Introduction: Hypertension is the most common non-communicable disease, which persists as a major risk factor of cardiovascular diseases such as stroke, myocardial infection, and heart failure. Another major problem in clinical practice was the patients' adherence to treatment, directly related to the number of hypertension pills to be taken. Thus, determining the appropriate time duration and action of a hypertensive drug to maintain the blood pressure is needed. Olmesartan is one of the drug compounds frequently used for long-acting anti-hypertensive treatment. It is often combined with amlodipine; however, their combination remains unclear to provide equal efficacy and safety. Thus, in this article, we systematically summarize the combination of Olmesartan with amlodipine.Methods: This systematic literature review was extracted from Science Direct and Pubmed to identify randomized clinical trials (RCT) of the outcome of the Olmesartan/amlodipine effect compared with other hypertension regimens by using PRISMA guideline 2009. The methodological quality of the included studies was assessed independently by two reviewers using The Cochrane Collaboration's RoB 2 tool.Results: We evaluated twelve studies in the last ten years, and there were four studies with an intention-to-treat protocol (25% of articles had some concern, and 75% had a low risk of bias.) and eight studies with per-protocol analysis (37,5% of articles were concerned, and the rest had a low risk of overall bias). We also presented the efficacy and safety outcomes of the study reviewed.Conclusion: Hypertension is a common non-communicable disease, and treatment approaches for hypertension vary widely. Administration of combination drugs is a good approach in reducing the dose of drug administration and reducing the incidence of side effects in monotherapy. Inhibiting the RAA system by olmesartan and reducing vascular smooth muscle tone by amlodipine gives better results and can be a safe and effective option for lowering blood pressure in hypertensive patients. The side effects observed were not severe and only observed in a few cases, making it an option to treat hypertension.
Introduction: Acute otitis media one of the most prevalent ear and throat infection, mostly affecting children. Diagnosis of this condition was complicated by the perceived invasive procedure and the shortage of qualified otologist. Digital video otoscopy is a new and evolving concept in otology which could be further enhanced with telemedicine. It increases access to specialist otologist care by having the examination performed by less qualified healthcare professional. In this review we would like to assess the newest evidence on digital video otoscopy as diagnostic modality for acute otitis media.Methods: We identified literature published from 2000 to 2020 from MEDLINE and Google Scholar. We included studies which reported diagnosis of acute otitis media using digital video otoscopy devices. We include both descriptive and analytical studies. We exclude literatures that reported secondary results or those that does not have acute otitis media as the diagnosis of interest. Articles that fulfill the criteria was then analyzed qualitatively to identify the themes that emerges.Results: Literature search resulted in 10 included studies which includes descriptive studies, diagnostic studies, and RCTs. Digital video devices used varied from add-ons to smartphones to dedicated digital video otoscopy results. The reported examiners also varied from otologist, general practitioners, to telemedicine facilitators. Most studies concur that digital video otoscopy provided adequate inter-examiner and intra-examiner reliability. At the same time, digital video otoscopy provides adequately accurate diagnosis of acute otitis media. Where comparison was available, the accuracy of digital video otoscopy was not significantly different compared to other modes of otoscopy.Conclusions: Digital video otoscopy provide adequately reliable and accurate diagnostic examination for acute otitis media. Some digital video otoscopy system was simple enough to be operated by nurses or telemedicine facilitators, supporting the utilization of this system for telemedicine.
ABSTRAK Obesitas dapat diartikan“sebagai suatu kelainan yang ditandai dengan penimbunan.”jaringan lemak tubuh secara berlebihan akibat ketidakseimbangan antara konsumsi kalori dan kebutuhan energi. Di Indonesia, prevalens “obesitas pada anak usia 6-15 tahun meningkat dari 5% tahun 1990 menjadi.”16% tahun 2001. Tujuan penelitian ini adalah untuk mengetahui karakteristik kasus obesitas pada anak yang terdapat“di RSUP Sanglah Denpasar periode Januari.”2016- Desember 2016. Penelitian ini merupakan studi deskriptif retrospektif dengan pendekatan potong lintang menggunakan data sekunder rekam medis dengan sampel anak obesitas yang datang ke Poliklinik Anak RSUP Sanglah Denpasar. Karakteristik yang diambil berupa umur, jenis kelamin, riwayat ASI ekslusif, pekerjaan orangtua dan pendidikan terakhir orangtua. Dari 34 anak dengan obesitas, ditemukan paling banyak berusia 7 tahun (23,5%) dan paling sedikit terjadi pada usia 12 tahun (5,9%). Anak lelaki lebih banyak menderita obesitas dibandingkan dengan anak perempuan (61,8% vs 38,2%). Lebih dari setengah sampel anak dengan obesitas tidak memiliki riwayat ASI ekslusif (55,9%). Orangtua anak dengan obesitas sebagian besar bekerja sebagai pegawai swasta (76,5%) dan memiliki riwayat pendidikan terakhir SMA (58,8%). Disimpulkan bahwa anak obesitas kebanyakan berusia 7 tahun, berjenis kelamin lelaki, tidak memiliki riwayat ASI ekslusif, memiliki orangtua dengan pekerjaan pegawai swasta dan pendidikan terakhir SMA. Kata kunci: Obesitas, Anak, Karakteristik, RSUP Sanglah
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