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Elderly is an age group that is susceptible to disease due to decreased function in the body due to the aging process. Uric acid is produced by every living thing as a result of the main metabolic process, namely a chemical process in the cell nucleus that functions to support survival. To overcome complaints of pain that appear in patients with gout, there are various pharmacological and non-pharmacological therapies. The usual pharmacological therapy is taking painkillers, namely the Nonstereoidal Antiinflammatory Drugs (NSAID) group. Complementary therapy is a natural therapy including herbal therapy in the form of bay leaves. The aim of the study was to describe a decrease in uric acid levels by giving bay leaf boiled water to the elderly at the Cilacap Dewanata Institution. The results of this study were obtained after therapy by giving boiled bay leaf water, the patient was more comfortable, the pain was reduced, the last day's observations of vital signs (TTV) showed Td: 110/80 mmHg, Respiration: 20 x/minute, Pulse: 96 x /minute pain scale 2. In conclusion, the application of giving bay leaf boiled water is proven to be able to overcome the problem of diagnosing acute pain associated with physical injury agents, the implementation of self-invasion care was carried out for 3 days, with extraction the results of reduced pain.

Fine motor development is a movement that uses fine muscles or parts of certain limbs that are influenced by opportunities to learn and practice. This study aims to analyse the effectiveness of folding paper and puzzle games on children's fine motor development. The study's research design was a pre-experimental type one-group pretest-posttest design. The population of this study were all children aged 4-5 years at PAUD Ceria Panji Lor Village in September 2023, as many as 28 people with the Total Sampling technique—data collection using DDST Denver II measurement. Analytical test used with Wilcoxon Test. The results showed that children's fine motor development before therapy mainly developed as expected, namely 15 children (54%); after treatment, most developed very well, namely 19 children (68%). This study shows an influence between the value before and after being given folding paper and puzzle game therapy on the fine motor development of children aged 4-5 years.

Introduction: Older adult with hypertension often experience several problems, one of which is disturbed sleep patterns. Disorders of sleep patterns experienced by the elderly have an impact on the recurrence of the disease, therefore the problem of sleep quality in the elderly must be addressed immediately One of them is providing foot massage reflexology Methods: This study uses a descriptive research design with a case study approach. This research is a study of the application of foot reflexology in the elderly with hypertension with nursing problems with sleep pattern disorders Result: The results of the study at the beginning of the study, on 3 Mey 2023 it was known that the respondent had problems with sleep patterns with a PSQI score of 18. Based on the evaluation results on 5 Mey 2023, it can be concluded that there was an increase in the quality of sleep of respondents with a PSQI score of 9 by giving intervention for 3 days starting from 3-5 Mey 2023 Discussion: Providing an effective foot massage reflexology intervention to overcome the problem of sleep pattern disorders in the elderly with hypertension, foot massage reflexology can relax the body so that sleep will feel more restful, foot massage reflexology intervention is recommended to be given every bedtime.

High blood pressure, marked by a sustained rise in arterial pressure, poses a complex medical challenge with diverse origins. Internal factors like gender, age, and heredity, combined with external elements such as obesity, unhealthy habits, and stress, contribute to its development. The aging process in elderly individuals often results in reduced adaptive capacity, making them more susceptible to various ailments, including hypertension. To address this issue, Therapeutic Touch is explored as a non-pharmacological intervention, utilizing touch energy to modulate the nervous system and hormonal responses, thereby restoring energy balance and reducing pain and blood pressure levels. This study investigates the impact of Therapeutic Touch on blood pressure reduction in hypertensive elderly individuals in Balung Village, Kendit District, Situbondo Regency, using an experimental design with a one-group pre- and post-test setup. The research involves the entire hypertensive elderly population of Balung Village (32 individuals), with 30 participants selected through purposive sampling for a six-session Therapeutic Touch intervention over two weeks. Data collection employs observation sheets with coded responses, revealing a significant post-intervention shift towards normal blood pressure. Statistical analysis, using the Wilcoxon signed test (p-value: 0.000 ? ? 0.005), supports the acceptance of the  hypothesis. In conclusion, Therapeutic Touch proves effective in reducing blood pressure among elderly individuals with hypertension, operating through mechanisms influencing nerves, hormones, and overall body relaxation.

