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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 906 Documents
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Article Review: Congenital Nasolacrimal Duct Obstruction With Massage Therapy of The Lacrimal Sac Farraz Kanya Syahra; Rani Himayani; Putu Ristyaning Ayu Sangging
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.693

Abstract

Nasolacrimal duct obstruction is a disorder that is often found in children at the early age of birth. In most cases, the obstruction lies distal to the nasolacrimal duct as a result of a patent Hasner's valve. Epidemiological studies report that the prevalence of congenital nasolacrimal duct obstruction ranges from 5% to 20% in early childhood. Clinical manifestations that can occur as a result of this obstruction are in the form of epiphora or tears that don't drain properly resulting in accumulation and overflow of tears. In addition, symptoms that arise can be erythema on the periorbital skin, upper and lower eyelids due to irritation originating from reflex rubbing due to teardrops and discharge with inadequate drainage. This case can be given conservative therapy in the form of massage of the lacrimal sac which has been proven in many studies with favorable results. This therapy can be given in the absence of further complications such as mucocele or dacryocystitis. Massage therapy used since 1923 is the Crigler Technique. There is a new technique devised by a pediatric ophthalmologist, Philip, who provides new information based on his experience. This writing uses the article review method using several sources obtained from journals and books. This paper aims to determine the understanding and conservative management of congenital nasolacrimal duct obstruction so that the obstruction will disappear and prevent further complications.
Liquid Biopsy on Lung Cancer Fasya Az Zahra; Zhafira Rima Wanjaya; Lucky T.H Hutapea
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.740

Abstract

Pulmonology intervention has experienced rapid progress, especially in diagnosing and treating lung cancer. Pulmonology intervention itself can be defined as the science and art related to the ability to perform invasive procedures in the field of pulmonology both for diagnostic and treatment needs and for this requires additional training beyond the existing standard training programs in the field of pulmonary diseases. Diagnostic and therapeutic procedures included in pulmonary interventions are transthoracic needle aspiration (TTNA), transbronchial needle aspiration (TBNA), rigid bronchoscopy, endobronchial ultrasonography (EBUS), laser bronchoscopy, electroendobronchial surgery, argon-plasma coagulation (APC), cryotherapy, airway stenting, balloon bronchoplasty, endobronchial radiation (brachytherapy), pleuroscopy (medical thoracoscopy), photodynamic therapy, percutaneous dilated tracheostomy, transtracheal oxygen indwelling and image-guided thoracic intervention. For nodules larger (>4 cm) and peripherally located, a CT-guided percutaneous approach with transthoracic needle aspiration (TTNA) showed high sensitivity and specificity of 90% and 97%, respectively. However, this procedure has a risk of causing a pneumothorax with an incidence that varies between 17% - 33%. Furthermore, if the size of the nodule is <1.5 cm, the success rate will be smaller, namely 74.4%. Likewise with mediastinoscopy which has been a standard procedure for determining the mediastinal stage in lung cancer, even though it shows a high sensitivity of up to >90%, but the risk of causing fatal complications is injury to the large blood vessels, nerves, trachea and bronchi and esophagus. (<0.5%) and complications of pneumothorax (2.5%).
Hubungan antara Kejadian Tuberkulosis Ekstra Paru dengan Kadar Limfosit dan Monosit di RSUD Dr. H. Abdul Moeloek Provinsi Lampung periode Januari 2018-Desember 2019 Raihanah Nabilah; Putu Ristyaning Ayu Sangging; Anggraeni Janar Wulan
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.745

