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Background: Carpal Tunnel Syndrome (CTS) is a condition caused by compression of the median nerve at the wrist, resulting in pain, paresthesia, and decreased hand function. This condition is commonly experienced by individuals who perform repetitive wrist activities. Objective: To determine the effectiveness of a combination of neural mobilization exercises and electrotherapy modalities in improving hand function, increasing muscle strength, and reducing pain in a patient with Carpal Tunnel Syndrome. Methods: This study used a case report design involving a 57-year-old female patient (Mrs. Q) who presented with pain and sensory disturbances in the right hand. The intervention was administered for four weeks and consisted of ultrasound therapy, Transcutaneous Electrical Nerve Stimulation (TENS), grip strengthening exercises, and nerve gliding exercises. Outcome measures included pain intensity assessed using the Numeric Rating Scale (NRS), muscle strength evaluated using Manual Muscle Testing (MMT), and functional ability measured using the Wrist Hand Disability Index (WHDI). Results: The evaluation showed a reduction in pain intensity, with resting pain at 0/10, tenderness at 4/10, and movement pain at 4/10. Muscle strength improved from grade 3 to grade 4 based on MMT. Functional ability also improved, as indicated by a 20% reduction in the WHDI score. The combination of these interventions proved effective as a conservative management approach for Carpal Tunnel Syndrome. Conclusion: The administration of ultrasound, TENS, grip strengthening exercises, and nerve gliding exercises over four therapy sessions in Mrs. Q resulted in decreased pain, increased muscle strength, and improved hand functional ability.

This study examines visual distortion, the use of emotional color, and expressive composition in Affandi's painting Self-Portrait Smoking a Pipe (1977), focusing on a systematic and contextual visual hermeneutic reading. The research background stems from the need to update the study of Indonesian expressionism through the integration of contemporary theories on visual perception, color psychology, and gestural analysis. This study aims to reveal how anatomical distortion, color dynamics, and non-linear compositional structures function as expressive strategies that reflect the artist's psychological condition and existential reflections in the final period of his life. The research method uses a descriptive qualitative approach and visual hermeneutic analysis through observation of digital documentation and a review of recent literature (2020–2025). The findings indicate that the distortion of shapes in the facial area and the finger-swiping gesture represent emotional tension, while the dominance of red, yellow, and green colors forms an affective spectrum that strengthens the psychological atmosphere in the work. The asymmetrical composition with diagonal lines creates a dynamic visual rhythm and directs the viewer's focus to the center of expression. The implications of the research emphasize that Affandi's works need to be read through a multidimensional approach that combines psychological, aesthetic, and hermeneutic aspects in order to obtain a more comprehensive understanding of his expressionist character.

Cardiovascular dysfunction is a disorder of the blood vessels, such as hypertension, heart failure, and stroke. In 2016, cardiovascular disease was the leading cause of death worldwide, based on data from the World Health Organization (WHO). Coronary Heart Disease (CHD) is the leading cause of death, along with stroke, as shown by the Sample Registration System survey in 2014.This case involves a 64-year-old male, Mr. N, who presented to the emergency department of RSUD dr. Fauziah Bireuen with complaints of chest pain that developed gradually and worsened over the past month. The pain was located across the entire chest and radiated to the back and neck. The pain was described as severe, like being crushed by a heavy load, worsened during strenuous activities such as cutting grass and chopping wood, and relieved when the patient bent forward. The pain could occur at any time, with a Visual Analog Scale (VAS) score of 10 (severe pain). The patient also reported easy fatigue during heavy physical activity over the past month. Laboratory examination revealed elevated leukocytes, mean corpuscular volume (MCV), segmented neutrophils, troponin I, cholesterol, and triglycerides. The patient was diagnosed with extensive anterior ST-elevation myocardial infarction (STEMI) post successful fibrinolytic therapy.

Background: Discomfort in third trimester pregnant women often arises due to physiological changes, with back pain being the most common complaint, occurring in 70% to 90% of cases. If left untreated, this pain can interfere with daily activities, cause insomnia, and even affect the childbirth process. Objective: This study aimed to determine the effect of back massage on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center. Methods: The research design used a pre experimental approach with a one group pretest posttest design. The sample consisted of 40 third trimester pregnant women experiencing back pain at Adow Community Health Center. Data were analyzed using the paired t test statistical method. Results: Before receiving back massage, the majority of respondents (57.5%) experienced moderate scale pain. After the intervention, the majority of respondents (70%) reported a reduction in pain to a mild scale. The statistical test results showed a p value of 0.000 (p < 0.05) with an average pain reduction of 1.125. Conclusion: Back massage has a significant effect on reducing the intensity of back pain in third trimester pregnant women at Adow Community Health Center.

