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Pengaruh Sarapan terhadap Konsentrasi Belajar Puteri Sahra Salsabila; Shinta Nareswari
Medula Vol 13 No 1 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i1.593

Breakfast is a daily consumption that is considered important to meet nutritional needs. Even though it is considered important, there are still many people who skip breakfast which can have a negative impact on the learning process at school, contribute to obesity, and increase the risk of unhealthy snacks. Breakfast should be done to support learning concentration and meet the nutritional needs needed by the body. Learning is defined as all psychological activities carried out by everyone so that their behaviour is different before and after learning. Attention to learning has been identified as a complex construct in psychology that does not express a unitary concept but involves psychological phenomena that interact with all other cognitive processes. In general, the brain works best when blood glucose levels are in the 80–120 mg/dL range. With the gradual depletion of blood glucose and the consequent energy consumption, people start to feel hungry and tired and experience a decline in cognitive function. A number of studies have reported that eating breakfast decreases cognitive function and work efficiency. Periods of fasting at night, depleting the glucose in the blood. So, in order to maintain its function, the brain needs intake in the morning. As an initial energy supplier, especially as a source of glucose energy for the brain, breakfast is highly recommended for everyone.

Koinfeksi Bronkopneumonia dan Demam Tifoid pada Anak dengan Status Gizi Kurang: Sebuah Laporan Kasus Fityah Zabrina Hidayat; Shinta Nareswari
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.1988

Bronchopneumonia and typhoid fever remain major causes of childhood morbidity and mortality in developing countries. Coinfection may aggravate the clinical course, particularly in children with malnutrition. This case report describes the clinical presentation, diagnostic evaluation, and management of bronchopneumonia and typhoid fever coinfection in a malnourished child. A 5-year-8-month-old boy was referred with a 9-day history of fever and persistent cough accompanied by shortness of breath, abdominal pain, and abdominal distension. The patient had a history of controlled epilepsy and was undernourished. Physical examination revealed tachypnea, chest wall retractions, bilateral rhonchi, and abdominal distension. Laboratory investigations showed leukopenia (4,600/µL), thrombocytopenia (101,000/µL), and elevated aspartate aminotransferase (160 U/L). Chest radiography demonstrated bilateral perihilar and paracardial infiltrates consistent with bronchopneumonia, while reactive anti-Salmonella IgM serology (score 6) supported the diagnosis of typhoid fever. The patient received oxygen therapy, intravenous fluid resuscitation with Ringer's lactate, intravenous ceftriaxone and gentamicin, salbutamol nebulization, zinc supplementation, and nutritional support. Progressive clinical improvement was observed, with resolution of fever, decreased respiratory rate, and improvement of respiratory symptoms after seven days of hospitalization. This case highlights the importance of considering coinfection in malnourished children presenting with overlapping respiratory and gastrointestinal manifestations. Early diagnosis, appropriate empirical antibiotic therapy, nutritional rehabilitation, and hygiene education are essential to optimize clinical outcomes and reduce the risk of recurrence.

Asymptomatic Congenital Syphilis with Bilateral Metaphysitis in a Term Neonate: A Case Report Daffa Fahreiza; Shinta Nareswari
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.2001

Congenital syphilis is a transplacental infection caused by Treponema pallidum that is associated with significant fetal and neonatal morbidity and mortality. Although many infected neonates appear clinically asymptomatic at birth, active infection may only be identified through serological and radiological evaluation. This report describes a 3-day-old full-term female neonate born at 37 weeks of gestation by cesarean section due to cephalopelvic disproportion, premature rupture of membranes, and maternal syphilis. The mother had not undergone antenatal syphilis screening or received treatment during pregnancy despite having a reactive Venereal Disease Research Laboratory (VDRL) test at delivery. The neonate appeared clinically well without dysmorphic features, respiratory distress, or other classic manifestations of congenital syphilis. However, laboratory evaluation revealed leukocytosis and persistently reactive VDRL titers of 1:64 on the first and third days of life. A skeletal survey demonstrated bilateral metaphysitis involving the distal radius, ulna, and first metatarsal base without periostitis or pathological fractures, consistent with early syphilitic osteochondritis. Initial empirical treatment with ampicillin and gentamicin was subsequently changed to benzathine penicillin G after the diagnosis was confirmed. This case highlights that congenital syphilis may present as subclinical skeletal involvement despite an apparently healthy neonate. Routine antenatal screening, prompt neonatal serological assessment, targeted skeletal imaging, and appropriate post-treatment follow-up are essential for early diagnosis, timely management, and prevention of long-term complications, particularly in resource-limited healthcare settings.

