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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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Bentuk-Bentuk Ketidakpatuhan Aturan Akademik oleh Mahasiswa Kedokteran dan Implikasinya terhadap Profesionalisme: Sebuah Tinjauan Literatur Aprilly Adlina Chalida; Vira Kamalia Niswah; Asep Sukohar; Septia Eva Lusina
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1789

Abstract

Professionalism is a fundamental value in medical education, encompassing integrity, responsibility, and adherence to academic regulations. However, medical students often encounter ethical dilemmas when personal values, social pressures, or academic demands trigger non-compliance with these rules. Such misconduct reflects challenges in developing a professional identity grounded in ethical integrity. This article presents a literature review of national and international studies published between 2020 until 2025 examining the relationship between medical ethics education, professionalism, and academic rule violations. The aim is to analyze ethical dilemmas arising from academic misconduct among medical students and to identify how ethical reflection and professionalism learning can be strengthened. The review indicates that academic dishonesty remains prevalent in various forms, including exam cheating, plagiarism, data and documentation falsification, attendance manipulation, and dishonesty in clinical practice. Contributing factors include academic pressure, heavy workload, collectivistic cultural norms, peer influence, previous cheating experiences, stress, and low moral reasoning. Dishonesty, particularly in clinical settings, can disrupt learning processes and jeopardize patient safety. Such behaviors also reflect a failure to meet the first competency area of the 2019 National Standard of Indonesian Medical Doctor Education (SNPPDI) and contradict the foundational principles of the 2012 Indonesian Code of Medical Ethics (KODEKI). Recommended strategies to address these issues include continuous ethics education, positive role modeling, clear professionalism assessment systems, psychological support, and consistent enforcement of sanctions.
Faktor Kecemasan Terhadap Ujian pada Mahasiswa Azzahra Fadhilla Amelia; Oktafany Oktafany; Shinta Nareswari; Oktadoni Saputra
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1798

Abstract

Test anxiety is a common psychological condition experienced by university students and can negatively affect academic performance and psychological well-being. This study aimed to examine the causes, manifestations, and impacts of test anxiety among students through a literature review approach. Relevant literature was obtained from Google Scholar and national and international scientific databases using the keywords “test anxiety,” “exam anxiety,” “students,” and “academic performance.” A total of 23 articles published between 2010 and 2025 met the inclusion criteria and were analyzed narratively. The findings revealed that test anxiety is influenced by various factors, including academic demands, social pressures, individual characteristics, and learning environment conditions. One of the reviewed studies by Bhuwana (2025) reported that 98.5% of students (197 of 200 respondents) experienced anxiety during the Objective Structured Clinical Examination (OSCE), with the primary causes being limited examination time (21%), the large amount of material to be studied (20.5%), and difficulties maintaining concentration or experiencing forgetfulness during examinations (19.5%). Manifestations of test anxiety include physical, cognitive, and behavioral symptoms such as increased heart rate, excessive worry, negative thoughts, impaired concentration, and procrastination. These symptoms may contribute to lower academic achievement, reduced learning motivation, increased stress levels, and emotional exhaustion. Therefore, effective stress management strategies and institutional support are essential to help students cope with examination-related stress, improve academic performance, and maintain psychological well-being through supportive learning environments and accessible counseling services.
Article Review: Personal Hygiene sebagai Faktor Risiko Infeksi Protozoa Usus pada Anak Sekolah Luthfi Shiba Andana; Suryadi Islami; Betta Kurniawan; Jhons Fatriyadi Suwandi
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1809

