Medical Profession Journal of Lampung

Pharmacological Activity of Avocado Leaf (Persea americana Mill.)

Wed, 25 Sep 2024 00:00:00 +0000

Indonesia possesses abundant natural resources, including the abundant fish, which are considered an alternative to modern diets. Fish, particularly alpaca, have high economic value and potential for local consumption. Alpaca is rich in protein, selenium, minerals, and anti-inflammatory properties that can help maintain health and prevent kidney damage.
Alpukat (Persea america Mill.) is a rich, commercially valuable, and potentially beneficial food source for local consumption. Research has shown that alpaca can help prevent kidney damage by providing essential nutrients like potassium, magnesium, vitamin E, flavonoid, saponin, alkaloid, steroid, vitamin E, mineral, natrium, tanin, alkaloida, quersetin, polifenol, asam lemak tidak jenuh, zat filantik, and kalium. Alpukat also contains flavonoid and quersetin, which help prevent cholesterol accumulation and reduce the risk of lipid oxidation. Flavonoid and quersetin also help prevent glucosa absorption and oxidative stress, which can lead to cancer and other health issues. Alpukat also contains potassium with diuretic effects, which can be used for treating ginkgo biloba, kencing biloba, tinggi, and sakit kepala. Diuretik, a substance that increases urine volume and excretion of waste, can help prevent kidney damage. In conclusion, Indonesia has a rich and diverse food supply, including various types of fish, which have significant economic and health benefits.

Management of A 16 Years-old Adolescent with Baby Blue Syndrome Through A Family Medicine Approach

Lely Sustantine Totalia, Tirta D Susanto, R. Wianti Soeryani — Mon, 30 Sep 2024 00:00:00 +0000

Adolescents are an age group that is vulnerable to various changes, both physically and psychologically. Adolescence is characterized by various challenges, including in terms of mental readiness to face new roles, such as becoming a mother. These conditions can trigger the onset of baby blues symptoms, such as feelings of sadness, anxiety, and excessive fatigue after childbirth.This case describes the treatment of a 16-year-old adolescent girl who experienced baby blues after giving birth to her first child with a family medicine approach. The patient complained of feelings of sadness, moodiness, difficulty sleeping, often brooding and crying without cause, and feeling useless and unsuitable for motherhood. The patient also showed symptoms such as not wanting to take care of the child, including breastfeeding, and sometimes even wanting to hurt the child because of fatigue. This condition was exacerbated by limited social support, where the husband's parents and the patient's parents were in a distant city. Through a holistic and comprehensive family medicine approach, the medical team sought to identify the factors contributing to the emergence of baby blues in the patient, as well as evaluate the effectiveness of the interventions made to help the patient overcome her condition. This case report is expected to serve as a reference for health practitioners in dealing with similar cases in the future and increase public awareness, especially among adolescents, regarding the importance of paying attention to mental health. Interventions involving medical, psychological and social support have been shown to be effective in helping patients overcome challenges and adapt to their new role as mothers.

Anestesia Approach at Spine Surgery

Imam Ghozali, Tasrif Hamdi, Ayu Assyifa Hamka Dinata — Thu, 24 Oct 2024 00:00:00 +0000

Spinal anesthesia is performed by injecting local anesthetic into the cerebro-spinal fluid. An anesthesiologist's adequate knowledge of anatomy, physiology, and pharmacology will make anesthesia safe and satisfactory for the patient, surgeon, and anesthesiologist. Spinal anesthesia is now often used in spinal surgery. The advantages of using this technique are a lower postoperative pain scale, minimizing the effects of postoperative nausea and vomiting, a shorter procedure, and high patient satisfaction. The first case was Mr S aged 55 years with a diagnosis of low back pain and compression of lumbar vertebra 4, lumbar 5 and sacrum 1 undergoing laminectomy, decompression and biopsy. The second case, Mrs. NH, aged 46 years, was diagnosed with ASIA 3 spinal cord syndrome and compression fracture of the T 10-11 vertebra, undergoing thoracic fusion and laminectomy surgery. The third case, Mrs. H, aged 53 years, was diagnosed with T10-11 tuberculous spondylitis who underwent laminectomy, thoracolumbar fusion and biopsy. Anesthesia for the first case (Mr. S) and the second case (Mrs. NH) used Single-Shot Anestesi Spinal Segmental Thoracic atau Thoracic Spinal Anesthesia (TSA). Meanwhile, the anesthesia for the third case (Mrs H) used the Two Stabbing Techniques.

Thirty Week Multigravid Pregnant Woman with Imminent Preterm and Cervical Shortening Single Life Fetus Presentation of Head : A Case Report

