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p-Index From 2020 - 2025
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All Journal The International Journal of Medical Science and Health Research
Abdul Mubdi Ardiansar Arifuddin Karim
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Vitamin D Supplementation Compared With Inhalation Therapy In Asthma Patients: A Meta-Analysis Using Revman Alifah Raihan Fadilla; Imran Safei; Abdul Mubdi Ardiansar Arifuddin Karim
The International Journal of Medical Science and Health Research Vol. 14 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/frtfrb79

Abstract

Introduction: Asthma is a chronic inflammatory disease of the airways that remains difficult to control despite the availability of standard therapies such as inhaled corticosteroids (ICS). The role of vitamin D as an immunomodulator with anti-inflammatory properties has attracted attention as a potential adjunctive therapy. Several studies have reported an association between vitamin D deficiency and increased asthma severity. This study aims to compare the effectiveness of vitamin D supplementation and inhalation therapy in controlling asthma symptoms. Methods: This meta-analysis was conducted in accordance with PRISMA guidelines. A systematic search was performed in PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov. Included studies were randomized controlled trials (RCTs) evaluating the effect of either vitamin D supplementation or inhalation therapy on the Asthma Control Test (ACT) score. Data were analyzed using a random-effects model in Review Manager 5.2, with effect sizes presented as Standardized Mean Differences (SMD). Results: A total of 11 studies were included (6 on vitamin D, 5 on inhalation therapy). Vitamin D supplementation showed a pooled SMD of 0.54 (95% CI: 0.25–0.84; p = 0.0003), indicating a moderate effect, with high heterogeneity (I² = 93%). Studies by Tuba Çiftçi (2019) and Rubén Andújar-Espinosa (2020) reported large effects (SMD > 1), while Adrian (2015) showed no significant effect. Inhalation therapy produced more variable outcomes; Belachew (2022) showed the largest effect (SMD = 1.32), while studies such as Boonsawat (2015) and Kondla (2016) reported small or nonsignificant effects. Overall, vitamin D showed a more consistent and generally greater effect compared to inhalation therapy. Conclusion: Vitamin D supplementation appears to be an effective adjunctive therapy for improving asthma control, particularly in patients with vitamin D deficiency. Further large-scale RCTs are needed to determine optimal dosing, duration, and the most responsive patient subgroups.
Systematic Review with Revman Method: Comparison of Creatinine Levels with Cystatin-C in Identifying CKD in Hypertension Patients Siti Anisah Azzahra Rasmin; Abdul Mubdi Ardiansar Arifuddin Karim; Muhammad Rasyidi Juhamran
The International Journal of Medical Science and Health Research Vol. 14 No. 3 (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: 10.70070/6yfxq676

Abstract

Background: Chronic kidney disease (CKD) is a serious complication frequently associated with hypertension. Early and accurate evaluation of kidney function is essential to prevent disease progression. Serum creatinine is commonly used to estimate glomerular filtration rate (eGFR), but its diagnostic accuracy is limited. Cystatin-C has emerged as a more sensitive and specific biomarker for detecting renal dysfunction, especially in high-risk populations such as hypertensive patients. Objective: To evaluate and compare the diagnostic accuracy of serum creatinine and cystatin-C in identifying CKD among hypertensive patients through a systematic review and meta-analysis. Methods: This systematic review followed the PRISMA guidelines and included studies retrieved from PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov. Quantitative data from 10 eligible studies were analyzed using Review Manager (RevMan) version 5.2. The primary outcomes included differences in eGFR values based on cystatin-C and creatinine, as well as diagnostic measures such as sensitivity, specificity, and area under the curve (AUC). Results: Analysis of 10 studies involving 8,554 hypertensive patients indicated that eGFR based on cystatin-C tends to yield lower estimates of kidney function compared to creatinine-based eGFR (Standardized Mean Difference [SMD] = –0.24; p = 0.12). This suggests a potential for earlier detection of kidney impairment, although the difference was not statistically significant. The majority of studies reported that cystatin-C had a higher area under the curve (AUC) and was more accurate in reclassifying CKD stages compared to creatinine. Conclusion: Cystatin-C offers superior diagnostic and predictive performance compared to creatinine in detecting CKD among hypertensive patients, especially in early detection and disease classification. Its selective use in high-risk populations is recommended to enhance diagnostic accuracy and improve clinical decision-making.
Co-Authors Alifah Raihan Fadilla Imran Safei Muhammad Rasyidi Juhamran Siti Anisah Azzahra Rasmin