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All Journal Medula Juke Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Jurnal Ilmu Kedokteran dan Kesehatan JURNAL PENELITIAN PERAWAT PROFESIONAL JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal Kesehatan Tambusai Anoa : Jurnal Pengabdian Masyarakat Sosial, Politik, Budaya, Hukum. Ekonomi Majority JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Iswandi Darwis
Faculty Of Medicine, Universitas Lampung, Bandar Lampung
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Tinjauan Penggunaan Metformin tehadap Defisiensi Vitamin B12 pada Pasien Diabetes Melitus Tipe 2 Natasya Hayatillah; Iswandi Darwis
MAJORITY Vol 9 No 2 (2020): MAJORITY
Publisher : Majority

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Abstract

Metformin is the most widely used oral hypoglycemia drug in the world. This drug become the first choice for the treatment of type 2 diabetes melitus (DM). However, metformin is known to have the effect of creating a vitamin B12 deficiency in type 2 DM patients who consume it. The existing hypothesis states that metformin interferes with the absorption of vitamin B12 through the mechanism of intestinal bacterial overgrowth, the disruption of the vitamin B12 complex with calcium and cubulin receptors. The effect of metformin is known to increase with increasing doses and the length of time uses. The incidence of worsening peripheral neuropathy and megaloblastic anemia have been reported to be associated with the effects of vitamin B12 deficiency in type 2 DM patients taking metformin. To date, there are no clear guidelines that discuss how to diagnose, manage and prevent vitamin B12 deficiency due to metformin, but some research results can be taken into consideration. Vitamin B12 deficiency should be suspected in type 2 DM patients who have taken metformin ≥3 years, at a dose of >1500 mg, experiencing hematological abnormalities or worsening peripheral neuropathy. Prevention that can be done is to give vitamin B12 with dose of 1000 μg intramuscularly per year. As for treatment, an intramuscular injection of vitamin B12 can be given a dose of 1000 μg per day for seven days, followed by an injection once a week for four weeks.
Hubungan Derajat Keparahan Gejala dengan Kualitas Tidur Pasien Penyakit Paru Obstruktif Kronik (PPOK) di RSUD Abdul Moeloek Provinsi Lampung Ayu Dinda Fatimah; Iswandi Darwis; Agustyas Tjiptaningrum; Khairun Nisa Berawi
MAJORITY Vol 11 No 1 (2022): MAJORITY
Publisher : Majority

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Abstract

Chronic Obstructive Pulmonary Disease is a disease that has a high prevalence. The prevalence of COPD is always increasing in every country in the world. Deaths of people with COPD are associated with an increase in the severity of symptoms of the disease. The symptoms of COPD continue to worsen and have an impact on the decline in sleep quality of COPD patients. The Lampung Provincial Government makes COPD as one of the threats in carrying out health development in Lampung Province in 2015 to 2019. The purpose of this study was to determine the relationship relationship between severity of symptoms and sleep quality of patients with Chronic Obstructive Pulmonary Disease (COPD) in Abdul Moeloek regional hospital Lampung Province. It is used observational analytical method with cross sectional design was registered in this research. The sample was 40 COPD patients in Abdul Moeloek Regional Hospital Lampung Province, taken by consecutive sampling method. The study was conducted using the COPD Assessment Test questionnaire and Pittsburgh Sleep Quality Index questionnaire in the hospital, patient’s house, or patient’s office. Then the results of this study were processed using computer software. Result of analysis with Chi Square test with 95% confidence level (α = 0,05) showed p value 0,01 < 0,05. There is a significant association of Severity of Symptoms and Sleep Quality of Patients with Chronic Obstructive Pulmonary Disease (COPD) in Abdul Moeloek Regional Hospital Lampung Province.
Management of anterior ST-elevation myocardial infarction presenting more than 48 hours from symptom onset without reperfusion therapy in the cardiac care unit Iswandi Darwis; Anggoro Budi Hartapo; Muhammad Gahan Sarwiko
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 8 No 01 (2024): Qanun Medika Vol 08 No 01 January 2024
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v8i01.16060

Abstract

ST-elevation myocardial infarction is a form of acute coronary syndrome that is the leading cause of death worldwide. Treatment with reperfusion therapy in the form of primary percutaneous intervention is the main treatment to reduce morbidity and mortality. However, reperfusion therapy is not recommended for patients presenting with symptoms onset of more than 48 hours. A 62-year-old male patient was diagnosed with anterior STEMI with symptoms onset of more than 48 hours based on complaints of anginal chest pain and shortness of breath. ST-segment elevation in V1-V4 and pathological Q in V1-V3 on ECG and increased hs-Troponin I was reported. The patient was not treated with reperfusion therapy based on treatment recommendations. The patient was given vasodilators, beta-blockers, statins, heparinization, and comorbid infection control in the cardiac care ward. Clinical improvement was obtained, and the patient was discharged after seven days of hospitalization and then was planned for Dobutamine Stress Echo during the follow-up visit. Conservative management and viability testing are the main options for patient management in STEMI with symptom onset of more than 48 hours without any complaints of chest pain, stable hemodynamics, and no life-threatening arrhythmia.
Ekstrak Lidah Buaya (Aloe Vera) Menurunan Kadar Glukosa Darah Tikus Putih (Rattus Norvegicus) Yang Diinduksi Streptozotocin Marzel, Rivaldi; Darwis, Iswandi; Windarti, Indri
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.857

