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Anemia in pregnancy remains a common public health problem and may lead to adverse outcomes for both the mother and the fetus, highlighting the need for effective and practical interventions. This study aimed to analyze the effect of cassava leaf (Manihot esculenta) consumption on hemoglobin levels among second-trimester pregnant women at UPT Puskesmas Rum Balibunga. A quasi-experimental study with a pretest–posttest design without a control group was conducted. The sample consisted of 30 second-trimester pregnant women with mild anemia, selected using purposive sampling. The intervention involved daily consumption of cassava leaves for 14 consecutive days. Hemoglobin levels were measured before and after the intervention using standardized examination tools. The results demonstrated a significant increase in hemoglobin levels following cassava leaf consumption, with a mean increase of 1.2 g/dL. These findings suggest that cassava leaves, which are rich in iron, vitamin C, and protein, can enhance hemoglobin synthesis and serve as a local food-based nutritional intervention. Therefore, cassava leaf consumption can be recommended as an alternative or complementary strategy for preventing and managing anemia among second-trimester pregnant women in primary healthcare settings. 

Pneumonia is a lung infection that causes the air sacs to fill with fluid or pus. This disease can be caused by bacteria, viruses, fungi, or parasites, with varying degrees of severity depending on the cause and condition of the sufferer. Symptoms include cough, fever, and shortness of breath. Data obtained from the Batam City Health Office of pneumonia in 2023, there were 1,509 cases of pneumonia, the most cases were found in Batam City (1,182 cases), while the fewest cases were recorded in Lingga Regency (5 cases). This Professional Scientific Paper aims to provide medical-surgical nursing care with the application of chest physiotherapy to Ms. N to reduce the amount of sputum for pneumonia sufferers in the inpatient room at Harapan Bunda Hospital, Batam City in 2025. The method used in this Professional Scientific Paper is a case study conducted based on the stages of nursing care including assessment, data analysis, diagnosis, intervention, implementation, and nursing evaluation. The results showed a decrease in sputum production on the third day, a decrease in fever, and an improvement in sleep patterns. Patients are expected to understand that chest physiotherapy can reduce sputum production.

Acute respiratory tract infections (ARTIs) indicate a higher prevalence among children compared to other infections, contributing to over 870,000 deaths of children under five years of age each year, or approximately 2,320 children every day. Eucalyptus oil contains chemical compounds such as eucalyptol, cineole, linalool, and terpineol, which produce a warming sensation when applied to the skin. Inhaling eucalyptus oil can relieve respiratory problems because the vapor acts as a decongestant, helping reduce nasal congestion, ease breathing, thin mucus for easier expulsion, and maintain moisture in the respiratory mucosa.The purpose of this study was to analyze nursing care for children with acute respiratory tract infections (ARTIs) experiencing ineffective airway clearance using the intervention of warm water vapor and eucalyptus oil inhalation. The method used was a case study, with data collected through interviews with the patient’s family, observation, physical examination, and nursing documentation.The coloring therapy intervention was given once daily for three consecutive days during the implementation phase. After the administration of warm water vapor and eucalyptus oil therapy to patient An.D, who had an acute respiratory tract infection with ineffective airway clearance, there was an observable improvement in cough intensity and mucus expulsion. The patient’s respiratory rate decreased from 42 breaths per minute to 30 breaths per minute, and oxygen saturation (SpO₂) returned to normal.It can therefore be concluded that warm water vapor and eucalyptus oil therapy has a positive effect on children with acute respiratory tract infections (ARTIs) who experience ineffective airway clearance.

