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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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Laporan Kasus: Retardasi Mental Berat Pada Remaja Usia 16 Tahun dengan Riwayat Epilepsi Tidak Terkontrol Aziz, Rachman; Jiofansyah, Jiofansyah; Septa, Tendry
Medula Vol 14 No 2 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i2.866

Abstract

Mental retardation (MR), also known as Intellectual Disability (ID), is a lifelong mental disorder characterized by significant cognitive and adaptive impairments, often associated with structural or functional brain anomalies and diverse etiologies that frequently co-occur with conditions such as epilepsy. In Indonesia, a survey conducted in 2012 revealed that 2.45% of the population had disabilities, including individuals with mental retardation. The World Health Organization (WHO) estimates the prevalence of mental retardation in Indonesia to be around 1-3% of the population, with one-quarter of cases classified as moderate to severe mental retardation. The occurrence of mental retardation is closely linked to a child's developmental trajectory, influenced by genetic and environmental factors. In terms of pathogenesis, the onset can originate from prenatal, perinatal, or postnatal factors, with various contributing elements, including a history of seizures. The severity levels are classified as mild, moderate, severe, or profound mental retardation. Epilepsy is a common neurological disorder in children, often co-occurring with mental retardation, found in 25% of cases. The occurrence of epilepsy can either accompany or be the cause of mental retardation, leading to a classification known as Developmental and Epileptic Encephalopathy (DEE). This case report will present the case of a teenager with mental retardation who has a history of recurrent seizures, illustrating the complex relationship between these two conditions. Hence, there is a need for a comprehensive approach and increased awareness in diagnosing and managing children with concurrent mental retardation and epilepsy with the goal of providing optimal care.
Ruptur Kornea dan Prolaps Iris Oculi Sinistra et causa Trauma Tumpul : Sebuah Laporan Kasus Gandaninata Yushan, Shina Megaputri; Sella, Martha; Juwita, Ratna
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.v13i7.868

Abstract

Corneal rupture is an injury that affects the entire thickness of the corneal wall due to blunt trauma. A 32-year-old man came to the eye clinic at RSUD A Dadi Tjokrodipo with complaints of red left eye accompanied by sudden decreased vision since 3 weeks ago after being hit by a rock while working to cut grass with an electric lawn mower. The patient complained of red left eye, sudden blurry vision after an incident that persisted and did not increase, pain that spread to the back of the head, glare when exposed to light, and excessive tears. Ophthalmological status showed right eye vision 20/30, left eye vision 20/100. Palpation intraocular pressure in the left eye increased, while the right eye was normal. In the left eye there was a ciliary injection, the cornea was clear and appeared to be torn at 7 o'clock, the iris was prolapsed, the pupil looked oval drawn towards the lip of the wound, the lens was clear. The patient was diagnosed with corneal rupture and left iris prolapse. The operative treatment performed on this patient was corneal repair and repositioning of the left iris. The non-operative treatment used was gentamicin 0.3% eye drops 6x1 drops, 1% atropine sulfate eye drops 4x1 drops, mefenamic acid tablets 3x500 mg. Prognosis of this patient are quo ad vitam ad bonam, quo ad fuctionam dubia ad bonam, dan quo ad sanationam dubia ad bonam.
Penatalaksanaan Holistik Pasien Vertigo Pada Ny. S Umur 34 Tahun Di Puskesmas Campang Raya Melalui Pendekatan Kedokteran Keluarga Yulia Puspita Sari; Zuraida, Reni
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.v13i7.870

