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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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HOLISTIC MANAGEMENT OF A 69 YEAR OLD FEMALE PATIENT WITH LOW BACK PAIN AND GRADE 2 HYPERTENSION IN A PRIMARY HEALTH CARE Adli, Farhan Kamali; Karyus, Aila; Ernawati, Tutik
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.v13i7.878

Abstract

Based on data from the World Health Organization, it is estimated that around 15-20% of the world's population suffers from hypertension and Hypertension in Indonesia is the third cause of death in all age groups, namely around 6.7% of the total population of deaths in Indonesia. The prevalence of musculoskeletal diseases in Indonesia is 11.9% and based on symptoms, the prevalence of musculoskeletal diseases in Indonesia reaches 24.7%. Meanwhile, the prevalence of musculoskeletal disease in Lampung reached 18.9%. Apply the principles of family medicine services to patients and carry out holistic management based on the patient problem found with patient-centered approach, family focused, and community oriented based on Evidence Based Medicine. This study is a case report with Primary data obtained through history taking, physical examination and home visits to complete family, psychosocial and environmental data. Secondary data was obtained from the patient's medical record. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study. Mrs. L 69 years old, came with complaints of headaches, heavy shoulders and lower back pain. The patient was diagnosed as hypertension and low back pain. In this case, the diagnosis and treatment were carried out according to the theory and related journals. After the intervention, there was a decrease in clinical symptoms and an increase in patient and family knowledge. Holistic management can improve the knowledge, attitudes, and behavior of patients and family in maintaining their health.
Penatalaksanaan Holistik Pada Wanita Usia 50 Tahun dengan Gout Arthritis Melalui Pendekatan Kedokteran Keluarga Maryanto, Erlicha Paramitha; Karyus, Aila
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.v14i1.879

Abstract

Gout arthritis is a progressive disease due to the deposition of monosodium urate crystals in joints, kidneys, and other connective tissues due to chronic hyperuricemia. This disease needs to be managed comprehensively so that patients must know about their disease and have awareness and can make lifestyle modifications so that treatment goals can be achieved, prevent complications that may occur, and improve the patient's quality of life. This can be realized with family medicine-based management. The aim of this study is to identify internal, external risk factors and clinical problems found in patients, apply a holistic and comprehensive family doctor approach according to the problems found in patients, and carry out evidence-based medicine management that is family-approach, patient-centered and community oriented. The 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. A 50-year-old female patient came with complaints of pain in the both knees. The patient has been diagnosed with uncontrolled gout since 2 months ago. In the knowledge assessment, the initial score before the intervention was 5 (low) and after the intervention it was 9 (high). In the aspect of uric acid levels there is a decrease in uric acid levels from 9,3 mg/dL to 5,6 mg/dL. In the aspect of diet there is a change in the type of food that is appropriate. In the aspect of physical activity there is a change in physical activity of 30 minutes of exercise per day. Enforcement of diagnosis and management of these patients has been done holistically, patient centered, family approach and community oriented based on several theories and the latest research. In the process of behavior change, the patient has reached the trial stage.
Hernia Umbilikalis: Ulasan Singkat Reghina Pratiwi Hidayat; Perwisa, Inna Rahmayanti; Satria, Muhammad
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.v13i7.880

