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All Journal Medula Jurnal Dunia Kesmas Jurnal Kesehatan Innovative: Journal Of Social Science Research JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai
Mukhlis Imanto, Mukhlis
Bagian Ilmu Penyakit Telinga Hidung Tenggorok Bedah Kepala Leher (THT-KL), Fakultas Kedokteran, Universitas Lampung
Humanities Computer Science & IT Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Journal : Medula

 1 
Hubungan Deviasi Septum Nasi dengan Derajat Obstruksi Nasi Berdasarkan Skor NOSE Panjaitan, Vania Christy M; Imanto, Mukhlis
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.v14i1.920

Abstract

Nasal septum deviation is the occurrence of the nasal septum shifting from the midline. According to the American Academy of Otolaryngology-Head and Neck Surgery, nasal septum deviation is a common condition that affects approximately 80% of the population. The prevalence of nasal septum deviation can increase with age, reaching 72% at the age of 3-14 years old. Although the prevalence is pretty high, specific prevalence for Indonesia is still limited. Nasal septum deviation can be caused by trauma, birth mold theory and hereditary factors. Lateral  trauma of the nose can cause changes in the position of the cartilaginous septum, while frontal trauma can cause indentations, fractures and duplication of the nasal septum. Some nasal septum deviation can also be caused by compression effects on the nose during the intrauterine period and birth, as well as the use of forceps. The classification of nasal septum deviation generally uses the Mladina classification which consists of 7 types. The main symptom of nasal septum deviation is nasal obstruction, which can be measured through subjective and objective measurements. Septoplasty therapy is often performed to reduce subjective complaints. Epidemiological studies indicated that approximately 260,000 septoplasties were performed in the United States and 10,000–95,000 in Europe. The use of questionnaires such as the NOSE score helps in the degree of nasal obstruction and its effect on the patient's quality of life. Studies showed a relationship between nasal septum deviation and complaints of nasal obstruction, especially in the nasal valve area. As a diagnostic tool, CT scan and measuring the angle of septal deviation are used to determine the degree of septal deviation. In Indonesia, more research is still needed to understand the prevalence and characteristics of nasal septum deviation in more detail. Subjective and objective parameters, along with valid questionnaires such as the NOSE score, provide a holistic understanding of the impact of septal deviation on patients and help in the assessment and management of this condition.
Etiologi dan Penegakan Diagnosis Disfagia Ni Komang Devi Wiratningrum; Imanto, Mukhlis
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.v14i1.922

Abstract

Dysphagia or complaints of difficulty swallowing is a problem that can occur in all age group, however, the incidence of dysphagia tends to be higher in the age group over 50 years, with a prevalence of around 7-22% of the total population in the world. Misidentification and the assumption that dysphagia symptoms are a process normal aging means many seniors do not seek medical help. Even though the prevalence of dysphagia is quite high, until now there is no data regarding the prevalence of dysphagia in Indonesia. The classification of dysphagia based on etiology is divided into three, namely mechanical dysphagia due to obstruction, motor dysphagia due to neuromuscular disorders and dysphagia caused by emotional disorders. The diagnosis of dysphagia is carried out using anamnesis, physical examination and supporting examinations such as Video Fluooscopy Swallow Assessment (VFSS), Flexible Endoscopy Evaluation of Shallowing (FEES), radiology, esophagoscopy and manometrics. Management that can be carried out for individuals with symptoms of dysphagia is postural techniques, modification of food patterns and textures, and maneuver techniques.
Laboratory Examination in Tonsillitis: A Literature Review Sembiring, Dustin Delano Pranata; Imanto, Mukhlis; Sangging, Putu Ristyaning Ayu; Angraini, Dian Isti
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.v14i11.1434