Manajemen Terpadu Bronkopneumonia dan Suspek Penyakit Jantung Bawaan pada Bayi dengan Sindrom Down Kamila Nastiti; Shinta Nareswari
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.2012

Bronchopneumonia is a major cause of morbidity and mortality in children under 5 years of age, particularly in developing countries. Infants with Down syndrome are known to have a higher susceptibility and risk of lower respiratory tract infections, including bronchopneumonia. We report the case of a 3-month-old female infant who presented to the Emergency Department of Dr. H. Abdul Moeloek Regional Hospital, Bandar Lampung with shortness of breath accompanied by a productive cough and fever for 7 days prior to admission. Physical examination revealed tachypnea (respiratory rate 56 breaths/min), tachycardia (heart rate 168 beats/min), body temperature 39.0°C, and an oxygen saturation of 91% on room air. Lung auscultation revealed bilateral rhonchi and wheezing. In addition, facial dysmorphic features typical of down syndrome and a continuous murmur in the left subclavicular area were found. Chest radiography demonstrated diffuse peribronchial infiltrates with bilateral patchy opacities, suggestive of bronchopneumonia. The patient was diagnosed with bronchopneumonia, down syndrome, and patent ductus arteriosus. Management included supportive therapy, intravenous antibiotics (ampicillin–sulbactam and gentamicin), and diuretics (furosemide). The patient’s clinical condition gradually improved, and the patient was discharged in good condition. This case highlights the increased susceptibility of infants with down syndrome to bronchopneumonia, including the potential presence of congenital heart disease as a comorbidity that may worsen the patient's clinical condition. A comprehensive management approach, including pharmacological and nonpharmacological therapies, as well as early evaluation of comorbidities, is crucial to improve patient outcomes.

Bronkopneumonia dengan Suspek Tuberkulosis Paru, Trombositopenia ec Dengue Fever, Gizi Kurang, dan Imunisasi Tidak Lengkap pada Bayi Usia 9 Bulan: Sebuah Laporan Kasus Herlingga Nirwana HR; Anselmus Libreya Sinulingga; Lariza Serafina Tobroni; Shinta Nareswari
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1848

Bronchopneumonia remains the leading cause of morbidity in infants, especially in developing countries, and can be exacerbated by various comorbid factors such as poor nutritional status, incomplete immunization, and possible chronic infections. This case report aims to describe the clinical course, diagnostic challenges, and management of complex bronchopneumonia in a 9-month-old infant with suspected pulmonary tuberculosis and thrombocytopenia. The method used was a descriptive case report of a 9-month-old male infant who was treated with the main complaints of shortness of breath, chronic cough with phlegm, intermittent fever, and accompanied by weight loss. Data were obtained through anamnesis, physical examination, laboratory and radiological support examinations, and observation during treatment. The results showed that the patient had recurrent bronchopneumonia with findings of respiratory distress, early thrombocytopenia, an increase in LED levels indicating the onset of an inflammatory process, poor nutritional status, and incomplete basic immunization. A pediatric tuberculosis score of 3 led to suspicion of pulmonary TB, although definitive tests had not yet been obtained. Empirical antibiotic therapy, supportive therapy, nebulization, and chest physiotherapy provided gradual clinical improvement. In conclusion, bronchopneumonia in infants with multiple risk factors requires a holistic approach and high alertness to the possibility of chronic infection and comorbidities. A comprehensive evaluation of nutritional status, immunization, and environmental factors is essential to prevent recurrence and improve patient clinical outcomes.

Osteogenesis Imperfecta in A Neonate with A Positive Family History: A Case Report Bryantdary Arrafif Nasution; Shinta Nareswari
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.2010

Osteogenesis Imperfecta (OI) is a rare genetic disorder characterized by bone fragility due to impaired type 1 collagen synthesis. This condition is generally caused by mutations in the COL1A1 and COL1A2 genes, which are inherited in an autosomal dominant or recessive manner, and are clinically heterogeneous. This report presents a case of a 5-day-old male neonate, born by cesarean section at 37 weeks of gestation, with a birth weight of 2,200 grams, who was referred to Dr. H. Abdul Moeloek Regional General Hospital, Bandar Lampung, with complaints of inactive right leg movement since 4 days of age. There was a positive family history, namely an older sibling who had been diagnosed with OI. Physical examination revealed bilateral blue sclerae, asymmetry in the lengths of the lower extremities, and pain with mobilization of the right leg. Radiological examination in the form of a right femur x-ray and bone survey showed a complete proximal fracture of the right femur, bowing of the left femur, and decreased bone density, which supports the diagnosis of OI. Serum Alkaline Phospatase (ALP) levels were within normal limits, distinguishing them from rickets or hypophosphatasia. Management included splinting immobilization, closed reduction, hip spica placement, prophylactic antibiotics and analgesics, and phototherapy for hyperbilirubinemia. The prognosis for this patient was quo ad vitam (dubia ad bonam), while quo ad functionam and quo ad sanationam (dubia ad malam) were quo ad functionam. This case report aims to raise clinical awareness of OI in the neonatal period, especially in cases with a confirmed family history.

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