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Farida Rusnianah
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Jurnal Ilmu Kedokteran Keluarga
Published by Universitas Brawijaya
ISSN : -     EISSN : 29646413     DOI : https://doi.org/10.56674/xxxx
Core Subject : Health, Science, Social,
Computer Science & IT Health Professions Physics Public Health Social Sciences
Jurnal Ilmu Kedokteran Keluarga is a journal managed by the Department of Family Medicine, Faculty of Medicine, Brawijaya University who has a mission to improves the health and well-being of individuals, families, and communities through leadership in education and clinical care. Jurnal Ilmu Kedokteran Keluarga is published regularly twice a year. Jurnal Ilmu Kedokteran Keluarga contains research articles on basic medical, clinical medicine, epidemiology, prevention, technology, social medicine, medicine in primary health settings related to family medicine. We accept all types of research articles, case reports, systematic reviews, meta-analyses, literature reviews, and letters to editors. The article review process will involve two reviewers in a double blind manner. Jurnal Ilmu Kedokteran Keluarga provides open access articles that can be accessed publicly and freely.
Arjuna Subject : Kedokteran - Kedokteran Keluarga
Articles 47 Documents
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Comprehensive Family Medicine Approach to Lumbar Radiculopathy in an Obese Patient : A Case Study Dwi Rahayu, Indriati; Rusnianah, Farida; Fernando, Alexander
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.42

Abstract

Lumbar radiculopathy, often stemming from Herniated Nucleus Pulposus (HNP), presents a significant challenge in primary care, frequently exacerbated by comorbid conditions such as obesity. Family medicine emphasizes a holistic, patient-centered approach, considering both biomedical and psychosocial factors for optimal management. This paper presents the case of a 50-year-old female housewife, diagnosed with Lumbar Radiculopathy due to suspected HNP Lumbal and Grade 1 Obesity. She presented with a one-month history of debilitating left lower back pain (VAS 8/10) radiating to her thigh, calf, and foot, accompanied by numbness. Her symptoms, triggered by exercise and daily activities, significantly impacted her mobility, sleep, and recreational pursuits like aerobics. The diagnostic process employed a holistic framework, integrating anamnesis, physical examination, and family assessments using the Family APGAR and SCREEM tools. Key internal risk factors included her age, obesity, and daily activities involving prolonged standing and stair use. External challenges identified through SCREEM highlighted patient confusion regarding medication adherence during fasting and a tendency for infrequent routine medical check-ups, due to a perceived state of good health. This multifaceted presentation necessitated a tailored management strategy focused on conservative measures, addressing both the radiculopathy and weight management through lifestyle modifications. This case underscores the complexity of managing chronic musculoskeletal pain within a family medicine context, particularly when compounded by obesity. A comprehensive approach, integrating clinical diagnosis with psychosocial and environmental considerations, is crucial for effective patient education, adherence to treatment, and improving functional outcomes.
Navigating Polymorbidity in Geriatric Primary Care : A Case of Herpes Zoster and Psychological Stress Hevy Purwaningtyas, Nuretha; Nur Rakhmani, Alidha; Haikal Ashomadoni, Fajar
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.43

Abstract

Managing complex health issues in elderly patients within primary care requires a holistic, patient-centered approach. This case report details the presentation and comprehensive management of a geriatric patient suffering from herpes zoster exacerbated by significant psychological stress. A 63-year-old male presented with a five-day history of severe, burning pain and pruritus in his right axilla extending to his back, accompanied by vesicular and bullous lesions on dermatomes T1-T2. Prodromal symptoms included headache, fatigue, anorexia, and myalgia. The patient, a former construction worker, also reported significant psychological distress due to prolonged unemployment and reduced communication with his eldest child, exacerbating his symptoms and impacting sleep. He had a history of varicella, controlled coronary artery disease, and hypertension. The clinical picture was consistent with Herpes Zoster Thoracis 1 Dextra, likely reactivated by age-related immunosenescence and heightened psychological stress. The patient's social determinants of health, including financial strain and family communication challenges, significantly contributed to his stress, impacting his functional status and disease perception. Management included antiviral therapy (acyclovir), pain relief (ibuprofen), and non-pharmacological interventions such as rest, nutritional guidance, and local care. Crucially, empathetic counseling addressed his psychological distress, emphasizing stress management techniques and reinforcing positive coping mechanisms through family support and engaging hobbies. This case highlights the intricate interplay between physical illness and psychosocial factors in elderly patients. A comprehensive family medicine approach, integrating biomedical treatment with an understanding of social, economic, and psychological contexts, is paramount for effective disease management and improving overall patient well-being.
Adult Recurrent Tonsillitis : Infection, Immune Dynamics, and Holistic Primary Care Dasa Novita, Khuznita; Rosita, Rita; Istiqomah, Rosyida
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.44

