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Medula
Published by Universitas Lampung
ISSN : -     EISSN : 97726154     DOI : -
Core Subject : Health, Science, Education,
Education Medicine & Pharmacology Neuroscience Public Health
Medical Profession Journal of Lampung didirkan pada tahun 2013. Medula hadir memenuhi kebutuhan publikasi jurnal bagi mahasiswa Fakultas Kedokteran, Dosen ataupun klinisi dan profesi lain dibidang kedokteran. Medula diterbitkan dengan frekuensi 4 kali dalam setahun yang tiap nomornya mencakup 30 jenis artikel ilmiah seperti artikel penelitian, laporan kasus, tinjauan pustaka dan lain-lain. Medula sudah memiliki nomor ISSN media cetak sejak tahun 2013
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 18 Documents
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Search results for , issue "Vol 14 No 12 (2024): Medula" : 18 Documents clear
Ensefalitis Fitriyani, Fitriyani; Martogi Simalango, Eka Yuliana
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.859

Abstract

Encephalitis is inflammation of the brain parenchyma, usually caused by an infectious agent for through an autoimmune process that may be post infectious, paraneoplastic or idiopathic. Symptoms that can be caused include fever, changes in behavior, personality, cognition and consciousness. Other complaints may also indicate focal neurological deficits, seizures, movement disorders or autonomic instability. Estimates of the incidence of encephalitis worldwide range from 3,5 to 12,3 per 100.000 patients/year. The groups most at risk of encephalitis are the elderly, children under 1 year of age, people with a weak immune system. To diagnose encephalitis, namely lumbar puncture, brain imaging with CT or MRI, EEG, blood tests, brain biopsy. Case: case report Mrs. A, 40 years old with a diagnosis encephalitis based on anamnesis and physical examination as well as support for administration of betahistine 3x24mg, KSR 3x1, Ramipril 1x2,5mg. Dexamethasone Inj/8hours, Ranitidine Inj/12hours, Phenitoin 3x1, Sucralfat syr 3x1, Racikan 3x1 (Paracetamol 500 mg, Ibuprofen 200 mg, Codeine 20 mg), Ericaf 3x1, Depakene syr 2x1, Flunarizine 2x1, Acyclovir 5x1.
Gagal Jatung Kongestif Pada Primigravida Hamil 31 Minggu Dengan Penyakit Jantung Bawaan: Sebuah Laporan Kasus Nurmayeni; Zulfadli, Zulfadli
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1203

Abstract

Congenital Heart Disease (CHD) is a congenital heart disease where this disease has been present since a person was born. In pregnancy there are significant physiological changes in the cardiovascular system. These hemodynamic changes pose problems for mothers with congenital heart disease. This study is a case report. Data was obtained from a 31 year old woman who came with complaints of preterm pregnancy with complaints of severe shortness of breath since 2 weeks before entering the hospital with CHD. On physical examination, it was found that the general condition was seriously ill, compost mentis, blood pressure 107/84 mmHg, pulse 130x/minute, respiration 39x/minute, temperature 36.6°C, SpO2 70% NRM 15 lpm. On chest examination, a continuous murmur and wet rhonchi were found. Hematological examination showed an increase in ESR, urea, creatinine, SGOT and SGPT. Chest X-ray showed suspicion of pulmonary edema, bronchopneumonia and cardiomegaly. The results of the echocardiography examination showed PDA balanced shunt, PH, Severe TR, Moderate PR, Mild MR, RV mass 0.5 x 0.9 cm susp Infective Endocarditis. The patient was diagnosed with G1P0A0 26 weeks pregnant, not yet in labor with Dyspenu ec CHF with Congenital Heart Disease (PDA), Intrauterine JTH. Management of this patient is observation of general condition and vital signs, IVFD RL 500 cc 20 tpm, injection of furosemide 2 ampoules, ISDN 3 x 5 mg. Then transferred to the intensive care unit (ICU) and then terminated the pregnancy abdominally. The patient was declared dead on the 2nd day of treatment due to cardiogenic shock.
Intracerebral Hemorrhage Hemisfer Dextra: A Case Report Fitriyani, Fitriyani; Sephia, Elmarossa Dinda
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1232