Inna Kurniaji, Zulfadli Zulfadli — Tue, 29 Oct 2024 00:00:00 +0000

Imminent preterm in the presence of a threat in pregnancy with emergence signs in 20 weeks – 37 weeks. Cervical shortening is one of the the common reason of preterm labour. Both Preterm labour and cervical shortening are are considered multifactorial syndromes. A short cervix is defined as a cervical length (CL) ≤25 mm on transvaginal sonography (TVS) before 24 weeks to 32 weeks of gestation.This is a case report. A 31 years old woman with preterm pregnancy come with pain that intermitently radiating to the waist and become worst seven hour before entering hospital. Complaints accompanied by blood and mucus discharge from the genitals. From physical examination found that moderate sick in general condition, compos mentis, Blood pressure 121/86 mmHg, heart rate 112x/min, respiratory rate 20x/min, temperature 36.5 C. General examination within normal limits. In obstetric examination found that fundus uteri is 3 finger under proccesus xiphoideus (25cm), his (+) 3x in 10 minutes duration 30-40 second, fetal heart rate 156x/min. In inspekulo examination found that portio is livide, OUE closed, not found active bleeding, erosion/laserasion/polip (-) and vaginal toucher not performed in this patient. In Transvaginal USG found cervical length 2.48 cm. The diagnosis are G5P3A1 in 30 weeks with imminent preterm and cervical shortening. Patient planned conservative therapy such as observation of his, fetal heart rate, and vital signs mother, IVFD ringer laktat + 2 amp isosuprine gtt xx/min, dexamethasone 2x10 mg, nifedipine 4x10 mg.

Holistic Management of Mrs. Z 56 Years Old Woman with Herpes Zoster through Family Medicine Approach in Puskesmas Campang Raya

Alifya Rizkiyana Qonita Fauzan, Syahrul Hamidi Nasution — Tue, 29 Oct 2024 00:00:00 +0000

Herpes zoster is a disease caused by reactivation of the varicella zoster virus which remains latent. The incidence of shingles increases with age and the immune system weakens. Herpes zoster is a disease that can recur at any time, so it needs to be treated holistically. The purpose of this case report is to implement a holistic and comprehensive family doctor service by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with a patient-centere and family approach. This study is a case report study. Primary data were obtained through history taking (autoanamnesis and alloanamnesis), physical examination and home visits. Secondary data were obtained from the patient's medical record. Patient Mrs. Z is 56 years old has been diagnosed with herpes zooster complaints of appearance of small groups of nodules filled with fluid on the right arm accompanied by fever since 3 days ago. The patient has a previous history of chickenpox. Patient does not know of the cause of her illness and hopes that her symptoms will disappear and not recur. Perform non-medical and medical interventions on patients and their families. The results of patient evaluations can follow these recommendations. Good progress has been seen in patients starting from a decrease in clinical symptoms and increased patient and family knowledge about her illness also changes in behavior. A family medicine approach can solve health problems and improve the patient’s quality of life.

Holistic Management of a 50-Year-Old Male Former Pelvic Porter with MB Type Morbus Hansen, Uncontrolled Hypertension, and Treatment Compliance through a Family Medicine Approach in the Sukaraja Health Center

Nabila Salwa Raehana, Winda Trijayanthi Utama — Tue, 29 Oct 2024 00:00:00 +0000

Kusta atau Morbus Hansen (MH) adalah penyakit menular kronis dengan keterlibatan yang menonjol pada kulit dan saraf yang disebabkan oleh Mycobacterium leprae. Penyakit kusta merupakan salah satu penyakit tropis yang terabaiakan yang masih banyak di dunia khususnya di Indonesia. Distribusi penyakit kusta di Provinsi Lampung pada tahun 2021 terdapat 136 kasus dan 21 kasus kusta di Kota Bandarlampung. Hipertensi adalah penyakit tidak menular yang merupakan masalah kesehatan utama di dunia maupun Indonesia. Kusta dan hipertensi dapat dihindari dan dikontrol melalui pola hidup sehat yang membutuhkan dukungan dari keluarga maupun komunitas maka dari itu penting dilakukan penatalaksanaan holistik melalui pendekatan keluarga pada pasien. Tujuan penulisan untuk menerapkan pendekatan dokter keluarga secara holistik dan komprehensif sesuai masalah yang dialami oleh pasien dan melakukan penatalaksanaan berbasis Evident Based Medicine yang bersifat patient-centered, family oriented dan community oriented. Studi ini merupakan sebuah laporan kasus. Data primer diperoleh melalui anamnesis (autoanamnesis), pemeriksaan fisik dan kunjungan rumah, untuk melengkapi data keluarga, data psikososial dan lingkungan. Data sekunder didapat dari rekam medis pasien. Penilaian berdasarkan diagnosis holistik dari awal, proses, dan akhir studi secara kualitatif dan kuantitatif. Setelah dilakukan intervensi, terdapat peningkatan pengetahuan pasien dan keluarganya mengenai penyebab, faktor risiko, serta mencegah kekambuhan pada penyakit kusta dan hipertensi. Penatalaksanaan secara holistik dapat meningkatkan pengetahuan, sikap, dan perilaku pada pasien. Selain itu, peran keluarga amat penting dalam perawatan dan pengobatan pasien serta dukungan juga diperlukan.

