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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 972 Documents
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Risiko Terjadinya Adiksi Internet pada Remaja dengan Gangguan Pemusatan Perhatian dan Hiperaktivitas: Sebuah Laporan Kasus Berbasis Bukti Dewanto Andoko; Darien Alfa Cipta; Tirta Darmawan Susanto
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.833

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) constitutes a prominent neurodevelopmental disorder frequently observed in childhood, characterized by three core symptoms encompassing inattention, hyperactivity, and impulsivity. Notably, the persistence of ADHD can extend from childhood into adolescence and even adulthood. Importantly, it has been noted that in nearly half of cases where ADHD endures beyond childhood and into the later stages of life, there is a substantial elevation in the risk of various addictive behaviors, encompassing alcohol, nicotine, other substances, and behavioral addictions like internet addiction, in comparison to individuals without a history of ADHD. Against this backdrop, the present literature exploration is specifically focused on discerning the influence of childhood ADHD on the propensity for internet addiction in adolescence and young adulthood. To comprehensively address this query, a meticulously structured search was conducted across several renowned databases including Pubmed, EBSCOhost, Scopus, and ProQuest. The search parameters were thoughtfully adapted and refined to align seamlessly with the clinical question, ensuring the retrieval of pertinent and valuable information. Among the amassed results, one article was identified as particularly pertinent, serving as a concise compilation of the most recent insights into the intricate interplay between ADHD and internet addiction. The outcomes derived from this thorough meta-analytical review not only establish a substantial association between childhood and adolescent ADHD and an augmented susceptibility to internet addiction in later years but also provide quantification through a notable Crude Odds Ratio (COR) of 3.76 (95% CI: 2.75, 5.15) and an Adjusted Odds Ratio (AOR) of 2.51 (95% CI: 2.09, 3.02) following meticulous confounder adjustments. Furthermore, a striking observation emerges wherein adolescents grappling with internet addiction manifest intensified ADHD symptoms, corroborated by evident elevation in Abbreviated Conners Rating Scale scores relative to their non-addicted counterparts. Collectively, these findings underscore the imperative of recognizing and addressing the heightened risk of internet addiction among adolescents with a history of ADHD and spotlight the pressing need for nuanced interventions and comprehensive support strategies.
Polytrauma dan Injury Severity Score (ISS) Gigaramadan Sema; Helmi Ismunandar; Rani Himayani; Risti Graharti
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.834

Abstract

Polytrauma is trauma that occurs at several areas on the body, followed by decline in physiological function which has the potential to cause multiple organ dysfunction and death in patients. Initial assessment of polytrauma is important to identify injuries that require initial treatment, determine the management of these injuries, and assess the patient's prognosis. There are several scoring systems that can be used to assess polytrauma injuries. Abbreviated Injury Scale (AIS) can be used to assess the severity of the injury and the probability of death of the patient. The Injury Severity Score (ISS) is a scoring system that assesses the three most severe injuries from six body regions. New Injury Severity Score (NISS) is an update from ISS; assessment of the three most severe injuries to the body regardless of body region. These assessment methods can help the trauma care system to better prevent complications and death in polytrauma patients.
Penatalaksanaan Pneumonia dengan Pendekatan Kedokteran Keluarga: Sebuah Laporan Kasus Afrileo Vebi Eka Utama; Wianti Soeryani Soedjal; Veli Sungono
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.835

