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All Journal Medula Wikrama Parahita : Jurnal Pengabdian Masyarakat Jurnal Ilmu Kedokteran dan Kesehatan JURNAL MUTIARA KESEHATAN MASYARAKAT JURNAL PENELITIAN PERAWAT PROFESIONAL Wellness And Healthy Magazine JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal teknologi Kesehatan Borneo Nusantara Hasana Journal Jurnal Riset Rumpun Ilmu Kedokteran (JURRIKE) Journal of Student Research Jurnal Kedokteran Ibnu Nafis Jurnal Kesehatan Metro Sai Wawai JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Sangging, Putu Ristyaning Ayu
Fakultas Kedokteran, Universitas Lampung
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Fluktuasi Nilai HbA2 pada Carrier β-Thalasemia: Literature Review Qoriba, Fathan; Sangging, Putu Ristyaning Ayu; Maulana, Muhammad; Lisiswanti, Rika
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1306

Abstract

Thalassemia is a form of microcytic anemia caused by impaired synthesis of the globin protein in hemoglobin, with β-thalassemia being one of the most common types. β-thalassemia arises from mutations in the β-globin gene located on chromosome 11, resulting in reduced or absent production of the β-globin chain. According to the World Health Organization (WHO, 2019), the global prevalence of β-thalassemia major is estimated at 39.96 million people (5.2% of the world’s population), with 1.5% identified as carriers. In Indonesia, the 2018 Riskesdas survey reported 7,209 cases of β-thalassemia. The decreased synthesis of the β-globin chain leads to elevated levels of HbA2 and HbF. β-thalassemia is classified into three categories: minor, intermediate, and major. This review focuses on the characteristics of HbA2 and its significance in diagnosing the β-thalassemia carrier. This article is a narrative literature review that examines various studies on HbA2 (HbA2) and its role in the β-thalassemia carrier. The literature reviewed was sourced from several databases, including PubMed, Google Scholar, and Elsevier, using the keywords "Carrier β-thalassemia" and "HbA2." The selected studies span from 2010 to 2024. Hemoglobin A (HbA) is the primary type of hemoglobin found in adults, with HbA2 and HbF serving as minor components. Individuals with β-thalassemia exhibit reduced or absent production of the β-globin chain, leading to an imbalance between α and β chains and an associated increase in HbA2 levels. Elevated HbA2 levels are commonly observed in β-thalassemia carriers, making this measurement important for predicting the risk of β-thalassemia major in their offspring. Studies suggest that HbA2 levels can be influenced by conditions such as megaloblastic anemia and iron deficiency. Additionally, factors like pregnancy and serum ferritin levels have been investigated, with mixed findings on their potential impact on HbA2 levels.  
Hubungan Rasio Neutrofil Limfosit (RNL) Dengan Lama Rawat Inap Pada Pasien Pneumonia Di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Julianti, Dinul Aliya; Sangging, Putu Ristyaning Ayu; Pardilawati, Citra Yuliyanda; Tjiptaningrum, Agustyas
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.v14i12.1316

Abstract

Pneumonia is an acute infection of the lung tissue due to bacteria, viruses, and fungi. Increased RNL values in pneumonia patients are biomarkers to systemic inflammatory responses that are easily quantified, inexpensive, and easily interpretable in the prognosis of pneumonia patients associated with length of stay. However, there is still not much relevant amount of research, and its application in daily practice is still minimal. This study aimed to identify the relationship of NLR with the length of hospitalization in pneumonia patients. This study used a cross sectional design. The data collection technique is a total sampling with a sample size of 39 patients. The research location is at Dr. H. Abdul Moeloek Regional General Hospital, Lampung Province and will take place in July-December 2022. The independent variable is RNL, while the dependent variable is the length of stay. Data obtained from the results of laboratory supporting examinations in the medical records of pneumonia patients. The collected data were then analyzed using the Chi-square test with a CI of 95%. The results showed that the majority of patients came from the age group of 51-60 years (51.3%) and were male (61%). The average pneumonia patient had a high ANC value (9,260) and a normal ALC (1,244) so that a high NLR average (10,067) was obtained with an average long stay (6 days). There is a relationship between NLR and length of stay in pneumonia patients at Dr. H. Abdul Moeloek Regional General Hospital, Lampung Province (p<0.05).
Gambaran Jenis Pekerjaan Ayah dan Status Pekerjaan Ibu Terhadap Kejadian Stunting di Puskesmas Seputih Surabaya Lampung Tengah Kalih, Abigael Ludwina; Sutarto, Sutarto; Suharmanto, Suharmanto; Sangging, Putu Ristyaning Ayu
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.v14i11.1409