Abstract

An abnormal protrusion of an organ in the fascia of the abdominal wall is called a hernia. An umbilical hernia indicates that there is a protrusion in the anterior abdominal wall. Congenital umbilical hernias occur more frequently due to failure to obliterate the umbilical blood vessels into ligaments after birth. However, congenital umbilical hernia can completely close 85-90% by the age of 5 years. Adult umbilical hernias are usually associated with increased intra-abdominal pressure, such as chronic coughing, frequent straining and large abdominal tumors, requiring surgical treatment. The clinical manifestation of an umbilical hernia is usually a protrusion in or near the navel, but if it is incarcerated or strangulated, symptoms of nausea, vomiting, difficulty defecating and abdominal pain will appear. On physical examination, you will find a lump in the navel with skin color even red to black if strangulation has occurred. In addition, to the touch it will feel warm. The most severe clinical manifestations can be symptoms of sepsis such as hypotension and tachycardia. The necessary supporting examinations include initial imaging such as ultrasound and the most sensitive, namely an abdominal CT scan. Surgical treatment for adult umbilical hernias can be done with suture or mesh repairs, while pediatric umbilical hernias can be repaired with non-absorbable sutures and umbilicoplasty for aesthetic improvement. Complications of umbilical hernia are usually related to post-surgery such as hematoma, post-operative wound infection. The prognosis for an umbilical hernia is good after surgery.
Penatalaksanaan Holistik Pada Wanita Usia 59 Tahun dengan Hipertensi dan Dislipidemia Melalui Pendekatan Kedokteran Keluarga di Wilayah Kerja Puskesmas Tanjung Sari Syafni, Alma Nazelia; Zuraida, Reni
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.v14i2.881

Abstract

Based on data from the World Health Organization, it is estimated that around 15-20% of the world's population suffers from hypertension and data from the 2018 National Basic Health Research, there are 54.4% of the Indonesian population aged ≥ 15 years with cholesterol levels (≥ 200 mg/dl. Purpose of writing This is to apply the principles of family medicine services and carry out holistic management based on a framework for solving patient problems using a patient-centered, family focused and community oriented approach based on Evidence Based Medicine. This study is a case report. Internal risk factors were found, namely family history, unbalanced nutritional intake, and lack of knowledge of the disease. Ekxternal risk factors include lack of family knowledge about desease prevention and complication, lack of supervision over diet and medication. Patient Mrs. J, 59 years old, was diagnosed as grade I hypertension, dyslipidemia, and grade I obesity. In this case, diagnosis and treatment were carried out in accordance with theory and related journals. After the intervention was carried out, there was a reduction in clinical symptoms and an increase in patient and family knowledge. Holistic management can improve the knowledge, attitudes and behavior of patients and families in maintaining health.
Penatalaksanaan Holistik Pada Perempuan Usia 65 Tahun Dengan Hypertensive Heart Disease (HHD) dan Dislipidemia Melalui Pendekatan Kedokteran Keluarga Akmal, Vina Amelia; 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 | DOI: 10.53089/medula.v14i1.882

Abstract

Hypertensive heart disease (HHD) is a term applied to refer to heart disease as a whole, starting from left ventricular hypertrophy (LVH), cardiac arrhythmias, coronary heart disease, and chronic heart disease, which are caused by increased blood pressure, either directly or indirectly. The number of patients with Hypertensive Heart Disease (HHD) is not known with certainty, but in several studies it is stated that people with hypertension will develop heart disease. Often patients fail in treatment because of their inability to modify their lifestyle, so doctors must treat patients holistically from various aspects. 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. The study conducted was a case report. Primary data were obtained through history taking, physical examination and home visits. Secondary data were obtained from patient medical records. Patient Mrs. S, 65 years old, came with complaints that discomfort when breathing and frequent palpitations. Known to suffer from hypertension since 18 years ago and a history of hospitalization due to a previous heart disease. The patient had been taking antihypertensive medication but stopped it because he felt he was fine. The patient is worried that the complaint will worsen and interfere with activities. The patient was clinically diagnosed with HHD. Furthermore, management, intervention and evaluation are carried out. The diagnosis and management of these patients has been carried out holistically, patient centered, family approach and community oriented based on several recent theories and research. In the process of behavior change, the patient has reached the trial stage.
Penatalaksaan Holistik Kandidiasis Kutis Pada An. N Usia 14 Tahun Melalui Pendekatan Kedokteran Keluarga Di Puskesmas Tanjung Bintang Rahmatika, Aufa Fitri; Arisanti, Viola; Sibuea, Sahab H.
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.v13i7.883