This meta-synthesis examines in depth the effectiveness of technology-assisted therapy (TAT) in the treatment of war-related trauma through a systematic analysis of 47 empirical studies with a total of 6,842 participants published between 2010 and 2024. The quantitative synthesis indicates that the implementation of TAT demonstrates statistically significant effectiveness in reducing the severity of post-traumatic stress disorder symptoms (d=0.78, 95% CI [0.65, 0.91]), anxiety (d=0.69, 95% CI [0.54, 0.84]), and depression (d=0.72, 95% CI [0.58, 0.86]) among populations affected by armed conflict. Among the various digital modalities, Virtual Reality Exposure Therapy (VRET) exhibits the strongest therapeutic effect (d=0.85) compared with mobile-based intervention (d=0.71) and teletherapy (d=0.68). Further moderator analysis identifies the optimal intervention duration as 12 to 16 weeks, with a significant effect contribution (β=0.34, p<.001) and a relatively moderate dropout rate of 18.7%. These findings extend Tng et al. (2024) by confirming the superiority of VRET and by confirming the significance of therapist support for the effectiveness of TAT (Wu et al., 2025). In contrast to the meta-analysis by Eshuis et al. (2021), which emphasized a single approach, this study reveals that hybrid interventions that integrate multiple digital platforms simultaneously (d=0.89) are superior to single-platform interventions (d=0.67). Overall, the results of this meta-synthesis provide a strong empirical foundation for the development of more comprehensive, adaptive, and contextually relevant TAT protocols for war-related trauma.

This study aims to examine the effect of group counseling services using the cognitive therapy technique on improving students’ self-efficacy at MTs Negeri Pematangsiantar. The research was motivated by initial findings that several students had low self-efficacy levels, which negatively impacted their learning motivation. This quantitative research employed a quasi-experimental method with a nonequivalent control group design. The sample consisted of 16 eighth-grade students with low self-efficacy, divided into an experimental group (8 students) and a control group (8 students), selected using purposive sampling. Data were collected using a self-efficacy scale with a reliability coefficient of α = 0.975. Data analysis used the Mann-Whitney test. The results revealed a significant difference between the post-test scores of the experimental and control groups (Asymp. Sig. = 0.005 < 0.05). The experimental group’s mean score increased from 39.375 (low category) to 53.5 (moderate category), while the control group only increased from 40.143 to 44.143 (remaining in the low category). These findings indicate that group counseling services using cognitive therapy are effective in enhancing students’ self-efficacy. The study recommends that school counselors apply this technique sustainably to help students develop positive thinking patterns, increase motivation, and strengthen confidence in facing academic and personal challenges.

This meta-analysis provides an in-depth examination of the effectiveness of community-based interventions in alleviating collective trauma experienced by populations in conflict zones of the Middle East, compiling 47 empirical studies (N = 12,483) published between 2000 and 2023. The synthesis indicates a significant impact of community-based interventions on reducing PTSD symptoms, with a substantial effect size (d = 0.82, 95% CI [0.76, 0.88], p < .001) and moderate heterogeneity (I² = 68%), reflecting inter-study variation yet remaining within interpretable bounds. Among the strategies analysed, community psychosocial support programs demonstrated the most pronounced effectiveness (β = 0.74, p < .001), followed by collective narrative therapy (β = 0.68, p < .001) and family-based rehabilitation interventions (β = 0.59, p < .001), all underscoring the relevance of approaches rooted in social networks and interpersonal relations. Moderator analyses revealed that longer program duration, particularly interventions spanning at least 6 months (β = 0.71, p < .001), and active engagement of local leaders (β = 0.65, p < .001) were critical determinants of intervention success. Furthermore, meta-regression findings indicated a strong and consistent correlation between the intensity of community involvement and reductions in collective trauma symptoms (R² = 0.73, p < .001), highlighting that social participation is not merely complementary but constitutes the foundation of program efficacy. In the researchers' view, these findings extend the contributions of prior studies by Hassan et al. (2016) and Morrison & Marrison (2024) by affirming the central role of local wisdom in trauma recovery processes, while offering a conceptual contribution in the form of an integrative framework that merges psychosocial interventions with community cultural values. Consequently, these results provide not only an empirical basis for developing more effective trauma-healing programs in Middle Eastern conflict zones but also underscore the urgency of contextual adaptation to ensure that interventions meet the most essential needs of affected populations.

