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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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Case Report: Dermatitis Kontak Iritan Pada Wanita 54 Tahun Setiawan, Putri Ayundari; Graharti, Risti; Fatmasari, Dina
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1668

Abstract

Irritant contact dermatitis (ICD) is a non-immunologic inflammatory skin disorder resulting from direct damage to the epidermal barrier by chemical, physical, or biological agents. ICD is more common than allergic contact dermatitis since most individuals are at risk of repeated exposure to irritants in daily activities, such as detergents. We report the case of a 54-year-old woman presenting with peeling, erythema, pruritus, and stinging pain on both hands after washing clothes with powdered detergent without protective gloves. Dermatologic examination revealed erythematous plaques with thick scales, diffuse borders, and fissures on the dorsal and palmar regions bilaterally. The diagnosis of ICD was established based on a clear exposure history, characteristic clinical features, and the absence of allergic manifestations. Management included ceramide-based moisturizer to restore skin barrier function, high-potency topical corticosteroid (clobetasol propionate 0.05%) to reduce inflammation, and oral antihistamine (cetirizine) to relieve pruritus. Patient education emphasized adherence to therapy, skin hygiene, and strict avoidance of repeated detergent exposure. Marked clinical improvement was achieved within a short period following combination therapy. This case highlights detergent exposure as an important cause of ICD among housewives and underscores the significance of preventive strategies, including the use of personal protective equipment, safer cleaning alternatives, and continuous patient education. Early recognition and comprehensive management are essential to reduce recurrence and improve patient quality of life.
Laporan Kasus : Pasien Anak 12 tahun dengan Katarak Juvenil Okuli Dekstra Ananda Fitriliani; Muhamad Maulana
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1672

Abstract

Juvenile cataract is one of the leading causes of visual impairment in children and adolescents, either due to congenital abnormalities or acquired factors. This condition may significantly reduce quality of life and carries a risk of amblyopia if not managed promptly. We report a 12-year-old boy presenting with blurred vision in the right eye for the past seven months, worsening within the last month. The patient complained of cloudy vision, difficulty seeing both near and far objects, and frequent glare. His mother noticed a whitish spot on the right eye. Ophthalmological examination revealed visual acuity of 1/300 in the right eye, leukocoria, whitish lens opacity, and a positive shadow test, while the left eye was within normal limits. The patient was diagnosed with juvenile cataract in the right eye and scheduled for cataract extraction with intraocular lens (IOL) implantation.    
PSEUDOANEURISMA ARTERI ILEOKOLIKA SEBAGAI KOMPLIKASI TRAUMA ABDOMEN TUMPUL: LAPORAN KASUS LANGKA Bastha, Sultan Mahathir; Wintoko, Risal
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1681

Abstract

Mesenteric artery pseudoaneurysm is a rare condition that can occur due to blunt abdominal trauma or postoperative complications. This lesion is often difficult to recognize early due to nonspecific symptoms, leading to diagnosis typically being made through imaging or intraoperative findings. Delayed management can result in serious complications, including bleeding and bowel necrosis. A 59-year-old female patient was reported to have arrived at the Emergency Department of Abdul Moeloeki Hospital with complaints of central abdominal pain for the past week, accompanied by nausea and vomiting. History of abdominal trauma was obtained from a fall in the bathroom one week prior, as well as a traffic accident one year ago. Physical examination revealed abdominal tenderness with muscle rigidity, decreased bowel sounds, and vital signs indicating tachycardia. Laboratory tests were within normal limits. Abdominal ultrasound showed a paraaortic cystic lesion. The patient then underwent exploratory laparotomy, where a pseudoaneurysm of the ileocolic artery was found along with necrosis of the ileum and cecum. A right hemicolectomy was performed. Histopathological examination of the tissue supported the diagnosis of pseudoaneurysm with necrosis. The patient successfully underwent the right hemicolectomy procedure without major postoperative complications. The clinical condition of the patient improved with stable postoperative recovery. Pseudoaneurysm of the ileocolic artery is a rare complication of blunt abdominal trauma that can lead to intestinal necrosis. Early diagnosis requires a high clinical suspicion and confirmation through imaging. Exploratory laparotomy with right hemicolectomy is the definitive therapy for cases with intestinal necrosis.
Kekuatan Genggaman Tangan pada Dewasa Muda Tiasti, Jania; Setiorini, Anggi; Nareswari, Shinta; Sangging, Putu Ristyaning Ayu
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1665