Holistic Management of Impetigo in 12 Years Old Girl at Kampung Sawah Community Health Center through a Family Medicine Approach

deralitha, Tutik Ernawati — Wed, 30 Oct 2024 00:00:00 +0000

Background: Impetigo is a classification of pyoderma, which attacks the epidermal layer of the skin. Impetigo is divided into two types, namely bullous and non-bullous impetigo. One of the clinical forms most often found in pediatric cases is bullous impetigo, this bacteria spreads from one individual to another through direct contact such as through hand contact. Bullous impetigo has lesions in the form of bullae and has thin walls with reddish edges, most often caused by Staphylococcus aureus. Non-bullous impetigo begins with an erythematous papulovesicle that continues to grow with a yellow crust, most often caused by Staphylococcus aureus and Group A Streptococcus. Objective: Implementing the principle of doctor service according to the problems found and carrying out holistic and comprehensive management including patient-centered and family approaches based on Evidence Based Medicine. Method: This study is a case report. The data obtained include primary data were obtained through alloanamnesis and autoanamnesis, physical examination and home visits and secondary data were obtained from the patient's medical record. Results: Patient girl 12 year old complained of brownish yellow scabs on his face and blisters filled with yellow fluid on his neck. The patient is worried that the complaint is getting worse. Clinically the patient was diagnosed with Impetigo. Next, holistic management is carried out, namely intervention using poster media. In the evaluation, results were obtained in the form of a better understanding of the disease and changes in behavior that had an impact on the success of therapy. Conclusion: The diagnosis and management of this patient has been carried out holistically and comprehensively based on several theories and recent research. In the process of changing behavior, the patient has reached the trial stage.

Holistic Management of Children with Scabies through Family Medicine Approach in Way Kandis Health Center

Tiara Trias Tika, Aila Kayrus — Wed, 30 Oct 2024 00:00:00 +0000

Scabies is a skin disease caused by infestation and sensitization of the parasite Sarcoptes scabiei var. hominis. The prevalence of scabies in the world reaches 300 million people each year. Scabies is often ignored because it is not life-threatening. However, this disease can become chronic and cause complications, and reduce the quality of life of sufferers. Therefore, proper holistic treatment is needed using a family medicine approach to achieve successful therapy. The purpose of this article is to apply the principle of a holistic and comprehensive family doctor approach in detecting internal and external risk factors and solving problems based on EBM (Evidence Based Medicine) which is family approach and patient centered. This study is a case report. The data obtained are primary data obtained through alloanamnesis, physical examination, and home visits and secondary data obtained from the patient's medical records. An. R aged 15 years came with complaints of itching since one month ago and there were small pin-sized bumps filled with clear fluid in the itchy area which were then scratched and burst. The patient was worried that the complaint would worsen and interfere with the patient's activities. Clinically, the patient was diagnosed with scabies (ICD-10 B.86; ICPC-2: S72). Furthermore, holistic management was carried out, namely intervention using poster media. In the evaluation, the results were obtained in the form of a better understanding of the disease and behavioral changes that had an impact on the success of therapy. After holistic and comprehensive management, the patient experienced an increase in knowledge about the disease by 37.5 points. Complaints of itching and pimples on the skin decreased and the patient had improved personal and environmental hygiene.

Case Report: Grade IV Uterine Prolapse in a 73-Year-Old Woman

Zulfadli Zulfadli, sherly malia — Thu, 14 Nov 2024 00:00:00 +0000

Uterine prolapse is a protrusion or lowering of an organ in a woman's pelvic cavity, such as the uterus, bladder, and rectum, while the cause of POP itself is multifactorial. A 73 year old patient came to the Emergency Department (IGD) with complaints of a pink lump coming out of the birth canal without bleeding accompanied by pain in the lower back, and lower abdominal pain which had gotten worse 2 days before entering the hospital. Previously, the patient had felt a lump in his genitals since 2 years ago, the lump came and went, especially when coughing, defecating, doing activities, walking, and standing, and came back by itself when lying down. The patient admitted that he had had a ring installed 1 year ago at RSIA AMC Metro because the patient felt that the lump coming out of his genitals was getting bigger and bigger. For 3 months, the patient has felt that the lump has completely come out and cannot go back in. From the results of the physical examination, the BMI was 26.7, and a pink mass without blood was seen coming out of the vagina. The treatment given to this patient was a total vaginal hysterectomy (TVH).

The Correlation Between Neutrophil-to-Lymphocyte Ratio and Mortality of COVID-19 Patients at RSUD Dr. H. Abdul Moeloek, Lampung

Fifi Nurliza Aini Tibar, Intanri Kurniati, Selvi Rahmawati — Sun, 15 Dec 2024 00:00:00 +0000

World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) a pandemic as of March 9, 2020. Data as of October 8, 2021 recorded a total positive case of COVID-19 in Lampung Province were 49,304 cases with 3,790 deaths. Disease progression in COVID-19 patients was determined based on the results of laboratory tests. Several studies reported that the value of Neutrophil Lymphocytes Ratio (NLR) was strongly associated with clinical worsening and even death in COVID-19 patients. This study was purposed to determine the relationship between NLR with death in COVID-19 patients. This study was an observational analytic study with a cross sectional design. The sample was medical record data taken from 44 COVID-19 patients who survived and 44 COVID-19 patients who died in March 2020 - September 2021 at Dr. RSUD. H. Abdul Moeloek Lampung Province. The sample was selected using purposive sampling technique. Statistical analysis was performed by univariate and bivariate analysis. The result of the bivariate analysis with chi quare test showed the p value was 0.000 (p<0.5), which indicated that there were a relationship between NLR with death in COVID-19 patients at RSUD Dr. H. Abdul Moeloek Lampung Province. There were a statistically significant relationship between NLR with death in COVID-19 patients at RSUD Dr. H. Abdul Moeloek Lampung Province.

