Medula
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
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<![CDATA[Psoriasis Pustulosa Generalisata: Tinjauan Kasus Pada Geriatri ]]>
<![CDATA[Febe Sintia Kristiani]]>;
<![CDATA[Dwi Indria Anggraini]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.236
<![CDATA[Psoriasis is a chronic disease of the skin that is characterized by accelerated epidermal exchange and a faster keratinization process. Psoriasis has a variety of manifestations, one of which is generalized pustular psoriasis characterized as pustular sterile eruption. This case report aims to determine the diagnosis and management of generalized pustular psoriasis. Case, a 75-year-old woman complained of the emergence of pustule throughout the body since four days ago accompanied by burning and itching sensation. Some pustule confluence make a lake form (lake of pus), and some lesion consist of erythematous plaque with yellowish greasy scale. The patient has a history of hypertension, use of pain killer, and sudden stopping steroids. Based on history taking, physical examination and laboratory, the diagnosis of generalized pustular psoriasis is made. The treatment given was in the form of corticosteroid methylprednisolone intravenous injection 31,25 mg/ 12 hours, ranitidine intravenous injection 50 mg/12 hours, cetirizine peroral 1x10 mg, betametason valerate cream 0.1% in urea 10% cream.]]>
<![CDATA[Manajemen Neurogenic Pulmonary Edema pada Laki-laki Usia 60 Tahun dengan Stroke Infark Luas di RSUD Jendral A. Yani Kota Metro ]]>
<![CDATA[M. Panji Bintang Gumantara]]>;
<![CDATA[Halomoan Simon Tambunan]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.237
<![CDATA[Neurogenic Pulmonary Edema (NPE) is a pulmonary compromise condition due to severe damage of the central nervous system that causes symptoms similar to ARDS accompanied by pulmonary edema. NPE often occurs in traumatic brain injury (TBI), hemorrhage, recurrent seizures, and epilepsy. Stroke is a focal or general acute neurological deficit condition during more than 24 hours caused by cerebrovascular factors. In patient with extensive stroke infarction of the brain can cause suppression of the respiratory center in the brain so that stroke patients can get complications in the respiratory system that aggravate the patient's condition. This case report described a 60-year-old man with decreased consciousness and weakness of the left limbs since 6 hours before entering hospital with shortness of breath, reddish coughing phlegm, fever, rapid and shallow breathing. Management was given to the patient in pharmacological and non-pharmacological collaborative therapies. Intensive care was planned in the Intensive Care Unit (ICU) formechanical ventilator. The patient's prognosis in this case report wasad malam. The purpose of this case report is to find out the description of clinical problems, identify the risk factors as the cause and provide the best management for patients.]]>
<![CDATA[Sindrom Obstructive Sleep Apnea ]]>
<![CDATA[William Bahagia]]>;
<![CDATA[Putu Ristyaning Ayu]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.238
<![CDATA[Obstructive Sleep Apnea (OSA) is a disorder and part of a complex sleep disorder breathing syndrome. OSA symptoms often occur althought it difficults to detect. If OSA does not get good management, it will cause long-term health problems. OSA is a condition of periodic upper airway obstruction during sleep that causes the breath to stop intermittently, either completely (apnea) or partial (hypoapnea). This condition is occurring in the upper respiratory tract (mainly in the oropharynx) resulting in decreased air flow. OSA symptoms are classified into night symptoms and daytime symptoms. Recurrent episodes of apnea, intermittent hypoxia and sleep fragmentation may affect organ function, especially the central nervous system and cardiovascular system, resulting in changes in metabolic balance. The gold standard for diagnosis of OSA is through a night sleep check with Polysomnography / PSG). The index used to determine the degree of mild-bad OSA is the Apnea-Hypoapnea Index (AHI), which counts the number of obstructive events per hour during sleep and the results of cardiorespiratory monitoring. Management of OSA consists of surgical therapy and non-surgical therapy. Positive airway pressure (PAP) is known to be the gold standard therapy for OSA. This article is a literature study to discuss pathophysiology, risk factors, signs and symptoms, to the handling and prevention of OSA.]]>
<![CDATA[Effect of Vitamins B1, B6, and B12 Supplements on Work Fatigue in Shift Workers at Oil Packing Factory ]]>
<![CDATA[Josua Tumpal Haloman]]>;
<![CDATA[Rasmi Zakiah Oktarlina]]>;
<![CDATA[T.A. Larasati]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.239
