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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 11 Documents
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Search results for , issue "Vol 11 No 2 (2021): Medula" : 11 Documents clear
Sindrom Serotonin Raisha Rahmani Rizal; Dewi Nur Fiana
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.186

Abstract

Serotonin (SS) syndrome (also referred to as serotonin toxicity) is a potentially life-threatening drug-induced toxidrome associated with increased serotonergic activity in the peripheral (PNS) and central nervous system (CNS). It is characterized by a dose-relevant spectrum of clinical findings associated with levels of free serotonin (5-hydroxytryptamine [5-HT]), or activation of 5-HT receptors (especially the 5-HT1A and 5-HT2A subtypes), which include neuromuscular disorders, autonomic hyperactivity, and altered mental states. Serotonin toxicity begins within a few hours of taking a drug that causes an increase in serotonin. The three classic sets of clinical features are neuromuscular excitation (eg, clonus, hyperreflexia, myoclonus, rigidity), autonomic nervous system excitation (eg, hyperthermia, tachycardia), and altered mental state (eg, agitation, confusion). Although serotonin syndrome rarely causes death, severe cases are medical emergencies that can rapidly lead to multisystem organ failure. Although many drugs have been implicated in serotonin syndrome, life-threatening cases generally occur only when a monoamine oxidase inhibitor is combined with a selective serotonin re-uptake inhibitor. or non-selective. Awareness of Serotonin Syndrome is critical not only in avoiding inadvertently harmful combinations of therapeutic drugs but also in recognizing the clinical picture when it occurs so that treatment can be started immediately. Doctors and nurses should be aware of serotonin syndrome because drugs that can cause it are often used, and intentional overdoses with drugs that can cause serotonin syndrome are seen with increasing frequency. This makes it difficult to detect and doctors can easily mistake serotonin syndrome for antoher diagnose. In this review, the pathophysiology, clinical features, drugs involved and diagnosis of serotonin syndrome are discussed.
PENATALAKSANAAN HOLISTIK PADA PEREMPUAN USIA 73 TAHUN DENGAN SINDROMA METABOLIK Vicki Lusbiyanti Utami; Putu Ristyaning Ayu
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.289

Abstract

Indonesia  dihadapkan  pada banyak masalah  kesehatan, salah satunya yaitu penyakit degeneratif. Penyakit degeneratif merupakan penyakit kronik menahun yang banyak mempengaruhi kualitas hidup serta produktivitas seseorang. Sindrom Metabolik (SM) merupakan kelainan metabolik kompleks.Komponen utama sindrom metabolik adalah obesitas, resistensi insulin, dislipidemia, dan hipertensi.Penyakit seperti hipertensi dan diabetes perlu dikelola secara komprehensif meliputi tatalaksana farmakologis dan non farmakologis.Menerapkan  pendekatan  dokter  keluarga  secara  holistik  dan  komprehensif dalam mendeteksi faktor risiko internal dan eksternal serta menyelesaikan masalah berbasis Evidence Based Medicine yang bersifat family-approached, patient-centered, dan communit oriented. Studi yang dilakukan adalah laporan kasus.Data primer diperoleh melalui anamnesis, pemeriksaan fisik dan kunjungan ke rumah.Data sekunder didapat dari rekam medis pasien.Pasien mengatakan tidak memiliki keluhan apapun.Pasien  mengatakan datang untuk memeriksakan kesehatannya serta membutuhkan surat rujukan ke RS tipe C untuk mendapatkan obat suntik terkait kencing manisnya. Pasien telah menderita kencing manis dan darah tinggi sejak ±7 tahun yang lalu, pasien mengetahui penyakitnya tersebut ketika melakukan skrining sebelum operasi Ca Servix di RSCM.  Pola makan pasien belum dapat dikontrol.Riwayat keluarga pasien yang terkena diabetes mellitus tidak ada, sedangkan riwayat darah tinggi ditemukan juga pada seluruh saudara kandung pasien dan ibu dari pasien serta suami pasien. Penegakan diagnosis dan penatalaksanaan pada pasien ini telah dilakukan secara holistik, patient centered, family approach dan community oriented berdasarkan beberapa teori dan penelitian terkini. Pada proses perubahan perilaku, pasien sudah mencapai tahap trial.
Tatalaksana Anestesi pada Mandibulektomi Rekonstruksi pada Adenokarsinoma Mandibula ari wahyuni; Brandon Caesario
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.246

Abstract

Metastatic carcinoma on mandibula is a very rare lesion, contributing to <1% of all oral malignancies. Usually metastatis originate from breast, lungs, prostate, followed by kidney, thyroid, liver, etc. Carcinoma type lesion is more common than sarcomas. Mandibular metastation from thyroid tumors were very rare, and follicular type was the most common. In maxillofacial surgeries, airway management is very important considering difficult airway is commonly present. Either caused by altered surrounding tissues, organ immobilities, or organ enlargements. A 58-year old woman, weighing 45 kgs, and 159 cm in height was admitted to Dr. dr. H. Abdoel Moeloek Hospital of Lampung Province with a lump on right jaw from 1 year ago. On physical examination, the tumor was 7x5 cm in size, immobile, with firm consistency. Histopathology examination reveal an adenocarcinoma. Patient was diagnosed with mandibular adenocarcinoma and reconstructive mandibulectomy was performed.
Laporan Kasus : Ruptur kornea + katarak traumatik OD dengan General Anestesi Sukma Nugroho; ari wahyuni
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.247

