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Utami, Winda Trijayanthi
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Education Medicine & Pharmacology Neuroscience Public Health

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Diagnosis & Tatalaksana Nekrosis Avaskular Caput Femur Purwanto, Tito; Utami, Winda Trijayanthi
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.v16i1.1745

Abstract

Avascular necrosis (AVN) of the femoral head is a condition resulting from compromised blood supply, leading to bone tissue death and progressive joint damage. Early diagnosis is challenging because initial radiographic findings are often normal, and most patients present at advanced stages. This narrative review discusses the etiology, diagnosis, classification, and treatment options for AVN based on disease stages, highlighting conservative approaches, biological interventions, and surgical procedures. Causes of AVN include alcohol consumption, corticosteroid use, trauma, anatomical abnormalities, and certain hematologic conditions. MRI is the most sensitive diagnostic modality in early phases, while the Ficat & Arlet classification is used for staging. In the pre-collapse phase, conservative management such as protected weight-bearing, bisphosphonates, anticoagulants, prostaglandin analogs, and hyperbaric oxygen therapy may help preserve the joint. Surgical interventions such as core decompression with or without bone grafting and the addition of biological agents aim to enhance angiogenesis and osteogenesis. In the post-collapse phase, joint preservation is not recommended, and total hip arthroplasty is the preferred treatment, although failure rates are higher than in non-AVN osteoarthritis cases. The prognosis of AVN depends on early detection and stage-appropriate intervention. A multimodal approach in the early phase may maintain joint integrity, while in advanced disease, joint reconstruction through arthroplasty provides the most effective outcome. Further evaluation of biological therapies and optimization of rehabilitation strategies are needed to improve clinical results.
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.
Co-Authors Fathunnisa, Ridha Riano Purwanto, Tito Sangging, Putu Ristyaning Ayu Tri Umiana Soleha