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Journal : Medula

Peran Anemia Sebagai Faktor Risiko Hipertensi Resisten pada Penyakit Ginjal Kronik Nasution, Salwa Salsabila; Kurniati, Intanri; Ratna, Maya Ganda; Ramadhian, M. Ricky
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1354

Abstract

Anemia is one of the most common complications in chronic kidney disease (CKD) that significantly affects quality of life and prognosis. Anemia is a condition where there is a decrease in iron-rich hemoglobin levels, which functions to circulate oxygen throughout the body. Chronic kidney disease is a kidney condition characterized by abnormalities in kidney structure or function. Men have a 2 times higher risk of developing CKD than women due to their generally poorer lifestyle habits. The condition of insufficient oxygen perfusion to tissues leads to activation of the renin-angiotensin-aldosterone system (RAAS). The RAAS system ultimately produces aldosterone and antidiuretic hormones that cause sodium retention in the body and lead to increased blood pressure. Additionally, anemia can cause changes in blood vessels, where there is an increase in vascular resistance, especially in CKD patients. Studies have also shown that erythropoietin therapy can increase the prevalence of hypertension. Resistant hypertension is a condition where someone suffering from hypertension fails to achieve target blood pressure of <140/80 mmHg in normal individuals and <130/80 mmHg in CKD patients despite adhering to a combination dose of three types of antihypertensive medications. Someone suffering from resistant hypertension must comply with the drug dosage prescribed by the doctor and also improve their lifestyle. This article aims to understand how anemia serves as a risk factor for resistant hypertension in CKD patients. Furthermore, the diagnosis and treatment of resistant hypertension are also discussed in this article.
Peran Shunt Ventrikuloperitoneal dalam Strategi Pengobatan Hidrosefalus Pada Anak : Literature Review Sari, Indah Purnama; Roro Rukmi Windi Perdani; Diana Mayasari; Intanri Kurniati; Fidha Ramayani; Rizki Hanriko; Dewi Nur Fiana
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1357

Abstract

Hydrocephalus is a condition characterized by the accumulation of cerebrospinal fluid (CSF) within the brain's ventricles, presents a significant challenge in pediatric care. The increased intracranial pressure resulting from this CSF buildup can lead to severe neurological damage if left untreated. Ventricular peritoneal shunt (VP shunt) surgery remains a primary surgical intervention aimed at diverting excess CSF, thereby reducing intracranial pressure and mitigating the risk of irreversible neurological damage. This literature review provides a comprehensive review of the role of VP shunts in the management of pediatric hydrocephalus, encompassing a detailed examination of indications and contraindications for shunt placement, various surgical techniques employed, and the effective management of common post-operative complications such as infection, shunt malfunction (obstruction or overdrainage), and hemorrhage. We meticulously analyze current literature data to assess the effectiveness of VP shunts in improving neurological outcomes, fostering cognitive development, and enhancing the overall quality of life for children affected by hydrocephalus. The analysis will incorporate a review of long-term followup studies to evaluate the durability and efficacy of different shunt types and materials. Case studies and clinical experiences are integrated to provide a nuanced understanding of current clinical practices and to highlight the complexities often encountered in managing this condition. Furthermore, this literature review delves into recent advancements in shunt technology, including the development of programmable valves and less invasive surgical approaches. It also addresses the persistent challenges in optimizing hydrocephalus care, emphasizing the crucial need for a multidisciplinary approach involving neurosurgeons, pediatric neurologists, developmental pediatricians, and other healthcare professionals to ensure holistic and individualized patient care. The ultimate goal is to provide practical, evidence-based guidance for healthcare professionals in the effective and safe management of pediatric hydrocephalus using VP shunts, ultimately improving patient outcomes and quality of life.
Tekanan Darah Pada Atlet Al Ghifari, Ghaza Ahmad; Berawi, Khairun Nisa; Graharti, Risti; Kurniati, Intanri
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1398

Abstract

Blood pressure in athletes is an important topic in exercise physiology studies, given its influence on performance and long-term health. In general, athletes exhibit lower blood pressure at rest compared to sedentary individuals, as a result of the body's adaptation to regular physical exercise. The purpose of this method is to analyze and collate knowledge relevant to the research topic. In this study, 12 articles from national and international journals published between 2015 and 2023 were used. The articles were obtained from databases such as PubMed and Google Scholar. The collected sources were then analyzed using the systematic literature review method. The result of this study is that blood pressure in athletes can be different compared to individuals who are not involved in intense physical activity, due to the body's adaptation to regular exercise. Blood pressure in athletes is influenced by a variety of factors, including sport type, training pattern, age, gender, as well as genetic and environmental factors. Understanding these blood pressure patterns is important for optimizing performance and maintaining cardiovascular health in athletes.
Faktor Gangguan Ginjal dan Diabetes Melitus yang Mempengaruhi Mortalitas Penderita Sindrom Koroner Akut di RSUD Dr. H. Abdul Moeloek Tahun 2020–2021 Fadhlurrahman, Fadhlurrahman; Yonata, Ade; Karima, Nisa; Kurniati, Intanri
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1676

