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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 REMAJA 16 TAHUN DENGAN BABY BLUES SYNDROME DENGAN PENDEKATAN KEDOKTERAN KELUARGA Totalia, Lely Sustantine; Susanto, Tirta D; Soeryani, R. Wianti
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1173

Abstract

Adolescents are an age group that is vulnerable to various changes, both physically and psychologically. Adolescence is characterized by various challenges, including in terms of mental readiness to face new roles, such as becoming a mother. These conditions can trigger the onset of baby blues symptoms, such as feelings of sadness, anxiety, and excessive fatigue after childbirth.This case describes the treatment of a 16-year-old adolescent girl who experienced baby blues after giving birth to her first child with a family medicine approach. The patient complained of feelings of sadness, moodiness, difficulty sleeping, often brooding and crying without cause, and feeling useless and unsuitable for motherhood. The patient also showed symptoms such as not wanting to take care of the child, including breastfeeding, and sometimes even wanting to hurt the child because of fatigue. This condition was exacerbated by limited social support, where the husband's parents and the patient's parents were in a distant city. Through a holistic and comprehensive family medicine approach, the medical team sought to identify the factors contributing to the emergence of baby blues in the patient, as well as evaluate the effectiveness of the interventions made to help the patient overcome her condition. This case report is expected to serve as a reference for health practitioners in dealing with similar cases in the future and increase public awareness, especially among adolescents, regarding the importance of paying attention to mental health. Interventions involving medical, psychological and social support have been shown to be effective in helping patients overcome challenges and adapt to their new role as mothers.
Review Artikel: Aktivitas Farmakologi Daun Alpukat (Persea americana Mill.) Rahmadhita, Elmira; Iqbal, Muhammad; Oktoba, Zulpakor; Nurmasuri, Nurmasuri; Triyandi, Ramadhan
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1174

Abstract

Indonesia possesses abundant natural resources, including the abundant fish, which are considered an alternative to modern diets. Fish, particularly alpaca, have high economic value and potential for local consumption. Alpaca is rich in protein, selenium, minerals, and anti-inflammatory properties that can help maintain health and prevent kidney damage.Alpukat (Persea america Mill.) is a rich, commercially valuable, and potentially beneficial food source for local consumption. Research has shown that alpaca can help prevent kidney damage by providing essential nutrients like potassium, magnesium, vitamin E, flavonoid, saponin, alkaloid, steroid, vitamin E, mineral, natrium, tanin, alkaloida, quersetin, polifenol, asam lemak tidak jenuh, zat filantik, and kalium. Alpukat also contains flavonoid and quersetin, which help prevent cholesterol accumulation and reduce the risk of lipid oxidation. Flavonoid and quersetin also help prevent glucosa absorption and oxidative stress, which can lead to cancer and other health issues. Alpukat also contains potassium with diuretic effects, which can be used for treating ginkgo biloba, kencing biloba, tinggi, and sakit kepala. Diuretik, a substance that increases urine volume and excretion of waste, can help prevent kidney damage. In conclusion, Indonesia has a rich and diverse food supply, including various types of fish, which have significant economic and health benefits.
The CORRELATION BETWEEN NEUTROPHIL LYMPHOCYTE RATIO WITH DEATH IN CORONAVIRUS DISEASE 2019 PATIENTS AT RSUD DR. H. ABDUL MOELOEK LAMPUNG PROVINCE Tibar, Fifi Nurliza Aini; Kurniati, Intanri; Rahmawati, Selvi
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1052

Abstract

World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) a pandemic as of March 9, 2020. Data as of October 8, 2021 recorded a total positive case of COVID-19 in Lampung Province were 49,304 cases with 3,790 deaths. Disease progression in COVID-19 patients was determined based on the results of laboratory tests. Several studies reported that the value of Neutrophil Lymphocytes Ratio (NLR) was strongly associated with clinical worsening and even death in COVID-19 patients. This study was purposed to determine the relationship between NLR with death in COVID-19 patients. This study was an observational analytic study with a cross sectional design. The sample was medical record data taken from 44 COVID-19 patients who survived and 44 COVID-19 patients who died in March 2020 - September 2021 at Dr. RSUD. H. Abdul Moeloek Lampung Province. The sample was selected using purposive sampling technique. Statistical analysis was performed by univariate and bivariate analysis. The result of the bivariate analysis with chi quare test showed the p value was 0.000 (p<0.5), which indicated that there were a relationship between NLR with death in COVID-19 patients at RSUD Dr. H. Abdul Moeloek Lampung Province. There were a statistically significant relationship between NLR with death in COVID-19 patients at RSUD Dr. H. Abdul Moeloek Lampung Province. 
Pendekatan Anestesi pada Bedah Tulang Belakang Ghozali, Imam; Hamdi, Tasrif; Ayu Assyifa Hamka Dinata
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1139