Abstract

Chronic tonsillitis, a frequent recurring inflammation of the pharynx, profoundly affects quality of life. Tonsils, which are important immune organs, are constantly exposed to germs. A long-lasting infection can cause chronic inflammation and lead to structural changes in the body, which is why family medicine needs to take a comprehensive approach. A 35-year-old male exhibited recurrent pharyngitis, T4 tonsil hypertrophy, and persistent snoring. This shows how much his condition affects his body, since he has had many episodes that have affected his daily life. A microbial infection, typically bacterial or viral, causes recurrent tonsillitis, accompanied by an immune response that isn't functioning properly in the tonsillar crypts. This causes long-term swelling and blockage of the airways, which can make it hard to breathe and snore. Lifestyle factors that make you more likely to get sick, like your diet and smoking history, make this worse. A comprehensive family medicine evaluation, encompassing biomedical, psychosocial, and environmental factors, informs individualized management that targets infectious agents, immune function, and physiological health. This method, which focuses on infectious causes, immune responses, and physical effects, is crucial for achieving good results and maintaining health in individuals with chronic tonsillitis.
The Intrinsic Link Between Food Allergy and Allergic Rhinitis : A Family Medicine Perspective on Atopic March and Persistent Nasal Symptoms Hidayati, Nurul; Dwi Rahayu, Indriati; Rizki Fauzi, Muhammad
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.45

Abstract

Allergic rhinitis (AR) is a prevalent chronic respiratory condition, yet its intricate connection with food allergy (FA) is often underappreciated in clinical practice. This paper examines the "atopic march", the natural progression of allergic diseases, through a case study that highlights the significant interplay between a patient's food allergy history and the manifestation of persistent, moderate-to-severe allergic rhinitis, emphasizing the crucial role of family medicine in comprehensive patient assessment. We present a case of a 25-year-old male experiencing persistent nasal congestion, rhinorrhea, and sneezing for a year, exacerbated by environmental triggers. Notably, he reported a resolved childhood seafood allergy. His family history revealed a strong pattern of atopy, with his mother having similar allergic rhinitis and seafood allergy, and his elder sister presenting with asthma and seafood allergy. This familial predisposition for both food and inhalant allergies strongly suggests an underlying atopic diathesis. This patient's presentation vividly illustrates the complex relationship between early-life food sensitization and the subsequent development of allergic rhinitis. While his childhood seafood allergy had clinically resolved, the underlying IgE-mediated immune response likely contributed to his sustained hyper-responsiveness, predisposing him to AR. The strong familial aggregation of both food and respiratory allergies underscores the genetic contribution to the atopic march. Management involved a comprehensive approach, including pharmacological interventions and environmental control, but crucially, also emphasized the importance of recognizing the historical and familial links to food allergies in understanding the patient's current rhinitis picture. Further investigation, such as specific IgE testing or skin prick tests, would be beneficial to identify any lingering or new food sensitivities that might contribute to his nasal symptoms. This case powerfully demonstrates that allergic rhinitis should not be viewed in isolation from a patient's broader allergic history, particularly early-life food allergies. A comprehensive family medicine approach that considers the full spectrum of atopic manifestations, including past and familial food allergies, is essential for a complete understanding, effective management, and improved long-term outcomes in patients with persistent allergic rhinitis.
The Biopsychosocial Spectrum of Osteoarthritis Management in Primary Care : A Case Report Kuntadi, Muhammad; Andarini, Sri; Wuri, Kinanthi
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.46

Abstract

Osteoarthritis (OA), a prevalent degenerative joint disease, poses significant challenges in primary care due to its chronic nature and multifaceted impact on patients' lives. This case report highlights the importance of a comprehensive, patient-centered approach to managing OA, integrating biomedical, psychological, and social considerations within the family medicine framework. A 60-year-old male, a civil servant and single parent, presented with chronic, worsening left knee pain and concurrent left shoulder pain of three months' duration, alongside a history of controlled hypertension. Initial self-management with topical analgesics and knee support provided minimal relief. Clinical assessment, based on ACR and ICPC criteria, led to a diagnosis of left genu osteoarthritis and left shoulder osteoarthritis. The management strategy adopted a holistic perspective, acknowledging the patient's physical symptoms, his concerns as a single parent, and the psychological burden of his condition. Non-pharmacological interventions, including lifestyle modifications, ergonomic advice, and regular light exercise, were emphasized. Pharmacological treatment involved analgesics, while a referral to an orthopedic specialist was initiated due to persistent symptoms. The Family APGAR score indicated good family function, crucial for supporting comprehensive interventions. This case underscores how family dynamics and psychosocial stressors influence chronic disease presentation and management in primary care. This case illustrates that effective OA management extends beyond pharmacological interventions to encompass a thorough understanding of the patient's biopsychosocial context. A robust family medicine approach, integrating patient education, lifestyle modification, and psychosocial support, is crucial for improving outcomes and enhancing the quality of life for individuals with chronic conditions, such as osteoarthritis.
Family-Centered Approach to Chronic Abdominal Pain in a Teacher : A Holistic Perspective Setijowati, Nanik; Kuntadi, Muhammad; Zarithsyafiqah, Siti
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.47