Abstract

Handgrip strength (HGS) is an important indicator that reflects both musculoskeletal health and overall well-being. Hand grip strength is widely applied in research and clinical practice because its measurement is simple, reliable, and able to represent overall muscle strength. The assessment of HGS is conducted using a handgrip dynamometer, which operates based on specific principles. However, the limited literature on normative data for young adult populations hinders the interpretation of handgrip performance in this age group. One normative study reported that in healthy young adults, the average HGS reached 36.32 kg in men and 22.96 kg in women. These values may vary depending on ethnicity, level of physical activity, and lifestyle habits. Factors influencing HGS include body composition, anthropometric characteristics, sex, age, nutritional status, and physical fitness. Physiologically, men tend to have higher HGS than women due to differences in muscle mass, hormonal levels, and muscle fiber distribution. The decline of HGS with increasing age is closely related to sarcopenia, a condition characterized by reduced muscle strength, mass, and function associated with aging. Therefore, maintaining handgrip strength from an early age is crucial to support daily activities, preserve independence in older age, and serve as an indicator of future health risks.
Episode Depresi Berat Dengan Gejala Psikotik Pada Wanita Berusia 17 Tahun: Sebuah Laporan Kasus rizki_novtarina21; Boy K.H, High; Graharti, Risti
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1674

Abstract

Major depressive episodes with psychotic symptoms are a form of major depressive disorder characterized by severe affective symptoms accompanied by delusions or hallucinations. This condition is relatively rare, but is associated with a poorer prognosis, a high risk of recurrence, and an increased suicide rate compared to depression without psychotic symptoms. This case report aims to describe the clinical manifestations, diagnostic process, and management strategies in patients with major depressive episodes accompanied by psychotic symptoms. The patient presented with feelings of depression, sadness, and lack of enthusiasm in performing daily activities for 1 year, which had worsened for 4 months prior to admission to the hospital, since the death of the patient's mother. The diagnosis was established based on a psychiatric interview, mental status examination, and diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Management consisted of a combination of antidepressants and antipsychotics, as well as intensive psychosocial support. This report emphasizes the importance of early detection, accurate diagnosis, and comprehensive management to reduce the risk of complications, improve the patient's quality of life, and reduce the recurrence rate. Thus, this case study is expected to serve as an additional reference in the clinical management of major depressive disorder with psychotic symptoms.
Update on Hypertension Guidelines: A Literature Review Andika, Gede Agus; Graharti, Risti
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1682

Abstract

Hypertension is one of the major worldwide health problems, with its prevalence continuing to increase year by year. This condition is known as the “silent killer” because it often does not cause specific symptoms, but is closely related to increased morbidity and mortality due to cardiovascular and non-cardiovascular complications. Various epidemiological studies show that hypertension contributes to high rates of coronary heart disease, stroke, kidney failure, and premature death. Recent literature also confirms that risk factors for hypertension include unhealthy lifestyles, high-salt diets, obesity, stress, and genetic predisposition. The diagnosis of hypertension requires accurate blood pressure measurement using standard protocols, either through examinations at healthcare facilities or self-monitoring at home. Various international guidelines, such as ACC/AHA, ESC/ESH, and national guidelines such as PERKI, emphasize the importance of early detection and blood pressure control with specific targets. Hypertension management strategies include non-pharmacological approach such as lifestyle modifications, as well as pharmacological approach using evidence-based antihypertension medications, such as diuretics, ACE inhibitors, ARBs, CCBs, and beta blockers. This literature concludes that hypertension management must be comprehensive, integrated, and sustained to prevent complications. These efforts does not only depend on medical interventions, but also involve patient education, routine monitoring, and health system support to reduce the burden of hypertension in the future.
Faktor-Faktor yang Mempengaruhi Kejadian Gangguan Muskuloskeletal (MSDs) pada Petani Tebu di Indonesia: Tinjauan Pustaka Nasser, Ghalib Abdul; Utomo, Muhammad Aditya; Winda Trijayanthi
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1698

Abstract

Musculoskeletal disorders (MSDs) are among the most common occupational health problems faced by workers in the agricultural sector, including sugarcane farmers in Indonesia. Excessive physical activity and performed without adequate ergonomic support make this group particularly vulnerable to musculoskeletal injuries. This study aims to synthesize determinant of MSDs among sugarcane farmers and to recommend targeted ergonomic strategies suitable for tropical agricultural environments through a literature review of scientific articles from relevant database. The findings indicate that MSDs are primarily influenced by repetitive work patterns, poor working posture, the use of non-ergonomic traditional tools, and adverse environmental conditions such as high temperatures and humidity. Additionally, psychosocial stress and limited access to ergonomic education and health facilities further exacerbate the condition. The review highlights the urgent need for comprehensive preventive strategies, including ergonomic interventions, occupational health education, improvements in working conditions, and psychosocial support. These efforts are essential to reduce the incidence of MSDs and enhance the occupational well-being of sugarcane farmers. The findings can guide policymakers in designing ergonomic-based agricultural health programs, especially among sugarcane farmers.
Ensefalitis Fitriyani, Fitriyani; Martogi Simalango, Eka Yuliana
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.859