Abstract

Acute Coronary Syndrome (ACS) is one of the leading causes of cardiovascular mortality worldwide and in Indonesia. Various risk factors have been investigated, yet two important comorbidities that frequently worsen the prognosis are diabetes mellitus and kidney disorders. Diabetes mellitus accelerates atherosclerosis and promotes plaque instability, whereas kidney disorders exacerbate cardiovascular metabolism and restrict therapeutic options due to impaired drug elimination. This study aimed to analyze the influence of diabetes mellitus and kidney disorders on the mortality of ACS patients at Dr. H. Abdul Moeloek General Hospital. An analytic observational study with a cross-sectional design was conducted involving 71 patients diagnosed with ACS during the 2020–2021 period. The main independent variables were diabetes mellitus and kidney disorders, while mortality served as the dependent variable. Data were analyzed using the Chi-Square test, Fisher’s Exact Test, and Odds Ratio (OR) calculations, with a significance level of p < 0.05. The study found an overall mortality rate of 25.3% among ACS patients. A significant relationship was observed between diabetes mellitus and mortality (p = 0.012; OR = 3.1) as well as between kidney disorders and mortality (p = 0.019; OR = 4.0). This indicates that ACS patients with diabetes mellitus have approximately three times higher risk of death, and those with kidney disorders have about four times higher risk compared to those without these comorbidities. In conclusion, diabetes mellitus and kidney disorders are significant predictors of mortality among ACS patients, highlighting the importance of comprehensive management for patients with these conditions in clinical cardiovascular care.
Hubungan Hipertensi dengan Penyakit Jantung Koroner (PJK): Tinjauan Pustaka Worocahyo, Avis Meyvika; Kurniati, Intanri; Damayanti, Putri; Susianti, Susianti
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.v15i4.1694

Abstract

Coronary Artery Disease (CAD) is still one of the leading causes of mortality worldwide, including in Indonesia with a steadily rising prevalence. Hypertension is recognized as a major risk factor, as it accelerates atherosclerosis, induces endothelial dysfunction, and promotes cardiac structural changes that ultimately lead to coronary artery narrowing. This study employed a literature review approach by analyzing scientific articles discussing the association between hypertension and CAD in Indonesia. The findings show a significant relationship between hypertension and CAD, with p-values < 0.05 across multiple studies, and hypertensive individuals found to be more than twice as likely to develop CAD compared to normotensive individuals. Pathophysiologically, chronic hypertension contributes to hemodynamic disturbances, cardiac remodeling, endothelial dysfunction, and activation of the renin-angiotensin-aldosterone system (RAAS), thereby accelerating atherosclerosis and triggering myocardial infarction. These results highlight the importance of early detection and effective management of hypertension as essential strategies for preventing cardiovascular complications.
Hubungan IMT Terhadap Kadar Gula Darah Pada Pasien Diabetes Mellitus Tipe 2: Tinjauan Pustaka Afifah, Ighra; Kurniati, Intanri; Marcellia, Selvi; Ramadhian, Muhammad Ricky
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.v15i4.1704

Abstract

Type 2 diabetes mellitus is a chronic metabolic disease with a steadily increasing prevalence globally, including in Indonesia. One of the main risk factors contributing to the development and severity of type 2 diabetes is obesity, clinically measured by Body Mass Index (BMI). Increased BMI is closely associated with impaired glucose metabolism and insulin resistance, which play a key role in the pathogenesis of type 2 diabetes. This study used a literature review approach by examining various studies analyzing the relationship between BMI and blood glucose levels. The results showed that increased BMI is positively correlated with fasting blood glucose, random blood glucose, and HbA1c levels. Individuals with a higher BMI tend to experience more severe glycemic control disorders. Pathophysiologically, increased adipose tissue, especially visceral fat, produces various inflammatory mediators such as TNF-α and IL-6, which disrupt the insulin signaling pathway, reduce glucose uptake by muscle tissue, and trigger hyperglycemia. Furthermore, dysfunction of adipokine hormones such as decreased adiponectin and resistance to leptin contribute to worsening insulin sensitivity
HUBUNGAN KADAR HBA1C DENGAN DERAJAT ULKUS DIABETIK MENURUT KLASIFIKASI MEGGITT-WAGNER PADA PASIEN DIABETES MELITUS TIPE 2 DI RSUD DR. H. ABDUL MOELOEK BANDAR LAMPUNG PERIODE JANUARI-JULI 2022 Salsabila, Kamila; Kurniati, Intanri; Wulan, Anggraeni Janar; Wintoko, Risal
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.v16i1.1718

