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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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Anak dengan Tuberkulosis (TB) Paru Kasus Baru Terkonfirmasi Bakteriologis dengan Riwayat Human Immunodeficiency Virus (HIV) yang Menjalani Pengobatan Antiretroviral (ARV) Soemarwoto, Retno Ariza S; Afryan, I Made; Nareswari, Shinta; Sinaga, Fransisca; Saputra, Oktadoni; Herliyana, Lina; Hidayat, Hidayat
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1423

Abstract

Tuberculosis (TB) in children with Human Immunodeficiency Virus (HIV) is a complex clinical challenge due to the synergistic interaction between these two diseases, which mutually worsen the patient's clinical condition. HIV decreases immunity, thus increasing the risk of TB infection, while TB accelerates HIV progressivity. TB-HIV co-infection is a major cause of morbidity and mortality, especially in children with undetected M. Tuberculosis infection. By 2022, an estimated 710,000 HIV patients will develop TB, of which 187,000 will die. This article aims to provide an update on the management of pulmonary TB in children with HIV who are routinely on antiretroviral (ARV) treatment. The discussion covers the definition, epidemiology, etiology, disease progression, pathogenesis, diagnosis, supporting investigations, and management of TB-HIV. The diagnosis of TB in children with HIV is often difficult due to non-specific clinical manifestations and limitations of diagnostic tests. Therefore, early detection through comprehensive testing is essential. TB-HIV management requires a multidisciplinary approach, including appropriate TB treatment and integrated ARV administration. Intensive monitoring is also required to prevent complications, such as drug resistance or adverse effects of therapy. In conclusion, this article emphasizes the importance of a holistic approach in evaluating and managing pulmonary TB in children with HIV, including interprofessional collaboration, family education, and preventive efforts to improve patients' quality of life and reduce mortality.
Preliminary Study on Anxiety Levels Among Palm Oil Farmers in Simpang Pematang District, Mesuji Regency-Lampung Province (2024) Bachtiar, Nabylly Aghna; Saftarina, Fitria; Larasati, Ratri Mauluti; Angraini, Dian Isti
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1425

Abstract

As the world's largest palm oil producer, Indonesia bears a significant responsibility for the well-being of its farmers, including mental health aspects, which remain a pressing issue. Farmers face various occupational pressures that have the potential to trigger psychological disorders, particularly anxiety. Poorly managed anxiety can lead to decreased concentration and productivity. This study aims to describe the anxiety levels experienced by palm oil farmers in Simpang Pematang District, Mesuji Regency, Lampung. A cross-sectional design was employed in this study, utilizing purposive sampling for sample selection. A total of 109 palm oil farmers participated as respondents, and the collected data were analyzed using frequency distribution. The results indicate that 14.7% of farmers exhibited symptoms of anxiety, with 11.9% experiencing mild anxiety and 2.8% experiencing moderate anxiety. No cases of severe anxiety were found among the respondents. Although the overall anxiety level identified in this study was lower than in previous research, it remains a matter of concern. These findings highlight the necessity of continuous efforts to enhance the mental well-being of farmers. Therefore, a more intensive mental health promotion program is required to improve farmers' understanding of stress management strategies. By doing so, farmers are expected to maintain their psychological well-being, ultimately contributing to increased productivity in Indonesia's palm oil agricultural sector.
Relationship Between Work Duration and Work Experience with the Occurrence of Low Back Pain in Online Motorcycle Drivers Farhah, Putri Dzahabiyyah; Setiorini, Anggi; Graharti, Risti; Saftarina, Fitria
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1429