Abstract

Diabetes mellitus (DM) is a chronic disorder in the metabolism of protein, fat and carbohydrates. Diabetes mellitus is described as an increase in blood glucose. DM cases in Indonesia rapidly increases. Diabetes mellitus  is a disease that requires anti-diabetes drugs continuously. Continuous use will have side effects that  encourages patients to look for alternative treatments that are cheaper, efficacious, without side effects, and easy to obtain such as herbal medicines. Many medicinal plants around the world contain antihyperglycemic compounds, such as Aloe vera.This is study experimental study using a randomized controlled design method with Post-test only Control Group Design. There were 24 rats consist of 4 treatment groups (K1, K2, K3, K4). (K1) = rats  were given by a standard diet. K2 = rats induced streptozotocin 40 mg/kgBW.K3 = rats were treated with metformin. K4 = rats were treated with Aloe vera extract 250 mg/kg BW. After 21st day,  blood glucose levels were measured. The research was conducted at the animal house of the Faculty of Medicine, University of Lampung. Samples were analyzed using the one way Annova test. Blood glucose levels of the 4 treatment groups were K1 = 67.16 mg/dl, K2 = 366.33 mg/ dl, K3 = 77.83 mg/dl, K4 = 127.16 mg /dl. The blood glucose level in the control and treatment groups were significantly different (p<0,05).  Aloe vera extract ameliorates blood glucose levels of streptozotocin-induced diabetes in white rats (Rattus norvegicus).
Efek Pemberian Ekstrak Biji Jintan Hitam (Nigella sativa) terhadap Penurunan Kadar Glukosa Darah Tikus Putih (Rattus norvegicus) yang diinduksi Streptozotocin Evingelinda, Shania; Kurniawati, Evi; Janar Wulan, Anggraeni; Darwis, Iswandi
Medula Vol 14 No 1 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i1.860

Abstract

Diabetes mellitus (DM) is a heterogeneous disease, characterized by chronic hyperglycemia caused by defects in insulin secretion, insulin action, or both. However, in diabetes mellitus therapy, oral hypoglycemia drugs cause side effects in form of digestive tract complaints in patients, hypoglycemia,and weight loss. Black cumin seed extract as a herbal therapy can reduce blood glucose levels. This study aims to determine effect of administering Black Cumin (Nigella sativa) extract in reducing blood glucose levels in white rats induced by streptozotocin. This study used a pre and post test control group design with a sample size of 32 white rats divided into 4 groups with treatment for 21 days. The groupK- was given 2 ml of distilled water. The group K+ was given an injection of 20 mg/kgBW streptozotocin. Thegroup P1 was given an injection of streptozotocin 20 mg/kgBW and metformin 40 mg/kgBW. Thegroup P2 was given an injection of 20 mg/kgBWstreptozotocin and 200 mg/kgBW black cuminseed extract. Assessment of blood glucose levels is carried out using a glucometer. The results of the difference in the mean pre and post test blood glucose levels at K1, K2, P1, and P2 respectively were 2,34 mg/dl, 157,4 mg/dl, 251,33 mg/dl, and 185,33 mg/dl. This study used a one-way ANOVA parametric test (p<0.05) and continued with the post-hoc Bonferroni test (p<0.05). Administration of black cumin seed extract (Nigella sativa) can have effect of reducing blood glucose levels in white rats (Rattus norvegicus) induced by streptozotocin.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN LUARAN PENDERITA INFEKSI SUSUNAN SARAF PUSAT DI BANGSAL RAWAT INAP ALAMANDA RSUD Dr. Hi. ABDUL MOELOEK PROVINSI LAMPUNG Assidiq, Hans Pratama; Perdani, Roro Rukmi Windi; Darwis, Iswandi; Berawi, Khairun Nisa
Medula Vol 14 No 4 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i4.1066

