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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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Penatalaksanaa Lansia Wanita Dengan Sindroma Metabolik Melalui Pendekatan Kedokteran Keluarga Di Wilayah Kerja Puskesmas Satelit Ratu Henggar Audrya Gharrieni; Dian Isti Angraini
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.v15i2.1616

Abstract

Metabolic syndrome is a collection of disorders that include insulin resistance, central obesity, dyslipidemia and high blood pressure. Definitions and criteria for diagnosing metabolic syndrome are constantly changing and are a topic of debate. In general, the prevalence of metabolic syndrome (SM) worldwide ranges from 20-25%, while in Indonesia it is 23.34%, with a higher prevalence in men (26.2%) than women (21.4%). Since hypertension and type 2 diabetes mellitus are chronic diseases and require long-term treatment, family physician services are needed to manage these diseases. The analysis in this study is a case report with primary data obtained from anamnesis and physical examination at the health center, and follow-up examinations during home visits to obtain environmental and social data. Secondary data were obtained from the patient's medical record at the Satellite Health Center. Assessment was carried out based on holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. In this case, diagnosis and treatment have been carried out according to theory and relevant journal references. After the intervention was given, there was an improvement in clinical symptoms and increased understanding of the patient and his family. The diagnosis and management of this patient was carried out holistically, patient centered, family approach, and community oriented. Based on a number of recent theories and studies, there is an increase in knowledge among the patient's family.
HOLISTIC MANAGEMENT OF A 48 YEAR OLD MAN WITH MATURE CATARACT AND GRADE II OBESE THROUGH A FAMILY MEDICINE APPROACH IN THE WORK AREA OF RAJABASA INDAH COMMUNITY HEALTH CENTER Farida, Lulu; 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.v15i2.1617

Abstract

Senile cataracts and obesity are two prevalent health conditions frequently observed among the adult and elderly population. Senile cataracts are characterized by lens clouding, leading to visual impairment, while obesity involves excessive fat accumulation, which can exacerbate ocular health through mechanisms of oxidative stress and systemic inflammation. The aim of this study was to apply a holistic and comprehensive family medicine approach to identify both internal and external risk factors and manage these issues based on Evidence-Based Medicine, incorporating family-approached, patient-centered, and community-oriented care. This research was conducted as a case report, with primary data gathered through anamnesis, physical examination, and home visits, and secondary data collected from the patient’s medical records. The case involved a 48-year-old male, Mr. D, who presented with progressively worsening blurred vision in his right eye over the past five months, originating two years prior. The patient reported overeating habits without regular physical activity. Physical examination revealed stable vital signs and a BMI of 36.3 kg/m² (obesity grade II). Local eye exam findings showed a right eye visual acuity of 1/300 with lens opacity and a negative shadow test. Both the patient and his family expressed concern due to their limited understanding of his condition. The diagnosis and management were carried out holistically—emphasizing patient-centered care, family involvement, and community support—based on current theories and research. Post-intervention, there was a notable improvement in the patient’s and family’s knowledge and behavior, contributing to better quality of life and overall health maintenance.
BODY STALK ANOMALY TIPE IV DENGAN OMFALOKEL BESAR PADA KEHAMILAN TRIMESTER TIGA: LAPORAN KASUS Saragih, Reynhard; Sari, Ratna Dewi Puspita
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.v15i2.1618

Abstract

Body stalk anomaly (BSA) is a rare and severe congenital malformation with an estimated incidence of approximately 1 in 14,000 births, and the majority of cases result in intrauterine death. Early detection of BSA is essential to differentiate it from exomphalos, which carries a significantly better prognosis. The exact etiology of BSA remains unclear, although chromosomal analyses have been conducted to investigate potential genetic abnormalities in affected fetuses. We report a case of a 35-year-old pregnant woman who presented to Dr. H. Abdul Moeloek General Hospital with complaints of premature rupture of membranes two hours prior to admission. A fetomaternal ultrasound examination revealed an intrauterine fetal demise in transverse lie, with a large omphalocele containing the small intestine, large intestine, liver, right kidney, and urinary bladder located outside the abdominal cavity. Additional findings included vertebral scoliosis and a short umbilical cord, with no other apparent major congenital anomalies. Biometric measurements were: BPD 80.7 mm, FL 54.4 mm, and HL 50.5 mm. The ultrasound impression concluded a diagnosis of body stalk anomaly. Early prenatal diagnosis using ultrasonography is feasible from 11 weeks of gestation, enabling detailed evaluation of fetal anatomy and abnormalities. Unlike gastroschisis and omphalocele, which are frequently associated with chromosomal abnormalities such as trisomy 18, 13, and 21, as well as Turner, Klinefelter, and triploidy syndromes, chromosomal aberrations in BSA are rarely reported, though mosaicism of 45,X and chromosome 16 polymorphisms have been documented.
Pasien Wanita 41 Tahun dengan Sindrom Hipersensitivitas Obat (SHO) akibat Antibiotik Purba, Kevin Jeremia; Angraini, Dwi Indria
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.v15i2.1619

