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Medula
Published by Universitas Lampung
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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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A Management of 66 Years Old Women With Gout Artritis, Type II Diabetes Melitus, and Hypertension Using a Family Medicine Approach in Rajabasa Indah Community Health Center Area Revika Gina Luthfiya; Nusadewiarti, Azelia
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1580

Abstract

Gout Arthritis is a chronic progressive non-communicable disease caused by monosodium urate (MSU) crystal deposits. The prevalence of gout in Indonesia is the highest among other Asian countries. Diabetes and Hypertension are non-communicable diseases that occur in the world. Diabetes mellitus (DM) is a metabolic disease caused by impaired insulin secretion or insulin function. Type 2 diabetes mellitus is the leading cause of death in the world. The prevalence of type 2 DM sufferers according to the 2018 Riskesdas is 8.5%. Hypertension is a silent killer disease, according to the 2018 Riskesdas the prevalence of hypertension was 34.1%, an increase compared to 2013 which was 25.8%. Hypertension is a condition when blood vessel pressure is more than 140/90 mmHg. According to WHO 1.28 billion adults aged 30-79 years worldwide suffer from Hypertension. The diagnosis of Gout arthritis, Diabetes mellitus, and Hypertension is made based on clinical and supporting findings. A holistic approach based on family physicians was implemented through drug and non-drug interventions, including nutrition education, physical exercise, and family counseling in three home visits. Evaluation showed a decrease in uric acid levels, blood sugar, and improvement in blood pressure, as well as an increase in understanding and changes in patient behavior related to disease management. Patients began to implement a healthy lifestyle, such as regular exercise and food recording. An evidence-based medicine approach with family support has been shown to be effective in improving disease control and patient quality of life.
Penatalaksanaan Holistik pasien Wanita usia 49 Tahun dengan Otitis Eksterna Melalui Pendekatan Kedokteran Keluarga Wilayah Puskesmas Satelit Bandar Lampung. Putra, Mahardika; Ernawati, Tutik
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1585

Abstract

Otitis externa is an inflammation of the outer ear skin that is commonly caused by excessive ear cleaning, exposure to high humidity, frequent swimming, and prolonged use of earplugs or headsets. The most common pathogens involved in this condition are Pseudomonas aeruginosa and Staphylococcus aureus. Otitis externa is a common condition that can occur in all age groups, although it is rarely found in children under two years of age. Its incidence peaks between the ages of 7 and 14, with approximately 10% of the population experiencing the condition at some point in their lives, and 95% of cases being acute. There is no difference in incidence based on gender. Studies in the Netherlands and the United Kingdom report an annual incidence of approximately 1%, while data from the Centers for Disease Control and Prevention (CDC) indicate approximately 2.4 million visits per year due to acute otitis externa in the United States (8.1 visits per 1,000 population). In developing countries, the prevalence is reported to reach 17.5%. This report is a case study conducted using a family medicine approach, involving the identification of risk factors, clinical issues, and evidence-based medicine management with a family-oriented, patient-centered, and community-based approach. Primary data was obtained through self-reporting, physical examination, and home visits, while secondary data was derived from patient medical records. The evaluation was conducted holistically through qualitative and quantitative approaches from the beginning to the end of the study.
Laporan Kasus : Multipel Kolelitiasis dan Kolesistitis Akut Moderat pada Laki-Laki 68 Tahun dengan Hipertensi Kronis Aswan, Naufal Rasyid; Wintoko, Risal
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1589

Abstract

Kolelitiasis (gallstones) is the deposition of crystals in the pacifier sac or in the pacifier duct, consisting of cholesterol, bilirubin, and pacifier. Although often asymptomatic and found incidentally, gallstones can cause right upper abdominal pain, nausea, vomiting, obstruction, cholangitis, and pancreatitis, especially after consuming oily or spicy foods. Obstruction of the cystic duct, either by stones or functional problems, can cause acute inflammation of the gallbladder (cholecystitis). Typical symptoms are usually biliary colic, including post-meal cramping pain in the right upper quadrant or epigastric pain radiating to the back or scapula, especially seen after eating high spicy foods, often accompanied by nausea and vomiting, while typical symptoms of cholecystitis are pain that does not go away, and a palpable mass in the right upper quadrant, causing congestion that is edematous and thickened. This disease occurs due to an imbalance involving lipids and bile salts in the bile stored in the gallbladder. Patient Mr. I, aged 68 years old have several risk factors and comorbid associated with Kolelitiasis and cholecystitis and the following case report presents a discussion of the patient's clinical features and laboratory test results related to the onset of this disease. The management given to this patient is operative management (Laparoscopic Cholecystectomy), drug management (analgesics), and non-drug management (education on lifestyle changes).
Penatalaksanaan Holistik Pasien Anak Laki - Laki Usia 3 Tahun Dengan Skabies Melalui Pendekatan Kedokteran Keluarga Di Puskesmas Tanjung Sari Natar Muhammad Gusti Fawwaz; Listiani, Farida
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1595

