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All Journal Medula Juke Rekayasa Mesin Jurnal Keolahragaan Jurnal Sistem Kesehatan Jurnal Ilmiah Manusia dan Kesehatan JK Unila (Jurnal Kedokteran Universitas Lampung) Journal of Language and Health Prosiding Konferensi Nasional PKM-CSR Sains Medisina Medic Nutricia : Jurnal Ilmu Kesehatan Majority JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Helmi Ismunandar
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Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Control & Systems Engineering Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Mechanical Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Journal : Medula

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Perkembangan Strategi Pengobatan β-Thalassemia Santhi, Komang Ria Yuliana; Sangging, Putu Ristyaning Ayu; Jausal, Anisa Nuraisa; Ismunandar, Helmi
Medula Vol 15 No 4 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i4.1663

Abstract

β-thalassemia is an inherited blood disorder caused by mutations in the β-globin gene that reduce or eliminate β-globin chain synthesis, leading to hypochromic microcytic anemia and significant morbidity worldwide. The disorder is prevalent in South Asia, Southeast Asia, the Mediterranean, the Middle East, India, and Africa, with approximately 1.5% of the global population identified as carriers. Severe complications, including iron overload, skeletal deformities, heart failure, and multi-organ damage, contribute to its substantial global health burden. This narrative literature review synthesizes evidence from PubMed, Cochrane, and Google Scholar to examine conventional and emerging therapeutic strategies for β-thalassemia, with particular emphasis on recent advances in gene therapy. Standard management relies on regular blood transfusions and iron chelation, which remain supportive and are associated with long-term complications. Hematopoietic stem cell transplantation is the only established curative treatment, especially effective in pediatric patients with matched HLA donors, although its availability is limited. Novel pharmacologic agents, such as luspatercept and mitapivat, have demonstrated reductions in transfusion requirements and improvements in hemoglobin production. Additional approaches, including fetal hemoglobin induction and modulation of iron metabolism, show encouraging potential. A major breakthrough is CRISPR-based gene therapy using exagamglogene autotemcel (Casgevy), approved by the FDA and EMA in 2024, with phase 3 trials reporting transfusion independence in more than 90% of patients and significant quality-of-life improvements. Despite persistent challenges related to cost, access, and long-term safety, these advances indicate a paradigm shift toward precision medicine with curative potential for β-thalassemia.
Diagnosis dan Tatalaksana Fraktur Klavikula: Tinjauan Pustaka Waton, Hisbul; Ismunandar, Helmi
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1735

Abstract

Clavicle fracture is one of the most common fractures of the upper extremity, resulting from either direct or indirect trauma to the shoulder with the arm positioned alongside the body. This injury is more frequently observed in young adult males, commonly due to traffic accidents, while in the elderly population it is often caused by falls. Clavicle fractures typically present with severe pain, swelling, shoulder deformity, and may be accompanied by neurovascular impairment, necessitating comprehensive clinical evaluation. Physical examination includes inspection, palpation, assessment of shoulder range of motion, and neurovascular evaluation such as the Allen test to assess collateral blood flow. Diagnostic confirmation is supported by imaging modalities including standard anteroposterior radiographs, 30° cephalad tilt view, apical oblique view, and computed tomography scan for complex fracture patterns and preoperative planning. The management of clavicle fractures aims to reduce pain, prevent disability, restore upper limb function, and consider cosmetic outcomes. Treatment options include nonoperative management using an arm sling or figure-of-eight brace for stable fractures, as well as operative management for unstable fractures or those associated with neurovascular complications. Post-treatment rehabilitation plays a crucial role in gradually restoring shoulder range of motion and functional recovery.
The The Role of Glucosamine and Chondroitin Supplementation in the Management of Osteoarthritis. Febriantara, M.Kaisar; Pestalozi, George; Ismunandar, Helmi
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.v16i2.1808

Abstract

Osteoarthritis (OA) is a chronic degenerative disease characterized by progressive damage to articular cartilage and surrounding joint tissues, clinically manifesting as pain, deformity, and disability. The main risk factors include aging, joint injury or overuse, and obesity. According to the Global Burden of Disease Study in 2020, approximately 595 million people worldwide were living with osteoarthritis. In Indonesia, data from the 2018 Basic Health Research report indicated that osteoarthritis affected about 55 million individuals, with the highest prevalence among those aged over 61 years, accounting for 65%. Pathophysiologically, osteoarthritis develops due to cartilage thinning, leading to biomechanical changes, reduced synovial fluid, and increased inflammatory processes associated with aging. Inflammatory cells, particularly macrophages, release mediators that accelerate cartilage degradation and exacerbate joint pain. Radiological assessment of osteoarthritis severity is commonly performed using the Kellgren–Lawrence classification. Management of osteoarthritis frequently involves nonsteroidal anti inflammatory drugs, although long term use is associated with adverse effects. Therefore, adjunctive therapies such as glucosamine and chondroitin have been widely studied. Glucosamine and chondroitin exhibit anti inflammatory and chondroprotective effects and play roles in inhibiting cartilage degradation while supporting anabolic processes in cartilage tissue. Several studies have demonstrated that supplementation with glucosamine and chondroitin improves pain scores, slows joint space narrowing, and enhances joint function in patients with osteoarthritis. These findings suggest that glucosamine and chondroitin may serve as beneficial adjunctive therapies in the management of osteoarthritis.
Co-Authors Ad-Dhuha, Rahmah Maziyah Agustina Daulay, Suryani Ahmad Fauzi Aisyah Lubis, Aisyah Alyzah Nabila Miranda Andrifianie, Femmy Ari Wahyuni Ari Wahyuni Arif Yudho Prabowo Asyifa, Takhfa Nur Devi, Maria Dewi, Hanifah Tiara Dhipayasa Adirinarso Dwi Indria Anggraini Elvara Fatimah Muzaki Ety Apriliana Fadhilah, Fuad Fatkhul Rizqi, Khoirul Febriantara, M.Kaisar Febrianti, Arlin Firsandini, Firsandini Fitra W.S, Muhammad Fitria Saftarina Frauprades, Kaltihennah Oktavia George Pestalozi Ghifari, Ghaza Ahmad Al Gigaramadan Sema Giska Tri Putri Hakim, Ganesha Rahman Hanna Mutiara Hisbul Waton Ihsanti Dwi Rahayu Ilhamy, Satria Rizqi Indika Poloriani Tunang Indri Windarti Intanri Kurniati Jasmine Putri Nabila Jausal, Anisa Nuraisa Junando, Mirza Junita, Aulia Khairun Nisa M. Aqmal Hidayah M. Frans Surya Pradana Muhammad Maulana Muhartono Muhartono Mukhlis Imanto Novita Carolia Oktadoni Saputra Oktoba, Zulpakor Rani Himayani Rasmi Zakiah Oktarlina Ratna Dewi Puspita Sari Ratna, Maya Ganda Risal Wintoko Risti Graharti Sangging, Putu Ristyaning Ayu Santhi, Komang Ria Yuliana Setiorini, Anggi Shafia, Anindya Sihaloho, Yohanna Christiani Soraya Rahmanisa Supriyadi, Satrio Darma Suryadiwansa Harun Susanti, Andani Dewanti Sutarto Sutarto Syazili Mustofa T. Adjeng, Andi Nafisah Tiffani Dinda Ashar Tri Umiana Soleha Waton, Hisbul Winda Trijayanthi Utama, Winda Trijayanthi Wiwi Febriani Yanuar Burhanuddin Yoyos Dias Ismiarto Yusnita Eka Rahayu