cover
Article Per Year (5 Year)
All
Home Page
OAI Link
Editorial Team
Contact
Reviewer
Google Scholar
Contact Name
Risti Graharti
Contact Email
risti.graharti@gmail.com
Phone
+6281369730011
Journal Mail Official
medulla.fkunila@gmail.com
Editorial Address
-
Location
Kota bandar lampung,
Lampung
INDONESIA
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
 94   95   96   97   98 
Pertimbangan Anestesi Preoperatif, Intraoperatif dan Pascaoperatif pada Pasien Geriatri: Literature Review Devi, Putri Puspa; Indrawan, Khadafi
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.v16i2.1768

Abstract

Geriatric patients commonly experience multiple anatomical and physiological changes related to the aging process, involving the cardiovascular, respiratory, metabolic, endocrine, digestive, nervous, and musculoskeletal systems. These changes increase perioperative risks associated with anesthesia and contribute to higher morbidity and mortality rates. This literature review aims to minimize undesirable events and complications that may occur during the preoperative, intraoperative, and postoperative phases in geriatric patients. The method used involved a literature search of studies published between 2015 and 2025 using the NCBI, PubMed, and Google Scholar databases, focusing on anesthetic considerations in geriatric patients across perioperative phases. Selected articles were analyzed using a systematic literature review approach, including data collection, evaluation, and synthesis in accordance with the review objectives. The findings indicate that preoperative preparation in elderly patients should include comprehensive functional assessment to identify cognitive impairment, reduced cardiopulmonary reserve, depression, frailty, nutritional status, polypharmacy, and anticoagulation issues. Intraoperative management involves appropriate selection of anesthetic techniques and pharmacological agents, close monitoring, careful fluid or intravenous transfusion management, adequate pulmonary ventilation, and prevention of hypothermia. Postoperative considerations include effective perioperative analgesia, prevention and early detection of postoperative delirium and cognitive dysfunction, as well as monitoring for other potential complications. A comprehensive and integrated anesthetic approach is essential to improve patient safety and optimize clinical outcomes in the geriatric population undergoing surgical procedures.
Korelasi NT-proBNP dengan Fraksi Ejeksi pada Pasien Gagal Jantung: Tinjauan Pustaka Darma, I Wayan Dika Aditia; Sangging, Putu Ristyaning Ayu
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.v16i2.1769

Abstract

Heart failure is a complex clinical syndrome characterized by typical signs and symptoms resulting from structural or functional cardiac abnormalities that impair the ability of the ventricles to fill with or eject blood effectively. It remains a major global health problem with high morbidity and mortality rates. One of the most widely used biomarkers for assessing disease severity and prognosis in heart failure is N terminal pro brain natriuretic peptide or NT proBNP. Elevated NT proBNP levels occur in response to increased ventricular wall stress and volume overload and are closely related to the degree of left ventricular dysfunction, which is commonly assessed by left ventricular ejection fraction or LVEF. Numerous studies have demonstrated a significant negative correlation between NT proBNP levels and ejection fraction, particularly in patients with heart failure with reduced ejection fraction, where higher NT proBNP concentrations are observed as LVEF decreases. In contrast, in patients with heart failure with preserved ejection fraction, this relationship is not consistently linear. This variability is influenced by additional factors such as diastolic dysfunction, the presence of comorbid conditions, increased myocardial stiffness, and structural cardiac remodeling that may not be fully reflected by ejection fraction values alone. This literature review aims to analyze the relationship between NT proBNP levels and ejection fraction in patients with heart failure based on findings from national and international studies published over the past ten years. A clear understanding of this relationship is essential to define the diagnostic and prognostic value of NT proBNP and to support its use in therapeutic monitoring and risk stratification in patients with heart failure.
Mosquito Control Methods and Dengue Fever Disease: a Literature Review Khairunnisa, Aulia; Graharti, Risti
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1772

