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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 1,081 Documents
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Manajemen Terpadu Bronkopneumonia dan Suspek Penyakit Jantung Bawaan pada Bayi dengan Sindrom Down Kamila Nastiti; Shinta Nareswari
Medula Vol 17 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v17i1.2012

Abstract

Bronchopneumonia is a major cause of morbidity and mortality in children under 5 years of age, particularly in developing countries. Infants with Down syndrome are known to have a higher susceptibility and risk of lower respiratory tract infections, including bronchopneumonia. We report the case of a 3-month-old female infant who presented to the Emergency Department of Dr. H. Abdul Moeloek Regional Hospital, Bandar Lampung with shortness of breath accompanied by a productive cough and fever for 7 days prior to admission. Physical examination revealed tachypnea (respiratory rate 56 breaths/min), tachycardia (heart rate 168 beats/min), body temperature 39.0°C, and an oxygen saturation of 91% on room air. Lung auscultation revealed bilateral rhonchi and wheezing. In addition, facial dysmorphic features typical of down syndrome and a continuous murmur in the left subclavicular area were found. Chest radiography demonstrated diffuse peribronchial infiltrates with bilateral patchy opacities, suggestive of bronchopneumonia. The patient was diagnosed with bronchopneumonia, down syndrome, and patent ductus arteriosus. Management included supportive therapy, intravenous antibiotics (ampicillin–sulbactam and gentamicin), and diuretics (furosemide). The patient’s clinical condition gradually improved, and the patient was discharged in good condition. This case highlights the increased susceptibility of infants with down syndrome to bronchopneumonia, including the potential presence of congenital heart disease as a comorbidity that may worsen the patient's clinical condition. A comprehensive management approach, including pharmacological and nonpharmacological therapies, as well as early evaluation of comorbidities, is crucial to improve patient outcomes.
Orbital Apex Syndrome in an Uncontrolled Diabetes Mellitus Patient: Case Report Astriani Rahayu; Olivia Putri Chairunnisa; Muhammad Yusran
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1664

Abstract

Orbital Apex Syndrome (OAS) is a rare and severe neurological condition characterized by dysfunction of multiple cranial nerves, including II, III, IV, V1, and VI, which can rapidly progress and lead to permanent vision loss. This report describes a case of a 63-year-old male with uncontrolled diabetes mellitus, hypertension, and gout arthritis who presented with left periorbital pain, swelling, redness, followed by vision loss and ophthalmoplegia. Clinical examination revealed no light perception, severe ptosis, proptosis, reduced corneal sensation, and a relative afferent pupillary defect in the left eye. Laboratory findings showed leukocytosis and markedly elevated HbA1c levels. Brain computed tomography demonstrated opacification of the left ethmoid and sphenoid sinuses with enhancement at the left orbital apex, supporting the diagnosis of OAS secondary to bacterial sinusitis. Despite prompt clinical evaluation and planned further imaging, the patient’s systemic condition rapidly deteriorated, leading to multi-organ failure and death before neurological improvement could be achieved. This case highlights the aggressive course of OAS in immunocompromised individuals, particularly those with poorly controlled diabetes. Inflammation and edema at the orbital apex can cause compression of multiple cranial nerves, resulting in visual impairment, ophthalmoplegia, and sensory deficits. Early recognition of symptoms, rapid diagnosis, and immediate multidisciplinary management, including targeted antimicrobial therapy and strict glycemic control, are essential to prevent irreversible complications and improve outcomes. OAS secondary to sinusitis should be strongly considered in patients presenting with painful ophthalmoplegia and visual loss, especially in those with significant metabolic comorbidities.
Sebuah Aspek Sosial dan Stigma pada Anak dengan Epilepsi : Sebuah Literature Review Amti Miftakhur Rizki; Roro Rukmi Windi Perdani; Linda Septiani; Anggi Setiorini
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1765