<![CDATA[Kelelahan kerja merupakan keluhan yang sering dijumpai pada pekerja, terutama pada pekerja shift. Kondisi fisik dan mental pekerja yang mengalami kelelahan berdampak negatif kepada pekerja itu sendiri dan hasil pekerjannya. Kombinasi multivitamin dengan kandungan vitamin B efektif mengatasi kelelahan fisik dan memperbaiki mood serta kemampuan kognitif. Penelitian ini bertujuan untuk mengetahui pengaruh suplemen multivitamin B1, B6, dan B12 terhadap kelelahan kerja khususnya pada pekerja shift. Penelitian ini merupakan penelitian eksperimental semu dengan sampel sebesar 31 orang pekerja shift di pabrik pengemasan minyak goreng yang sesuai dengan kriteria restriksi. Seluruh subjek diukur kelelahan kerjanya sebelum dan sesudah suplementasi dengan tablet kombinasi vitamin B1, B6 dan B12 selama 7 hari. Kelelahan kerja diukur dengan kuisioner Chalder Fatigue Scale (CFS) dan reaction timer. Data yang diperoleh dianalisis dengan uji statistik untuk melihat perbedaan nilai tengah sebelum dan sesudah suplementasi. Rata- rata skor kuisioner CFS sebelum dan sesudah suplementasi adalah 12,13 dan 8,52. Terdapat penurunan rata- rata skor kuisioner CFS sesudah suplementasi (p=0,001). Rata- rata waktu reaksi sebelum dan sesudah suplementasi adalah 209,45 dan 193,67. Terdapat penurunan rata-rata waktu reaksi sesudah suplementasi (p=0.028). Terdapat pengaruh suplementasi multivitamin B1, B6 dan B12 terhadap kelelahan kerja.]]>
<![CDATA[Terapi Gabapentin pada Pasien Herpes Zoster Oftalmikus Fase Akut: Neuralgia Paska Herpetika ]]>
<![CDATA[Iffat Taqiyah]]>;
<![CDATA[Hendra Tarigan Sibero]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.240
<![CDATA[Herpes zoster (HZ) is one of skin disease caused by viral infection, characterized by rash and pain, developed within unilateral dermatome consequence by Varicella Zoster Virus (VZV) reactivation in infected nerve. One of complication of HZ is pain that persists after the rash dissappears called postherpetic neuralgia (PHN). Postherpetic neuralgia can be predicted by people aged more than 50 years, severe prodromal symptoms, and severe acute pain of HZ. No treatment of prevention therapy for PHN has been shown but early therapy for reducing pain is expected for better outcome. Theory of early therapy of PHN has been still questionable. A 73-years old- women presenting with multiple blisters on her right forehead and eyelid accompanied by pain since 4 days ago. Dermatological status region of orbitalis and frontalis dextra, ophtalmic division of trigeminal nerve level appears pustules with erythematous base, circumscript, multiple, regular, lenticular, confluence, zoosteriform. Diagnosis of this case is herpes zoster ophtalmicus dextra. Management of this case is Acyclovir 5x800 mg for 7 days, Gabapentin 2x300 mg for 7 days, and compress with NaCl 0,9%. Patient has better outcome and patient has PHN that persist 5 months after rash dissappears. In this case, Gabapentin therapy in the acute phase can not prevent PHN but has a good outcome for reducing pain.]]>
<![CDATA[Penatalaksanaan Holistik pada Remaja Laki-Laki dengan Urtikaria Kronik Tanpa Angioedema et causa Rangsangan Fisik ]]>
<![CDATA[Veronica Debora]]>;
<![CDATA[Reni Zuraida]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.241
<![CDATA[Urticaria is skin disease characterized by the sudden appearance of wheals and/or angioedema. Chronic urticarial is characterised by the recurrence of hives/angioedema for >6 weeks. The disease is a common and important clinical problem in care and treatment so that it becomes a diagnostic and therapeutic challenge. This study is a case report. Primary data obtained through history taking, physical examination, and home visits. Secondary data were obtained from the patient's medical record. At the first visit, the patient’s complaints were obtained which appeared reddish bumps on the neck, chest, back, both arms and thighs. Internal risk factors in patients are the lack of patient knowledge about the disease they are experiencing, as well as the causes/factorsat influence it and how to prevent the disease, curative treatment patterns, lifestyle: frequent swimming in the river during the day, bathing habits that are less clean and irregular . External risk factors for patients are families seeking medical treatment if complaints are already disturbing (hygiene around the outside of the house is lacking), neighborhoods and playgrounds in dense residential areas surrounded by rice fields. The second visit was an intervention with a family conference method using pictorial leaflet media. The third visit showed complaints of redness and red itching due to the patient taking loratadine 10 mg and dexamethasone 0.5 mg. Patients already have better lifestyle patterns such as maintaining personal hygiene and the environment. There is an increase in patient knowledge about the disease experienced, as well as the causes / factors that influence it and how to prevent the disease experienced, characterized by an increase in post-test scores by 6 points.]]>
<![CDATA[Potensi Isoflavon Genistein Sebagai Terapi Suportif Imunonutrisi Pada Pasien Kanker Payudara ]]>