Patients undergoing surgery often experience preoperative anxiety due to concerns about the outcome, pain, and the risk of complications. Uncontrolled anxiety can affect the patient's physiological and psychological condition and slow the recovery process. One non-pharmacological effort that can be used to reduce anxiety is the finger-holding relaxation technique, a simple method that can help balance emotions and provide a sense of calm. To determine the effect of the finger-holding relaxation technique on changes in preoperative anxiety levels in patients at Batang Regional General Hospital. Method: This study used a descriptive case study approach. The respondents were four patients who were about to undergo surgery and were experiencing anxiety. The intervention was conducted for approximately 15 minutes using the finger-holding relaxation technique. Anxiety levels were measured before and after the intervention using the Hamilton Anxiety Rating Scale (HARS). All respondents experienced a decrease in anxiety levels after the intervention. The average reduction in anxiety scores was 7.25 points. Before the intervention, two patients experienced severe anxiety and two patients experienced moderate anxiety. After the intervention, two patients experienced mild anxiety and two others experienced a decrease to moderate levels. This indicates that finger-holding therapy has a positive effect on reducing preoperative anxiety in patients. The finger-holding relaxation technique has been proven effective in reducing preoperative anxiety in patients. This intervention can be used as a simple, safe, and easy-to-implement non-pharmacological therapy alternative for nurses to improve patient psychological comfort.

Background: Oral health is an important indicator of overall health, well-being, and quality of life. According to the WHO, oral health is a state of freedom from various diseases and conditions, including dental and oral diseases that limit an individual's ability to bite, chew, smile, speak, and psychosocial well-being. Therefore, it is necessary to maintain oral hygiene as an effort to improve oral health. Case report: A 45-year-old man came to Soelastri General Hospital complaining of a large cavity in his upper left tooth. The tooth had been painful for about a year and had not undergone any treatment.Extraoral examination revealed a symmetrical face. Clinical examination of the maxillary left first premolar revealed a large cavity on the distoocclusal surface with pulpal depth. Discussion: Perforations can be treated through cavity access; the prognosis depends on the elimination and prevention of infection in the perforation area and the choice of material. The success of perforation closure management is influenced by several factors, including the timing of perforation closure, the choice of material used, the location of the perforation, and adequate perforation closure. Conclusion: Case of maxillary left premolar with diagnosis of pulp necrosis which experienced lateral perforation and the area was closed using MTA, then root canal treatment.

Tomato (Solanum lycopersicum) extract is known to contain potent antioxidant compounds such as lycopene, vitamin C, and flavonoids that can protect reproductive cells from oxidative stress. This study aims to analyze the effectiveness of tomato extract in improving the quality of spermatozoa in white rats (Rattus norvegicus) exposed to cigarette smoke, which is a major source of free radicals. The research applied a literature review approach by identifying, selecting, and analyzing related studies published between 2013 and 2023 from the Google Scholar and Academia.edu databases. Ten eligible studies were included for synthesis. The results show that the administration of tomato extract at doses ranging from 20 to 60 mg/kgBW/day significantly increased sperm motility, morphology, and viability in rats exposed to cigarette smoke. The improvement was associated with the antioxidant effect of lycopene, which protects Leydig cells and maintains testosterone production. These findings suggest that tomato extract has significant potential as a natural antioxidant therapy to prevent oxidative damage and reproductive disorders caused by cigarette smoke exposure.

Low Birth Weight (LBW) infants are among the leading causes of neonatal morbidity and mortality in Indonesia. This condition results from the immaturity of organ systems, including thermoregulation, making infants vulnerable to hypothermia. One non-pharmacological intervention to maintain body temperature stability is the nesting technique, which positions the baby in a flexed posture similar to the intrauterine condition using soft rolled cloths as a “nest.” This case study aimed to determine the effect of nesting on body temperature changes in LBW infants in the perinatology room of RSUD Batang. The study used a descriptive case study with a nursing process approach involving five LBW infants (<2500 g, spontaneous breathing). The intervention involved applying nesting for 30 minutes daily over three consecutive days. Body temperature was measured before and after the intervention using a digital thermometer. The results showed an increase in body temperature in all subjects. The average temperature before intervention was 35.9°C and increased to 36.6°C after three days of nesting therapy. This indicates that nesting effectively helps maintain body temperature stability in LBW infants by providing comfort, reducing stress, and conserving body energy. In conclusion, nesting is an effective evidence-based nursing intervention for improving body temperature in LBW infants and is recommended for perinatology care settings.