Abstract

Chronic abdominal pain, a prevalent yet often multifactorial complaint in primary care, frequently extends beyond purely biomedical etiologies to encompass significant psychosocial stressors and family dynamics. This case report highlights the importance of a holistic, family-centered approach in diagnosing and managing such conditions, moving beyond a narrow symptomatic focus. We present the case of a 35-year-old female kindergarten teacher experiencing recurrent right lower abdominal bloating and pain for three days, exacerbated by activity and alleviated by rest. Associated symptoms included nausea, irregular bowel movements (once every three days), and feelings of overwhelm due to work and domestic responsibilities. Despite her concerns about a prior hepatomegaly during her second pregnancy, physical examination and initial assessment pointed towards a more generalized abdominal discomfort influenced by lifestyle and stress. This case illustrates how chronic abdominal discomfort, initially perceived by the patient as a singular biomedical issue, can be intricately linked to a confluence of biological, psychological, and social factors. The patient's irregular eating habits, high coffee consumption, lack of exercise, and significant work-life imbalance contributed to her symptoms. While an initial diagnosis of acute gastritis was considered, the persistent nature and association with stress suggest a broader functional gastrointestinal disorder. The family APGAR score of 9 indicated a highly functional family unit, yet the Family SCREEM identified cultural factors (husband's limited domestic involvement) and the patient's poor stress management as potential contributors. Comprehensive intervention involved patient education on lifestyle modification, stress management techniques, and family involvement to alleviate domestic burdens. This case underscores the necessity of a comprehensive, family-oriented approach in managing chronic abdominal pain. By addressing not only the physical symptoms but also the underlying psychosocial stressors and family dynamics, healthcare providers can facilitate more effective and sustainable patient outcomes. This holistic perspective aligns with the principles of family medicine, advocating for interventions that consider the patient within their unique family and community context.
Holistic Management of Chronic Headache and Co-morbidities in Primary Care : A Family-Centered Approach Rosita, Rita; Hidayati, Nurul; Septian Prihatma, Wika
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.48

Abstract

Chronic headaches, particularly tension-type headaches (TTH), pose a significant burden in primary care, often co-occurring with various health and psychosocial challenges. This case report highlights the importance of a holistic, family-centered approach to effectively manage such complex presentations. We present the case of a 52-year-old male, a self-employed electrical installation worker, presenting with a one-week history of worsening daily headache, described as pressing and heavy, predominantly occipital spreading to frontal regions, rated 7-8/10 on the pain scale. The patient has a history of hypertension since 2019, regularly taking amlodipine 10mg, and is classified as overweight (24.2 kg/m2). He reports reduced sleep quality due to work-related stress and a tendency to internalize problems. The patient's TTH appears exacerbated by poor sleep hygiene, work-related stress, and reduced physical activity during the pandemic. While hypertension is not directly correlated with TTH pathophysiology, it adds to the overall health risk. A comprehensive intervention included pharmacotherapy (paracetamol 1000 mg, amlodipine 10mg) and extensive non-pharmacological strategies focusing on sleep hygiene, stress management, increased physical activity, and improved communication within the family. Despite a "Highly Functional Family" APGAR score of 8, the patient's reluctance to share problems with his wife indicates a communication gap requiring attention. This case underscores that effective management of chronic conditions like TTH and hypertension necessitates addressing biomedical aspects alongside psychosocial and family dynamics. A holistic, patient and family-centered approach in primary care is crucial for improving patient outcomes and overall well-being.
Chronic Atopic Dermatitis in Adults : A Family Medicine Approach to Psychosocial Factors and Holistic Management Andarini, Sri; Hevy Purwaningtyas, Nuretha; Fakhrizah Wildani , Safira
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.49

