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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 Hypertension and Hypercholesterolemia Patients with Vertigo Through a Family Medicine Approach: Penatalaksanaan Holistik Pasien Hipertensi dan Hiperkolesterolemia dengan Vertigo Melalui Pendekatan Kedokteran Keluarga Hero, Syifa Khairunnisa; Nusadewianti, Azelia
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.1009

Abstract

Hypertension is one of the most common problems that occurs in the population, whether diagnosed or not. Cholesterol levels are closely related to hypertension and its complications. The characteristic of geriatric patients is multipathology. In hypertensive patients with hypercholesterolemia, it is very likely to cause vertigo. Vertigo or in Latin, Vertere, means twisting. In general, vertigo is known as a syndrome that occurs due to disturbances in the balance system. Implement family doctor services based on evidence-based medicine holistically and comprehensively for patients by identifying risk factors, clinical problems, and patient management based on a framework for solving patient problems using a patient-centered, family approach, and community-oriented approach. The study carried out a case report by carrying out an overall assessment, namely history taking, physical examination, and visits to the patient's home to assess the environment. Secondary data was obtained from the patient's medical records. Assessment is based on a holistic diagnosis of the beginning, process, and end of the study qualitatively and quantitatively. Based on an examination of a 70-year-old male patient with complaints of dizziness, nausea, vomiting, and blurred to dark vision. The patient also admitted that he had soreness in his neck and shoulders. The patient admitted that the complaints came and went. On physical examination, it was found to be within normal limits. On supporting examinations, high cholesterol levels were found. Holistic and comprehensive management was carried out. Services with a family medicine approach in pharmacological and non-pharmacological therapy can solve health problems and improve the patient's quality of life. The role and support of the family is very much needed in monitoring.
Hernia Nukleus Pulposus Lumbal: Sebuah Laporan Kasus Fitriyani, Fitriyani; Putri, Sezia Marina
Medula Vol 14 No 4 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i4.1010

Abstract

Lumbar herniated nucleus pulposus (HNP) is a condition where fibroblasts experience degenerative or external changes in the intervertebral disc and nucleus which can cause neurological symptoms due to compression of the dura mater or nerves. The prevalence of disc herniation is around 1 to 3% and increases with age up to age 80 years. It often occurs in men compared to women with a ratio of 2:1. Lumbar invertebral discs are complex structures that frequently experience axial loads. Due to the biomechanics of this structure and its avascular nature, lumbar disc herniation often occurs. A 65 year old woman came to the emergency room at RSAM with complaints of low back pain that radiated to the thigh, calf to the sole of the right foot, as if being pricked and getting worse since 3 weeks before entering the hospital. The patient works as a farmer and when working often carries heavy objects and the patient's working position is often bent. Denied history of falls. The patient did not complain of disturbances in BAK and defecation. From the results of the physical examination, Lasseque's test was positive on the right. A lumbosacral MRI radiological examination was carried out and the results showed multiple protruded discs in the L4-L5 and L5-S1 intervertebralis accompanied by a diffuse posterior herniated nucleus pulposus which was pressing on the anterior saccus thecalis and bilateral spinal roots. Patients are treated with medication and rehabilitation. HNP is the most common cause of lower back pain complaints in the elderly. Immediate treatment can impact the prognosis.
Perbedaan Kekuatan Otot Genggam Tangan Antara Atlet Calisthenics Dengan Pekerja Konstruksi Bangunan Wibowo, Gatra Hadimuti; Fiana, Dewi Nur; Fauzi, Ahmad; Berawi, Khairunnisa
Medula Vol 14 No 4 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i4.1011