Abstract

Ocular trauma is one of the main causes of visual impairment. Ocular trauma can be divided into sharp trauma, blunt trauma, chemical trauma and thermal trauma. Ocular trauma can cause cataracts called traumatic cataracts, which can result from penetrating or blunt trauma to the eyeball. Prompt and appropriate treatment can improve visual acuity. In this case report, an 8-year-old female patient came to the ER Abdul Moeloek Hospital with complaints of blurred vision in the right eye accompanied by sudden red eyes. This complaint was felt due to the patient playing with the simcard opening tweezers and the tweezers fell into the patient's eye in a piercing position. patient. In addition, the patient complained of vision in the right eye that felt like seeing fog and was dazzled when he saw light. Then the right eye felt watery, sore and felt lumpy. On physical examination, ocular ophthalmology with cloudy cornea and visible tears, shallow anterior ocular camera, uneven cloudy lens. This patient was diagnosed as right ocular corneal rupture with traumatic cataract and cataract extraction was planned with some prior anesthetic considerations. Complete preoperative, intraoperative, and postoperative management will improve the success of the operation.
Laporan Kasus: Hematokolpos et Hematometra e.c Septum Vagina Transversal Km Allan Wahyu Permana; Ghaaliya dyah adheline; Nurul Islamy; Marzuqi Sayuti
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.249

Abstract

Transverse vaginal septum is rare mullerian duct anomaly, the incidence was report around 1 : 70.000 in every birth, transverse vaginal septum occures due to failure of canalization of vaginal plate in junction point of urogenital sinus and mullerian duct, usually with obstruction symtoms during menstruation. Classification of mullerian duct anomaly divide into 7 class, hypoplasia or agenesis, unicomuate, didelphys, bicornuate, septate, arcuate, and diethulstillbestrol related anomaly. Diagnosis of transverse vaginal septum was made on basis of medical sign and symtoms, physical examination, and ultrasound examination, CT Scan, or MRI. Treatment of septum vaginal transversal is surgical resection of septum vagina. This study is a case report at Abdul Moeloek Hospital in Bandarlampung. It has been reported the case of a female patient aged 10 years, patient compained of pain in lower abdomen since september, pain felt every month, patient has not had menarche. Physical examination shows swelling in suprapubic with no pain in palpation. Gynecology examination with sonde show length of vagina is 4 cm.  In rectal touche there was impression of mass in anterior to the rectum. On ultasound examination show hematocolpos and hematometra, CT scan examination show the impression of hematocolpos and hydrosalping bilateral. Patient was diagnosed with Hematocolpos et hematometra e.c. septum transversal
Penatalaksanaan Holistik Asma Eksaserbasi Pada Pasien Perempuan Usia 39 Tahun dengan Pendekatan Kedokteran Keluarga Hanifa Yuniasari; fitria saftarina
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.295

Abstract

Asthma is a chronic respiratory disease with a complex multifactorial disorder and its etiology is associated with the interaction between genetic susceptibility, host factors, and environmental exposures. Asthma can be considered a significant public health problem. Recurrent asthma symptoms often cause difficulty, daytime fatigue, reduced activity and productivity, and increase absenteeism from school and work. Asthma management must be with continuous monitoring to achieve controlled asthma, so it is necessary to manage patients holistically and comprehensively to improve patients’ quality of life. This study is a case report of asthma exacerbation in a woman who has various internal and external risk factors that influence the patient's disease. Primary data were obtained through history taking, physical examination and support during home visits. Secondary data obtained from the patient's medical record. Management of patients with asthma exacerbations is carried out comprehensively with the concept of a patient-centered, family-focused, and community-oriented approach. Medical management is in the form of relieving drugs and asthma control drugs. Non-medical management is in the form of education about asthma, including explaining and asking patients to identify and avoid asthma triggers. The results of the evaluation showed changes in attitudes in reducing the risk of exacerbations and improvements in asthma control as assessed by the Asthma Control Test.
Frozen Shoulder Anggun Budi Wardani; Risal Wintoko
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.297

