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Fournier gangrene (FG) is a progressive and life-threatening necrotising fasciitis that affects the perineum, perianal region, and external genitalia. FG is a rare condition with a high mortality rate, which is significantly influenced by comorbidities such as uncontrolled diabetes mellitus, which acts as a major predisposing factor. Early diagnosis and aggressive management, particularly surgical debridement, are key to improving patient outcomes. This study is a case report aimed at describing the clinical findings, management, and final outcome in one patient diagnosed with Fournier gangrene. Data were collected from the patient's medical records after obtaining consent. A 52-year-old man with a history of uncontrolled DM presented with complaints of pain radiating from the scrotum to the lower abdomen and perineum, scrotal swelling, and fever, which developed over 5 days. A urological physical examination revealed scrotal oedema, crepitus, and necrotic skin accompanied by foul-smelling discharge. Laboratory results showed leukocytosis and hyperglycemia. The patient was diagnosed with Fournier gangrene and immediately underwent necrotomy debridement. Pharmacological management included aggressive fluid resuscitation, broad-spectrum antibiotics, and supportive therapy. The diagnosis of Fournier gangrene was established based on clinical findings of skin necrosis, crepitus, and severe pain in the genital/perineal area with uncontrolled DM as a predisposing factor. Rapid and integrated management, including aggressive surgical debridement, broad-spectrum antibiotics, and fluid resuscitation, is fundamental to successful treatment. The patient in this case report showed improvement and was discharged after 8 days of treatment.

The third trimester of pregnancy is a phase prone to anxiety due to physical and psychological changes and preparation for childbirth. Knowledge of pregnant women plays an important role in shaping mental readiness and reducing anxiety. This study aims to determine the relationship between knowledge levels and anxiety levels of pregnant women in the third trimester. The study used a quantitative correlational approach with 24 respondents selected through accidental sampling technique at Jatirogo Community Health Center, Central Kalimantan. Data were collected using a closed questionnaire and analyzed univariately and bivariately using the Chi-Square test. The results showed that 41.7 % of respondents had good knowledge and 66.7% did not experience anxiety. The Chi-Square test produced a significance value of p = 0.018, indicating a significant relationship between knowledge levels and anxiety of pregnant women. In conclusion, the higher the level of knowledge, the lower the anxiety experienced by pregnant women in the third trimester.

In order to guarantee the best possible maternal health and fetal growth throughout pregnancy, complementary services for expectant mothers are required. These services include nutrition, mental health, and supplementary medical treatment. According to data, 70% of pregnant women have low back discomfort. According to a different poll, eight out of ten third-trimester pregnant women report having back pain. Doing Childpose (Balasana) exercises is one more way to lessen this problem. This study sought to ascertain if Childpose (Balasana) exercises were beneficial in lowering low back pain complaints among pregnant women in their third trimester at the South Bolango City Health Center. This study employed a quasi-experimental pretest-posttest approach with a sample of 34 pregnant women in the third trimester. There were twenty participants in the study's sample. Childpose or balasana exercises are beneficial in relieving back discomfort in third trimester pregnant women at the South Bolango Health Center, according to the data, which indicated a P-value of 0.000 <0.05.

Work activities in workshops often require static and repetitive body positions, such as bending over, lifting heavy loads, or reaching into narrow areas of vehicles. These habits can gradually cause muscle tension and lead to neck and lower back pain. Given the high risk, physiotherapy counseling on occupational safety and health (OSH) and ergonomics was conducted to provide practical understanding to B-Garage, Batu City workshop workers. The counseling was delivered interactively through material presentations, direct discussions, and demonstrations of stretching exercises that can be easily applied in daily activities. The results of the activity showed a very significant increase in knowledge; participants who initially did not understand the principles of ergonomics and musculoskeletal pain prevention were able to identify work risks and practice stretching exercises correctly after the education session. This change was clearly evident from the post-test results, which showed a significant overall improvement compared to the pre-test. These findings indicate that physical therapy education not only enhances knowledge but also promotes behavioral changes toward safer, more comfortable, and more productive work patterns.