Case Report of Bartholin’s Cyst: Clinical Presentation and Management

M. Rizki Rahman, Fonda Octarianingsih Shariff — Wed, 18 Dec 2024 00:00:00 +0000

Bartholin's cyst is a type of cystic tumor that is located in the vulva and is formed due to blockage of the Bartholin's gland duct. This blockage causes fluid buildup and cystic enlargement. A report noted that a 43 year old woman came to the Obstetrics and Gynecology Polyclinic at Pertamina Bintang Amin Hospital in Bandar Lampung, complaining of a lump in the genital area that had appeared since a year ago, the size of a quail egg, but the patient stated that she did not feel any pain. The treatment given includes antibiotics and analgesics, and it is recommended to undergo a surgical procedure using the marsupialization technique. Marsupialization is a procedure in which stabilization is carried out, that is, the cyst must be stabilized and gently retracted using finger pressure applied on both sides of the affected labium, below the cyst. Then an incision is made over the body of the cyst and within the hymeneal loop, usually at the 4-5 or 7-8 o'clock position from the introitus. The incision is generally made in a cross manner and extended up to 2-3 cm according to the size of the cyst.

A case report Management of a 72-Year-Old Female Patient with Anemia in Chronic Kidney Disease Using a Family Medicine Approach

Hasri Aghnia Salsabila, Dian Isti Angraini — Wed, 18 Dec 2024 00:00:00 +0000

Anemia is a body condition characterized by a lower number of red blood cells or hemoglobin concentration than normal limits. According to WHO, 64 million or 23.9% of elderly suffer from anemia worldwide. One of the causes of anemia in the elderly is chronic kidney disease (CKD). According to RISKESDAS, the reported prevalence of CKD at ages ≥15 years is 0.38% in Indonesia with the highest incidence at ages 65-74 years. Appropriate holistic treatment using a family medicine approach is needed to improve the patient's quality of life. Implement comprehensive and holistic family doctor services by identifying risk factors, clinical problems, and patient management based on evidence-based medicine with strategies that are patient centered, family approach and community oriented. This study is a case report. Primary data was obtained through history taking, physical examination and home visits. Secondary data was obtained from patient medical records. Patient Mrs. T, 72 years old, has been diagnosed with anemia, complains of weakness accompanied by fatigue, dizzy eyes and unsteadiness when walking. An intervention was carried out in the form of providing health promotion using health posters regarding anemia in chronic kidney disease. The results of the intervention in patients obtained increased knowledge about the disease and compliance in maintaining health for successful therapy. Holistic management can improve the knowledge, attitudes and behavior of patients and families in maintaining health.

Key words: Family Doctor, Anemia, Chronic Kidney Disease.

Holistic Approach to Tinea Pedis Management in 62-Year-Old Housewives in the Sukarame Health Center Working Area

Febrina Aulia Natasya, Syahrul Hamidi Nasution — Thu, 19 Dec 2024 00:00:00 +0000

Dermatophytosis is a superficial infection caused by dermatophyte fungi. This infection is also often called tinea. Classification is based on the affected body part, namely tinea capitis (head), tinea faciei (face), tinea barbae (beard), tinea corporis (body), tinea manuum (hands), tinea cruris (groin), tinea pedis (feet), tinea unguinum (nails). The prevalence of dermatophytosis in Asia is 35.6%, while in Indonesia it is 52%. The risk factors are related to the agent, host, and environment. These factors include immunocompromised, high humidity, high temperature, increased urbanization, variations in fungal virulence. The purpose is application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework using a patient-centered and family approach. This study is a case report. The data obtained are primary data obtained through autoanamnesis, alloanamnesis, physical examination, and home visits and secondary data obtained from the patient's medical record. The results of this study are, patient Mrs. I 62 years old came with complaints of itching and redness in the foot area since two week before coming to the puskesmas. Complaints of itching worsen if the patient feet are damp. Physical examination revealed a numular sized eritematous lesion, the edges of the lesion had fine scales. Clinically the patient was diagnosed with Tinea pedis (ICD-10 B35.3). Furthermore, management, intervention and evaluation are carried out. In conclusion, holistic management can increase knowledge and change attitudes and behavior of patients, especially in patients wuth dermatophytosis. The role and support of the family is needed in the care and treatment of patients.

Management of Dengue Fever in a 21-Year-Old Female Through a Family Medicine Approach at Kedaton Health Center

Afriza Winata, Dian Isti Angraini — Thu, 19 Dec 2024 00:00:00 +0000

Dengue fever (DF) is an acute viral infectious disease caused by the dengue virus which in general can be characterized by symptoms of fever for 2-7 days, accompanied by other symptoms in the form of bleeding, such as nosebleeds and red spots on the body (ptekiae), bleeding gums, decreased platelets, the form of hemoconcentration in the form of plasma leakage with signs such as increased hematocrit, ascites, pleural effusion. The purpose of this case report is to Implementing family doctor services by identifying risk factors, clinical problems, and patient management based on Evidence-Based Medicine that is family-approach, patient-centred and community-oriented. The study conducted is a case report. Primary data were obtained through history taking, physical examination and home visits. Secondary data were obtained from the patient's medical records at the puskesmas. Assessment is carried out based on a holistic diagnosis from the beginning, process, and end of the study quantitatively and qualitatively. Patient is female with complaints of fever since 4 days ago. Fever followed by weakness, hedache, and nausea. In this case, the diagnosis and treatment have been carried out according to the latest theory and journals. After the intervention, there was an improvement in patient symptoms and an increase of patient knowledge.