Abstract

Frozen shoulder or also known as adhesive capsulitis is a shoulder pain disorder that It is caused by thickening and tightening of the connective tissue capsule around the shoulder joint. The most common risk factors are age > 40 years, women > men as much as 70%, recent trauma such as surgery or fracture of the arm can cause immobility during recovery. Typical in frozen shoulder, there is progressive shoulder stiffness, severe pain (especially at night) and almost complete loss of passive and active external rotation of the shoulder. In the history, it is necessary to know the onset and duration of symptoms, location, function, and previous trauma. On physical examination, deltoid and supraspinatus atrophy can be found in the old case, the arm can be adducted and turned inward and painful when pressed. Plain radiography, ultrasound, and MRI investigations. Management is carried out both non-operatively to help relieve pain and relieve inflammation in the early phase by administering NSAIDs, corticosteroids (oral/injection), physiotherapy and cryotherapy. Surgical management may be considered if previous conservative efforts have failed.
PENATALAKSANAAN HOLISTIK PASIEN PRIA USIA 61 TAHUN DENGAN TB PARU, GIZI KURANG, MELALUI PENDEKATAN DOKTER KELUARGA DI WILAYAH PUSKESMAS GEDONG TATAAN Joko Widodo Joko Widodo; Imelda Carolia
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.311

Abstract

Tuberculosis (TB) is still a problem in developing countries and even the world. TB is one of the top 10 causes of death and the first cause of death from an infectious agent worldwide. The government plans to eliminate TB by 2030, which is carried out with the National Strategy for TB control. Family doctors play an important role in which the role of family doctors is not only to cure but also to promote health and prevention of TB disease, Identifying risk factors, clinical problems, and providing management to patients with the application of holistic, evidence-based medicine-based family doctor services through a patient-centered approach and a family approach, The analysis of this study is case report. Primary data were obtained through history taking, physical examination and home visits to complete family data, psychosocial and environmental data. Secondary data were obtained from patient medical records at Puskesmas. Assessment is carried out based on a holistic diagnosis from the start, process, and end of the study quantitatively and qualitatively, The diagnosis of new cases of pulmonary TB with underweight in this patient is in accordance with national guidelines. The management given is in accordance with the guidelines, it can be seen that changes in behavior and knowledge of the patient and the patient's family are seen after intervention based on evidence-based medicine which is patient-centered, family approach.
the Perkembangan dalam Penatalaksanaan Covid-19 F Dea Chika; Asep Sukohar
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.312

Abstract

The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made a serious public health threat worldwide with millions of people at risk in a growing number of countries. Though there are no clinically approved antiviral drugs and vaccines for COVID-19, attempts are ongoing for clinical trials of several known antiviral drugs, their combination, as well as development of vaccines in patients with confirmed COVID-19. This review focuses on the latest approaches to diagnostics and therapy of COVID-19. We have summarized recent progress on the conventional therapeutics such as antiviral drugs, vaccines, anti-SARS-CoV-2 antibody treatments, and convalescent plasma therapy which are currently under extensive research and clinical trials for the treatment of COVID-19. The developments of nanoparticle-based therapeutic and diagnostic approaches have been also discussed for COVID-19. We have assessed recent literature data on this topic and made a summary of current development and future perspectives.
High-Flow Nasal Cannula Oxygenation pada Pasien Lanjut Usia dengan Kegagalan Pernafasan Akut Terkait SARS-CoV-2: High-Flow Nasal Cannula Oxygenation in Older Patients with SARS-CoV-2-Related Acute Respiratory Failure Faris Putra Haryanto; Khadafi Indrawan; Ari Wahyuni
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.313

Abstract

Currently, In this World, many cases about comparing the mortality and comfort associated with method of high-flow nasal cannula oxygenation (HFNCO) and high-concentration mask (HCM) in older SARS-CoV-2 infected patients done hospitalized in non-intensive care units. In this retrospective cohort study, author included all consecutive patients aged 75 years and older who were hospitalized for acute respiratory failure in either an acute geriatric unit or an acute pulmonary care unit, and tested positive for SARS-CoV-2. This journal compared the in-hospital prognosis between patients treated with HFNCO and patients treated with HCM. To determinate another bias factor, this journal created a propensity score for HFNCO. From March 2020 to January 2021, 67 patients (median age 87 years, 41 men) were hospitalized with SARS-CoV-2-related akut respiratory failure, of whom 41 (61%) received HFNCO and 26 (39%) did not. Age and comorbidities did not significantly differ in the two groups, whereas clinical presentation was more severe in the HFNCO group (NEW2 score: 8 (5–11) vs. 7 (5–8), p = 0.02, and Sp02/Fi02: 88 (98–120) vs. 117 (114–148), p = 0.03). Seven (17%) vs. two (5%) patients survived at 30 days in the HFNCO and HCM group, respectively. Overall, HFNCO was significantly associated with greater survival (adjusted hazard ratio (AHR) 0.57, 95% CI 0.33–0.99; p = 0.04). HFNCO use was associated with a lower need for morphine (AHR 0.39, 95% CI 0.21–0.71; p = 0.005), but not for midazolam (AHR 0.66, 95% CI 0.37–1.19; p = 0.17). In conclusion, HFNCO use in non-intensive care units may reduce mortality and discomfort in older inpatients with SARS-CoV-2-related akut respiratory failure.  

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