Abstract

Vertigo is a term that comes from the Latin, vertere, which means twisting. In general, vertigo is known as an illusion of movement or a hallucination of movement. Vertigo is found in the form of complaints in the form of a sense of spinning or a sense of moving from the surrounding environment (circular vertigo) but sometimes complaints are also found in the form of a feeling of being pushed or pulled away from the vertical plane (vertical linear). Apply a holistic and comprehensive approach to family doctors in detecting risk factors, clinical problems, and patient management based on evidence based medicine and is family- approached and patient-centered. Primary data were obtained through anamnesis, physical examination, supporting examinations and home visits to assess the physical environment. Mrs. S, 34 years old, came to the Campang Raya Community Health Center with complaints of dizziness since two days before coming to the Puskesmas. Spinning dizziness arises suddenly, is felt continuously and gets worse when the patient raises his head to sit or stand after sleeping. Complaints accompanied by nausea, vomiting, and cold sweats. Complaints have been repeated and the first time was felt six years ago. The patient's concern is that the complaint gets heavier and interferes with daily activities. The patient was diagnosed with vertigo based on history and physical examination. A holistic management has been carried out with the approach of a family doctor, through non-medical and medical interventions were carried out on patients and their families with education related to the patient's illness in three home visits. The evaluation results obtained were reduced patient complaints and increased knowledge of patients and their families regarding vertigo.
Penatalaksanaan Holistik Pada Ibu Rumah Tangga Dengan Carpal Tunnel Syndorme (CTS) Melalui Pendekatan Kedokteran Keluarga Di Wilayah Kerja Puskesmas Kebon Jahe Aurelina, Renata; Angraini, Dian Isti
Medula Vol 14 No 1 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Carpal tunnel syndrome (CTS) is a syndrome that arises due to neuropathic pressure on the median nerve in the carpal tunnel at the wrist which is precisely under the flexor retinaculum. Risk factors for CTS include obesity, sedentary wrist activity, pregnancy, genetic heredity, and rheumatic inflammation. So that proper treatment is needed and carried out holistically with a family medicine approach to achieve therapeutic success. Application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient-centered and family problem-solving framework. Primary data were obtained through anamnesis, physical examination, supporting examinations and home visits to assess the physical environment. Patient Mrs. S, 49 years old, came with complaints that the thumb, index finger and middle finger of the right hand felt numb and stiff since one month ago. The patient is worried that the complaint will worsen and interfere with activities. The patient was clinically diagnosed with CTS (ICD-10 G56.0). Furthermore, management, intervention and evaluation are carried out. On evaluation, there were reduced complaints, increased patient knowledge about the disease and changes in behavior in the position of doing daily homework. After carrying out holistic and comprehensive management, patients experience an increase in knowledge about their disease. Complaints of numbness and stiffness in the patient's right hand are reduced, the patient and his family do homework in the right way and position.  
Tuberkuloma : Sebuah Laporan Kasus Fitriyani, Fitriyani; Suwanda, Meyliana; Perdana, Aditya Andra; Mellisa, Stefani
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.v13i7.872

Abstract

Intracranial tuberculoma is a rare but severe form of extrapulmonary tuberculosis with high mortality and morbidity rates. Early diagnosis and treatment are crucial determinants of tuberculoma prognosis. A 61-year-old female presented to the emergency department of RSAM with complaints of headache, nausea, and vomiting for the past 2 months prior to hospital admission. The patient had a history of weight loss for 5 months before hospitalization, a history of dry cough, and night sweats for the last 2 months before admission. Radiological examination via a head MRI revealed multiple lesions, with the largest measuring 1.7x1.3x1.8 cm in the left parietal cortical lobe and the right frontal lobe, suspected to be tuberculomas. A CT scan of the thorax showed multiple consolidations in the lateral segment of the right lower lobe with a long axis of 1.1 cm and in the anterior segment of the left lower lobe with a long axis of 1.6 cm, suspected of malignancy with concomitant active long-standing pulmonary tuberculosis and endobronchial spreading. The patient was treated with anti-tuberculosis drugs and corticosteroids. She was discharged with reduced headache and vomiting. The rare occurrence and atypical clinical manifestations, along with radiological characteristics, pose challenges in diagnosing tuberculomas. Establishing a diagnosis and initiating treatment as early as possible is crucial and key to the prognosis of tuberculomas.
Stroke Hemoragik dengan Riwayat Hipertensi Tidak Terkontrol: Sebuah Laporan Kasus Aisyah, Putri; Putri , Pratiwi Hendro; Pangestu, K Widhi Indra; Salsabila, Salsabila; Rahma, Balqist Ar; Putri, Siti Fhatima Novariani
Medula Vol 14 No 3 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i3.873

Abstract

Stroke is a functional disorder of the brain that occurs suddenly with clinical signs and symptoms, both focal and global, that last more than 24 hours, or can cause death, caused by impaired cerebral blood circulation. Hemorrhagic stroke is a rupture of a brain blood vessel causing blood to leak into the brain parenchymal tissue, cerebrospinal fluid space around the brain or a combination of both. A 62 year old man came to the emergency room at Jendral Ahmad Yani Metro Hospital accompanied by his family with complaints of sudden loss of consciousness since 3 hours ago. Previously, the patient complained of severe, sudden headaches, which did not decrease at rest or after taking headache medication, vomited twice, vomited without nausea, and finally the patient fainted. Vomiting contains liquid with food. The patient has a history of uncontrolled hypertension since 10 years ago. Brain pons bleeding was found with an estimated bleeding volume of +1.75 ml, but the family refused surgery. The patient's general condition continued to decline so that after 3 days of treatment in the ward of the Department of Neurology, the patient was declared dead.
A Holistic Management 48 Years Old Woman With Vertigo Through The Family Medicine Approach Wardani, Hanifa Nurusita; Sibuea, Sahab
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.v13i7.874

