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Nova Nasikhatussoraya
General Practitioner, Roemani Muhammadiyah Hospital, Semarang, Indonesia
Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Economics, Econometrics & Finance Engineering Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology

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A Systematic Review and Meta-Analysis: The Long-Term Effects of Oral N-Acetylcysteine in Chronic Obstructive Pulmonary Disease Nova Nasikhatussoraya; Hamid Faqih Umam; Ainingtyas Marda Rizkani; Hidayat Santoso
Nusantara Science and Technology Proceedings The 4th International Conference on Community Medicine and Medical Sciences
Publisher : Future Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/nstp.2024.4404

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the world's most prevalent causes of morbidity and mortality. About 5.6% of Indonesians have COPD. Most COPD patients have mucus hypersecretion and inadequate mucus clearance, leading to airway obstruction. N-acetylcysteine (NAC) is a mucolytic drug with antioxidant and anti-inflammatory effects. Long-term oral NAC use in COPD remains controversial. We searched four databases to analyze the effects of oral NAC in COPD over a minimum six-month treatment. The data was analyzed through Review Manager 5.4. Eight randomized controlled trials, comprising 3.187 patients, were selected for inclusion in the study. NAC had a lower risk of exacerbations (RR 0.78, 95% CI 0.66-0.93; p=0.005), whether at high dose (1200mg/day) or low dose (600mg/day). The risk is higher at the high dose (RR 0.90, p=0.04) than at the low dose (RR 0.70, p=0.0002). NAC did not affect FEV1 (mean difference 4.71, 95% CI -3.20-12.61; p=0.24), and adverse events were the same as with placebo (RR 1.14, 95% CI 0.78-1.67; p=0.51). Long-term oral NAC reduces the risk of COPD exacerbations at any dose and was well tolerated.
The Importance of Blood Pressure Control in End-Stage Renal Disease: A Case Report of Intracranial Hemorrhage Hamid Faqih Umam; Nova Nasikhatussoraya; Shofa Chasani; Durrotul Djannah
Nusantara Science and Technology Proceedings The 4th International Conference on Community Medicine and Medical Sciences
Publisher : Future Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/nstp.2024.4407

Abstract

Introduction: End-Stage Renal Disease (ESRD) is a growing global health concern. ESRD often presents with high blood pressure that is unresponsive to medication. Long-standing high blood pressure is the primary cause of intracranial hemorrhage. It is more likely to occur in ESRD patients. Case Illustration: A 69-year-old woman was brought to the emergency room because of unconsciousness four hours earlier. She had a sudden severe headache before that. No history of trauma. Her consciousness was poor (GCS E1M2V1) and her blood pressure was high (213/78 mmHg) in the emergency unit. Head CT revealed intracerebral, intraventricular, and subarachnoid hemorrhages with a total volume of 81 cc and midline shift. The patient had been on dialysis twice a week for six years. She had uncontrolled hypertension said to routinely take antihypertensive drugs independently. Last year's dialysis visits showed high blood pressure, with a mean of 187/72 mmHg (224/112-166/51 mmHg). Given her complex condition, she underwent conservative therapy and died on the third day of treatment. Conclusion: ESRD patients are at high risk of intracranial hemorrhage. It is crucial to closely monitor blood pressure during dialysis visits. ESRD with intracranial hemorrhage has a poor prognosis, emphasizing the importance of preventive care.
Co-Authors Ainingtyas Marda Rizkani Durrotul Djannah Hamid Faqih Umam Hidayat Santoso Shofa Chasani