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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 30 Documents
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Search results for , issue "Vol 10 No 4 (2021): Medula" : 30 Documents clear
‘Happy’ Hipoksemia pada pasien COVID-19 Dita Ayu Permata Dewi; Winda Trijayanthi Utama
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.107

Abstract

One of the dubious aspects for a doctor who treats COVID-19 patients with patients who have experienced hipoxia, but without the proper signs of respiratory distress, even the absence of complaints of shortness of breath. This phenomenon is referred to as ‘happy hipoxia’. For doctors, the presence of ‘happy hipoxia’ in a Covid-19 patient, even though the patient is in a hypoxemic state, can mistakenly lead to the message that the patient is not in a critical condition and is fine. These cases can rapidly skip the clinical evolutionary stage and develop Acute Respiratory Distress syndrome (ARDS), with cardiac and respiratory attacks simultaneously leading to sudden death. Pulse oximetry should be interpreted with caution, as the oxyhemoglobin dissociation curve shifts to the left. The pathophysiology of ‘happy hipoxia’ can be accepted by the hypothesis that neurological factors are involved. Hypoxia usually activates carotid body chemoreceptors, and afferent signals are transmitted through the nucleus tractus solitarius. This usually causes an increase in the respiratory rate and sensation of dyspnea. SARS-CoV-2 infects the brain via the olfactorial bulb and olfactory nerves, via trans-synaptic spread, eventually reaching the brain stem, and the nucleus tractus solitarius. Inflammation of the nucleus solitarius tract by viral invasion that stimulates afferent hypoxia from the carotid body may not be transmitted effectively to the nucleus solitarius tract, resulting in impaired efferent respiratory response. This explains why COVID-19 patients exhibit near normal breathing in the presence of severe hipoxia (Happy hypoxia). The clinician must not only trust a patient who appears ‘happy’ but must also trust the respiratory rate, signs of hyperventilation, oxygen saturation, and invasive measurements of hipoxia / hypocapnia at regular time intervals.
Penatalaksanaan Holistik Pasien Wanita Usia 16 Tahun Dengan Diabetes Melitus Tipe I Larasati Anindiya Basica; Sahab Sibuea
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.109

Abstract

Diabetes melitus type 1 (DM type 1) is a serious problem because it’s a chronic disease that last a lifetime. This type of diabetes can only be controlled but can’t be cured. Patients with diabetes melitus type 1 must continue to use insulin for life so it’s called as an insulin-dependent diabetes melitus. To Identify clinical problems owned by patient to improve patient’s quality of life as well as prevent complications and toatient holistically and comprehensively according to the problems were found in patient, and managing based on Evidence Based Medicine with a patient-centered approach and family approach. This study is a case report. Primary data werw obtained through history taking, physical examination and home visits. Secondary data were obtained from the patient's medical record. Assessment was based on a holistic diagnosis from the beginning, process, and the end of study qualitatively. Ms.K, 16 years old, has been diagnosed diabetes melitus type 1, with concerns that her complaints will increase and not improve. Limited knowledge of the patient's health condition in the form of life style, physical activities, dietary habit and lack of motivation and family encouragement to bring patients to control their health regularly are factors that cause problems that occur in patients and family. Education of Ms.K problems has been done by providing counseling to improve the patient's family knowledge.
Laporan Kasus Endoftalmitis et causa Ulkus Kornea Perforasi Okuli Sinistra Ratu Faradhila Jonis; Rani Himayani
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.110

Abstract

Endophthalmitis is purulent inflammation of the entire intraocular tissue, accompanied by the formation of an abscess in the glass body. If there is further inflammation that affects the third wall of the eyeball, this condition is called panophthalmitis. Endophthalmitis is divided into endogenous endophthalmitis (spread of pathogens into the eye through systemic) and exogenous endophthalmitis (pathogens enter through mechanisms such as eye surgery, open trauma, and intravitreal injections). This case report describes endophthalmitis et causa. corneal ulcer perforation ocular sinistra in 41-year-old male due to eye trauma. Management in these patients is pharmacotherapy to reduce initial symptoms and operative measures in the form of eviseration.
Perbaikan Asupan Makan Pada Pasien Tuberkulosis Anak Usia 11 Tahun Setelah dilakukan Pendekatan Kedokteran Keluarga Secara Holistik Luthfi Aulia Oktofani; Reni Zuraida
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.111