The Effect of Zumba Gymnastics on Anthropometric Profiles and Mean Arterial Pressure in Obese Students of Lampung University

Caroline Virgine Putri Lesilolo, Khairun Nisa Berawi — Thu, 19 Dec 2024 00:00:00 +0000

Obesity contributes for about 2.8 deaths each year and has an effect on increasing blood pressure. The prevalence of obesity in Indonesia in 2018 in adults was 21.8% and is predicted to continue to increase every year. Zumba exercise is an aerobic exercise that is proven to be effective in reducing body fat percentage by burning calories from body fat stores and effective in lowering blood pressure. Seeing the great benefits of Zumba gymnastics but the still limited research on the influence of Zumba gymnastics on the anthropometric profile and Mean Arterial Pressure (MAP) in obese individuals, researchers are interested in conducting research on the influence of Zumba gymnastics intervention on the anthropometric profile and MAP in students at the University of Lampung who are obese. This research is a quasi experimental design with a non-randomized control group pretest-posttest approach. The samples used is 26 samples for each zumba group with zumba fitness exercise treatment and the control group without zumba exercise treatment, which were taken by purposive sampling technique. The analysis is using a paired t-test parametric test and non-parametric wilcoxon test. The results showed that zumba exercise had a significant effect on the anthropometric profile Body Mass Index (BMI) with p-value = 0.000, abdominal circumference with p-value = 0.000, and MAP with p-value = 0.000. Based on the statistical results, there is a significant effect of zumba exercise on BMI, abdominal circumference, and MAP in obese students of Lampung University.

Holistic Management Of A 27-Years-Old Male Patient with Varicella through The Family Doctor Approach in Sukaraja Puskesmas

Meyliana Suwanda, Azelia Nusadewiarti — Thu, 19 Dec 2024 00:00:00 +0000

Varicella or chicken pox is an acute and highly contagious disease caused by infection with the Varicella Zoster virus (VZV). Apply the principles of family medicine services and carry out holistic management based on a framework for solving patient problems with a patient-centered, family focused and community-oriented approach based on Evidence Based Medicine. This study analysis is a case report. Primary data is obtained through history taking, physical examination and home visits to complete family data, psychosocial and environmental data. Secondary data was obtained from patient medical records at the Community Health Center. The assessment is carried out based on a holistic diagnosis of the beginning, process and end of the study quantitatively and qualitatively. Male patient Mr. C 27 years-old came with complaints that he had tingles on his face, neck, body, back, arms, and leg for two days ago accompanied by itching. Elastic in the form of vesicles the size of billions, round shape, well-defined, with an erythematosus base, distributed regionally. Clinically and on physical examination the patient was diagnosed with Varicella (ICD 10 B01.9). In this case, diagnosis and treatment have been carried out according to theory and related journals. After the intervention was carried out, there was a reduction in clinical symptoms and an increase in patient and family knowledge. Holistic management can improve the knowledge, attitudes and behavior of patients and families in maintaining health.

The Effects of Lampung Robusta Coffee Bean (Coffea canephora) Extract on the Histopathological Appearance of Renal Proximal Tubules in Monosodium Glutamate-Induced Male Sprague-Dawley Rats

aina salsabila, Anggraeni Janar Wulan, Rodiani Rodiani — Fri, 20 Dec 2024 00:00:00 +0000

Excessive consumption of monosodium glutamate can form free radicals and is nephrotoxic which causes damage to organs, one of which is the kidneys, especially in the proximal tubule. Chlorogenic acid compounds contained in coffee beans have potential as antioxidants and nephroprotective agents. Coffee consumption at a certain dose is assumed to prevent and or reduce damage to the proximal kidney tubules of rats caused by free radicals. This research is an experimental study with a completely randomized design (CRD) with a Posttest Only Control Group Design approach. This research was conducted for 14 days. The samples used were 25 rats which were divided into 5 groups, namely K- (aquades 3 ml/day), K+ (MSG 4 g/kgBW/day), P1, P2, and P3 (MSG 4 g/kgBW/day). and Lampung robusta coffee bean extract 1 ml/200gBW/day with a concentration of 0.006 g/ml; 0.012 g/ml; 0.024 g/ml respectively) with each group consisting of 5 rats. Kidney histopathological assessment was carried out by observing kidney preparations in 5 visual fields each in 400x magnification. The mean total score of proximal tubular damage in groups K-, K+, P1, P2, and P3 respectively was 2.48; 3.40; 2.80; 2.64; 3.04. One Way ANOVA test obtained p value = 0.001 (p <0.05). Post Hoc LSD test on proximal tubular damage scores showed a significant difference (p<0.05) between K- and K+ (p=0.000), K- and P3 (p=0.008), K+ and P1 (p=0.005) , K+ with P2 (p=0.001), and P2 with P3 (p=0.047). There is an effect of administration of Lampung Robusta (Coffea canephora) coffee bean extract on the histopathological appearance of the kidney proximal tubules of male rats (Rattus norvegicus) strain Sprague-Dawley induced by monosodium glutamate.

