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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.

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

An autoimmune condition that targets the joints is rheumatoid arthritis. The joints and surrounding tissues are inflamed due to this disease. Symptoms of this arthritis include joint stiffness, edema, and persistent discomfort. Women are more likely to suffer from rheumatoid arthritis than men, especially those between the ages of 40 and 75. Chronic pain is a sensory or affective experience that lasts >3 months, has mild to severe intensity, and can begin suddenly or gradually. This is related to real or functional tissue damage. To minimize the chronic pain experienced by rheumatoid arthritis patients, this case study aims to assess the effectiveness of cutaneous stimulation, also known as skin stimulation (foot massage). The nursing care method provided to patients with rheumatoid arthritis who complained of discomfort during five morning sessions using skin stimulation therapy (Foot Massage) is described in this case study using descriptive methodology. The application questionnaire was used to measure pain levels before and after the procedure, and the Rheumatoid Arthritis Pain Scale (Raps) was used to evaluate the results. After five sessions, the patient's pain level decreased, according to the case study findings. Conclusion: Discomfort is reduced by applying cutaneous stimulation (foot massage). Since foot massage helps alleviate pain, it can be used as an intervention for RA patients experiencing chronic pain.

Lymphadenopathy is a condition characterized by the enlargement of lymph nodes, commonly encountered in clinical practice, and may indicate both infectious and non-infectious disorders. This condition often causes anxiety as it is frequently associated with chronic diseases or malignancies. This study aims to describe nursing care in patients with lymphadenopathy through a case study approach and theoretical review. The method used was a descriptive case study with data collected through interviews, physical examinations, observations, and documentation. The results revealed the main complaint of pain in the anterior neck following surgical intervention. The identified nursing diagnoses included acute pain, knowledge deficit, and risk of infection. Interventions were carried out in the form of infection prevention, pain management, and health education. Evaluation showed significant improvements. The study concludes that comprehensive nursing care for patients with lymphadenopathy is effective in reducing symptoms, alleviating anxiety, increasing patient knowledge, and positively impacting quality of life.

Hypertension is one of the most common non-communicable diseases, with a high incidence rate that has become a major global health concern. It is often referred to as a “silent killer” because many patients are unaware of their condition until serious complications arise. In Indonesia, the prevalence of hypertension is relatively high, yet many sufferers remain undiagnosed or do not receive proper medical treatment. Several risk factors contribute to hypertension, including age, heredity, high-salt diet, obesity, lack of physical activity, and unhealthy lifestyles such as smoking and alcohol consumption. Without proper management, hypertension may lead to severe complications such as stroke, heart failure, and chronic kidney disease. Management of hypertension generally involves pharmacological therapy, such as the administration of antihypertensive drugs, as well as non-pharmacological interventions through lifestyle modifications. Nurses play a crucial role in patient education, monitoring, and preventing complications through comprehensive nursing care. The purpose of this study is to describe the nursing care provided to Mr. R, who experienced a cardiovascular system disorder, namely hypertension, in the Dahlia Ward of RSUD dr. Soeselo, Tegal Regency. The research method used was descriptive with a case study approach, allowing for a systematic and clear presentation of the patient’s condition. The case findings showed that the patient’s main complaint was a headache radiating to the nape of the neck. Based on nursing assessment, two nursing diagnoses were identified: acute pain and lack of knowledge regarding the disease and its management. Interventions were determined using national standards such as SDKI, SLKI, and SIKI, which are expected to reduce symptoms and improve the patient’s understanding of hypertension.

Non-Communicable Diseases (NCDs) remain the leading cause of global morbidity and mortality, and one of the chronic conditions included in this group is rheumatoid arthritis (RA). RA is an autoimmune disease that affects the synovial joints, resulting in persistent inflammation, chronic pain, stiffness, and eventual deformities if left untreated. In Indonesia, the burden of RA continues to grow; the prevalence reaches 11.9% based on clinical diagnosis and rises to 24.7% when measured using symptom-based diagnosis. This case study aimed to describe family nursing care for a client with RA through a structured nursing process approach to improve quality of life and family involvement. The study took place in Purwodadi Village, Tonjong Subdistrict, Brebes Regency, focusing on the family of Mr. AS with Mrs. W as the client diagnosed with RA. Data collection involved comprehensive interviews, direct observation, physical examination, and documentation review. Assessment findings included chronic pain with an intensity score of 4, limited mobility, and inadequate family knowledge regarding RA management. Nursing interventions implemented were family education on RA, simple rheumatic exercises tailored to the client’s ability, and the application of warm ginger compresses as a non-pharmacological pain relief method. Post-intervention evaluation showed pain reduction to a score of 2, improved independence in performing light daily activities, and enhanced family understanding and support. In conclusion, family-centered nursing care combined with non-pharmacological interventions can effectively reduce pain, improve mobility, and strengthen the family’s role in supporting RA management.

