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All Journal Medula Jurnal Kreativitas PKM Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Mandala Pharmacon Indonesia JK Unila (Jurnal Kedokteran Universitas Lampung) Jurnal Pengabdian Kepada Masyarakat (JPKM) Tabikpun Buguh: Jurnal Pengabdian Kepada Masyarakat Jurnal Kedokteran Ibnu Nafis JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai Jurnal Agromedicine Unila: Jurnal Kesehatan dan Agromedicine
Risti Graharti
Bagian Ilmu Patologi Klinik, Fakultas Kedokteran Universitas Lampung
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Dampak Konsumsi Pemanis Buatan terhadap Profil Glukosa dan Risiko Diabetes Mellitus: Tinjauan Pustaka Prameswari, Putu Arya Indira; Darwis, Iswandi; Graharti, Risti
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.v16i1.1740

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from impaired glucose regulation, and its global prevalence continues to rise substantially. Effective management of DM requires an integrated approach involving pharmacological therapy, lifestyle modification, and appropriate dietary strategies, including carbohydrate regulation, consumption of low–glycemic index foods, and restriction of added sugars. Artificial sweeteners such as aspartame, sucralose, saccharin, and stevia are widely utilized as low-calorie sugar substitutes because they provide sweetness without elevating blood glucose levels. Nevertheless, accumulating evidence indicates that the metabolic effects of artificial sweeteners are heterogeneous and depend on the specific compound as well as the physiological condition of the consumer. Experimental studies have shown that stevia and nano-stevia can reduce hyperglycemia in diabetic rat models, while the Rebaudioside M (Reb M) form of stevia has been reported to enhance insulin sensitivity and attenuate weight gain in obese rats. In contrast, intake of sucralose and acesulfame-K at Acceptable Daily Intake levels has been associated with increased subcutaneous and perirenal adipose tissue accumulation, along with vascular endothelial dysfunction in Wistar rats, suggesting a potential elevation in cardiometabolic risk. Saccharin has similarly been shown to disrupt glucose homeostasis and decrease GLP-1 secretion in animal models, independent of insulin release. Human studies yield more variable outcomes. Most individuals with type 2 diabetes exhibit no significant changes in body weight or glycemic control following artificial sweetener consumption, although more than half report gastrointestinal disturbances such as bloating and diarrhea. These divergent findings underscore that each artificial sweetener possesses a distinct metabolic profile; therefore, their use should be tailored to individual needs, particularly among populations with heightened metabolic vulnerability, including patients with diabetes.
Peran Pangan Ultra Proses terhadap Peningkatan Risiko Obesitas Anak Cintawan, Ni Made Karenina Rini Dwi; Graharti, Risti; Sitepu, Ricky Rivalino
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.v16i1.1741

Abstract

The problem of obesity in adolescents has developed into a global health crisis, exacerbated by lifestyle changes and the consumption of ultra-processed foods (UPF). Indonesia is predicted to become one of the countries with the highest cases of childhood obesity, marked by a doubling in the prevalence of adolescent obesity between 2013 and 2018. This literature review aims to comprehensively analyze the role of UPF consumption in increasing the risk of obesity in the child and adolescent population. This study uses a literature review method by searching scientific databases to identify and synthesize articles discussing the relationship between UPF intake and childhood obesity. (Note: The literature search section has been adjusted to focus on UPF and Obesity). Obesity in adolescents is defined based on WHO criteria (BMI/A Z-score >+2 SD) and is classified predominantly as primary obesity (multifactorial). High UPF consumption has been shown to have a positive and significant association with overnutrition; studies show a drastically increased risk of obesity (40% - 66%) in UPF consumers. The etiological mechanisms are multifactorial, including: 1) Energy Balance Disruption (high energy density, poor nutrient profile, fiber deficit); 2) Decreased Thermogenic Effect of Food (TEF) by up to 50; 3) Hormonal Metabolic Disturbances (increased insulin, insulin resistance, changes in brain circuitry); and 4) Exposure to Obesogenic Substances (Endocrine Disruptors) from additives and packaging. Consumption of UPF is a major and complex risk factor for the pathogenesis of childhood and adolescent obesity, acting through metabolic, neurological, and toxicological pathways. Food policy interventions are needed to mitigate these health risks.
Identification of Active Compound and Effectiveness Test of 96% Tithonia diversifolia Ethanol Extract on Mortality of Aedes aegypti Mosquito A.P, Gadila; Mustofa, Syazili; Graharti, Risti; Setyaningrum, Endah
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.v16i1.1758

