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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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Kelainan Genetik Pada Down Syndrome Cahyana, Adinda Husna; Syachrani , Fayza; Maharani , Mentari Putri; Himayani, Rani; Rahmanisa, Soraya
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.v15i2.926

Abstract

Down syndrome (SD) is a common and easily recognized genetic disorder. In the genetic disorder trisomy or SD, there is an extra chromosome on chromosome 21. This chromosome causes the production of certain proteins in excessive amounts, thus disrupting the normal growth of the organism and causing changes in brain development. The estimated incidence of SD is one in 800-1000 births. The incidence of SD in the world is 10 per 10,000 live births, and in recent years this figure has increased. The World Health Organization (WHO) estimates that there are around 8 million SD sufferers worldwide. In Indonesia itself, the prevalence of SD is 1 per 600 live births. Down syndrome is a condition where the sufferer has retarded physical and mental development due to abnormal chromosome development. Chromosomes contain genetic material that determines human characteristics, so that some children with Down syndrome will usually experience mental disabilities, whether mild or moderate.
Hubungan antara Imunisasi Rotavirus dengan Kejadian Diare pada Balita Syahfira, Reisyah; Nareswari, Shinta; Berawi, Khairunnisa
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.v15i2.969

Abstract

Diarrhea is a condition of defecating more than 3 times a day accompanied by a change in the consistency of the stool to liquid with or without mucus and blood that lasts less than one week. Diarrhea results in a loss of fluids and electrolytes, especially sodium and potassium, in large amounts. Fluid loss that continues and is not balanced with adequate replacement will result in dehydration. The risk of dehydration in toddlers is greater due to the inability to meet their fluid needs while their body fluid composition is large. Dehydration that is allowed to continue will result in several complications and even death. Therefore, diarrhea is one of the diseases that is the main cause of morbidity and death in children under five. One prevention of diarrhea is rotavirus immunization. Rotavirus immunization is an effort to actively create/increase a person's immunity against a disease so that if one day they are exposed to the disease they will not get sick or will only experience mild illness. This research was conducted to determine the relationship between rotavirus immunization and the incidence of diarrhea in toddlers. This research uses a literature review method with data sources from the National Center for Biotechnology Information, Google Scholar, and Science. The research year range of articles is 2018 to 2021 and articles conducted in English and Indonesian literature. The results of this literature review from the 6 articles analyzed stated that there was a relationship between rotavirus immunization and the incidence of diarrhea in toddlers.
Perdarahan Uterus Abnormal et causa Suspek Myoma Geburt+Anemia Sedang: Studi Kasus Shariff, Fonda Octarianingsih; Ningrum, Dewi
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.v15i2.1035

Abstract

The patient experienced complaints of bleeding from the genitals since 3 days ago and repeated since one month ago. At first the blood was just reddish spots, over time there was more and more, and the blood that came out was fresh, clotted blood accompanied by lower abdominal pain that spread to the waist. During bleeding, the patient uses approximately 10 40 cm pads a day. On physical examination, general condition/consciousness was found, both compos mentis and vital signs, general status examination revealed anemic conjunctiva (+/+), pale lips, and tenderness in the lower abdomen. Meanwhile, on external obstetric and gynecological examination, tenderness was found in the hypogastric region and bleeding appeared on internal examination. The working diagnosis in this case is Abnormal Uterine Bleeding et causa Suspected Myoma Gobert + Anemia based on clinical considerations, physical examination findings, and supporting examinations. On external obstetric and gynecological examination, tenderness was found in the hypogastric region and bleeding appeared on internal examination. In supporting examination, namely histopathological examination, the results showed Adenomyoma (Polyp of Cervix Uteri). Management in this case is curettage and extirpation
Sistokel: Laporan Kasus Shariff, Fonda Octarianingsih; Septia Rini, Vica Sukma
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.v15i2.1036

