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Medula
Published by Universitas Lampung
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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 30 Documents
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Search results for , issue "Vol 14 No 6 (2024): Medula" : 30 Documents clear
Myasthenia Gravis Pada Wanita 42 Tahun: Laporan Kasus Tania Tamara; Fitriyani
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1027

Abstract

Myasthenia gravis (MG) is an autoimmune disease, MG attacks the postsynaptic membrane, disrupts neuromuscular transmission, and causes skeletal muscle weakness and fatigue. Myasthenia gravis is a treatable disease but can result in significant morbidity and even death. This article aims to discuss the diagnosis, therapy, and prevention of disease progression. A 42-year-old woman presented with complaints of weakness all over the body since 4 years ago, which has worsened in the last 2 months, accompanied by shortness of breath, coughing, difficulty speaking, and a nasal voice. Physical examination revealed ptosis (+/+), motor strength 3/3/3 / 3/3/3. Laboratory examination showed leukocytes 11,500/µL. Electromyography (EMG) and nerve conduction velocity (NCV) examination showed a 10% reduction in repetitive nerve stimulation (RNS), Harvey Maslan (+). The clinical symptoms of MG are fluctuating weakness in the extra-ocular, bulbar, and proximal muscles. Signs of muscle weakness include unilateral or bilateral ptosis, binocular diplopia, inability to lift the head straight, dysphagia, and dysarthria. MG can progress generally to proximal muscle weakness with varying degrees of severity. The main treatments for MG are cholinesterase enzyme inhibitors and immunosuppressive agents. Previously, a case of myasthenia gravis was described in a 42-year-old female patient. The diagnosis of this case was made based on a previous history of myasthenia gravis, symptoms of weakness in the ocular, bulbar, and extremity muscles. A possible risk factor for re-triggering MG symptoms in patients is infection. Establishing the current diagnosis and treatment options for MG play an important role in preventing worse disease progression.
Meningoensefalitis TB Pada Laki-Laki Usia 20 Tahun dengan Human Immunodeficiency Virus : Sebuah Laporan Kasus Fitriyani, Fitriyani; Saragih, Andriani Dearta
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1029

Abstract

Meningoencephalitis is a neurological condition that contains both symptoms of meningitis and encephalitis – inflammation of the meninges (lining of the CNS) and inflammation of the brain tissue itself. Fever, headache, meningismus, changes in mental status, neurological deficits and/or seizures are symptoms of meningoencephalitis. Mycobacterium tuberculosis infection in the central nervous system can cause several diseases, one of which is meningitis. Meningitis is an inflammatory condition of the meninges caused by an infective agent. If this meningeal infection process affects the brain parenchyma, it is called meningoencephalitis. Meningoencephalitis patients who present with decreased consciousness should be considered whether they have tuberculous meningitis (TB), especially if there is a history of pulmonary tuberculosis, alcohol use, Human Immunodeficiency Virus (HIV) infection or other conditions associated with impaired immune response. The diagnosis of TB meningoencephalitis is often delayed due to late presentation of the clinical picture, resulting in high morbidity and mortality rates. TB meningoencephalitis is also associated with a high incidence of sequelae that persist for a long time and tends to have a poor prognosis, so immediate treatment or management is needed for patients. We report the clinical presentation and management of a case of a man with meningoencephalitis and a history of HIV disease. A 20 year old man with the main complaint of loss of consciousness and pain throughout the body. Additional complaints include fever, dizziness, trembling in both hands accompanied by nausea and vomiting since 8 days of SMRS. The patient was then taken to the emergency room at Abdul Moeloek Regional Hospital with complaints of loss of consciousness, body shaking and pain throughout the body. Cough (-), runny nose (-), vomiting (-), diarrhea (-), head trauma (-), coma consciousness. Previously the patient had been diagnosed with HIV. Physical examination showed meningeal stimulation (+), Management of meningoencephalitis using antibiotic therapy. Several neurological disorders can occur in Meningoencephalitis patients.
Hubungan Usia, Jenis Kelamin, Dan Pekerjaan Dengan Kejadian Dermatofitosis di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Periode 2017- 2021 Graceciela, Yohana Eva; Anggraini, Dwi Indria; Himayani, Rani; Sibero, Hendra Tarigan
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1097

Abstract

Dermatophytosis is a dermatophyte fungal infection that attacks keratinized tissues. This disease can be caused by various internal and external factors. The internal risk factors causing dermatophytosis include age, gender, and occupation. In addition to that, this study aimed at determining the relationship between age, gender, and occupation toward dermatophytosis cases. This study used an analytical observational design with a cross-sectional approach. The sample in this study consisted of 114 patients with dermatophytosis sourced from the secondary data in the form of medical records. The research data were conducted by using total sampling technique in RSUD Dr. H. Abdul Moeloek Lampung Province. The recorded data included the patients’ age, gender, occupational, and diagnosis. Then, the data were analysed using chi-square test presented in tabular form. The results showed that the majority of dermatophytosis patients were adults, female, and employees who worked in government/private institutions. The results of the chi-square test showed a significant value for the age variable (p = 0.035) and the gender variable (p = 0.041), while for the work variable there was no significant relationship (p = 0.615). There is a significant relationship between age and gender with the dermatophytosis cases and there is no significant relationship between occupation and the dermatophytosis cases.
Single-Shot Thoracic Spinal Anesthesia (TSA) pada Pasien dengan Abses Hepar Segmen VI Posterior untuk Operasi Laparascopy: Laporan Kasus Yusmita, Dini; Ghozali, Imam; Rahmadilla, Alda Putri
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1115

