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Chronic Obstructive Pulmonary Disease Exacerbation Complicated with Pneumonia and Lung Cancer: An Evidence-based Case Report of Erdosteine Role in the Management of Complex COPD Ahmad Fadhil Ilham; Muhammad Ilham Dhiya Rakasiwi; Ris Raihan Felim; Ahmad Arfan; Erlina Burhan
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.05

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are strongly associated with poor health status and morbidity. Erdosteine is a mucolytic agent that also has anti-inflammatory, antioxidant and antibacterial effects. This case report aims to evaluate the role of erdosteine in the prevention and treatment of acute exacerbations of complex COPD case. Case: A 73-year-old male arrived at the emergency department with an increased difficulty in breathing that had deteriorated over the previous 5 days, and had a history of heavy smoking for more than 40 years. Following a thorough examination, he was diagnosed with acute exacerbation of COPD (Anthonisen criteria type 2) in clinical group E, pneumonia, along with stage IIIA right lung tumor (T4N1Mx), and received erdosteine inhalation as part of his treatment. Discussion: A comprehensive search of journal databases (PubMed, EMBASE, CENTRAL, EBSCO Medline, Scopus, and ProQuest) was conducted using specific keywords, critical appraisal based on the Oxford Center for Evidence-Based Medicine. Article selection resulted in 1 systematic review article for the prevention of acute exacerbations and 1 systematic review article for the management of acute exacerbations of COPD. In patients with stable COPD, administration of erdosteine in the standard COPD regimen significantly reduced the risk of exacerbations (RR=0.65; p=0.01), while in patients with acute exacerbations of COPD, erdosteine increased treatment success (OR=3.2; p<0.0001). Conclusion: Erdosteine may serve as a therapeutic choice for COPD patients in preventing or managing acute exacerbations.
Comparison of Cyclosporine and Steroids in Treating Severe Allergic Conjunctivitis in Children: an Evidence-based Case Report Muhammad Ilham Dhiya Rakasiwi; Julie Dewi Barliana; Afid Brilliana Putra; Muhammad Imran Khan Ismail; Awliya Awliya; Gusti Candra Pamungkas; Nida Ghitha Aulia
Journal of Agromedicine and Medical Sciences Vol 10 No 2 (2024)
Publisher : Faculty of Medicine, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ams.v10i2.46062

Abstract

The efficacy of cyclosporine compared with corticosteroid in reducing symptoms and signs in children with severe allergic conjunctivitis, either in vernal keratoconjunctivitis or atopic keratoconjunctivitis, is still unknown. Here we present the case of an 8-year-old boy with a case of allergic keratoconjunctivitis. The patient had been given steroid eye drops (Dexamethasone 1 mg) for 2 weeks and only slight improvement was found. Considering the steroid’s long-term effects, the doctor prescribed cyclosporine eye drops. Therefore, this case study is conducted to compare the better efficacy between cyclosporine eye drops and steroid eye drops as a treatment for severe allergic conjunctivitis. After conducting a systematic literature analysis following the PRISMA guidelines, full-text analysis was carried out on two RCTs by assessing their validity, clinical importance, and applicability according to the Oxford CEBM criteria. One of the studies did not meet the validity criteria, while another study showed that cyclosporine eye drops that were given to patients with severe vernal keratoconjunctivitis could reduce signs and symptoms. There was no significant difference between cyclosporine eye drops and dexamethasone eye drops. Cyclosporine's function to reduce signs and symptoms of severe allergic conjunctivitis in children is equivalent to that of corticosteroids. Keywords: Cyclosporine, corticosteroid, severe allergic conjunctivitis, therapy