Abstract

Extra pulmonary tuberculosis (extra pulmonary TB) is a TB infection that attacks organs other than the lungs and is also a complication of TB. Adaptive immune response plays an important role in TB patients, one of which is the role of lymphocytes as antigen-antibody specificity and monocytes as phagocytosis of pathogens. The aim of this study was to determine the relationship between the incidence of extrapulmonary TB patients with lymphocyte and monocyte levels in RSUD dr. H. Abdul Moeloek Lampung Province. This research is a type of retrospective analytic observational study with a cross-sectional research design which was conducted in December 2020 levels in RSUD dr. H. Abdul Moeloek Lampung Province by looking at medical records for the period January 2018-December 2019. The sampling technique was consecutive sampling and calculated using the Slovin formula with a total sample of 103 patients. The analysis used is the chi square test. Central nervous system TB patients totaled 80 people who had lymphocytopenia 66 people (82.5%) and normal lymphocytes 14 people (17.5%), in TB lymphocytopenic patients there were 23 people who had lymphocytopenia 14 people (60.9%) and normal lymphocytes 9 people (39.1%). As for monocyte levels, there were 80 central nervous system TB patients with normal monocytes 50 people (62.5%) and monocytosis as many as 30 people (37.5%), in TB lymphadenitis patients there were 23 people with normal monocytes 12 people (52 .2%) and monocytosis in 11 people (47.8%). The results of the chi square test on lymphocyte levels with a value of p = 0.028 and monocyte levels with a value of p = 0.373, which means that there is a relationship between the incidence of extra pulmonary TB and lymphocyte levels and there is no relationship between the incidence of extra pulmonary TB and monocyte levels levels in RSUD dr. H. Abdul Moeloek Lampung Province.
Management of pterygium surgery: Limbal Conjunctival Autograft and Subconjunctival Amniotic Membrane Graft Reisyah Syahfira; Putu Ristyaning Ayu Sangging; Rani Himayani
Medula Vol 13 No 4.1 (2023): Medula - Edisi Spesial (Special Sense)
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i4.1.751

Abstract

Pterygium is one of the common ocular surface disorders. From two Greek words, the word "pterygium" has been derived: “pteryx” meaning wing and “pterygion” meaning fin. Usually, pterygium is asymptomatic apart from its appearance. Meanwhile, no special examination is needed to diagnose it, only a physical examination is needed using a slit lamp to diagnose this condition. A slit lamp for observing the eye using magnification and bright lighting. Medical treatment in modern times includes lubrication with artificial tear drops or decongestants to provide short-term comfort and a slight improvement in cosmetics. Topical NSAIDs, eye drop loteprednol, brings added comfort. Vasoconstrictive agents minimize redness and enhance the appearance and add antihistamines to the decongestant drops to help prevent the effect of histamine associated edema and itching. However, surgical treatment remains the preferred option. In patients with pterygium, the reasons for surgery are decreased vision due to visual axis encroachment, chronic pain, persistent inflammation, abnormal astigmatism, restrictive ocular motility, and cosmesis. Many surgical techniques have been used since past to present, though none is universally accepted because of variable recurrence rates. Some examples of surgery, namely the avulsion technique, Simple excision technique, The Bare Sclera Technique, Conjunctival Autograft, and Limbal Conjunctival Autotransplant (LCAT). However, combined between limbal conjunctival autograft with the adjunctive use of a prophylactic subconjunctival graft of the amniotic membrane can decrease the recurrence rate after surgery in an ethnically diverse population with a statistically higher risk for recurrence.
Pendekatan Holistik Pada Pria Usia 52 Tahun Dengan Tinea Cruris Melalui Pendekatan Kedokteran Keluarga di Puskesmas Rawat Inap Tanjung Sari Shoafa Marwah; Reni Zuraida
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.758

Abstract

In Indonesia, dermatophytosis is 52% of all dermatomycosis and Tinea Cruris is the most common dermatophytosis. This disease is important to be managed comprehensively so that treatment goals can be achieved. Family doctor practice are evidence based medicine by identifying risk factors, clinical problems, and patient management based on patient problems with a patient centered and family approach. This study is a case report. Primary data were obtained through history taking, physical examination, labs exam and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning to the end. Before intervention, the patient's knowledge about the disease and personal hygiene was lacking. The family's knowledge of Tinea Cruris is still low. After the intervention, there was an improvement in the knowledge score of patients and their families which increased by 50 points. A holistic management has been carried out with the approach of a family doctor, Mr. I was 52 years old with Tinea Cruris based on initial holistic diagnostics. The interventions carried out have increased patient knowledge and changed some of the behavior of patients and their families, as indicated by improvements in the final holistic diagnostic
PENATALAKSANAAN HOLISTIK KRISIS HIPERTENSI PADA PASIEN GERIATRI DENGAN SIKAP NEGATIF TERHADAP KEPATUHAN PENGOBATAN, SELF-MONITORING DAN MODIFIKASI GAYA HIDUP MELALUI PENDEKATAN KEDOKTERAN KELUARGA DI WILAYAH KERJA PUSKESMAS GEDONG AIR Cassa Victoria Regia Divandra; dr. Diana Mayasari, M.K.K
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.759