Abstract

Scabies is a skin disease caused by an infestation that can be transmitted through direct or indirect contact. This condition can become chronic and lead to complications; therefore, appropriate and holistic management is necessary using a family medicine approach to achieve successful therapy. The aim of this study is to identify the internal and external risk factors and clinical problems present in the patient, to apply a holistic and comprehensive family physician approach based on the issues identified, and to carry out management based on Evidence-Based Medicine that is family-approach, patient-centered, and community-oriented. This study is a case report. Primary data were obtained through anamnesis, physical examination, and home visits. Secondary data were obtained from the patient's medical records. The patient, F, a 3-year-old child, presented with the main complaint of itching on the hands, feet, and body for the past two months. Internal risk factors for the patient included poor personal hygiene, a sibling with a history of scabies, a curative treatment pattern, and a lack of knowledge about the causes, risk factors, complications, prevention, transmission, and treatment of scabies. External risk factors included the family's lack of knowledge about the patient’s illness, its risk factors, complications, prevention, transmission, and treatment. Diagnosis and management of the patient were carried out in a holistic, patient-centered, family-focused, and community-oriented manner. Clinical improvements, as well as increased knowledge and behavioral changes in the patient and their family, were observed following the intervention.
Polycystic Kidney Disease Stadium Lanjut dengan Komplikasi Ekstrarenal pada Wanita 55 Tahun : Laporan Kasus Sihotang, Hillery; Sijabat, Hotmen
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1606

Abstract

Polycystic Kidney Disease (PKD) is an inherited kidney disorder characterized by the formation of multiple fluid-filled cysts in the kidneys, frequently involving other organs such as the liver. It is a progressive condition that can lead to end-stage renal disease (ESRD). This case report aims to explore the clinical course and management approach of a PKD patient with poor follow-up adherence since diagnosis. A 55-year-old female with a diagnosis of PKD since 2009 presented with abdominal enlargement, fatigue, and right upper quadrant discomfort. Despite a positive family history, the patient did not receive regular monitoring and relied on herbal remedies. Over 16 years, disease progression was marked by significant increases in serum urea and creatinine, development of multiple renal and hepatic cysts, and progression to chronic kidney disease (CKD) stage 4–5. The patient currently suffers from hepatic cyst complications and ESRD. This case highlights the accelerated progression of PKD in the absence of consistent clinical monitoring and early therapeutic intervention. It underscores the importance of early detection, regular renal function evaluation, patient and family education, and supportive care. Planning for renal replacement therapy and genetic screening of offspring are crucial to mitigate disease progression and improve outcomes in PKD patients.
PENGARUH EKSTRAK DAUN RANDU (Ceiba pentandra) TERHADAP PROSES PENYEMBUHAN LUKA SAYAT PADA MENCIT (Mus musculus L) Jezmy, Beby Kelidia; Oktarlina, Rasmi Zakiah; Sari, Ratna Dewi Puspita; Kurniawati, Evi
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1607

Abstract

Wound causes mechanical bleeding, inducing a response of the body to fix itself which undergoes a wound healing process through a few phases; hemostasis, inflammation, proliferation, and maturation or remodelling. Wound healing is a complex process due to biocellular and biochemistry activities occuring continously. One of the natural treatments is the administration of randu (Ceiba pentandra) leaf, a Spermatophyte which has been identified and used for its healing properties. This study was an experimental study with a post-test-only control group design, and datas were analyzed using a non-parametric Kruskal Wallis test. Treatments were given randu (Ceiba pentandra) leaf extract, grouped into 4: (K1): a negative control group, (P1): 40 ml of randu (Ceiba pentandra) leaf extract, (P2): 60 ml of randu (Ceiba pentandra) leaf extract, and (P3): 80 ml of randu (Ceiba pentandra) leaf extract. Through this study, randu (Ceiba pentandra) leaf extracts were rated based on the its wound healing rate and showed results of 80 ml, 60 ml, and 40 ml respectively. There is an effect of administration of randu (Ceiba pentandra) leaf extract on cut wound healing in mice (Mus musculus L) (p=0,037)  
The Management 52 Years Old Male With Hypercholesterolemia and Prehypertnsion Through Medical Approach Family in The Work Area of Puskesmas Tanjung Sari Natar Ahdalifa, Pinkan; Angraini, Dian Isti
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1608