Abstract

Infection of the Central Nervous System is a disease that can cause death and serious disability if not detected and treated appropriately. Meningitis was a specific cause of death for children under 5 years old during 2000-2013. In the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province, during 2020-2021 there were 50 cases of CNS infections. The aim of this study was to determine the factors associated with the outcomes of CNS infection sufferers in the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province. This research uses an observational analysis method with a cross sectional research design. The population of this study were pediatric patients with a medical diagnosis of central nervous system infection at the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province, for the period January 2020 – May 2021, totaling 50 patients with a total sample population. Univariate analysis showed that 39 sufferers of CNS infections in the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province, mostly aged > 1 year as much as 79.6%, male as much as 51.3%, type of infection is meningitis or encephalitis as much as 66.7%, GPCS score not comatose 79.5%, normal nutritional status 69.2%, long hospitalization >5 days 69.2% and survival outcome is 82.1%. Bivariate analysis using the Chi-Square test showed that the factors that had the most influence on the outcomes of CNS infection sufferers in the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province., in order of long hospitalization, GCPS coma score, nutritional status, type of infection, and age. Meanwhile, gender does not influence the outcome of CNS infection sufferers in the Alamanda Inpatient, RSUD Dr. Hi. Abdul Moeloek, Lampung Province.
Literature Review: Gagal Ginjal Akut Akibat Nefrotoksisitas Gentamisin Akbar, Dafa Rafiqi; Yonata, Ade; Ratna, Maya Ganda; Darwis, Iswandi
Medula Vol 14 No 9 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i9.1312

Abstract

Acute kidney failure or Acute Kidney Injury (AKI) is a sudden decline in kidney function that is often caused by various factors such as sepsis, ischemia, and nephrotoxicity. One of the significant causes of nephrotoxicity is gentamicin, an aminoglycoside antibiotic commonly used to treat Gram-negative bacterial infections. Although effective, gentamicin has nephrotoxic side effects, especially at high doses or long-term use, which can cause damage to the renal tubular epithelium and trigger AKI. This literature review aims to describe and study more deeply the relationship between gentamicin consumption and the incidence of acute kidney failure. Gentamicin works by inhibiting bacterial protein synthesis on the 30S ribosome. Still, its mechanism of action also has the potential to cause nephrotoxicity through drug accumulation in kidney cells, impaired mitochondrial function, increased production of reactive oxygen species (ROS), and mesangial contractions that reduce the glomerular filtration rate. Signs of gentamicin nephrotoxicity include increased serum creatinine levels, blood urea nitrogen, albuminuria, and decreased glomerular filtration rate, accompanied by structural damage such as tubular necrosis and edema in the proximal tubular epithelium. Previous studies have shown that high doses of gentamicin can increase the number of necrotic cells in the kidney and cause renal fibrosis in test animals. In humans, the incidence of gentamicin-induced nephrotoxicity has been reported to reach 10-25% of therapeutic use, with an estimated incidence of AKI of around 15% of total AKI cases. The importance of proper monitoring and management for patients using gentamicin to reduce the risk of nephrotoxicity. Prevention strategies include monitoring kidney function, dose adjustment, adequate hydration, and considering various alternative antibiotic therapies for patients at high risk of nephrotoxicity.
Analisis Klinis Dispepsia pada Pasien Kolelitiasis: Studi Literatur Gultom, Dea Debora Romauli; Ramadhian, Muhammad Ricky; Lusina, Septia Eva; Darwis, Iswandi
Medula Vol 14 No 9 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i9.1377

Abstract

Cholelithiasis, also known as gallstones, is a health problem that has been increasing in prevalence worldwide. Some patients with cholelithiasis experience dyspepsia, a condition that causes discomfort in the upper digestive tract. This study aims to analyze the clinical relationship between cholelithiasis and dyspepsia based on a literature review. The articles used in this study were collected from scientific sources such as PubMed, Google Scholar, and Science Direct. A descriptive analysis was conducted to identify the prevalence, risk factors, and mechanisms linking cholelithiasis with dyspepsia. The results show that most patients with cholelithiasis and dyspepsia are female. The most frequently reported symptoms are abdominal pain (100%), nausea (69%), and vomiting (27%). Eating fatty foods can make these symptoms worse. While many patients feel better after having cholecystectomy, about 30% still experience dyspepsia even after surgery. This connection may be due to issues with gastrointestinal motility disorders, bile reflux, and other multifactorial causes. However, the relationship between cholelithiasis and dyspepsia remains a subject of debate, requiring further research to uncover its mechanisms and develop more effective diagnostic and therapeutic strategies.
The Literatur Review: Hubungan Kadar Hemoglobin terhadap Lama Rawat Inap Pasien Laparotomi: - Buana, Faris Agung; Darwis, Iswandi; Marcellia, Selvi; Susianti, Susianti
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1432