Abstract

Epilepsy in children not only results in neurological impairments but also carries a significant psychosocial burden, with social stigma emerging as a major challenge affecting quality of life. This literature review aims to explore the forms of stigma, social impacts, contributing factors, and strategies to mitigate stigma in children with epilepsy by analyzing published research. The literature search was conducted through PubMed, Google Scholar, and Scopus, focusing on articles published between 2020 until 2025. Findings from the review indicate that stigma is experienced by approximately one-third of children and adolescents with epilepsy (34%–35.6%), showing consistent patterns across countries such as Tiongkok, Uganda, and Turki. Stigma is significantly correlated with increased psychological distress and reduced self-esteem. Factors such as lack of formal education (62% stigma rate in Uganda), low family income, and higher seizure frequency were found to exacerbate stigma levels. The impact of stigma also extends to parents, contributing to health fatalism the belief that health outcomes are predetermined and cannot be changed. However, physical activity has been identified as a mediating factor that can reduce the negative psychological consequences of stigma. Overall, stigma represents a universal issue that adversely affects the mental health of children with epilepsy and their families. A holistic approach combining seizure control with psychosocial interventions including public education, school-based support, and promotion of physical activity is essential to combat stigma and improve quality of life.
Luka Bakar: Epidemiologi, Patofisologi Dan Faktor Faktor Yang Mempercepat Penyembuhannya Muhamad Djamil Alviando Arja; Syazili Mustofa
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1771

Abstract

Burn injuries are a type of injury that can be life-threatening and cause extensive tissue damage, requiring proper treatment to prevent complications and accelerate healing. The healing process of burn injuries involves complex biological mechanisms that are influenced by various factors, including inflammatory mediators, immune cells, and tissue components. This study aims to examine the epidemiology of burns, explain the pathophysiological process, and identify factors that can accelerate healing. The research method used is a literature review by searching scientific articles from PubMed, ScienceDirect, Google Scholar, and the Cochrane Library using keywords related to burn injury, pathophysiology, wound healing, and healing factors. The review results show that burns are more common in the productive age group, with the most common causes being fire, hot water, and electric current. The pathophysiology of burns includes the phases of hemostasis, inflammation, proliferation, and remodeling, all of which are influenced by the complex interaction of various cellular and molecular mediators. Several factors have been proven to accelerate wound healing, such as the active compounds in tobacco (flavonoids, tannins, saponins, and alkaloids), adequate nutrition, proper wound care management, and the patient's overall health condition. Understanding the epidemiology, pathophysiology, and healing factors of burn wounds is crucial for improving patient management quality and can serve as the basis for developing more effective and safer therapies.
Comparison of Conventional and Modern Extraction Methods on the Antibacterial Activity of Natural Products Aisyah Ramadhani Paduan Ratu; Syazili Mustofa; Giska Tri Putri; Hendri Busman
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1774

Abstract

Indonesia memiliki keanekaragaman hayati yang kaya, dan banyak spesies tumbuhan yang dapat dimanfaatkan sebagai agen antibakteri. Pemilihan metode ekstraksi diduga memengaruhi efektivitas antibakteri. Artikel ini bertujuan untuk membandingkan efektivitas metode ekstraksi konvensional dan modern dalam menghasilkan hasil optimal dan aktivitas antibakteri. Studi ini dilakukan dengan menggunakan pendekatan tinjauan sistematis. Penelaahan literatur menghasilkan 27 studi yang memenuhi kriteria inklusi. Metode konvensional yang paling umum diterapkan meliputi maserasi dan sokletasi, sedangkan teknik modern yang diidentifikasi meliputi ekstraksi berbantuan gelombang mikro (MAE), ekstraksi berbantuan ultrasonik (UAE), dan ekstraksi fluida superkritis (SFE). Bukti yang ditinjau menunjukkan bahwa metode ekstraksi modern mampu menghasilkan hasil yang lebih tinggi dalam durasi yang lebih singkat dibandingkan dengan teknik konvensional. Lebih lanjut, aktivitas antibakteri tertinggi juga dilaporkan pada ekstrak yang dihasilkan melalui metode modern. Meskipun demikian, beberapa studi menunjukkan bahwa metode konvensional masih dapat menghasilkan aktivitas antibakteri yang kompetitif, tergantung pada pilihan pelarut dan karakteristik fitokimia bahan tanaman. Secara keseluruhan, metode ekstraksi modern menawarkan peningkatan efisiensi dan potensi untuk meningkatkan aktivitas antibakteri, namun pemilihan metode yang ideal harus mempertimbangkan sifat bahan baku, senyawa target, dan aplikasi yang dimaksud.
Hubungan Disfungsi Endotel dengan Preeklamsia Gejala Pemberat Angelie Cahya Putri; Nurul Islamy; Anisa Nuraisa Jausal; Suharmanto Suharmanto
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1777