Postpartum anxiety is a psychological problem that often occurs after childbirth and can have a direct impact on decreased breast milk production. Non-pharmacological efforts that can help overcome this are Spiritual Emotional Freedom Technique (SEFT) therapy and Endorphin, Oxytocin, and Suggestive Massage Stimulation (SPEOS). This community service activity aims to improve comfort, calmness, and increase breast milk production through the application of a combination of SEFT and SPEOS therapy to postpartum mothers in the Sambau Community Health Center, Batam City. The activity method is carried out through education, demonstrations, and direct practice with postpartum mothers given to 48 postpartum mothers. The results of the activity showed an increase in mothers' knowledge about SEFT and SPEOS relaxation techniques, about managing anxiety, and how to increase breast milk production as obtained from the results of qualitative evaluations through interviews and group discussions. This activity received a positive response from participants and local health workers, and is recommended for routine implementation in community midwifery services.

Importance of gut microbiota during neurodevelopment has increased, as has the potential relationship between the gut microbiota and (ASD). Complex associations between gut microbiota and ASD are explored here, including significant pathways such as immune modulation, neurotransmitter control, and gut-brain axis signaling. Based on available data, individuals with ASD possess distinctive microbial signatures that are characterized by reduced diversity and altered abundance of specific bacterial species. Such modifications could be related to symptoms of the behavioral nature, neuroinflammatory, as well as gastrointestinal. ASD growth as well as severity could be influenced by the composition of microbiome, depending on genetic, nutrition, microbial exposure during the earliest phases, as well as antibiotic use. Additional therapies based on the microbiome that presented the potential to alleviate the symptoms related to ASD include the use of probiotics, prebiotics, diet modification, as well as fecal microbiota transplantation (FMT). Still, establishing the causal associations, standardizing the procedure of handling the patients, as well as solving the problem related to the manipulation of microbiome, are still challenging activities, though. Large-scale, long-term studies need to be the core agenda of subsequent research, so that specific microbial signatures associated with ASD will be clearly defined, as well as tailored therapies that address the microbiome will be developed. Understanding more about the role that the microbiota plays during ASD may open up the diagnosis as well as the therapy based on the entirely new concepts, something that will ultimately benefit the patients who possess the disorder.

Sectio caesarean surgery is a surgical procedure that can effectively prevent ma- ternal and newborn deaths when used for reasons of medical indications. Post operative sectio caesarean can pose several risks of complications, one of which is pain and surgical wound infection. Non pharmacological approach aromatherapy as a complementary therapy to reduce postpartum pain. This case study aims to analyze the influence aromatherapy lavender on reducing pain levels in post sectio caesarean mothers by using the case study method pre and post test. The case study was carried out in 25 May 2025 – 07 June 2025. This type of case study is descriptive with the number of subjects used, namely three post partum mothers in the RSUD Batang private sector with pain assessment using a questionnaire Numeric Rating Scale (NRS). The results of the case study showed a change in pain intensity from a scale of 6-7 to a scale of 4-5. This shows an influence aromatherapy lavender on reducing pain levels in postpartum mothers caesarean section Giving innovation aromatherapy can be used as an independent nursing in- tervention so that it can be applied to patients regularly.