Abstract

The prevalence of hypercholesterolemia in Indonesia increases with age. Hypercholesterolemia can cause cardiovascular and metabolic diseases. Riskesdas data shows abnormal cholesterol levels in the age of 45-55 years in Indonesia of 27.4%. Tekanan darah tinggi juga menjadi faktor risiko utama penyakit kardiovaskular. Risk factors for hypercholesterolemia and prehypertension are related to lifestyle so that they can be modified with appropriate management such as lifestyle interventions to prevent long-term complications and improve the quality of life of patients. Implementation of family doctor services based on evidence-based medicine in patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework with a patient-centered approach and a family approach. The analysis of this study is a case report. Primary data were obtained from anamnesis and physical examination. Secondary data were obtained from patient medical records at the Health Center. The assessment was carried out based on a holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. Patient Mr. M, 52 years old, came to the Tanjung Sari Natar Health Center with complaints of tingling in the feet, especially when the patient stood for more than 5 minutes since 3 days before. The patient was worried that his complaints could interfere with his daily activities. The patient is a casual laborer. Non-drug and drug interventions were carried out on the patient and his family with education related to the patient's illness in three home visits. The evaluation results obtained were that the patient's complaints decreased and the patient's and his family's knowledge regarding hypercholesterolemia increased. Holistic and comprehensive management of Mr. M's patient problems has been carried out by providing counseling to increase the knowledge of the patient and the patient's family.
Penatalaksanaan Perempuan Usia 48 Tahun Dengan Diabetes Melitus Tipe 2 Dan Prehipertensi Melalui Pendekatan Kedokteran Keluarga Di Wilayah Kerja Puskesmas Tanjung Sari Natar Miranda, Alyzah Nabila; Angraini, Dian Isti
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1610

Abstract

Diabetes Mellitus is a metabolic disease characterized by hyperglycemia due to abnormalities in insulin secretion, insulin action or both. Diabetes Mellitus is one of the degenerative diseases with a high prevalence and is increasing every year. There is a possibility of an increase in the number of people with Diabetes Mellitus in the future, so comprehensive management must be carried out which is expected to prevent complications and improve the quality of life of patients. The purpose of this case report is to apply Evidence Based Medicine-based services to patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework with a patient-centered, family-focused, and community-oriented approach. This study is a case report. Primary data were obtained through anamnesis, physical examination and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. After the intervention, there was an increase in patient and family knowledge regarding the importance of health care checks, regular medication consumption, diet patterns and physical activity that are appropriate for people with Diabetes Mellitus. After holistic management with a family doctor approach, Mrs. N age 48 years with type 2 Diabetes Mellitus adjusted based on initial holistic diagnostics. The interventions carried out have increased patient and family knowledge about the importance of control to health workers, regular drug consumption, diet patterns and physical activity as indicated by improvements in the final holistic diagnostics.
PENATALAKSANAAN HOLISTIK PASIEN PADA PEREMPUAN USIA 25 TAHUN DENGAN ASMA PERSITEN RINGAN BERBASIS LAYANAN KEDOKTERAN KELUARGA DI WILAYAH KERJA PUSKESMAS KEDATON Sari, Zada Amalia Agatha; Susanto, Eko Budi
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1613

Abstract

Asthma is a heterogeneous disease, characterized by chronic inflammation of the airways characterized by a history of respiratory symptoms such as wheezing, shortness of breath, chest tightness, and coughing that vary in time and intensity, accompanied by variations in expiratory airflow obstruction. The purpose of this study is to apply a holistic and comprehensive family medicine approach in detecting internal and external risk factors and solving problems based on Evidence Based Medicine which is a family approach, patient-centered, community oriented. This research method uses a descriptive study of case reports. Primary data were obtained through autoanamnesis, physical examination, and home visits to patients. Secondary data were obtained from patient medical records at the Kedaton Health Center. The assessment was carried out based on a holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. The results obtained were that patient Ms. S, 25 years old, diagnosed with mild persistent asthma was managed comprehensively, namely given medication in the form of bronchodilators and inhalers and carried out interventions using poster media and showing asthma exercise videos. The evaluation showed that the results were in the form of improved patient complaints, increased understanding of the disease as evidenced by a comparison of pre- and post-test values, and increased family support. The conclusion obtained was that the application of a family doctor approach was needed for holistic and comprehensive management of patients with mild persistent asthma to detect internal and external risk factors in order to support the success of therapy and improve the patient's quality of life.
Penatalaksanaan Holistik Pada Pasien Laki-Laki Usia 54 Tahun dengan Gout Artritis dan Hipertensi Melalui Pendekatan Kedokteran Keluarga di Puskesmas Sumur Batu Attara Rafilia Adhata; Ernawati, Tutik
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.1614

Abstract

Gout arthritis is a chronic progressive disease caused by the deposition of monosodium urate (MSU) crystals in the joints, kidneys and other connective tissues due to hyperuricemia. Based on the 2016 Bandar Lampung City health profile, hyperuricemia was included in the 10 most common diseases 141,857 cases. Hypertension is a condition when blood pressure is more than 140/90 mmHg. According to WHO, hypertension is a major problem that attacks 22% of the world's population. The purpose of this case report is to Identify internal risk factors, external risk factors, and clinical problems in patients. Implementing Evidence Based Medicine-based family doctor services for patients and patient management based on a framework for solving patient problems with a patient centered, family focused and community oriented 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 Mr.MY is 54 years old, has been diagnosed with gout arthritis and hypertension has concerns about his complaint is getting worse and cant be cured. The patient's hope is that the complaints disappear completely and do not recur. 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 gout arthritis and in this case is in accordance with several theories and critical studies from recent research. 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.

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