Abstract

Dengue Hemorrhagic Fever (DHF) remains a major public health problem in tropical regions, with Asia accounting for 70% of global cases and Indonesia reporting a massive 90,269 cases in 2024. Vector control is the primary mitigation strategy due to limitations in available therapies and vaccines, yet reliance on chemical insecticides poses ecological toxicity and resistance risks, driving the need for safer bioinsecticide alternatives. Tithonia diversifolia is known to contain active phytochemical constituents with insecticidal potential. This true experimental study used a Post Test Only with Control Group design conducted from August to September 2025 involving 25 Aedes aegypti per group with four replications. Leaf simplicia were extracted using 96% ethanol, followed by alcohol-free verification, qualitative phytochemical screening, and formulation into spray preparations at concentrations of 5%, 10%, 15%, 20%, and 25%. Mortality was assessed over 24 hours, and statistical evaluation included univariate, bivariate, and probit analyses to determine LC50, LC90, LT50, and LT90. Extraction produced a 12.53% yield containing saponins, flavonoids, phenols, tannins, alkaloids, and steroids. Mosquito mortality increased with rising concentrations, with the highest effectiveness observed at 25%. The Kruskal–Wallis test confirmed significant differences between groups, while LC50 and LC90 values were 2.77% and 5.37%, respectively. Although the highest mortality was observed at 25%, the 20% concentration was considered optimal because it met WHO efficacy standards while using a lower extract concentration.
Prevalensi Komplikasi Kematian Ibu Dengan Persalinan Sectio Caesarea Di RSUD Dr. H. Abdul Moeloek Pada Tahun 2019 Assirri, Agung; Graharti, Risti; Kusumaningtyas, Intan
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.v16i2.1761

Abstract

Maternal mortality is defined as the number of deaths in women that occur during pregnancy up to 42 days after delivery, caused by conditions directly related to pregnancy or its management, not by accidents or injuries. In Indonesia, the pattern of causes of maternal mortality over time has remained relatively constant, with hemorrhage, preeclampsia-eclampsia, and infection as the dominant factors contributing to high maternal mortality rates. One medical intervention that can help reduce the risk of maternal mortality is delivery by cesarean section (CS), especially in cases where the condition of the mother or fetus does not allow for vaginal delivery. This study aims to identify the prevalence of complications that cause maternal mortality in cesarean section deliveries at Dr. H. Abdul Moeloek Regional General Hospital. The research design used is a descriptive study with a qualitative approach. Secondary data were collected from patient medical records, and the sampling method used was total sampling, so that all 351 cases of C-section deliveries during the study period were analyzed. The results showed that there were 2 cases of maternal mortality out of a total of 351 C-section deliveries, or 0.57%. Both deaths were caused by postpartum hemorrhage (50%) and pre-existing heart disease (50%). These findings indicate that although the maternal mortality rate in CS deliveries at Dr. H. Abdul Moeloek Regional General Hospital is relatively low, risk factors such as hemorrhage and comorbidity still require special attention in delivery management.
Mosquito Control Methods and Dengue Fever Disease: a Literature Review Khairunnisa, Aulia; 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.v16i3.1772

Abstract

Dengue Hemorrhagic Fever (DHF) is one of the vector-borne diseases that remains a public health challenge in Indonesia, characterized by high incidence rates, widespread vector distribution, and an increased risk of outbreaks in various endemic areas. The transmission of the dengue virus is greatly influenced by community behavior, residential environmental conditions, and the bioecology of the Aedes aegypti mosquito, which is able to breed in clean water puddles around homes. The dengue virus consists of four serotypes and can survive through vertical and horizontal transmission mechanisms, thereby strengthening the chain of transmission in the environment. On the other hand, vector control efforts using larvicides and chemical insecticides are still widely chosen by the community, even though improper use can cause insecticide resistance. This study aims to examine various methods of dengue vector control, including physical, mechanical, biological, chemical approaches, and the EcoHealth concept. The method used was a literature review of official guidelines, research articles, and the latest scientific publications on DHF and vector control. The results of the study show that physical control methods such as 3M Plus are the most effective and safest, while biological control through larval predators and environmentally friendly bacteria can reduce the larval population without causing negative ecological impacts. Chemical control still provides rapid effects, but must be used wisely to prevent resistance. The EcoHealth approach is considered more comprehensive because it involves environmental, social, cultural, and economic aspects of the community in sustainable control. In conclusion, optimal DHF control requires an evidence-based integrated strategy with cross-sector participation and the application of ecological principles to ensure long-term success in reducing disease incidence.
Faktor Yang Mempengaruhi Kepatuhan Penggunaan Alat Pelindung Diri (APD) Pada Tenaga Kesehatan : Literatur Review Ningrum, Kurnia; Graharti, Risti; Larasati, TA
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.v16i3.1812