Abstract

Abstract Pneumonia is an acute inflammation of the lung parenchyma caused by microorganisms (bacteria, viruses, fungi, parasites, protozoa), not caused by Mycobacterium tuberculosis. Pneumonia has clinical symptoms such as fever, cough, shortness of breath, chest pain, ronkhi, wheezing and decreased breathing sounds. The diagnosis of pneumonia itself is based on anamnesis, physical examination, and supporting examinations such as laboratory tests and thoracic photographs. This case report applies a holistic and comprehensive family medicine approach and prioritizes patient centered, family focused and community oriented management. This case study was obtained through history taking, physical examination and home visits. This case report describes a 17-year-old male with clinical symptoms of pneumonia, namely fever, cough and shortness of breath with laboratory examination found leukocytosis and radiology obtained infiltrates in both lungs with the impression of pneumonia. In this case, comprehensive management has also been carried out, namely patient centered, family focused and community oriented.
Pleural Mesothelioma: Asbestosis-Related Pathogenesis: Mesothelioma Pleura : Patogenesis Terkait Asbestosis Adityo Wibowo
Medula Vol 13 No 6 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i6.836

Abstract

Pleural mesothelioma is a malignancy that develops from the pleura's mesothelial layer. Pleural mesothelioma is classified into three distinct categories of cells, which have different prognoses. This condition can be caused by different kinds of sources, one of which is chronic exposure to asbestos that enters the airways and causes asbestosis. Asbestos is the main carcinogen related to pleural malignancy. In most cases of pleural mesothelioma, asbestos exposure occurs over a 30-year period. The accumulation of asbestos fiber in the pleural cavity will induce chronic inflammation and abnormal tissue repair. Asbestos is a silicate mineral found in various forms, including chrysotile, crocidolite, amosite, anthophyllite, actinolite and tremolite. Asbestosis can be developed through both direct and indirect exposure. The most frequent causes of asbestosis and pleural mesothelioma are direct asbestos exposure at the workplace and domestic exposure around the environment. The greater risk factors for pleural mesothelioma are directly correlated to high concentration and long duration of exposure. Further study is needed to understand the pathophysiology and immunological pathways that lead to the development of pleural mesothelioma from asbestosis. Significant amounts of exposure have been associated with increasing risk factors for pleural mesothelioma.
Penatalaksanaan Holistik Gagal Jantung Kongestif Dan Hipertensi Pada Wanita Usia 65 Tahun Melalui Pendekatan Kedokteran Keluarga Isabel Theodora; Sahab H Sibuea
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.837

Abstract

Heart disease is the highest cause of death worldwide for the last 20 years. The prevalence of CHF in Indonesia according to Riskesdas in 2018 was 1.5%, while the prevalence in Lampung in 2013 was estimated at around 5560 patients. Hypertension is a global health problem with the biggest morbidity rate in the world. In Indonesia, the estimated number of cases of hypertension is 63,309,650 people, while in Lampung,  is around 6,216,638 cases. This research aims to implementing a holistic and comprehensive approach of a family doctor according to the problems experienced by patients and patient management based on evidence based medicine, patient centered, family oriented and community oriented. Primary data was obtained through autoanamnesis, physical examination and home visits. Secondary data was obtained from patient's medical record. Assessment based on a holistic diagnosis from the beginning of the process and the final study qualitatively and quantitatively. In results patient Mrs. H, 65 years old, came to the Health Center to ask for a routine drug referral, the patient had complaints of congested breath when doing strenuous activities and improved while resting. The patient was diagnosed with CHF 10 years ago and hypertension 20 years ago. Patient has a high salt and fat diet, low physical activity, lack of knowledge and family support regarding the patient's disease and treatment. Furthermore, the management of patients is carried out according to the theory and related journals. At the time of evaluation, patients can follow the recommendations for both pharmacological and non-pharmacological therapy. Holistic management can increase knowledge and change the patient’s behavior. The role and support of the family are needed in the treatment of the patient in order to drugs consumption monitoring.
Perbandingan antara Bone Patellar Tendon Bone Autograft dengan Hamstring Tendon Autograft pada Rekonstruksi Anterior Cruciate Ligament : Sistematik Review Fuad Iqbal Elka Putra; Hanifah Hanum
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.838