Background: The elderly are individuals who have reached the age of 60 and above. For most elderly people, loss or limitation of resources is a factor that can trigger anxiety. Anxiety is a complex emotional condition associated with feelings of fear and often accompanied by physical symptoms such as rapid heartbeat, shortness of breath, or chest pain. The role of nurses as care providers in reducing complaints in anxious clients uses independent nursing interventions, one of which is the application of non- pharmacological therapy. Non-pharmacological therapy is diversionary therapy. Objective: To determine the effectiveness of diversionary therapy in reducing anxiety levels in elderly people at the Abiyoso Yogyakarta BPSTW unit .Method: The design of this case study is descriptive. This study conducted treatment or intervention on clients to observe changes before and after using the HARS questionnaire .Results: All three forms of diversion therapy administered showed a decrease in anxiety levels in Mr. B. Measurements using the HARS instrument showed a decrease in scores  from an initial 19 to 13 after three interventions. Conclusion: The intervention, administered over three consecutive days, showed positive  changes with a decrease in anxiety scores.

Background: Dysmenorrhea is commonly experienced by female adolescents and may interfere with daily activities and academic concentration. Non-pharmacological interventions such as listening to the murottal of Surah Ar-Rahman and the use of lemon aromatherapy have been reported to provide relaxation and analgesic effects. However, evidence regarding the effectiveness of their combined use remains limited. Therefore, this study aimed to evaluate the effect of combined therapy using Murottal Surah Ar-Rahman and lemon aromatherapy on dysmenorrhea pain levels among female adolescents at SMA Negeri 10 Semarang. Method: This study was conducted at SMA Negeri 10 Semarang using a Quasi-Experimental design with a Pretest–Posttest Group approach. The population consisted of 188 students who met the inclusion criteria. The sample size was determined using the Slovin formula, resulting in 40 respondents selected through purposive sampling. A normality test was performed prior to analysis, and the bivariate analysis utilized the Wilcoxon Signed Rank Test. Result: The Wilcoxon Signed Rank Test showed a p-value of 0.000 (p < 0.05), indicating a significant difference between pain levels before and after the intervention. These findings demonstrate that the combination of Murottal Surah Ar-Rahman and lemon aromatherapy is effective in reducing dysmenorrhea pain among female adolescents at SMA Negeri 10 Semarang. Conclusion: The combined therapy of Murottal Surah Ar-Rahman and lemon aromatherapy is effective in reducing dysmenorrhea pain levels among female adolescents.  

Background: Recurrent Aphthous Stomatitis (RAS) is one of the most frequently encountered oral mucosal conditions. Although RAS has been extensively considered clinically and through research, ulcer occurrence remains unavoidable, and most treatment approaches are primarily symptomatic. Objective: To identify anxiety as a predisposing factor in patients with minor RAS. Case Report: A 24-year-old female patient presented to Soelastri Dental and Oral Hospital with a complaint of an ulcer on the right upper lip. The patient reported pain and a burning sensation for the past four days. The pain worsened when consuming hot food or beverages. The patient had experienced similar episodes previously but had never sought treatment for this condition. Intraoral examination revealed a single shallow ulcer with an oval shape, regular margins, a yellowish-white base surrounded by an erythematous halo, measuring 3 × 2 mm on the right upper lip, and was symptomatic. Case Management: The treatment provided focused primarily on Communication, Information, and Education (CIE). The patient was informed about the predisposing factor experienced, which may contribute to the occurrence of RAS, namely anxiety. The patient also received education regarding maintaining oral hygiene, consuming fruits and vegetables, increasing water intake, eating more regularly, attending a follow-up visit seven days after treatment, and managing anxiety. Conclusion: In this case, RAS management was focused on eliminating predisposing factors, particularly anxiety, which was strongly suspected to be the triggering factor for minor RAS in this patient.