Abstract

Encephalitis is inflammation of the brain parenchyma, usually caused by an infectious agent for through an autoimmune process that may be post infectious, paraneoplastic or idiopathic. Symptoms that can be caused include fever, changes in behavior, personality, cognition and consciousness. Other complaints may also indicate focal neurological deficits, seizures, movement disorders or autonomic instability. Estimates of the incidence of encephalitis worldwide range from 3,5 to 12,3 per 100.000 patients/year. The groups most at risk of encephalitis are the elderly, children under 1 year of age, people with a weak immune system. To diagnose encephalitis, namely lumbar puncture, brain imaging with CT or MRI, EEG, blood tests, brain biopsy. Case: case report Mrs. A, 40 years old with a diagnosis encephalitis based on anamnesis and physical examination as well as support for administration of betahistine 3x24mg, KSR 3x1, Ramipril 1x2,5mg. Dexamethasone Inj/8hours, Ranitidine Inj/12hours, Phenitoin 3x1, Sucralfat syr 3x1, Racikan 3x1 (Paracetamol 500 mg, Ibuprofen 200 mg, Codeine 20 mg), Ericaf 3x1, Depakene syr 2x1, Flunarizine 2x1, Acyclovir 5x1.
Hemorrhagic Stroke in Patients with a History of Ischemic Stroke Irawan, Wildan Kautsar; Fitriyani, Fitriyani; Putri, Giska Tri
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.v15i2.901

Abstract

Stroke is an acute neurological disorder characterized by disruption of the blood supply to the brain, either due to obstruction or bleeding. Stroke is currently still a health problem that causes many disabilities and deaths in Indonesia. Stroke can also cause economic problems because of the disability that arises as a result of stroke and the funds that must be allocated to treat stroke in the national health system. One of the complications of stroke that can occur is recurrent stroke. This study aims to systematically establish a diagnosis in a 42 year old female patient so that the patient can be treated appropriately. The method used is a case report with analysis of primary data obtained through autoanamnesis, alloanamnesis, physical examination and supporting examinations. A 42 year old woman came with complaints of decreased consciousness accompanied by headache, nausea, vomiting, and weakness in the left limbs. The patient had experienced a non-hemorrhagic stroke 3 years ago. The patient was diagnosed with hypertension 7 years ago, the hypertension was not controlled and the patient did not take medication. The patient in this case was diagnosed with hemorrhagic stroke with a history of ischemic stroke. Patients are managed with non-medical, medical and rehabilitative management. In non-medical management, bed rest is performed. Medical management was given mannitol 250/125/125 every 8 hours, domperidone 3x10mg, sucralfate 3x2c, amlodipine 5 mg at night, lisinopril 5 mg in the morning, and paracetamol 3x1000 mg. The patient also underwent physiotherapy.
A case report Space Occupying Lesion Pamarta, Alma Abigail; Fitriyani, Fitriyani; Putri, Giska Tri
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.v15i2.906

Abstract

Space Occupied Lession (SOL) is a substantial physical lesion, such as neoplasm, bleeding, or granuloma located in the skull cavity. The most common causes of increased intracranial pressure in neurological cases are brain trauma, brain tumors, inflammation, and hydrocephalus. Mrs. SU, 46 years old, 17 November 2023 MRS with complaints of sudden unconsciousness since this morning, approximately 15 hours SMRS. Initially the patient complained of a severe headache accompanied by nausea and vomiting. The patient has a history of headaches for many years that have become worse for the past 3 days. To overcome headaches, patients often take paracetamol. Additional complaints: left eyelid closes and swells and cannot see at all. The patient had never previously experienced decreased consciousness. When he arrived, the patient's general condition appeared to be moderately ill with somnolence with a GCS of 9 (E2 V2 M5). Blood pressure 145/95 mmHg. After observation the next day, awareness of apathy with GCS 13 (E3 V4 M5). Blood pressure was 132/85 mmHg, on physical examination there was left ptosis and left eyelid edema. On visual acuity examination, the visual acuity was 3/60 and the left oculi was 1/. The pupil is round, anisocoric, with a central position. Nystagmus in the left oculi is positive. From the supporting examination, namely a CT scan, it was found that there was an amorphous isodense lesion with ill-defined boundaries in the left frontotemporal lobe measuring 6.5 cm x 5.4 cm with minimal perifocal edema, suspected of glioma, which deviated from the midline to the right as far as 0.5. cm. The patient's clinical diagnosis was increased intracranial pressure in the frontotemporal with the etiology of SOL caused by hydrocephalus. Management for this patient is medical treatment, namely: IV FD NaCl 0.9% 20 gtt/minute, Dexametson 1 ampoule/8 hours, Mannitol 250cc – 125cc – 75cc – 50 cc, Paracetamol 500 mg 3x1, Ceftriaxon 1 gr/12 hours, B12 2x1. VP-Shunt installation. For patients with a diagnosis of increased intracranial pressure caused by SOL and hydrocephalus, medical management and VP-Shunt installation will result in a good prognosis.

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