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Azelia Nusadewiarti
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Diagnosis dan Tatalaksana Stroke dengan Disfungsi Ereksi pada Pria Usia 50 Tahun Melalui Pendekatan Dokter Keluarga Vika Annisa Putri; Azelia Nusadewiarti
Medula Vol 10 No 1 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i1.15

Abstract

Stroke is a rapidly clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no cause other than of vascular origin. Stroke may cause disability and psychosocial disturbance. This study is a case report which aims to identify risk factors and clinical problems found in patients, and apply a holistic and comprehensive family doctor approach according to the problems found in patients, and conduct Evidence Based Medicine based management that is patient-centered and family focused. Primary data is obtained through history taking, physical examination and home visits. The result, Mr. UH, 50-years-old, complained left-sided limbs weakness since 2 years ago and also unable to get an erection. On the neurological clinical examination, we found parase of the left side of the limb, increase of left-sided physiological reflex, positive left-sided babinsky reflex, positive left-sided hoffman tromer, and left-sided facial nerve palsy. Uncontrolled hypertension and dyslipidemia causes stroke in these patients. In the psychosocial aspect, there is a lack of family knowledge about the patient's illness. Education and intervention are given to patients and families about stroke, prevention of other complications and treatment in 3 home visits. In the evaluation found an increase in patient compliance to avoid risk factors and family knowledge about patient care.
Penatalaksanaan Holistik Dermatitis Kontak Iritan Pada Pekerja Bangunan Muhammad Ega Alfarizi; Azelia Nusadewiarti
Medula Vol 10 No 1 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i1.47

Abstract

Irritant contact dermatitis is a skin disorder that can be found in about 85-98% of all skin diseases caused by work in Indonesia. Symptoms of burning, stinging and pain relief after exposure to cement and wood dust which are irritating. Pharmacologic treatment and preventive measures using personal protective equipment (PPE) are important in the management of occupational dermatitis. Study analysis in this case report identified risk factors and clinical problems in patients by implementing a holistic and comprehensive family doctor approach and its management with holistic and comprehensive, patient centered, family focused, and community oriented by conducting health promotion intervention methods, applying healthy behaviors with precaution adoption process model and treatment of irritant contact dermatitis based on evidence based medicine. Primary data obtained through history taking, physical examination and home visits to complete family data, psychosocial and environmental data. Assessment is based on a holistic diagnosis from the beginning, process, and end of study quantitatively and qualitatively. Patients have aspects of internal risk lack of knowledge about irritan contact dermatitis, curative treatment patterns, behavior that does not use personal protective equipment when working. The external risk aspect for patients is the lack of knowledge and family support in treatment. Furthermore, holistic management of patients and families is carried out through health promotion intervention methods in the form of information about irritan contact dermatitis such as educating the precipitating factors and emphasizing the importance of using personal protective equipment (PPE) when working. In the evaluation it was found that the patient’s complaints were reduced, sufficient knowledge of the disease, changes in patient behavior, and application of personal protective equipment (PPE) at work. Holistic management can improve knowledge, attitudes, and behavior in patients.
Penatalaksanaan Holistik Pasien Remaja Akhir Usia 19 Tahun Dengan Tuberkulosis Rontgen Positif (Kategori I) Melalui Pendekatan Kedokteran Keluarga Sabrina Fazriesa; Azelia Nusadewiarti
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.81

Abstract

According to WHO in the Global TB Report 2017, Indonesia ranks third out of six countries which account for 60% of TB cases worldwide, after China and India. Prevention and control of TB risk factors is done in a way that is to cultivate clean and healthy living behavior, to cultivate cough ethical behavior, to maintain and improve the quality of housing and the environment in accordance with healthy home standards, increase endurance, handling of TB comorbidities, the application of prevention and control TB infection in Health Care Facilities, and outside Health Care Facilities. Patient Mr. P, 19 years old, has been diagnosed with primary pulmonary tuberculosis (ICD 10 A16.0). Having concerns about lack of adherence to taking medication. Limited knowledge of patients and their families about the disease and the right lifestyle according to the illness. Interventions were conducted regarding education and motivation to take medications regularly, always control according to schedule, cough ethics, ways to prevent TB transmission and side effects that might arise during treatment. After an evaluation, the patient and family's knowledge about the disease and the importance of taking medication regularly is quite good. Mr. P started to have daily routine activities, exercising regularly and taking medicine regularly with his mother as PMO. Family doctor services in pharmacological and non-pharmacological therapy are able to solve health problems and improve the quality of life of patients.
Penatalaksanaan Pasien Diabetes Melitus Tipe 2 dengan Neuropati dan Retinopati Diabetikum Melalui Pendekatan Kedokteran Keluarga Yuwandita Tamara Putri D; Azelia Nusadewiarti
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.227