Abstract

Spinal anesthesia is performed by injecting local anesthetic into the cerebro-spinal fluid. An anesthesiologist's adequate knowledge of anatomy, physiology, and pharmacology will make anesthesia safe and satisfactory for the patient, surgeon, and anesthesiologist. Spinal anesthesia is now often used in spinal surgery. The advantages of using this technique are a lower postoperative pain scale, minimizing the effects of postoperative nausea and vomiting, a shorter procedure, and high patient satisfaction. The first case was Mr S aged 55 years with a diagnosis of low back pain and compression of lumbar vertebra 4, lumbar 5 and sacrum 1 undergoing laminectomy, decompression and biopsy. The second case, Mrs. NH, aged 46 years, was diagnosed with ASIA 3 spinal cord syndrome and compression fracture of the T 10-11 vertebra, undergoing thoracic fusion and laminectomy surgery. The third case, Mrs. H, aged 53 years, was diagnosed with T10-11 tuberculous spondylitis who underwent laminectomy, thoracolumbar fusion and biopsy. Anesthesia for the first case (Mr. S) and the second case (Mrs. NH) used Single-Shot Anestesi Spinal Segmental Thoracic atau Thoracic Spinal Anesthesia (TSA). Meanwhile, the anesthesia for the third case (Mrs H) used the Two Stabbing Techniques.
POTENSI INTERAKSI OBAT PADA PASIEN SKIZOFRENIA Suri, Nurma; Salsabila, Lyansaputri; Adjeng, Andi Nafisah Tendri; Oktafany, Oktafany
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1165

Abstract

In the treatment of schizophrenia, antipsychotics as the main therapy are generally combined with additional therapy. Combination therapy has a risk of drug interactions. The aim of the study was to describe the potential factors that influence drug interactions. The study was conducted using observational quantitative analytic methods with a retrospective cross-sectional approach. The sample was selected by total sampling method in the medical records of inpatients at the Lampung Mental Hospital from January-December 2022. The Lexicomp software was used to identify potential drug interactions. In the 265 samples, 344 treatment profiles were obtained with a total of 1349 drugs used. Then, 1786 potential drug interactions were classified as level of risk A (0%), B (0.8%), C (80.2%), D (19%), and X (0%). There was a significant relationship between gender, length of stay, and number of drugs (p<0.05) on potential drug interaction level D (major). Multivariate analysis showed the number of drugs had the strongest relationship (p=0.000 OR=8.233) to potential drug interactions. There was a significant relationship between gender, length of stay, and number of drugs with potential drug interactions level D. The number of drugs had the strongest with potential drug interactions.
Penatalaksanaan Fourniers Ganggrene pada Area Skrotum dengan Diabetes Mellitus Tipe II Sustantine Restiany, Helen; Sustantine Totalia, Lely; Anthony, Willy; Taba Parinding, Imanuel
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1175

Abstract

Fournier's Gangrene (FG) is a rare but progressive and life-threatening necrotizing fasciitis (NF) with a prevalence rate of approximately 1.6 cases per 100,000 males annually. FG is often caused by polymicrobial infections, with common sources being urological diseases in the perianal region. A 35-year-old male presented with a painful boil in the lower scrotal area. The lesion ruptured, discharging pus mixed with blood and emitting a foul odor. The wound progressively enlarged, extending from superficial layers to the peripheral nervous system. The patient had a one-year history of diabetes mellitus (DM) with an HbA1C of 7.8% and a random blood glucose level of 98 mg/dL. Based on culture, radiological, and laboratory findings, a diagnosis of scrotal FG was established. The patient underwent debridement from the scrotum to the abdominal wall, including both iliac regions. Regular post-debridement wound evaluations were conducted to ensure the removal of necrotic tissue. Broad-spectrum antibiotics, such as ceftriaxone and metronidazole, were administered to reduce systemic toxicity, inhibit infection progression, and eliminate causative microorganisms. Early and radical debridement of necrotic and non-viable tissue is crucial in halting infection progression, especially in patients with type 2 DM. The cornerstone of FG management includes hemodynamic stabilization, systemic broad-spectrum antibiotic therapy, and surgical debridement. Supportive care, such as hyperbaric oxygen therapy, may be beneficial in certain FG cases. The mortality rate for FG is considerably high, with studies indicating rates ranging from 17% to 28% in Indonesia. Diabetes mellitus and infections with Clostridium perfringens have been identified as independent risk factors for in-hospital mortality among male FG patients. FG is a medical emergency requiring prompt diagnosis and aggressive treatment, including surgical debridement and broad-spectrum antibiotics. Early intervention is essential to improve patient outcomes.
Uncontrolled Type 2 Diabetes Mellitus Induces an Enterococcus faecalis Lung Abscess: A case report Aryana, Wayan Ferly; Wibowo, Adityo; Gozali, Achmad; Saputra, Tito Tri; SL, I Made Afryan; Febrihartati, Isura
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1184

