncertain. Conclusion: Studies regarding the relationship between long working hours and an increased risk of type 2 diabetes mellitus in non-sedentary workers showed inconsistent and unclear results. Further evaluation is still needed to find more evidence on the health effects of long working hours on workers.

Will-To-Live Scale as a Predictor of Depressive Symptoms in Elderly: an Evidence-Based Case Report

Will-To-Live Scale as a Predictor of Depressive Symptoms in Elderly: an Evidence-Based Case Report

Enhancing Pedagogic Practice: A Review of Educational Processes

This paper focuses on the improvement process in the educational setting, highlighting the importance of the participation of various agents, including students, parents, teachers, principals and other educational professionals. The improvement process is based on the continuous review and evaluation of educational practice, with the aim of identifying areas for improvement and addressing them effectively. The paper describes the different stages of the improvement process, starting with the identification of areas for improvement through data collection and analysis. These data are used to produce evidence-based reports that serve as the basis for planning necessary improvements. During improvement planning, areas for improvement are prioritized and action plans are designed to address them. The implementation of improvements involves the implementation of the action plans, with a focus on gathering evidence to assess the impact of the improvements. The improvement process is seen as a continuous cycle, with constant review and feedback to further adjust and improve educational practices. The paper also highlights the importance of the involvement of review and improvement groups throughout the process, as they help to identify problems, needs and areas for improvement, as well as to make evidence-based decisions. Several techniques and tools are mentioned, such as brainstorming, review guide, time profiles and cause-effect diagrams, which are used in the process of data collection and analysis. In conclusion, the importance of an evidence-based approach in the educational improvement process, with the active participation of multiple stakeholders and constant feedback to achieve higher quality education is emphasized. The improvement process is described as a continuous cycle of identifying areas for improvement, planning, implementing and reviewing, with the aim of optimizing educational practice and meeting the needs of students and the educational community at large

Efektivitas Citicoline sebagai Agen Neuroprotektif dalam Tata Laksana Traumatic Brain Injury

Background: Traumatic brain injury (TBI) is a condition resulting from physical trauma to the head which can cause structural damage to the brain and interfere with cognitive, motor and emotional functions. Citicoline is a natural compound that plays an important role in phospholipid metabolism and neurotransmitter synthesis in the brain. This evidence-based case report (EBCR) study aims to provide scientific evidence of the potential benefits of citicoline in improving clinical outcomes in TBI patients. Method: Literature search using the PICO format. The formulation of clinical questions was arranged by case. Search for articles on March 6–7th 2023 using the Publish or Perish (PoP) software with the target of searching articles for the last 10 years (2013-2023) on the Scopus, Pubmed, Google Scholar databases, and manual searches on the Cochrane database, using the keyword 'traumatic brain' injury' AND 'therapy' AND 'citicoline' AND 'neuroprotective' AND 'treatment' AND 'outcome' along with synonyms and related terms. Results: Four studies were obtained, with the level of evidence 1a which resulted from a meta-analysis or systematic review of various randomized controlled trials, which were then critically reviewed. Two studies reported no significance of clinical assessment and the Glasgow Coma Scale (GCS); two other studies showed significant results at the level of independence. Conclusion: This study shows that citicoline is beneficial in the independence of TBI patients but does not produce a significant difference in the Glasgow Coma Scale assessment.

Selective Serotonin Reuptake Inhibitors and Risk of Gastrointesinal Bleeding In Dyspepsia: An Evidence-Based Case Report

Aim: This evidence-based case report aims to provide the latest evidence about the risk of gastrointesinal (GI) bleeding in selective serotonin reuptake inhibitor (SSRI) users with dyspepsia.Method: The literature search was conducted in four major electronic databases (PubMed, Cochrane, Scopus, ProQuest). The selected articles were sorted through screening abstract based on the inclusion and exclusion criteria. Critical appraisal was performed by using validated critical appraisal tool.Results: Of 247 records from extensive literature searching, three eligible studies (one randomized clinical trial and two cohort studies) were obtained to answer the clinical question. All studies showed SSRIs did not increase the risk of GI bleeding in patients with functional dyspepsia and peptic ulcer. However, the adverse event of SSRIs might be under-reported.Conclusion: According to the evidence, the risk of GI bleeding in SSRIs users with dyspepsia is still unclear. Larger size of sample of controlled trial study is recommended to be conducted to calculate the precise risk of GI bleeding in SSRI users with dyspepsia.

An Evidence-Based Case Report of Female Infertility Treated with Individualised Homoeopathic Medicine

Abstract Introduction Infertility is defined as the failure to conceive within 1 or more years of regular unprotected coitus. The World Health Organization (WHO) estimates the overall prevalence of primary infertility in India to be between 3.9 and 16.8%. Medical therapy includes the treatment of reversible endocrine or infectious causes of subfertility. In the medical literature, case reports of infertility are scanty. We aimed to report a case treated with homoeopathic constitutional medicine in a lady suffering from infertility. Case summary A female patient, aged 30, married for 6 years, presented with a complaint of having no issue despite treatment of infertility for a couple of years by a reproductive endocrinologist. Subsequent investigations showed that her ovarian reserve was inadequate. She was encouraged to undergo in vitro fertilisation because her husband's semen analysis report was normal. She decided to take homoeopathic treatment and received individualised care based on the holistic tenets of homoeopathy. After 3 months of treatment with the constitutional homoeopathic drug Natrum muriaticum, she became pregnant and gave birth to a healthy boy at term. This case report demonstrates the beneficial effects of individualised homoeopathy on infertility. The Modified Naranjo Criteria score (MONARCH) showed causal attribution of changes in her condition to the homoeopathic treatment.