Abstract

Vertigo is a false perception of a person's movements or the surrounding environment. The prevalence of vertigo in Indonesia in 2018 is 50% of those aged 40-50 years and is the third most common complaint complained of by patients who come to general practice after headaches and strokes. 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 the 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. S, 48 years old, came to the primary care with dizziness, nausea, vomiting, and cold sweats. On physical examination, there was the results of the Dix Hallpike neurological test, nystagmus, Romberg, tendem gait, and past pointing test were positive. Fukuda stepping test result was negative. The patient has curative treatment patterns, lack of knowledge about the disease. The external risk aspects of the patient are the lack of family knowledge about the patient's illness and curative family treatment patterns. Furthermore, holistic management of patients and families through poster and power point in the form of information about the diseases suffered by patients, exercise that can be done by the patient. At the time of evaluation, the patient had no symptoms anymore. 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.
Penatalaksanaan Holistik pada Pasien Anak Usia 7 Tahun dengan Herpes Zoster melalui Pendekatan Kedokteran Keluarga di Puskesmas Rawat Inap Panjang Harahap, Rara Julia Timbara; Nusadewiarti, Azelia
Medula Vol 14 No 1 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i1.875

Abstract

Herpes zoster (HZ) is an acute vesicular eruption caused by reactivation of latent varicella-zoster virus (VVZ) in sensory ganglia previously exposed to primary varicella infection. The incidence of HZ increases with age but many case reports show that herpes zoster can also occur in adolescents and even in children. The purpose of this case report is to implement a holistic and comprehensive family doctor service by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with a patient-centered and family approach. This study is a case report study. Primary data were obtained through history taking (autoanamnesis from the patient and alloanamnesis from the patient's family), physical examination and home visits. Secondary data were obtained from the patient's medical record. Assessment is based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Patient Ms. K, 7 years old, has been diagnosed with uncomplicated herpes zoster, has concerns about his health condition, the patient feels inferior and is afraid that the disease cannot be cured and is afraid of transmitting it to other family members. The patient hopes that the complaints disappear completely and do not recur, so they can be comfortable with their activities as usual. The patient's limited knowledge of the illness and an unfavorable lifestyle are factors that cause problems that occur in patients and their families. The diagnosis of herpes zoster, in this case, was in accordance with several theories and a critical review of recent studies. Management has been given in accordance with the management guidelines. There is good progress in patients starting from decreased clinical symptoms to changes in behavior after an intervention based on evidence-based medicine that is family-approach and patient-centered.
Penatalaksanaan Holistik Pada Anak Usia 9 Tahun Dengan Tonsilitis Kronis Melalui Pendekatan Kedokteran Keluarga Djuardi, Attisya Milenty Putri; Mayasari, Diana
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.v13i7.876

Abstract

Tonsillitis can occur at any age, especially in children. Tonsillitis has become one of the causes of decreased academic achievement and absenteeism from school. Patients with tonsillitis are also patients who often come to the practice of ear, nose, throat, head and neck surgeons (ENT-KL), pediatricians, and other health care facilities. This case report describes a 9 year old child who complained of fever accompanied by cold, cough, pain of swallowing, bad breath, and snoring. Patients often experience this complaints at least once every two months. Local status examination revealed a hyperemic pharynx, enlarged T3-T2 tonsils, widened crypts (+/+), detritus (+/+), and an uneven surface. The management provided is in the form of medical and non-medical therapy as a holistic intervention with a family medicine approach. The aim of this article is to identify risk factors, clinical problems, and management using a patient centered and family approach. This study is a case report. Primary data was obtained through history taking, physical examination and home visits.. As a result of this study, the patient was diagnosed with chronic tonsillitis. Internal risk aspects that influence the patient's condition include the patient's age, patient’s knowledge, patient’s lifestyle, dental and oral hygiene, and poor diet. External risk aspects that influence the patient's condition include a lack of family supervision regarding the patient's snack consumption, and slow decision making regarding follow-up actions based on patient complaints, the patient's family does not know enough about patient’s disease. Furthermore, holistic management has been carried out for patients and families through colored poster intervention media in the form of information about diseases, triggers and complications.
Penatalaksanaan Holistik pada Pasien Lansia Dengan PPOK dan Hipertensi Melalui Pendekatan Kedokteran Keluarga di Puskesmas Kalirejo Khairunnisa, Lyliani; Angraini, Dian Isti; Harmaina, Harmaina
Medula Vol 14 No 1 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i1.877

Abstract

Chronic Obstructive Pulmonary Disease (COPD) and Hypertension is a non-communicable disease which become a health problem globally and in Indonesia. COPD and Hypertension can be controlled through a healthy lifestyle which support from family and community is needed, therefore it is important to carry out holistic management through a family approach to patients. This study is a case report. Primary data were obtained through anamnesis from the patient's family, physical examination, and home visits to assess the physical environment. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study. The results, Mr. E is 64 years old, with COPD and history of uncontrolled hypertension in the past 10 years. Internal risk factors include a history of smoking in the past 30 years and lack of knowledge about the disease. External risk factors are the lack of knowledge of the patient's family about the patient's disease, smoking behavior in the home by other family members and the patient's workplace with a lot of exposure to smoke. Interventions were carried out in the form of education. After the intervention, changes in patient knowledge, blood pressure, CAT Score and lifestyle were obtained. The diagnosis in this patient complies with the national guidelines. The management given is in accordance with the guidelines, there is a change in knowledge of the patient and the patient's family after the intervention is carried out by providing counseling based on evidence-based medicine which is patient centered and a family approach.

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