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Osteoatritis Lutut dengan Hipertensi Derajat 1 pada Pasien Lanjut Usia: Sebuah Laporan Kasus Mentari Putri Maharani; Winda Trijayanthi Utama
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.1956

Osteoarthritis (OA) and hypertension are chronic degenerative diseases commonly found in older adults and share interrelated pathophysiological mechanisms that may exacerbate each other through vascular, inflammatory, and functional decline pathways. This case report aims to describe a comprehensive approach in a patient with knee OA and stage 1 hypertension. A 62-year-old woman presented with chronic left knee pain that worsened with activity, accompanied by morning stiffness lasting less than 30 minutes. The patient had a history of uncontrolled hypertension and obesity with a body mass index of 27.6 kg/m². The diagnosis of knee OA and stage 1 hypertension was established based on history taking, physical examination, and clinical investigations. Management was performed comprehensively using pharmacological therapy consisting of sodium diclofenac, omeprazole, and amlodipine, along with non-pharmacological interventions including patient education, lifestyle modification, weight control, increased physical activity, and dietary adjustment. Particular attention was given to NSAID use in patients with cardiometabolic risk factors due to the potential for increased blood pressure and cardiovascular risk, necessitating careful risk–benefit consideration and regular clinical monitoring. Follow-up evaluation demonstrated improvement in blood pressure and reduction in pain, leading to enhanced daily functional capacity. This case highlights the importance of a multidimensional approach in OA with comorbid hypertension, focusing not only on symptom control but also on cardiovascular risk stratification, analgesic safety, and sustained lifestyle interventions to improve therapeutic outcomes and patient quality of life.

Demam Tifoid pada Seorang Pasien Usia 21 Tahun: Laporan Kasus Abrila Tamara Putri; Winda Trijayanthi Utama
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.1959

Typhoid fever is an endemic infectious disease in Indonesia caused by systemic infection with Salmonella typhi and transmitted through the fecal–oral route. This disease has become a significant contributor to morbidity and mortality. Clinical manifestations, diagnostic approaches, comprehensive management, and preventive education are discussed in this case report. A 21-year-old female patient presented to a primary healthcare center with complaints of a step-ladder pattern fever for seven days, accompanied by nausea and vomiting, dry cough, and joint pain. A history of irregular dietary habits and poor hygiene practices, including frequent consumption of street food and inadequate hand hygiene before meals, were identified as major risk factors for fecal–oral transmission. Physical examination revealed a moderately ill general condition, coated tongue, and tenderness in the epigastric region. The diagnosis of acute typhoid fever was established based on serological examination using the Widal test, which demonstrated an elevated Salmonella Typhi O antibody titer of 1:320. Empirical pharmacological management included first-line antibiotic therapy with cefixime for intracellular bacterial eradication, antipyretic treatment with paracetamol, and antiemetic therapy. Non-pharmacological management consisted of strict bed rest to reduce metabolic demands, oral rehydration therapy, and dietary modification with a soft, low-fiber diet. Preventive education focused on modifying environmental and personal risk factors, including proper handwashing with soap, maintaining food sanitation to prevent contamination by fly vectors, and boiling drinking water thoroughly to reduce the risk of recurrent infection and interrupt disease transmission within the community. Early diagnosis and appropriate management are essential to prevent potentially life-threatening complications.

Stroke Iskemik dengan Hemiparesis Sinistra pada Pasien Laki-Laki Usia 54 Tahun : Laporan Kasus Ditya Ananda Safira; Winda Trijayanthi Utama
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.1964

Ischemic stroke is an acute neurological condition requiring rapid onset-time assessment because reperfusion therapy is only beneficial in selected patients within a specific therapeutic window. This case report discusses ischemic stroke with left hemiparesis in a 54-year-old male patient presenting outside the reperfusion therapy window. The patient arrived at the emergency department on September 1, 2024, at 13:31 Western Indonesian Time with left arm and leg weakness, dysarthria, left tongue deviation, and swallowing difficulty. Symptoms began on August 30, 2024, at approximately 09:00, resulting in an estimated onset-to-door time of 52 hours and 31 minutes. Blood pressure on arrival was 157/108 mmHg. A non-contrast head CT scan showed a hypodense lesion in the right temporal lobe, supporting ischemic stroke. Reperfusion therapy was not performed because the patient presented beyond the therapeutic window. Management included antiplatelet therapy, antihypertensive therapy, dysphagia screening using the water swallow test, inpatient physiotherapy, and home exercise education. After seven days of hospitalization, the patient was discharged in stable condition with compos mentis consciousness, GCS 15, left-sided motor strength of 5/5, improved dysarthria, improved tongue deviation and swallowing ability, and independent ambulation. Discharge medications included amlodipine 10 mg once daily and aspirin 80 mg once daily. This case emphasizes the importance of onset documentation, swallowing assessment, early rehabilitation, and secondary prevention in ischemic stroke.