Abstract

The number of TB cases in Indonesia in 2019 reached 543,874 cases, of which 11.92% of the total cases in Indonesia were aged 0-14 years. In the management of TB patients, especially TB in children, it really needs cooperation from various parties, one of which is the role of the family doctor. The study is Case Report. Primary data was obtained through history taking and physical examination, filling out family folders, and filling in patient files. Assessment was carried out based on the initial holistic diagnosis and end of the visit qualitatively and quantitatively using foodrecall. Based on a holistic diagnosis, patients complain of coughing that does not improve for 1 month and has weight loss. The patient is concerned that the illness cannot be cured and can spread to other people. Patient perceives that TB is dangerous diseases. Patient hopes the child can get the treatment completely so that he can recover again. Patients diagnosed with new case of pulmonary tuberculosis in child that diagnosed clinically based on the results of history, physical examination, and rontgen. The patient has a history of contact with child TB. The diagnosis of pediatric pulmonary TB in this case is in accordance with the theory and critical analysis of current research, using TB scoring system. The management given is in accordance with the guidelines, there are changes in behavior and knowledge of healthy life and dietary habit in patients and  families of patients after an intervention based on evidence based medicine that is patient centered, family approach.
Laki – laki 30 Tahun dengan Skizofrenia Paranoid Melati Indah Jelita; High Boy K. Hutasoit
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.112

Abstract

Emergency psychiatry is unforeseen circumstances with the potentiality ofkatastrophic, which 12% of emergency departments presented with psychiatric complaints. Violence or aggressiveness is the most common reason patients are admitted to emergency room, with attacking behavior seen in 3-10% in psychiatric patients. Many medical diseases  commonly  present  with  behavioral  pathology  and  may  lead  to  a  change  in  thinking  and mood. Schizophrenia is a functional psychosis with major abnormalities in thought processes and disharmony between thought processes, affect or emotion, will and psychomotor, accompanied by distortions of reality that lasts for at least 6 months and includes at least 1 month of active phase symptoms. Meanwhile, schizophrenic disorders are characterized by positive symptoms, negative symptoms, and cognitive impairment. There are several types of schizophrenia (paranoid, hebephrenic, catatonic, undifferentiated, and residual). Mr P, 30 years old came with complaints of attack his neighbors with a knife. In patient, there are perceptual disorders in the form of auditory hallucinations, and disturbances of thought content in the form of suspicious and chasing thoughts that have occurred since 4 years ago and tend to be alone.  The patient was diagnosed with paranoid schizophrenia and was given therapy in the form of psychotherapy, psychoeducation, and psychopharmaceutical.
Penatalaksanaan Holistik Skabies Pada pelajar Usia 14 Tahun melalui Pendekatan Kedokteran Keluarga Nikom Sonia Purohita; Aila Karyus
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.113

Abstract

Scabies is a skin disease caused by Sarcoptei scabei mites hominis variety. According to WHO, an estimated 300 million people are currently infected with scabies globally, with a prevalence ranging from 0.2% to 71%. Scabies attacks community because it is transmitted easily through skin contact. There are various factors that can lead to the failure of management of patients with scabies. Therefore, proper holistic management using a family medicine approach is needed. This study is a case report with primary data obtained from anamnesis, physical examination, and home visit. Secondary data were obtained from patient medical records. Patient A, a 14 year old student complained itching between his fingers, especially at night since 3 months. He already looking for treatment three times but his symptoms have not decreased. Then an initial holistic diagnosis is carried out. Pharmacological and non-pharmacological management is carried out with the principles of patient-centered, family focused, and community-oriented. The intervention was done using posters and pamphlets, including general knowledge about scabies, how to maintain personal and environmental hygiene, how to use medicine properly, and how to prevent transmission in the community. After the pharmacological and non-pharmacological management, evaluation is carried out. There is an increase in knowledge and changes in behavior for both patients and his families. It can be concluded, holistic management with a family medicine approach is needed for the management of patients with scabies in order to support the success of therapy and prevent transmission to the community.
PENGARUH PENGETAHUAN DAN SIKAP SUAMI TERHADAP PERILAKU IBU DALAM PEMBERIAN ASI EKSKLUSIF DI DESA NEGERI SAKTI KECAMATAN GEDONG TATAAN KABUPATEN PESAWARAN Adelia Meutia Putri; Dian Isti Angraini; Sofyan Musyabiq Wijaya
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.114

Abstract

Breast milk is infant food that God made that can not be replaced with any food. Giving breast milk can increase emotional relationship between baby with their mother. The husband who is an integral part of the family and has the role of head of the family, is very necessary for his support so that exclusive breastfeeding is achieved. Some research shows that implementation on giving exclusive breastfeeding will increase if there is a family support. This research purpose is to knowing the effect of husband’s knowledge and attitude towards mother’s behavior on giving exclusive breastfeeding in Negeri Sakti Village, Pesawaran Regency. This research done with analytical observation with case control method. Data source is using secunder data from health centre’s noting and interview with a questionnaire of 60 respondents. The results shows a meaningful relation between husband’s knowledge towards mother’s behavior on giving exclusive breastfeeding in Negeri Sakti Village, Pesawaran Regency (p=0,00) with odds ratio 25,000. And there is a meaningful relation between husband’s attitude towards mother’s behavior on giving exclusive breastfeeding in Negeri Sakti Village, Pesawaran Regency (p=0,007) with odds ratio 4,571).
Penatalaksanaan Holistik dengan Pendekatan Dokter Keluarga pada Laki-laki Usia 50 Tahun dengan Hipertensi Primer Efry Theresia Sianturi; Sahab H. SIbuea
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.116