Abstract

Preeclampsia with severe features is a major pregnancy complication contributing substantially to maternal and perinatal morbidity and mortality worldwide. This condition primarily arises from impaired placentation that leads to placental hypoperfusion and the release of anti-angiogenic factors such as sFlt-1 and soluble endoglin, which suppress pro-angiogenic activity of VEGF and PlGF, ultimately triggering systemic endothelial dysfunction. This review aims to analyze the relationship between endothelial dysfunction and the pathophysiological mechanisms of severe preeclampsia through current scientific literature. A narrative literature review was conducted, examining clinical and molecular studies related to angiogenesis, oxidative stress, inflammation, and biomarkers influencing disease progression. The findings indicate that angiogenic imbalance, increased oxidative stress, inflammatory activation, and hemodynamic alterations are key drivers of endothelial injury, resulting in hypertension, proteinuria, edema, and multi-organ involvement. Additionally, the sFlt-1/PlGF ratio is identified as a strong predictor of disease severity and progression toward severe preeclampsia. The discussion highlights that deeper understanding of endothelial mechanisms provides promising pathways for developing early screening tools and targeted therapeutic strategies. Thus, endothelial dysfunction represents a central component in the pathogenesis of severe preeclampsia and remains critical for improving detection and clinical management.
Infeksi Protozoa Usus Pada Anak Sekolah Dasar Di Indonesia: Tinjauan Naratif Tentang Pengetahuan Dan Faktor Resiko Ipan Jeremia Manik; Anisa Nuraisa Jausal; Endah Setyaningrum; Jhons Fatriyadi Suwandi
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1782

Abstract

Intestinal protozoan infections are a prevalent public health problem among primary school children in Indonesia, contributing significantly to acute and chronic diarrhoea, malnutrition, and anaemia, which ultimately reduce cognitive performance and learning ability. This literature review aims to identify patterns of knowledge, hygiene behaviour, and environmental and socio-economic factors that serve as key risk predictors for intestinal protozoan infections in this population. Various cohort and cross-sectional studies in Indonesia highlight Giardia duodenalis, Entamoeba histolytica/dispar, and Blastocystis spp. as the dominant pathogens, with the highest prevalence in areas with poor sanitation, limited access to clean water, and high population density. Behavioural factors include a lack of consistency in handwashing with soap (HWS), nail hygiene, and healthy snacking habits, despite the widespread implementation of health education interventions. Multivariate analysis of the literature review indicates a synergistic interaction between low hygiene knowledge and inconsistent practices, coupled with suboptimal environmental sanitation, limited potable water infrastructure, and low socioeconomic status as key determinants. Overall, these findings emphasise the need for a multidimensional intervention approach that integrates behaviour-based education, improved sanitation infrastructure, and socio-economic support to reduce the burden of intestinal protozoan infections in primary school children in Indonesia. Further prospective research is needed to validate causality and evaluate the effectiveness of interventions.
PROTOZOA USUS SEBAGAI FAKTOR RISIKO MALNUTRISI PADA ANAK SEKOLAH DASAR: TINJAUAN LITERATUR Husaini Gustiar; Linda Septiani; Betta Kurniawan; Jhons Fatriadi Suwandi
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1783