Background: Section Caesarea (SC) is the process of giving birth through surgery by making an incision in the mother's stomach (laparatomy) and uterus (hysterectomy) to remove the baby. 75% of surgical patients experience moderate to severe pain after surgery. Women experience high levels of pain intensity for 24 hours after SC. Objective: The aim of this research is to determine the effectiveness of lavender aromatherapy to reduce pain intensity in post-section caesarean mothers at Muhammadiyah Kalikapas Hospital. Methods: In this research, researchers used a Quasi Experimental type of research with a one group pre test and post test design. The population was 39 and a sample of 35 patients was obtained using purposive sampling. This research data uses the Verbal Rating Scale (VRS) observation sheet. After tabulating the data, it was analyzed using the Wilcoxon test with a significance level of p= ? ? 0.05. The results of the study showed that before being given lavender aromatherapy, most of the 35 post- SC mothers experienced severe pain, after treatment 19 people (54.3%) experienced moderate pain. Result: The Wilxocon Test results obtained a significant value, namely p-value 0.000, then Ha is accepted so it can be concluded that there is an effect of using lavender aromatherapy to reduce pain intensity in post caesarean section. This means that there is an influence of the use of Lavender Aromatherapy to Reduce Pain Intensity in Post Sectio Caesarea Mothers at Muhammadiyah Kalikapas Hospital in 2024. Conclusion: Lavender Aromatherapy can be a non-pharmacological therapy in reducing pain intensity for post SC Mothers

Background: Indonesia, as an agrarian country, has a large workforce engaged in physically demanding activities that increase the risk of myofascial pain. The prevalence of myofascial pain syndrome (MPS) in the upper trapezius muscle in Indonesia reaches 40% annually, with a higher rate in women. This condition often causes complaints in the neck, shoulders, and lower back, leading to a decline in quality of life. Various management strategies exist, but many are less effective in the long term and carry potential side effects. Lidocaine, as a local anesthetic, offers an alternative therapy due to its simple procedure, affordable cost, rapid effect, and good safety profile; therefore, its effectiveness in managing myofascial pain needs to be evaluated. Methods: This study was an observational research with a prospective cohort design conducted at PKU Muhammadiyah Gamping Hospital. Patients with myofascial pain who received lidocaine injections were followed for 4 weeks, and pain intensity was measured using the Numeric Rating Scale (NRS) to assess the relationship between lidocaine administration and pain reduction. Results: The study showed that lidocaine injection was effective in significantly reducing myofascial pain. The Wilcoxon Signed Rank Test produced negative Z values with p = 0.000 (<0.05) for all comparisons from pretest to the fourth week. The Friedman test also indicated significant differences between weeks (χ² = 9.731; p = 0.021), with optimal pain reduction observed in the second week. Although lidocaine provided significant analgesic effects, its effectiveness tended to decrease in subsequent weeks, indicating a short-term effect that should be combined with other interventions for sustained outcomes. Conclusion: Lidocaine injection proved effective in reducing pain among patients with myofascial pain syndrome, with the most optimal reduction occurring in the second week after therapy. The dominant factors influencing the outcomes were the relatively short duration of lidocaine’s action and individual variability in response. This implies that lidocaine can be used as an effective initial therapy, but should be combined with other interventions such as physiotherapy or activity modification to achieve more stable and sustainable pain management.

Osteoarthritis (OA) is one of the most common degenerative diseases of the joints experienced by the elderly, characterized by damage to cartilage that causes pain, stiffness, and decreased joint function. This disease usually occurs in joints that support body weight, such as the knees, which can interfere with the mobility and quality of life of the elderly. To overcome this, one approach that can be done is physiotherapy, which focuses on strengthening exercises to improve joint stability and function. Exercises such as straight leg raise, heel raise, and wall squat can help strengthen the muscles around the knee joint, reduce pain, and improve mobility in the elderly. This physiotherapy counseling was carried out at the Sawojajar Posyandu on October 20-24, 2024, with the aim of educating the elderly about Osteoarthritis and providing strengthening exercises. During the activity, pre-tests and post-tests were carried out to measure the effectiveness of the counseling. The results of the evaluation showed an increase in the elderly's knowledge about OA and their ability to perform the strengthening exercises that had been taught. The education delivered using leaflets also helps the elderly better understand ways to prevent and manage OA with proper physical exercise. In conclusion, this activity succeeded in improving the knowledge and skills of the elderly in dealing with Osteoarthritis through structured and easy-to-understand physiotherapy interventions.

The World Health Organization (WHO) reported in 2019 that 40 million people worldwide require palliative care, including those with cardiovascular disease (38%), cancer (34%), chronic lung disease (10.3%), AIDS (5.7%), and diabetes (4.6%). Palliative care aims to improve the quality of life of patients and families facing life-threatening illnesses by managing pain and physical, psychological, social, and spiritual problems. The main goal of this care is to reduce suffering and help patients cope with the limitations imposed by illness. The principles are to respect life, consider death a normal process, neither hasten nor delay death, and provide support until the end of life. This study aims to determine whether knowledge can influence the level of self-efficacy of nursing students at Awal Bros University. Using a correlational quantitative method, data were collected through the Palliative Care Quiz for Nursing and Self-efficacy Palliative Care Scale questionnaires. The results of the study show a significant relationship between knowledge and self-efficacy among students with p<0.005. These findings can be used as a basis for learning to improve the understanding of nursing students, especially in the context of palliative care, which is important for the quality of health services in the future.

