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All Journal Cermin Dunia Kedokteran Journal of Health and Therapy
Kemal Akbar Suryoadji
Fakultas Kedokteran, Universitas Indonesia
Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Perbandingan Efektivitas Leflunomide dengan Methotrexate untuk Terapi Artritis Rematoid Kemal Akbar Suryoadji; Pramesti Kusumadini Wibowo
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.1053

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by symmetrical joint involvement and extra-articular manifestations. Methotrexate and leflunomide are disease modifying anti-rheumatic drugs(DMARD) and use as treatment options for rheumatoid arthritis. This report aims to compare the effectiveness of leflunomide with methotrexate as therapy for rheumatoid arthritis. Methods: Literature search was carried out through three electronic databases: PubMed, Cochrane, and EBSCOHost with specific keywords based on PICO. Selection was in accordance with inclusion and exclusion criteria based on the clinical question. Selected literature was critically reviewed using an adapted instrument from the University of Oxford’s CEBM. Result: One systematic review and meta-analysis literature by Alfaro-Lara, et al, (2017) was obtained. The results showed a trend towards methotrexate in achieving response according to American College of Rheumatology (ACR20) (0.88 [95% CI: 0.74-1.06]; p = 0.18), reduction in joint swelling was greater with methotrexate (-0.82 [95% CI: 0.24-1.39]; p = 0.006), no significant difference in joint pain reduction (p>0.05). Liver enzyme elevations were more frequent with leflunomide (0.38 [0.27-0.53]; p = 0.007); gastrointestinal (GI) complaints were more frequent with methotrexate (1.44 [1.17-1.79]; p = 0.0007), no significant difference in the incidence of non-severe infections. Conclusion: Leflunomide has the same efficacy as methotrexate for RA therapy; more reduction of joint swelling with methotrexate. Leflunomide was associated with greater increases in liver enzymes, but fewer GI complaints.
Peran sentinel node pada kanker ginekologi Fitriyadi Kusuma; Marshaly Safira Masrie; Geraldus Sigap Gung Binathara; Abdul Hafiidh Surya Putra; Kemal Akbar Suryoadji
Journal of Health and Therapy Vol. 5 No. 2 (2026): Journal of Health and Therapy
Publisher : Nur Science Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53088/jht.v5i2.2371

Abstract

This review evaluated the role of sentinel lymph node mapping in early-stage gynecologic cancers, cervical, endometrial, and vulvar, as a staging approach that balanced diagnostic accuracy and patient safety. The search methods assembled evidence from major clinical trials and cohort studies on detection performance, diagnostic accuracy, and surgical morbidity compared with systematic lymphadenectomy. The findings indicated that this mapping achieved high detection rates with adequate sensitivity and reduced operative time, blood loss, and risks of lymphedema, lymphocele, and neurovascular injury. In cervical and endometrial cancer, multicenter and prospective studies demonstrated comparable oncologic safety alongside lower postoperative complications, whereas in vulvar cancer, a strategy based on a negative sentinel node reduced groin morbidity without compromising disease control in selected lesions. Tracer approaches, including radioisotopes, blue dye, and indocyanine green fluorescence, together with enhanced assessment through in-depth histopathology, supported broad clinical adoption. Overall, this review concluded that sentinel lymph node mapping was appropriate for routine use in suitable cases, provided bilateral mapping and standardized pathological evaluation.
Co-Authors Abdul Hafiidh Surya Putra Fitriyadi Kusuma Geraldus Sigap Gung Binathara Marshaly Safira Masrie Pramesti Kusumadini Wibowo