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Shorter All-oral Bedaquiline-containing MDR-TB Regimen : The Backgrounds & Implementations Winoto, Eden Suryoiman; Candradikusuma, Didi
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.6

Abstract

The continuing spread of Multidrug-Resistant Tuberculosis (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, become one of the most urgent and difficult challenges in TB control. In Indonesia, the estimated total DR-TB case incidence of 24,000 or 8.8/100,000 population (2.4% of total new TB patients). The first-ever MDR-TB treatment guideline published by WHO required a long duration (up to 20–24 months) and contained toxic second-line drugs with less effective & unfavorable outcomes. About ten years ago, a short regimen lasting nine instead of 20 months, called “Bangladesh regimen”, revolutionized MDR-TB treatment. The advent of rapid molecular diagnostic tests, discoveries of new and repurposed drugs, promising results based on trials and meta-analysis had prompted WHO to update its guidelines. Notably, drugs such as bedaquiline and clofazimine are now strongly recommended for the treatment of MDR-TB. At the same time, older injectables drugs have been downgraded due to poor effectiveness and side-effect profiles. In 2019, based on the programmatic data from the shorter all-oral bedaquiline-containing regimen implemented routinely in South Africa, WHO revised its recommendations on the use of a standardized shorter regimen. Based on the analysis, WHO affirmed its conditional recommendation for the shorter all-oral bedaquiline-containing MDR -TB regimen to be offered as a treatment option to MDR -TB patients who satisfy the eligibility criteria. The implementation of this all-oral shorter regimen is expected to improve the programmatic management of the MDR-TB worldwide.
Comparison of Carotid Intima-Media Thickness (CIMT) and Calcium-Phosphorus (Ca × P) Product Between Hemodialysis (HD) Patients and Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients. Rosandy, Kharisma Ogit; Winoto, Eden Suryoiman; Samsu, Nur
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.09

Abstract

Background: Cardiovascular disease is the leading cause of death in end-stage renal disease (ESRD). Carotid intima-media thickness (CIMT) and the calcium–phosphate (Ca × P) product are recognised surrogate markers of cardiovascular risk in dialysis recipients. Objective: This study aims to compare CIMT and Ca × P product levels between patients undergoing HD and CAPD. Methods: A cross-sectional study was conducted on 93 dialysis patients (49 HD, 44 CAPD) at Saiful Anwar General Hospital, Indonesia. Participants were over 18 years old, on dialysis for at least three months (HD at least twice weekly), and physically independent. Critically ill and pregnant patients were excluded. The Mann-Whitney U test compared CIMT and Ca × P levels, and Spearman's rank correlation analyzed the relationship between CIMT and Ca × P product Results: Significant differences in CIMT (p=0.0013) and Ca × P product (p<0.0001) were found between the HD and CAPD groups. A positive correlation between CIMT and Ca × P product was observed in HD patients compared to CAPD patients (r = 0.212, p = 0.044), Conclusion: This study revealed that CIMT was higher in HD patients compared to CAPD patients. Furthermore, the Ca × P product was lower in the CAPD group than in the HD group, and a positive correlation existed between CIMT and Ca × P in HD patients.