Preschool-aged children are susceptible to dental issues, and improper tooth brushing may lead to dental caries. Behavior, a response to stimuli, is influenced by knowledge, impacting positive toothbrushing behavior. This study aimed to assess the impact of tooth brushing practice on preschool-aged children (3-6 years) at PGRI 5 Kapongan, Kandang Village, Kapongan District, Situbondo Regency. The research employed an experimental design with a single-group pre and post-test, involving a population of 38 preschoolers at Kindergarten PGRI, Kandang Village. A non-probability purposive sampling technique was used to select 35 participants, with observations recorded using an observation sheet. The Wilcoxon matched statistical test yielded a p-value of 0.000 ? ? 0.005, indicating significance. Initially, 65.7% of respondents exhibited suboptimal tooth brushing (not quite right), but after intervention, 91.4% demonstrated proper brushing behavior. The Wilcoxon matched statistical test confirmed significance (p-value 0.000 ? ? 0.005). In conclusion, H1 is accepted, signifying the influence of tooth brushing practice on tooth brushing behavior in preschool-aged children. This insight into toothbrushing is anticipated to cultivate positive behavior, promoting oral health and mitigating dental diseases among children.

MRI (Magnetic Resonance Imaging) examination becomes tool diagnostic important in evaluation the soft tissue anatomy of the human body. MRI examination of the ankle joint role crucial in detect soft tissue impingement in the ankle joint. Fast Spoiled Gradient Echo (FSPGR) is an MRI method with high sensitivity in diagnose soft tissue problems in the ankle joint. Ankle joint MRI protocol at RSUD Dr. Moewardi uses several types of sequences with addition 3D sequences but not routinely. This study aims to examine the use of the 3D FSPGR oblique sequence in MRI ankle joint, while comparing it with the Sagittal T1 FSE and Sagittal FSE STIR sequences. This quantitative study involved 5 people to compare imaging 3D oblique FSPGR, sagittal T1 FSE and sagittal FSE STIR sequences. Analysis was carried out using the intraclass correlation coefficient (ICC) test, Friedman test, and Kruskal Wallis test. The results study showed there is difference information MRI ankle joint anatomy with oblique 3D FSPGR, sagittal T1 FSE, and sagittal FSE STIR sequences (p-value = 0.000). Test Kruskal Wallis show sequence 3D FSPGR and sagittal T1 FSE produce imaging different on every type anatomy (p-value= 0.045; 0.020), whereas Sagittal FSE STIR sequence shows results No different significant (p-value= 0.065. 3D oblique sequence of FSPGR is proven effective show anatomy ankle joint and posterior talofibular ligament.

Lower back or waist pain is a disorder in musculoskeletal position due to incorrect ergonomics, characterized by pain in the muscle area between the costal border and the inferior gluteal fold. Risk factors that can influence the incidence of lower back pain are age, gender, body mass index, smoking habits, lack of exercise, years of work, work position, and heavy workload. This community service is a forum to improve and provide education to the elderly about prevention and how to deal with lower back pain using a home program. This service activity was carried out using the counseling method with approximately 20 respondents participating. After being given a presentation of material regarding low back pain and a demonstration regarding recommended home exercises/home programs, most respondents understood and were able to explain the definition, risk factors, symptoms and prevention of low back pain.