Horner Syndrome: Understanding Damage to the Oculosympathetic Pathway

Fitriyani Fitriyani, Melissa Dwi Mayang Sari, Betsheba Betsheba — Fri, 20 Dec 2024 00:00:00 +0000

Horner's syndrome is a group of symptoms consisting of a slightly drooping upper eyelid (ptosis) and a smaller pupil (miosis) on the affected side (ipsilateral), less commonly accompanied by a lack of sweat production (anhidrosis) over the ipsilateral eyebrow or face. Horner’s syndrome can be congenital, acquired, or inherited disorder, but the cause is sometimes unknown. Based on the anatomical location of the underlying pathological process, Horner's syndrome is classified into central, preganglionic, and postganglionic. Although in most cases clinical examination may predict the etiology, in other cases pharmacological testing can help in localizing the lesion. Pharmacological testing agents used in the diagnosis of Horner's syndrome include apraclonidine, cocaine, hydroxyamphetamine, or phenylephrine. Imaging approaches such as targeted Magnetic Resonance Imaging (MRI) or Computed Tomography Angiography (CTA) are recommended, given the financial burden of imaging the entire oculosympathetic pathway. This article reviews the clinical signs and symptoms as well as the pharmacological and imaging modalities that can help in the diagnosis and localization of Horner's syndrome and the cause of the condition.

Holistic Management of 52 Year Old Male Patient With Schizophrenia Paranoid in Primary Health Care

Athaya Taufiqy, Dian Isti Angraini — Fri, 20 Dec 2024 00:00:00 +0000

Schizophrenia is characterized by fundamental and characteristic deviations from thought and perception, as well as by abnormal affect. Based on Riskesdas in 2019, the prevalence of schizophrenia in Indonesia was 6.7% per 1000 households. Proper handling holistically using a family medicine approach is needed to improve the patient's quality of life. Applying the principles of a holistic and comprehensive family doctor approach in detecting internal and external risk factors and solving EBM problems. This study is a descriptive study of case reports. Primary data were obtained through autoanamnesis and alloanamnesis, mental examination, and home visits. Secondary data were obtained from the patient's medical record. Patient Mr. P, 52 years old, has been diagnosed with schizophrenia paranoid, has difficulty sleeping at night accompanied by frequent talking to himself, hearing voices, and seeing shadows that others cannot see. Furthermore, comprehensive management is carried out, namely carrying out interventions using poster media and inviting patients to socialize. In the evaluation, the results were obtained in the form of a better understanding of the disease and changes in behavior that have an impact on the success of therapy. Holistic management with family medicine approach is needed for patients with paranoid schizophrenia disease to identify problems in various aspects to support the success of therapy and improve the patient's quality of life.

Management In 22-Year-Old Male with Gastroesophageal Reflux Disease (Gerd) through Family Medicine Approach in Gedong Tataan Health Center

Muhammad Heickal Ikhlasul Amal Arrizky, Fitria Saftarina — Fri, 20 Dec 2024 00:00:00 +0000

Gastroesophageal Reflux Disease (GERD) is a medical condition where stomach acid rises into the esophagus, with primary symptoms such as heartburn, regurgitation, chest pain, chronic cough, and hoarseness. GERD occurs due to the weakness of the valve between the stomach and esophagus. According to Riskesdas 2018, the prevalence of GERD in Indonesia is 40.8%, making it a significant health issue. Family doctor services that are oriented towards evidence-based medicine focus on identifying risk factors, clinical issues, and patient management through an approach that actively involves the patient and their family. This study used primary data through anamnesis, physical examination, and home visits to assess the environmental conditions that may impact the patient’s health. The assessment was done holistically, covering diagnosis, process, and research results both qualitatively and quantitatively. Indicators evaluated include diet, stress levels, adherence to therapy, physical activity, and environmental factors such as home cleanliness and access to healthcare. Before the intervention, the patient and family had limited knowledge about GERD, with unhealthy eating habits, such as irregular meals, overeating in one sitting, minimal intake of fruits and vegetables, and lack of exercise. After the intervention, the knowledge score increased from 4 in the pre-test to 9 in the post-test, indicating improved understanding of GERD and preventive measures. The holistic approach proved effective in improving the patient’s understanding, attitude, and behavior, as evidenced by improvements in the diagnostic evaluation at the end of the study.

Comprehensive Management of a 60-Year-Old Woman with Grade 1 Hypertension and Scabies in Family Medicine Practice, Way Kandis Health Center

Lovina Ramadhita Agung, Fitria Saftarina — Fri, 20 Dec 2024 00:00:00 +0000

Family doctors provide evidence-based medicine services with a patient-centered and family-focused approach to identify clinical problems, risk factors, and patient management. This article is compiled using a case report method according to research needs. The data used are primary data obtained through anamnesis, both auto and alloanamnesis, physical examination, home visits to obtain data related to family, psychosocial and environment. A holistic diagnosis of various factors is carried out from beginning to end to solve the problem holistically. A 60-year-old woman was diagnosed with Grade I Hypertension and Scabies. The patient has internal risk aspects, namely obesity, poor hygiene, unbalanced diet, low knowledge of the disease, and stress. The external risk in this case is the lack of family knowledge regarding the patient's disease. Then, comprehensive management is carried out for the patient and family. Through this approach, it is expected to be able to improve the patient's knowledge, perspective, and actions. The role of the family to change the patient's lifestyle to be healthier as support for the patient, such as reminding to take medication and inviting exercise greatly affects the results of holistic management. The complexity of this problem requires time and cooperation between family doctors, patients, and families.