Abstract

Candidiasis is a fungal infection caused by Candida albicans. In Indonesia, cases of cutaneous candidiasis are the third highest incidence among dermatomycosis cases. In 2013-2016, candidiasis cases were dominated by intertriginous cutaneous candidiasis at 50.5%. Internal risk factors, personal hygiene, and compliance with both medical and non-medical treatment, will greatly influence the patient's recovery. The study conducted was a case report. Data was obtained through anamnesis and physical examination by conducting home visits. The assessment is carried out based on a holistic diagnosis, process and end of visit qualitatively. Based on the examination carried out, the patient was a 14 year old girl with intertriginous candidiasis cutis. The patient's personal hygiene is not good. Patient and family knowledge about the disease is very limited. Education and intervention are provided to patients and families about candidiasis and risk factors that can trigger this disease. The internal factors in this case are the patient's lack of knowledge about the disease they are experiencing, poor personal hygiene, excessive body weight. Meanwhile, the external factors in this case were the family's lack of knowledge about candidiasis, the dominant hot weather. Pharmacological and non-pharmacological interventions are carried out by providing education regarding the causes and risk factors for candidiasis, how to use drugs, good personal hygiene, regular exercise and consumption of food with a balanced nutritional pattern. In the evaluation, it was found that there was an increase in patient and family knowledge regarding candidiasis, improvement in patient personal hygiene, and achievement of patient treatment compliance. Services with a family medicine approach in pharmacological and non-pharmacological therapy are able to solve health problems and improve the patient's quality of life.
PERBEDAAN PENGARUH PEMBERIAN TOPIKAL EKSTRAK DAUN BAKAU (Bruguiera gymnorrhiza) DAN GEL BIOPLACENTON PADA MAKROSKOPIS KULIT TIKUS PUTIH JANTAN (Rattus norvegicus) GALUR Sprague dawley DENGAN LUKA SAYAT Akib, Salsabila Nadhifa; Kurniawaty, Evi
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.v13i7.886

Abstract

Wound is loss of continuity from tissue’s anatomical structure which can be caused by pathological process from within or outside body. Wound healing process consists of four stages, namely haemostasis, inflammation, proliferation, and maturation. Bruguiera gymnorrhiza mangrove plant is a type of mangrove that is rich in bioactive compounds. Bruguiera gymnorrhiza leaf extract has bioactive compounds that can work as antibacterial, anti-inflammatory, analgesic and proliferative agents which affect wound healing process. This research is pure experimental with post test only control group design. Sample consisted of 30 rats divided into 3 groups. K-: 0,2 cc topical aquades, K +: 0,2 cc topical bioplacenton gel, P1: Bruguiera gymnorrhiza leaf extract 80% in 14 days of observation. Observation data were recorded in observation sheet and analyzed statistically. The results showed that topical extract of Bruguiera gymnorrhiza leaves 80% affected macroscopic wound healing in form of wound length’s reduction to 0.17 cm on 14th day but Kruskal-wallis test showed no significant macroscopic difference in wound healing (p > 0.05) between K-, K +, and P1. Topical extract of Bruguiera gymnorrhiza leaves 80% affected macroscopic wound healing in form of wound length’s reduction but there was no significant difference in incision wound healing macroscopically between K-, K +, and P1 at dose 0.2 cc / day.
Radikulopati Lumbal e.c. Herniasi Nukleus Pulposus (HNP) Fitriyani; Aswan, Naufal Rasyid
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.v14i1.887

