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Journal : Medula

Penatalaksanaan Holistik Hemoroid Interna Grade II pada Pria Usia 42 Tahun Melalui Pendekatan Kedokteran Keluarga di Wilayah Kerja Puskesmas Rawat Inap Sukaraja Retno Mareintika; Ernawati, Tutik
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.v15i3.1514

Abstract

Hemorrhoids are submucosal swellings in the anal canal, consisting of venous plexuses, small arteries, and dilated areolar tissue. in 2019, approximately 4.4% of the global population suffered from hemorrhoidal disease. Data from WHO in 2017, the number of hemorrhoids cases reached 230 million people. In 2017, the global incidence of hemorrhoids increased to 54%. In Indonesia, based on the Basic Health Research (Riskesdas) data, it is estimated 2030, the number of individuals suffering from hemorrhoids will reach 21.3 million. The objective of this study is to identify internal and external risk factors, as well as clinical problems in patients, and to apply Evidence-Based Medicine (EBM) in the family doctor services for these patients. The management of patients was conducted based on a patient-centered, family-focused, and community-oriented problem-solving framework. Primary data were obtained through autoanamnesis, physical examination, and home visits, while secondary data were gathered from patients' medical records. The evaluation was based on a holistic diagnosis from the beginning to the end of the study, both qualitatively and quantitatively. Patient Mr. T, 42 years old, had a main complaint of bulging protruding mass from his anus that is exacerbated with defecation and bowel movements. accompanied by bleeding for the past week. The patient was concerned about the worsening of the condition. Clinically, the patient was diagnosed with Grade II Internal Hemorrhoids. A holistic management approach was implemented, including an intervention using a poster as a media. The diagnosis and management of this patient were carried out holistically and comprehensively, based on several theories and current research. During the behavior change process, the patient has reached the trial stage.
Case Report: Tonsilitis Kronik Pada Anak Usia 12 Tahun Retno Mareintika; Graharti, Risti; Hayati, Rina
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.v15i3.1670

Abstract

Chronic tonsillitis is one of the most common upper respiratory tract infections in children. This condition is characterized by recurrent inflammation of the tonsils, which can interfere with daily activities, reduce appetite, impair sleep quality, and increase the risk of severe complications such as peritonsillar abscess, parapharyngeal abscess, or sepsis. Appropriate management is essential to prevent recurrence and further complications.This case report describes a 12-year-old female patient who presented with complaints of odynophagia, a foreign body sensation in the throat, halitosis, recurrent fever, and snoring during sleep. Physical examination revealed T3–T3 tonsils with enlarged crypts and the presence of detritus, leading to a diagnosis of chronic tonsillitis or recurrent acute tonsillitis. Initial management included amoxicillin 500 mg three times daily for 10 days, paracetamol 10–15 mg/kgBW as needed for fever, and an antiseptic mouthwash. The patient and her family were also educated on medication adherence, maintaining oral hygiene, and avoiding triggering foods such as spicy meals, cold drinks, and unhygienic snacks.Conservative therapy provided temporary symptomatic improvement; however, considering the recurrent episodes and sleep disturbances, the patient was advised to undergo tonsillectomy as definitive therapy. This case emphasizes that chronic tonsillitis in children requires accurate diagnosis, comprehensive management, and timely intervention. Conservative treatment may alleviate symptoms, but tonsillectomy plays a pivotal role in preventing recurrence, reducing the risk of complications, and improving the patient’s quality of life.