Background: Adolescence is a transitional phase marked by biological changes, one of which is menstruation. A common problem during menstruation is dysmenorrhea or lower abdominal pain, which can interfere with quality of life and daily activities. One non-pharmacological effort to address this is consuming dark chocolate, which contains magnesium and triggers the release of endorphins as a natural pain reliever. Methods: This study used a quantitative method with a pre-experimental design through a one-group pretest-posttest design. The research population and sample consisted of 30 adolescent girls experiencing menstrual pain, selected using total sampling technique. Data analysis used the Wilcoxon Test to examine the effect before and after the intervention. Results: Before consuming dark chocolate, the majority of respondents experienced moderate pain (76.7%) and severe pain (16.7%). After the intervention, a significant reduction in pain level occurred, with 90% of respondents falling into the mild pain category and no respondents experiencing severe pain. The mean pain level decreased from 2.07 to 1.20 with a p-value = 0.000. Conclusion: The administration of dark chocolate has a significant effect on reducing the level of dysmenorrhea pain in adolescents at Puskesmas Ibu.

Background: Comprehensive midwifery care is essential for early detection of complications and reducing maternal and infant mortality rates. In Sleman Regency, despite high access to health services, continuous monitoring remains crucial for ensuring maternal and fetal safety. Objective: To provide comprehensive midwifery care for Mrs. M at Klinik Pratama Shaqi, Sleman, from the third trimester of pregnancy through the postpartum and neonatal periods. Methods: This is a descriptive qualitative study using a case study approach based on Varney's seven-step midwifery management and SOAP documentation. Findings: During pregnancy (37 weeks 6 days), the mother experienced physiological complaints of back pain and shortness of breath, managed through posture education and pregnancy exercises. Labor proceeded normally and spontaneously on October 6, 2024, utilizing "gentle birth" practices such as endorphin massage to reduce pain. A second-degree perineal tear occurred and was treated according to procedure. The baby was born healthy, weighing 3100 grams, with successful Early Initiation of Breastfeeding (EIB). During the postpartum and neonatal periods, uterine involution was normal, breast milk production was adequate, and the infant's growth met standards with no danger signs. Implications: Continuous assistance improves the mother's physical and psychological readiness and ensures a healthy neonatal transition.

Background: Dental caries is a major problem in orodental health, especially in children. The primary cause of caries is the activity of cariogenic microorganisms. Unbalanced remineralization of dental tissue followed by destruction of organic matters may cause cumulative and progressive damage to the tooth structure. Extensive caries lesions that have reached the pulp are an indication for pulp therapy with appropriate crown restoration. Case Report: A 10-year-old boy came with a complaint of a painful cavity in his upper right front tooth. The patient was considered communicative and cooperative. The patient also had a habit of consuming sweets. An intraoral examination revealed extensive caries on the entire surface of 53. A periapical radiograph showed a radiolucent area reaching the pulp cavity on the occlusal surface of 53 with resorption of the apical one-third of the root. Based on the examination results, reversible pulpitis was established as the primary diagnosis. The treatment plan was pulpotomy with a dental crown restoration. Treatment was carried out over four visits. First visit included complete examination, periapical radiography, and pulpotomy. The second visit included core buildup, tooth preparation, and dental impressions. The third visit included try-in and crown insertion, followed by a final follow-up visit. Conclusion: Pulpotomy with dental crown restoration can be an effective clinical approach to restore the function and aesthetics of anterior deciduous teeth, especially in cases that consider aesthetics and cost limitations.

Low back pain is one of the most common complaints experienced by pregnant women, particularly in the third trimester, as a result of various physiological, hormonal, and biomechanical changes that occur during pregnancy. Changes in posture, weight gain, and shifts in the center of gravity contribute to the development of this condition. This study aims to examine various non-pharmacological interventions that can be used to reduce low back pain in pregnant women and to analyze the role of midwives in implementing these interventions in midwifery practice. The method employed is a narrative literature review synthesizing ten verified and relevant studies, particularly those discussing prenatal yoga and pregnancy exercise as forms of non-pharmacological intervention. The results indicate that the implementation of prenatal yoga and pregnancy exercise is effective in reducing the intensity of low back pain, improving muscle flexibility and strength, and providing physical and psychological relaxation for pregnant women. In addition, these interventions contribute to increased comfort and improved quality of life during pregnancy. The findings of this study support the importance of evidence-based midwifery practice and highlight the active role of midwives in providing education, assistance, and empowerment for pregnant women through the application of safe and effective non-pharmacological interventions.