Abstract

Laboratory tests play a crucial role in the diagnosis and etiology of tonsillitis, especially in children. Tonsillitis, an inflammation of the palatine tonsils, commonly affects children aged 5–15 years and is a significant cause of morbidity associated with upper respiratory tract infections. The disease can be classified into acute and chronic tonsillitis based on duration, with causes varying from viral to bacterial infections. Laboratory parameters such as leukocyte, neutrophil, lymphocyte, platelet counts, and C-reactive protein are used to differentiate the etiology of tonsillitis. Bacterial tonsillitis generally shows an increase in leukocytes and neutrophils, while viral infections are more commonly associated with lymphocytosis. Complete blood count, throat culture, and rapid antigen detection test (RADT) are the mainstays of diagnostic testing. Throat culture is considered the gold standard for pathogen identification, although it is more time-consuming. RADT offers a faster alternative with high sensitivity and specificity. Anti-Streptolysin O (ASO) titer is also important to detect Group A β-hemolytic Streptococcus infection, which is often associated with chronic tonsillitis. Recent studies have shown a correlation between laboratory results and the severity of tonsillitis. For example, a study in Sudan found that 64% of patients with tonsillitis had neutrophilia, 54% showed an elevated erythrocyte sedimentation rate, and 50% were ASO positive. These findings confirm the association between bacterial infection and chronic tonsillitis. However, interpretation of laboratory results must be done with caution, considering factors such as the time of sampling, examination technique, patient age, and the skill of the health care provider. Appropriate clinical decision-making requires the integration of laboratory results with the patient's clinical history. Further research is needed to explore the correlation between laboratory parameters, the severity of tonsillitis, and their impact on optimal therapy choices. A better understanding of these relationships will help improve the accuracy of diagnosis and the effectiveness of tonsillitis treatment.
Penyuluhan Edukasi Penggunaan Earphone Pasien Poli THT-KL RSUD dr H. Abdul Moeloek Provinsi Lampung Tahun 2024 Akbar, Tasya; Imanto, Mukhlis
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.v14i11.1462

Abstract

One of the five main senses in humans is the ear which is very necessary to capture the communication delivered. The human ear can only receive sound frequency intensity with a range of about 20 Hz to 20kHz. If the ear is exposed to quite loud noise and for a long period of time, it will cause noise-induced hearing loss. Earphone users who use the device more than 8 hours / week compared to earphone users with a time limit of only a few hours, the results of hearing levels are worse. This activity aims to provide knowledge about education in the use of earphones which is carried out by the ENT-HN Polyclinic of Dr. H. Abdul Moeloek Hospital, Lampung Province. The activity began with providing counseling and continued with a discussion session. Before and after the counseling, a pre- and post-test was given with an average result of 50 and 82.5, there was a significant increase in knowledge in patients about ear health. Through this activity, it is known that there is an increase in knowledge from patients at the ENT-HN Polyclinic of Dr. H. Abdul Moeloek Hospital, Lampung Province regarding education in the proper use of earphones in everyday life.
Edukasi Bahaya Penggunaan Cotton Buds: Upaya Pencegahan Risiko Kesehatan Setiawan, Salsabila Alifiyah; Imanto, Mukhlis
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1466

Abstract

A common practice in the community is to clean the ears independently to remove earwax that is considered annoying. The act of cleaning the ear canal by using ear cotton aids, actually causes the cerumen to be pushed deeper, which can close the tympanic membrane, causing temporary hearing loss. Cleaning the ear itself is inserting objects into the ear canal with the aim of removing earwax is a practice that has the potential to disrupt the natural cleaning mechanism, and is a risk factor for injury to the ear. Community service activities in the form of counseling “Education on the Dangers of Using Cotton Buds” were carried out on Thursday, January 25, 2024 which took place on the 3rd floor of the Poli Dr. H. Abdul Moeloek Hospital Lampung Province. This activity was attended by 12 audiences who were patients who were checking themselves to the ENT-KL Poly and Poly on the 3rd floor of the Poly Building of Dr. H. Abdul Moeloek Hospital Lampung Province. Pre and Post Tests were conducted as a measuring tool to evaluate the increase in audience knowledge after being given counseling. An increase in percentage was obtained, from 60% in the pretest results and 97% in the post-test results. This counseling activity proved to be effective in increasing community knowledge so it is recommended to be carried out regularly. Lack of knowledge about the dangers of using cotton buds could potentially increase the risk of ear injury. Therefore, it is important to educate the community on the correct way to care for the ears, as well as the dangers of improper use of cotton buds. Through this counseling activity, it is hoped that it can increase public awareness and understanding of the importance of safe and healthy ear care.
Penyuluhan Kesehatan Untuk Meningkatkan Pemahaman Tentang Menjaga Kebersihan Telinga Zhalif Zhafir Aghna; Imanto, Mukhlis
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.v14i11.1470