Abstract

Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. Currently DM has become a global health threat. 415 million people worldwide suffer from DM in 2015 and are expected to increase to 642 million by 2040. Application of family doctor based services based on evidence based medicine in patients by identifying risk factors, clinical problems, and patient management based on the framework of solving patient problems with approached and family approached patient. Analysis of this study is a case report. Primary data is obtained through history taking, physical examination and home visits to supplement family data, psychosocial and environmental data. Assessment is based on a holistic diagnosis from the beginning, the process, and the end of the study quantitatively and qualitatively. Patient ny. S 56 years old was diagnosed with Type 2 Diabetes Mellitus. Patients had internal risk aspects such as obesity, non-physical activity, offspring of diabetes mellitus, history of DM drug breakdown, curative treatment patterns. The external risk aspect of the patient is that the family does not understand the patient's disease and its complications, the family economy is low. Furthermore, the management consists of education about DM and its care for patients and families as well as initial GDS measurements. After evaluating, a decrease in GDS is obtained in patients.
Penatalaksanaan Holistik Pada Pasien TBC Milier – HIV Seronegatif Annisa Abdillah; Azelia Nusadewiarti
Medula Vol 9 No 2 (2019): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i2.284

Abstract

Miliary TBC is a potentially fatal form of TBC. Mortality rates for military TBC occurs higher in adults (25% - 30%) than in children (15% - 20%). Clinical manifestations of patients with miliary tuberculosis in adults are not specific. Therapy is given not only by using drugs, but also the therapy should be focus on the patient or patient-centered and family approach which is done holistically. The study is Case Report. Primary data was obtained through history taking and physical examination by making home visits, filling out family folders, and filling in patient files. Assessment was carried out based on the initial holistic diagnosis, process, and end of the visit quantitatively and qualitatively. Based on holistic diagnosis, the patient complains fever for 6 months, accompanied by night sweats, decrease appetite, nausea, weight loss. The patient is worried that his pain will become increasingly burdensome and life threatening. The patient is a man, 53 years. Patients have fungtional degrees 2 with Milliary TBC – HIV Seronegative, have internal risk factors, such as drinking alcohol and smoking habits, curative treatment patterns, rarely exercise and lack of knowledge about the disease. The intervention and evaluation has been done to the patient and his family members about patient’s illness, medications, lifestyles, obtained changes in the behavior of patients and families. The diagnosis of milliary tuberculosis in this cases is in accordance with the theory and critical appraisal of resent research.
The management of hypertension : penatalaksaan hipertensi dan gout artritis Aldi Setia; Azelia Nusadewiarti
Medula Vol 12 No 1 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i1.323

Abstract

The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made a serious public health threat worldwide with millions of people at risk in a growing number of countries. Though there are no clinically approved antiviral drugs and vaccines for COVID-19, attempts are ongoing for clinical trials of several known antiviral drugs, their combination, as well as development of vaccines in patients with confirmed COVID-19. This review focuses on the latest approaches to diagnostics and therapy of COVID-19. We have summarized recent progress on the conventional therapeutics such as antiviral drugs, vaccines, anti-SARS-CoV-2 antibody treatments, and convalescent plasma therapy which are currently under extensive research and clinical trials for the treatment of COVID-19. The developments of nanoparticle-based therapeutic and diagnostic approaches have been also discussed for COVID-19. We have assessed recent literature data on this topic and made a summary of current development and future perspectives.
Penatalaksanaan Holistik Pasien Wanita Usia 18 Tahun dengan Asma Bronkial Melalui Pendekatan Dokter Keluarga di Wilayah Puskesmas Satelit Jihan Nur Pratiwi; Azelia Nusadewiarti
Medula Vol 12 No 1 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i1.408

Abstract

Asthma is a chronic inflammation of the airways that causes narrowing of the airways. The prevalence of asthma in Indonesia ranks highest for the category of non-communicable diseases. Asthma is a disease that needs to be controlled to prevent exacerbations and improve the patient's quality of life. Both patients and families are expected to have the knowledge and motivation to make lifestyle modifications so that treatment goals can be achieved, so treatment is needed through a family approach. Primary data were obtained from home visits to complement family data, psychosocial data, and the environment. Secondary data obtained from medical records. Assessment is carried out based on a holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. Patient Mrs. PF is 18 years old, has the main complaint of shortness of breath since 1 day ago. Shortness of breath accompanied by wheezing and coughing, worsening especially at night and early in the morning, cold weather, and after cleaning the house. The patient was diagnosed as bronchial asthma. In this case, diagnosis and treatment have been carried out according to the latest theory and journals. After the intervention, there was a decrease in clinical symptoms and an increase in the knowledge of patients and their families. The diagnosis of bronchial asthma in this patient was in accordance with the theory from several guidelines and journals, it was seen that there was a change in knowledge of the patient and his family after an intervention based on Evidence-Based Medicine that was patient-centred and a family approach.
Penatalaksanaan Holistik Pada Wanita Usia 63 Tahun Dengan Penyakit Osteoarthritis dengan Hipertensi dan Dispepsia Melalui Pendekatan Kedokteran Keluarga thaharatin Giza; Azelia Nusadewiarti
Medula Vol 12 No 4 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i4.585

