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All Journal Medical Journal of Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Rahman, Farhan Haidar Fazlur
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Kasus Kateter Dialisis Peritoneal yang Terpuntir pada Seorang Anak Ambarsari, Cahyani Gita; Rahman, Farhan Haidar Fazlur; Bermanshah, Evita Karianni; Kadaristiana, Agustina
Majalah Kedokteran Indonesia Vol 70 No 2 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.2-2020-175

Abstract

Objective: Mechanical complications of peritoneal dialysis (PD) may occur because of surgical complications when inserting a Tenckhoff catheter or non-surgical complications during chronic care of a PD catheter. We aim to highlight the latter by presenting a case report of twisted external catheter. Method: We report an 11-year-old Indonesian girl with end-stage renal disease on continuous ambulatory PD at Cipto Mangunkusumo Hospital who was hospitalized due to repeat peritonitis.Result: Upon examination, the external catheter seemed twisted without inflow, outflow, or ultrafiltration problems. Her exit score was 4 with gaping. Both abdominal X-ray and ultrasound showed that the catheter and its cuffs were properly placed. The patient frequently pulled and manipulated her PD catheter. Additionally, the catheter-site care procedure was frequently done by untrained caregivers and catheter fixation was also not performed. A retraining program for all involved caregivers was carried out. Peritonitis resolved after 14-day-treatment using intraperitoneal gentamicin. We determined that the twisted catheter and repeat peritonitis were due to a combination of mechanical trauma, poor chronic catheter-site care, and suboptimal PD catheter training. Conclusion: Maintaining compliance for chronic PD catheter exit-site care by well-trained caregivers and by patients themselves, as well as the external catheter fixation are important.
Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones Rahman, Farhan Haidar Fazlur; Leonardo, Kevin; Ardaya, Radhyaksa; Atmoko, Widi; Parikesit, Dyandra
Medical Journal of Indonesia Vol. 32 No. 4 (2023): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247180

Abstract

BACKGROUND Ureteral stones are a common urological condition causing significant discomfort and morbidity. Medical expulsive therapy (MET) is a noninvasive approach to facilitate the passage of stones. This study aimed to compare the efficacy and safety of silodosin and tamsulosin as MET in patients with distal ureteral stones (DUS). METHODS We searched CINAHL, Cochrane Library, PubMed, and ScienceDirect for randomized controlled trials (RCTs) on the administration of silodosin and tamsulosin for DUS. The primary outcomes analyzed were stone expulsion rates and expulsion times, measured as risk ratio (RR) and mean difference (MD), respectively. Statistical analyses were performed using Review Manager 5.4 and STATA 17. RESULTS 14 RCTs comprising 1,535 patients (770 received silodosin) met the inclusion criteria. The silodosin group had notably higher stone expulsion rates (RR 1.20, 95% confidence interval [CI] 1.13–1.27, p<0.00001, I² = 37%), shorter expulsion times (MD −2.98, 95% CI −4.35–−1.62, p<0.01, I² = 85%), and fewer colicky pain episodes (MD −0.35, 95% CI −0.59–−0.10, p<0.01, I² = 83%) than the tamsulosin group. Retrograde ejaculation was the only adverse event that had a significant difference between both groups, statistically favoring tamsulosin (RR 1.61, 95% CI 1.12–2.33, p = 0.01, I² = 0%). CONCLUSIONS Silodosin should be preferred as the first-line MET agent for DUS owing to its better expulsion rate, shorter stone expulsion time, and fewer colicky pain episodes. However, tamsulosin may be used in selected cases where patients experience retrograde ejaculation after receiving silodosin.
Co-Authors Ardaya, Radhyaksa Bermanshah, Evita Karianni Cahyani Gita Ambarsari Dyandra Parikesit, Dyandra Kadaristiana, Agustina Leonardo, Kevin Rahmawati, Vita Kusuma Tasya, Galuh Anis Widi Atmoko