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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 30 Documents
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Search results for , issue "Vol 14 No 6 (2024): Medula" : 30 Documents clear
Laporan Kasus: Usia Lebih dari 40 Tahun sebagai Faktor Risiko Mola Hidatidosa Nasution, Rizqiani Astrid; Algifari, Muhammad Zaidan; Zulfadli, Zulfadli
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.v14i6.1150

Abstract

Hydatidiform mole is a type of abnormal pregnancy in which the fetus does not develop and almost all of the chorial villi undergo hydropic changes or degeneration that resemble grapes or fish eyes. The incidence of hydatidiform mole is higher in Asian, African, and Latin American countries compared with Western countries. In Indonesia, the incidence of hydatidiform mole is 1 in 85 pregnancies. This condition is caused by abnormal chromosomal fertilization. A diagnosis of hydatidiform mole can be made if the following signs are found: amenorrhea, vaginal bleeding, uterine size larger than expected for gestational age, no signs of pregnancy, beta-hCG levels that are higher than normal, and a vesicular appearance in the uterine cavity. on ultrasound examination. The most accurate diagnosis is when a molar bubble is found. In the first trimester, molar appearance is usually less specific than in the second trimester, where the appearance becomes more typical. In the second trimester, it can be seen that the uterine cavity contains an echogenic mass mixed with anechoic vesicular parts with a diameter of 5-10 mm or looks like a honeycomb. Risk factors that increase the prevalence of molar pregnancy include extreme maternal age (age >40 years has a five to ten-fold increased risk) and early adolescence (usually <20 years), a history of previous molar pregnancy increases the risk by 1%-2% for subsequent pregnancies, women who have had a spontaneous abortion or infertility, dietary factors include patients who have a diet deficient in carotene (a precursor of vitamin A) and animal fats, and smoking. In this case, the risk factor for hydatidiform mole was the patient's age.
Sebuah Laporan Kasus Manajemen Anestesi pada Lansia dengan Peritonitis Sekunder: Sebuah Laporan Kasus Saputra, Baridi Adlan; M. Hidayatullah Saputra Amsia; Luthfi, Ahmad Angga
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.v14i6.1152

Abstract

Thyroid carcinoma is the most common malignancy of the endocrine system and ranks 9th out of the 10 most common cancers in Indonesia. Thyroid carcinoma can lead to possible difficulties in airway management and intubation as well as the possibility of thyroid storm although this is rare. Anesthesiologists should pay special attention to the preoperative, perioperative and postoperative measures of patients with thyroid carcinoma because primary tumors or metastases in the head neck, lung or mediastinum region can cause airway obstruction at the level of the larynx, trachea or bronchi. The American Society of Anesthesiologists (ASA) and the Difficult Airway Society (DAS) have created difficult airway and difficult intubation management algorithms to facilitate anesthesiologists in dealing with these conditions. This case report discusses a 55 year old male patient with right thyroid carcinoma who underwent radical neck dissection surgery using a long laryngoscope blade number 4. The patient was successfully intubated and underwent surgery with normal hemodynamic monitoring. The importance of good and correct preoperative, intraoperative and postoperative management, especially with regard to airway management, will make the operation run smoothly and safely and reduce morbidity and mortality in patients.
Fetal Distress Management due to Fever in Pregnancy: a Case Report Ulhayah, Syiva; Zulfadli, Zulfadli
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.v14i6.1153

Abstract

As one of many body response to fight infection, trauma, etc., fever is a process that requires the work of cytokine, pyrogen, hypothalamus and many others. Therefore, a fever during pregnancy could potentially lead to complications such as infection and declining health problems, even fetal distress caused by the mom's infection or inflammatory condition. In the following case, a women had came with chief complaints of reappearing fever even after taking antipyretic medications as well as painful urination. The patient then diagnosed with partus premature imminens while getting into 34th week of pregnancy, as well as urinary tract infection and suspect of bacterial vaginosis. Observation of general conditions, vital signs and fetal heart rate were done, as well as some other medications were given to the patient. Vaginal swab was also scheduled for the patient. The immunology and serology lab test result were out in the next 24 hours and showed that positive dengue fever IgG and typhoid fever were indicated within IgM anti salmonella 6 scale result. Additional medications were added, yet signs of declining vital conditions of the patient as well as the fetus kept shown. Therefore, sectio caesarea delivery was needed. vital signs observation and medications were given post-operation. The raising awareness of pregnant women regarding fever during pregnancy had to be done to reduce any possible complications that could occur in the future. Pregnant women also need to increase their nutritional intake which can help increase the body's immunity so that pregnant women are not easily infected by bacteria, viruses and others.
PENGARUH EKSTRAK BAWANG PUTIH (Alium sativum) TERHADAP GAMBARAN HISTOPATOLOGI HEPAR PADA TIKUS PUTIH (Rattus norvegicus) GALUR Sprague- dawley YANG DIINDUKSI STREPTOZOTOCIN Fadly, Ahmad Aulia; Windarti, Indri; Hanriko, Rizki
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.v14i6.1154