B value is a factor that reflects the strength and timing of the gradient that will be used to generate a diffusion-weighted image. The higher the b value, the stronger the effect on diffusion. B value can be expressed in units of s/mm2 with a b value range of 500 s/mm2 to 1500 s/mm2. The use of b value in Diffusion Weighted Imaging (DWI) sequences is very important in detecting prostate cancer to distinguish malignant and benign cancer tissue because b value determines the amount of diffusion weighting and shows the sensitivity of the sequence to diffusion. The purpose of this study is to determine the difference in the quality of SNR and CNR images with b value variations in Pelvic MRI examination in prostate cancer cases. This study uses quantitative research methods with an experimental approach. The study population and samples were 4 Pelvic MRI patients with prostate cancer cases who underwent examination in July-August 2023 at the Radiology Installation of Prof.Dr.I.G.N.G Ngoerah Hospital, and each sample was subjected to b value variations of 800, 1000, 1400 and 2000 on the Diffusion Weighted Imaging (DWI) sequence. Data were processed using radiant DICOM and then analyzed using normality test and repeated anova test on SPSS 25 software. The results showed a significance value (p-value) > than 0.05, it can be concluded that H0 is accepted and Ha is rejected, which means that there is no difference in Pelvic MRI image quality in Prostate Cancer Cases with b value variations. The b value variation of 800 on Pelvic MRI examination on Diffusion Weighted Imaging (DWI) sequences with prostate cancer cases can produce more optimal image quality compared to b value variations of 1000, 1400 and 2000.

Anxiety is a mistake, doubt in something that will happen with an unclear cause or object related to feelings of uncertainty such as worry about facing surgery. To overcome anxiety, there are types of therapy that can be applied by nurses, namely pharmacological therapy and non-pharmacological therapy. One type of non-pharmacological therapy that can be used is the Benson relaxation technique. This study aims to determine the effect of Benson relaxation on reducing anxiety levels in pre-operative patients in the Dahlia Room, Tanjungpinang City Hospital. The design of this research is a pre-experiment with one group pretest posttest type. The number of samples in this study was 21 preoperative patients using the Accidental Sampling technique. The instrument used was the Amsterdam Preoperative Anxiety And Information Scale (APAIS) questionnaire. Then analyzed using the non-parametric Wilcoxon test. Univariate results before being given Benson relaxation showed that 33.3% had mild anxiety, 66.7% had moderate anxiety, and after Benson relaxation 85.7% had mild anxiety, 14.3% had moderate anxiety. Bivariate results show that the hypothesis is accepted with a p-value of 0.000. It was concluded that there was an effect of Benson relaxation on reducing anxiety levels in pre-operative patients in the Dahlia Room, Tanjungpinang City Hospital. From this research, it is hoped that the Benson relaxation technique can be used as an alternative therapy to reduce patient anxiety levels that does not have harmful side effects for patients.

Maternal Mortality Rate (MMR) is one indicator to see the success of maternal health efforts. MMR is the ratio of maternal deaths during pregnancy, childbirth and postpartum which are caused by pregnancy, childbirth and postpartum or its management but not due to other causes such as accidents for every 100,000 live births. This research aims to analyze the factors that influence the incidence of anemia in Third Trimester Pregnant Women at PMB Kunti Sari Lubis District. Perbauangan 2023. The type of research used is an analytical survey with a cross sectional approach. The population is all pregnant women in the third trimester of PMB Kunti Sari Lubis Kec. Perbauangan in 2023 and the sample in this study was 48 people. The data analysis technique used chi square. Based on statistical tests, the results obtained were p = 0.001 < 0.05, which can be interpreted that there is an influence between maternal age and the incidence of anemia in third trimester pregnant women. . p value = 0.021 < 0.05, which means that there is an influence between maternal education and the incidence of anemia in third trimester pregnant women. p value = 0.010 < 0.05, which means that there is an influence between maternal knowledge and the incidence of anemia in third trimester pregnant women. p value = 0.038 < 0.05, which means that there is an influence between maternal parity and the incidence of anemia in third trimester pregnant women.  