Abstract

Radiculopathy is a disease involving the spinal nerve roots resulting from compression associated with the intervertebral discs; bone trauma; bone disease; and other conditions. Its prevalence is estimated to reach 3% -5% of the total population in the world. Age is the main risk factor, because it occurs due to degenerative processes in the spine. Men are often affected in their 40s while women are affected in their 50s and 60s. Clinical manifestations include radicular pain, weakness, and sensory loss referring to the structures innervated by the involved nerve root. The most common cause of lumbar radiculopathy is nerve root compression. Usually caused by disc herniation and spondylosis. This study aims to systematically assess patients diagnosed with lumbar radiculopathy. The method used is a Case Report with analysis of primary data obtained through anamnesis, physical examination and supporting examinations. It was reported that a female patient, aged 72 years, came to Dr. Hospital. H. Abdul Moeloek with complaints of pain in the back that radiates to both thighs, accompanied by numbness and weakness of the lower extremities. Denied history of trauma, history of hypertension, controlled with medication. On physical examination, he was aware of compos mentis and appeared to be in moderate pain, with vital signs and generalist status within normal limits. On neurological examination, he found decreased sensory and motor abilities in both thighs and positive results on the Lasegue sign examination. The supporting examination that was carried out was a lumbar MRI, which revealed diffuse posterior herniation of the nucleus pulposus L4-S1. Patients are given anti-pain and anti-hypertension therapy.
Penatalaksanaan Pasien Wanita 33 Tahun dengan Otitis Media Supuratif Kronik Melalui Pendekatan Kedokteran Keluarga di Puskesmas Campang Raya Wulandari, Aprilia; Effendi, RE Rizal
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.v13i7.889

Abstract

Chronic Suppurative Otitis Media (CSOM) is a Chronic inflamationn in the middle ear with perforation of tymphani membrane and characterized by reccurent or persistent mucopurullent otorrhoea more than 2 months. CSOM usually occur in chilhood, most commonly arround two years of age, percentage CSOM in adult 31-35 years old is 6,8%. This case report aims to provide holistic and comprehensive family medicine services by identifying risk factors, clinical problems, management, and prevention of patient complications based on evidence-based medicine while adopting a patient-centered and family-oriented approach. This study is a case report. The primary data were obtained through auto anamnesis, physical examination, and home visits. Meanwhile, the secondary data was obtained from the patient's medical record. The assessment is based on a holistic diagnosis from the beginning, process, and end of the study using qualitative and quantitative methods. Patient Mrs. N 33 years old, female has been diagnosed with CSOM. The internal factor that affects the condition is a lack of knowledge about the triggering factors, while the external factor is due to the family's less awareness of CSOM and its complication prevention. Pharmacological and non-pharmacological interventions were carried out by educating the patient about the prevention of recurrent Chronic Suppurative Otitis Media (CSOM). The diagnosis and management of the patient have been carried out holistically, patient-centered, family-oriented approach, and based on several theories and recent research. As a result of this study, both the patient and the family have progressed to the adoption stage in the behavior change process.
Thrombolysis as a Treatment for Ischemic Stroke: A Case Report Fitriyani, Fitriyani; Fadilah, Aulia Nur; Nurhardita, Fika; Atthariq, M. Naufal; Archie, Avicenna M
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.v14i3.891

Abstract

Stroke is defined as a neurological deficit caused by an acute focal injury to the central nervous system, whether in the brain, retina, or spinal cord, caused by blood vessels. More than 13.7 million people suffer strokes every year, and around 70% of strokes are ischemic strokes. A 66-year-old man came to the RSAM emergency room with complaints of decreased consciousness since 3 hours of SMRS and weakness of the left limb. Physical examination revealed a Babinsky reflex (-/+), and a CT scan of the head without contrast showed thromboembolism in the right middle cerebral artery. The patient was treated with thrombolysis and medical therapy. The patient was discharged after one week of hospitalization and then scheduled for re-control at the polyclinic, and the patient's National Institute of Health Stroke Score (NIHSS) score was assessed. A total score of 5 was obtained with the interpretation of mild neurological deficits, which concluded that the patient's clinical condition had improved. Establishing diagnosis and therapy as early as possible is important for the key prognosis of ischemic stroke. Thrombolysis is the right choice as a treatment for ischemic stroke in patients who meet the inclusion criteria.

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