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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) Nusantara Hasana Journal Jurnal Riset Rumpun Ilmu Kedokteran (JURRIKE) Journal of Student Research Jurnal Kedokteran Ibnu Nafis JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine Jurnal teknologi Kesehatan Borneo
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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Korelasi NT-proBNP dengan Fraksi Ejeksi pada Pasien Gagal Jantung: Tinjauan Pustaka I Wayan Dika Aditia Darma; Putu Ristyaning Ayu Sangging
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.
Hubungan Asupan Black Garlic Terhadap Gambaran Histopatologi Ginjal Tikus Putih (Rattus Norvegicus) Galur Sprague-Dawley Yang Diinduksi Minyak Jelantah Dimas Dimas; Putu Ristyaning Ayu Sangging
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.
Perkembangan Strategi Pengobatan β-Thalassemia Komang Ria Yuliana Santhi; Putu Ristyaning Ayu Sangging; Anisa Nuraisa Jausal; Helmi Ismunandar
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.
Evaluasi kadar CRP High Sensitivity sebagai Marker Risiko Kardiovaskular pada Dewasa Muda: Indonesia Aldiano Rachmantiawan; Putu Ristyaning Ayu Sangging
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.
Peran Laju Endap Darah dalam Evaluasi Penyakit Inflamasi Kronik Faraztya Purnama Sari; Putu Ristyaning Ayu Sangging; Risti Graharti
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.
Analisis Faktor Prediksi Peningkatan Kontrol Glikemik Pada Pasien Diabetes Melitus Tipe 2 Di RSUD Abdul Moeloek Provinsi Lampung Periode Januari-Desember 2022 Yovani Tria Ananda; Intanri Kurniati; Novita Carolia; Putu Ristyaning Ayu Sangging
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.v16i3.1910

Abstract

The 2018 Basic Health Research report indicated that prevalence of Diabetes Mellitus (DM) in Indonesia increased to 8,3%. This rise was accompanied by an increase in obesity prevalence, a major risk factor for DM, from 14,8% in 20113 to 21,8% in 2018. These findings suggest that the number of individuals with DM in Indonesia is substantial and continues to grow annually. Data from Bandar Lampung City in 2021 showed that out of 6,467,624 individuals aged ≥15 years, approximately 198,046 (3%) were diagnosed with DM. This study aimed to analyze the association between predictive factors and glycemic control among patients with type 2 diabetes mellitus at Abdul Moeloek Hospital, Lampung Province, during January-December 2022. This research employed an observational study with a cross-sectional design. Secondary data were obtained from medical records of both inpatient and outpatient type 2 diabetes mellitus patients. Data analysis was performed using the Chi-Square test, with the Mann-Whitney test as an alternative. The result demonstrated significant associations between age at diagnosis (p=0,006), duration of Diabetes (p=0,012), body mass index (p=0,016), and comorbidities (p=0,020) with glycemic control. In conclusion, age at diagnosis, duration of disease, body mass index, and comorbid conditions were significantly associated with glycemic control among patients with type 2 diabetes mellitus receiving oral antidiabetic drugs and insulin therapy at Abdul Moeloek Hospital, Lampung Province, during January-December 2022.
POLYGENIC RISK SCORE SEBAGAI PREDIKTOR DIABETES MELLITUS TIPE 2: SYSTEMATIC RIVIEW Ni Ketut Diah Ayu Pramisswari; Ety Apriliana; Selvi Marcellia; Putu Ristyaning Ayu Sangging
Nusantara Hasana Journal Vol. 5 No. 8 (2026): Nusantara Hasana Journal, January 2026
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v5i8.1881

Abstract

Type 2 diabetes mellitus (T2DM) is a multifactorial metabolic disease with a significant genetic contribution. Polygenic risk score (PRS) has been developed to integrate the cumulative effects of multiple genetic variants to improve T2DM risk prediction. This Systematic review aimed to evaluate the role of PRS in predicting T2DM incidence, disease progression, and related complications across different populations. This study was conducted in accordance with the PRISMA guidelines, with a literature search performed using the PubMed database and keywords related to PRS and T2DM. Included studies were observational in design and assessed the association between PRS and T2DM incidence or clinical outcomes. Three main studies with case-control, cross-sectional, and cohort designs were analyzed. The results demonstrated that PRS was significantly associated with increased T2DM risk, disease progression, and metabolic complications such as liver fibrosis, including in the context of organ transplantation. Integration of PRS with traditional clinical risk factors improved predictive performance. PRS has the potential to support precision-based T2DM risk stratification, although further cross-population validation is still required.
Co-Authors Adinda Husna Cahyana Agung Ikhssani Agustyas Tjiptaningrum Ahmad Duta Al-Ihya Aldiano Rachmantiawan Alghani, Sulthan Rafi Almaina Puteri Jasmine Almaina Amira Nabila Andi Nafisah Angelica Philia Christy Anggraeni Janar Wulan Anisa Nuraisa Jausal Annisarahma, Lyvia Ardian Reza Putra Arfa Salma Firnandya Ari Irawan Ari Irawan Ari Wahyuni Aulia Nur Fitriatsani 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 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 Faraztya Purnama Sari 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 I Wayan Dika Aditia Darma Imtinan Khoirunnisa Indah Kurnia Putri Waruwu Indah Salsabila Indri Windarti Intanri Kurniati Isabela Irene Pangestu Jhons Fatriyadi Suwandi Josephine, Felicia Key Julianti, Dinul Aliya Kalih, Abigael Ludwina Kamila Nastiti Karima, Nisa Keziah Tirtawijaya Khairun Nisa Komang Ria Yuliana Santhi 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 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 Novita Carolia Nurul Fadhilah Az-zahro Nurul Utami Oktafany Oktafany Oktoba, Zulpakor Pardilawati, Citra Yulianda Pardilawati, Citra Yuliyanda Qoriba, Fathan RA Genta Syakira Hatta Rachel Agustin Inggrid Zefanya 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 Selvi Marcellia Sembiring, Dustin Delano Pranata Setiorini, Anggi 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 Yovani Tria Ananda Zayatri Nurul Jannaty Zheva Aprillia Yozevi