Abstract

Hypertensive crisis is a condition where systolic blood pressure is 180 mmHg and/or diastolic is 120 mmHg. Hypertension rarely causes symptoms, so it can cause other morbidities that are often not recognized. The prevalence of hypertension in Indonesia based on Riskesdas 2018 increased by 34.1% compared to 2013 which was 25.8%. Applying the principle of a family doctor approach in detecting internal and external risk factors and solving EBM (Evidence Based Medicine) based problems. This study is a Case Report. Primary data were obtained through history taking, physical examination and home visits. Secondary data were obtained from the patient's medical record. Mrs. M, 63 years old, has a chief complaint of throbbing headache since 2 days ago. Headaches are felt to be throbbing and occur throughout the day. The patient has a history of hypertension which has been diagnosed since 2017 but does not take the medicine regularly. Furthermore, interventions were carried out using poster media and daily checklists regarding symptoms, causes, risk factors, ways of controlling, complications, low-fat diet and limiting salt consumption and physical activity for people with hypertension. Management with a family medicine approach is needed for patients with Hypertensive Crisis to identify problems in various aspecs in order to support the success of therapy and improve the patient's quality of life.
PENATALAKSANAAN HOLISTIK PADA PRIA USIA DEWASA MUDA DENGAN GANGGUAN CEMAS MENYELURUH DAN KEPRIBADIAN INTROVER MELALUI PENDEKATAN KEDOKTERAN KELUARGA Mhd. Nur Ridha Asshaf; Diana Mayasari
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.765

Abstract

Anxiety disorders are a group of conditions that have characteristics in the form of excessive anxiety conditions, accompanied by behavioral, physiological, and emotional changes of the person. Behaviors found in individuals with anxiety disorders include panic for no reason, excessive and unwarranted fear of objects or living conditions, and unexplained worry. By identifying risk factors, clinical problems, and providing management to patients with the application of holistic family doctor services based on evidence-based medicine. This study is a case report. Primary data are obtained through history and physical examination. Secondary data is obtained from the patient's medical record at the Puskesmas. Assessment is carried out based on a holistic diagnosis of the beginning, process, and end of the study quantitatively and qualitatively. Assessment based on the initial holistic diagnostics, process and end of study qualitatively and quantitatively. Mr. A, 35, came in for routine control of his excessive anxiety. The results of the axial diagnosis are established Axis 1 of generalized anxiety disorder (F41.1). Axis 2 there is no diagnosis. Axis 3 there is no diagnosis.  Axis 4 patients have problems related to the social environment. Axis 5 patient GAF score 70-61.  When measured using the Penn State Worry Questionnaire, a score of 45 was obtained. Patients are intervened holistically using a family doctor approach. The patient's final diagnostic results have applied an intervention in the form of Cognitive Behavior Therapy and when remeasured using the Penn State Worry Questionnaire obtained a value of 29 which means not in a state of anxiety that interferes
PENATALAKSANAAN HOLISTIK PADA PRIA LANSIA DENGAN PENYAKIT PARU OBSTRUKTIF KRONIS EKSASERBASI AKUT DENGAN RIWAYAT MEROKOK DAN PAPARAN DEBU OKUPASI MELALUI PENDEKATAN KEDOKTERAN KELUARGA Feby Aulia Hasanah; Diana Mayasari
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.766