Abstract

Hemoglobin is an important protein in the blood whose job is to transport oxygen to body tissues. Low hemoglobin levels (anemia) in laparotomy patients can affect postoperative recovery time, including the duration of hospitalization. This study aims to evaluate the relationship between pre-operative hemoglobin levels and length of stay in laparotomy patients. Data were obtained from medical records of patients who underwent laparotomy at the hospital, including hemoglobin levels before surgery, length of stay, and additional variables such as Body Mass Index (BMI) and Surgical Apgar Score (SAS). The analysis showed that patients with low hemoglobin levels had a greater risk of experiencing longer hospital stays. This is due to suboptimal oxygen supply to the tissue, thereby slowing wound healing and increasing the risk of complications, such as infection and organ failure. Treating anemia with blood transfusions or iron supplementation has proven effective in increasing hemoglobin levels and speeding up patient recovery, with the average length of stay reduced to less than four days. Apart from hemoglobin levels, factors such as BMI, SAS, level of complexity of surgery, and the patient's health condition also influence the length of treatment. These findings emphasize the importance of monitoring and correcting hemoglobin levels before surgery as a preventive measure to speed recovery, minimize complications, and reduce hospital operational burden, especially in health facilities with limited resources. Further research is needed to determine the most effective clinical interventions in managing anemia in preoperative patients.
Fraksi Ejeksi Ventrikel Kiri dan Mortalitas Pasien IMA-EST di Rumah Sakit Umum Daerah Abdul Moeloek Provinsi Lampung Ramadhan, Rifqi Ihza; Darwis, Iswandi; Maulana, Muhammad; Saftarina, Fitria
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 3 (2025): Volume 12 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i3.18960

Abstract

Data spesifik mengenai angka mortalitas IMA-EST di Bandar Lampung belum tersedia, proyeksi dari Institute of Health Metrics and Evaluation menunjukkan adanya peningkatan yang signifikan hingga tahun 2030. Studi ini mendalami hubungan antara fraksi ejeksi ventrikel kiri dan tingkat mortalitas pada pasien yang mengalami infark miokard akut dengan elevasi segmen ST (IMA-EST) di RSUD Abdul Moeloek, Bandar Lampung, selama periode 2021 hingga 2023. Penelitian ini menggunakan desain observasional kuantitatif dengan pendekatan retrospektif kohort, memanfaatkan data rekam medis pasien IMA-EST. Sejumlah 98 Pasien didapat dan dibagi menjadi dua kelompok: FE rendah (≤40%) dan FE Normal (>40%). Hasil analisis chi-square menunjukkan p-value 0,001 dan relative risk (RR) sebesar 5,71 yang menunjukkan adanya hubungan signifikan dengan risiko kematian yang 5,71 kali lebih tinggi pada kelompok FE rendah. Secara keseluruhan, angka mortalitas tercatat sebesar 36,8%, dengan kelompok FE rendah mencapai 60,7% dan kelompok FE normal sebesar 10,6%. Temuan ini menegaskan bahwa pasien IMA-EST dengan FE rendah memiliki risiko kematian yang jauh lebih tinggi dibandingkan dengan kelompok lainnya, sehingga fraksi ejeksi dapat dianggap sebagai prediktor prognosis yang kuat dalam konteks IMA-EST.
Co-Authors Ade Yonata, Ade Agustyas Tjiptaningrum Akbar, Dafa Rafiqi Aldi Setia Aminuyati Angelia, Tisa Anggoro Budi Hartapo Anggoro Budi Hartopo Assidiq, Hans Pratama Ayu Agustira Ayu Dinda Fatimah Buana, Faris Agung Dian Isti Angraini Evingelinda, Shania Fayola, Diva Fitria Saftarina Gultom, Dea Debora Romauli Gusti Ngurah P Pradnya Wisnu Hadibrata, Exsa Hafizh, Ahmad Fauzan Hartapo, Anggoro Budi Hendra Tarigan Sibero Hendri Busman Indri Windarti Intanri Kurniati Janar Wulan, Anggraeni Jausal, Anisa Nuraisa Khairun Nisa Lusina, Septia Eva Marcellia, Selvi Marzel, Rivaldi Muhammad Gahan Sarwiko Muhammad Gahan Sarwiko Muhammad Maulana Muhammad Ricky Ramadhian Natasya Hayatillah Neema Putri Prameswari Probosuseno Probosuseno Prof. Sutyarso Purnama, Dara Marissa Widya Putu Ristyaning Ayu Rahmayani, Fidha Ramadhan, Rifqi Ihza Ratna, Maya Ganda Reni Zuraida Risal Wintoko Rizka Humardewayanti Asdie Roro Rukmi Windi Perdani, Roro Rukmi Saragih, Pieter Sarwiko, Muhammad Gahan Sekar Mentari Sharlene Sabrina Sudarmanto, Syifa Hasna Susianti, Susianti Suwaib Amiruddin Wiwi Febriani