Abstract

Hypertension is a global health problem resulting in an increase in morbidity and mortality and health costs, including in Indonesia, which can be handled by modifying lifestyle, including diet, exercise habits, stress, and smoking habits. Holistic and comprehensive family doctor approach in detecting internal and external risk factors, prioritizing patient-centered and family-approached is hoped to improve patient’s quality of life. This study is a case report. Primary data were obtained through history taking, physical examination and home visits. Secondary data were obtained from medical records of the patient at the health center. A 50-year-old man was diagnosed with primary hypertension since 5 years ago. Patient has taken anti-hypertension medicine but his lowest blood pressure is 140/80 mmHg. Internal risk factors, namely 50 years of age, male, overweight, curative medical seeking behavioral, inappropriate diet, does not know how to choose food based on nutrition fact labels, family history with hypertensive father and mother, and mother died of stroke. External risk factors, namely the lack of support from his brother regarding the patient's treatment and the length of his work for 10 hours a day. Non-medical and medical interventions were done on the patient and his family with education related to the patient's disease and the recommended dietary pattern in 3 home visits. The evaluation results obtained that complaints and worries of patients were reduced, the knowledge of patients and their families regarding hypertension increased and behavior related to hypertension improved.
Diabetes Mellitus akibat Anti Psikotik pada Pasien Skizofrenia Danang hafizfadillah; Rasmi Zakiah Oktarlina
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.121

Abstract

Schizophrenia is a mental illness with complex pathophysiology and covers various aspects such as behavioral, nerve, perception, and senses that can affect social life even disfunction at work. Schizophrenia requires a long-term treatment with anti-psychotic. The use of antipsychotics among adults and older has increased. Recent information regarding the use of antipsychotics in schizophrenic patients is associated with risk factors of cardiovascular and metabolic syndrome such as obesity, hypertension, insulin resistance, low HDL levels and high triglyceride levels. Diabetes mellitus is a syndrome of metabolic diseases characterized by chronic hyperglycemia either because the body does not produce enough insulin or because the cells do not respond to the insulin that has been produced. The numbers of type 2 diabetes mellitus is estimated to be two to three times higher in people with schizophrenia than in the general population, with a prevalence of 10% to 15%. The risk of diabetes is caused by antipsychotics which cause chronic effects of weight gain and systemic inflammation that will lead to insulin resistance, the direct effect of antipsychotic drugs on insulin action and drug-induced apoptosis of pancreatic beta cells. This article is a literature study to discuss the effects of using antipsychotic drugs in schizophrenic patients who have a role in the development of diabetes mellitus, direct and indirect effect of antipsychotics on the incidence of diabetes mellitus.
Pengaruh Konsumsi Teh Hijau Terhadap Penurunan Tekanan Darah Pada Pasien Hipertensi Andini Pramesti Ningrum; Winda Trijayanthi Utama; Intanri Kurniati
Medula Vol 10 No 4 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i4.122

Abstract

Hypertension is one of the most common diseases found in primary medical practice. The manifestation of hypertension is a disorder of cardiovascular hemodynamic balance which has an increase in systolic blood pressure ≥ 140 mmHg and or diastolic blood pressure ≥ 90 mmHg which is persistent, on repeated examinations. Hypertension complications can affect various target organs such as the heart, brain, kidneys, eyes, and peripheral arteries. Hypertension is influenced by the role of intravascular volume, the role of autonomic nerve control, and the role of renin angiotensin aldosterone. Tea is thought to have a variety of health benefits and most of the evidence suggests that green tea consumption is associated with lowering blood pressure. Tea and its secondary metabolites, namely polyphenolic compounds called flavonoid, play an important roles in relaxing smooth muscle contraction, enhancing eNOS activity, reducing vascular inflammation, inhibiting rennin and endothelin-1 activity and anti-vascular oxidative stress. Consumption of green tea can significantly reduce systolic blood pressure by 1.98 mmHg and diastolic blood pressure by 1.92 mmHg. The positive effect of green tea on blood pressure was obtained after consuming low doses (<582.8 mg/day) with long-term duration (≥12 weeks). A drop in blood pressure can lower the chance of complications.

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