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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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RESIKO KECELAKAAN KERJA PADA TENAGA KESEHATAN DAN PENCEGAHANNYA: SEBUAH TINJAUAN LITERATUR Pratiwi, Naisya Midary Mutia; Utama, Winda Trijayanthi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1730

Abstract

Healthcare workers represent an occupational group with a high risk of work related accidents, including biological exposure, injuries caused by sharp objects, exposure to hazardous chemical substances, and musculoskeletal disorders associated with ergonomic hazards. These risks are influenced by high workload, suboptimal use of personal protective equipment, and the incomplete implementation of safety procedures in healthcare settings. This study aims to identify the main types of hazards commonly experienced by healthcare workers and to analyze prevention strategies recommended in previous studies. The method used was a literature review by selecting relevant national and international scientific articles related to occupational accidents, needle stick injuries, chemical hazards, and ergonomic risks among healthcare workers. Selected articles were analyzed using a systematic literature review approach, focusing on key findings, contributing factors, and prevention recommendations reported in each study. The results indicate that needle stick exposure is the most frequently reported occupational accident among healthcare workers. In addition, chemical exposure from substances such as cytotoxic drugs and disinfectants, as well as musculoskeletal complaints caused by non ergonomic working techniques, are also commonly identified. Dominant contributing factors include inadequate occupational safety and health training, inconsistent use of personal protective equipment, weaknesses in healthcare facility risk management, and high workload. In conclusion, occupational accidents among healthcare workers are multifactorial and require comprehensive preventive measures through improved training, provision of safe working facilities, compliance with standard operating procedures, and strengthening of a safety culture in healthcare services.  
HUBUNGAN USIA, ULTRAFILTRATION RATE (UFR), INTERDIALYTIC WEIGHT GAIN (IDWG), DAN DIABETES MELITUS DENGAN KEJADIAN HIPOTENSI INTRADIALITIK PADA PASIEN GAGAL GINJAK KRONIK DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG Nurfatin, Ghina Nisrina; Yonata, Ade
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1731

Abstract

Chronic kidney disease is a clinical syndrome due to changes in kidney’s function or structure with management by hemodialysis. The complication of hemodialysis is intradialytic hypotension, whose incidence is influenced by several factors. The study aims to determine the correlation between age, Ultrafiltration Rate (UFR), Interdialytic Weight Gain (IDWG), and diabetes mellitus with the incidence of intradialytic hypotension. The study is an analytic observational study with cross-sectional design at the hemodialysis installation of RSUD Dr. H. Abdul Moeloek in December 2022 - January 2023 using primary data from 72 patients. Data analysis using the Chi-Square test and multiple logistic regression. Most of the respondents were female (56.9%), ≤65 years old (83.3%), had UFR >10 ml/KgBB/H (59.7%), IDWG of >3 kg (37.5%), history of diabetes mellitus (55.6%) , intradialytic hypotension (58.3%), and the most blood pressure reduction occurred in the 1st hour. There was no correlation between patient’s age (p=0.200) and intradialytic hypotension but there were a correlation between UFR (ml) (p=0.000), IDWG (kg) (p=0.000), and a history of diabetes mellitus (p=0.000) with intradialytic hypotension. Ultrafiltration Rate has an effect of 20.744 times on intradialytic hypotension. There was a correlation between UFR (ml), IDWG (kg), and diabetes mellitus with the incidence of intradialytic hypotension in patients with chronic renal failure. Ultrafiltration Rate (UFR) has the most impact on the incidence of intradialytic hypotension at RSUD dr. H. Abdul Moeloek Lampung.
LOW BACK PAIN PADA TENAGA KESEHATAN DI RUANG OPERASI: SEBUAH TINJAUAN LITERATUR Poppy Monika Sari; Utama, Winda Trijayanthi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1732