The endocrine system is a ductless body control system that produces hormones to regulate various organs and physiological processes. Hormones act as important biological messengers in the human body. One of the most essential hormones is insulin, which plays a key role in blood sugar regulation. Insufficient insulin production or impaired insulin action can cause disruption of blood glucose control, leading to diabetes mellitus. Diabetes mellitus is a chronic metabolic disorder characterized by persistently high blood glucose levels caused by impaired insulin secretion, insulin action, or both. The purpose of this paper is to apply nursing care to Mr. N, a patient with endocrine system disorders: diabetes mellitus, treated in the Dahlia Ward of Dr. Soeselo Regional Hospital, Tegal Regency. This descriptive case study method was used to explain the nursing process in a structured manner. The main complaint presented by the client was pain in the wound on the left foot. Four nursing diagnoses were identified during the assessment, namely unstable blood glucose levels, acute pain, impaired skin/tissue integrity, and knowledge deficit. Nursing interventions were developed and implemented based on the Standar Diagnosis Keperawatan Indonesia (SDKI), Standar Luaran Keperawatan Indonesia (SLKI), and Standar Intervensi Keperawatan Indonesia (SIKI). The case highlights the importance of comprehensive nursing care in diabetes management, with a focus on blood glucose stabilization, pain management, wound care, and patient education. The results of this study are expected to provide additional references for clinical practice and strengthen the role of nurses in preventing complications of diabetes mellitus.

Phlebitis is one of the most common complications that occur as a result of intravenous infusion, especially in pediatric patients. This condition is characterized by inflammation of the vein wall, which can cause pain, redness, and swelling around the puncture site. The high incidence of phlebitis in children requires serious attention because it can prolong hospitalization, increase healthcare costs, and reduce the overall quality of care. This study aimed to identify the factors associated with the occurrence of phlebitis in pediatric patients at RSUI Harapan Anda, Tegal City. This research employed a correlational analytic design with a cross-sectional approach. The sample consisted of 46 pediatric patients undergoing intravenous therapy in the inpatient ward, selected using purposive sampling. The research instrument was an observation sheet that included independent variables such as age, chronic illness, duration of infusion, infusion site, type of infusion fluid, and nurses’ skills. The dependent variable was the incidence of phlebitis. Data were analyzed using the chi-square test to determine the relationships between variables. The results showed that most patients were in the toddler age group (1–3 years), had chronic illnesses, underwent infusion for more than 72 hours, had high-risk puncture sites, used hypotonic fluids, and were treated by nurses with insufficient skills. Statistical analysis revealed significant associations between all independent variables and the occurrence of phlebitis. These findings highlight the importance of improving nurses’ competence through continuous training, strict monitoring of infusion duration and fluid type, as well as special attention to high-risk pediatric patients. Such efforts are expected to reduce the incidence of phlebitis and improve the quality of nursing care in hospitals.

Gout arthritis is a metabolic disease characterized by elevated uric acid levels in the blood. This condition causes joint pain, especially in the lower extremities. Elderly people with gout arthritis often experience decreased mobility and quality of life due to chronic joint pain. Stretching exercises are an effective non-pharmacological intervention to reduce pain and increase joint flexibility. The purpose of this study was to examine the implementation of stretching exercises in reducing lower extremity joint pain in elderly people with gout arthritis. This study used a descriptive case study approach that applied the medical-surgical nursing care process, including assessment, diagnosis, intervention, implementation, and evaluation. This study used two elderly subjects with gout arthritis and moderate pain scales. Stretching exercises were implemented twice daily for 25-30 minutes for six days, based on the development of nursing interventions according to SIKI (2018). The results showed a decrease in moderate pain scale to mild pain scale after the implementation of stretching exercises in both subjects for six days. The results of this study are expected to be implemented independently and provide motivation to improve the quality of life of gout arthritis sufferers.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the musculoskeletal system and often causes severe pain and functional limitations, especially among the elderly. This study aimed to provide a comprehensive overview of nursing care for a patient diagnosed with RA through a family-based approach. The research employed a descriptive qualitative method with a case study design conducted in a rural village in Brebes, Central Java. Data were collected through in-depth interviews, observation, and documentation. The results showed that the integration of non-pharmacological interventions, including warm compresses using ginger and lemongrass, and deep breathing techniques, significantly reduced pain intensity. Additionally, increased family involvement in caregiving, facilitated by structured health education, enhanced the patient's quality of life. This study confirms the importance of applying Dorothea Orem’s Self-Care Deficit Theory to support the independence and well-being of RA patients within their home environments. The findings suggest that community nurses should prioritize family empowerment in chronic disease management, particularly in areas with limited health access.