Abstract

Intracerebral hemorrhage is a brain injury due to acute extravasation of blood into the brain parenchyma with or without expansion of blood into the ventricles due to rupture of blood vessels. Several factors that increase the risk of this condition are chronic hypertension, amyloid angiopathy, anticoagulant treatment, and vascular malformations. Intracerebral hemorrhage can cause primary and secondary brain injury. Primary brain injury is the initial damage to the parenchyma by a blood clot. While secondary brain injury is a pathological change after bleeding. The most common clinical sign of this disease is a sudden focal neurological deficit. Management of intracerebral hemorrhage starts from drug therapy to surgery. This article discusses the case of a 43-year-old male patient with complaints of weakness in the left leg and arm since 3 hours before admission to the hospital. Other complaints include sudden vomiting preceded by a severe headache 1 day before admission to the hospital. The patient has a history of hypertension since 13 years ago but rarely consumes drugs and heart disease (STEMI) in June 2024. The patient also has a smoking habit since 10 years ago. Physical examination found blood pressure 165/97 mmHg, mouth turned to the left (N VII), tongue deviation to the left (N XII), left hemiparesis. Sodium examination found 133 mmol / L (hyponatremia). Non-contrast head CT scan examination found the impression of a hyperdense lesion in the right hemisphere, an impression of intracerebral hemorrhage. The patient was given drug management without surgical management.
Hubungan Protein Urin dengan Berat Jenis Urin pada Pasien Nefropati Diabetik Putri, Najwa Naraniya; Kurniati, Intanri; Yuningrum, Hesti; Susianti
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1273

Abstract

Diabetic nephropathy is one of the main causes of end-stage renal failure or End Stage Renal Disease (ESRD) in patients with type 2 diabetes. Diabetic nephropathy is defined as the presence of albumin or protein of more than 30 mg/day in urine on two examinations within a period of 3-6 months, as well as a decrease in the glomerular filtration rate. Urinalysis examination using the dipstick method is carried out for certain indications or suspicions of complications of diabetes mellitus, one of which is diabetic nephropathy. Dipstick examination can detect protein, pH, glucose, specific gravity, ketones, urobilinogen, nitrite, blood, bilirubin, and leukocyte esterase. The specific gravity of urine depends on the concentration of glucose, urea, and protein particles in the solution. Therefore, the purpose of this study was to determine the relationship between protein in urine and specific gravity in patients with diabetic nephropathy. Observational analytical research was conducted with a cross-sectional approach. This study was conducted at the Medical Records Installation of Dr. H. Abdul Moeloek Hospital. The population of this study was diabetic nephropathy patients treated at Dr. H. Abdul Moeloek Hospital in January-December 2023. The sampling technique used the total sampling technique so that 49 samples were obtained that met the inclusion and exclusion criteria. The data obtained were analyzed using the Spearman correlation test. The results showed a correlation coefficient (r) of 0.589 and a significance p-value = 0.000. There is a relationship between urine protein and urine specific gravity in diabetic nephropathy patients.
Meningitis TB Pada Anak 16 tahun: Laporan Kasus Alghani, Sulthan Rafi; Nareswari, Shinta
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1279

Abstract

Tuberculous meningitis is a form of Mycobacterium tuberculosis infection that affects the meninges of the brain. The case discussed involves a 16-year-old male adolescent who initially presented with symptoms of headache, fever, neck pain, and neck stiffness, which persisted for several weeks. The delay in diagnosis occurred due to the similarity of the initial symptoms to bacterial meningitis, often leading to postponed TB treatment. The diagnosis was established through anamnesis, physical examination, and supporting tests, including a molecular rapid test (TCM) on cerebrospinal fluid (CSF) and a head CT scan, which confirmed the presence of miliary TB in the lungs and meningitis accompanied by hydrocephalus. The patient also experienced a weight loss of four kilograms over the past two weeks, indicating systemic signs of chronic infection. Although the patient received Anti-Tuberculosis Treatment (ATT) such as rifampicin, isoniazid, pyrazinamide, and ethambutol, his condition deteriorated, and he ultimately passed away on the ninth day of hospitalization. Neurological examination revealed a progressive decline in consciousness to a GCS score of 8 and the presence of pathological reflexes, such as a positive Babinski sign, confirming central nervous system involvement. The mortality rate of TB meningitis remains high due to delayed ATT caused by the lack of early diagnosis, emphasizing the importance of early detection to improve patient prognosis. Preventive efforts through active screening of high-risk groups and education about the early symptoms of TB meningitis are crucial in reducing morbidity and mortality rates.
Identifikasi Kandungan Senyawa Aktif Antibakteri Ekstrak Bawang Putih dalam Menghambat Pertumbuhan Bakteri Cutibacterium acnes Penyebab Acne Vulgaris Aprianti, Shervia Dwi; Sibero, Hendra Tarigan; Aditya, Muhammad; Himayani, Rani
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1302