Abstract

Physical activity has an important role in increasing muscle strength. High intensity physical activity can build muscle mass ,endurance and increase muscle strength compared to low intensity physical activity. One way to determine the strength of the hand or upper extremity muscles can be measured by the strength of the hand grip muscles. In this study, researchers wanted to look at the differences in hand grip muscle strength between calisthenics athletes and building construction workers. The research was conducted with a cross sectional approach using total sampling techniques. Data was taken in November 2023 at Saburai Field and Unila Bandar Lampung with 40 calisthenics athletes and 40 building construction workers who met the inclusion and exclusion criteria. Data was obtained by measuring using a Camry dynamometer. Data were analyzed using the Independent T-test. The result showed that there was a significant difference between the hand grip muscle strength of calisthenics athletes and building construction workers with a p value of 0.000. It concluded that there was a significant difference between the hand grip muscle strength of calisthenics athletes and building construction workers.
Faktor-Faktor yang Mempengaruhi Penggunaan Obat Herbal dan Obat Tradisional pada Pasien Hipertensi Sahanaz Zaqiyah Darozah; Dwi Aulia Ramdini; Afriyani; Oktafany
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.v14i3.1012

Abstract

The use of traditional medicine derived from various types of plants has become a culture and tradition in Indonesia. It is primarily used for treating metabolic and degenerative diseases, with hypertension being one of the notable examples. Hypertension stands as a leading cause of premature death worldwide. The global incidence of hypertension in 2015 reached 1.13 billion, with a prevalence ranging between 30-45%. Currently, approximately 75-80% of the world's population with hypertension decide to use herbal medicines because they can be tolerated by the body and have fewer associated side effects. The utilization of herbal and traditional medicines is widespread across various countries, including 29.4% in Iran, 21% in South Africa, 75.6% in Tanzania, 30.6% in Malaysia, and 54%-78% in Indonesia. Therefore, this article discusses factors influencing the use of herbal and traditional medicines among hypertensive patients. Factors known to influence the utilization of these medicines include gender, age, education, occupation, and medication adherence. Health professionals have to be concerned about herbal and traditional medicines use in hypertensive patients to ensure that the treatment is safe, effective, and minimizes the risk of side effects and drug interactions.
HERPES ZOSTER DEXTRA FACIAL Panonsih, Resati Nando; Valentine, Amelia; Rizdanti, Fezagustia; Rachmawati, Endah; Risdinar, Risa Rismaya; Imalambasi, Nada Nisrina; Faatin, Nafiisa Nur; Prayoga, Muhammad Fachmi; Ningrum, Dewi Wahyu Setia; Fitriani, Anisa
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.1017

Abstract

Herpes zoster is a manifestation of reactivation of latent endogenous infection of the varicella zoster virus in the neurons of the dorsal root sensory ganglion, cranial nerve ganglion or autonomic nerve ganglion which spreads to nerve tissue and skin in the same segment. Herpes zoster occurs sporadically throughout the year without knowing the season. The incidence of herpes zoster reaches two to three cases per thousand population each year. The incidence and severity of the disease increases with age. More than half of all cases reported occur in people over 60 years of age and complications occur in almost 50% of people in old age. Herpes zoster is rarely found at an early age (children and young adults), but when it occurs, it is likely due to maternal varicella during pregnancy. The incidence of herpes zoster in men and women is the same. The risk of disease increases with the presence of malignancy, or with bone marrow/kidney transplantation or HIV infection. There is no gender predilection. Herpes zoster is contagious but its transmission capacity is small compared to varicella. The treatment received by the patient was observing bleeding, checking vital signs periodically, and providing pharmacological treatment in the form of acyclovir 400mg tablets and acyclovir cream. Patients are advised to check in a week later. The prognosis for this patient is dubia ad bonam.
Kondiloma Akuminata pada Kehamilan: Tinjauan Kasus dan Tatalaksana Andriana, Risa; Zulfadli, Zulfadli
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.v14i2.1019