Hypertension is categorized as one of the most widespread chronic non-infectious conditions among the elderly and can heighten the risk of serious complications. A non-pharmacological strategy that may be implemented to manage hypertension is the administration of boiled moringa leaves (Moringa oleifera), which are known among scientific communities for possessing antioxidant agents and potent bioactive molecules that function synergistically in maintaining cardiovascular stability and decreasing arterial pressure. This empirical study sought to examine how far the intake of boiled moringa leaves contributes to reducing blood pressure values in hypertensive older adults living within Meunasah Papeun Village, situated in Krueng Barona Jaya Subdistrict, Aceh Besar District. The statistical evaluation showed a significant p-value of 0.001 (p < 0.05), confirming a substantial effect under a quantitative quasi-experimental approach applying the One Group Pretest-Posttest model. The research sample included 20 participants chosen from a total population of 77 individuals through purposive sampling. The investigation took place from May 27 to June 25. Data were obtained using observation forms, standard operating procedures (SOP) for moringa leaf preparation, and manual sphygmomanometer readings. The findings revealed that prior to the application of treatment, the mean systolic blood pressure reached a level of 193.30 mmHg, whereas following the intervention it displayed a considerable decrease, it fell to 129.75 mmHg. The mean diastolic pressure also exhibited a decrease from 94.00 mmHg, confirming the notable influence of moringa leaf decoction in controlling hypertension. In summary, moringa leaf infusion proved effective in lowering blood pressure among elderly individuals suffering from hypertension. It is recommended that patients regularly consume boiled moringa leaves when experiencing increased blood pressure, that community health services provide education regarding non-pharmacological hypertension management through moringa leaf decoction, and that further research explore this topic with broader variables.

Chronic kidney disease (CKD) patients undergoing hemodialysis are at risk of experiencing intradialytic complications, one of which is hypertension. Management of hypertension in hemodialysis units is generally pharmacological, although non-pharmacological interventions may serve as an effective, simple, and safe complementary option. One such technique is Benson relaxation, which combines controlled deep breathing with spiritual elements to reduce sympathetic activity and promote relaxation. This case study to determine the effect of Benson relaxation therapy on blood pressure of intradialytic hypertension patients at RSUD Batang. The case study design was a case study involving 5 CKD patients undergoing hemodialysis. The intervention was performed by guiding patients to practice Benson relaxation for about 10–15 minutes, with blood pressure measured before and after the intervention using a digital sphygmomanometer. The results showed a decrease in blood pressure in most respondents. The average systolic blood pressure decreased from 153.4 mmHg to 145.6 mmHg, while diastolic pressure decreased from 92.4 mmHg to 87.6 mmHg. In addition to physiological improvement, patients also reported subjective relief such as reduced dizziness, palpitations, and tension. In conclusion, Benson relaxation therapy proved effective in reducing blood pressure among intradialytic hypertension patients. This intervention can be recommended as a complementary non-pharmacological therapy in nursing care to improve comfort in hemodialysis patients.  

Background: Anemia in pregnancy increases the risk of maternal and fetal morbidity and mortality, with a higher incidence in the third trimester. Although Fe tablets serve as the main therapy, non-pharmacological alternatives such as beetroot and lemon juice also have the potential to raise hemoglobin levels. Objective: To determine the effect of consuming beetroot-lemon juice combined with Fe tablets on hemoglobin levels in third-trimester pregnant women in Semarang. Method: This study applied a quasi-experimental design with a two-group pre-test post-test approach, allowing the measurement of hemoglobin level changes before and after the intervention. The study population consisted of all pregnant women in their third trimester, with gestational ages between 32 and 38 weeks, registered at two community health centers: PMB Puji Widiastuti, Amd.Keb, with 16 anemic respondents, and PMB Ika Febri Setyaning Astuti, Str.Keb, with 15 anemic respondents. A total of 31 respondents were obtained using total sampling. Data collection was conducted through observation sheets, and analysis was performed using the Mann Whitney statistical test. Results: The intervention group, which consumed beetroot and lemon juice along with Fe tablets, achieved a Mean Rank of 13.41, whereas the control group recorded a Mean Rank of 18.77, with an effectiveness difference of 5.36. Statistical analysis yielded a p-value of 0.048, indicating a significant difference between the groups. In conclusion, the combination of beetroot and lemon juice with Fe tablets effectively increased hemoglobin levels among third-trimester pregnant women with anemia. This finding suggests that such combination therapy can serve as a valuable alternative in the management of anemia during pregnancy.

