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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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Penatalaksanaan Holistik Pada Pasien Hipertensi Derajat II Melalui Pendekatan Kedokteran Keluarga Zaharuddin, Khairul Husni; Susanto, Tirta Darmawan; Soeryani, Wianti
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.v14i2.939

Abstract

Hypertension is a global health problem that requires serious attention. Basic Health Research (Riskesdas) in 2018 shows that the prevalence of hypertension in Indonesia with a population of around 260 million is 34.1%, this shows an increase compared to the prevalence of hypertension in Riskesdas in 2013, which was 27.8%. The estimated number of hypertension cases in Indonesia is 63,309,620 people, while the death rate in Indonesia due to hypertension is 427,218 deaths. Data from WHO shows that the number of people suffering from hypertension doubled between 1990 and 2019, from 650 million people to 1.3 billion people worldwide. The purpose of this case report is to explore the role of hypertension management in the context of family medicine holistically and comprehensively through a Patient Centered, Family Focused, and Community Oriented approach. Family medicine has a crucial role in detecting, preventing, and managing hypertension. 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. Mrs. E, 32 years old, has been complaining of headaches for the past day. Internal risk factors in the patient are being overweight, not exercising regularly, often eating fast food, having a history of cancer in parent, feeling stressed at work, and a curative treatment pattern. External risk factors in the patient is that patient have work activities that are mostly sitting. Diagnosis and management of patient is carried out holistically, Patient Centered, Family Focused, and Community Oriented. There are changes in clinical and patient behavior after the intervention. The family medicine approach emphasizes preventive interventions, patient education, and long-term management. This approach is expected to enhance the understanding of patients and their families regarding the importance of hypertension management and encourage sustainable behavioral changes.
Emergency and Disaster Management in the Health Sector Yusanda, Carissa Aprilia; Sidharti, Liana
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.v14i1.940

Abstract

  In this era of globalization, humans are faced with various challenges, including threats from disasters and emergency situations that can harm the health sector. Emergency and disaster management in the health sector is a critical aspect that requires serious attention. The importance of emergency and disaster management in the health sector is not only related to handling individual cases, but also involves prevention, preparedness and recovery efforts. The absence of adequate preparation can have serious impacts on public health, threaten the resilience of health systems, and increase the risk of disease. By adopting a qualitative approach, this research uses a case study design to gain an in-depth understanding of practices and policies related to preparedness, response and recovery in health emergencies. Through an in-depth understanding of emergency and disaster management in the health sector, it is hoped that innovative and effective solutions can be found in facing complex challenges that arise from natural disasters, armed conflicts, or global health threats. This research is expected to provide a valuable contribution to the development of policy, practice and advanced research in the field of emergency and disaster management that focuses on health aspects. The research findings highlight significant variations in the level of health system preparedness across contexts. The active involvement of stakeholders, including governments, non-governmental organizations and local communities, is identified as a key factor in successful emergency management. Environmental factors, such as geography and social dynamics, also influence the strategies implemented to respond to and recover from the health impacts of disasters.
Homeostasis Tubuh Nasyafa, Syabila Febrilia; Saputra, Oktadoni; 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.v14i2.941

Abstract

The body has mechanisms at the cellular level to maintain internal balance, called dynamic balance. Even though the external environment undergoes changes, the body continues to operate to prevent deviation from this balance. Environmental changes can affect internal systems, so homeostasis is needed to prevent damage to cells, tissues and organs through regulatory mechanisms. Homeostasis regulation involves local control (paracrine and autocrine responses) as well as reflex control involving the nervous and endocrine systems. Homeostasis is a basic concept of physiology that plays an important role in maintaining internal stability and adaptive responses in the body. The importance of homeostasis lies in the fact that the body's cells and tissues can only remain alive and function efficiently if their internal conditions are maintained properly. All organ systems depend on each other to maintain homeostasis, and changes in one system can affect other body systems. Homeostasis includes the body's ability to maintain a stable internal environment despite changes such as temperature, air, atmospheric oxygen, carbon dioxide levels, physical activity, exposure to toxins, disease, drug therapy, fever, and diet. Disruption of homeostasis can cause dysfunction and loss of control of organs in the body. Several physiological systems are regulated by homeostasis, such as thermoreceptors which regulate body temperature and the role of homeostasis in the endocrine system to regulate hormonal balance and hormone regulation in the body. Homeostasis is influenced by several constant conditions, including body temperature and body fluid balance, which are maintained within predetermined limits (the so-called homeostatic range). Examples of other variables are the pH of the extracellular fluid, the concentration of sodium, potassium and calcium ions, and blood sugar levels. Homeostasis is an automatic process and mechanism carried out by living creatures to maintain constant conditions so that their bodies can function normally, even though changes occur in the environment inside or outside the body.
Enterobactericeae Sebagai Bakteri Patogen Infeksi Nosokomial di Rumah Sakit Putri, Abrila Tamara; Soleha, Tri Umiana; Nareswari, Shinta; Ramadhian, M. Ricky
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.v14i1.942