Abstract

Condyloma acuminata (CA) or genital wart is a benign proliferative epidermal or mucosal lesions attributed mostly to HPV type 6 or 11. CA is reported to occur frequently in pregnant women. Management of CA in pregnancy requires consideration of the appropriate benefit and safety ratio. Although there are no standard guidelines for the management of CA in pregnancy, there are several options including cryotherapy, topical imiquimod, laser therapy, photodynamic therapy, trichloracetic acid, and local hyperthermia. This case review aims to demonstrate the effectiveness of KA therapy in pregnancy. The case of a 30 years-old woman with a gestation age of 34 weeks went to RSUD Dr. H. Abdul Moeloek, Lampung Province with multiple verrucous vegetation lesions on vulva and perianal area. The patient was diagnosed with anogenital condyloma acuminata. The patient was treated with 80% TCA once per week until term of pregnancy and the CA lesions were reduced. The patient gave birth by Caesarean Section (SC) to avoid the risk of transmitting viral infections to the baby being born and postpartum electrosurgery was performed on the remaining CA lesion. In conclusion, the management of CA in pregnancy requires several considerations, including gestational age, location and size of the lesion, and potential risks and benefits of therapy.
G5P4A0 HAMIL 28 MINGGU DENGAN PARTUS PREMATURUS IMMINENS (PPI) Shariff, Fonda Octarianingsih; Irhamna, Teguh
Medula Vol 14 No 4 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i4.1020

Abstract

Prematurity Iminens is a threat to pregnancy where signs of labor appear at preterm gestational age (20 weeks – 37 weeks) and the baby's birth weight is less than 2500 grams. In a patient with G5P4A0 28 weeks pregnant with complaints of lower abdominal pain and cramps. Complaints accompanied by blood coming out of the birth canal at 14.00 WIB, BAK and defecation felt painful. Imminent premature parturition is a threat to pregnancy where signs of labor appear at preterm gestational age (20 weeks – 37 weeks) and the baby's birth weight is less than 2500 grams. Imminens premature labor is diagnosed with contractions that repeat at least once every 7-8 minutes, or 2-3 times within 10 minutes, pain in the lower back, spotting bleeding, feeling of pressure on the cervix. Pregnant women who are at risk of preterm labor and/or showing signs of preterm labor need intervention to improve neonatal outcomes. The conclusion has been established through a working diagnosis of G5P4A0 28 weeks pregnant with Partus Prematurus Imminens (PPI) based on clinical considerations, physical examination findings, and supporting examinations. Several types of drugs that can be given as tocolysis are calcium antagonists, for example Nifedipine 10 mg/oral repeated 2-3 times/hour, continued every 8 hours until contractions disappear and can be given again if contractions recur and the maintenance dose is 3 x 10 mg. Other alternative medications are other types of β-mimetics such as salbutamol, terbutaline, rithrodine and soxuprin or magnesic sulfate (MgSO4) and antiprostaglandins (indomethacin), but these are rarely used because of side effects on the mother or fetus. The aim of providing corticosteroid therapy is to mature fetal lung surfactant, reduce the incidence of RDS, prevent intraventricular bleeding, which ultimately can reduce the risk of neonatal death. Corticosteroids need to be given if the gestational age is <35 weeks. The drugs that can be given are dexamethasone (at a dose of 4 x 6 mg i.m with a 12 hour interval) or bexamethasone (at a dose of 2 x 12 mg i.m with a 24 hour administration interval).
Amenore Sekunder Shariff, Fonda Octarianingsih; Rizdanti, Fezagustia
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.1022

Abstract

Primary amenorrhea is a condition where menstruation does not occur in women aged 16 years. This situation occurs in women of reproductive age 0.1-2.5%. Meanwhile, secondary amenorrhea is the absence of menstruation for three cycles or 6 cycles after previously having a normal menstrual cycle. The incidence rate is around 1 to 5% in women of reproductive age. Treatment or management of amenorrhea depends on the cause. If the cause is drastic weight loss or obesity, sufferers are advised to follow an appropriate diet. If the cause is excessive exercise, sufferers are advised to reduce it. If the cause is a tumor, then surgery is performed to remove the tumor. So basically treating amenorrhoea always requires the help of a doctor to help diagnose or find the cause. The patient came to the Pertamina Bintang Amin Husada Hospital polyclinic on February 6 2024 with complaints of no menstruation since 4 months accompanied by lower abdominal and back pain. The treatment obtained by the patient was observation of bleeding, checking vital signs regularly, norelut tab twice a day, 2 tablets for 5 days, the patient was advised to diet. The prognosis for this patient is dubia ad bonam. The working diagnosis in this case is secondary amenorrhea based on clinical considerations, physical examination findings, and supporting examinations.
Myasthenia Gravis Pada Wanita 42 Tahun: Laporan Kasus Tania Tamara; Fitriyani
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1027