Abstract

Diabetes Mellitus (DM) is a chronic disease characterized by blood sugar levels that exceed normal limits. Chronic DM can cause liver complications in the form of inflammation. Streptozotocin can induce mice to become a DM model and can also directly damage the liver. Garlic (Allium sativum) is a tuber that is often found in Indonesia. The various compounds contained in it have anti-diabetic and antioxidant effects which have the potential to prevent inflammation in the liver. This research was conducted to determine the effect of garlic extract (Allium sativum) on histopathological features in the form of lymphocyte cell infiltration in the portal and lobular tracts of the liver in white rats (Rattus norvegicus) of the Sprague-dawley strain induced by streptozotocin. The method used was a randomized controlled design with a pre-clinical Post-test Only Control Group Design pattern. This study used 24 mice divided into 4 groups with 6 mice in each group. The appearance of lymphocyte cell infiltration will be assessed based on the Omenetti scoring. The mean scores for lymphocyte cell infiltration in the portal tract obtained were KN=0.22, K+=2.10, P1=0.60, and P2=0.56. From the analysis using the One-Way ANOVA test followed by the Post Hoc Benferroni test, the results showed a significant difference in scores between K+ and P1 and P2. Meanwhile, the mean scores for lymphocyte cell infiltration in the lobular area obtained were KN=0.50, K+=1.16, P1=0.50, and P2=0.33. From the analysis using the Kruskal-Wallis test, no significant differences in scores were found between all groups. There was an effect of garlic extract (Allium sativum) on the infiltration of lymphocyte cells in the portal tract and no effect was found on the lobular area of ​​the liver in white rats (Rattus norvegicus) of the Sprague-dawley strain which were induced by streptozotocin.
A 32-Year-Old Woman (G2P1A0) with Partial HELLP Syndrome and Severe Preeclampsia in a Term Pregnancy Arwin, Leonardo; Sari, Ratna Dewi Puspita
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.v14i6.1157

Abstract

Preeclampsia and HELLP syndrome are cases of obstetric emergencies that are still serious problems and have a high level of complexity. Preeclampsia is characterized by hypertension and proteinuria after 20 weeks of gestation, while HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and thrombocytopenia. A 32 year old woman, term pregnant, G2P1A0, presented with a history of hypertension since pregnancy. The results of the physical examination, blood pressure was 165/120 mmHg, laboratory results showed that platelets were 150,000/µL, LDH 731 U/L, SGOT/SGPT 84/46 U/L and urine excretion showed proteinuria 500. The importance of knowing the risk factors for preeclampsia include the mother's age at the time. pregnant for more than 35 years, obesity, history of preeclampsia in a previous pregnancy, multiple pregnancies, and a history of certain diseases such as chronic hypertension, diabetes, kidney disease or degenerative diseases such as rheumatoid arthritis or lupus. Regular antenatal examinations and recognizing signs of preeclampsia as early as possible can prevent severe preeclampsia and its complications. Management of these patients includes stabilization, fluid management, preventing eclampsia, administering antihypertensive drugs and corticosteroids. Appropriate management in this case can prevent further complications and reduce maternal mortality. Diagnosis is based on anamnesis, physical examination and supporting support in patients given medical therapy in accordance with the theory and termination of pregnancy by caesarean section.
Penatalaksanaan Holistik Pasien Anak Usia 15 Tahun dengan Dermatitis Atopik melalui Pendekatan Dokter Keluarga di Wilayah Puskesmas Segala Mider Dewi, Mega Endiana; Bulfiah, Siti Noor Fadilah; 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.v14i6.1159

Abstract

Atopic dermatitis (AD) is a skin disorder that often occurs in infants and children, characterized by itching, frequent relapses, and a characteristic distribution of lesions. Management of DA contained in the 5 pillars which include patient education, prevention and modification of precipitating factors, improvement of optimal skin barrier function, management of inflammatory skin disorders, and control of the itch-scratch cycle. The aim of this study is to apply the principles of family medicine services to patients and carry out holistic management based on the patient problem found with patient-centered approach, family focused, and community oriented based on Evidence Based Medicine. This study is a case report with Primary data obtained through history taking, physical examination and home visits to complete family, psychosocial and environmental data. Secondary data was obtained from the patient's medical record. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study. The result is there are internal and external factors happened to tje patient.  After the intervention, there was an improvement of symptom. Then there is an increase in knowledge through pretest and posttest. After holistic management was carried out based on the problems identified through family doctor approach, there was an increase in symptom as well knowledge abaout the disease.
PENATALAKSANAAN OSTEOARTHRITIS DAN HIPERTENSI PADA WANITA USIA 62 TAHUN DENGAN PRINSIP PENDEKATAN KEDOKTERAN KELUARGA DI PUSKESMAS KEDATON Ananti, Anggini T; Effendi, R.E. Rizal
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.v14i6.1163