Abstract

Enterobactericeae are gram-negative rod bacteria which are often pathogenic bacteria that cause nosocomial infections. Enterobactericeae bacteria have several characteristics including small size and rod shape, natural habitat in the digestive tract of humans or animals and some others originate from bodies or inanimate objects, are motile and non-motile, cannot form spores, and are aerobic to facultative anaerobic. Nosocomial infections are infections that are acquired during the health care process at the hospital, but are not present when the patient is admitted to the hospital. The source of transmission of nosocomial infections can result from direct or indirect contamination in the health care process in hospitals. Common nosocomial infections include Central Line Associated Blood Stream Infection (CLABSI), Catheter Associated Urinary Tract Infection (CAUTI), Surgical Site Infection (SSI), and nosocomial pneumonia consisting of Hospital Acquired Pneumoniae (HAP), Ventilator Associated Pneumoniae (VAP), and Health Care Associated Pneumoniae (HCAP). The Enterobactericeae bacteria that often cause nosocomial infections in hospitals include Escherichia coli, Klebsiella sp, Enterobacter sp, Pseudomonas sp, and so on. Nosocomial infections have a negative impact on the health recovery process of inpatients in hospital, so they need to be handled well and preventive efforts are made to avoid this undesirable event through health service efforts that comply with standard operational procedures and pay attention to aseptic principles.
Gangguan Sekresi dan Sensitivitas Insulin pada Remaja dengan Riwayat Keluarga Diabetes Melitus Tipe 2 Ardika, Okta Besti; Larasati, TA; Suharmanto, Suharmanto; Kurniati, Intanri
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.v14i1.943

Abstract

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by impaired insulin secretion or hyperglycemia due to the inability of pancreatic β-cells to compensate for increased glucose levels in the blood. The pathophysiology of T2DM may result from the interaction of environmental and genetic factors. A person who has a family history of T2DM will experience genetic mutations that cause impaired insulin secretion and sensitivity. The genetic inheritance of the child is based on the parent alleles of both parents including some genes that have mutations. There are three types of genetic inheritance mechanisms described by parent of origin effects (POE), namely genomic imprinting, mitochondrial inheritance, and maternal intrauterine effects. The mechanism of impaired insulin secretion and sensitivity in someone with a family history of T2DM during puberty, which is also triggered by stress and hormonal imbalance, results in insulin resistance, especially significant when entering adolescence and supported by a family history of T2DM. In children with a family history of T2DM, it was found that pancreatic β-cell compensation was 30% lower compared to children without a family history of T2DM.
Literature Review: Helminthiasis pada Kehamilan Cahyani, Faradhila Azqiah; Septiani, Linda; Mutiara, Hanna; Suwandi, Jhons Fatriyadi
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.v14i2.944

Abstract

Helminthiasis is a disease caused by intestinal nematode worms that are transmitted through soil orSoil Transmitted Helminth (STH). The types of STH are:Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. Helminthiasis has infected as many as 1.5 billion of the world's population. Helminthiasis is often found in countries with tropical, subtropical climates and countries that are still categorized as poor. Helminthiasis falls into the categoryNeglected Tropical Disease (NTD) which if left untreated can cause health problems. Purpose ofliterature review This provides a review of the epidemiology, clinical manifestations, necessary examinations, and management of helminthiasis, especially in pregnant women. This research uses a literature study method from 2016-2023. The results of this literature study show that clinical manifestations are influenced by the severity or lightness of the infection, gold standardTo find out the incidence of helminthiasis is to do a stool examination, and helminthiasis can be treated by providing care servicesantenatal care. The conclusion is that helminthiasis in pregnant women can affect the condition of the mother and fetus in the womb.
Diabetes Mellitus Tipe 1 Fauziani, Andra Nabila; Adelia, Anggi; Ardika, Okta Besti; Himayani, Rani; Rahmanisa, Soraya
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.v14i3.946

