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Journal : Medula

Pendekatan Diagnosis dan Tatalaksana Syringomyelia Sekunder dengan Komplikasi Gagal Nafas Dzulfiqar; Fidha Ramayani; Ari Wahyuni
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.v9i4.214

Abstract

Syringomyelia is a rare condition characterized by fluid-filled cavities called syrinx in spinal cord. Enlarging syrinx often cause progressive neurological damage, through combination of direct pressure on neural tissue and ischemia. Syringomyelia divided into primary and secondary based on it’s cause. More than half of secondary syringomyelia cases are caused by Chiari Malformation (CM) type I. Prevalence of CM is higher in children and younger adult than older adult. Diagnosis is effectively determined by Magnetic Resonance Imaging (MRI) and management are based on the main cause of syringomyelia. In this study, we describe a case in a 59 year-old women pesented with progressive weakness of all extremities for the past three months associated with respiratory failure. In physical examination we found flaccid type tetraplegia and absent of reflexes in all extremities. MRI result found syringomyelia from cervical 2 until 6 with MC type I. Foramen magnum decompression become primary management in syringomyelia caused by CM type I in order to return the abnormal flow of cerebrospinal fluid. Foramen magnum decompression in adults can improve the symptoms with minimal complication.
Pengaruh Vitamin D terhadap Keparahan dan Mortalitas COVID-19 Jundi Fathan Mubina; Ari Wahyuni
Medula Vol 11 No 1 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i1.252

Abstract

COVID-19 which caused by SARS-CoV 2 infection has becoming health crisis globally. There is urgent need to identify strategy to reduce the level of severity and mortality of COVID-19. However little is known about protective factors for this infection. This review aim to discuss the possible effect of vitamin D in reducing severity and mortality risk of COVID-19. This literature review use several journal databases, namely PubMed, Google Scholar, and ScienceDirect and analysis was carried out qualitatively. The result obtained 10 literature two of which were randomized controlled trials. The result of retrospective analysis shows correlation between vitamin D and reduced COVID-19 severity and mortality. However findings in randomized controlled trials is still limited and there is the need for more large-scale cohort and randomized controlled trials to test this hypothesis. Based on findings of previous study vitamin D suppmelentation shows protective effect in respiratory infection. Therefore, individuals with risk of vitamin D deficiency especially in this global pandemic situation is reccomended to pay attention to their vitamin D status and if needed, to take vitamin D supplement to keep serum vitamin D at optimal level.
Manajemen Anestesi pada pasien Abses serebri dengan Tetralogy of Fallot: Sebuah Laporan Kasus ANNISA; Ari Wahyuni
Medula Vol 12 No 2 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i2.414

Abstract

Tetralogy of Fallot is a congenital heart defect consisting of pulmonary valve stenosis, ventricular septal defect, right aortic valve deviation (overriding aorta), and right ventricular hypertrophy. TOF abnormalities constitute 7%-10% of congenital heart defects. The incidence is 0.23-0.63 cases per 1000 births. Tetralogy of Fallot is a congenital heart defect which is one of the most common cyanotic heart defects. The incidence of cerebrovascular disorders and brain abscess in TOF patients were 9.6% and 13.7%, respectively. In patients with tetralogy of Fallot who require surgery, it is important to know the proper anesthetic management. The goal is to perform anesthetic management according to the patient. The study conducted is a case report. Data were obtained through alloanamnesis and physical examination of patients. Assessment based on interview diagnosis and observation. A female patient aged 40 years came with complaints of decreased consciousness, vomiting and no appetite since 4 days ago. Previously, the patient had a history of VP Shunt insertion surgery 1 month ago due to hemorrhagic stroke. On physical examination, the general condition appeared to be severe, apathetic consciousness. On examination of the thorax and heart, abnormalities were found in the form of widening of the heart boundaries. On the superior and inferior extremities clubbing of fingers was found. Neurological examination revealed left limb weakness and motor speech disturbances. The patient underwent a craniotomy with prior anesthesia considerations. Preoperative, intraoperative, and postoperative management makes the success of surgery better
Faktor-Faktor yang Berpengaruh Terhadap Kejadian Ventilator Associated Pneumonia Nadya Salsabilah; Ari Wahyuni; Liana Sidharti
Medula Vol 13 No 3 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i3.664

Abstract

Nosocomial infections also reffered to as healthcare-asscociated infections (HAI). This infection can occur both while in the treatment room, during surgical procedurs or actions, and it can also be transmitted through medical devices that have contact with patients such as mechanical ventilators. The use of a mechanical ventilator machine is intended as a life saving measure in critical patients and is usually found in the intensive care unit (ICU) room of a hospital. Ventilator associated pneumonia is a risk that can occur when using a mechanical ventilator machine. VAP is nosocomial pneumonia in patients who have mechanically ventilated with endotracheal tube and tracheostomy for at least 48 hours. In United States, Ventilator Associated Pneumonia is one of the causes of mortality in patients with a mortality rate of 13%. In Europe, mortality rate due to early Ventilator Associated Pneumonia is 19,2% and late Ventilator Associated Pneumonia is 31,4%. Ventilator associated pneumonia is reported to have varying incidence rates ranging from 9-27%. The mortality rate from ventilator associated pneumonia can be more than 50%. This event is influenced by several risk factors, one of which is the duration of using a mechanical ventilator. The use of a mechanical ventilator, especially during the installation of an endotracheal tube (ETT) can damage the defense barrier in the airways, the installation of an ETT can also damage the mucociliary and tracheal epithelium and interfere with the cough reflex. This allows pathogens to invade the lower respiratory tract resulting in ventilator associated pneumonia.  
Faktor-Faktor yang Mempengaruhi Self-esteem pada Mahasiswa: Tinjauan Pustaka ANGGITA DERIZKY VIRGINIA; Rika Lisiswanti; Sutarto; Ari Wahyuni
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1412

Abstract

Self-esteem is a concept that everyone needs in life that includes an individual's subjective evaluation of their worth. Selfesteem can be defined as a person's perception of themselves, both positive and negative. Studies have shown that selfesteem has a tremendous impact on many important aspects of life, including relationships and job satisfaction, employment status, physical and mental health. In the condition of students with low self-esteem, it can affect their academic life, social life, and mental state which can cause stress to severe depression. Based on previous research, it can be seen that there are still many students who have low self-esteem. Therefore, this study aims to analyze the various factors that influence self-esteem in college students. In this study, researchers used the literature study method by compiling and analyzing fourteen articles. The results of the articles that have been reviewed, concluded that there are several factors that can affect the level of self-esteem of college students. High or low levels of self-esteem in students can be caused by a combination of family factors such as parental attention and education, academic factors such as the student's cumulative grade point average and other academic achievements, then social factors such as support from friends and their college environment, and psychological factors such as stress and depression.