Abstract

Anterior wall prolapse (cystocele) occurs when the front wall of the vagina bulges. The patient is 52 years old with complaints of pain and soreness in the vaginal canal area for the past 6 months which has worsened for the last 3 weeks. Complaints are accompanied by a small amount of urination, and if the patient coughs or sneezes it is always accompanied by a small amount of urine output. The patient also complained of lower abdominal pain that radiated to the waist about 6 months ago, the pain came and went, and the pain got worse when the patient was active, especially when urinating, and decreased when the patient rested. The patient has no history of diabetes mellitus but has a history of hypertension. First menstruation at the age of 11 years. The patient did not use contraception. Based on the diagnosis based on anamnesis, physical examination, gynecological examination and supporting examinations, there is Cystocele. In the anamnesis, there were complaints of pain and soreness in the vaginal canal area since 6 months ago and worsened in the last 3 weeks. Complaints are accompanied by a small amount of BAK, and if the patient coughs or sneezes it is always accompanied by a small amount of urine output. The patient has a history of hypertension and is taking Amlodipine 5mg. History of menarche: 11 years, regular menstrual cycle, length of menstruation: 3-4 days with history of P3A0 pregnancy. On physical examination, external obstetric and gynecological examination revealed tenderness in the hypogastric region. On internal examination with VT there was no palpable protrusion, then the patient was asked to perform the Valsalva maneuver and an organ protrusion appeared from the vagina. On a supporting ultrasound examination, the results of the uterus were within normal limits. The patient goes home and is given education not to lift heavy loads and strain.
Preeklampsia Berat dan Infeksi HIV pada Primigravida Usia Kehamilan 37 Minggu: Sebuah Laporan Kasus Daraz, Fadila Gustiani; Zulfadli, Zulfadli
Medula Vol 14 No 9 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i9.1197

Abstract

The three main causes of maternal death in obstetric fields are: bleeding, hypertension in pregnancy, and infection. Severe preeclampsia is hypertension that appears at 20 weeks of pregnancy with accompanying organ disorders. HIV infection during pregnancy can cause vertical transmission from mother to child both during pregnancy and during labor. This case report discusses a primigravida woman in 37 weeks' gestation, with the chief complaints of about to give birth with HIV positive, there is no history of hypertension before pregnancy. Patient's physical examination showed fully conscious, blood pressure 161/112 mmHg, pulse frequency 112 x/minute, breathing frequency 20 x/minute, temperature 36.5ºC. Generalized status is obtained within normal limits. On obstetric examination, TFU is 39 cm, the uterus contracts with a frequency of 3 times in 10 minutes and a duration of 30 seconds, fetal heart rate 131 x/minute and 135 x/minute. Ultrasound examination is obtained by a double fetus. Patients undergo blood tests and obtained hemoglobin value 11.7 gr/dl, leukocytes 6,800/μl, hematocrit 33%, platelets 285,000/μl, AST 18 U/L, ALT 7 U/L, Ureum 18 mg/dl, creatinine 0 , 68 mg/DL and LDH 326 U/L. On urinalysis 150 protein (++). On immunological and serological examinations, HIV positive results were obtained. Management for this patient is observation of vital signs, uterine contractions, fetal heart rate, 1-3 hours stabilization, catheter installation permits with input/output recording. Medications were given to the patient including RL 20 drops/minute, 4 grams MgSO4 40% then drip 6 gram MgSO4 40% in RL 500 cc 10 drops/minutes, nifedipine orally 3x10mg, and injection of dexamethasone 10mg/12 hours, ARV medicine and performed termination of pregnancy by caesaria section. Childbirth through caesaria section surgery is at a less risk for transmission to infants, but adds other risks to the mother. Good, intraoperative, and postoperative preoperative management will make this caesaria section successful without obstacles.
Ketuban Pecah Dini pada Primigravida Usia Kehamilan 37 Minggu: Sebuah Laporan Kasus Ikram, Lucky; Zulfadli, Zulfadli
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.v14i8.1198