Abstract

General anesthesia is the standard technique for operation. Due to many complication of general anesthesia, thoracic spinal anesthesia (TSA) is widely used for several operation. Thoracic segmental spinal anesthesia has been proven safe and effective for a variety of laparoscopic surgeries. Thoracal spinal anesthesia is also proven usefully in maintaining hemodynamics and reducing side effects. Laparoscopic surgery is an alternative to the drainage of liver abscess in addition to laparotomy. A 58-year-old man with a diagnosis of posterior segment VI of liver abscess lead a laparoscopic surgery which became a laparotomy under thoracic spinal anaesthesia. Thoracic spinal anesthesia with a median approach at the level of 9-10 intervertebral space (T9-10) single shot using a combination regimen of Isobaric 5 mg and Hyperbaric 2.5 mg, Fentanyl 50 mcg, Dexmetomidine 10 mcg, and Ketamine 20 mg. During the operation there were no hemodynamic fluctuations. Postoperative monitoring found the patient's condition was stable, pain control was good, and there were no postoperative complications such as headache, nausea, and vomiting. Single dose thoracal spinal anesthesia (TSA) is one of the regional anesthetic techniques of choice for abdominal surgery, especially in high-risk patients. In this patient it was found that TSA was effective and safe even though the surgical technique used was different. Monitoring during and postoperatively showed good results without any complications and significant hemodynamic fluctuations.
Penatalaksanaan Holistik Pada Ibu Rumah Tangga Usia 52 Tahun Dengan Dermatitis Kontak Iritan Melalui Pendekatan Kedokteran Keluarga Di Puskesmas Kalirejo Dita Rifzian, Malyca Rachmaniar; Angraini, Dian Isti
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1117

Abstract

Irritant contact dermatitis (ICD) is an inflammatory skin disease caused by irritant materials or substances and can be found in everyone from all age groups, races, and genders. The definitive management is to find and avoid the cause (irritants). Applying a holistic and comprehensive family doctor approach in detecting risk factors, clinical problems, and patient management based on evidence based medicine through family-approached, patient-centered, and community-oriented. This is a case report study, which the primary data were obtained through anamnesis, physical examination, home visits. The secondary data were obtained through patient’s medical records. Mrs. P, 52 years old, presents redness and itchy spots on both soles of the feet and peeled skin since two weeks ago. The patient is worried that the complaints may interfere her daily activities. The patient is a housewife who has just replaced the bathroom floor cleaning fluid. Patient was diagnosed with ICD based on history and physical examination. The intervention results were patient complaints’ were reduced, knowledge of patients and her family regarding ICD increased, and some behaviours of the patients and family changed.
Perbedaan Kadar Gula Darah Puasa Setelah Melakukan Senam Zumba pada Wanita yang Mengalami Obesitas di Pusat Kebugaran Bandar Lampung Agustina, Mezza; Khairunnisa; Oktarlina, Rasmi Zakiah
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1118

Abstract

Obesity is a global epidemic health problem and the cases continue to increase every year. Obesity is a predisposing factor for an increase in blood sugar levels. A relatively simple and easy way to prevent obesity and control blood sugar levels is to exercise regularly. One of them is the zumba exercise. During exercise, muscle cells use more glucose and other nutrient fuels than usual for muscle contraction activities. During physical activity, insulin sensitivity increases and causes a decrease in plasma blood sugar levels. This study aims to determine differences in fasting blood sugar levels for those who have exercised for the first time and who have done exercise twelve times in obese women. This research is an observational analytic study with a cross-sectional approach. In this study, fasting blood sugar levels were measured in 52 respondents who took part in zumba exercises at Fitness Center Bandar Lampung. Sampling was carried out on respondents who did zumba exercise for the first time and who had done zumba exercise twelve times. The results showed that the average fasting blood sugar levels for those who had exercised for the first time and who had done exercise twelve times were 98.65 and 91.38 mg/dl, respectively. Based on statistical tests, zumba exercise has a significant difference in changes in the value of fasting blood sugar levels in obese women who have done exercise.
Penatalaksanaan Holistik Penyakit Pada Anak dengan Skabies Melalui Pendekatan Kedokteran Keluarga di Wilayah Kerja Puskesmas Segala Mider Amourisva, Assyiva Putri; Angraini, Dian Isti
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1120