<![CDATA[Regina Triswara]]>;
<![CDATA[Ahmad Farishal]]>;
<![CDATA[Bintang Abadi Siregar]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.242
<![CDATA[Breast cancer is a malignancy in breast cells that grow out of control with a variety of mechanisms and risk factors. Breast cancer can be started from the ducts or lobular breasts. Breast cancer has a high incidence and high mortality in the Asian region due to various things, especially the process of early detection and therapy. Prevention stage is preferred over surgical or chemotherapy therapy. The condition of breast cancer patients must have a strong and tough immune system to supply cancer cells so that the need for proper nutrition is very much needed. Soybeans are rich in isoflavones known as antioxidants, antibacterial and most recently have anticancer potential. Genistein isoflavones in soybeans will be more active after the fermentation process and show the potential of cancer cell inhibitors by changing the phase of carcinogenesis with hormone receptor pathways and Nf-Kb-Akt signaling. Genistein is also proven as an inhibitor of angiogenesis in cancer cells. Further clinical trials need to be carried out on safety and the right dosage to be applied as immunonutrition in breast cancer patients.]]>
<![CDATA[Manajemen Anastesi pada Laminektomi pada Cedera Vertebra Servikal V-VI di RSUD Dr. H. Abdul Moeloek, Bandar Lampung ]]>
<![CDATA[Fairuz Nabila Afia]]>;
<![CDATA[Bambang Eko Subekti]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.243
<![CDATA[Cervical spinal cord injuries can occur directly or inderectly that can cause neurological disorder or death. Cervical injuries occur 2-3% of all cedera events and 8,2% of all cederas that cause of death. Symptoms of cervikal cedera can be partial or loss of limb movements and / or sensation that can be in calssified as complete or incomplete. A 40 year-old man with complaints of weakness and tingling in all four limbs since 3 days before entering the hospital, patient had history of motorcycle accidents. Resuscitation and protection of cervical vertebrae have been carried out, which aim to preventing or minimize other damage to the nervous system after servikal injury , increase the patient's recovery and planning specifically during perioperative, including airway management, induction, general anesthesia, and recovery phase. The purpose of this case report is to find out the anesthetic management in the form of planning, description of clinical problems, identifying the risk factors that cause and providing the best management for patients.]]>
<![CDATA[Seorang Laki-Laki Usia 27 Tahun dengan Gangguan Panik ]]>
<![CDATA[Kadek Aryati]]>;
<![CDATA[Cahyaningsih Fibri R]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.244
<![CDATA[Panic disorder is an ongoing public health problem. Panic disorder is an unexpected experience of panic attacks followed by persistent fears about the possibility of repeated attacks or changes in behavior in daily life as a result of these attacks. Women 2-3 times more suffer from this disorder than men. there are very anxiety episodes, their duration is short, repetitive, and unpredictable, followed by typical clinical manifestations. Factors that influence biological, genetic or psychosocial factors. Management with pharmacotherapy and psychotherapy. In this case, a 27-year-old man with complaints of fear and anxiety that occurred suddenly and did not know the cause since 6 months ago. Feelings of fear and anxiety come at any time and in any situation.]]>
<![CDATA[Tatalaksana Anestesi pada Pasien Cedera Otak Traumatik Berat ]]>
<![CDATA[Rani Tiara]]>;
<![CDATA[Bambang Eko Subekti]]>
<![CDATA[ Medula Vol 9 No 4 (2020): Medula ]]>
Publisher : <![CDATA[CV. Jasa Sukses Abadi ]]>
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DOI: 10.53089/medula.v9i4.245
<![CDATA[Anesthetic management in 40-year-old men, body weight 60 kg, height 172 cm. Patient brought to the emergency department due to a traffic accident, fell from a motorcycle. In the emergency department, initial management was management by evaluating the clear airway, breathing with breath rate 20-24x /min, and circulation with blood pressure 90/60 mmHg and pulse rate 64x /min, with patient GCS E3V1M3. Patients diagnosed with intracerebral hemorrhage and subdural hemorrhage who need perform hematoma evacuation with craniotomy procedure, with ASA III in patient physical status. Surgery is performed under general anesthesia, with the specific procedure remaining to stable and maintaining intracranial pressure in optimal condition. Hemodynamics stabilitations by maintaining MAP 70-100 mmHg. The operation held for 2.5 hours, after the operation, the patient was moved to the recovery room and received for further treatment in the surgical care room. Faster management of head injuries, resuscitation with cerebral protection and management of intensive therapy can improve the outcome of patients.]]>