Abstract

Osteoarthritis is a chronic disease characterized by damage to joint and cartilage. This causes the bones to rub against each other, causing stiffness, pain and impaired movement. Degenerative diseases are non-communicable diseases (PTM) that are chronic and related to genetic, environmental and behavioral factors. The study uses a method in the form of case reports with primary data were obtained from anamnesis, physical examination, and home visits. Secondary data obtained from medical records. The assessment is based on holistic diagnostics from the initial, process, and final studies quantitatively and qualitatively. Patient Mrs. M, sixty-two years old, with complaints of pain in the left knee since two years ago. The complaint began with pain in his knee, especially when walking and getting up from a sitting position to standing, so that in the last two weeks it greatly hampered his activities. In the patient's personal history, she often lifts heavy burdens because she has to care for her husband who has been sick due to an accident 4 years ago. The patient also has a history of hypertension since 3 years ago. The evaluation results showed reduced clinical symptoms and increased knowledge about the disease. Obtained internal and external risk factors in patients. Increased knowledge about disease in patients and prevention of hypertension and osteoarthritis as evidenced by an increase in pretest-posttest scores by 30 points from 60 to 90 points.
Dampak Penggunaan Obat Off Label Terhadap Adverse Drug Reactions (ADR): Studi Pada Pasien Pediatri Nur Hidayah, Fitri; Iqbal, Muhamad; Wardana, Muhammad Fitra; Triyandi, Ramadhan
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.v14i6.1164

Abstract

Limited types of drugs that can be used in the age range of children aged 0-2 years have resulted in treatment of patients using off-label drugs. Unwanted drug reactions (ROTD) are a health problem in society that occurs especially in the pediatric population. ROTD in children can have relatively more severe effects when compared to adults. Research on off-label drug use has been carried out in several places in Indonesia but most of it is limited to the percentage of off-label drug use and it is also not known further about its influence on the emergence of ROTD, namely information on drug labeling, efficacy and safety in the pediatric population is limited. Limited information results in many off-label drug prescribing in pediatric patients. Several studies aim to obtain an overview of off-label drug use in pediatric patients. A review of this literature is that off-label drug use in pediatric patients is still an issue that needs attention. With a better understanding of off-label drug use, steps can be taken to improve the safety and effectiveness of treatment in pediatric patients.
Penatalaksanaan Holistik pada Lansia dengan Neurodermatitis, Infeksi Sekunder dan Obesitas melalui Pendekatan Kedokteran Keluarga di Wilayah Puskesmas Susunan Baru Syarifatunnisa; Mayasaari, Diana
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.v14i6.1166

Abstract

Neurodermatitis is a chronic inflammatory skin disease characterized by symptoms of itching and thickening of the skin due to repeated scratching. Secondary infections can occur if there has been damage to skin integrity, or changes in local immune conditions due to primary skin disease followed by bacterial infection. People who are obese and who consume steroids or antibiotics are at risk of neurodermatitis. With triggers in the form of psychological stress which often occurs in adults and the elderly, because they tend to experience psychological disorders, in the form of anxiety, feelings of helplessness, and changes in body image. It is estimated to occur in around 12% of the total population. The aim of implementing Evidence Based Medicine (EBM) based family doctor services for patients is by identifying risk factors, clinical problems, and patient management based on patient problems using a patient centered and family approach. Data is obtained through history taking, physical examination and home visits to complete family data, psychosocial and environmental data. The assessment is carried out based on a holistic diagnosis from the beginning, process and end of the study quantitatively and qualitatively. The patient, Mrs. SU, 63 years old, has internal risks, namely elderly age, minimal knowledge, psychological stress, poor personal hygiene, and rarely exercising. Management of patients in a holistic and comprehensive manner, patient-centered, family approach, and community-based in literature based on EBM. Interventions were provided medically and non-medically in 3 visits. Based on the evaluation results, it was found that there was an increase in knowledge, changes in clean and healthy lifestyles and understanding of disease.
Penatalaksanaan Holistik pada Anak Usia 6 Tahun dengan Tinea Kapitis melalui Pendekatan Kedokteran Keluarga di Wilayah Puskesmas Susunan Baru Nova Sabila; Mayasari, Diana
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.v14i6.1167

Abstract

Dermatophytosis is a superficial infection caused by dermatophyte fungi. This infection is also often called tinea. Classification is based on the part of the body affected, namely tinea capitis (head), tinea faciei (face), tinea barbae (beard), tinea corporis (body), tinea manuum (hands), tinea cruris (groin), tinea pedis (legs), tinea unguinum (nails). The prevalence of dermatophytosis in Asia is 35.6%, while in Indonesia it is 52%. Tinea capitis is the first and most common infection that occurs in pre-school and school-age children when compared to other types of tinea with risk factors originating from exposure to the school environment and hygiene applied at home. The aim of implementing family doctor services based on evidence-based medicine for patients is to identify risk factors, clinical problems, and patient management based on a framework for solving patient problems using a patient centered and family approach. The data obtained were primary data obtained through autoanamnesis, alloanamnesis, physical examination, and home visits and secondary data obtained from the patient's medical records. Patient An. B aged 6 years as the age with the highest prevalence has internal risks, namely lack of knowledge, poor personal hygiene, and external factors found in the patient's environment. Management of patients holistically and comprehensively, patient-centered, family approach, and community-based in literature based on EBM. Interventions are provided medically and non-medically. Based on the evaluation results, it was found that there was an increase in knowledge, changes in clean and healthy lifestyles and understanding of disease.

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