Hypertension is one of the most common diseases experienced by the community and poses a high risk of causing serious complications. Persistently elevated blood pressure can damage vital organs and increase the risk of cardiovascular diseases such as heart attacks, strokes and kidney failure. The purpose of this study is to determine the implementation of foot reflexology massage to reduce blood pressure in patients with hypertension. This research employed a case study approach involving two hypertensive patients at TK II Putri Hijau Hospital Medan. The Nursing care process included assessment, nursing diagnosis, planning, implementation, and evaluation. The results showed a decrease in both systolic and diatolic blod pressure after the foot reflexology intervention. The first patient experienced a reduction in blood pressure from 145/90 mmHg to 130/82 mmHg, while the second patient’s blood pressure from 144/89 mmHg to 128/82 mmHg. The study cocludes that the implementation of foot reflexology massage is proven to be efeective in lowering blood pressure in hypertensive patients. This therapy is recommended as a complementary intervention in nursing practice to assist in controlling hypertension.

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: Hemorrhagic stroke is a critical condition caused by the rupture of cerebral blood vessels, which leads to intracranial bleeding, increased intracranial pressure (ICP), and decreased adaptive capacity of the brain. One of its main impacts is a significant disturbance of consciousness. Nurses have applied non-pharmacological approaches, such as bimodal sensory stimulation, as innovative interventions to stimulate neurological function and indirectly stabilize intracranial pressure. Objective: This study analyzed the implementation of bimodal sensory stimulation in improving intracranial adaptive capacity in patients with hemorrhagic stroke. Methods: This case study involved a patient with a hemorrhagic stroke and impaired consciousness in an intensive care unit. The intervention was conducted for three consecutive days by providing auditory stimuli (voices of family members and nurses) and gustatory stimuli (lemon) five times daily. Measurements included the Glasgow Coma Scale (GCS) and neurological response observations. Results: After receiving bimodal sensory stimulation therapy, the patient showed improved consciousness, as indicated by a consistent increase in GCS scores from 9 to 11 over the three days. The patient's responses to auditory and gustatory stimuli also improved, including mild motor movements, pupil reflexes, and simple interactions such as blinking or opening the eyes in response to sounds. Conclusion: Bimodal sensory stimulation effectively facilitated the recovery of consciousness and enhanced intracranial adaptive capacity in patients with hemorrhagic stroke. Nurses can integrate this intervention into evidence-based nursing practice in intensive care units with active family involvement.

Background: Patients with chronic kidney failure must undergo hemodialysis/dialysis therapy. Chronic kidney failure patients undergoing hemodialysis experience several changes in their lives due to the patient's illness. Objective: This study aims to gain an in-depth understanding of the life experiences of chronic kidney failure patients undergoing hemodialysis. Methods: This research uses a qualitative research method with a phenomenological approach. The instruments for this research were the researcher himself, voice recorder, field notes, stationery, interview guide, and informed consent form. The informants used in this research were 7 informants. Results were analyzed using thematic analysis techniques. Results: Based on the results obtained in this study, 4 themes were found, namely (1) physiological, psychological, social, spiritual and economic changes, (2) Coping techniques in overcoming problems or changes due to chronic kidney failure, (3) Experiences in undergoing the hemodialysis process , (4) The hardest experience while suffering from chronic kidney failure. Conclusion: All informants experienced physiological, psychological and spiritual changes, while only a few informants experienced social and economic changes. Coping techniques for dealing with these changes are good except for economic changes where there is no solution for these changes. Experiences in undergoing the hemodialysis process include some being positive and some being negative. Meanwhile, the hardest experiences while suffering from chronic kidney failure vary according to what happens in the informant's life.