Abstract

Anterior Cruciate Ligament is a ligament injury is the most common injury around knee and divided into partial tear or complete tear. The aim of this study is to compare the outcome between Bone Patellar Tendon Bone (BPTB) autograft versus Hamstring Tendon (HT) for ACL reconstruction. The outcomes were assessed with International Knee Documentation Committee (IKDC), Lysholm score, Tegner activity scale and donor site morbidity. This systematic review uses Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were searched for studies that compared functional outcomes of ACL reconstruction between BPTB autograft versus hamstring tendon autografts with a minimum 6 months follow-up. We analayzed 8 studies that compare outcomes of BPTB autograft (862 patient) vs HT autograft (4.991 patient). There was no significant differences in a patient underwent ACL reconstruction with BPTB autograft vs HT autograft the outcomes by IKDC score, Lysholm score and Tegner activity scale. In one study showed was significant in donor site morbidity where BPTB autograft makes postoperative pain during kneeling higher than HT autograft in 10 years follow up (BPTB 64%, HT 33%, p value 0.019) and the prevalence in pain during squatting BPTB was higher than HT autograft in 10 years follow up (BPTB 55%, HT 29%, p value 0.046). This study concluded there was no significant difference of comparison between BPTB autograft and HT autograft group after ACL reconstruction. Donor site morbidity most commonly occured in BPTB group than HT gorup. Keywords : Anterior Cruciate Ligament Injury, autograft, bone patellar tendon bone, hamstring tendon
Kompartemen Sindrom Ekstremitas Bawah : Diagnosis, Anatomi dan Tatalaksana Fuad Iqbal Elka Putra; Hanifah Hanum
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.839

Abstract

Abstract Acute compartment syndrome (ACS) is an orthopaedic emergency that can threaten life and limb. A comprehensive understanding of anatomy, along with proper diagnosis and treatment, plays a crucial role in preventing lower limb ischemia. We conducted an updated review of the literature using digital databases such as PubMed, Springer Link, and Science Direct. A clinical diagnosis of compartment syndrome must be followed by surgical decompression. Clinical signs of ACS include the 6 P’s: pain, poikilothermia, pallor, paresthesia, pulselessness, and paralysis. This literature review revealed that some studies showed fasciotomy is an emergency surgical procedure performed to decompress a compartment. The most common and validated method to measure limb intracompartment pressure (ICP) is by using the handheld Stryker Intra-Compartmental Pressure (STIC) Monitor System. Lower leg compartment divided into anterior, lateral, superficial posterior and deep posterior compartment, inside of compartment there are muscle, nerve, artery and vein. After diagnosis compartment syndrome we should continue to surgical decompression by fasciotomy in two methode medial incision (deep and superficial posterior compartment) and lateral incision (anterior and lateral compartments). As a conclusion early recognition and diagnosis of conditions of compartment syndrome are essential in preventing lower limb ischemia. Keywords: acute compartment syndrome, intracompartmental pressure, lower extremity
Penatalaksanaan Pasien Laki-Laki Usia 59 Tahun dengan Hipertensi Urgensi Melalui Pendekatan Kedokteran Keluarga Zulia Yasminanindita Fahmi; Azelia Nusadewiarti
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.843