The goal of continuous midwifery care is to use the SOAP documentation technique to provide comprehensive care to pregnant women up to birth control according to care standards. From May 2 - July 14, 2025, Mrs.C, G2P1A0, 32 years old received continuous midwifery care from pregnancy until get contraception methods, starting at 34 weeks of gestation. The mother complained of back pain during prenatal check-ups. The labor process went smoothly. With the assistance of a midwife, the baby was born on June 10, 2025. Birth weight: 3000 grams; length: 50 cm; head circumference: 34 cm; chest circumference: 33 cm; received Hb0 vaccine two hours after birth, eye ointment, and vitamin K shortly thereafter. The baby did not experience any problems or complaints during the first visit. Mrs. C received four visits during the postpartum period. The mother did not feel anything during the first visit up to the following visits. She continued to breastfeed exclusively, and her vital signs and fundal height returned to normal. The mother used a three-month injectable contraceptive so as not to interfere with the exclusive breastfeeding program. Mrs.C has received continuous midwifery care during pregnancy and contraceptive use, and her health is normal. It is expected that the midwife will be able to provide continuous midwifery care so that in the event of an emergency, it can be immediately identified and promptly handled.

Low back pain (LBP) is one of the most common musculoskeletal complaints globally and is the main cause of decreased work productivity. One of the risk factors that has been widely studied in the literature is prolonged sitting duration. Prolonged sitting activities cause increased static pressure on the lumbar spine, fatigue of the supporting muscles, as well as a decrease in local blood flow that can trigger chronic pain. This study is a literature review with a meta-analytical approach that aims to analyze the relationship between long-term sitting and the incidence of LBP. The review process was carried out following PRISMA guidelines through searches on PubMed, Scopus, ScienceDirect, and Google Scholar databases for publication in 2020–2025. Of the 20 previous studies analyzed, most showed a positive association between sitting time and an increased risk of LBP, both in adults, adolescents, and children. Sitting for more than 6 hours per day increases the risk of LBP by 33%, especially in individuals with low physical activity. In addition, longer sitting durations with poor posture and minimal active rest were found in the group of office workers and professional drivers who had a high prevalence of LBP. Physical activity has been shown to play a protective role against the risk of LBP, while ergonomic interventions such as lumbar support can reduce pain complaints. Although most studies were observational, the consistency of results supports the importance of prevention through reduced sitting time, increased physical activity, and ergonomic work environment settings. These findings provide a scientific basis for multidimensional interventions to effectively reduce the incidence of LBP.  

During gravidity, back pain is a significant issue, especially due to changes in posture along with increasing physical load in the third trimester. Muscle relaxation and stretching exercises for pregnant women can help reduce back pain, one of which is the butterfly exercise. That study aims until determine the impact to the butterfly activity on gravidity in their third trimester at TPMB Amilia Intarti Klampisrejo, Pasuruan Regency. A quantitative method was used with a quasi-experimental approach employing a one-group pre-test also post-test design. The study involved 32 third-trimester gravidity as respondents. Data were collected using purposive sampling, before-and-after measurements, and assessed with the Numeric Rating Scale (NRS). The intervention be carried out over a period of four weeks. The findings show that the butterfly pregnancy exercise effectively reduces back pain in third-trimester gravid. Therefore, the butterfly exercise can serve as an alternative method to help alleviate back pain and enhance comfort during pregnancy.  

Musculoskeletal Disorders (MSDs) complaints in muscles, joints, and soft tissues can be caused by poor posture, repetitive movements, and excessive physical load. In the wet cake-making industry, workers often sit or stand for long periods, bend, and perform monotonous hand movements, which increases the risk of MSDs. The impact includes decreased work comfort, productivity, and quality of life. This study aims to assess the ergonomic risk level in wet cake-making workers and identify the relationship between work activities and MSD complaints. The method used is descriptive quantitative research with a cross-sectional design, involving 45 workers at Kue X Silaberanti. Ergonomic risk was assessed using the REBA method, while MSD complaints were measured using the Nordic Body Map questionnaire. The results show that in the mixing process, 58.8% of workers experienced a very high risk of MSDs. In the molding and baking processes, 52.9% and 68.8% of workers, respectively, were at high risk. The most frequent complaints were pain in the back, neck, shoulders, arms, and wrists due to poor posture and repetitive movements. To reduce the risk of MSDs, workers need to improve their posture, use ergonomic aids, rotate tasks, and undergo training in safe working techniques.

