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The Analysis Study of Comparative Effectiveness of Different Therapies for Hyperthyroidism: A Comprehensive Systematic Review Luthfiyya Syafiqa Tahany; Sinarty Hartanto
The International Journal of Medical Science and Health Research Vol. 11 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/x12tpb19

Background: Hyperthyroidism is a condition characterized by excessive thyroid hormone production, which can lead to serious health complications if not properly managed. Available treatments—antithyroid drugs, radioactive iodine therapy, and thyroidectomy—vary in efficacy, safety, and appropriateness depending on individual patient factors. This review aims to systematically assess and compare these therapies to guide evidence-based clinical decision-making. Methods: This review followed PRISMA 2020 requirements and included only peer-reviewed, full-text English papers from 2015 to 2025. Editorials and review papers lacking DOIs were eliminated to ensure source dependability and citation tracking. To find articles that fit the review's study topic, PubMed, ScienceDirect, and SAGE Publications were extensively searched. Result: The initial database search identified more than 2,000 potentially relevant studies. Eight studies met the predefined inclusion criteria and were selected for detailed analysis through a structured three-phase screening and selection process. The studies underwent thorough evaluation for methodological quality and relevance, guaranteeing that the final synthesis relied on strong and high-quality evidence. The findings offer essential insights into the strengths and limitations of the comparative effectiveness of various therapies for hyperthyroidism. Conclusion: The effectiveness of hyperthyroidism treatments depends on individual patient factors, clinical conditions, and treatment goals. Antithyroid drugs are suitable for initial therapy, while radioactive iodine and surgery provide more definitive outcomes, each with distinct risks and benefits. This review highlights the importance of personalized, evidence-based approaches to optimize treatment selection and enhance patient care..

Can Musculoskeletal Ultrasound Improve Early Detection And Mon- Itoring Of Musculoskeletal Manifestations In Patients With Systemic Lupus Erythematosus? Luthfiyya Syafiqa Tahany; Sinarty Hartanto
The International Journal of Medical Science and Health Research Vol. 12 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/94q1p503

Introduction: Musculoskeletal manifestations are common in systemic lupus erythematosus (SLE) and significantly impact patient quality of life. Traditional clinical assessments often underestimate joint inflammation. Musculoskeletal ultrasound (MSUS) has emerged as a sensitive, non-invasive imaging modality to detect synovitis, tenosynovitis, and bone erosions in SLE patients. Methods: A comprehensive review of recent clinical trials, cohort studies, and observational research was conducted, focusing on the use of MSUS in detecting and monitoring musculoskeletal involvement in SLE. Studies included grayscale and power Doppler ultrasound protocols assessing multiple joints over various follow-up periods. Results: MSUS consistently detected subclinical synovitis and tenosynovitis, correlating strongly with clinical disease activity indices such as CDAI and DAS28. Persistent power Doppler signals were predictive of structural joint damage and lower remission rates. MSUS also demonstrated utility in monitoring treatment response, with faster reductions in ultrasound inflammation scores observed in patients treated with Janus kinase inhibitors. However, variability in ultrasound protocols and scoring systems was noted across studies. Discussion: MSUS enhances early detection and precise monitoring of musculoskeletal disease activity in SLE, complementing clinical evaluation. Challenges include lack of standardized scanning protocols, operator dependency, and limited correlation with patient-reported outcomes. Standardization efforts like the EULAR-OMERACT scoring system are promising for improving consistency. Conclusion: MSUS is a valuable tool for improving diagnosis, prognosis, and treatment monitoring in SLE-related musculoskeletal disease. Further research and standardization are needed to optimize its integration into routine clinical practice.

What Are The Most Effective Management Strategies For Nonalcoholic Fatty Liver Disease Across Different Age Groups, Obesity Levels, And Metabolic Risk Profiles? : A Systematic Review Luthfiyya Syafiqa Tahany; Sinarty Hartanto
The International Journal of Medical Science and Health Research Vol. 8 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/p1nt9150

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a growing global health issue linked to obesity and metabolic syndrome, ranging from simple steatosis to severe conditions like cirrhosis. Its complex pathophysiology, centered around insulin resistance, necessitates a multifaceted management approach to address its hepatic and extrahepatic consequences. This systematic review synthesizes evidence from recent randomized controlled trials to identify the most effective management strategies across diverse patient populations. Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Semantic Scholar, Springer, and Google Scholar. Inclusion criteria targeted randomized controlled trials examining lifestyle, dietary, exercise, or pharmacological interventions for NAFLD, with quantifiable liver and metabolic outcomes. Nine studies were selected for data extraction and quality assessment. Results: The nine trials demonstrated significant improvements with various interventions. Exercise interventions reduced intrahepatic triglycerides by up to 16%. Dietary changes were highly effective; a "green" Mediterranean diet reduced intrahepatic fat by 38.9%, and an Indo-Mediterranean diet improved steatosis in children. Pharmacological agents also showed promise; the combination of dapagliflozin and omega-3 carboxylic acids reduced liver fat by 21%, while resmetirom achieved reductions of 42-49%. Mobile app-supported lifestyle interventions and intensive weight loss programs also led to significant metabolic and hepatic benefits. Discussion: The evidence confirms that tailored interventions are crucial. Exercise provides benefits independent of significant weight loss. The superiority of specific diets, like the polyphenol-rich green Mediterranean diet, highlights the importance of dietary quality over mere caloric restriction. Pharmacological therapies, particularly resmetirom, are emerging as powerful options for high-risk patients. The effectiveness of interventions is modified by factors like age, comorbidities, and adherence, underscoring the need for personalized medicine. Conclusion: NAFLD is a manageable condition. Effective management is achievable through diverse, tailored pathways, including structured exercise, specific diets, intensive lifestyle programs, and targeted pharmacotherapies. A personalized, multifaceted approach that considers individual patient characteristics is essential for optimizing both liver-specific and systemic metabolic outcomes.

