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Journal : Medical Journal of Indonesia

Mycophenolate mofetil versus cyclophosphamide for therapy of lupus nephritis: an evidence-based case report from systematic reviews and meta-analyses Pramono, Laurentius A.; Karim, Birry; Rajabto, Wulyo; Siregar, Parlindungan; Sukmana, Nanang; Setyohadi, Bambang
Medical Journal of Indonesia Vol 21, No 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.305 KB) | DOI: 10.13181/mji.v21i1.474

Abstract

Background: The aim of this case study is to compare the effectiveness between cyclophosphamide and mycophenolate mofetil to achieve remission of lupus nephritis in an evidence-based case report from meta-analyses.Methods: Method in this case study is evidence-based case report using meta-analyses. Clinical question used in this paper is; which immunosuppressant gives better result in achieving remission in lupus nephritis patient: cyclophosphamide or mycophenolate mofetil? To answer this question, we search the evidence from PubMed with the keywords: “lupus nephritis AND mycophenolate mofetil AND cyclophosphamide” with inclusion criteria of meta-analysis, written in English, and focused comparing cyclophosphamide and mycophenolate mofetil.Results: From the searching method, we found 11 articles which is relevant. One has been excluded since it written in Hebrew, 4 articles excluded since are not focus answering the clinical question. At the end, 6 studies were included to the critical appraisal step.Conclusion: Based on the evidences, mycophenolate mofetil is non-inferior to cyclophosphamide in achieving remission in lupus nephritis patients, but with the better safety profile. Patient in our case study get mycophenolate mofetil and shows better clinical condition towards remission as she are evaluated in the outpatient clinic. (Med J Indones 2012;21:44-51)Keywords: Cyclophosphamide, evidence-based case report, lupus nephritis, meta-analysis, mycophenolate mofetil, remission, systematic review
A comprehensive management of hypertension among patients with metabolic syndrome: an evidence-based update Nursalim, Alvin; Siregar, Parlindungan
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (382.39 KB) | DOI: 10.13181/mji.v22i3.590

Abstract

Individuals with hypertension and metabolic syndrome are at increased risk of developing future morbidities. Therefore, an evidence-based comprehensive approach is required. It is recommended to start with lifestyle modification as the first step, then followed by antihypertensive drugs. Weight loss through decreased caloric intake and increased excercise have been proven to yield a better control over diabetes, blood pressure, and lipid profile. Inhibitor of renin-angiotensin is the recommended first-line drugs for this population, while β blocker and diuretic should remain as the second line drugs due to increased risk of developing new onset diabetes with these drugs.  A more rigorous blood pressure control is reasonable with a target of < 130/80. A comprehensive management which include good control over blood pressure, weight, blood glucose, and lipid profile, may reduce future morbidities among hypertensive individuals with metabolic syndrome. (Med J Indones. 2013;22:189-94. doi: 10.13181/mji.v22i3.590) Keywords: Cardiovascular, diabetes, hypertension, metabolic syndrome