Abstract

Introduction: The cases of antibiotic resistance in the treatment of acne vulgaris have been steadily increasing. A study conducted by the Dermatology Clinic of Hanyang University Hospital, South Korea, showed an increase in antibiotic resistance cases in the management of acne vulgaris, with resistance rates of 30% for clindamycin and 26.7% for erythromycin. One adjunctive therapy believed to be a breakthrough in anticipating the increase in antibiotic resistance causing acne vulgaris is the use of garlic extract. This study aims to conduct antibacterial phytochemical screening of garlic extract in inhibiting the growth of Cutibacterium acnes. Methods: The antibacterial active compounds in garlic plants were identified through phytochemical screening. Meanwhile, the antibacterial test was conducted using the well diffusion method with garlic extract concentrations of 25%, 50%, 75%, and 100%. Clindamycin was used as the positive control. Results: The phytochemical screening results of garlic extract in this study revealed the presence of flavonoids, alkaloids, tannins, phenols, and terpenoids. In the antibacterial test using the well diffusion method, the largest inhibition zone was observed with clindamycin treatment, while the smallest inhibition zone diameter was recorded with 25% garlic extract concentration. Discussion: The active antibacterial compounds found in garlic extract, including flavonoids, alkaloids, tannins, phenols, and terpenoids, have been proven to inhibit the growth of Cutibacterium acnes, as indicated by the formation of inhibition zone diameters in the antibacterial test.
Hubungan Rasio Neutrofil Limfosit (RNL) Dengan Lama Rawat Inap Pada Pasien Pneumonia Di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Julianti, Dinul Aliya; Sangging, Putu Ristyaning Ayu; Pardilawati, Citra Yuliyanda; Tjiptaningrum, Agustyas
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1316

Abstract

Pneumonia is an acute infection of the lung tissue due to bacteria, viruses, and fungi. Increased RNL values in pneumonia patients are biomarkers to systemic inflammatory responses that are easily quantified, inexpensive, and easily interpretable in the prognosis of pneumonia patients associated with length of stay. However, there is still not much relevant amount of research, and its application in daily practice is still minimal. This study aimed to identify the relationship of NLR with the length of hospitalization in pneumonia patients. This study used a cross sectional design. The data collection technique is a total sampling with a sample size of 39 patients. The research location is at Dr. H. Abdul Moeloek Regional General Hospital, Lampung Province and will take place in July-December 2022. The independent variable is RNL, while the dependent variable is the length of stay. Data obtained from the results of laboratory supporting examinations in the medical records of pneumonia patients. The collected data were then analyzed using the Chi-square test with a CI of 95%. The results showed that the majority of patients came from the age group of 51-60 years (51.3%) and were male (61%). The average pneumonia patient had a high ANC value (9,260) and a normal ALC (1,244) so that a high NLR average (10,067) was obtained with an average long stay (6 days). There is a relationship between NLR and length of stay in pneumonia patients at Dr. H. Abdul Moeloek Regional General Hospital, Lampung Province (p<0.05).
Eksplorasi Imunoterapi dan Terapi Gen dalam Pengobatan Tumor Otak: Literature Review Hana Muthi'a Putri; Windarti, Indri; Mayasari, Diana; Susianti, Susianti
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1378