Abstract

The habit of cleaning the external auditory canal (EAC) with cotton buds and other objects is a common practice. Among the general public, ears are believed to need to be cleaned frequently to remove dirt in the form of earwax. This is usually done by inserting objects into the ear itself, most often with Q-tips also known as cotton buds. Medical concerns over cotton bud use and its complications were first reported in 1972, with reports of tympanic membrane perforation, otitis externa, and cerumen impaction. Today, cotton bud-related injuries have become a common reason for visits to ear, nose, and throat clinics. The purpose of this activity is to increase public understanding of how to properly maintain ear hygiene and reduce the incidence of complications due to lack of understanding about it. The target of this activity is 20 patients at the Abdul Moeloek Hospital Polyclinic, Lampung Province on November 21, 2023, 10:00-12:00 WIB. The form of this activity includes providing material on maintaining ear hygiene properly followed by discussion. The results of this activity are that there are still some patients who still have a low level of understanding, attitude, and practice regarding maintaining ear hygiene and health. After counseling, there was an increase in understanding, attitudes, and practices among respondents which is expected to increase knowledge among individual, family, and community components in maintaining ear hygiene.
Laporan Kasus : Pasien Anak 8 Tahun dengan Tonsilitis Kronik Eka Putra, Muhammad Rafi; Imanto, Mukhlis
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.v15i3.1690

Abstract

Tonsillitis is one of the most common otorhinolaryngological (ENT) diseases in children, characterized by inflammation of the tonsils caused by recurrent or persistent infections. This condition has significant clinical implications as it may lead to respiratory disturbances, sleep disorders, and a decrease in overall quality of life if not managed comprehensively. Chronic tonsillitis is typically characterized by prolonged symptoms with recurrent episodes, often accompanied by tonsillar hypertrophy and obstructive manifestations. We report a case of an 8-year-old boy who presented with a sore throat that had persisted for three years prior to hospital admission, with worsening symptoms in the past month. The patient’s father reported a sensation of a lump in the throat, visibly enlarged tonsils, and frequent snoring during sleep. Physical examination revealed hyperemia of the soft palate, a midline uvula with edema and hyperemia, hyperemic pharyngeal mucosa, posterior arch that was difficult to assess, hyperemic tonsils with widened crypts and no detritus, and tonsil size graded T3–T2. Based on clinical history and physical findings, the diagnosis of chronic tonsillitis was established. Management of this condition requires a thorough evaluation of recurrence frequency, degree of airway obstruction, and its impact on systemic function to determine the appropriate therapeutic approach, either conservative or surgical, in order to prevent long-term complications.
Efektivitas Kortikosteroid Intranasal vs Antihistamin Oral pada Rhinitis Dwiyanti, Fitri; Ferdiani, Fivien; Imanto, Mukhlis
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.v16i1.1742

Abstract

Allergic Rhinitis (AR) is a chronic inflammatory disorder of the nasal mucosa mediated by immunoglobulin E after exposure to specific allergens. It is characterized by rhinorrhea, nasal obstruction, sneezing, and nasal itching. AR has a high and increasing global prevalence and significantly affects quality of life, sleep quality, cognitive performance, and daily productivity. Effective management is required to control symptoms and prevent complications and comorbidities. This literature review compares the effectiveness of intranasal corticosteroids (INCS) and oral antihistamines (OAH) in the management of allergic rhinitis. A literature search was conducted using the Google Scholar database for studies published between 2017 and 2025, using the keywords “allergic rhinitis”, “allergic rhinitis therapy”, and “intranasal corticosteroids and oral antihistamines”. Included articles were accessible, written in English or Indonesian, and discussed the comparative effectiveness of INCS and OAH. Studies published before 2017 were excluded. The findings show that oral antihistamines effectively relieve early-phase, histamine-mediated symptoms such as sneezing, nasal itching, and rhinorrhea, with a rapid onset of action suitable for intermittent use. In contrast, intranasal corticosteroids are more effective in reducing nasal congestion and controlling persistent inflammation due to their broad anti-inflammatory effects. INCS also improve ocular symptoms and provide greater overall improvement in health-related quality of life compared to antihistamines alone. Overall, intranasal corticosteroids are recommended as first-line therapy for moderate to severe or persistent allergic rhinitis, while oral antihistamines remain useful for mild symptoms or as adjunctive therapy according to individual clinical needs.
Case Report: Laki-Laki Usia 42 Tahun dengan Laryngopharingeal Refluks Pangestu, Farhan Ridho; Imanto, Mukhlis
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.v16i2.1759