Abstract

Intestinal protozoa infections remain a significant public health problem, particularly among school children in developing countries such as Indonesia. These infections contribute substantially to morbidity related to gastrointestinal disorders, including both acute and chronic diarrhea. Transmission of intestinal protozoa generally occurs through the fecal–oral route and is strongly influenced by personal hygiene practices in daily life. This article aims to determine the association between personal hygiene and the risk of intestinal protozoa infections among elementary school children through a literature review method. A literature search was conducted in the PubMed and Google Scholar databases using the keywords personal hygiene, intestinal protozoa infections, and school children, covering publications from 2011 to 2025. Relevant articles were selected and critically analyzed to identify the relationship between personal hygiene and the incidence of intestinal protozoa infections. The findings indicate that poor personal hygiene, particularly the habit of not washing hands with soap before meals and after defecation, inadequate nail hygiene, nail biting, and poor food and beverage hygiene, is significantly associated with an increased risk of intestinal protozoa infections. Several studies also reported a statistically significant higher risk of infection among children with poor personal hygiene compared to those with good hygiene practices. In conclusion, personal hygiene is a significant risk factor for intestinal protozoa infections.
Analisis Forensik terhadap Tahapan Pembusukan sebagai Indikator Post-Mortem Interval: Tinjauan Pustaka Zahra Dewi Hasna Difa; Anggela; Septia Eva Lusina
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1816

Abstract

Decomposition is a complex biological process that occurs after death as a result of the interaction between autolysis, microbial activity, and environmental influences. In forensic medicine, the analysis of decomposition stages plays an important role in estimating the post-mortem interval (PMI), particularly in cases of unnatural death and advanced body decomposition. Open wounds and traumatic injuries are known to accelerate decomposition due to increased microbial exposure and insect activity within body tissues. This literature review aims to discuss the physiological and morphological mechanisms of decomposition, factors affecting the rate of body degradation, and recent advances in modern approaches for PMI estimation. The study was conducted using a literature review method through article searches in PubMed, ScienceDirect, and Google Scholar databases using the keywords “forensic”, “decomposition”, “medicolegal”, “thanatology”, and “post-mortem interval”. The included literature consisted of national and international articles published between 2020 and 2025, along with several major forensic medicine textbooks. The review demonstrated that decomposition begins with the failure of cellular homeostasis, leading to tissue autolysis followed by putrefaction caused by microbial activity. The rate of decomposition is influenced by several factors, including environmental temperature, humidity, body location, insect activity, body mass, and the presence of open wounds. Multidisciplinary approaches integrating morphological observation, histopathology, forensic entomology, thanatomicrobiome analysis, and molecular biomarkers have been shown to improve the accuracy of PMI estimation compared to the use of a single method. Therefore, understanding the stages of decomposition and the factors influencing them is essential in supporting medical and criminal investigations as well as improving the accuracy of post-mortem interval interpretation.
Hubungan Antara Determinan Sosial Dan Pengetahuan Dengan Upaya Pencegahan Penularan Penyakit Tuberkulosis (Tbc) Di Puskesmas Panjang Kota Bandar Lampung Jefri Irawan; Dyah Wulan Sumekar Rengganis Wardani; Betta Kurniawan
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1820

Abstract

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. The primary symptom of TB is a cough with phlegm that lasts for two weeks or more. The general objective of this study was to determine the relationship between social determinants and knowledge of TB transmission prevention efforts at Panjang Community Health Center, Bandar Lampung. This was an analytical cross-sectional study, with samples comprised of TB patients registered at Panjang Community Health Center between December and January 2022 and meeting the inclusion criteria. The sampling technique used total sampling. Data were obtained using a questionnaire. Data were analyzed using the Chi-square test. Low income, low education (elementary and junior high school), have a job, belong to the lower social class group, are male and have good knowledge. The results of statistical tests show a significant relationship between income and efforts to prevent TB transmission (p-value = 0.034), There is no significant relationship between education level (p-value = 0.076), employment (p-value = 0.079) and efforts to prevent TB transmission, and there is a significant relationship between class (p-value = 0.026), gender (p-value = 0.017), knowledge (p-value = 0.000) and efforts to prevent TB transmission. There is a relationship between social determinants and knowledge and efforts to prevent tuberculosis (TB) transmission at Panjang Community Health Center, Bandar Lampung City.
Profil Pasien Kanker Kolorektal di RSUD Dr. H. Abdoel Moeloek Periode Januari 2022-Desember 2024 Muhammad Satria; Marcella Andinatania
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1826