Abstract

Scabies is a skin disease caused by the mite Sarcoptes scabei parasite, which causes itching that gets worse at night and can be transmitted through prolonged contact with sufferers. Factors that influence the prevalence of scabies are age, gender, poor hygiene, contact with sufferers, and also low knowledge about the disease. So that proper treatment is needed and carried out holistically with a family medicine approach to achieve therapeutic success. The purpose of writing this article is to apply of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient problem solving framework using a patient centered and family approach. This study is a case report. The data obtained are primary data obtained through autoanamnesis, alloanamnesis, physical examination, and home visits and secondary data obtained from the patient's medical record. Patient An. N, 15 years old, came with his mother with complaints of severe itching at night since a month ago, there were reddish nodules the size of pins appearing on the palms of his hands, then spreading to other areas. The patient is worried that it will get worse and interfere with activities. The patient was clinically diagnosed with scabies. Furthermore, management, intervention and evaluation are carried out. On evaluation, there were reduced complaints, patient knowledge about the disease increased, and changes in behavior in maintaining personal and environmental hygiene. After holistic and comprehensive management, patients experience an increase in knowledge about their disease. Complaints of itching and nodules in patients are reduced, patients and their families maintain personal and environmental hygiene.
Penatalaksanaan Holistik Pasien Perempuan Dewasa Usia 54 Tahun Dengan Dermatitis Kontak Alergi Melalui Pendekatan Kedokteran Keluarga Dzakirah, Inas; Karyus, Aila
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1126

Abstract

Allergic contact dermatitis is dermatitis that occurs due to exposure to allergens outside the body, mediated by a type 4 hypersensitivity reaction. This disease is generally synonymous with pruritus has erythema, oedem,. This disease results in a high rate of morbidity and its prevalence has increased in recent decades. This article is a form of application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and management based on a problem-solving framework with a patient-centered and family-centered approach. This study is a Case Report. Primary data were obtained through autoanamnesis, physical examination, home visits to complete family and psychosocial data, as well as the environment. Assessment based on a holistic diagnosis from the beginning, process and end of the study quantitatively and qualitatively.Adult female patient aged 54 years with allergic contact dermatitis. On internal factors in cases such as genetic factors, age factors, and ignorance of the originator. External factors are the lack of family knowledge about kontak alergic dermatitis, its complications and the environment that has many allergens. Pharmacological and non-pharmacological interventions were carried out in the form of education in preventing the onset of symptoms of allergic contact dermatitis in patients. Diagnosis and management of these patients has been carried out in a holistic, patient-centered, family approach and based on several theories and recent research. In the process of change, patients and families have reached the adoption stage.
Penatalaksanaan Holistik Pada Tn. B Usia 50 Tahun dengan Ulkus Diabetikum Melalui Pendekatan Kedokteran Keluarga di Puskesmas Rawat Inap Tanjung Sari Salsabila, Dea Muthia; Zuraida, Reni
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1129

Abstract

Diabetes Mellitus is a metabolic disorder characterized by chronic hyperglycemia. Diabetic ulcer is a state of ulcer, infection, and/or tissue damage, which is associated with neurological disorders and peripheral vascular disease in the lower extremities. The family approach in the management of diabetic ulcers and Diabetes Mellitus helps to identify factors that influence both clinically, personally and psychosocially in the family so that management will be more comprehensive. The purpose of this study was to application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework using a patient-centered and family approach. This study is a case report. Primary data were obtained through anamnesis (autoanamnesis), physical examination, supporting examination and physical environment. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. The patient complained of an open wound on the leg, numbness on both left, frequent urination and easy thirst. The patient has been diagnosed with DM since 2019. The patient was diagnosed with DM based on history, physical examination and supporting examinations. Knowledge of patients and families about the disease they suffer is lacking. After the intervention, the patient showed clinical improvement and there was a change in behavior. In the quantitative assessment, there was an increase in all aspects assessed, namely knowledge, diet and physical activity. Diagnosis and management of these patients is carried out in a holistic and comprehensive manner, patient center, family appropriate with regular DM treatment according to EBM is needed in order to control blood sugar by changing the patient's behavior so as to prevent other complications from arising.
24 Years-Old Adolescent WITH Internet Addiction Disorder Through A Family Medicine Approach Emilius, Denny; Soeryani, R. Wianti; Lumbuun, Nicolaski
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1131

Abstract

Internet Addiction Disorder (IAD) is an increasing public health problem among adolescents. As a branch of medical science that plays an important role in handling public health problems, family medicine has a unique perspective in understanding and seeking solutions to the problem of IAD in adolescents. This case report aims to explain the family medicine approach in managing IAD in adolescents, including the identification of risk factors, holistic interventions, and the role of family physicians in preventive, curative, and rehabilitative efforts.  The case study of a 24-year-old adolescent with IAD, using a family medicine approach, obtained an in-depth understanding of the psychological, social, and physiological dynamics underlying IAD in adolescents is key for family doctors in designing effective interventions. A family medicine approach that focuses on the unique needs and context of each adolescent patient can provide more comprehensive solutions. Family physicians play an important role in early screening, education, referral to mental health services, and collaboration with parents, schools, and communities.  Preventive efforts are also made through the promotion of healthy internet use, development of self-regulation skills, and family/community empowerment. The family medicine approach in managing adolescent IAD places doctors as agents of change who focus on promotive, preventive, curative, and rehabilitative efforts. Collaboration between the government, professional associations, and other stakeholders is needed to develop an effective framework to prevent and address IAD in adolescents.

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