Abstract

Abstract The use of Personal Protective Equipment (PPE) is a key component of infection prevention and control in healthcare facilities. Compliance among healthcare workers determines the effectiveness of protection against biological, chemical, and physical hazards in the workplace. However, PPE compliance remains a challenge in many healthcare settings. This literature review aims to identify factors influencing PPE compliance among healthcare workers based on recent studies. The review was conducted using Google Scholar, PubMed, and ScienceDirect databases with the keywords “personal protective equipment,” “compliance,” and “healthcare workers.” Articles published between 2015 and 2025 were included. Of the 62 articles identified, 13 met the inclusion criteria and were analyzed in depth. The analysis focused on synthesizing findings related to individual, organizational, and work environment factors affecting PPE compliance. The results show that individual factors such as knowledge, attitude, risk perception, and work experience significantly influence compliance behavior. Organizational factors, including PPE availability, institutional policies, supervision, safety culture, and continuous training, also play an important role in shaping compliance. In addition, work environment factors such as workload, comfort of PPE, and physical conditions of care areas contribute to compliance levels. Understanding these factors is essential for improving patient and healthcare worker safety through comprehensive intervention strategies. Improving education, strengthening institutional policies, and ensuring adequate PPE supply systems are expected to enhance compliance. In Indonesia, integrated studies examining factors influencing PPE compliance remain limited, highlighting the need for further research to support policy development and occupational safety practices for healthcare workers.
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.
PEMANFAATAN POTENSI ALAMI SEBAGAI ANTIOKSIDAN Happy, Terza Aflika; Septiani, Linda; Graharti, Risti; Andrifianie, Femmy
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1825

Abstract

Indonesia is one of the world’s most biodiverse countries and possesses a vast potential of medicinal plants as natural therapeutic resources. Many medicinal plants traditionally used by local communities are known to contain secondary metabolites with antioxidant properties. Antioxidants play an essential role in preventing oxidative stress associated with degenerative and infectious diseases. This article aims to review the potential of secondary metabolite compounds from Indonesian medicinal plants as antioxidant agents based on previous studies. This study was conducted using a literature review method by analyzing relevant national and international scientific publications. The results indicate that various medicinal plants, including sweet potato leaves, green tea, roselle, celery, and Peperomia pellucida, contain polyphenolic compounds such as flavonoids, tannins, and phenols, as well as other secondary metabolites including alkaloids, saponins, terpenoids, quinones, coumarins, and anthocyanins. These compounds exhibit antioxidant activity through free radical scavenging, hydrogen atom donation, and inhibition of lipid peroxidation processes. In conclusion, Indonesian medicinal plants demonstrate significant potential as natural sources of antioxidants and offer promising prospects for further development in pharmaceutical and health applications, particularly as raw materials for phytopharmaceutical products and supportive therapies.
Efektivitas Beberapa Ekstrak Tanaman sebagai Ovisida terhadap Aedes aegypti dalam Pencegahan Demam Berdarah Dengue Septiani, Linda; aflika happy, terza; Graharti, Risti; Andrifianie, Femmy; Setyaningrum, Endah
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.v15i4.1827