Case report of palmoplantar psoriasis: Specific remedies to constitutional remedies for condition

Psoriasis, an autoimmune and chronic inflammatory disease of the skin, can leave the patient in agony with its distressing infection episodes. Palmoplantar psoriasis is a chronic variant of psoriasis that characteristically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic, pustular, or mixed morphologies. Palmoplantar psoriasis is a variant of psoriasis and accounts for 3–4% of total cases of psoriasis. Though historically difficult to treat, recent studies on biologic therapies have shown promising results for the treatment of palmoplantar psoriasis. This activity describes the pathophysiology, evaluation, and management of palmoplantar psoriasis and highlights the role of the interprofessional team in the care of affected patients. The homoeopathic system of medicine offers a wide range of medicines that can have a beneficial role in managing cases of psoriasis as depicted in the previous studies. 1. Identify the trigger factors and aetiology for palmoplantar psoriasis. 2. Describe the mental and physical presentation of a patient with palmoplantar psoriasis. 3. Summarize the out of treatment and management options available fin homeopathy for palmoplantar psoriasis. 3. Review interprofessional team strategies for improving care coordination and communication to enhance outcomes for patients affected by palmoplantar psoriasis. 4. Review of recurrence of palmoplantar psoriasis.A distinct case of Palmoplantar psoriasis treated with homoeopathic remedies of ultrahigh potentised dilution has been presented here. The evidence-based illustrations were done before and after the treatment and the periodical objective assessment of the lesions with psoriasis area and severity index (PASI) calculation to ascertain the prognosis. The causal attribution of outcome to the treatment was evaluated using Modified Naranjo Criteria for Homoeopathy (MONARCH) tool. Marked improvement was found in the psoriatic lesions evidenced photographically and the PASI scores showed significant reduction affirming the same. The MONARCH score (+10) suggested that the clinical improvement was likely attributable to the homoeopathic treatment. This evidence-based case report suggests a beneficial role of homoeopathy in the treatment of palmoplantar psoriasis.

Treatment of Depression With Psychotic Features in Maltreated Adolescents: Evidence-Based Case Report

Introductions: Depressive disorders are expected consequences of experiencing child maltreatment. Many depressive disorders can occur with or without psychosis, which has different implications for treatment and prognosis. This condition raises the challenge of treating depression in maltreated adolescents because the patient has inadequate family and social support. Consequently, it is difficult for the patient to undergo psychotherapy that involves family. Case: A 17-year-old female was diagnosed with psychotic depression. The patient had symptoms of depression, accompanied by hallucinations, since five years ago. The patient was hospitalized for suicidal ideation and food refusal for days. Patient had a history of child maltreatment by family and experienced bullying since elementary school. Patient believes that her family, especially her mother, had hated her from the beginning. Discussions: After stabilization of the patient’s general condition, psychopathology exploration was done together with selection of appropriate treatment. Combined Cognitive Behavioral Therapy (CBT), Selective Serotonin Reuptake Inhibitor (SSRI) and atypical antipsychotic treatment are the evidence-based treatments for psychotic depression in maltreated adolescents. Studies involving patients with psychotic depression which were treated by combination of sertraline and olanzapine showed significant improvement of depression and psychotic symptoms and reduced the risk of relapse over 36 weeks, compared to sertraline plus placebo. Conclusion: Combination of SSRI, atypical antipsychotic and CBT with a trauma-informed approach should be considered as treatment for psychotic depression in maltreated adolescents.

Pan American League of Associations for Rheumatology recommendations for the management of axial spondyloarthritis.

Axial spondyloarthritis (axSpA) comprises a spectrum of chronic inflammatory manifestations affecting the axial skeleton and represents a challenge for diagnosis and treatment. Our objective was to generate a set of evidence-based recommendations for the management of axSpA for physicians, health professionals, rheumatologists and policy decision makers in Pan American League of Associations for Rheumatology (PANLAR)countries. Grading of Recommendations, Assessment, Development and Evaluation-ADOLOPMENT methodology was used to adapt existing recommendations after performing an independent systematic search and synthesis of the literature to update the evidence. A working group consisting of rheumatologists, epidemiologists and patient representatives from countries within the Americas prioritized 13 topics relevant to the context of these countries for the management of axSpA. This Evidence-Based Guideline article reports 13 recommendations addressing therapeutic targets, the use of NSAIDs and glucocorticoids, treatment with DMARDs (including conventional synthetic, biologic and targeted synthetic DMARDs), therapeutic failure, optimization of the use of biologic DMARDs, the use of drugs for extra-musculoskeletal manifestations of axSpA, non-pharmacological interventions and the follow-up of patients with axSpA.

Tinea cruris treated with individualised homoeopathic medicine – An evidence-based case report

Tinea cruris treated with individualised homoeopathic medicine – An evidence-based case report