Abstract

Type 2 diabetes mellitus can lead to various complications if they are not managed adequately, including diabetic ulcers. Classification of diabetic ulcers is necessary to describe the lesion and to study the prognosis of the patients. The Meggit-Wagner classification was chosen because it is a classification system that has many advantages. Measurement of glycated hemoglobin (HbA1C) is a glycemic control that is considered good for describing blood sugar levels. High blood glucose levels are one of the reasons why patients have difficulty healing wounds, which can affect the grade of diabetic ulcers. The purpose of this study was to determine the relationship between HbA1C levels and the grade of diabetic ulcers according to the Meggitt-Wagner classification in type 2 diabetes mellitus patients at Dr. H. Abdul Moeloek Hospital Bandar Lampung from January-July 2022. This research is a retrospective observational analytic study with a cross-sectional approach. The research sample was 66 patients. The data used is medical records. Selection of the sample using total sampling technique. Statistical analysis was performed using univariate and bivariate analysis. The results of the bivariate analysis using the chi-square test showed a value of p=0.003 (p <0,05) in HbA1C levels and the grade of diabetic ulcers, which means that there is a significant relationship between the variables. There is a significant relationship between HbA1C levels and the grade of diabetic ulcers according to the Meggitt-Wagner classification in type 2 diabetes mellitus patients at Dr. H. Abdul Moeloek Hospital Bandar Lampung from January-July 2022.
Co-Authors Ade Yonata Ade Yonata, Ade Afifah, Ighra Agustya Tjiptaningrum Agustyas Tjiptaningrum Agustyas Tjiptaningrum Al Farisi, Ahmad Fathin Al Ghifari, Ghaza Ahmad Alyssa Fairudz Shiba Andriani, Silvia Angelia, Tisa Anggraeni Janar Wulan Anggraeni Janar Wulan, Anggraeni Janar Aprilia, Sandrina Audy Ardika, Okta Besti Arif Yudho Prabowo Arisqan, Ferdian Syukri Armadani, Melni Audah, Kholis A. Azhar, Hafidz Sirojudhin Baehaqi Bagus Pratama Bayu Anggileo Pramesona Chanief Hassan Widjaja Chicy WIdya Morfi Dalillah, Fathian Nur Damayanti, Putri Deborah Natasha Dewi Nur Fiana Dian Isti Angraini Diana Mayasari Ety Apriliana Evi Kurniawati Evi Kurniawati, Evi Fadhlurrahman, Fadhlurrahman Febilla Naili Alfalah Ferry Mulyadi Fidha Ramayani Giska Tri Putri Hadibrata, Exsa Helmi Ismunandar Hendri Busman Hilmi, Tamadar Indah Salsabila Indri Windarti Intan Kusumaningtyas Iswandi Darwis Jausal, Anisa Nuraisa Jhons Fatriyadi Suwandi Jonathan Rivaldo Gultom Kamila Salsabila Karima, Nisa Kenos Stefanus Khairun Nisa Kurniawaty, Evi Maharani, Denisa Marcellia, Selvi Muhammad Ricky Ramadhian Muhammad Yusran Muhartono Muhartono Nasution, Salwa Salsabila Ni Made Shanti Novita Carolia Nurrahma, Alya Nabila Nurul Utami Oktadoni Saputra Putri, Morica Angellia Shyama Putri, Najwa Naraniya Putu Ristyaning Ayu Qurani, Istiqomatul rahmawati, selvi Rana Noor Fakhira Siregar Rani Himayani Ratna Dewi Puspita Sari Ratna, Maya Ganda Rengganis Wardani, Dyah Wulan Sumekar Reni Zuraida Risal Wintoko Risti Graharti Rizki Hanriko Rizky Agung Purnomo Roro Rukmi Windi Perdani, Roro Rukmi Salsabila, Kamila Sangging, Putu Ristyaning Ayu Septia Eva Lusina Septiani, Linda Setiawan, Gigih Sinaga, Herman Fransiskus Siti Maharani Suci, Maghfirly Juniarti Eka Suharmanto Suherman, Auriva Renasha Susianti Susianti, Susianti Syazili Mustofa TA Larasati Tibar, Fifi Nurliza Aini Tutik Ernawati Utari Gita Mutiara Vira Katya Aurelia Winda Trijayanthi Utama, Winda Trijayanthi Worocahyo, Avis Meyvika Wulan, Anggraini Janar Yuningrum, Hesti