Abstract

Low Back Pain (LBP) is one of the most prevalent musculoskeletal disorders globally and a leading cause of disability. One of the occupational groups at high risk of LBP is online motorcycle taxi drivers, who spend long hours in a static sitting position while riding. The primary factors contributing to LBP among online motorcycle taxi drivers include long working hours and extended work tenure. This study aims to analyze the relationship between working duration and work tenure with the occurrence of LBP among online motorcycle taxi drivers. Based on various studies, it has been found that working more than 8 hours per day can increase the risk of LBP by up to 3.6 times due to excessive muscle strain and spinal load. Additionally, work tenure exceeding 5 years is associated with a higher risk of LBP due to accumulated physical stress, which can reduce muscle performance and deteriorate overall physical condition. Studies conducted in various cities, such as Makassar, Surabaya, and Padang, have demonstrated a significant relationship between working duration, work tenure, and the incidence of LBP among online motorcycle taxi drivers. Implementing proper work time management and ensuring sufficient rest breaks during riding are crucial steps in reducing the risk of LBP among online motorcycle taxi drivers. Additionally, attention to ergonomic factors in riding posture is essential to minimize the negative impact on musculoskeletal health.
Literature Review: Mekanisme Bacterial Vaginosis dalam Infeksi Intrauterin dan Dampaknya terhadap Kesehatan Reproduksi Wanita Ayuningtyas, Diah; Dewi Puspita Sari , Ratna; Sutarto; TA Larasati
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1430

Abstract

Intrauterine infection is an inflammatory condition involving various components of pregnancy, including the amniotic fluid, placenta, fetus, amniotic membranes, and decidua. One of the main mechanisms contributing to this infection is ascending infection from the lower genital tract, in which microorganisms such as Ureaplasma, Escherichia coli, and Streptococcus agalactiae ascend into the amniotic cavity. Imbalances in the vaginal microbiota, such as in bacterial vaginosis (BV), exacerbate the risk of ascending infection, by replacing the protective Lactobacillus dominance with anaerobic pathogens. This condition can lead to various obstetric complications, including preterm labor, preterm rupture of membranes, and increased maternal and neonatal morbidity and mortality. Studies have shown that changes in the vaginal microbiota can have significant impacts on reproductive health. Processes such as menstruation, sexual activity, and invasive medical interventions can alter the composition of the microbiota, affect vaginal pH, and reduce the dominance of Lactobacillus, thereby increasing the risk of intrauterine infection. In addition, uterine pumps play a role in the transfer of microorganisms from the vagina to the uterine cavity, further increasing the risk of infection. With the advancement of molecular technology, the understanding of vaginal and uterine microbiota is growing, especially in relation to the mechanism of intrauterine infection. Microbiota imbalance not only contributes to inflammation, but also alters immunological signaling pathways, reduces the barrier function of the endometrial epithelium, and allows pathogens to cross the placenta. Therefore, microbiota-based approaches, such as the use of Lactobacillus probiotics, as well as education about reproductive health, are potential strategies in preventing complications associated with intrauterine infection.
Pengaruh Pemberian Ekstrak Etanol Lada Hitam (Piper nigrum L) Terhadap Kadar Gula Darah dan Jumlah Spermatogonia Model Diabetes Tikus Putih Jantan (Rattus norvegicus) Galur Sprague dawley Talin, Jinan Naura; Hadibrata, Exsa; Rudiyanto, Waluyo; Windarti, Indri
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.v14i12.1431

Abstract

Diabetes mellitus that is not treated properly can result in infertility. The piperine content in black pepper can help in the quality of spermatogenesis process and blood sugar levels. This study aims to determine the effect of black pepper (P. nigrum L) ethanol extract on blood sugar levels and the number of spermatogonia in a diabetes model of male white rats (R. norvegicus) Sprague dawley strain. The study used a Posttest-only Randomized Control Group on 24 rats divided into 4 groups. All groups were induced with alloxan 150 mg/kgBW except for KN. P1 and P2 were given 122.5 mg/kgBW and 245 mg/kgBW black pepper ethanol extract. Blood sugar levels were checked using Easy Touch GCU with a normal limit of 50-135 mg/dL. The number of spermatogonia was calculated using a tool, namely ImageJ. The data were analyzed using the Shapiro- Wilk normality test and homogeneity test, followed by the Kruskal Wallis non-parametric test and the Post Hoc test. The statistical results of blood sugar levels obtained normally distributed data p>0.05, non-homogeneous data p<0.05, significant Kruskal-Wallis test results and continued Post Hoc test obtained significant results at P2 and K-. The number of spermatogonia obtained normally distributed data p>0.05, non-homogeneous data p<0.05. The results of the Kruskal-Wallis test were significant p<0.05 and continued Post Hoc test obtained significant results at P2 and P1. There was a decrease in blood sugar levels in the administration of black pepper ethanol extract (P. nigrum L) in the diabetes model of male white rats (R. norvegicus) Sprague dawley strain. However, there was no effect of administering black pepper ethanol extract (P. nigrum L) on the number of spermatogonia in the diabetes model of male white rats (R. norvegicus) Sprague dawley strain.
Laboratory Examination in Tonsillitis: A Literature Review Sembiring, Dustin Delano Pranata; Imanto, Mukhlis; Sangging, Putu Ristyaning Ayu; Angraini, Dian Isti
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1434