Hypertension is the medical definition of high blood pressure. This condition can cause various complications and even death. There are several risk factors that can cause hypertension such as stress levels and poor dietary habits. Objective: to determine the relationship between stress and diet with the incidence of hypertension at the bakti tin hospital in karimun. Methods: This study used a quantitative design with a cross-sectional approach in 92 hypertensive patients using Chi-Square analysis techniques. Results: It is known that respondents who have mild stress are 34 patients (37%) more than patients with moderate and severe stress. Patients who have a good diet as many as 57 patients (62%) are greater than patients who have a poor diet. In this study, patients who had normal blood pressure were 31 patients (33.%), while first-degree hypertension was 27 patients (29.3%), second-degree hypertension was 32 patients (34.8%), third-degree hypertension was 2 patients (2.2%). The results of the analysis show that stress and diet have a relationship with the incidence of hypertension with p value (stress = 0.015, diet = 0.001). Conclusion: there is a relationship between stress and diet with the incidence of hypertension in the bakti tin hospital in karimun. Suggestion: In this case the nurse should be able to provide education to patients so that they can control their minds to avoid stress and regulate their diet to avoid the risk of increasing blood pressure.

Currently, the use of smartphones cannot be avoided by early childhood, therefore parents must have good knowledge about the use of smartphones and a good attitude towards the use of smartphones in children where parents have a very important role in supervising children when playing smartphones. Objective: to determine the relationship between parents' knowledge and attitudes towards the use of smartphones with the development of children aged 4-6 years at Canggai Putri Kindergarten, Karimun Regency. Methods: This study used a quantitative design with a cross-sectional approach on 45 respondents using purposive sampling technique and analyzed using Chi-Square. Results: Parents' knowledge of the use of smartphones in children in the good category was 28 respondents (62.2%), parents' attitudes towards the use of smartphones in children were positive as many as 24 respondents (53.3%), children who were in accordance with behavioral and emotional development were 26 children (57.8%). The results of the analysis using Chi Square show that there is no relationship between parental knowledge about the use of smartphones and the development of children aged 4-6 years at Canggai Putri Kindergarten, Karimun Regency (p value = 0.257) and there is a relationship between parental attitudes towards the use of smartphones and the development of children aged 4-6 years at Canggai Putri Kindergarten, Karimun Regency (p value = 0.012), (OR = 4.875). Conclusion: there is a relationship between parental attitudes towards the use of smartphones with the development of children aged 4-6 years at Canggai Putri Kindergarten, Karimun Regency stress and diet with the incidence of hypertension in the karimun tin devotion hospital. Suggestion: In this case, parents should be able to have a good attitude in terms of using smartphones in children, it is intended that children have a limit on both the time and type of application used in order to keep children from becoming addicted to smartphones.

Comparison Of Metabolic Value On MR-Spectroscopy With and Without Contrast Media at Persahabatan Hospital, East Jakarta. Magnetic Resonance Spectroscopy is a non-invasive technique that can be used to measure the metabolism of several biochemical components in body tissue, especially the brain. Based on observations made by the author at Persahabatan Hospital, the spectroscopy technique used at Persahabatan Hospital is a multi-voxle technique, with sequences selction namely s2D_PRESS_144, where the spectroscopy images are taken after administering contrast and prevalence for tumor cases in the Radiology Installation at Persahabatan Hospital, with 5 data from the month May-August 2023. To determine the validity of this opinion, the authors performed pre and post- contrast MR-Spectroscopy on patients with contrast and compared the results with patients without contrast. In this study the author used a quantitative analysis type of research with an experimental approach aimed at whether the administration of contrast material affects the results of MR-Spectroscopy in patients with brain tumor cases. Where the research data comes from primary data in the Radiology installation at Persahabatan Hospital from May - August 2023 using 5 patient data. Results: Based on an observational study carried out on primary data from 5 patients, there were differences in metabolic values with and without contrast media in brain tumor cases. And MR-Spectroscopy examination without contrast is better to use than with contrast, although from the overall data it turns out there are some data that say post- contrast is higher.