Holistic Management of Acute Tonsillitis in Six Years Old Girl at Pasar Ambon Community Health Center through a Family Medicine Approach

Syahfa Alzena Asadha, Tutik Ernawati — Fri, 20 Dec 2024 00:00:00 +0000

Tonsillitis can strike any age but is more common in children. Inflammation of the tonsils can be caused by bacteria or viruses. Inflammation of the tonsils will result in enlargement which causes difficulty swallowing or feels like there is a lump in the throat. Enlarged tonsils can also cause other symptoms such as hoarseness (muffled voice) or even breathing problems in severe cases. If there is no complete healing of the tonsils, recurrent infections can occur. Applying the principles of family medicine services and carrying out holistic management based on a framework for solving patient problems with a patient-centered, family-focused, and community-oriented approach based on Evidence-Based Medicine. This study is a case report using primary data obtained through history taking, physical examination, and home visits to complement family data, and psychosocial and environmental data. Secondary data was obtained from patient medical records. Patient An. N aged six years old with complaints of swallowing pain since four days ago. Patients have a habit of consuming iced drinks and light snacks which may be unhygienic and can be a risk factor for infection. Holistic management with a family doctor approach has been carried out for An. N aged six years with Acute Tonsillitis which was adjusted based on the initial holistic diagnosis. Before the intervention, the patient and family are given a pretest to measure the patient's level of knowledge regarding the disease they are suffering from. During the intervention, the family is explained about the disease she is suffering from using media in the form of posters, and the family is given education regarding the importance of treatment and how to prevent the disease. At the last visit a posttest was given to the family with the results being a significant increase in knowledge about the disease they were suffering from and awareness of the importance of changing patient habits.

Holistic Management of a 55-Year-Old Female Patient with Chronic Obstructive Pulmonary Disease (COPD) and a History of Pulmonary Tuberculosis (TB) through a Family Medicine Approach at Pasar Ambon Primary Care Center

Dwi Wulan Noviyanti, Fitria Saftarina — Fri, 20 Dec 2024 00:00:00 +0000

Chronic obstructive pulmonary disease (COPD) is defined as a lung disease with clinical symptoms as shortness of breath, coughing, phlegm production due to airway abnormalities that cause persistent airflow obstruction. This airflow obstruction in COPD is progressive and often associated with chronic-inflammation caused by exposure to noxious substances, such as cigarette smoke. Tuberculosis (TB) is a contagious-infectious disease caused by Mycobacterium-tuberculosis and most often manifests in the lungs (pulmonary TB), although-M.Tb can also infect other organs (extrapulmonary TB). History of pulmonary TB could cause permanent-damage to lung-anatomy and associated with loss of lung-function, such as bronchiectasis, fibrosis, or post-TB emphysema, which can increase the risk of COPD. Research by Fan H et al in 2021 stated that there was a risk of COPD in patients with a previous history of pulmonary TB. Providing family doctor services rooted in evidence-based medicine involves the identification of risk factors and clinical issues, along with the management of patients, all within a patient centered and family oriented problem solving framework. This study involves a case-report-analysis. Primary data were gathered through history taking, physical examinations, and home visits. The evaluation is conducted based on a comprehensive diagnosis-spanning the initial, process-oriented, and final phases of the study, using both quantitative and qualitative methods. Interventions for the patient-consisted of educational measures for patients and their families using posters and direct discussions. Following these interventions, there was an observed improvement in both knowledge and behavioral-changes both patient and family-behaviors, as evidenced by improvements in the final holistic-diagnostics.

Holistic Approach of a 54-Year-Old Woman with Type 2 Diabetes Mellitus and Grade II Obesity: A Family Medicine Approach at Rajabasa Indah Health Center

Bella Pratiwi, Tutik Ernawati — Fri, 20 Dec 2024 00:00:00 +0000

Diabetes Mellitus is one of the degenerative diseases with high prevalence and is increasing every year in Lampung province by 22,345 cases or 1.37%. Obesity is one of the predisposing factors for diabetes mellitus. The prevalence of obesity in the population aged 18 years and over increased from 14.8% to 21.8%. In Lampung province, it was 17.3%. Diabetes mellitus and Obesity must be managed comprehensively which is expected to prevent complications and improve the quality of life of patients. Objective: Implementation of Evidence Based Medicine-based services in patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework with a patient-centered, family-focused, and community-oriented approach. Method: This study is a case report. Primary data was obtained through anamnesis, physical examination and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Results: After the intervention, there was an increase in patient and family knowledge regarding the importance of health care provider check-ups, regular medication consumption, appropriate diet and physical activity patterns for patients with Diabetes Mellitus and Obesity. Conclusion: Holistic management has been carried out with a family doctor approach for Mrs. A, 54 years old with type II Diabetes Mellitus and grade II Obesity which was adjusted based on the initial holistic diagnosis. The intervention has increased patient and family knowledge regarding the importance of health care provider check-ups, regular medication consumption, diet and physical activity patterns as indicated by improvements in the final holistic diagnosis.