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and limited airflow due to airway or alveolar abnormalities that are usually caused by exposure to harmful gases or particles. In addition, COPD causes deaths related to factors of old age and exposure to harmful substances. Symptoms can worsen into acute exacerbation COPD which can lead to death. The family approach in the management of acute exacerbation COPD helps to identify influential factors both clinically, personally, and psychosocially so that the management will be more comprehensive. Family doctor practice are evidence based medicine by identifying risk factors, clinical problems, and patient management based on patient problems with a holistic approach. This study is a case report. Primary data were obtained through history taking, physical examination, labs exam and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning to the end. Prior to the intervention, the patient's knowledge of the disease he suffered was lacking, curative treatment patterns, poor diet, infrequent exercise, and cachexia. The family's knowledge of chronic obstructive pulmonary disease is still low. After the intervention, there was an improvement in the postest value of knowledge, CAT index, PSQI, 6MWD, food recall, and weight gain. After the treatment was carried out on the patient, there was a hope to an improvement in the knowledge regarding the disease, as well as an improvement in diet and physical activity patterns.
PENGARUH PEMBERIAN EKSTRAK BUAH PLUM (Prunus domestica L.) TERHADAP BERAT BADAN FETUS TIKUS PUTIH (Rattus norvegicus) Galur Sprague-dawley PADA TIKUS PUTIH (Rattus norvegicus) HAMIL YANG DIBERI PAPARAN ALKOHOL Arinda Rifana Nabillah; Rodiani Rodiani
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.771

Abstract

Alcohol is a source of free radicals that come out from outside of the body. Alcohol consumed during pregnancy can cause various teratological effects on the fetus, one of which is low birth weight (LBW). Plum as a food that contains a lot of antioxidants can prevents oxidative stress caused by alcohol. The purpose of this study was to determine the effect of giving plum (Prunus domestica L.) extract on the fetal body weight of white rats (Rattus norvegicus) Sprague-Dawley strain in pregnant white rats (Rattus norvegicus) induced by alcohol. This study used Post-test Only Control Group Design using 30 pregnant rats divided into 5 groups. The KP group was a group of rats that was not given alcohol or plum extract. The KN group was exposed to 0.27 ml/day of alcohol for days 6-15 of pregnancy. The P1group was exposed to 15% alcohol 0.27 ml/day for days 6-15 of pregnancy and plum extract 40mg/day for 21 days of pregnancy. The P2 group was exposed to 15% alcohol 0.27 ml/day for days 6-15 of pregnancy and plum extract 80 mg/day for 21 days of pregnancy. The P3 group was exposed to 15% alcohol 0.27 ml/day for days 6-15 of pregnancy and plum extract 160 mg/day for 21 days of pregnancy. Data were analyzed using One-Way ANOVA and Post Hoc-LSD tests. The One-Way ANOVA test result showed the value of p = 0.000 (p <0.05). The result of Post Hoc-LSD test showed that there are significant avegare differences in some groups except between KN and P1; P2 and P3.  Plum (Prunus domestica L.) extract had an effect on fetal body weight of white rats (Rattus norvegicus) Sprague-Dawley strain in pregnant white rats (Rattus norvegicus) induced by alcohol.
Penatalaksanaan Holistik Pasien Laki-Laki Usia 57 Tahun Dengan Low Back Pain (LBP) Melalui Pendekatan Kedokteran Yuliana; Dian Isti Angraini
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.779

Abstract

Low back pain is one of the common health problems that 50–80% of adults experience at some point in their life. The overall burden of LBP arising from ergonomic exposures at work was estimated at 21.8 million disability adjusted life years (DALYs). To apply the principles of family doctor medicine according to the problems found in patients in various aspects and carry out a holistic and comprehensive management that includes patient-centered, family approached, and community-oriented based on evidence-based medicine. This study is a case report. Primary data were obtained through autoanamnesis, physical examination and home visits, filling in family folders, completing family data, psychosocial and environmental data. Patient Mr. S, 57 years old, working as a mosque cleaner, came to Karang Anyar Primary Health Care, has a complaint of lower back pain since 2 months ago. The pain felt was like being stabbed and radiated to the patient's left leg. Initially, the patient admitted that the pain didn’t interfere with his work activities, but since the last 2 weeks before came to the Primary health care, the patient complained that the pain was getting worses and interfered with his activities. The patient was diagnosed as Low Back Pain (LBP). There are several factors that influence the patient's condition, namely internal and external risk factors. Holistic management with a family medicine approach is needed for patients with to low back pain to identify problems in various aspects in order to support the success of therapy.

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