Percutaneous coronary interventional (PCI) is a minimally invasive blood vessel widening procedure using balloons and stents, the PCI procedure in CTO cases uses the double puncture technique and the C-arm tube angle position LAO 45 ? - Cranial 15 ? and Frontal 0 ? - Cranial 30 ?. The aim of using the double puncture technique is to see the entry point and exit point of chronic total occlusion. This study aims to find out the latest literature related to PCI procedures in CTO cases, including current developments and status. This research is a literature review (Summary Method) where literature exploration is carried out using various sources with the keyword "Percutaneous Coronary Interventional (PCI) Chronic Total Occlusion (CTO)". Reference sources used in preparing this article include books, as well as articles in scientific journals in English and Indonesian. Based on the results of a review of several literature procedures, PCI procedures with CTO cases consist of patient preparation, preparation of tools and materials, and examination techniques for selecting puncture access. radial artery and femoral artery, patient position, C-arm angle position. There is a role for radiographers that conforms to SKKNI radiographer Number 237 of 2020, and the role of radiographers in the actions taking place in the cathlab is to prepare the readiness of the C-arm aircraft and pay attention to radiation protection during the action.  

Counseling is carried out aimed at providing health information and education to adolescents about dysmenorrhea or pain during menstruation which can cause a teenager to be absent from school or other activities where dysmenorrhea is not a disease, but a symptom that arises due to abnormalities in the pelvic cavity and is very severe. Interfere with women's activities, even often requiring sufferers to rest or leave their work for hours due to dysmenorrhea. The method used is to provide information in the form of health promotion to adolescents by using posters as a medium in counseling, giving pre-test and also post-test in the form of questions to adolescents to measuring the effectiveness of the counseling that is being carried out. The extension went well so that in the evaluation there was a level of knowledge from the participants after being given counseling. Extension activities could increase the knowledge of adolescents about desminorrhea and how to reduce pain during menstruation. 

Osteoarthritis is a degenerative joint disorder that often occurs with age. This joint disorder can cause various kinds of problems that can interfere with daily activities, such as walking, going up and down stairs, sitting to standing position, prayer activities, standing too long, and so on. Community service activities are carried out by conducting counseling activities related to knee osteoarthritis. The purpose of the outreach activities carried out in the Prolanis community consisting of the elderly or elderly is to increase knowledge and understanding of the role of physiotherapy, especially regarding the management of physiotherapy related to the treatment of osteoarthritis through exercises that can be done independently at home. Physiotherapy management in osteoarthritis can be done using hamstring stretch exercises and quadriceps setting exercises.

Heart failure is a pathophysiological condition where the heart's function as a pump is no longer able to meet the need for blood throughout the body for tissue metabolism (Price, 2015). This situation causes a decrease in cardiac output which can cause comfort problems based on clinical manifestations such as tightness, pain, heart palpitations, a feeling of coldness in the peripheral area, even swelling, muscle stiffness, numbness, and other subjective feelings felt by the patient himself. is defined as a disturbance of comfort because it is difficult for someone to determine the feeling they are experiencing so that the use of the word comfort is more appropriate to describe the feelings experienced by the patient so it is appropriate that in this condition there is a disturbance of comfort in the patient (Potter & Perry, 2014). The aim of this study was to determine the effect of hydro-aromatherapy on comfort in Heart Failure patients. This research method is a quasi-experimental pre test and post test with two groups, namely the intervention and control groups. Research data collection was carried out during September 2023 at the Integrated Heart Center (PJT) RSUP.H. Adam Malik Medan. The number of respondents with a diagnosis of CHF that met the study inclusion and exclusion criteria was 32 patients. In the intervention group, they were given a warm water foot soak mixed with aromatherapy oil, while in the control group they only soaked their feet in warm water. Measurement of comfort level uses the "daisy comfort scale" or the numerical daisy comfort intensity scale (Kolcaba, 2000). The results of this study showed that there was a significant difference in effect on increasing comfort levels (p<0.005) in the intervention group by soaking feet in warm water mixed with aromatherapy oil (p=0.000). Conclusion: The results of this study indicate that soaking feet in warm water mixed with aromatherapy oils in heart failure patients can increase comfort.