Abstract

Dengue Hemorrhagic Fever (DHF) is one of the vector-borne diseases that remains a public health challenge in Indonesia, characterized by high incidence rates, widespread vector distribution, and an increased risk of outbreaks in various endemic areas. The transmission of the dengue virus is greatly influenced by community behavior, residential environmental conditions, and the bioecology of the Aedes aegypti mosquito, which is able to breed in clean water puddles around homes. The dengue virus consists of four serotypes and can survive through vertical and horizontal transmission mechanisms, thereby strengthening the chain of transmission in the environment. On the other hand, vector control efforts using larvicides and chemical insecticides are still widely chosen by the community, even though improper use can cause insecticide resistance. This study aims to examine various methods of dengue vector control, including physical, mechanical, biological, chemical approaches, and the EcoHealth concept. The method used was a literature review of official guidelines, research articles, and the latest scientific publications on DHF and vector control. The results of the study show that physical control methods such as 3M Plus are the most effective and safest, while biological control through larval predators and environmentally friendly bacteria can reduce the larval population without causing negative ecological impacts. Chemical control still provides rapid effects, but must be used wisely to prevent resistance. The EcoHealth approach is considered more comprehensive because it involves environmental, social, cultural, and economic aspects of the community in sustainable control. In conclusion, optimal DHF control requires an evidence-based integrated strategy with cross-sector participation and the application of ecological principles to ensure long-term success in reducing disease incidence.
Evaluasi kadar CRP High Sensitivity sebagai Marker Risiko Kardiovaskular pada Dewasa Muda: Indonesia Rachmantiawan, Aldiano; Sangging, Putu Ristyaning Ayu
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1773

Abstract

Atherosclerosis and cardiovascular disease originate from chronic low grade inflammatory processes, making high sensitivity C reactive protein or hs CRP widely studied as a cardiovascular risk marker, including in young adults. This study is a narrative review of 16 articles published between 2019 and 2025 that examine hs CRP in young adults aged 18 to 45 years and its association with cardiometabolic risk factors, cardiovascular disease events, and clinical outcomes. The review findings indicate that in overweight or obese young adults, elevated hs CRP levels are associated with central obesity, atherogenic dyslipidemia, impaired fasting glucose, and higher blood pressure. In addition, irregular sleep patterns and short term variability in diastolic blood pressure are also linked to increased hs CRP levels, suggesting the presence of subclinical inflammation early in life. In older populations and in patients with established cardiovascular disease, high hs CRP levels are reported to predict cardiovascular disease incidence, carotid plaque formation, cardiometabolic multimorbidity, functional disability, and short term mortality. However, hs CRP is not associated with the progression of coronary artery calcification and demonstrates substantial intra individual variability. Overall, hs CRP has potential value as an additional marker to identify young adults at higher cardiovascular risk. Nevertheless, hs CRP is not sufficient as a single screening tool and should be interpreted alongside traditional cardiovascular risk factors and lifestyle patterns. Repeated measurements are recommended to improve risk assessment accuracy and to account for biological variability in hs CRP levels.
DRY EYE SYNDROME PADA PEKERJA KANTOR: TINJAUAN PUSTAKA Eltidar, Tyaradhia Ranita; 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.v16i2.1779

Abstract

An epidemiological study in the United States involving 75,000 adults reported that 5,051 individuals, or 6.73%, were diagnosed with Dry Eye Syndrome (DES), highlighting its growing importance as a public health issue, particularly among office workers with prolonged digital screen exposure. The extensive use of computers, smartphones, and tablets contributes to DES primarily through reduced blink frequency and incomplete blinking, which increase tear evaporation and lead to ocular surface dryness. Prolonged screen exposure may also induce oxidative stress and inflammation on the ocular surface, accelerating DES development. Workplace environmental factors, including air conditioning, artificial lighting, and low humidity, further elevate the risk, while blue light from screens may disrupt circadian rhythms, reduce tear production, and exacerbate symptoms. Poor ergonomic practices, such as improper screen positioning and prolonged near work, add visual strain and worsen Digital Eye Strain. A cross-sectional study in Bangladesh in 2023 found that daily screen time exceeding 8 hours, blink rates below 10 blinks per minute, and air-conditioned work environments significantly increased DES risk among office workers. Similar findings were reported in a 2024 cross-sectional study from India, which also identified screen distances of less than 50 cm and workplace humidity below 30% as risk factors. In addition, a cohort study in the Netherlands showed that professionals in legal, health, business, and administrative sectors had a higher risk of developing DES, which has been shown to reduce work productivity after symptom onset.
Dry Eye Pasca Operasi Katarak yang diberikan Diquafosol Sodium Azzahra, Natasya Jasmine; Maulana, Muhammad
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.v16i2.1780