Abstract

Myasthenia gravis (MG) is an autoimmune disease, MG attacks the postsynaptic membrane, disrupts neuromuscular transmission, and causes skeletal muscle weakness and fatigue. Myasthenia gravis is a treatable disease but can result in significant morbidity and even death. This article aims to discuss the diagnosis, therapy, and prevention of disease progression. A 42-year-old woman presented with complaints of weakness all over the body since 4 years ago, which has worsened in the last 2 months, accompanied by shortness of breath, coughing, difficulty speaking, and a nasal voice. Physical examination revealed ptosis (+/+), motor strength 3/3/3 / 3/3/3. Laboratory examination showed leukocytes 11,500/µL. Electromyography (EMG) and nerve conduction velocity (NCV) examination showed a 10% reduction in repetitive nerve stimulation (RNS), Harvey Maslan (+). The clinical symptoms of MG are fluctuating weakness in the extra-ocular, bulbar, and proximal muscles. Signs of muscle weakness include unilateral or bilateral ptosis, binocular diplopia, inability to lift the head straight, dysphagia, and dysarthria. MG can progress generally to proximal muscle weakness with varying degrees of severity. The main treatments for MG are cholinesterase enzyme inhibitors and immunosuppressive agents. Previously, a case of myasthenia gravis was described in a 42-year-old female patient. The diagnosis of this case was made based on a previous history of myasthenia gravis, symptoms of weakness in the ocular, bulbar, and extremity muscles. A possible risk factor for re-triggering MG symptoms in patients is infection. Establishing the current diagnosis and treatment options for MG play an important role in preventing worse disease progression.
Meningoensefalitis TB Pada Laki-Laki Usia 20 Tahun dengan Human Immunodeficiency Virus : Sebuah Laporan Kasus Fitriyani, Fitriyani; Saragih, Andriani Dearta
Medula Vol 14 No 6 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i6.1029

Abstract

Meningoencephalitis is a neurological condition that contains both symptoms of meningitis and encephalitis – inflammation of the meninges (lining of the CNS) and inflammation of the brain tissue itself. Fever, headache, meningismus, changes in mental status, neurological deficits and/or seizures are symptoms of meningoencephalitis. Mycobacterium tuberculosis infection in the central nervous system can cause several diseases, one of which is meningitis. Meningitis is an inflammatory condition of the meninges caused by an infective agent. If this meningeal infection process affects the brain parenchyma, it is called meningoencephalitis. Meningoencephalitis patients who present with decreased consciousness should be considered whether they have tuberculous meningitis (TB), especially if there is a history of pulmonary tuberculosis, alcohol use, Human Immunodeficiency Virus (HIV) infection or other conditions associated with impaired immune response. The diagnosis of TB meningoencephalitis is often delayed due to late presentation of the clinical picture, resulting in high morbidity and mortality rates. TB meningoencephalitis is also associated with a high incidence of sequelae that persist for a long time and tends to have a poor prognosis, so immediate treatment or management is needed for patients. We report the clinical presentation and management of a case of a man with meningoencephalitis and a history of HIV disease. A 20 year old man with the main complaint of loss of consciousness and pain throughout the body. Additional complaints include fever, dizziness, trembling in both hands accompanied by nausea and vomiting since 8 days of SMRS. The patient was then taken to the emergency room at Abdul Moeloek Regional Hospital with complaints of loss of consciousness, body shaking and pain throughout the body. Cough (-), runny nose (-), vomiting (-), diarrhea (-), head trauma (-), coma consciousness. Previously the patient had been diagnosed with HIV. Physical examination showed meningeal stimulation (+), Management of meningoencephalitis using antibiotic therapy. Several neurological disorders can occur in Meningoencephalitis patients.

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