Abstract

Intestinal protozoal infection is an important health problem among elementary school children, especially in areas with poor sanitation and high population density. Protozoa such as Giardia lamblia, Entamoeba histolytica, Cryptosporidium spp., and Blastocystis hominis can disrupt nutrient absorption, trigger chronic diarrhea, alter gut microbiota composition, and induce mucosal inflammation, which directly affects children’s nutritional status. This literature review aims to analyze the role of protozoal infections as risk factors for malnutrition by examining publications from 2020 to 2025 indexed in PubMed, Google Scholar, and ScienceDirect. The method involved selecting articles based on inclusion criteria, methodological quality, and relevance to nutritional status variables. The analysis showed that the prevalence of protozoal infections in children ranged from 3.2 percent to 62.5 percent, with wide geographic variation. Giardia lamblia was associated with stunting, with odds ratios ranging from 1.8 to 2.4. Cryptosporidium spp. contributed to wasting through recurrent chronic diarrhea. Entamoeba histolytica was related to underweight conditions. Blastocystis hominis played a role in mild nutritional deficits through subclinical inflammation and disruption of microbial balance. Behavioral factors such as lack of handwashing with soap, consumption of untreated water, fecal-oral exposure, and prolonged residence in high-risk environments increased the likelihood of malnutrition. This review concludes that intestinal protozoal infections significantly contribute to malnutrition among elementary school children through impaired absorption, chronic diarrhea, mucosal inflammation, and persistent digestive dysfunction.
Personal Hygiene dalam Pencegahan Infeksi Soil Transmitted Helminth Nayla Priyanka Dara Tsanya; Terza Aflika Happy; Betta Kurniawan; Jhons Fatriyadi Suwandi
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1795

Abstract

Soil-transmitted helminth (STH) infection is a disease caused by intestinal nematode worms transmitted through contaminated soil. The STH species that most commonly infect humans include Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. STH infection remains a global public health problem and is estimated to affect more than 1.5 billion people worldwide, particularly in developing countries with tropical and subtropical climates and inadequate sanitation conditions. Among school-aged children, STH infection is one of the most frequently encountered forms of helminthiasis due to suboptimal hygiene-related behaviors. This infection can lead to various adverse health outcomes, including impaired nutrient absorption, poor nutritional status, reduced learning ability, and delays in children’s growth and development. This literature review aims to provide an overview of the role of personal hygiene, including handwashing with soap, nail hygiene, and the use of footwear, in preventing STH infection among  children. The findings indicate that the prevalence of STH infection among children with poor personal hygiene ranges from 24% to more than 80% in several endemic areas. Children who do not wash their hands with soap are reported to have a 6–9 times higher risk of infection compared to those who practice good hygiene. Poor nail hygiene and not wearing footwear are also associated with an increased risk of infection. This literature review emphasizes that personal hygiene plays a crucial role in preventing STH infection and reinfection among children and should be strengthened as part of school-based promotive and preventive strategies.
The Efektivitas Sediaan Topikal Berbasis Tanaman Herbal terhadap Penyembuhan Luka Sayat pada Studi In Vivo: Sebuah Tinjauan Naratif: Sebuah Tinjauan Studi Hewan Coba Rijal Rahman Hakim; Syazili Mustofa; Giska Tri Putri; Hendri Busman
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1804

Abstract

Incision wounds are injuries that result in the disruption of skin tissue continuity and are at risk of infection as well as delayed healing if not managed optimally. Standard treatment often uses chemical antiseptics which risk causing irritation and resistance side effects. Indonesia has a wealth of herbal plants that have the potential to be effective wound healing alternatives. To evaluate the effectiveness of herbal-based topical preparations on incision wound healing in in vivo studies of white rats (Rattus norvegicus). This study is a narrative review conducted by searching for experimental scientific articles (True Experimental) published between 2020–2025. Inclusion criteria included in vivo studies on white rats with incision wound models, using herbal topical preparations (gels, ointments, creams), and comparing them with positive controls (standard drugs) and negative controls. Nine selected articles were analyzed descriptively. The review results showed that plants such as Papaya Stem, Jatropha curcas Leaves, Jatropha multifida Leaves, Lantana camara, Stenochlaena palustris, Shallots, Allium chinense, Lime Peel, and Taro showed significant wound healing activity. Topical preparations with optimal extract concentrations were able to match the healing speed of standard drugs and improve histopathological parameters (collagen and fibroblasts). Based on the literature review, herbal-based topical preparations are proven effective in accelerating incision wound healing in rat models and have the potential to be developed as phytopharmaceuticals.

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