Abstract

Dry eye is one of the most common complications following cataract surgery, primarily caused by tear film instability, ocular surface epithelial damage, and altered mucin secretion. This condition may reduce visual comfort, delay postoperative recovery, and negatively impact patients’ quality of life. Recent literature from the last five years indicates that 3% Diquafosol sodium, a P2Y₂ receptor agonist, provides substantial therapeutic benefits by promoting tear and mucin secretion, enhancing ocular surface integrity, and supporting epithelial repair after surgical trauma. Multiple studies report that Diquafosol, either as monotherapy or in combination with sodium hyaluronate, significantly improves tear breakup time (TBUT), reduces corneal and conjunctival staining, and enhances Schirmer test scores. Improvements in subjective symptoms, including dryness, irritation, and discomfort, were also noted in many postoperative individuals. Perioperative administration initiated prior to surgery and continued during the healing phase has demonstrated superior outcomes compared to postoperative use alone. However, heterogeneity among study designs, variation in treatment duration, and inconsistent subjective symptom improvement remain limitations in current evidence. Overall, available scientific findings support Diquafosol sodium as an effective and safe therapeutic option for managing postoperative dry eye and suggest its incorporation into standard management protocols, especially for patients with pre-existing dry eye or those at high risk.
Case Report: Kehamilan Ektopik Terganggu pada G3P1A1 Wanita 29 Tahun Hendarto, Hasta; Oktarlina, Rasmi Zakiah; Kusumaningtyas, Intan
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.v16i2.1786

Abstract

Ectopic pregnancy is a condition in which the gestational sac is located outside the uterine cavity, representing the most common life-threatening emergency during the first trimester of pregnancy. Implantation in ectopic pregnancy frequently occurs in the fallopian tube. The clinical manifestations are typically characterized by amenorrhea, followed by vaginal bleeding and sudden onset abdominal pain. In this case, a 29-year-old woman, G3P1A1, presented at 6–7 weeks of gestation with severe lower abdominal pain accompanied by vaginal bleeding, along with a risk factor of a previous history of ectopic pregnancy. Data were obtained through anamnesis, general physical examination, obstetric assessment, ultrasonography, and both medical and non-medical management. Physical examination revealed conjunctival pallor, abdominal distension with muscular defense, tenderness in the lower abdomen, and a non-palpable uterine fundus. Pelvic examination demonstrated cervical motion tenderness and bulging in the pouch of Douglas. Ultrasonography findings were highly suggestive of ectopic pregnancy. The diagnosis was established as gravida 3 para 1 abortus 1, 6–7 weeks of gestation, with a complicated ectopic pregnancy. The patient underwent exploratory laparotomy with left salpingectomy due to rupture of the left ampullary segment of the fallopian tube. Methotrexate therapy was not administered, as the patient did not meet the eligibility criteria for medical management, given that tubal rupture had already occurred.
Analisis Faktor Risiko Terhadap Mortalitas Pasien Sepsis di Ruang Intensive Care Unit (ICU) RSUD DR. H. Abdul Moeloek Provinsi Lampung Tahun 2018-2021 Aiko Purba, Putri Grace; Wahyuni, Ari; Carolia, Novita; Sidharti, Liana
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.v16i2.1788

Abstract

Sepsis is an organ dysfunction due to dysregulation of infection response. It is characterized by cardinal inflammatory signs such as vasodilation, leukocyte accumulation, and increased microvascular permeability in tissues away from the site of infection. Sepsis is identified using clinical criteria, specifically the Sequential (Sepsis-Related) Organ Failure Assessment Score with ≥2 points. Sepsis is a leading cause of mortality in the Intensive Care Unit. Its mortality is triggered by several risk factors, including age, low Glasgow Coma Scale and Mean Arterial Pressure scores, and the presence of comorbidities. This study aims to analyze the relationship between these determinants and mortality among the Intensive Care Unit sepsis patients. This study used an observational analytic method with a cross-sectional approach. The subjects were sepsis patients in the Intensive Care Unit of RSUD DR. H. Abdul Moeloek Lampung in 2018-2021 who met the inclusion and exclusion criteria. The independent variables were age, Glasgow Coma Scale, Mean Arterial Pressure, and comorbidities, while the dependent variable was mortality. Samples were collected using total sampling technique. The results showed that age, Glasgow Coma Scale, Mean Arterial Pressure, and comorbid disease were significantly associated sepsis mortality, with p-values of 0.008, 0.029, 0.040, and 0.013, respectively. Thus, there is a relationship between age, Glasgow Coma Scale, Mean Arterial Pressure, and comorbid disease to the mortality among sepsis patients.
Hubungan Asupan Black Garlic Terhadap Gambaran Histopatologi Ginjal Tikus Putih (Rattus Norvegicus) Galur Sprague-Dawley Yang Diinduksi Minyak Jelantah Dimas, Dimas; Sangging, Putu Ristyaning Ayu
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.v16i2.1790