Abstract

Laboratory tests play a crucial role in the diagnosis and etiology of tonsillitis, especially in children. Tonsillitis, an inflammation of the palatine tonsils, commonly affects children aged 5–15 years and is a significant cause of morbidity associated with upper respiratory tract infections. The disease can be classified into acute and chronic tonsillitis based on duration, with causes varying from viral to bacterial infections. Laboratory parameters such as leukocyte, neutrophil, lymphocyte, platelet counts, and C-reactive protein are used to differentiate the etiology of tonsillitis. Bacterial tonsillitis generally shows an increase in leukocytes and neutrophils, while viral infections are more commonly associated with lymphocytosis. Complete blood count, throat culture, and rapid antigen detection test (RADT) are the mainstays of diagnostic testing. Throat culture is considered the gold standard for pathogen identification, although it is more time-consuming. RADT offers a faster alternative with high sensitivity and specificity. Anti-Streptolysin O (ASO) titer is also important to detect Group A β-hemolytic Streptococcus infection, which is often associated with chronic tonsillitis. Recent studies have shown a correlation between laboratory results and the severity of tonsillitis. For example, a study in Sudan found that 64% of patients with tonsillitis had neutrophilia, 54% showed an elevated erythrocyte sedimentation rate, and 50% were ASO positive. These findings confirm the association between bacterial infection and chronic tonsillitis. However, interpretation of laboratory results must be done with caution, considering factors such as the time of sampling, examination technique, patient age, and the skill of the health care provider. Appropriate clinical decision-making requires the integration of laboratory results with the patient's clinical history. Further research is needed to explore the correlation between laboratory parameters, the severity of tonsillitis, and their impact on optimal therapy choices. A better understanding of these relationships will help improve the accuracy of diagnosis and the effectiveness of tonsillitis treatment.
Krisis Hiperglikemik: Diabetic Ketoacidosis (DKA) dan Hyperglycemic Hyperosmolar State (HHS) Wibowo, Muhammad Rafi; Rudiyanto, Waluyo; Yunianto, Andi Eka; Soleha, Tri Umiana
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1435

Abstract

Hyperglycemic crisis is an acute metabolic complication of diabetes mellitus that can be life threatening if not treated appropriately. This research aims to examine in more depth the hyperglycemia crisis. This research is a literature study using relevant literature such as articles and journals from various national and international databases such as Google Scholar, NCBI, and PubMed. Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS) are serious and emergency forms of hyperglycemic crisis. DKA is often found in people with type 1 diabetes due to severe insulin deficiency, which is characterized by the triad of hyperglycemia, acidosis, and ketosis. In contrast, HHS occurs more frequently in type 2 diabetes, with features of hyperglycemia, hyperosmolarity, and dehydration, but without significant ketosis and acidosis. Both of these conditions have a high risk of death if left untreated, with the death rate for DKA around <1% and HHS around 15%. The goal of treatment for both is to improve circulation and tissue perfusion, correct hyperglycemia, ketogenesis, and electrolyte imbalances, and identify precipitating factors. Treatment begins with correcting dehydration and electrolyte imbalances through rehydration with crystalloid fluids, as well as treating hyperglycemia by administering insulin boluses or infusions. Prevention of DKA and HHS is to ensure that patients do not stop insulin or oral hyperglycemic drugs, monitor blood sugar levels regularly and immediately seek professional medical help if something undesirable happens.
Overview of Personal Protective Equipment Use Among Oil Palm Farmers in Simpang Pematang Subdistrict, Mesuji Regency Camilia, Anita; Saftarina, Fitria; Febriani, Wiwi; Larasati, TA
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1437