Background:Non-hemorrhagic strokeis a cerebrovascular disease that occurs when the blood supply to part of the brain is suddenly interrupted by occlusion, usually caused by thrombosis, embolism, and focal hypoperfusion which can cause a reduction or disruption in cerebral blood flow (CBF) and affect neurological function due to lack of glucose and oxygen. Computed tomography scanning (CT Scan) of the head is a special examination of the head that uses tomography techniques with X-ray beams penetrating the patient's head from various directions using a computer system to produce anatomical images in axial, sagittal and coronal planes..One of the parameters for a CT scan of the head is Increment Reconstruction. Reconstruction Increment is the distance between reconstruction images in volume data. Method: Typeresearch is quantitative with an experimental approach, carried out in July-August 2023 at Bali Mandara Regional Hospital. The population and sample of this study were 10 patients with indications of non-hemorrhagic stroke. Results :research results from the overall Friedman test on CT scans of the head with clinical non-hemorrhagic stroke using variations in reconstruction increments of 0.5mm, 0.9mm, 1.5mm, 2mm, the results of the most optimal anatomical image information in producing images from 4 variations of increments, namely in the 2mm increment reconstruction which has the highest mean rank value, namely 3.30 in the thalamus area, 3.40 in the lateral ventricle area, 3.25 in the white matter area, 3.40 in the gray matter area, 3.40 in the lesion area hypodense/infarction of 3.25. Conclusion:From the results of the Friedman test on CT scans of the head with clinical non-hemorrhagic strokes using variations in reconstruction increments of 0.5mm, 0.9mm, 1.5mm, 2mm against anatomical criteria, the most optimal value in producing an image is at a reconstruction increment of 2mm which has the highest mean rank value.

Background: Knowledge about wound care in families and patients with diabetes mellitus foot wounds needs to be increased so that families can assist in the optimal wound healing process and patients can understand more about wound care. The need for education with booklets and audiovisual media for families of diabetes mellitus patients is to increase the effectiveness of family understanding in detecting signs of diabetes mellitus foot problems and appropriate treatment. The purpose of the case study is to illustrate the application of education using booklets and audiovisual media to increase family knowledge about the treatment of diabetic foot wounds in the Sekaran Health Center target area. This research method uses a case study with a descriptive approach. The results of the study regarding family knowledge about the treatment of diabetes mellitus foot wounds were obtained in subject I before receiving education a good level of knowledge with a score of 24, after receiving education a good level of knowledge with a score of 28, subject II before receiving education a moderate level of knowledge with a score of 19, after receiving education level of knowledge is good with a score of 26. Conclusion: health education is very important to increase family knowledge about the treatment of foot wounds with diabetes mellitus, carried out at the Sekaran Health Center.

Service quality can be measured by comparing perceptions between the expected service and the service received and felt by the patient. Patient satisfaction is the level of patient feelings after comparing with his expectations. If a patient is satisfied with the value provided by a product or service, it is very likely that they will become a customer for a long time. The aim of this research is to analyze the relationship between service quality in the registration section and patient satisfaction for pregnant women at the Highlands Assistant Health Center, Highlands District, Binjai City in 2023. The type of research used in this study is analytical with a cross-sectional approach with the research sampling technique being non-probability sampling. or non-random sampling was carried out at PMB Tuti Khairina, Serdang Bedagai Regency with a sample of 32 KF 1 post partum mothers from February to May 2023. The results of the chi-square test obtained a p value = 0.001 (p <0.05). This means that there is The Relationship between Early Initiation and the Smooth Expenditure of Breast Milk in Post Partum KF 1 Mothers in PMB Tuti Khairina Serdang Bedagai Regency in 2023