Abstract

Stunting refers to short or very short stature based on length or height for age that is less than -2 standard deviations on the WHO growth curve. The World Health Organization (WHO) estimated that 22.2% or 149.2 million children under 5 years old suffered from stunting in 2020. Stunting is caused by two factors: direct and indirect factors.This study aims to examine the relationship between the father's type of occupation and the mother's employment status with the incidence of stunting in the working area of the Seputih Surabaya Public Health Center, Central Lampung. The study employed a cross-sectional design, with a sample of 57 toddlers from the Seputih Surabaya Subdistrict, Central Lampung Regency. The research was conducted from September to November 2024. The sampling technique used proportional random sampling and simple random sampling. This study utilized consent forms containing statements of willingness to participate as respondents, and data collection was conducted using questionnaires. The questionnaire included questions about the father’s type of occupation (e.g., farmer, civil servant, entrepreneur/trader, accountant, livestock farmer, fisherman, employee, teacher, or unemployed) and the mother’s employment status (working or not working). The data were analyzed univariately. The results showed that among toddlers with stunting, the most common type of father's occupation was farming, involving 33 children (58%). Regarding the mother’s employment status, the majority of stunted toddlers had mothers who were not working, accounting for 35 children (61.4%).
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.
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.
Hubungan Jenis Kelamin, Usia, dan Pekerjaan dengan Kejadian Anemia pada Pasien Tuberkulosis Paru di Rumah Sakit Umum Daerah Abdul Moeloek Bandar Lampung pada Bulan Januari - Agustus 2022 Fathunnisa, Ridha Riano; Sangging, Putu Ristyaning Ayu; Utami, Winda Trijayanthi; Soleha, Tri Umiana
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.v16i1.1754

Abstract

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is classified as a chronic multisystem infection with diverse clinical manifestations. Hematological abnormalities are frequently observed in tuberculosis patients and are generally associated with non-immunological mechanisms. Anemia is one of the most common abnormalities. All chronic infections, including tuberculosis, can induce anemia through various pathogenic pathways. However, most studies indicate that suppression of erythropoiesis mediated by inflammatory factors plays a major role in the development of anemia in tuberculosis patients. This study aimed to describe the characteristics of anemia and identify factors associated with its occurrence in patients with pulmonary tuberculosis. An observational analytic study with a cross-sectional design was conducted. Data were obtained from the medical records of pulmonary tuberculosis patients with anemia at the Medical Records Unit of RSUD Dr. H. Abdul Moeloek Bandar Lampung from January to December 2022. A total of 85 patients who met the inclusion criteria were included and analyzed using univariate and bivariate analyses with the Chi-Square test. Univariate analysis showed that most patients had normocytic normochromic anemia, accounting for 66 patients or 77.6%, while microcytic hypochromic anemia was observed in 19 patients or 22.4%. Anemia was more common in male patients, with a proportion of 74.1%. Bivariate analysis demonstrated a significant association between age and anemia occurrence, with a p value of 0.024. No significant association was found between occupation and anemia or between sex and anemia. This study concludes that age is the only factor associated with anemia among pulmonary tuberculosis patients at RSUD Dr. H. Abdul Moeloek Bandar Lampung.
Korelasi NT-proBNP dengan Fraksi Ejeksi pada Pasien Gagal Jantung: Tinjauan Pustaka Darma, I Wayan Dika Aditia; Sangging, Putu Ristyaning Ayu
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.v16i2.1769

Abstract

Heart failure is a complex clinical syndrome characterized by typical signs and symptoms resulting from structural or functional cardiac abnormalities that impair the ability of the ventricles to fill with or eject blood effectively. It remains a major global health problem with high morbidity and mortality rates. One of the most widely used biomarkers for assessing disease severity and prognosis in heart failure is N terminal pro brain natriuretic peptide or NT proBNP. Elevated NT proBNP levels occur in response to increased ventricular wall stress and volume overload and are closely related to the degree of left ventricular dysfunction, which is commonly assessed by left ventricular ejection fraction or LVEF. Numerous studies have demonstrated a significant negative correlation between NT proBNP levels and ejection fraction, particularly in patients with heart failure with reduced ejection fraction, where higher NT proBNP concentrations are observed as LVEF decreases. In contrast, in patients with heart failure with preserved ejection fraction, this relationship is not consistently linear. This variability is influenced by additional factors such as diastolic dysfunction, the presence of comorbid conditions, increased myocardial stiffness, and structural cardiac remodeling that may not be fully reflected by ejection fraction values alone. This literature review aims to analyze the relationship between NT proBNP levels and ejection fraction in patients with heart failure based on findings from national and international studies published over the past ten years. A clear understanding of this relationship is essential to define the diagnostic and prognostic value of NT proBNP and to support its use in therapeutic monitoring and risk stratification in patients with heart failure.
Evaluasi kadar CRP High Sensitivity sebagai Marker Risiko Kardiovaskular pada Dewasa Muda: Indonesia Rachmantiawan, Aldiano; Sangging, Putu Ristyaning Ayu
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1773