Abstract

The use of personal protective equipment (PPE) is an essential effort in preventing occupational health and safety risks, especially for farmers working in the plantation sector. This study aims to analyze the use of PPE among oil palm farmers in Simpang Pematang Subdistrict, Mesuji Regency. The research employs a cross-sectional approach involving 105 oil palm farmers selected through purposive sampling. Data were collected using questionnaires and analyzed univariately. The findings show that the level of compliance with PPE usage is still low, with only 48.6% of farmers consistently adhering to PPE usage procedures. The use of specific PPE items such as masks and protective glasses is particularly low, at just 13.3% and 5.7%, respectively. The main barriers to PPE use include farmers' lack of understanding about its importance, limited availability of PPE, and misconceptions about its comfort. This study concludes that strategic efforts are needed to improve PPE compliance through education, outreach programs, and the provision of adequate PPE.
Mekanisme Hiperglikemia Kronis terhadap Densitas Mineral Tulang Dwiputri, Maliya Finda; Larasati, TA; Jausal, Annisa Nuraisa; Carolia, Novita
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.v14i12.1438

Abstract

Hyperglycaemia or high levels of glucose in the blood is the hallmark of diabetes mellitus. Diabetes mellitus type 2 (DMT2) significantly impacts bone health, leading to a condition known as diabetic bone disease, characterized by decreased bone mineral density and an increased risk of fractures. This condition arises from metabolic disturbances triggered by hyperglycemia, insulin resistance, and inflammatory factors that compromise bone structure. Research indicates that over 35% of DMT2 patients experience reduced bone density, with approximately 20% meeting osteoporosis criteria. The pathophysiology involves several mechanisms, including the accumulation of advanced glycation end-products (AGEs), which hinder bone formation and increase resorption. Insulin deficiency further exacerbates this issue by impairing osteoblast function and reducing the synthesis of key bone matrix proteins like collagen and osteocalcin. Treatment options such as metformin have shown potential in improving bone health, while other medications like sulfonylureas and SGLT-2 inhibitors may have detrimental effects on bone density. Therefore, careful management of diabetes is essential to mitigate the risks of osteoporosis and fractures in patients with DMT2. Ongoing research is needed to deepen the understanding of diabetic bone disease and optimize treatment strategies to protect bone health in these patients.
Hubungan antara Postur Kerja dan Keluhan Muskuloskeletal pada Pekerja Kantoran : Literature Review Ramadhan, Yasmine Aulia; Wardani, Dyah Wulan Sumekar Rengganis; Komala, Ramadhana; Berawi, Khairunnisa
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1442

Abstract

Musculoskeletal disorders (MSDs) are commonly experienced by office workers, particularly those who spend long hours working in front of computers with non-ergonomic postures. Frequent complaints such as pain in the neck, back, arms, and wrists are often caused by unsupported sitting positions or the use of work equipment that does not adhere to ergonomic principles. An evaluation to understand the relationship between work posture and musculoskeletal complaints among office workers is necessary to assess its risk level for MSDs.. One effective method to assess MSD risk is the Rapid Office Strain Assessment (ROSA). This method evaluates three key aspects of the work environment: chair design, monitor position, and the placement of the mouse and keyboard, all of which significantly impact worker comfort and health. The assessment assigns scores to each element to determine the level of risk. Studies reveal that many workers face high risks due to non-ergonomic working postures, which directly contribute to musculoskeletal complaints. Implementing ergonomic principles, such as using chairs that support proper posture, adjusting desk height to match the worker's stature, and optimizing computer device arrangements, is crucial to reducing these risks. Additionally, incorporating breaks for stretching into work schedules is strongly recommended. These measures not only alleviate MSD complaints but also enhance workplace comfort and overall productivity.

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