Abstract

Laryngopharyngeal Reflux (LPR) is an inflammatory condition affecting the mucosa of the larynx and pharynx caused by the retrograde flow of gastroduodenal contents into the upper aerodigestive tract. This condition is frequently underdiagnosed due to its nonspecific symptoms, which often mimic other upper airway disorders. LPR presents with a wide range of clinical manifestations and is commonly managed by multiple medical disciplines without an accurate or standardized diagnostic approach. This case report aims to describe the clinical presentation, risk factors, diagnostic process, and management of LPR in an adult patient. We report the case of a 42-year-old male who presented with recurrent choking sensations, shortness of breath, dry cough, frequent throat clearing, and hoarseness persisting for four months, accompanied by worsening heartburn and epigastric discomfort. The patient had several predisposing factors, including obesity and unhealthy lifestyle habits such as high-fat and acidic food consumption and lying down shortly after meals. The diagnosis of LPR was established based on a Reflux Symptom Index (RSI) score of 14 obtained during anamnesis and a Reflux Finding Score (RFS) of 9 derived from indirect laryngoscopic examination. Management consisted of pharmacological therapy with high-dose proton pump inhibitors and antacids, combined with non-pharmacological interventions including lifestyle and dietary modifications. This integrated approach aims to reduce reflux episodes and mucosal inflammation. This case highlights the clinical importance of RSI and RFS as practical diagnostic tools for LPR and emphasizes the need for comprehensive management strategies to improve patient outcomes and quality of life.
Laporan Kasus : Pasien Perempuan 25 Tahun dengan Rhinitis Alergi Ricardo, Muchammad Aqsa Enrico; Imanto, Mukhlis
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.v16i2.1792

Abstract

Allergic rhinitis is an immunoglobulin E mediated inflammation of the nasal mucosa characterized by recurrent sneezing, nasal obstruction, rhinorrhea, and ocular symptoms such as itching and tearing. This condition is commonly observed in young adults and is closely associated with environmental allergen exposure and genetic predisposition. This case report describes a 25 year old woman who presented with recurrent nasal obstruction for the past four years. The symptoms were more pronounced in the morning and during exposure to cold air. The patient also reported repetitive sneezing episodes, occurring 10 to 15 times after exposure to dust, accompanied by clear rhinorrhea, nasal and ocular itching, and a habitual nose rubbing behavior. Ocular complaints, including watery and itchy eyes, were consistently reported. Physical examination revealed livid discoloration of the nasal cavity mucosa and septum. The inferior turbinates appeared edematous and hyperemic with clear nasal secretions. No septal deviation or signs of acute infection were observed. Based on the persistence of symptoms for more than four weeks and the characteristic clinical findings, the patient was diagnosed with mild persistent allergic rhinitis. Management included oral antihistamine therapy with cetirizine, a nasal decongestant containing pseudoephedrine hydrochloride, and intranasal corticosteroid therapy with fluticasone furoate. In addition to pharmacological treatment, the patient received education on allergen avoidance, adoption of healthy lifestyle practices, and regular physical activity. This case highlights the importance of recognizing long term symptoms, performing a thorough physical examination, and applying an appropriate combination of pharmacological and non pharmacological interventions to achieve symptom control, improve quality of life, and prevent disease progression in patients with allergic rhinitis.
Co-Authors Adila, Naza Tsasbita Hayuning Akbar, Tasya Augesti, Gita Dian Isti Angraini Dwi Indria Anggraini Dwiyanti, Fitri Eka Putra, Muhammad Rafi Fatwa, Zahra Ramadhani Fauzi Ahmad Muda Ferdiani, Fivien Khairani Khairani Kurniawaty, Evi Kusuma, Anggia Shinta Wijaya Larasati, Ratri Mauluti M. Ridho Ulya Magistra, Muhammad Akbar Muhammad Yusran Ni Komang Devi Wiratningrum Pangestu, Farhan Ridho Panjaitan, Vania Christy M Permata, Alfiah Yusi Puspitasari, Ratna Dewi Rasmi Zakiah Oktarlina Ricardo, Muchammad Aqsa Enrico Rizki Hanriko Rodiani, Rodiani Salima, Jeanna Sangging, Putu Ristyaning Ayu Sembiring, Dustin Delano Pranata Setiawan, Salsabila Alifiyah Suharmanto Wiwi Febriani Zhalif Zhafir Aghna