Abstract

Low Back Pain is one of the most common musculoskeletal complaints among Healthcare Workers, especially nurses, and directly affects quality of life, work performance, and productivity. The high physical demands of healthcare services increase the risk of Low Back Pain through multiple factors. Individual factors include age, body mass index, level of physical activity, and a history of back injury. Occupational factors involve non-ergonomic working postures, patient lifting and transfer activities, repetitive movements, prolonged working hours, and heavy workloads. This study aims to review the literature related to risk factors, impacts, and the effectiveness of preventive interventions for Low Back Pain among Healthcare Workers. The method used is a literature review of scientific articles retrieved from relevant international databases, focusing on Healthcare Workers as the primary population. The review results show that more than half of Healthcare Workers in various countries report experiencing Low Back Pain, with occupational factors identified as the main contributors. Reported impacts include increased absenteeism, decreased work performance, and a higher risk of developing chronic musculoskeletal disorders. Preventive interventions such as workplace ergonomic modifications and posture education demonstrate more consistent effectiveness in reducing the incidence of Low Back Pain compared to physical activity-based interventions or stretching exercises alone. Stretching exercises provide limited benefits when not combined with ergonomic improvements. Therefore, prevention of Low Back Pain among Healthcare Workers requires an integrated approach that combines education, application of ergonomic principles, and systematic workload management to reduce prevalence and mitigate its negative impact.
Penggunaan High-Sensitivity Troponin dalam Diagnosis Dini Infark Miokard Nuraini, Bianti; Graharti, Risti; Rakhman, Farid
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1733

Abstract

Infark miokard akut (IMA) masih menjadi salah satu penyebab utama morbiditas dan mortalitas di seluruh dunia, sehingga diagnosis yang cepat dan akurat sangat penting untuk meningkatkan luaran pasien serta menurunkan risiko komplikasi fatal. Keterlambatan diagnosis IMA dapat menimbulkan berbagai konsekuensi serius, termasuk gagal jantung, aritmia maligna, dan peningkatan angka kematian, terutama pada pasien dengan manifestasi klinis yang atipikal. Oleh karena itu, evaluasi dini pada pasien dengan dugaan sindrom koroner akut merupakan komponen krusial dalam pelayanan kegawatdaruratan dan kardiovaskular. Biomarker jantung memiliki peran sentral dalam diagnosis IMA, dengan troponin jantung diakui sebagai indikator paling spesifik dan sensitif terhadap cedera miokard apabila dikombinasikan dengan penilaian klinis dan pemeriksaan elektrokardiografi. Namun, pemeriksaan troponin konvensional memiliki keterbatasan sensitivitas pada fase awal setelah onset gejala, sehingga berpotensi menyebabkan keterlambatan atau kegagalan diagnosis. Untuk mengatasi keterbatasan tersebut, dikembangkan pemeriksaan high-sensitivity cardiac troponin (hs-cTn) yang mampu mendeteksi kadar troponin sangat rendah serta perubahan dinamis kecil dalam interval waktu yang singkat. Penggunaan hs-cTn memungkinkan identifikasi cedera miokard lebih dini, bahkan dalam satu hingga tiga jam setelah terjadinya iskemia, serta mendukung penerapan algoritma diagnosis cepat seperti protokol rule-in dan rule-out 0/1 jam dari European Society of Cardiology. Strategi ini terbukti meningkatkan akurasi diagnosis, mempercepat pengambilan keputusan klinis, dan mengoptimalkan pemanfaatan sumber daya di unit gawat darurat. Meskipun demikian, peningkatan kadar hs-cTn juga dapat ditemukan pada kondisi non-iskemik, seperti penyakit ginjal kronik, gagal jantung, sepsis, dan takiaritmia. Oleh karena itu, interpretasi hasil hs-cTn harus dilakukan secara hati-hati dengan mempertimbangkan gambaran klinis, perubahan elektrokardiografi, serta pemeriksaan troponin serial. Tinjauan ini membahas peran, manfaat, keterbatasan, dan implikasi klinis hs-cTn dalam diagnosis dini infark miokard akut.
HUBUNGAN GANGGUAN GINJAL DENGAN ANGKA KEMATIAN PADA PASIEN RAWAT INAP COVID-19 DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG Gerizha, M. Rakha; Yonata, Ade
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1734