Abstract

Hypertension is one of the biggest causes of morbidity in the world, often referred to as the silent killer. The prevalence of hypertension in Indonesia in 2018 based on Basic Health Research (Riskesdas) with a population of approximately 260 million increased by 34.1% compared to 2013. According to data from the Lampung Provincial Health Office in 2021, the prevalence of hypertension in South Lampung is 24.8% of the total population aged ≥ 15 years is 762,894 people. The purpose of this case report is to implement holistic and comprehensive family doctor services by identifying risk factors, clinical problems, and patient management based on Evidence Based Medicine with a patient centered and family focused approach. This study is a case report. Primary data were obtained through autoanamnesis, physical examination, and home visits. Secondary data were obtained from the patient's medical record. Mr. M, 59 years old, had a chief complaint of difficulty sleeping since 1 day ago. Internal risk factors in the patient are male gender, 59 years old, a history of smoking since 39 years ago, a mother with a history of hypertension, a curative treatment pattern, and the patient's lack of knowledge about: hypertension classification where the patient does not know he is included in hypertension urgency; risk factors that cause the disease; complications that may occur; how to control the disease. External risk factors in the patient are: lack of family knowledge about the patient's disease, risk factors, complications, and prevention and control of the disease in the family and economic stress due to crop failure losses. Diagnosis and management of patients have been carried out holistically, patient centered, family focused, and community oriented. Changes in the clinical, knowledge, and behavior of patients and their families occurred after the intervention was given.
Pola Pengobatan Coronavirus Disease-19 (COVID-19) dengan Komorbiditas Tuberkulosis Paru Pada Pasien Rawat Inap RSUD Al-Ihsan Bandung Tahun 2020 Chanief Hassan Widjaja; Novita Carolia; Intanri Kurniati
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.846

Abstract

Coronavirus disease-19 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and attacks the respiratory tract as its main target. Pulmonary tuberculosis (TB) is a disease with high incidence in Indonesia and transmitted through the respiratory tract and attacks lung organs same as COVID-19, allowing the possibility for co-infection of the two microorganisms simultaneously. The purpose of this study was to determine the pattern of treatment for COVID-19 and pulmonary TB at inpatient care facility Al-Ihsan Hospital Bandung. This study was an observational descriptive study with retrospective approach. The number of samples were 15 who had COVID-19 and pulmonary tuberculosis, taken from March until December 2020 at inpatient care facility Al-Ihsan Hospital Bandung. The sample taken using the total sampling technique, then analyzed using univariate test.There are five types of drugs found in this study, which is antibiotics, anti-tuberculosisdrugs, antivirals, corticosteroids, and vitamins. The types of antibiotics used were azithromycin (80%), levofloxacin (80%), ceftazidime (13.33%), ofloxacin (6.67%), and cefotaxime (6.67%). Anti-tuberculosis drugs with fixed dose combination (FDC) were given to 13 samples (86.67%). The types of antiviral drugs used were isoprinosine (80%), oseltamivir (13.33%), and chloroquine (6.67%). The types of corticosteroid drugs used were dexamethasone (33.33%) and bethametasone (6.67%). Types of vitamins used were vitamin C (100%), vitamin B6 (6.67%), vitamin D (73.33%), and zinc supplements (33.33%).
Penatalaksanaan Pasien Wanita 63 Tahun dengan Tuberkulosis Paru dan Diabetes Melitus Tipe 2 Melalui Pendekatan Dokter Keluarga di Puskesmas Susunan Baru Desti Dwi Rahmah; Aila Karyus
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.847

Abstract

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which can attack the lungs and other organs. As many as 10.6 million people worldwide suffer from tuberculosis (TB) with an increase in the incidence rate of 3.6% between 2020 and 2021. Type 2 diabetes mellitus (DM) is one of the most important risk factors for worsening TB with a risk of active TB 2 -4 times higher in individuals with type 2 DM than non-DM. The study conducted in the form of a case report. Data were obtained through anamnesis, physical examination, laboratory examination, and medical records at PUSKESMAS. The assessment carried out based on the initial holistic diagnosis, process, and the final of the study both quantitatively and qualitatively. Based on the study, case a 63-year-old female patient with complaints of dry cough and phlegm for 2 months accompanied by an itchy throat, chills, decreased appetite and body weight. The patient has type 2 DM since 6 years. Family doctor services carried out to identify risk factors, clinical problems, as well as evidence-based medicine with patient management through a family approach, patient-centred, and community-oriented. Interventions done both medically and non-medically in the form of patient and family education about pulmonary tuberculosis and type 2 DM. Evaluation after the intervention obtained a decrease in fasting blood sugar, an increase in knowledge about the patient's disease, and an improvement in eating patterns.

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