Labor is a complex interaction between psychological and physiological drives in women. (90%) delivery is accompanied by pain. In the active phase there is an increase in the intensity and frequency of contractions, so that the peak pain response is in this phase. Pain and soreness during labor are basically caused by strong contractions during labor. Breathing relaxation techniques can control pain by minimizing sympathetic activity in the autonomic nervous system. This study aims to determine the effect of deep breathing relaxation techniques on reducing labor pain in the first active phase. The type of design in this study is pre-experimental with The number of samples was taken according to the Accidental Sampling technique, samples were taken when patients went to the Andra Agustiana PMB Clinic with a minimum of 30 respondents. The data collection technique used a questionnaire sheet and a Numeric Rating Scale (NRS) pain scale. Data analysis used the Wilcoxon test. The results showed that before being given the breathing relaxation technique, most respondents experienced severe pain or pain levels on a scale of 7-10, namely 25 respondents (71.4%) and after being given deep breathing relaxation technique treatment, most respondents experienced moderate pain (scale 4-6) as many as 28 respondents (80%). The results of data analysis obtained the Asymp.significancy value = 0.000 (ρ<0.05). The conclusion is that there is an effect of providing deep breathing relaxation techniques on reducing labor pain in the first active phase. It is hoped that deep breathing relaxation techniques can be applied in the management of labor care as an alternative to reduce labor pain for mothers giving birth in the first active phase

This research aims to understand how the meaning of loss is constructed in the lyrics of the song “Cutting My Fingers Off” by Turnover, using Ferdinand de Saussure’s semiotic approach. The song was chosen as the object of study because it expresses the emotion of loss intensely through poetic and emotional lyrical symbols. According to Saussure’s theory, meaning is formed through the relationship between the signifier and the signified, where words in the lyrics function as signs that carry deep meaning. This study uses a descriptive qualitative method with interview, textual analysis techniques, supported by literature review and observation of listener Turnover’s “Cutting My Fingers Off”. The analysis involves breaking down each verse to identify signifiers and signifieds that shape the emotional meaning of loss. The findings show that the lyrics reflect not only physical loss but also psychological experiences such as alienation, regret, and severed emotional attachment. Symbols like “Cutting My Fingers Off” form a visual metaphor for deep emotional pain. This research concludes that music particularly lyrics is an effective medium of symbolic communication to convey personal experiences. “Cutting My Fingers Off” successfully constructs a complex meaning of loss that resonates personally with its listeners.

Burns are one of the global health problems that still cause high morbidity and mortality rates, especially in countries with limited resources. Burn management is currently undergoing rapid development through a multidisciplinary approach that includes early resuscitation, local wound care, infection control, pain management, nutritional support, and long-term rehabilitation. This study uses the literature review method by examining articles from international databases for the period 2020–2025 to obtain the latest information on burn management updates. The results of the analysis showed that innovative therapies such as the use of stem cells, biomaterials (e.g. fish skin graft), as well as nanomedicine technology with silver nanoparticles have been proven to accelerate tissue healing and reduce complications. In addition, classic approaches such as early debridement, modern dressing selection, and enteral nutrition remain the primary basis in clinical treatment. Psychosocial and physical rehabilitation aspects are also increasingly considered because they have a significant effect on the quality of life of patients. Although various therapeutic innovations have shown promising results, translation to clinical practice still faces barriers in the form of cost, regulation, and limited facilities. Therefore, updates on burn management are needed to ensure more effective, efficient, and equitable management in modern medical practice.

Osteoarthritis of the knee is a degenerative condition of the knee joint characterized by the thinning of cartilage, leading to friction between the femur and tibia. This condition results in pain, limited joint mobility, and reduced strength of the quadriceps and hamstring muscles. Physiotherapy plays a crucial role in reducing these symptoms through modality-based approaches and structured exercise therapy. This study is a case study involving a single patient with right knee osteoarthritis. Data were collected through direct observation and evaluation of therapeutic outcomes. Interventions were conducted over four sessions using Transcutaneous Electrical Nerve Stimulation (TENS) to reduce pain, Ultrasound to enhance blood circulation and reduce inflammation, and exercise therapy focusing on improving muscle strength and joint range of motion. After four therapy sessions, there was a reduction in pain intensity, improved strength of the quadriceps and hamstrings, and increased joint range of motion. These results demonstrate that the combination of TENS, ultrasound, and exercise therapy is effective in improving function and quality of life for patients with right knee osteoarthritis. This study emphasizes the importance of a multimodal physiotherapy approach in managing chronic musculoskeletal disorders.