Abstract

Coronavirus Disease 2019 (Covid-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The risk of death from Covid-19 is reported to be higher due to kidney damage which causes various complications in patients. The background of this research was to determine the relationship between kidney disorders and the mortality rate of inpatients with Covid-19 at RSUD Dr. H. Abdul Moeloek, Lampung. This type of research is a retrospective analytic descriptive with a cross sectional approach, conducted from November to December 2022 at the Abdul Moeloek Hospital in Bandar Lampung. The population in this study were patients diagnosed with Covid-19 who were recorded as inpatients at RSUD Dr. H. Abdul Moeloek with a total of 361 samples selected according to the inclusion and exclusion criteria. The analytical test in this study used the Chi square test. Based on research, the majority of Covid-19 patients were female, aged 19- 59 years, with length of stay <14 days. The mortality rate for Covid-19 patients with comorbid kidney disorders is 54%. The results of the Chi Square test for the relationship between kidney impairment and mortality in Covid-19 hospitalized patients showed a p-value of 0.000. There is a relationship between kidney disorders and the death rate of Covid-19 inpatients at Dr. H. Abdul Moeloek Lampung Province. Hospitalized patients with comorbid CKD are more at risk of dying compared to Covid-19 patients without CKD.
Diagnosis dan Tatalaksana Fraktur Klavikula: Tinjauan Pustaka Waton, Hisbul; Ismunandar, Helmi
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1735

Abstract

Clavicle fracture is one of the most common fractures of the upper extremity, resulting from either direct or indirect trauma to the shoulder with the arm positioned alongside the body. This injury is more frequently observed in young adult males, commonly due to traffic accidents, while in the elderly population it is often caused by falls. Clavicle fractures typically present with severe pain, swelling, shoulder deformity, and may be accompanied by neurovascular impairment, necessitating comprehensive clinical evaluation. Physical examination includes inspection, palpation, assessment of shoulder range of motion, and neurovascular evaluation such as the Allen test to assess collateral blood flow. Diagnostic confirmation is supported by imaging modalities including standard anteroposterior radiographs, 30° cephalad tilt view, apical oblique view, and computed tomography scan for complex fracture patterns and preoperative planning. The management of clavicle fractures aims to reduce pain, prevent disability, restore upper limb function, and consider cosmetic outcomes. Treatment options include nonoperative management using an arm sling or figure-of-eight brace for stable fractures, as well as operative management for unstable fractures or those associated with neurovascular complications. Post-treatment rehabilitation plays a crucial role in gradually restoring shoulder range of motion and functional recovery.
Hubungan Dua Arah Antara Gastroesophageal Reflux Disease dengan Gangguan Tidur Rahmadani, Tiara Sekar; Graharti, Risti; Septa, Tendry
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1736

Abstract

Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder characterized by recurrent reflux of gastric contents into the esophagus, causing symptoms such as heartburn, chest pain, chronic cough, and nocturnal discomfort. The global prevalence of GERD continues to increase and is closely associated with lifestyle factors, including high body mass index, excessive caffeine and alcohol consumption, psychological stress, and poor sleep patterns. In Asia, GERD prevalence has risen markedly over the past two decades, with intercountry differences reflecting variations in socioeconomic status and health behaviors. Nocturnal GERD symptoms frequently disrupt sleep quality, most commonly through insomnia and obstructive sleep apnea (OSA). These sleep disorders can physiologically worsen reflux by altering intrathoracic pressure and reducing lower esophageal sphincter tone. Recent evidence suggests a bidirectional relationship between GERD and sleep disorders, in which nocturnal reflux leads to sleep fragmentation, while sleep disturbances increase the frequency and severity of reflux episodes. Other contributing factors include stress, high-fat dietary intake, impaired esophageal motility, and reduced nocturnal acid clearance. This literature review summarizes current evidence regarding the physiological links between GERD and sleep disorders, associated risk factors, and available management strategies. Therapeutic approaches include pharmacological treatments such as proton pump inhibitors (PPIs) and potassium-competitive acid blockers (P-CABs), along with non-pharmacological interventions, including sleeping in the left lateral position, which has been shown to reduce nocturnal reflux events. This review highlights the importance of a multidisciplinary management approach and the need for further research to improve GERD symptoms and sleep quality.
DAMPAK BURNOUT PADA TENAGA KESEHATAN: TINJAUAN LITERATUR TENTANG FAKTOR PENCETUS DAN STRATEGI PENCEGAHAN Ni Putu Swastini; Utama, Winda Trijayanthi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1737