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition often exacerbated by psychosocial stressors, significantly impacting patients' quality of life. This case highlights the intricate relationship between psychological burden and AD pathogenesis, emphasizing the crucial role of a holistic family medicine approach in its comprehensive management. We present the case of a 54-year-old male, a motivational trainer, who presented with recurrent pruritic erythematous plaques on both ankles, consistent with chronic atopic dermatitis. His symptoms were significantly aggravated by psychological stress stemming from a substantial decline in work engagements and income during the recent pandemic, which also restricted his stress-coping hobbies. Clinical evaluation, guided by Hanifin Rajka criteria, confirmed the diagnosis of atopic dermatitis, with psychological stress identified as a key exacerbating factor through neuro-immuno-cutaneous mechanisms. A comprehensive family medicine intervention was employed, integrating pharmacological management with topical corticosteroids, non-pharmacological strategies like skin barrier optimization, and extensive psychosocial counseling. The patient's functional family dynamics, as assessed by a high Family APGAR score, supported the feasibility of a multi-faceted approach, addressing both physical symptoms and underlying stressors. This case underscores the necessity of a biopsychosocial model in managing chronic conditions like atopic dermatitis. A holistic family medicine perspective, incorporating patient education, stress management, and collaborative care, is vital for achieving optimal outcomes and improving patient well-being.
A Navigating Chronic Conditions in Primary Care : A Case of Recurrent Tinea Corporis and Prediabetes Arifin, Samsul; Nauli Purba, Edelen; Brakumara , Aditya
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.51

Abstract

Chronic conditions like tinea corporis and prediabetes significantly impact patient quality of life and present multifaceted challenges in primary care. This case report highlights the complex interplay between lifestyle factors, personal hygiene, and the recurrence of dermatological and metabolic issues within a family medicine context. We present a 39-year-old female with a two-year history of recurrent, intensely pruritic tinea corporis, currently manifesting on her right crus. Concurrently, she was diagnosed with prediabetes. Contributing factors included a sedentary lifestyle, poor dietary habits marked by frequent sweet consumption, and suboptimal personal hygiene, such as infrequent bathing and inadequate skin drying. Her mother also had a history of Type 2 Diabetes Mellitus. Discussion : This case underscores the crucial role of family medicine in addressing co-morbidities and lifestyle-related health issues. The patient's recurrent fungal infection was exacerbated by poor hygiene and a constantly moist skin environment due to sweating and inadequate drying. Her prediabetes, linked to obesity and a family history of diabetes, was further compounded by a sedentary lifestyle and poor dietary choices. Effective management necessitates a holistic, family-centered approach, integrating education on hygiene, dietary modifications, increased physical activity, and consistent adherence to medication, rather than solely focusing on symptomatic relief. Managing chronic, lifestyle-influenced conditions like recurrent tinea corporis and prediabetes requires comprehensive primary care interventions. A holistic approach that educates patients on self-care, promotes healthy lifestyle changes, and considers family health dynamics is paramount for achieving sustained improvement and preventing disease progression.
The Hidden Nexus : A Case Report on the Interconnectedness of Metabolic Syndrome, Lifesyle, and Bilateral Nephrolitiasis Kuntadi, Muhammad; Reilinvia, Shanine
Jurnal Ilmu Kedokteran Keluarga Vol. 4 No. 1 (2025): Juni 2025
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v4i1.52

Abstract

Chronic non-communicable diseases (NCDs) often share common root causes, necessitating a holistic approach to care. This report describes the case of a 42-year-old male presenting with bilateral nephrolithiasis. It refines the patient’s initial perception that his back pain was solely caused by hypertension, demonstrating instead that his condition is part of a broader metabolic dysfunction. A 42-year-old male presented with recurring right flank pain, diagnosed as bilateral nephrolithiasis. He had a history of hypertension, obesity (BMI 31.22 kg/m2), and hyperuricemia with gout. His mother also had a history of hypertension and nephrolithiasis. His lifestyle, including irregular eating habits, sedentary work, smoking, and a history of urine retention due to a demanding profession, along with a belief that medication is harmful to the kidneys, were key risk factors. The patient’s bilateral nephrolithiasis, likely uric acid stones given his history of hyperuricemia and gout, and hypertension are manifestations of an underlying metabolic syndrome. This condition, driven by obesity, lifestyle, and genetic predisposition, leads to low urinary pH, directly causing stone formation. This case illustrates the crucial role of a family-oriented approach in identifying and managing complex biopsychosocial barriers to care. This case highlights that managing chronic diseases effectively requires an understanding of their interconnectedness. A holistic family medicine approach, extending beyond symptoms to address lifestyle, psychosocial factors, and genetic risks, is essential for improving patient outcomes and preventing disease recurrence.

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