Abstract

Atherosclerosis and cardiovascular disease originate from chronic low grade inflammatory processes, making high sensitivity C reactive protein or hs CRP widely studied as a cardiovascular risk marker, including in young adults. This study is a narrative review of 16 articles published between 2019 and 2025 that examine hs CRP in young adults aged 18 to 45 years and its association with cardiometabolic risk factors, cardiovascular disease events, and clinical outcomes. The review findings indicate that in overweight or obese young adults, elevated hs CRP levels are associated with central obesity, atherogenic dyslipidemia, impaired fasting glucose, and higher blood pressure. In addition, irregular sleep patterns and short term variability in diastolic blood pressure are also linked to increased hs CRP levels, suggesting the presence of subclinical inflammation early in life. In older populations and in patients with established cardiovascular disease, high hs CRP levels are reported to predict cardiovascular disease incidence, carotid plaque formation, cardiometabolic multimorbidity, functional disability, and short term mortality. However, hs CRP is not associated with the progression of coronary artery calcification and demonstrates substantial intra individual variability. Overall, hs CRP has potential value as an additional marker to identify young adults at higher cardiovascular risk. Nevertheless, hs CRP is not sufficient as a single screening tool and should be interpreted alongside traditional cardiovascular risk factors and lifestyle patterns. Repeated measurements are recommended to improve risk assessment accuracy and to account for biological variability in hs CRP levels.
Hubungan Asupan Black Garlic Terhadap Gambaran Histopatologi Ginjal Tikus Putih (Rattus Norvegicus) Galur Sprague-Dawley Yang Diinduksi Minyak Jelantah Dimas, Dimas; Sangging, Putu Ristyaning Ayu
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.v16i2.1790

Abstract

Cooking oil consumed orally contains toxic substances that can cause cell damage in the kidneys. Black garlic contains antioxidants that can have an anti-toxic effect on the kidneys. This study is a true experimental study using a posttest only control group design to determine whether there is a relationship between black garlic intake and renal histopathology in Sprague-Dawley strain white rats (Rattus norvegicus) induced by used cooking oil. In this study, there were 25 rat samples divided into 5 groups: a control group with distilled water (K1), a control group with waste oil (K2), a 200mg/kgBW group (P1), a 400mg/kgBW group (P2), and an 800mg/kgBW group from the black garlic dose (P3). Microscopic aspects such as cellular infiltration, edema, and necrosis were assessed to evaluate the histopathology of the kidney. The data obtained were then statistically tested using One-Way ANOVA and PostHoc LSD tests. Based on the results of the One-Way ANOVA statistical test, a p-value of 0.000 was obtained, and group P3 had the lowest renal histopathological damage compared to groups P1 and P2. There was a relationship between black garlic intake and the histopathology of the kidneys of Sprague-Dawley strain white rats (Rattus norvegicus) induced by waste oil, and the group with a black garlic dose of 800 mg/kgBW had the lowest histopathological damage to the kidneys compared to the other treatment groups.
Peran Laju Endap Darah dalam Evaluasi Penyakit Inflamasi Kronik Purnama Sari, Faraztya; Sangging, Putu Ristyaning Ayu; Graharti, Risti
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1821