Hypertension is a global health problem that plays a major role as a leading cause of premature death because it can lead to various serious cardiovascular complications, such as stroke, heart failure, and chronic kidney disease. This condition is often characterized by complaints of severe headaches, especially in the nape of the neck, due to increased blood flow to the brain. In addition to medical therapy in the form of antihypertensive drugs, complementary therapies are also needed to support blood pressure reduction and improve the patient's quality of life. One method that has proven effective is slow deep breathing, a slow, deep breathing technique that helps activate the parasympathetic nervous system, reduce sympathetic activity, improve tissue oxygenation, and produce a relaxation effect that is beneficial in lowering blood pressure and reducing pain. This paper aims to describe the experience of nursing care for hypertensive patients using slow deep breathing therapy. The research method used is a quantitative descriptive with a case report design that is carried out through the stages of assessment, establishing a nursing diagnosis, intervention, implementation, and evaluation. Research data were obtained through interviews, direct observation, and physical examination. The results showed that after three consecutive days of therapy, the patient's pain scale decreased from 5 (moderate pain category) to 2 (mild pain category), while blood pressure, which was initially at 196/122 mmHg, successfully decreased to 140/90 mmHg. These results indicate that slow deep breathing plays an important role in lowering blood pressure and improving the comfort of hypertensive patients. In conclusion, slow deep breathing can be used as a simple, safe, inexpensive, and effective non-pharmacological intervention, and is highly recommended for patients to practice independently in their daily lives to prevent worsening hypertension and optimize disease control efforts.

Introduction: Periodontitis treatment depends on the severity of the disease, pocket depth, and bone damage. It consists of (1) emergency phase, (2) non-surgical phase, (3) surgical phase, and (4) maintenance or restorative phase. Each phase plays a crucial role in ensuring healing and controlling periodontitis. The non-surgical phase involves scaling and root planing to remove plaque and tartar, while the surgical phase addresses bone damage and pocket reduction. The maintenance phase is critical to preventing disease recurrence. Objective: The purpose of this case report is to demonstrate the success of curettage in a patient with chronic localized periodontitis stage II grade A and stage I hypertension, within a two-week post-treatment period. Case: A 52-year-old female patient presented at RSGM Soelastri with complaints of bleeding gums during tooth brushing. The patient reported gum bleeding around the lower front teeth for the past six months, without any pain. She was regularly taking antihypertensive medication (amlodipine). Examination revealed deep periodontal pockets in teeth 41 and 42, accompanied by gum swelling, indicating chronic localized periodontitis stage II grade A. The patient also had a history of stage I hypertension, which required careful management during treatment. Conclusion: The treatment for chronic localized periodontitis stage II grade A on teeth 41 and 42 with stage I hypertension was curettage. After two weeks of treatment, the patient showed significant improvement, including reduced bleeding and a decrease in pocket depth, with stable hypertension control. Curettage proved effective in managing the condition, with careful consideration of the patient's hypertension risk factors.

Rapid technological advancements have brought convenience to various fields, including healthcare. Osteoarthritis (OA) is a chronic degenerative joint disease that often affects the knees and hips, particularly in the elderly, and is a major cause of pain, joint dysfunction, and reduced quality of life. The prevalence of OA increases with age, with risk factors such as obesity, excessive activity, and muscle weakness. Early and accurate diagnosis is essential for appropriate treatment. This study aims to develop a diagnostic system for inflammatory arthritis, specifically osteoarthritis, using the Dempster-Shafer method. This method was chosen because of its ability to combine various evidence and expert beliefs to produce a more accurate diagnosis. By utilizing mathematical proof theory, this system is expected to assist medical personnel in detecting OA symptoms more efficiently. The research findings are expected to contribute to the healthcare sector, particularly in improving the accuracy of osteoarthritis diagnosis, allowing for earlier and more appropriate treatment. This system can also be a supporting tool for doctors and patients in understanding joint health conditions.