Abstract

The incidence of lung abscess has increased due to the rise in antibiotic resistence, aging population, and immunocompromised patients.  Lung abscess is associated with high mortality rates, ranging from 1—20% globally, long treatment cycles, and significant management costs. Diabetes millitus affect innate and adaptive immunity, This dysregulation, microvascular complications, poor vascular flow, can further compromise an appropriate immune response and healing leading to worsening or secondary infections. Uncontrolled diabetes mellitus can lead patients to immunocompromised conditions, predisposing them to infectious disease. This study is a case report with data obtained through self-history, physical examination, and supporting examinations. A 49-year-old female patient presented with complaints of dyspnea, productive cough, and fever. The patient had a history of uncontrolled type 2 diabetes mellitus with fasting blood glucose 219 mg/dL. Chest examination showed a decreased of tactile fremitus on the left lung field, dullness on percussion of the left lung field, and decreased vesicular sound on auscultation of the left lung field. Laboratory and radiological examinations were also carried out. The CT show a well-demarcated lesion measuring 13.1x7.2x11.2 cm, air-fluid level (+), walled 0.5 cm thick  indicating suspicion of left lung abscess. The patient received treatments and showed clinical improvement so that therapy could be continued on an outpatient basis.
Seorang Wanita Usia 73 Tahun dengan Prolaps Uteri Derajat IV : Sebuah Laporan Kasus Zulfadli, Zulfadli; malia, sherly
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

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

Abstract

Uterine prolapse is a protrusion or lowering of an organ in a woman's pelvic cavity, such as the uterus, bladder, and rectum, while the cause of POP itself is multifactorial. A 73 year old patient came to the Emergency Department (IGD) with complaints of a pink lump coming out of the birth canal without bleeding accompanied by pain in the lower back, and lower abdominal pain which had gotten worse 2 days before entering the hospital. Previously, the patient had felt a lump in his genitals since 2 years ago, the lump came and went, especially when coughing, defecating, doing activities, walking, and standing, and came back by itself when lying down. The patient admitted that he had had a ring installed 1 year ago at RSIA AMC Metro because the patient felt that the lump coming out of his genitals was getting bigger and bigger. For 3 months, the patient has felt that the lump has completely come out and cannot go back in. From the results of the physical examination, the BMI was 26.7, and a pink mass without blood was seen coming out of the vagina. The treatment given to this patient was a total vaginal hysterectomy (TVH).
Penatalaksanaan Holistik pada Perempuan Usia 56 Tahun dengan Herpes Zoster Melalui Pendekatan Kedokteran Keluarga di Puskesmas Campang Raya Fauzan, Alifya Rizkiyana Qonita; Nasution, Syahrul Hamidi
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1192

Abstract

Herpes zoster is a disease caused by reactivation of the varicella zoster virus which remains latent. The incidence of shingles increases with age and the immune system weakens. Herpes zoster is a disease that can recur at any time, so it needs to be treated holistically. 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-centere and family approach. This study is a case report study. Primary data were obtained through history taking (autoanamnesis and alloanamnesis), physical examination and home visits. Secondary data were obtained from the patient's medical record. Patient Mrs. Z is 56 years old has been diagnosed with herpes zooster complaints of appearance of small groups of nodules filled with fluid on the right arm accompanied by fever since 3 days ago. The patient has a previous history of chickenpox. Patient does not know of the cause of her illness and hopes that her symptoms will disappear and not recur. Perform non-medical and medical interventions on patients and their families. The results of patient evaluations can follow these recommendations. Good progress has been seen in patients starting from a decrease in clinical symptoms and increased patient and family knowledge about her illness also changes in behavior. A family medicine approach can solve health problems and improve the patient’s quality of life.
Multigravida Hamil 30 Minggu dengan Partus Prematurus Imminens dan Pemendekan Serviks Janin Tunggal Hidup Presentasi Kepala : Laporan Kasus Kurniaji, Inna; Zulfadli, Zulfadli
Medula Vol 14 No 7 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i7.1193

Abstract

Imminent preterm in the presence of a threat in pregnancy with emergence signs in 20 weeks – 37 weeks. Cervical shortening is one of the the common reason of preterm labour. Both Preterm labour and cervical shortening are are considered multifactorial syndromes. A short cervix is defined as a cervical length (CL) ≤25 mm on transvaginal sonography (TVS) before 24 weeks to 32 weeks of gestation.This is a case report. A 31 years old woman with preterm pregnancy come with pain that intermitently radiating to the waist and become worst seven hour before entering hospital. Complaints accompanied by blood and mucus discharge from the genitals. From physical examination found that moderate sick in general condition, compos mentis, Blood pressure 121/86 mmHg, heart rate 112x/min, respiratory rate 20x/min, temperature 36.5 C. General examination within normal limits. In obstetric examination found that fundus uteri is 3 finger under proccesus xiphoideus (25cm), his (+) 3x in 10 minutes duration 30-40 second, fetal heart rate 156x/min. In inspekulo examination found that portio is livide, OUE closed, not found active bleeding, erosion/laserasion/polip (-) and vaginal toucher not performed in this patient. In Transvaginal USG found cervical length 2.48 cm. The diagnosis are G5P3A1 in 30 weeks with imminent preterm and cervical shortening. Patient planned conservative therapy such as observation of his, fetal heart rate, and vital signs mother, IVFD ringer laktat + 2 amp isosuprine gtt xx/min, dexamethasone 2x10 mg, nifedipine 4x10 mg.

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