Abstract

Premature rupture of membranes (PROM) is the rupture of the amniotic membranes before delivery which is characterized by painless discharge and the patient being unable to hold it in. Preterm premature rupture of membranes can occur at or after 37 weeks of gestation and is called term PROM or prelabor rupture of membranes (PROM) and before 37 weeks of gestation or preterm PROM or preterm prelabor rupture of membranes (PPROM) PROM affects 3–15% of all pregnancies. global. PROM is associated with causes of perinatal mortality and morbidity with percentages of 18%–20% and 21.4% respectively. This study is a case report. A 24 year old female patient complained of a full term pregnancy accompanied by watery discharge. The patient complained that water was coming out, the patient realized that his trousers were suddenly wet, and suddenly this complaint was felt since 7 o'clock before administred. According to the patient's statement, the air is clear and has no smell. On physical examination, the level of consciousness was compos mentis, blood pressure 113/83 mmHg, pulse 80x/m, RR 20x/m, temperature 36.5oC, SpO2 98%. On obstetric examination, the height of the uterine fundus was 34 cm, the second part of the fetus was the buttock impression. It is located along the right back. The lowest part of the fetus's head. Convergent with the impression that the head has not yet entered the PAP. Decreased 5/5 The uterus contracts regularly, 3 times in 10 minutes, duration 30 – 40 seconds. Fetal DJJ was 141x/m and EFW was 3410. And an internal examination was carried out, on inspection a Pooling sign was obtained (+) and a nitrazine test was carried out with positive results. The patient was diagnosed as G1P0A0, 37 weeks pregnant in the 1st stage of late stage pregnancy with a history of PROM, a single live fetus in cephalic presentation. The patient's treatment consisted of giving broad spectrum antibiotics as prophylaxis and planned vaginal delivery. The treatment given was appropriate.
Gagal Jatung Kongestif Pada Primigravida Hamil 31 Minggu Dengan Penyakit Jantung Bawaan: Sebuah Laporan Kasus Nurmayeni; Zulfadli, Zulfadli
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.v14i12.1203

Abstract

Congenital Heart Disease (CHD) is a congenital heart disease where this disease has been present since a person was born. In pregnancy there are significant physiological changes in the cardiovascular system. These hemodynamic changes pose problems for mothers with congenital heart disease. This study is a case report. Data was obtained from a 31 year old woman who came with complaints of preterm pregnancy with complaints of severe shortness of breath since 2 weeks before entering the hospital with CHD. On physical examination, it was found that the general condition was seriously ill, compost mentis, blood pressure 107/84 mmHg, pulse 130x/minute, respiration 39x/minute, temperature 36.6°C, SpO2 70% NRM 15 lpm. On chest examination, a continuous murmur and wet rhonchi were found. Hematological examination showed an increase in ESR, urea, creatinine, SGOT and SGPT. Chest X-ray showed suspicion of pulmonary edema, bronchopneumonia and cardiomegaly. The results of the echocardiography examination showed PDA balanced shunt, PH, Severe TR, Moderate PR, Mild MR, RV mass 0.5 x 0.9 cm susp Infective Endocarditis. The patient was diagnosed with G1P0A0 26 weeks pregnant, not yet in labor with Dyspenu ec CHF with Congenital Heart Disease (PDA), Intrauterine JTH. Management of this patient is observation of general condition and vital signs, IVFD RL 500 cc 20 tpm, injection of furosemide 2 ampoules, ISDN 3 x 5 mg. Then transferred to the intensive care unit (ICU) and then terminated the pregnancy abdominally. The patient was declared dead on the 2nd day of treatment due to cardiogenic shock.
Mola Hidatidosa Komplit dan Hipertiroid pada Multigravida : Laporan Kasus Maitsa, Nisrina Ayu; Zulfadli
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.v14i8.1206