Abstract

Chronic inflammation is a persistent immune response resulting from continuous inflammatory stimuli, such as chronic infections, autoimmune diseases, and metabolic disorders, and plays a significant role in the pathogenesis of various chronic diseases. Continuous evaluation of inflammatory activity requires laboratory parameters that are easily accessible and capable of reflecting long-term inflammatory processes. The erythrocyte sedimentation rate (ESR) is a non-specific hematological test that remains widely used in clinical practice to assess systemic inflammation. Elevated ESR values occur as a result of changes in acute-phase proteins, particularly fibrinogen and immunoglobulins, which promote erythrocyte aggregation and accelerate the sedimentation process. This review article aims to discuss the role of ESR in the evaluation of chronic inflammatory diseases, including the mechanisms underlying ESR elevation, its advantages, limitations, and comparison with other inflammatory biomarkers. ESR has advantages in representing stable chronic inflammation, its simplicity, and relatively low cost; however, it also has limitations, including low specificity and a slow response to changes in inflammatory activity. Therefore, ESR should be interpreted comprehensively in conjunction with clinical evaluation and other inflammatory biomarkers to support optimal management of chronic inflammatory diseases.
Co-Authors Adinda Husna Cahyana Agung Ikhssani Agustyas Tjiptaningrum Ahmad Duta Al-Ihya Al Ayubi, M. Mahdi Alghani, Sulthan Rafi Almaina Puteri Jasmine Almaina Amira Nabila Andi Nafisah Angelica Philia Christy Anggraeni Janar Wulan Annisarahma, Lyvia Aprilia, Intan Rahma Ardian Reza Putra Arfa Salma Firnandya Ari Irawan Ari Irawan Ari Wahyuni Aulia Nur Fitriatsani Aurelia, Faizah Zahra Aurora Awindya Nareswari Azizah Nur Rahmah Bagus Pratama Brigitta Shinta dewi Carissa Aprilia Y Cholyviona W.S Handhayani Citra Yuliyanda Pardilawati Cut Karel Dithia Daffa Fahreiza Daffa Fahreiza Darma, I Wayan Dika Aditia Devina Hardianto Devira Fitriani Kamal Devya Aulia Dian Isti Angraini Dilla Syahra Noor Fitri Dimas, Dimas Dzakwan Cedri Ketierteu Ellysa Angguman Putri Ety Apriliana Evan Christian Christian Fadila Gustiani Daraz Fadilah Alwiyah Faiq Razaan Razaan Farid Hammadi Faridi Pani Farraz Kanya Syahra Fathunnisa, Ridha Riano Fayza Syachrani Fityah Zabrina Hidayat Ganesha Rahman Hakim Ghina Salsabila Fenty PNR Gusnirwan, Alief Hanifah Qollama Astrid Hanna Mutiara Helmi Ismunandar Hendri Busman Herlambang, Geri Indra Imtinan Khoirunnisa Indah Kurnia Putri Waruwu Indah Salsabila Indri Windarti Intanri Kurniati Isabela Irene Pangestu Jausal, Anisa Nuraisa Jhons Fatriyadi Suwandi Josephine, Felicia Key Julianti, Dinul Aliya Kalih, Abigael Ludwina Kamila Nastiti Karima, Nisa Keziah Tirtawijaya Khairun Nisa Kurnia Fithrananda Kurniawaty, Evi Laja, Rana Salsabila Putri Lintang Lestari Cahya Sawitri Mafalda Marzon Maria Devi Melni Armadani Mentari Putri Maharani Mira Yustika Mochamad Fauzan Dava Muhamad Zaidan Algifari Muhammad Ammar Naufal Muhammad Arsy Kamal Faadhil Muhammad Maulana Muhammad Ricky Ramadhian Muhammad Rizki Akbar, Muhammad Rizki Mukhbita, Khalila Alya Mukhlis Imanto, Mukhlis Nabila Alsa Sagia Nabila Shafira Nabila Yoli Rahmadani Nadhia Wihelga Nahrassyiah Rahma Putri Ni Ketut Diah Ayu Pramisswari Ni Putu Sari Widiyani Noval Ramadirta Nurul Fadhilah Az-zahro Nurul Utami Oktafany Oktafany Oktoba, Zulpakor Pardilawati, Citra Yulianda Pardilawati, Citra Yuliyanda Prasetyo, Muhammad Purwono Purnama Sari, Faraztya Putra, Rangga Pratama Wahyuono Qoriba, Fathan RA Genta Syakira Hatta Rachel Agustin Inggrid Zefanya Rachmantiawan, Aldiano Rafi Gutra Aslam rahmawati, selvi Rahmi Zuraida Raihanah Nabilah Rani Himayani Rani Himayani Rani Himayani Rasmi Zakiah Oktarlina Ratna Dewi Puspita Sari Regita Dwi M Reisyah Syahfira Rifka Putri Dewi Rika Lisiswanti Risti Graharti Rizqiani Astrid Nasution Rudiyanto, Waluyo Salsabila Haqya Kusuma Salshabilla, Annisa Santhi, Komang Ria Yuliana Satria, Rasha Andhika Selvi Marcellia Sembiring, Dustin Delano Pranata Setiorini, Anggi Shiddiq, Muhammad Nasrullah Nur Shinta Nareswari, Shinta Simanungkalit, Jesica Natalia Sinulingga, Anselmus Libreya Siti Shafira Elfreda Suharmanto Suryani Agustina Daulay Susianti Susianti Sutarto Sutarto Sutyarso Sutyarso Syahrani Alya Murfi Syalwa Meutia Syiva Ulhayah Tamaulina Br Sembiring Tiasti, Jania Tri Umiana Soleha Tsurayya Fathma Zahra Utami, Winda Trijayanthi Wardani, Nanda Fitri Yashila Rahimah Zahira TS, Shifa Tanjia Zahra, Siti Aqila Zayatri Nurul Jannaty Zheva Aprillia Yozevi