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Kamila Nastiti
Fakultas Kedokteran Universitas Lampung

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Optic Disc Cupping Kamila Nastiti; Putu Ristyaning Ayu Sangging; Rani Himayani
Medula Vol 13 No 4.1 (2023): Medula - Edisi Spesial (Special Sense)
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i4.1.728

Abstract

Optic disc cupping is an enlargement of the cup and disc diameter ratio which is known as one of the characteristics of glaucoma. Glaucoma itself is one of the leading causes of blindness in Indonesia. Diabetes, heart disease, hypertension, nearsightedness and farsightedness can be risk factors for optic disc cupping due to glaucoma. Optic disc cupping can also be caused by various cases of non-glaucoma optic neuropathy. Distinguishing glaucomatous and non-glaucoma-induced optic disc cupping is a challenge for the observer. This research was conducted using the literature study method by conducting literature searches from various international and national journal sources. This study aims to collect data that is relevant to the material that is interested in being studied, namely regarding optical disc cupping. The results of the research that has been done are in the form of deepening material regarding optic disc cupping. The results showed that while the ratio of the cup to the optic nerve disc is quite variable in humans, the contours of the cup should be determined by biomicroscopic background assessment in order not to rely solely on color and to monitor blood flow and tipping on the rim of the cup. Optic disc cupping most often results from glaucoma. Deeper in the optic disc cupping occurs due to thinning of the prelaminar and laminar layers or high intraocular pressure.
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

Abstract

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.