Medical Profession Journal of Lampung

Pneumonia as a Secondary Complication Related to Inhaled Corticosteroid Combination Treatment for Chronic Obstructive Pulmonary Disease with Eosinophilic Phenotype Patient

Adityo Wibowo — 2024-12-30

Chronic obstructive pulmonary disorder (COPD) is a progressive respiratory condition characterized by chronic inflammation, proteases and antiproteases imbalance, and airway remodeling. Several hypotheses, including immune dysregulation, microbial colonization, and environmental triggers, explain the underlying cause of the deteriorating state and recurrence of exacerbations in COPD. Eosinophils, one of the inflammatory mediators, are involved in about 30% of cases of COPD. In COPD with an eosinophilic phenotype, specific therapy recommendations include inhaled corticosteroids (ICS) combined with a long-acting bronchodilator therapy typically includes the combination of inhaled corticosteroids (ICS) (e.g., fluticasone, budesonide) and a long-acting bronchodilator (LABA) (e.g., formoterol, salmeterol) to improve airflow and reduce inflammation. While ICS therapy is beneficial, side effects of pulmonary infections become more likely as the dose increases, particularly with prolonged use. The risk of pneumonia can be managed through dose optimization and careful patient monitoring.

Profile of Thyroid Carcinoma Patients at Dr. H. Abdul Moeloek Hospital (January 2023 – August 2024)

Istiqomatul Qurani — 2024-12-30

Thyroid carcinoma is the most common cancer found in the endocrine system that arises from thyroid parenchymal cells. Its prevalence has increased over the past few decades with a mortality rate of 0.5% per 100,000 cases. The incidence of thyroid carcinoma in 2020 ranks 7th in the world as the 9th most frequent incidence occurs from all types of cancer. Objective: This study aims to determine the characteristics of thyroid carcinoma patients at Dr. H. Abdul Moeloek Regional General Hospital for the period of January 2023 – August 2024. Method: This study used a descriptive observational design and Total Sampling technique with a data source in the form of secondary data on medical records from 82 thyroid carcinoma patients at the Dr. H. Abdul Moeloek Regional General Hospital for the period January 2023 to August 2024. Results: In this study, thyroid carcinoma patients were mostly female, with an age group in the range of 41-60 years. The most common type of thyroid carcinoma is papillary carcinoma and the least common type is anaplastic carcinoma. Conclusion: In this study, the characteristics of thyroid carcinoma patients were obtained based on gender, age group, and type of histopathological diagnosis.

Uncontrolled Type 2 Diabetes Mellitus Induces an Enterococcus faecalis Lung Abscess: A case report

Wayan Ferly Aryana — 2024-12-30

The incidence of lung abscess has increased due to the rise in antibiotic resistence, aging population, and immunocompromised patients. Lung abscess is associated with high mortality rates, ranging from 1—20% globally, long treatment cycles, and significant management costs. Diabetes millitus affect innate and adaptive immunity, This dysregulation, microvascular complications, poor vascular flow, can further compromise an appropriate immune response and healing leading to worsening or secondary infections. Uncontrolled diabetes mellitus can lead patients to immunocompromised conditions, predisposing them to infectious disease. This study is a case report with data obtained through self-history, physical examination, and supporting examinations. A 49-year-old female patient presented with complaints of dyspnea, productive cough, and fever. The patient had a history of uncontrolled type 2 diabetes mellitus with fasting blood glucose 219 mg/dL. Chest examination showed a decreased of tactile fremitus on the left lung field, dullness on percussion of the left lung field, and decreased vesicular sound on auscultation of the left lung field. Laboratory and radiological examinations were also carried out. The CT show a well-demarcated lesion measuring 13.1x7.2x11.2 cm, air-fluid level (+), walled 0.5 cm thick indicating suspicion of left lung abscess. The patient received treatments and showed clinical improvement so that therapy could be continued on an outpatient basis.

Potential Drug Interaction in Patients with Schizophrenia

Nurma Suri — 2025-01-03

In the treatment of schizophrenia, antipsychotics as the main therapy are generally combined with additional therapy. Combination therapy has a risk of drug interactions. The aim of the study was to describe the potential factors that influence drug interactions. The study was conducted using observational quantitative analytic methods with a retrospective cross-sectional approach. The sample was selected by total sampling method in the medical records of inpatients at the Lampung Mental Hospital from January-December 2022. The Lexicomp software was used to identify potential drug interactions. In the 265 samples, 344 treatment profiles were obtained with a total of 1349 drugs used. Then, 1786 potential drug interactions were classified as level of risk A (0%), B (0.8%), C (80.2%), D (19%), and X (0%). There was a significant relationship between gender, length of stay, and number of drugs (p<0.05) on potential drug interaction level D (major). Multivariate analysis showed the number of drugs had the strongest relationship (p=0.000 OR=8.233) to potential drug interactions. There was a significant relationship between gender, length of stay, and number of drugs with potential drug interactions level D. The number of drugs had the strongest with potential drug interactions.