Holistic Management of a 54-Year-Old Woman with Hypertension, Type 2 Diabetes Mellitus, and Hypercholesterolemia Using a Family Medicine Approach in the Karang Anyar Public Health Center Area

Innou Dhanu Muhammad, Fitria Saftarina — Fri, 20 Dec 2024 00:00:00 +0000

Hypertension is a condition when blood pressure in the blood vessels increases chronically. Data from the World Health Organization (WHO) in 2015 showed that the incidence of hypertension in the world reached 1.13 billion and in 2025 the number of hypertension sufferers will continue to increase to reach 1.5 billion individuals. Type 2 DM is a metabolic disease characterized by hyperglycemia due to insufficiency of insulin secretion by pancreatic beta cells or impaired insulin function. According to the International Diabetes Federation (IDF), it is estimated that one in 11 adults or 90 million people (aged 20-79 years) in Southeast Asia will suffer from DM in 2021. Hypercholesterolemia is a condition characterized by high levels of cholesterol in the blood. According to (Riskesdas) 2018, it shows 21.2% of the Indonesian population aged ≥ 15 years. Hypertension, type 2 diabetes mellitus (T2DM) and hypercholesterolemia are chronic disease disorders that are interrelated with each other due to overlapping risk factors such as endothelial dysfunction, vascular inflammation, arterial remodeling, atherosclerosis, dyslipidemia and obesity. There are many cardiovascular complications in diabetes and hypertension, especially related to microvascular and macrovascular diseases such as stroke, heart failure, kidney disease, retinopathy, neuropathy and amputation. To reduce morbidity and mortality rates, Evidence Based Medicine-based service management is carried out in patients by identifying risk factors, clinical problems, and patient management based on a patient problem-solving framework with a patient-centered, family-focused and community-oriented approach. This study is a case report. Primary data were obtained through anamnesis, physical examination and home visits to assess the physical environment. Assessment based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively.

Management and Exercise for Type 2 Diabetes Mellitus with Neuropathy in Elderly Male Patients: A Family Medicine Approach at Kebon Jahe Primary Healthcare Center

Aditya Andra, Diana Mayasari — Fri, 20 Dec 2024 00:00:00 +0000

Diabetes mellitus, a metabolic disorder characterized by elevated blood glucose levels due to insulin deficiency or insulin resistance, is a pressing global health issue, with more than 537 million people affected worldwide, according to WHO data from 2023, and an annual mortality rate of 1.5 million. In Indonesia, the prevalence of type 2 diabetes reached 19,572,564 cases in 2021, with Lampung reporting 38,923 cases. One key area of concern is the Kebon Jahe Community Health Center, which has recorded a high incidence of diabetes. A lack of awareness about diabetes contributes to a high rate of complications such as neuropathy, which can lead to damage to sensory, autonomic, and motor nerves in the peripheral nervous system if not well controlled. The management aimed to implement a holistic and comprehensive family physician approach tailored to the patient’s problems, utilizing evidence-based medicine that is patient-centered, family-oriented, and community-oriented. Primary data were obtained through auto-anamnesis, physical examination, and home visits. Secondary data were gathered from the patient’s medical records. Evaluations were conducted based on a holistic diagnosis from the initial process to the final study, analyzed qualitatively and quantitatively. Mr. H, a 66-year-old man, visited the Kebon Jahe Community Health Center with complaints of tingling and numbness in his hands for the past two months. The patient also reported frequent urination, excessive thirst, and increased hunger. He experienced weight loss of 3 kg over the past three months. A physical examination revealed a deficit in protopathic sensory function. The patient had a habit of consuming sugar from tea or coffee, adding 1-2 tablespoons in 5 servings daily. The patient’s knowledge about his condition was limited. Management was carried out according to related theories and journal guidelines. During the evaluation, the patient was able to adhere to both pharmacological and non-pharmacological therapy recommendations.

Infections and Microbial Types in Neonatal Sepsis: Literature Review

Ghina Sabila, Ety Apriliana, Suryadi Islamy, Ratna Dewi Puspita Sari — Fri, 20 Dec 2024 00:00:00 +0000

Neonatal sepsis is a systemic infection that involves the entire bloodstream and organs of newborns, making it one of the leading causes of neonatal morbidity and mortality, particularly in low- and middle-income countries. Neonatal sepsis is classified into early-onset sepsis (EOS) and late-onset sepsis (LOS), with varying etiologies involving gram-positive bacteria, gram-negative bacteria, and fungi. This article aims to provide a comprehensive review of the etiology, risk factors, diagnosis, and management of neonatal sepsis using an evidence-based approach. This article is based on an analysis of current literature relevant to the epidemiology, pathogenesis, and treatment of neonatal sepsis. EOS is primarily caused by vertical transmission of infection during delivery, with Group B Streptococcus (GBS) as the leading cause, while LOS is often associated with nosocomial infections caused by Staphylococcus epidermidis. Risk factors include prematurity, low birth weight, invasive procedures, and poor infection control. Management involves the administration of broad-spectrum empirical antibiotics within one hour of suspected sepsis, tailored to culture results. A holistic approach, including NICU care, family education, and optimization of infection prevention, has been shown to effectively reduce morbidity and mortality. Neonatal sepsis remains a significant challenge in perinatology, necessitating comprehensive management with an evidence-based approach encompassing timely antibiotic therapy, nosocomial infection control, and family education to improve neonatal outcomes. Preventive efforts, such as enhancing perinatal hygiene and neonatal care, must be optimized to reduce the incidence of neonatal sepsis.