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Evidence Based Case Report Therapy

Evidence Based Case Report Therapy. Group 1A Al Ciptaning Laras Andy Arifputera Cindy Rahardja Festus Adrianto Susilo Imma Nurliana Fauzi Agung Nugroho. Case Illustration.

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Evidence Based Case Report Therapy

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  1. Evidence Based Case ReportTherapy Group 1A Al Ciptaning Laras Andy Arifputera Cindy Rahardja Festus Adrianto Susilo Imma Nurliana Fauzi Agung Nugroho

  2. Case Illustration A 58-year old man came to doctor with unconscious since 1 hourbefore admission. He was not doing any activity in a rehabilitation center when he fell and brought to the hospital by a worker from the facility. No history of alcohol, drugs consumption, and fever. The patient was complaining of dizziness and headache a moment before he fell unconscious. While being transferred to the hospital, the patient vomit brownish liquid. Then patient is suspected having haemmorhagic stroke. The doctor gives citicoline to him for initial treatment.

  3. Clinical Question • Does citicholine lead to a better outcome in terms of mortality and neurological damage for the initial treatment of 58 years old male with hemorrhagic stroke? PICO

  4. Type of Question Therapy/ treatment • Type of study Meta Analysis of Double-Blind Randomized Controlled Trials

  5. Stroke • A syndrome characterized by • rapidly developing clinical symptoms and/or signs of focal, or at times global, loss of cerebral function, • with symptoms lasting more than 24 hours or leading to death, • with no apparent cause other than that of vascular origin. Warlow C, vanGijn J, Dennis M, Wardlaw J, Bamford J, Hankey G, et al. Specific Treatments for Acute Ischaemic Stroke. Stroke Practical Management. 2008. Oxford: Blackwell Publishing. p. 635-653.

  6. Citicoline • Citicoline, also known as citidine diphospate-choline (CDP-choline) is a psychostimulant. This agent is an intermediate of the generation phosphatidylcholine from choline • Several studies show that CDP-choline supplements increase the density of dopamine receptors and can help improve memory damage caused by environmental factors. • Citicoline also increases ACTH independent of CRH levels. It also increase the release of other hormones in the HPA axis, such as LH, FSH, GH, and TSH in their response to hypothalamic releasing factors Saver JL. Citicoline:update on a promising and widely available agent for neuroprotection and neurorepair. Rev Neurol Dis. 2008 Fall; 5(4):167-77

  7. Citicoline usage on stroke patients is based on the theory that citicoline reduces ischemic injury to the central nervous system: • Stabilizing the cell membranes • reducing the formation of free radicals Up to this date, there are conflicting data on the therapeutic effects of citicoline on stroke

  8. Reference • Warlow C, vanGijn J, Dennis M, Wardlaw J, Bamford J, Hankey G, et al. Specific Treatments for Acute Ischaemic Stroke. Stroke Practical Management. 2008. Oxford: Blackwell Publishing. p. 635-653. • Saver JL. Citicoline:update on a promising and widely available agent for neuroprotection and neurorepair. Rev Neurol Dis. 2008 Fall; 5(4):167-77 • Clark WM, Williams BJ, Selzer KA, Zweifler RM. A Randomized efficacy trial of citicoline in patients with acute ischemic stroke. Stroke 1999;30:2592

  9. Thank you

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