Abstract

Aberrant reactions to drugs vary, ranging from mild to severe clinical symptoms. Drug Hypersensitivity Syndrome (SHO) is a systemic autoimmune disorder caused by aberrant reactions to drugs which can cause symptoms in the form of skin eruptions, fever accompanied by involvement of one or several internal organs. Drug Hypersensitivity Syndrome is often caused by drugs such as trimethoprim, allopurinol, metronidazole, dapsone and abacavir. This disease can also occur due to cross-reaction of drugs, such as anti-convulsant drugs (carbamazepine, phenytoin, phenobarbital) and non-steroidal anti-inflammatory drugs (piroxicam). Reported on a 41 year old female patient with complaints including: the main complaint was red spots accompanied by itching all over the body and yellowing of both eyes. Clinical symptoms appeared after the patient consumed various types of drugs in the last two weeks. Investigation revealed thrombocytopenia and a drastic increase in liver enzymes. Based on the physical and supporting examination, a diagnosis of Drug Hypersensitivity Syndrome et causa susp was made. amoxicillin. The main management of SHO is identification and stopping the causative drug, symptomatic therapy and recommended administration of systemic corticosteroids.
Pendekatan Holistik pada Perempuan Usia 29 Tahun dengan Kehamilan dan Anemia Melalui Pendekatan Kedokteran Keluarga di Puskesmas Rajabasa Indah Siregar, Kenos Stefanus; Nusadewiarti, Azelia
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.v15i2.1620

Abstract

Anemia remains a significant health concern, particularly among pregnant women, despite existing intervention efforts. Its prevalence is influenced by several risk factors, including inadequate iron intake, leading to iron deficiency anemia. A holistic approach is necessary to manage anemia effectively during pregnancy. This case report aims to identify the risk factors and clinical condition of a pregnant patient in order to provide comprehensive management that is patient-centered, family-focused, and community-oriented. The subject of this case is Mrs. A, a 29-year-old woman who was five weeks pregnant and presented with fatigue and dizziness for approximately one month. The diagnosis of iron deficiency anemia was made, and her condition was classified as functional class II. Both internal and external risk factors contributed to her clinical presentation. Management of her condition was carried out according to current theory and evidence-based medicine. The intervention focused not only on treating clinical symptoms but also on empowering the patient and her family to improve health behavior. A holistic approach in the treatment of disease is essential as it helps reduce risk factors by increasing patient awareness and encouraging sustainable lifestyle changes.
Laporan Kasus: Kehamilan 36 Minggu dengan Ketuban Pecah Dini dan Skizofrenia tanpa Pengobatan Nirfandi, Haikal; Sari, Ratna Dewi Puspita; Saragih, Reynhard Theodorus
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.v15i2.1621

Abstract

Perinatal mental disorders, including schizophrenia, increase the risk of complications during pregnancy, labor, and neonatal health. Schizophrenia in pregnant women can lead to premature rupture of membranes, preterm labor, and fetal distress. The use of antipsychotics during pregnancy is also associated with an increased risk of obstetric and metabolic side effects. This case report presents a 38-year-old pregnant woman, G5P4A0, at 36 weeks of gestation, with a seven-year history of untreated schizophrenia, who presented with premature rupture of membranes. Examination revealed stable maternal condition, although fetal distress was suspected. The patient was treated with intravenous fluids, antibiotics, tocolytics, and antipsychotics (haloperidol, CPZ, risperidone), and subsequently underwent cesarean section due to fetal distress. Women with schizophrenia are at higher risk of premature rupture of membranes, fetal distress, and preterm delivery. Antipsychotic use during pregnancy also increases the risk of complications such as gestational diabetes and metabolic disorders. The management of pregnant women with mental disorders requires a multidisciplinary approach involving psychiatrists, obstetricians, and neonatologists to minimize risks to both mother and fetus. Close monitoring of maternal medical conditions, medication dosages, and fetal growth is essential to optimize care, and decisions regarding the mode of delivery should consider both psychiatric and obstetric conditions.
Penatalaksanaan Dermatitis Numularis pada Perempuan 50 Tahun melalui Pendekatan Dokter Keluarga di Puskesmas Satelit Kota Bandar Lampung: Fakultas Kedokteran, Universitas Lampung Bagian Ilmu Kedokteran Komunitas, Fakultas Kedokteran, Universitas Lampung Ali, Muhammad Chaidar; 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.v15i2.1622