Shuttlecock industry workers in Arjosari Village perform many repetitive activities that involve intensive use of their upper extremities, putting them at high risk of musculoskeletal disorders, particularly frozen shoulder. This condition is characterized by pain, limited movement, and decreased shoulder function, which can interfere with work productivity. This community service activity was carried out through community physiotherapy counseling with a promotive and preventive approach, using leaflets, ergonomic education, and demonstrations of simple exercises such as cross-body arm stretches, pendulum exercises, arm circles, finger walk exercises, and towel exercises. The methods used included pre-tests, material delivery, exercise practice, discussions, and post-tests to assess knowledge improvement. The results of the activity showed that the majority of workers had experienced initial shoulder complaints, with a predominance of female respondents (93.33%). Average knowledge increased from 0% on the pre-test to 100% on the post-test. The counseling proved effective in increasing workers' understanding of frozen shoulder prevention, thereby reducing the risk of shoulder pain and increasing work productivity

Rheumatism in the elderly can cause chronic pain that affects the quality of sleep. One of the factors influencing the sleep pattern of elderly patients with rheumatism is the level of physical activity. Insufficient physical activity can worsen joint stiffness and increase sleep disturbances. This study aims to examine the effect of physical activity on sleep patterns in elderly rheumatism patients at the Sumber Pucung Elderly Posyandu, Malang Regency. This study is a quantitative study with an analytical correlational design using a cross-sectional approach. The population of this study consisted of all elderly rheumatism patients at the Sumber Pucung Elderly Posyandu, totaling 33 people. The sampling technique used was total sampling. The study was conducted from July 20 to 27, 2025. Data collection instruments used the Global Physical Activity Questionnaire (GPAQ) and the Pittsburgh Sleep Quality Index (PSQI) questionnaires. The results showed that most respondents (90.9%) had low physical activity and all respondents (100%) had poor sleep patterns. The simple linear regression test yielded a significance value of p = 0.479 (p > 0.05) and R Square = 0.016, indicating no significant effect of physical activity on sleep patterns. Based on these results, it is expected that elderly rheumatism patients can increase physical activity according to their abilities to help maintain sleep quality, and Posyandu officers can provide education and elderly exercise programs appropriate for rheumatism conditions.

Hyperkeratotic hand dermatitis (HHD) is a chronic hand eczema subtype marked by thick hyperkeratotic plaques, painful fissures, and minimal erythema or vesiculation.It is diagnostically challenging due to overlap with palmoplantar psoriasis and keratoderma and is strongly linked to repeated irritant exposure in wet work. A 60-year-old male taro leaf farmer presented with itching and burning on the palms and backs of both hands, spreading to the forearms for 2–3 weeks. Examination revealed papules, hyperpigmented plaques, erythematous macules, irregular scaling, and about 1 cm palmar fissures on both hands. The working diagnosis was chronic hyperkeratotic hand dermatitis. Initial treatment included oral cetirizine, topical betamethasone valerate, and Vaseline gel, plus education on using long rubber gloves at work. HHD results from skin barrier dysfunction and keratinocyte hyperproliferation caused by repeated irritant exposure. In this case, exposure to taro leaves and prolonged rubber glove use likely maintained irritation and occlusion. Differential diagnoses include palmoplantar psoriasis, contact dermatitis, and tinea manuum. Management involves potent corticosteroids, antihistamines, occlusive emollients, and occupational modifications such as replacing gloves and limiting occlusion time. Identifying occupational factors in HHD is essential. Effective management requires combined topical therapy, symptom control, and strict workplace modifications, along with patient education and allergy screening if needed.

Musculoskeletal disorders (MSDs) represent a prevalent health issue among clinical medical students, with global studies reporting incidence rates of 73% in India and 81.9% in Saudi Arabia. Pain is most frequently reported in the neck, lower back, and shoulder areas. However, similar data from Indonesia, particularly Papua, remains limited. This study aims to identify the prevalence and risk factors of MSDs among clinical medical students at the Faculty of Medicine, Cenderawasih University. The research employed a cross-sectional design with a sample of 78 clinical students selected through purposive sampling. Data collection utilized the Standardized Nordic Musculoskeletal Questionnaire (NMQ) to measure prevalence and the Nordic Body Map to localize pain. Data analysis used Chi-Square test to evaluate the relationship between risk factors (such as Body Mass Index/BMI and physical activity) and musculoskeletal complaints. Results showed the majority of respondents were female (74.4%) and aged ≥25 years (51.3%). Most respondents experienced pain at the "moderate pain" level (57.7%), with the most frequently reported pain areas being the back, waist, calves, knees, shoulders, and wrists. There was a statistically significant relationship between BMI and pain complaints (p=0.035), but no significant relationship was found between physical exercise and musculoskeletal complaints (p=0.129). This study concludes that BMI is a risk factor for MSDs in the studied population. Evidence-based recommendations are needed to reduce MSD risk and improve students' quality of life during clinical education.