Abstract

Brain tumors are a significant neurological disorder with a high mortality rate, especially in cases of glioblastoma, which is highly aggressive and difficult to treat. Conventional treatment methods, such as surgery, radiation therapy, and chemotherapy, are often not effective enough, particularly in advanced stages. This study aims to explore two innovative approaches, namely immunotherapy and gene therapy, as alternative treatments for brain tumors. Immunotherapy works by enhancing the immune system's ability to fight cancer cells through methods such as checkpoint inhibitors, cancer vaccines, and CAR-T therapy. However, the success of immunotherapy is often hindered by the blood-brain barrier (BBB), which limits the delivery of therapy to the brain. On the other hand, gene therapy offers a solution by modifying genetic material, either to repair damaged genes or to directly destroy cancer cells. Approaches such as the use of oncolytic viruses, CRISPR technology, and nanoparticles have shown promising results in preclinical research and early clinical trials, particularly for glioblastoma. The combination of immunotherapy and gene therapy opens new opportunities to enhance treatment effectiveness by strengthening the immune response and targeting tumors more specifically. However, challenges remain, including treatment resistance, side effects, and limitations in brain delivery methods. Further research is needed to ensure the safety, efficacy, and widespread application of this combination therapy. Immunotherapy and gene therapy have great potential as breakthroughs in the future treatment of brain tumors. Relevant literature, including articles and journals from both national and international sources, were gathered through online searches in various databases, such as Google Scholar, PubMed, and NCBI, and used to compile this article.
Dampak Stres pada Kesehatan Qonita, Adzrok; Setiorini, Anggi; Ratna, Maya Ganda; Zuraida, Reni
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1404

Abstract

Stress is a bodily response to a stressor, which refers to any condition perceived as threatening or causing pressure. Stress can have both positive (eustress) and negative (distress) effects. Prolonged distress can affect various body systems through the activation of the Hypothalamus-Pituitary-Adrenal (HPA) axis and the Sympathetic-Adreno-Medullary (SAM) axis. Activation of these axes triggers the release of cortisol, epinephrine, and norepinephrine, leading to physiological and behavioral changes. Stress impacts multiple organ systems, including the cardiovascular, respiratory, gastrointestinal, hepatobiliary, urinary, reproductive, musculoskeletal, integumentary, sensory, and immune systems. It also affects sleep quality and mental health. In the cardiovascular system, stress can cause hypertension, atherosclerosis, and an increased risk of heart disease. In the respiratory system, stress worsens asthma and increases the risk of airway infections. In the gastrointestinal system, stress triggers digestive disorders, such as gastritis and peptic ulcers, due to increased stomach acid production and inflammatory mediators. Stress affects the hepatobiliary system by impairing liver function through increased inflammation. In the urinary system, stress can cause dysfunctions such as enuresis and increased urination frequency. In the reproductive system, stress can result in menstrual disorders in women and decreased testosterone levels in men. The musculoskeletal system can be affected by excessive muscle contractions, leading to pain and muscle fatigue. Stress impacts the integumentary system, triggering conditions such as acne, psoriasis, and alopecia areata. It can also cause sensory system disorders, affecting hearing, taste, and vision. In the immune system, stress suppresses immune responses, increasing susceptibility to infections and prolonging wound healing. Prolonged stress negatively impacts both physical and mental health, highlighting the importance of understanding the mechanisms through which stress affects the body to reduce the risk of serious health problems.
Hubungan Antara Jenis Kelamin dengan Tingkat Kecemasan pada Mahasiswa Kedokteran: Tinjauan Pustaka Firdausy, Daniatul; Wardani, Dyah Wulan Sumekar Rengganis; Larasati, Ratri Mauluti; Pramesona, Bayu Anggileo
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1413

Abstract

Anxiety is one of the mental disorders often experienced by medical students due to high academic pressure. Factors that influence anxiety include biological, psychological, and social aspects. This study aims to determine the relationship between gender and anxiety levels in medical students. The method used is a literature review with a total sampling technique, in which four selected journals from the period 2015–2025 were analyzed. The results showed that female students have higher levels of anxiety compared to male students. This is due to several factors, such as hormonal differences, where estrogen plays a role in the regulation of serotonin which affects anxiety, and differences in emotional responses, where women are more likely to use emotion-based coping strategies. In addition, greater social pressure on women also contributes to their high levels of anxiety. The impact of high anxiety on students can affect academic achievement, concentration, and overall mental health. Therefore, it is important for educational institutions to provide psychological support and effective stress management programs to help students, especially women, manage anxiety. With the right intervention, it is hoped that medical students can be better prepared to face academic and professional challenges without experiencing significant psychological disorders.

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