Abstract

Burnout is a common work-related stress syndrome among healthcare workers, characterized by emotional exhaustion, depersonalization, and reduced professional achievement. This condition has a negative impact on service quality, worker health, and patient safety. Factors contributing to burnout include personal characteristics, sociodemographic factors, work environment conditions, high workload, and lack of organizational support. This study aims to review the literature on the factors that trigger burnout in healthcare workers and effective prevention strategies at the individual and organizational levels. The study used a literature review design with a search of articles in the PubMed, ScienceDirect, and Google Scholar databases using the keywords “burnout,” “healthcare workers,” “risk factors,” and “prevention strategies.” The articles included were publications from the last ten years, in Indonesian and English, and relevant to the research objectives. Data were synthesized narratively to identify risk factors and prevention strategies for burnout. Factors contributing to burnout included individual factors (age, gender, personality type), working conditions (high workload, overtime, interaction with patients), and organizational environment (managerial support, work culture). Effective prevention strategies combine individual interventions, such as mindfulness, CBT, and coping training, with organizational interventions, including supportive leadership, flexible policies, open communication, and empowerment of healthcare workers. Preventing burnout in healthcare workers requires a holistic approach that integrates individual and organizational strategies. Management and leadership support that emphasizes employee well-being is key to reducing burnout and improving the quality of healthcare services.
Karsinoma Kolon Sigmoid dengan Metastasis Hepar: Analisis Klinis, Diagnostik, dan Penatalaksanaan Khalishah, Iffatunnada; Fathurrahman, Yusmaidi; Pestalozi, George
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1739

Abstract

Colorectal cancer is one of the most common cancers affecting the colon or rectum, with prevalence continuing to increase. In Indonesia, this cancer is ranked fourth with more than 34,000 new cases in 2020. The main risk factors for colorectal cancer include a diet high in fat and low in fiber, age over 50 years, and a family history of colorectal cancer. Symptoms often involve changes in bowel patterns, blood in the stool, abdominal pain, and unexplained weight loss. In more advanced cases, intestinal obstruction or metastasis to other organs, including the liver, may occur. This article reviews a case of a 57-year-old female patient who came with complaints of difficulty defecating accompanied by blood in the stool, abdominal pain, and weight loss. Based on the results of physical examination, laboratory, and other supporting examinations such as colonoscopy and histopathology, colorectal cancer with liver metastases was diagnosed. Treatment is carried out with fluid therapy, symptomatic treatment, and Hartmann procedure surgery to remove the sigmoid colon mass. A patient's prognosis is influenced by the stage of the cancer, with advanced stages having a poor prognosis. This research aims to increase knowledge about colorectal cancer and emphasize the importance of early detection and a multidisciplinary approach to treating colorectal cancer.
Dampak Konsumsi Pemanis Buatan terhadap Profil Glukosa dan Risiko Diabetes Mellitus: Tinjauan Pustaka Prameswari, Putu Arya Indira; Darwis, Iswandi; Graharti, Risti
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1740

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from impaired glucose regulation, and its global prevalence continues to rise substantially. Effective management of DM requires an integrated approach involving pharmacological therapy, lifestyle modification, and appropriate dietary strategies, including carbohydrate regulation, consumption of low–glycemic index foods, and restriction of added sugars. Artificial sweeteners such as aspartame, sucralose, saccharin, and stevia are widely utilized as low-calorie sugar substitutes because they provide sweetness without elevating blood glucose levels. Nevertheless, accumulating evidence indicates that the metabolic effects of artificial sweeteners are heterogeneous and depend on the specific compound as well as the physiological condition of the consumer. Experimental studies have shown that stevia and nano-stevia can reduce hyperglycemia in diabetic rat models, while the Rebaudioside M (Reb M) form of stevia has been reported to enhance insulin sensitivity and attenuate weight gain in obese rats. In contrast, intake of sucralose and acesulfame-K at Acceptable Daily Intake levels has been associated with increased subcutaneous and perirenal adipose tissue accumulation, along with vascular endothelial dysfunction in Wistar rats, suggesting a potential elevation in cardiometabolic risk. Saccharin has similarly been shown to disrupt glucose homeostasis and decrease GLP-1 secretion in animal models, independent of insulin release. Human studies yield more variable outcomes. Most individuals with type 2 diabetes exhibit no significant changes in body weight or glycemic control following artificial sweetener consumption, although more than half report gastrointestinal disturbances such as bloating and diarrhea. These divergent findings underscore that each artificial sweetener possesses a distinct metabolic profile; therefore, their use should be tailored to individual needs, particularly among populations with heightened metabolic vulnerability, including patients with diabetes.

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