Abstract

Diabetes mellitus (DM) is a chronic condition with an increasing incidence worldwide. Not only does it occur in adults, but the incidence rate in children is also quite high. Type-1 DM is an autoimmune disease characterized by absolute insulin deficiency due to pancreatic gland cell damage. Although it can occur at any age, type-1 DM most commonly appears in adolescence with a peak onset around puberty. Diabetes mellitus is often caused by genetic factors and a person's lifestyle. Symptoms of Type 1 DM in children are the same as in adults: polyphagia, polydipsia, polyuria and nocturia, weight loss, and about a third suffer from diabetic ketoacidosis. Complications of diabetes can be divided into microvascular and macrovascular. Microvascular complications include nervous system damage (neuropathy), renal system damage (nephropathy) and eye damage (retinopathy), but can also affect cognitive function, heart and other organs. HbA1c screening is recommended every 3 to 6 months. HbA1c levels reflect glycemic control over the previous 2-3 months. The target HbA1c is generally <7.0%. Other laboratory tests include lipid profile, serum creatinine, eGFR, and urine albumin to creatinine ratio. Management of Type 1 DM includes insulin injection, blood sugar monitoring, nutrition, physical activity, and education. The goal of insulin therapy is to ensure that insulin levels in the body are sufficient for 24 hours to meet metabolic needs due to the glycemic effect of food.
Kejadian Gagal Ginjal Kronik pada Pasien Diabetes Melitus Tipe 2 Mentari Putri Maharani; Kurniati , Intanri; Sidharti, Liana
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.v14i2.948

Abstract

Diabetes is widely regarded as the most prevalent factor leading to end-stage renal disease. The rising prevalence of obesity and the growing number of elderly individuals will result in an increased population of individuals with diabetes who also have chronic kidney disease. This kidney disease can either be caused by diabetic nephropathy or have a different underlying cause. The management of diabetes and accurate assessment of kidney disease are influenced by the factors of ageing and obesity. Individuals suffering from both diabetes and chronic kidney disease account for a disproportionately large portion of medical care expenses. Individuals afflicted with diabetes and diabetic nephropathy exhibit heightened susceptibility to retinopathy and foot complications necessitating synchronized medical attention. Individuals with both diabetes and chronic kidney disease have a higher susceptibility to anaemia and metabolic bone disease compared to those without diabetes who are at the same stages of chronic kidney disease. Considering the high prevalence of kidney disease (30-40%) among individuals with diabetes, it is estimated that over 2% of the adult population falls into this category. Therefore, it is crucial to develop new surveillance models for providing care to individuals with both diabetes and kidney disease. Additionally, primary care teams, who are responsible for managing the majority of these individuals, should also be supported.
PENATALAKSANAAN HOLISTIK WANITA USIA 50 TAHUN DENGAN NEURODERMATITIS MELALUI PRINSIP PENDEKATAN KEDOKTERAN KELUARGA DI WILAYAH KERJA PUSKESMAS SUMUR BATU Nurladira, Salsanisa Tisno; Utama, Winda Trijayanthi
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.v14i1.949

Abstract

Neurodermatitis Circumscripta is a chronic inflammatory skin condition that often occurs in individuals aged 30 - 50 years, characterized by itching and thickening of the skin due to repeated friction. Applying the principles of family medicine and implementing holistic management based on the patient-centered, family-focused, and community oriented approach grounded in Evidence-Based Medicine. This study is a case report utilizing primary data obtained through anamnesis, physical examination, and home visits to get family, psychosocial, and enviromental data. Secondary data were obtained from the patient’s medical records. Patient Mrs. I, 50 years old, came with a complaint of itching on the back of the right leg since the last 3 months, the itching increased when the patient was resting or at night. The patient often scratched it, causing thickening and darkening of the skin. The patient was diagnosed with neurodermatitis circumscripta. Holistic management was performed with a family physician-designed approach for Mrs I, 50 years old, with neurodermatitis based on the initial holistic diagnosis. The intervention has improved the patient’s knowledge and changed some behaviours of the patient and her family.
The Effect Of Hyperglycemia On Early Hospital Admission To The Incidence Of Mortality In Iscemic Stroke Patiens At Abdul Moeloek Regional General Hospital In 2017-2020 Zahrani, Raisha Naomi; Ramayani, Fidha; Mayasari, Diana; Zanariah, Zam
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.v14i1.950

Abstract

Stroke is the third leading cause of death in the world after coronary heart disease and cancer, both in developed and developing countries. Hyperglycemia can exacerbate neurological deficits and even increase mortality in ischemic stroke patients, but this is still controversial. This study aims to determine the effect of hyperglycemia at the beginning of hospital admission to the incidence of mortality in ischemic stroke patients at the Abdul Moeloek Regional General Hospital in 2017-2020. This type of research is analytic observational with a retrospective cohort study design. Data were taken from medical records with a total of 62 samples selected using a consecutive sampling technique. The results of the univariate analysis test showed that 53% of subjects experienced death (33 people). The results of the bivariate analysis test obtained p value <0.05 (p = 0.000), relative risk of 3.7, and a threshold value of 222.5 mg/dL. There is an effect of hyperglycemia at the beginning of hospital admission to the incidence of mortality in ischemic stroke patients at Abdul Moeloek Regional General Hospital.

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