ABSTRACT Background: Traditional medicinal plants play a significant role in public health in Indonesia, particularly in Bali, where the local wisdom of Usada is upheld. One of the commonly used plants is sandalwood (Santalum album L.), which is empirically believed to treat skin issues and minor injuries. Purpose: This study aimed to examine the community's perceptions of sandalwood in Perean Tengah Village using the HBM approach. Method: A qualitative method with an ethnographic study design was employed, and five informants (four sandalwood users and one traditional healer) were purposively selected. Data were gathered through in-depth interviews, participant observation, and documentation, and they were analyzed thematically using NVIVO software. Results: The results indicated that the community recognizes their susceptibility to minor injuries resulting from daily physical activities and uses sandalwood as a form of first aid. Sandalwood is perceived as beneficial because it provides a cooling sensation, reduces pain and swelling, and is considered safe and practical for use. However, the main barriers to its use include the limited availability of sandalwood in the local area and reliance on supplies from other regions. Conclusion: The tradition of using sandalwood is preserved through intergenerational practices and positive personal experiences. This study emphasizes the significance of sandalwood for health applications, cultural identity, and the local wisdom of the Balinese community.

Lower back pain is one of the most common discomforts experienced by third-trimester pregnant women due to increased uterine size, postural changes, and musculoskeletal strain. Complementary therapies such as effleurage massage offer a non-pharmacological, safe, and easily applicable technique to reduce pregnancy-related pain. This study aimed to examine the effect of effleurage massage on reducing lower back pain among third-trimester pregnant women at TPMB Lina Contesa. This research employed a quasi-experimental one-group pretest–posttest design. The study was conducted from October to November 2025 involving 32 third-trimester pregnant women selected through purposive sampling. Pain intensity was measured before and after the intervention using the Visual Analog Scale (VAS). Effleurage massage was administered for 15–20 minutes on the lower back region following standard midwifery procedures. Data were analyzed using the Wilcoxon test. The findings showed a significant reduction in lower back pain intensity after the intervention (p < 0.001). The proportion of respondents in the moderate-pain category decreased from 65.6% to 21.9%, while those in the mild-pain category increased from 34.4% to 78.1%. The mean VAS score dropped from 5.81 ± 1.12 before intervention to 2.47 ± 1.03 after effleurage massage. Effleurage massage is effective in reducing lower back pain among third-trimester pregnant women and can be recommended as a complementary therapy in midwifery care to improve maternal comfort.

ABSTRACT Background: Pain is the most common complaint and can interfere with patient comfort. Pain management can be done pharmacologically and non-pharmacologically. Acupressure that can reduce pain is Li 4 acupressure. Objective: The purpose of this study was to determine the difference in pain intensity of post-cesarean section wounds before and after acupressure point Li 4. Method: The research method used was Pre Experiment using the One Group Pretest Postest Design research design approach. The number of samples in this study was 50 people using purposive sampling techniques. The pain measurement instrument used a numeric scale and the statistical test used was the Wilcoxon test. Results: Based on the Wilcoxon test, the difference between the average value of pain intensity before and after therapy was 1.3 points, a p-value of 0.00 or <0.05. Conclusion: Li 4 acupressure therapy can reduce pain intensity.

Low back pain is a common complaint among pregnant women in the second and third trimesters due to biomechanical and hormonal changes. Non-pharmacological interventions like prenatal exercise are believed to be effective, though evidence from controlled trials is limited. This study aimed to evaluate the effectiveness of prenatal exercise in reducing low back pain intensity. A quasi-experimental pretest–posttest control group design was used with 30 pregnant women (15 in the intervention group, 15 in the control group), selected by purposive sampling. The inclusion criteria were gestational age of 20–36 weeks, no medical contraindications, and willingness to participate. The intervention group performed prenatal exercises twice a week for 8 weeks (45 minutes per session), while the control group received health education without physical exercise. Pain intensity was measured using the Visual Analogue Scale (VAS). Data analysis was conducted using paired t-test, independent t-test/Mann–Whitney, and ANCOVA to control for age, parity, and BMI. Both groups had homogeneous baseline characteristics (p > 0.05). The intervention group’s pain score decreased from 6.9 ± 1.1 to 3.6 ± 1.0 (Δ = -3.3; p < 0.001), while the control group’s pain score decreased from 6.8 ± 1.2 to 6.3 ± 1.1 (Δ = -0.5; p = 0.09). The difference in pain reduction between groups was significant (p < 0.001). ANCOVA confirmed that prenatal exercise was significantly effective after adjusting for confounders (β = -2.8; p < 0.001). Prenatal exercise is an effective, safe, and affordable intervention for reducing low back pain in pregnant women.

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.