Abstract

Colorectal cancer is a malignancy of the colon or rectum and is one of the leading causes of cancer-related morbidity and mortality worldwide. It ranks as the third most commonly diagnosed cancer, with more than 1.9 million new cases annually, and as the second leading cause of cancer-related death, accounting for approximately 935,000 deaths each year. In Indonesia, the incidence of colorectal cancer continues to rise, reaching 12.4 cases per 100,000 population. The majority of cases are diagnosed at an advanced stage and are often accompanied by metastatic disease. This trend is primarily attributed to inadequate early detection and screening programs, resulting in limited therapeutic options and poorer prognosis. This study aims to describe the profile of colorectal cancer patients who underwent evaluation and management at RSUD Dr. H. Abdoel Moeloek from January 2022 to December 2024. Methods: This study employed a retrospective descriptive design involving 100 colorectal cancer patients at Dr. H. Abdoel Moeloek General Hospital from January 2022 to December 2024 who met the inclusion criteria. Variables assessed included sex, age, tumor location, and histopathological findings. Data were presented in frequency and percentage distributions. Results: A total of 56 males (56%) and 44 females (44%) were included in this study, with the majority aged 45–50 years (39%). The rectum was the most common tumor location (61%), and adenocarcinoma was the predominant histopathological type (82%).
Acute Decompensated Heart Failure pada Pasien Wanita 41 Tahun dengan Chronic Kidney Disease Stadium V: Laporan Kasus Amanda Dewi Rosita; Fajar Yuwanto
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1832

Abstract

Acute decompensated heart failure (ADHF) is a cardiovascular emergency that frequently occurs in patients with advanced chronic kidney disease (CKD) due to impaired fluid regulation, electrolyte imbalance, and cardiorenal syndrome. This condition increases the risk of acute pulmonary congestion, severe metabolic disturbances, and reduced tissue perfusion, which may be life-threatening. A 41-year-old woman with stage V CKD presented with progressive acute dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and decreased activity tolerance for several days before hospital admission. Physical examination revealed tachypnea, hypertension, peripheral edema, bilateral basal crackles, and elevated jugular venous pressure. Laboratory findings showed severe anemia, hyperkalemia, metabolic acidosis, and elevated urea and creatinine levels, while chest radiography demonstrated cardiomegaly and pulmonary congestion. Electrocardiography and echocardiography supported the presence of cardiac dysfunction that aggravated the clinical condition. Based on clinical and diagnostic findings, the patient was diagnosed with acute decompensated heart failure with pulmonary congestion in the setting of stage V CKD. Management included oxygen therapy, fluid restriction, intravenous loop diuretics, nitroglycerin, correction of metabolic abnormalities, and packed red cell transfusion. Due to persistent fluid overload and severe metabolic disturbances unresponsive to conservative treatment, emergency hemodialysis was planned as definitive therapy. ADHF in patients with stage V CKD is a serious condition that requires early detection, comprehensive evaluation, and multidisciplinary management. Renal replacement therapy plays a crucial role in improving hemodynamic stability, reducing fluid burden, and preventing recurrent decompensation.
Validitas dan reliabilitas instrumen patient health questionnaire-9 (PHQ-9) untuk skrining depresi pada pasien dengan penyakit ginjal terminal kronik stadium 5 (gagal ginjal terminal) Denny Emilius; Tirta Darmawan Susanto; Marshell Timotius; Nicolaski Lumbuun
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1838