Abstract

Osteoarthritis is a chronic disease characterized by damage of joint cartilage that causing stiffness, pain, and movement disorders. While hypertension is a condition where a person’s systolic and diastolic blood pressure is >140/90 mmHg. Both osteoarthritis and hypertension are diseases that must be managed comprehensively because they are chronic. Implementing family doctor services by identifying risk factors, clinical problems, as well as patient management based on evidence-based medicine that is family-approach, patient-centred dan community oriented. The study conducted is a case report. Patient, Mrs. S, a woman, 63 years old, has a complaint of pain in both knee joints since about 3 days ago. Pain felt come and go and getting worse especially in the morning with a duration is about 15 minutes. The patient has an additional complaint of headache and epigastric pain. The patient was diagnosed as osteoarthritis with hypertension and dyspepsia. Several factors can affect patient’s condition, both internal and external risk factors. In this case, diagnosis and treatment have been carried out according to the latest theory and journals. After the intervention, there was a decrease in clinical symptoms and an increase in the knowledge of patients and their families. The diagnosis of osteoarthritis with hypertension and dyspepsia in this patient was in accordance with the theory from several guidelines and journals, it was seen that there were a change in knowledge of the patient and his family after the intervention based on evidence-based medicine yang bersifat patient-centred dan family medicine approach.
Penatalaksanaan Holistik Pada Wanita Usia 21 Tahun dengan Asma Persisten Ringan Melalui Pendekatan Kedokteran Keluarga Rika Partika; Azelia Nusadewiarti
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.796

Abstract

Indonesia is ranked 19th in the world regarding deaths due to asthma. Asthma is a heterogeneous disease characterized by chronic airway inflammation. Asthma is a reversible obstructive disorders which is requires control to improve the patient's quality of life. Holistic management through a family medicine approach is expected to be able to assist patients in identifying, controlling precipitating factors and preventing individuals with predisposition to asthma from developing asthma and preventing asthma patients from experiencing asthma attacks. In this study, primary data were obtained from autoanamnesis, physical examination and home visits. Secondary data was obtained from the patient's medical record. Patient Ms. C, 21 years old, has a main complaint of shortness of breath accompanied by a feeling of heaviness in the chest, coughing, and "wheezing" breath sounds that are felt to come and go and get worse, especially at night, early in the morning, cold weather, dust exposure and when the patient is under stress. The patient was diagnosed as mild persistent asthma. Internal risk factors include family history of asthma and atopy, lack of patient knowledge about the disease, and curative treatment behavior. External risk factors include lack of knowledge and attention of the family towards the patient's illness and dusty house conditions and lack of air circulation through windows. Medical and non-medical interventions are carried out for patients and families according to theory and literature with a patient-centered, family-oriented, and community-oriented approach.
Penatalaksanaan Holistik Pada Pasien Wanita Usia 42 Tahun dengan Hipertensi dan Diabetus Melitus Tipe 2 dengan Neuropati Diabetikum Melalui Pendekatan Kedokteran Keluarga di Puskesmas Natar Annisa Ridha Salsabilla; Azelia Nusadewiarti
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.789

Abstract

The current pattern of disease incidence has undergone changes which are characterized by epidemiological transitions. Changes in disease patterns that were originally dominated by infectious diseases turned to non-communicable diseases. Hypertension and Diabetes Mellitus are one of the non-communicable diseases which are very serious health problems both in the world and in Indonesia. The purpose of this case report is to implement a holistic and comprehensive family doctor service by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with a patient-centered and family approach. This study is a case report study. Primary data were obtained through history taking (autoanamnesis from the patient and alloanamnesis from the patient's family), physical examination and home visits. Secondary data were obtained from the patient's medical record. Assessment is based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Patient Mrs. E is 42 years old, has been diagnosed with hypertension and type 2 diabetes mellitus with neuropathy has concerns about his health condition getting worse. The patient's hope is that the complaints disappear completely and do not recur, so they can be comfortable with their activities as usual. The patient's limited knowledge of the illness and an unfavorable lifestyle are factors that cause problems that occur in patients and their families. The diagnosis of hypertension and type 2 diabetes mellitus with neuropathy in this case is in accordance with several theories and critical studies from recent research. Management has been given in accordance with the management guidelines. There is good progress in patients starting from decreased clinical symptoms to changes in behavior after an intervention based on evidence-based medicine that is family-approach and patient-centered.
Co-Authors Aldi Setia Annisa Abdillah Annisa Ridha Salsabilla Fadillah Maulidia Iqbal Lambara Putra Jihan Nur Pratiwi Muhammad Ega Alfarizi Muhammad Reqza Pratama Rika Partika Sabrina Fazriesa Sella Kintania Sari thaharatin Giza Vika Annisa Putri Winda Trijayanthi Utama, Winda Trijayanthi Yuwandita Tamara Putri D Zulia Yasminanindita Fahmi