Low Back Pain Pada Petani Karet: Sebuah Tinjauan Pustaka Redi Bintang Pratama; Muhammad Aditya Utomo; Winda Trijayanthi Utama
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1818

Low Back Pain (LBP) is one of the most common musculoskeletal disorders experienced by agricultural workers, including rubber farmers, due to heavy physical demands, repetitive activities, and non-ergonomic work postures. The high prevalence of LBP among rubber farmers has the potential to reduce work productivity, increase the risk of disability, and negatively impact quality of life. This study aims to review the literature related to the incidence, prevalence, risk factors, and prevention and management efforts for Low Back Pain in rubber farmers. The method used is a literature review by searching for scientific articles through the Google Scholar, PubMed, ScienceDirect, and Garuda databases. The articles included were original studies in Indonesian and English published in the last ten years and discussed LBP in rubber farmers or agricultural workers with similar work characteristics. The results of the study showed that the prevalence of LBP among rubber farmers was relatively high, ranging from 33% to more than 70%. The main risk factors include heavy workloads, non-ergonomic work postures, repetitive work activities, prolonged standing or bending, and working without ergonomic training. Individual factors such as age, length of service, body mass index, and smoking habits also contribute to an increased risk of LBP. Recommended LBP prevention and management efforts include applying ergonomic principles at work, regulating work and rest times, occupational health education, stretching and back muscle strengthening exercises, and controlling individual risk factors. The conclusion of this literature review indicates that LBP among rubber farmers is a multifactorial occupational health problem that requires ergonomic interventions and continuous occupational health promotion.

Efektivitas Amoxicillin dan Piperacillin Terhadap Klebsiella pneumoniae pada Kasus Infeksi Saluran Pernapasan Akut di RSUD Dr. H. Abdul Moeloek Periode 2019 – 2023 Nadhira Azalia; Tri Umiana Soleha; Ratri Mauluti Larasati; Winda Trijayanthi Utama
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1846

Acute respiratory tract infection (ARI) is one of the leading causes of morbidity that often requires antibiotic therapy, with Klebsiella pneumoniae being one of the most commonly found bacterial pathogens and known to have a high level of antibiotic resistance. Irrational use of antibiotics can accelerate the development of resistance, so the effectiveness of antibiotics needs to be evaluated periodically. Amoxicillin and piperacillin are commonly used antibiotics in the management of ARTI. This study aimed to evaluate the effectiveness of amoxicillin and piperacillin against Klebsiella pneumoniae in cases of ARTI at Dr. H. Abdul Moeloek General Hospital from 2019 to 2023. This study is an observational analytical study with a cross-sectional design using secondary data in the form of culture results and antibiotic sensitivity tests from patient medical records. The sampling technique used total sampling with a total of 106 Klebsiella pneumoniae isolates. Data analysis was performed using the Chi-Square test. The results showed that the resistance rate of Klebsiella pneumoniae to amoxicillin was 92.5% with a sensitivity of 7.5%. In contrast, piperacillin showed a higher sensitivity of 58.5% although resistance was still found at 41.5%. Statistical tests showed a significant relationship between the type of antibiotic and the level of bacterial sensitivity (p-value < 0.001). The conclusion of this study indicates that piperacillin is more effective than amoxicillin in the management of ARI caused by Klebsiella pneumoniae and can be considered in the selection of empirical antibiotic therapy.

Dermatitis Kontak Iritan Kronik Pada Pekerja Penyadap Karet: Laporan Kasus Ni Komang Devi Wiratningrum; Winda Trijayanthi Utama
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1903

Irritant contact dermatitis (ICD) is one of the most common occupational skin diseases and is caused by direct and repeated exposure to irritant substances. Workers in the rubber plantation sector are at high risk of developing ICD due to exposure to natural rubber latex and chemicals such as ammonia solution used in the latex processing process. This case report aims to describe a case of chronic irritant contact dermatitis in a rubber tapper. A 50-year-old male presented with a burning sensation on both palms for the past three months, accompanied by erythema, pruritus, dry skin, and scaling. The patient had been working as a rubber tapper for 10 years and was frequently exposed to latex and ammonia solution without using personal protective equipment. Dermatological examination revealed erythematous plaques with diffuse hyperpigmentation and ill-defined borders on the bilateral palmar and plantar regions, accompanied by xerosis, coarse scales, fissures, lichenification, and hyperkeratosis. Based on the history, occupational exposure to irritants, and clinical findings, the patient was diagnosed with chronic irritant contact dermatitis. Management included topical therapy and patient education to avoid irritant exposure and to use personal protective equipment while working. This case highlights the importance of identifying occupational risk factors in establishing the diagnosis and emphasizes preventive measures to reduce irritant exposure in order to prevent disease recurrence.

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