Abstract

Nummular dermatitis (ND) is a chronic inflammatory skin disorder characterized by round, coin-shaped lesions accompanied by itching and inflammation. Although more commonly affecting men aged 55–65 years, it can also occur in other age groups. Several risk factors contribute to its development, including dry skin, irritant exposure, infections, and environmental conditions. Family physicians play a vital role in promotive, preventive, curative, and rehabilitative efforts to improve patients’ quality of life. This study aimed to implement a comprehensive family medicine approach by identifying both internal and external risk factors and providing management based on Evidence-Based Medicine (EBM), emphasizing patient-centered, family-focused, and community-oriented care. This case report involved primary data collection through direct interviews, family anamnesis, physical examinations, and home visits to assess environmental, social, and family aspects. Secondary data were obtained from medical records. A holistic assessment using qualitative and quantitative methods was conducted throughout the management process. A 50-year-old woman presented with complaints of sudden-onset itching on the dorsal feet, knees, and arms persisting for one week, which progressively worsened and was accompanied by skin lesions. Interventions included patient and family education, family conference, pharmacological therapy, and supportive non-pharmacological management. Triggering factors identified in this case were dry skin, repeated trauma, limited health literacy, and occupational exposure. A holistic family medicine approach proved effective in reducing symptoms, enhancing patient knowledge, and preventing recurrence.
Management Of a 56 Year-Old Female Patient with Herpes Zoster Through a Family Medicine Approach in Panjang Primary Healthcare Center Itsa, Nando Abdila; Dian Isti Angraini
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.v15i2.1625

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 which are patient centred, family approach, and community oriented. 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 was based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Patient Mrs. S, 56 year-old, complaints of small nodules in groups containing fluid accompanied by sensations of pain, heat and itchy on the right side of his back since 8 days ago. The complaint began with fever a day before. The patient has a previous history of chickenpox. Non-medical and medical interventions are performed on patients and their families. The result reveals that the patient can follow these recommendations. Management has been given according to management guidelines. Good progress has been seen in patients starting from a decrease in clinical symptoms to changes in behavior. The role and support of the family is needed in the care and treatment of patients.
Penatalaksanaan Holistik Pasien Anak Perempuan Usia 12 Tahun dengan Impetigo Bulosa melalui Pendekatan Keluarga Hasan, Hasan; 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.v15i2.1627

Abstract

The World Health Organization Department of Child and Adolescent Health and Development states that impetigo is an endemic disease that is found in many tropical and subtropical countries. The global prevalence of impetigo is estimated at 11.2%, 2.5 times higher in children (12.3%) than adults (4.9%). Impetigo is divided into two types, namely bullous and nonbullous impetigo. Bullous impetigo is a bullous, thin-walled lesion with a reddish border, most commonly caused by Staphylococcus aureus. The aim of study is implementing the principle of doctor service according to the problems found and carrying out holistic and comprehensive management including patient-centered and family approaches based on Evidence Based Medicine. This study is a case report. The data obtained include primary data were obtained through alloanamnesis and autoanamnesis, physical examination and home visits and secondary data were obtained from the patient's medical record. A twelve year old teenager patient had the main complaint of blisters in the left hand and left leg area. Complaints about the blisters that are felt do not decrease and become more widespread and itchy. The patient’s family is concerned that her complaints are getting worse. Clinically the patient was diagnosed with Impetigo Bullosa. Next, holistic management is carried out, namely intervention using poster media.The diagnosis and management of this patient has been carried out holistically and comprehensively. In the process of changing behavior, the patient has reached the trial stage.
Literature Review: Hubungan Kepuasan Pasien Hipertensi Rawat Jalan Terkait Kepatuhan Minum Obat Hipertensi Disaputera, Alfafa Tsalaatsa; Oktarlina, Rasmi Zakiah; Graharti, Risti; Larasati, TA
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.v15i2.1628

Abstract

Patient satisfaction is a key indicator in assessing healthcare quality, especially in hospital pharmacy services which play a vital role in treatment effectiveness. Hypertension is a major chronic illness requiring strict medication adherence to prevent complications such as heart disease, stroke, and kidney failure. This review examines the relationship between outpatient hypertension patients' satisfaction with pharmacy services and their medication adherence. Findings highlight that satisfaction dimensions such as reliability, empathy, responsiveness, tangibles, and assurance significantly shape patient perceptions. Higher satisfaction correlates with increased adherence. Continuous education, empathetic interaction, efficient service systems, and clear pharmacist communication are essential. Quality pharmacy services not only improve patient outcomes but also support long-term hypertension control.

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