Management of Dyslipidemia and Dyspepsia in the Elderly with Limited Knowledge and Low Physical Activity: A Family Medicine Approach at Kebon Jahe Public Health Center

Zakiah Nur Rohmah — 2025-01-04

Dyslipidemia is a lipid metabolism disorder characterized by an increase or decrease in the levels of lipid fractions in plasma. Dyspepsia is a feeling of discomfort in the upper stomach. In Maret, in 2018 there were 28.8% of the Indonesian population aged ≥ 15 years with abnormal total cholesterol levels. In 2020, the prevalence of dyspepsia was 28 million people, 11.3% of the Indonesian population. The aim of this research is to determine risk factors, clinical problems, and manage patients by applying the principles of family medicine according to evidence-based medicine through a patient centered and family approach. The method of this study is a case report. Primary data through history taking, physical examination and home visits, to complete family data, psychosocial and environmental data. The assessment is carried out based on a holistic diagnosis of the beginning, process and end of the study quantitatively and qualitatively. Result: 69 years old patient with complaints of neck stiffness and headache since two weeks ago. The patient has a history of high cholesterol since the past year and does not regularly take cholesterol medication. The patient likes to eat oily foods and coconut milk. The patient has insufficient nutritional intake. The patient’s total cholesterol level was 271 mg/dL. The patient complained of upper stomach pain, a feeling of bloating in his stomach that had been getting worse for the past 2 days. Complaints were caused by sour, spicy and late eating. The patient experienced this complaint since 30 years ago. The patient was diagnosed with dyslipidemia and dyspepsia. In this case, diagnosis and treatment are carried out in accordance with theories and journals. After the intervention, there was improvement in clinical symptoms, increased knowledge, and changes in the patient’s lifestyle.

Effectiveness of Lindur Mangrove Bark Extract (Bruguiera gymnorrhiza) as an Antibacterial Against Streptococcus pyogenes

Annisa Fath — 2025-01-07

The bacterium Streptococcus pyogenes is a gram-positive bacterium that causes various diseases in humans. Pharyngitis is the most common infection caused by Streptococcus pyogenes, occurring in 15-30% of children and 5-10% of adults. The extract of mangrove bark contains bioactive compounds that can serve as an antibacterial alternative. This research is an experimental study. The mangrove bark was extracted using 96% ethanol solvent through the maceration method and subjected to phytochemical testing. The treatment consists of 96% ethanol extract preparations with concentrations of 25%; 50%; 70%; 90%; and 100%, as well as a negative control using aquades and a positive control using amoxicillin. Each treatment was repeated 4 times. Antibacterial activity testing was conducted using the well method on Muller Hinton Agar. The results of the phytochemical test showed that the 96% ethanol extract positively contained flavonoid, phenol, alkaloid, tannin, saponin, steroid, and triterpenoid compounds. The results of the antibacterial activity study from 25%, 50%, 70%, 90%, and 100% concentrations of 96% ethanol extract produced zone diameters of 4.33 mm; 5.68 mm; 6.61 mm; 7.72 mm; and 9.02 mm. These results indicate that the 96% ethanol extract of the mangrove bark has an inhibitory effect on the growth of Streptococcus pyogenes. Data analysis of the 96% ethanol extract of the mangrove bark using the One-Way ANOVA test showed p< 0.05.

Relationship Between The Consumption of Probiotics and Emotion Regulation

Atifah Fadilah Maharani — 2025-01-07

Digestion organs and brain communicate through specific pathway that involves nervous, endocrine, and immune system onto it. Guts microbiota especially probiotics holds a crucial matter in communicating with brain, that’s why it can affect one’s mood and cognitive functions by producing neurotransmitters that are related to brain through endocrine and autonomy nervous system. The consumption of probiotics is known to be able to improve the quality of guts microbial environment, where this matter has a profound impact in increasing mood so that a person can regulate their emotion better. A good emotion regulation has a beneficial impact in order to prevent and solve stress, anxiety, and depression. Psychosocial changes can be a stressor for individual so that the ability to regulate mood and emotion is needed to help a person adapt well. The aims of this study is to know how beneficial probiotics can be in individual mood changes. The relation between probiotics consuming and mood changes have been such an interest topics to be researched in order to gain knowledge and truth how it may give an enormous impact on people’s health by consuming it regularly. It is also proved by many articles and prior literatures that show the benefits of it in physical and mental aspects yet individual quality of life, vice versa it has negative impacts if it happens in a long-term period. Daily stressors are inevitable so that by knowing what could help to at least manage it. Managing how to face stressor isn’t easy for several people, thus it also can be fatal if it isn’t treated well, such as depression or even suicide.

Fournier's Gangrene of the Scrotum in Type 2 Diabetic Patients

Helen Sustantine Restiany — 2025-01-09

Fournier's Gangrene (FG) is a rare but progressive and life-threatening necrotizing fasciitis (NF) with a prevalence rate of approximately 1.6 cases per 100,000 males annually. FG is often caused by polymicrobial infections, with common sources being urological diseases in the perianal region. A 35-year-old male presented with a painful boil in the lower scrotal area. The lesion ruptured, discharging pus mixed with blood and emitting a foul odor. The wound progressively enlarged, extending from superficial layers to the peripheral nervous system. The patient had a one-year history of diabetes mellitus (DM) with an HbA1C of 7.8% and a random blood glucose level of 98 mg/dL. Based on culture, radiological, and laboratory findings, a diagnosis of scrotal FG was established. The patient underwent debridement from the scrotum to the abdominal wall, including both iliac regions. Regular post-debridement wound evaluations were conducted to ensure the removal of necrotic tissue. Broad-spectrum antibiotics, such as ceftriaxone and metronidazole, were administered to reduce systemic toxicity, inhibit infection progression, and eliminate causative microorganisms. Early and radical debridement of necrotic and non-viable tissue is crucial in halting infection progression, especially in patients with type 2 DM. The cornerstone of FG management includes hemodynamic stabilization, systemic broad-spectrum antibiotic therapy, and surgical debridement. Supportive care, such as hyperbaric oxygen therapy, may be beneficial in certain FG cases. The mortality rate for FG is considerably high, with studies indicating rates ranging from 17% to 28% in Indonesia. Diabetes mellitus and infections with Clostridium perfringens have been identified as independent risk factors for in-hospital mortality among male FG patients.

FG is a medical emergency requiring prompt diagnosis and aggressive treatment, including surgical debridement and broad-spectrum antibiotics. Early intervention is essential to improve patient outcomes.