Abstract

Cooking oil consumed orally contains toxic substances that can cause cell damage in the kidneys. Black garlic contains antioxidants that can have an anti-toxic effect on the kidneys. This study is a true experimental study using a posttest only control group design to determine whether there is a relationship between black garlic intake and renal histopathology in Sprague-Dawley strain white rats (Rattus norvegicus) induced by used cooking oil. In this study, there were 25 rat samples divided into 5 groups: a control group with distilled water (K1), a control group with waste oil (K2), a 200mg/kgBW group (P1), a 400mg/kgBW group (P2), and an 800mg/kgBW group from the black garlic dose (P3). Microscopic aspects such as cellular infiltration, edema, and necrosis were assessed to evaluate the histopathology of the kidney. The data obtained were then statistically tested using One-Way ANOVA and PostHoc LSD tests. Based on the results of the One-Way ANOVA statistical test, a p-value of 0.000 was obtained, and group P3 had the lowest renal histopathological damage compared to groups P1 and P2. There was a relationship between black garlic intake and the histopathology of the kidneys of Sprague-Dawley strain white rats (Rattus norvegicus) induced by waste oil, and the group with a black garlic dose of 800 mg/kgBW had the lowest histopathological damage to the kidneys compared to the other treatment groups.
Laporan Kasus : Pasien Perempuan 25 Tahun dengan Rhinitis Alergi Ricardo, Muchammad Aqsa Enrico; Imanto, Mukhlis
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.v16i2.1792

Abstract

Allergic rhinitis is an immunoglobulin E mediated inflammation of the nasal mucosa characterized by recurrent sneezing, nasal obstruction, rhinorrhea, and ocular symptoms such as itching and tearing. This condition is commonly observed in young adults and is closely associated with environmental allergen exposure and genetic predisposition. This case report describes a 25 year old woman who presented with recurrent nasal obstruction for the past four years. The symptoms were more pronounced in the morning and during exposure to cold air. The patient also reported repetitive sneezing episodes, occurring 10 to 15 times after exposure to dust, accompanied by clear rhinorrhea, nasal and ocular itching, and a habitual nose rubbing behavior. Ocular complaints, including watery and itchy eyes, were consistently reported. Physical examination revealed livid discoloration of the nasal cavity mucosa and septum. The inferior turbinates appeared edematous and hyperemic with clear nasal secretions. No septal deviation or signs of acute infection were observed. Based on the persistence of symptoms for more than four weeks and the characteristic clinical findings, the patient was diagnosed with mild persistent allergic rhinitis. Management included oral antihistamine therapy with cetirizine, a nasal decongestant containing pseudoephedrine hydrochloride, and intranasal corticosteroid therapy with fluticasone furoate. In addition to pharmacological treatment, the patient received education on allergen avoidance, adoption of healthy lifestyle practices, and regular physical activity. This case highlights the importance of recognizing long term symptoms, performing a thorough physical examination, and applying an appropriate combination of pharmacological and non pharmacological interventions to achieve symptom control, improve quality of life, and prevent disease progression in patients with allergic rhinitis.

Page 96 of 98 | Total Record : 972

 94   95   96   97   98 

Filter by Year

2019 2026


Reset
Filter By Issues
All Issue Vol 16 No 3 (2026): Medula Vol 16 No 2 (2026): Medula Vol 16 No 1 (2026): Medula Vol 14 No 10 (2025): Medula Vol 15 No 4 (2025): Medula Vol 15 No 3 (2025): Medula Vol 15 No 2 (2025): Medula Vol 15 No 1 (2025): Medula Vol 14 No 12 (2024): Medula Vol 14 No 11 (2024): Medula Vol 14 No 9 (2024): Medula Vol 14 No 8 (2024): Medula Vol 14 No 7 (2024): Medula Vol 14 No 6 (2024): Medula Vol 14 No 5 (2024): Medula Vol 14 No 4 (2024): Medula Vol 14 No 3 (2024): Medula Vol 14 No 2 (2024): Medula Vol 14 No 1 (2024): Medula Vol 13 No 4.1 (2023): Medula - Edisi Spesial (Special Sense) Vol 13 No 7 (2023): Medula Vol 13 No 6 (2023): Medula Vol 13 No 5 (2023): Medula Vol 13 No 4 (2023): Medula Vol 13 No 3 (2023): Medula Vol 13 No 2 (2023): Medula Vol 13 No 1 (2023): Medula Vol 12 No 4 (2022): Medula Vol 12 No 3 (2022): Medula Vol 12 No 2 (2022): Medula Vol 12 No 1 (2022): Medula Vol 11 No 4 (2021): Medula Vol 11 No 3 (2021): Medula Vol 11 No 2 (2021): Medula Vol 11 No 1 (2021): Medula Vol 10 No 4 (2021): Medula Vol 10 No 3 (2020): Medula Vol 10 No 2 (2020): Medula Vol 10 No 1 (2020): Medula Vol 9 No 4 (2020): Medula Vol 9 No 3 (2019): Medula Vol 9 No 2 (2019): Medula More Issue