Abstract

Dengue Hemorrhagic Fever (DHF) remains a major public health concern, with Aedes aegypti serving as the primary vector. The continuous use of synthetic insecticides has led to resistance development and environmental concerns, highlighting the need for safer and sustainable alternatives. This review aims to evaluate the ovicidal potential of selected plant extracts against Aedes aegypti as an early-stage vector control strategy. A literature review was conducted using relevant national and international publications focusing on plant-based ovicides. The findings indicate that extracts from Piper nigrum L., Ocimum basilicum, Syzygium myrtifolium Walp., Tithonia diversifolia, Acorus calamus L., Solanum lycopersicum, and Euphorbia hirta L. effectively reduce egg hatchability of Aedes aegypti. The ovicidal activity is associated with secondary metabolites such as flavonoids, alkaloids, saponins, tannins, terpenoids, polyphenols, and essential oils, which disrupt egg membranes and inhibit embryonic development in a concentration-dependent manner. These findings suggest that plant extracts possess promising potential as natural ovicides and may serve as a basis for further pharmaceutical development and formulation in sustainable dengue vector control.
Co-Authors A.P, Gadila Ade Yonata, Ade Adrifianie, Femmy aflika happy, terza Agatha Catherine Agustyas Tjiptaningrum Airlangga Damara Akbar, Fareel Wahyu Al Ghifari, Ghaza Ahmad Ali, Nur Fitriana Muhammad Andika, Gede Agus Andrifianie, Femmy Angga Wijaya, Angga Anggraeni, Ranesya Eka Annisa Fath Ari Wahyuni Arif Yudho Prabowo Arnida Rahman Asep Sukohar Assirri, Agung Aulia Berliana Avisa Jinan Azura Ayu, Putu Ristyaning Bayu Anggileo Pramesona Benny Syahputra Gumay betta kurniawan Betta Kurniawan, Betta Boy K.H, High Cintawan, Ni Made Karenina Rini Dwi Daffa, Meysha Nur Devya Aulia Dewi Nur Fiana Diaru Fauzan Farizy Disaputera, Alfafa Tsalaatsa Djausal, Anisa Nuraisa Dorisman, Hari Dwiki WIjaya Rahman Endah Setyaningrum, Endah Evi Kurniawati Fardiansyah, Ahmad Irzal Farhah, Putri Dzahabiyyah Farid Rakhman Fatmasari, Dina Fitria Saftarina George Pestalozi Gigaramadan Sema Hadibrata, Exsa Hafizh, Ahmad Fauzan Happy, Terza Aflika Helmi Ismunandar Hendra Tarigan Sibero Idris, Mohamad Indri Windarti Indriyani, Reni Intan Kusumaningtyas Intanri Kurniati Iswandi Darwis Izdihar, Adinda Fairuz Jati, Pandu Kumaya Khairun Nisa Khairunnisa, Aulia Kurniawaty, Evi Kusumaningrum, Desy Liana Sidharti, Liana Maharani, Atifah Fadilah Mallarangeng, Andi Nafisah Tendri Adjeng Maulida, Syakira Zahra Mayasari, Diana Muhammad Ihsan Fariqy Muhammad Maulana Muhammad Ricky Ramadhian Ningrum, Kurnia Nisa, Lutfi Khoirun Novita Carolia Nuraini, Bianti Nurul Utami Oktoba, Zulpakor Prameswari, Putu Arya Indira Pratiwi, Aulia Sari Prayogi, Norbertus Marcell Purnama Sari, Faraztya Putri, Syalika Dianisa Putu Ristyaning Ayu Rachman Aziz Rahmadani, Tiara Sekar Rahmat, Aprin Nabila Rahmayani, Fidha Rani Himayani Rasmi Zakiah Oktarlina Ratna Dewi Puspita Sari Reni Indriyani Retno Mareintika Ricky Rivalino Sitepu, Ricky Rivalino Rika Lisiswanti Rina Hayati Risal Wintoko rizki_novtarina21 Rodiani Roro Rukmi Windi Roro Rukmi Windi Perdani, Roro Rukmi Rudianto, Waluyo Ruslani, Nada Oktista Sangging, Putu Ristyaning Ayu Sany Setiawan Sema Gigaramadan Septa, Tendry Septiani, Linda Setiawan, Putri Ayundari Setiorini, Anggi Sheira Indah Anjani Soemarwoto, Retno Ariza Soeprihatini Sofyan Musyabiq Wijaya Suharmanto Sulthan Alam Yasyfa Susianti, Susianti Sutarto Sutarto Sutarto Sutarto Syahrul Hamidi Nasution Syazili Mustofa TA Larasati Tri Umiana Soleha Wardhani, Dyah Wulan Sumekar Rengganis Wardhani, Oktiva Risma Widjaja, Jovan Winda Trijayanthi Utama, Winda Trijayanthi