Abstract

Hydatidiform mole is an abnormal condition in pregnancy in which some or all of the chorial villi undergo hydrophic degeneration. Hydatidiform moles are classified into complete hydatidiform moles and partial hydatidiform moles. The incidence rate in Indonesia is around 1:80 normal births. Meanwhile, the incidence of partial molars is very rare, the incidence varies between 5:100,000 and 1:10,000 pregnancies. A 23 year old G4P2A1 woman came with complaints of bleeding from the genitals for 2 hours at SMRS. Fresh red blood, bubbles like fish eyes (+) but blood clots (-). Complaints accompanied by abdominal pain and genital pain. The patient was declared pregnant by the midwife. History of trauma (-), infection (-), history of abortion with a distance of ±4 months. Physical examination revealed consciousness compost mentis, BP 113/85 mmHg, pulse 125x/minute, respiration 24x/minute, temperature 36.6 C. Obstetric examination of the abdomen slightly convex, weak, striae (+), tenderness (-), fundal height uterus at the level of the umbilicus, DJJ (-). On inspection, the portio livid was found, the external uterine orifice was closed, the blood flux (+) was inactive. Laboratory examination revealed Hb 9 gr/dl, T3 3.06 nmol/l, T4 236.31 nmol/l, TSH 0.03 uIU/L and β hCG >5000 mIU/ml. Ultrasound shows snowstorm and vesicular pattern. This patient was diagnosed with complete hydatidiform mole and hyperthyroidism. Therapy consists of suction curettage and hyperthyroid medication. The conclusion is that the examination for the patient's diagnosis is sufficient and the therapy given is appropriate.
A Literature Review: Diagnosis and Management of Tympanic Membrane Perforation Brilliantama, Fandy Akbar; Arifin, Ahmad Fuadi Hasan; Al Farosi, Ulaiya Tsania; Clarista, Silva Anggraini; Verawati Ridhoi, Khonsa Khoirunnisa
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.v15i2.1215

Abstract

Tympanic membrane (TM) perforation is a medical condition in which the tympanic membrane ruptures, causing a hole between the outer and middle ear. This can be caused by infection, trauma, or sudden changes in pressure resulting in symptoms such as otalgia, otorrhea, tinnitus, and vertigo. Although many perforations heal spontaneously without complications, some cases can progress to chronic conditions resulting in hearing loss, chronic otitis media, cholesteatoma, and mastoiditis. The tympanic membrane, which functions to transmit sound waves to the inner ear, may not function properly after perforation, affecting hearing. Tympanic membrane perforation can occur at any age, is more common in men and is often associated with acute otitis media at a young age and trauma at an older age. This study provides a comprehensive review of the etiology, diagnosis, and management of tympanic membrane perforation, with a focus on common and rare causes and current clinical approaches. The conclusion of this article emphasizes the importance of appropriate diagnosis and management to reduce the risk of long-term complications and improve clinical outcomes.
Intracerebral Hemorrhage Hemisfer Dextra: A Case Report Fitriyani, Fitriyani; Sephia, Elmarossa Dinda
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.v14i12.1232

Abstract

Intracerebral hemorrhage is a brain injury due to acute extravasation of blood into the brain parenchyma with or without expansion of blood into the ventricles due to rupture of blood vessels. Several factors that increase the risk of this condition are chronic hypertension, amyloid angiopathy, anticoagulant treatment, and vascular malformations. Intracerebral hemorrhage can cause primary and secondary brain injury. Primary brain injury is the initial damage to the parenchyma by a blood clot. While secondary brain injury is a pathological change after bleeding. The most common clinical sign of this disease is a sudden focal neurological deficit. Management of intracerebral hemorrhage starts from drug therapy to surgery. This article discusses the case of a 43-year-old male patient with complaints of weakness in the left leg and arm since 3 hours before admission to the hospital. Other complaints include sudden vomiting preceded by a severe headache 1 day before admission to the hospital. The patient has a history of hypertension since 13 years ago but rarely consumes drugs and heart disease (STEMI) in June 2024. The patient also has a smoking habit since 10 years ago. Physical examination found blood pressure 165/97 mmHg, mouth turned to the left (N VII), tongue deviation to the left (N XII), left hemiparesis. Sodium examination found 133 mmol / L (hyponatremia). Non-contrast head CT scan examination found the impression of a hyperdense lesion in the right hemisphere, an impression of intracerebral hemorrhage. The patient was given drug management without surgical management.

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