Silicotuberculosis is a complex lung disease, a combination of silicosis and tuberculosis (TB). Silicosis is a disease caused by the inhalation of silica particles, which can lead to pulmonary fibrosis, while TB is an infectious disease caused by Mycobacterium tuberculosis. Long-term exposure to silica dust can cause silicosis and also increase the risk of TB infection, especially in countries with a high TB burden. Workers exposed to silica dust in the mining, construction, and manufacturing industries are among the groups most at risk. The diagnosis of silicotuberculosis is often difficult because the clinical and radiological symptoms of the two diseases often overlap. Symptoms, such as chronic cough, shortness of breath, and chest pain, can be very similar in silicosis and TB, often delaying a correct diagnosis. The pathophysiology of silicotuberculosis involves impaired function of macrophages, immune cells that play a role in fighting infection, and a compromised immune response due to silica exposure. These disruptions facilitate the progression of TB infection, further worsening the patient's health. Primary management of silicotuberculosis includes controlling TB infection with standard anti-tuberculosis drug therapy (OTT) and preventing silica exposure. Preventing occupational exposure to silica dust is crucial to reducing the risk of developing the disease. The prognosis of the disease is greatly influenced by the severity of pulmonary fibrosis and delay in diagnosis. The more severe the fibrosis, the worse the prognosis. Therefore, preventing silica dust exposure, along with routine TB screening for high-risk workers, is crucial to reducing the incidence of silicotuberculosis. Furthermore, education about the risks of the disease is crucial to raise awareness among workers and the general public.

Low back pain, also known as low back pain, is a common condition characterized by pain or discomfort in the lower back area, which is between the lower ribs and the buttock folds. This condition can be mild to severe, and can be temporary or chronic. One of the nonpharmacological methods that is often used to reduce the intensity of pain is ice packs. Ice packs are able to provide an analgesic effect by lowering local blood flow and reducing inflammation in the area experiencing pain. This study aims to determine the effectiveness of ice packs in reducing low back pain in office administration employees. The research design uses an experimental method with a one group pre-test–post-test design approach. The research sample consisted of 25 respondents who were administrative employees at the Helvetia Health Institute. Pain intensity measurements were taken before and after the administration of ice packs to determine the effect of this therapy on low back pain. The results showed a decrease in the intensity of low back pain with an average value before treatment of 51.63 and after treatment decreasing to 38.8. Statistical analysis yielded a significance value (p) of 0.004 < 0.05, which showed that ice packs had a significant effect on reducing low back pain in administrative employees. Regular application of ice packs can be a simple, safe, and effective intervention that can be done independently at home by employees to reduce pain. This study provides recommendations for health workers to promote ice pack therapy as a non-pharmacological pain relief method, especially for office workers who often experience low back pain due to static work positions.

Low Back Pain (LBP) is one of the most common musculoskeletal problems experienced by people in various age groups and work backgrounds. This complaint can be acute, subacute, or chronic, with various causes ranging from mechanical, degenerative, to psychosocial factors. This study aims to examine the characteristics of LBP through a literature review of several previous studies that focus on prevalence, risk factors, and their impact on patients' daily lives. The method used is a narrative literature review, with data sources coming from national and international journals, research reports, and academic repositories. The results of the study show that the prevalence of LBP is very high, with a significant percentage of occurrence in the elderly, pregnant women, administrative workers, and individuals with a sedentary lifestyle and non-ergonomic work posture. In addition to age, female gender, non-ideal body mass index, and long work duration, it was also found that psychosocial characteristics such as low social support and high work pressure play a role in triggering or worsening LBP. A study at Ibnu Sina Hospital Makassar showed that most LBP patients were elderly women with acute pain and radiological results showed lumbar spondylosis as the most common diagnosis. The conclusion of this study emphasizes the importance of prevention through ergonomic education, work stress management, and early intervention based on a healthy lifestyle. These findings are expected to be the basis for designing promotive and preventive strategies for high-risk groups.