Abstract

Depression is one of the most common comorbidities among patients with stage 5 chronic kidney disease (CKD) and has a significant impact on quality of life, treatment adherence, morbidity, and mortality. Early detection of depression in this population is essential. However, diagnosis is often challenging due to the overlap between somatic symptoms of advanced CKD and depressive symptoms. This overlap may lead to underdiagnosis and delayed intervention. Therefore, a simple, valid, and reliable screening instrument is needed for routine clinical practice. This study aimed to evaluate the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression in patients with stage 5 CKD. A descriptive-analytic design was used, focusing on psychometric testing of the instrument. Item validity was examined using item–total correlation analysis, while internal consistency reliability was assessed using Cronbach’s alpha coefficient. The results showed that item–total correlation values ranged from 0.524 to 0.886, indicating good validity for all questionnaire items. Reliability testing produced a Cronbach’s alpha value of 0.928, demonstrating excellent internal consistency. These findings indicate that the PHQ-9 is a valid and reliable instrument for screening depression in patients with stage 5 CKD. The implementation of PHQ-9 in clinical settings can support healthcare providers in early identification of depressive symptoms, enable timely psychosocial interventions, and contribute to improved quality of life and clinical outcomes for patients with advanced chronic kidney disease in both primary and referral healthcare facilities.
Hubungan Antara Profil Pemakaian Sepatu dengan Keluhan Plantar Heel Pain (PHP) pada Karyawan Wanita di Rumah Sakit Bhayangkara Polisi Daerah Lampung Nurlaili Wardah Humairoh; Helmi Ismunandar; Sutarto; Rani Himayani
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1843

Abstract

Plantar heel pain is a common musculoskeletal complaint among female workers, particularly in workplaces that require prolonged standing, walking, and the use of formal footwear. Biomechanical factors such as duration of shoe use, heel height, and body mass index are believed to increase mechanical stress on the plantar fascia and contribute to heel pain, yet evidence in Indonesia remains limited. This study aimed to examine the relationship between shoe-wearing profiles and body mass index with plantar heel pain among female employees at Bhayangkara Hospital, Lampung Regional Police, using an analytic observational design with a cross-sectional approach. A total of 120 participants were selected through purposive sampling. Plantar heel pain was assessed using the Plantar Fasciitis/Disability Scale questionnaire, body mass index was obtained through anthropometric measurements, and heel height was measured directly. Data were analyzed using univariate and bivariate methods with Spearman correlation tests at a significance level of p < 0.05. The results showed a relatively high prevalence of plantar heel pain among participants, with a significant association between duration of shoe use and plantar heel pain, while heel height and body mass index were not significantly associated, indicating that prolonged shoe use is the main contributing factor in practice.
Spondilitis Tuberkulosis: Sebuah Laporan Kasus Rifka Putri Dewi; Fitriyani Fitriyani
Medula Vol 16 No 4 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i4.1845

Abstract

Tuberculous spondylitis is the most common form of musculoskeletal tuberculosis, accounting for approximately 40–50% of all musculoskeletal tuberculosis cases. The disease may lead to vertebral body destruction, kyphotic deformity, paravertebral abscess formation, and neurological deficits resulting from spinal cord compression. Diagnosis is often delayed because the initial manifestations are nonspecific and may occur in the absence of classic constitutional symptoms such as fever, chronic cough, weight loss, or night sweats. This case report aims to highlight the importance of magnetic resonance imaging (MRI) in establishing the diagnosis of tuberculous spondylitis in a patient presenting primarily with neurological manifestations without systemic symptoms. A 44-year-old man presented with numbness and a burning sensation in the left chest for 20 days, accompanied by a progressive thoracolumbar gibbus deformity that had developed over one year. Neurological examination revealed left lower extremity weakness with a motor strength grade of 3/5. The patient denied fever, chronic cough, weight loss, night sweats, or a history of tuberculosis contact. Laboratory investigations demonstrated an elevated erythrocyte sedimentation rate, while chest radiography was unremarkable. Thoracic MRI revealed multiple compression fractures involving the T6–T8 vertebrae, bone marrow edema, bilateral epidural and paravertebral abscesses, and intradiscal fluid at the T7–T8 level, findings highly suggestive of tuberculous spondylitis. The patient was scheduled for surgical decompression followed by long-term anti-tuberculosis therapy. This case highlights that tuberculous spondylitis may present predominantly with progressive neurological deficits despite the absence of constitutional symptoms and normal chest radiographic findings. Early MRI evaluation plays a crucial role in prompt diagnosis and timely management, thereby preventing irreversible neurological complications.

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