Hot and Cold: Coexistent Graves’ and Hashimoto’s Thyroiditis: A Case Series Luthfiyya Syafiqa Tahany; I Made Wisnu Wardhana; Darma Irawan
The International Journal of Medical Science and Health Research Vol. 6 No. 2 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/zbvjt594

Introduction: Autoimmune Thyroid Disease (AITD) is a common endocrine disorder, with Graves’ Disease (GD) and Hashimoto’s Thyroiditis (HT) as its primary manifestations. Both conditions share overlapping pathophysiological mechanisms, often leading to diagnostic challenges. This case series aims to describe and analyze cases of hyperthyroidism with complex clinical and laboratory features, suggesting GD, HT, or both. Case Reports: Three patients (Mr. D, 42 years old; Mr. RKA, 47 years old; Ms. MMR, 26 years old) presented with clinical manifestations of hyperthyroidism. Laboratory examinations consistently showed low or very low TSH levels, along with increased Free T3 (FT3) and Free T4 (FT4) levels. A significant finding in all three cases was positive TSH Receptor Antibodies (TRAb), typical for GD, accompanied by very high Anti-Thyroid Peroxidase (Anti-TPO) levels, characteristic of HT. This indicates the possibility of a dual autoimmune process. Discussion: The simultaneous findings of positive TRAb and very high Anti-TPO in all three patients support the concept that GD and HT exist within a single spectrum of AITD and can coexist. The term "Hot and Cold" in the title reflects the dynamics between the hyperthyroid ("hot") phase, caused by TRAb stimulation in GD or Hashitoxicosis, and the potential transition to hypothyroidism ("cold") due to glandular damage by the Hashimoto autoimmune process. These cases highlight the diagnostic complexity, where dominant hyperthyroidism manifestations due to GD coexist with markers of chronic thyroid destruction from HT. Therapeutic implications include administering antithyroid drugs to control hyperthyroidism and the necessity of long-term monitoring to anticipate changes in thyroid function. Conclusion: This case series illustrates the diagnostic and management complexity in AITD patients with overlapping features of GD and HT. The concomitant presence of positive TRAb and very high Anti-TPO underscores the spectrum nature of AITD. Understanding this variability is crucial for clinicians for accurate diagnosis, personalized management, and effective long-term monitoring.

How do Stem Cell Transplantation Outcomes Differ between Various Types of Leukemia (Acute Lymphoblastic vs Acute Myeloid Leukemia) : A Systematic Review Luthfiyya Syafiqa Tahany; I Putu Hartawan Mataram
The International Journal of Medical Science and Health Research Vol. 10 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ctz4rm13

Introduction : This systematic review investigates the differential outcomes of stem cell transplantation (SCT) in various types of leukemia, specifically acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). SCT is a crucial therapeutic approach for these aggressive hematologic malignancies, offering potential for long-term remission. Understanding the varying outcomes between AML and ALL is vital for optimizing treatment strategies, including conditioning regimens, donor selection, and post-transplant care. Methods : The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Eligibility criteria included studies focusing on adult patients ( ≥ 18 years) diagnosed with ALL or AML, examining allogeneic or autologous SCT, comparing outcomes between ALL and AML, reporting clinical outcomes like overall survival (OS), disease-free survival (DFS), treatment-related mortality (TRM), graft-versus-host disease (GVHD) incidence, or relapse rates, including ≥ 10 patients, and involving human subjects. Data extraction focused on study design, participant characteristics, SCT details, primary outcomes, and study limitations. A comprehensive search strategy utilizing Boolean MeSH keywords was applied to databases such as PubMed, Semantic Scholar, Springer, and Google Scholar. Results : From 15 included studies showed that overall survival rates varied significantly, with some reports indicating 3-year OS of 35% for AML versus 0% for ALL, while others showed 5-year OS of 23.5% for AML versus 70% for ALL. Engraftment rates generally exceeded 89%. Relapse rates ranged widely from 4% to 49%. Acute GVHD incidence varied from 19.8% to 69%. Conditioning regimens significantly impacted outcomes; high-dose cytarabine improved survival in AML, whereas etoposide increased mortality risk in ALL. Novel T-cell manipulation techniques and mesenchymal stem cell use showed promise in reducing severe acute GVHD. In conclusion : SCT outcomes differ considerably between AML and ALL due to variations in disease biology, conditioning regimens, GVHD prophylaxis, and stem cell sources. Tailoring transplantation protocols to the specific leukemia subtype and individual patient characteristics is crucial for improving survival and minimizing complications. Continued research into novel conditioning approaches, immune modulation, and cell source optimization is essential to advance SCT as a curative therapy for acute leukemias. Keywords: Stem Cell Transplantation, Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Overall Survival, Graft-versus-Host Disease, Relapse Rate.

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