This study investigates doctor–patient communication strategies in overcoming verbal and non-verbal language barriers within the Pain Clinic of RSUD Genteng Banyuwangi, a public hospital in East Java, Indonesia. Pain clinics pose unique communicative challenges, as patients often struggle to express their discomfort clearly due to limited health literacy, cultural norms, or emotional inhibitions. This research aims to identify and analyze the communicative methods employed by doctors to facilitate accurate information exchange and build therapeutic rapport with patients experiencing chronic pain. Utilizing a qualitative approach, this study applies Conversation Analysis (CA) to naturally occurring doctor–patient consultations recorded through non-intrusive video methods. Verbal and non-verbal interactions were transcribed and analyzed to uncover recurring communicative patterns. The data were interpreted through sociolinguistic and pragmatic lenses to account for the local language diversity and cultural context of Banyuwangi. Findings reveal that doctors employ multiple strategies to clarify meaning and adapt communication: repetition, strategic questioning, utterance correction, and linguistic adaptation. Additionally, doctors interpret and respond to patients' non-verbal cues, including vocal tone, facial expressions, and body gestures, to supplement incomplete verbal communication. These strategies not only enhance diagnostic accuracy but also promote empathy, trust, and patient-centered care. The study concludes that effective communication in pain clinics must account for linguistic diversity, cultural sensitivities, and emotional dynamics. Adaptive and empathetic communication fosters better understanding, reduces the risk of diagnostic error, and improves treatment outcomes. The findings offer practical implications for clinical training and healthcare policy, particularly in multicultural and linguistically diverse settings.

Adolescent Idiopathic Scoliosis (AIS) is the most common progressive musculoskeletal disorder among adolescents, characterized by a lateral curvature of the spine with an unknown cause. This condition often results in postural asymmetry, chronic low back pain, and reduced mobility. This case report involves a 17-year-old female high school student diagnosed with AIS, presenting with lower back pain and functional limitations. The physiotherapy intervention included three sessions over two weeks, utilizing Microwave Diathermy (MWD) as a physical modality, along with Schroth method and strengthening exercises. The outcomes demonstrated a reduction in pain intensity, improved muscle strength, increased spinal mobility, and enhanced thoracic expansion. Additionally, the patient showed an improvement in quality of life as measured by the Scoliosis Research Society-22 (SRS-22) questionnaire. These findings suggest that structured conservative physiotherapy, combining physical modalities and specific exercises, is effective in alleviating clinical symptoms, improving postural awareness, and supporting the functional well-being of AIS patients. This case highlights the importance of early and consistent physiotherapeutic intervention to manage symptoms and potentially slow curve progression.

 Chronic pain is pain that persistent and will continue beyond the proper healing time, there are two time points used in daily practice, namely 3 months and 6 months after the first injury. Sensitivity of peripheral nociceptive neurons and central underlying the process of transition from acute pain to chronic pain. There are several factors that influence the increasing incidence of postoperative chronic pain including preoperative, intraoperative and postoperative factors. Untreated acute postoperative pain also increases the risk of increasing chronic postoperative pain. In Asia, the prevalence of chronic pain varies widely, between 7% in Malaysia to 60% in Cambodia. The prevalence of postoperative chronic pain in adults is reported to be around 20% in developed countries. The incidence includes all ages with a higher incidence in women and the elderly. The purpose of this study was to describe the characteristics of postoperative chronic pain in outpatients in the surgical polyclinic and obstetrics and gynecology polyclinic at RSU Medan. The type of research used in this study was Observational with a Cross Sectional method approach. Based on the research that has been done, it was found that ages 26-35 years experienced the most chronic pain, namely as much as 29.8% and women experienced more chronic pain compared to men. Based on this study it was found that the majority of respondents experienced moderate pain intensity as many as 36 respondents (63.2%). There were descriptions of characteristics that were mostly 26-35 years old.

Low back pain (LBP) is one of the most common musculoskeletal problems experienced by workers, especially those in professions that require prolonged static sitting, such as public transportation drivers. This condition not only impacts work productivity but can also disrupt daily activities and increase the risk of chronic health problems. This study aims to analyze factors associated with the incidence of LBP in public transportation drivers on the Latuhalat route at Mardika Terminal, Ambon City. The study design used an observational analytical approach with a cross-sectional approach. The study population consisted of 96 public transportation drivers, and 51 were selected as samples through a purposive sampling technique based on inclusion criteria. The independent variables in this study included driving position, driving duration, age, and length of service, while the dependent variable was low back pain. Data were collected using questionnaires and observation sheets, then analyzed using the Chi-square test. The results showed that all independent variables, namely driving position, driving duration, age, and length of service, had a significant relationship with the incidence of LBP (p < 0.05). Thus, ergonomic factors and workload significantly contribute to the occurrence of NPB in public transportation drivers. Therefore, ergonomic interventions, proportional work hour arrangements, and the implementation of occupational health programs are important steps in reducing the risk of NPB in drivers.