http://localhost:8080/xmlui/handle/123456789/8865 2026-04-09T05:41:51Z http://localhost:8080/xmlui/handle/123456789/8971 Title: Expert Panel Recommendations on the Clinical Practice Guidelines for the Diagnosis and Management of Invasive Candidiasis in Indonesia Authors: Rozaliyani, Anna; Nelwan, Erni Juwita; Wahid, Mardiastuti; Aditianingsih, Dita; Karyanti, Mulya Rahma; Pratiekauri, Siti Abstract: Invasive candidiasis (IC) ranks among the primary causes of deadly fungal infections. The frequency of IC rises alongside increasing number of patients with altered immune systems, critically ill, chronic diseases, and various medical procedures. The disease causes high morbidity and mortality, as well as prolonged stay and increases hospital costs. The diagnosis and management of IC in Indonesia is still a challenge. Laboratory facilities in identifying pathogenic fungi and susceptibility tests to antifungals are still limited. Clinical awareness and financial support from health policymakers are also insufficient. Early diagnosis is essential for proper treatment to reduce morbidity and mortality rates. Initiated by the Indonesian Pulmonary Mycoses Centre (IPMC), several expert representatives from six medical professional organizations in Indonesia have agreed to set up a meeting series to prepare a joint draft on the diagnosis and management of IC. The expert panel aimed to achieve a consensus on the clinical practice guidelines for diagnosing and treating IC in Indonesia. 2024-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8969 Title: Systemic Corticosteroid as an Adjunct for Acute Respiratory Distress Syndrome in Non-Fatal Fresh Water Drowning: An Evidence-based Case Report Authors: Tenda, Eric Daniel; Henrina, Joshua; Setiadharma, Andry; Pitoyo, Ceva W.; Yulianti, Mira; Santoso, Raden Fidiaji Hiltono Abstract: Background: Acute lung injury or acute respiratory distress syndrome (ARDS) is one of the most common complications of non-fatal drowning. Although respiratory societies’ guidelines endorse the role of systemic corticosteroids in ARDS, the evidence for systemic corticosteroids use in ARDS due to non-fatal drowning is limited. Methods: A search was conducted on Pubmed, OVID, and EuropePMC, assessing the clinical question using inclusion and exclusion criteria. The selected studies were critically appraised, and the results were summarized. Results: A total of six retrospective studies were selected and assessed, all studies showed poor validity and a high risk of bias. Out of six studies, only four informed us of steroid administration's effect on outcomes. In two studies, mortality associated with corticosteroid administration seemed to be higher. On the contrary, one study found no mortality in the corticosteroid group, but 100% mortality was observed in the control group. In another study, steroid therapy seemed to not affect hospital length of stay or mechanical ventilation rates. Conclusion: Corticosteroid administration for non–fatal drowning and its impact on clinical outcomes remain equivocal. Routine administration of corticosteroids is not indicated and should be done on a case-by-case basis. 2024-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8966 Title: Symptomatic Follicular Lymphoma: Complete Remission After Chemoimmunotherapy with Bendamustine–Rituximab Authors: Rajabto, Wulyo; Harahap, Agnes Stephanie; Putra, Handy Nugraha 2024-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8962 Title: Periendoscopic Care Continuum in Acute Cholangitis Caused by Common Bile Duct Stone Authors: Pribadi, Rabbinu Rangga; Yoga, Vesri; Tandan, Manu; Rani, Abdul Aziz; Makmun, Dadang Abstract: Acute cholangitis (AC) is a biliary tract infection with in-hospital mortality rates reaching up to 14.7%. The underlying condition is biliary obstruction caused by benign and malignant etiologies, as well as bacteriobilia, with commom bile duct (CBD) stone being one of the most common causes. Currently, the diagnosis is validated using Tokyo Guidelines 2018 criteria. Acute cholangitis due to CBD stone should be managed in a comprehensive manner, i.e., periendoscopic care continuum, consisting of pre-endoscopic care, endoscopic management, and post-endoscopic care. Pre-endoscopic care is primarily comprised of supportive therapy, antibiotic administration, optimal timing of endoscopic retrograde cholangiopancreatography (ERCP), pre-ERCP preparation, and informed consent. Endoscopic management is biliary decompression with stone extraction facilitated via ERCP procedure. Selective biliary cannulation should be performed meticulously. Bile aspiration and minimal bile duct contrast injection should be done to minimize the worsening of biliary infection. Endoscopic biliary sphincterotomy, endoscopic papillary balloon dilatation, and/or endoscopic papillary large balloon dilatation are all safe procedures that can be used in AC. Special precautions must be undertaken in critical and severe acute cholangitis patients who may not tolerate bleeding, in whom endoscopic biliary sphincterotomy may be postponed to decrease the risk of bleeding, and biliary decompression may be only attempted without CBD stone extraction. Nasobiliary tubes and plastic biliary stents are equally effective and safe for patients who have only undergone biliary decompression. In post-endoscopic care, management of adverse events and observation of therapy response are mandatory. 2024-04-01T00:00:00Z