Prenatal exercise plays a vital role in maintaining the physical and mental well-being of pregnant women. This activity helps reduce common discomforts such as back pain, enhances stamina, and strengthens pelvic muscles in preparation for childbirth. However, knowledge among pregnant women regarding safe and effective exercises remains limited. The lack of structured information often leads to uncertainty and discourages participation in physical activities during pregnancy. This condition highlights the need for well-directed and comprehensive physiotherapy education. This community service program was conducted in Building B of the Kedungkandang Community Health Center and involved 15 participants. A holistic approach was employed, combining interactive counseling to convey the theoretical benefits and safety of exercise, group discussions to share experiences, and practical demonstrations. The exercises demonstrated were carefully selected to be simple, safe, and easy to perform independently at home, ensuring continuity beyond the educational sessions. The results indicated a significant improvement in participants’ knowledge, as evidenced by the comparison between pre-test and post-test scores. This improvement reflects the growing awareness among pregnant women of the importance of maintaining fitness through structured and safe physical activity. Continuous education through a community physiotherapy approach is necessary to ensure consistent implementation of prenatal exercise and to support long-term behavioral changes toward better maternal health.

Osteoarthritis is a degenerative joint disease whose exact cause is not yet fully understood. This condition is characterized by damage to the articular cartilage, resulting in pain, joint stiffness, decreased muscle strength, muscle spasms, and reduced functional activity of the patient. Several factors contribute to the development of osteoarthritis, including age, gender, race, genetic factors, smoking habits, history of trauma, type of occupation or physical activity, exercise habits, and obesity. The prevalence of osteoarthritis increases with age; among individuals aged 65–74 years, approximately 39% experience knee osteoarthritis and 23% experience hip osteoarthritis. In those over 70 years old, almost all individuals, both men and women, show symptoms of this condition. Osteoarthritis is a chronic progressive disease characterized by inflammation of the articular cartilage and synovial membrane, which causes persistent pain, joint stiffness, decreased muscle strength, and reduced mobility. Physiotherapy management for this condition aims to reduce pain, improve muscle strength, and enhance joint function. Common therapeutic modalities used include Shortwave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), and the Hold Relax exercise technique, which helps relax muscles and increase joint range of motion

Introduction: Pregnancy is a natural process that every woman experiences. During pregnancy, pregnant women experience many changes, both physiological and psychological. These changes can cause various symptoms in each pregnant woman. Some common complaints during pregnancy include nausea and vomiting, back pain, edema, and shortness of breath. Method: This activity was conducted through counseling aimed at explaining the condition and understanding it to pregnant women. This activity used leaflets and live demonstrations so that participants could perform exercises correctly. Conclusion: After conducting counseling on the role of physiotherapy in pregnancy problems at the integrated health posts (Posyandu) for pregnant women in Sempulang Village, Janju Village, and Keluang Lolo Village, it can be concluded that education is important regarding understanding good exercises to do during pregnancy, such as child pose, cat and camel exercise or yoga for pregnant women, and breathing exercises. This is useful for reducing and preventing symptoms during pregnancy by always paying attention to signs of when to stop the exercise.

Myalgia is a muscle pain condition that can occur in a specific area of the body or spread to several regions. Its main symptoms include pain, soreness, or discomfort in the muscles, whether during movement or at rest. The pain may range from mild to severe and is sometimes accompanied by stiffness, muscle tension, or even cramps that interfere with daily activities. This condition is commonly experienced by the elderly due to aging, loss of muscle mass, improper physical activity, stress, lack of stretching, or an unhealthy lifestyle. This community service activity aimed to provide education and raise awareness about myalgia among 10 elderly participants in the Elderly Community of Kalirejo, Malang, to help them better understand prevention, pain management, and self-care strategies. The method used was service learning (SL) with achievement parameters measured through pre-test and post-test evaluations. The results showed an increase in participants’ knowledge regarding the definition, causes, and rehabilitation of myalgia from 10% to 90%, demonstrating that this program effectively improved the elderly’s understanding and awareness of myalgia.