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According to the WHO and the Ministry of Health, hypertension is defined as blood pressure ≥ 140/90 mmHg, consistent with the ESC/ESH guidelines. Hypertension is one of the leading causes of premature death worldwide. Symptoms experienced by patients with hypertension include headaches, sweating, palpitations, snoring, daytime sleepiness, muscle weakness, cramps, and cardiac arrhythmia. Clinical manifestations of hypertensive urgency include elevated blood pressure, severe headache, anxiety, and shortness of breath. Mrs. M, a 68-year-old woman, came to the Samudera Community Health Center complaining of a headache that had worsened approximately 3 days ago. The headache is felt at the back of the head, feeling heavy, and sometimes radiates throughout the entire head. The patient also describes the headache as throbbing. The headache was exacerbated when the patient could not sleep, consumed salty foods, and did not take her medication regularly.  The headache subsides slightly when the patient takes medication and sleeps with their head elevated.  The patient reported that the symptoms were also accompanied by nausea, dizziness, palpitations, and an inability to sleep at night. The patient has been diagnosed with hypertension for approximately 5 years. On physical examination, the patient’s blood pressure was 190/100 mmHg. The patient was advised to adopt a healthy diet by reducing salt intake. The patient was also prescribed the following medications: Captopril 25 mg twice daily, Amlodipine 5 mg once daily, Paracetamol 500 mg three times daily, and Domperidone 10 mg twice daily, to be taken as needed.

The ICU is one of the largest clinical cost centers in hospitals due to its high demand for human resources, medical equipment, and operational costs. This situation emphasizes that intensive care unit efficiency is a multidimensional issue that cannot be assessed solely from a single aspect. This study aims to analyze the efficiency of the intensive care unit at Ciremai Hospital, Cirebon City, using the Data Envelopment Analysis (DEA) model to determine resource optimization. Analytical quantitative study with a cross-sectional design. The population in this study consisted of personnel in the ICU of Ciremai Hospital from 2023 to 2025, with total sampling applied. The input variables included the number of physicians, nurses, beds, monitors, and ventilators, while the output variables consisted of BOR, LOS, and recovered patients. The ICU input variables remained stable during the study period, while output variables fluctuated with a declining trend in BOR and LOS. The results of the Data Envelopment Analysis (DEA) indicated that all study periods achieved an efficiency score of 1.00 (efficient), with a slack value of 0.00 across all input variables.

Critically ill patients are individuals with unstable health conditions who require close monitoring of hemodynamic parameters. The high mortality rate among critically ill patients treated in intensive care units reaches 36.5% of 33,148 patients. Hemodynamic instability in critically ill patients can be influenced by underlying diseases, medical interventions, as well as physical and psychological stress responses during treatment. Therefore, in addition to pharmacological therapy, non-pharmacological interventions such as Asmaul Husna dhikr therapy are needed, as they can provide a relaxation effect and help stabilize hemodynamic parameters in critically ill patients. To determine the outcomes of the implementation of Asmaul Husna dhikr therapy. This study used a descriptive case study method involving two critically ill patients with unstable non-invasive hemodynamic parameters. Changes in non-invasive hemodynamic parameters were observed in both respondents after the implementation of Asmaul Husna dhikr therapy. In respondent 1, the hemodynamic status was initially categorized as increased and became stable after the intervention. Similarly, in respondent 2, the hemodynamic status changed from increased before the intervention to stable after the intervention. The implementation of Asmaul Husna dhikr therapy can be used as a complementary therapy to help stabilize hemodynamic parameters in critically ill patients.

Pressure ulcers are a common complication in patients with impaired consciousness due to prolonged immobilization. This condition can increase morbidity and prolong the length of stay, thus requiring effective preventive interventions such as progressive mobilization. To determine the outcomes of implementing progressive mobilization on the incidence of pressure ulcers in patients with impaired consciousness at the Anggrek 2 High Care Unit (HCU) of Dr. Moewardi General Hospital. This study employed a case study design involving two participants with impaired consciousness. The intervention, consisting of progressive mobilization, was conducted over 3 days with monitoring of skin condition and pressure ulcer risk. Findings: Following the implementation of progressive mobilization, both participants showed improvement in skin condition and a reduction in the risk of pressure ulcers, as evidenced by the absence of progression to more severe wounds and an increase in skin integrity. The application of progressive mobilization is effective in preventing and reducing the risk of pressure ulcers in patients with impaired consciousness. This intervention can serve as a safe and planned nursing intervention in the intensive care unit.

Laparotomy is a major surgical procedure associated with a high risk of acute postoperative pain. According to Gan (2017), if pain is not properly managed, it can progress to chronic pain. (Toro et al., 2018) reported that severe pain on the first postoperative day is still commonly found in laparotomy patients, while (Small & Laycock, 2020) indicated that moderate to severe pain within the first 24 hours following major surgery remains a significant clinical issue. This study aims to evaluate the effectiveness of pharmacological pain management following laparotomy under general anesthesia, specifically to identify the types of opioid analgesics used, analyze their effectiveness in reducing pain intensity, identify side effects, and examine administration techniques and routes. This study employed a Systematic Literature Review (SLR) method following the PRISMA guidelines. Literature searches were conducted in the PubMed, ScienceDirect, and SpringerLink databases covering the years 2015–2026. The included studies comprised randomized controlled trials (RCTs), cohort studies, and retrospective studies addressing opioid pharmacological pain management in adult patients following laparotomy under general anesthesia. Study quality assessment was performed using the Joanna Briggs Institute (JBI) instrument. A total of 11 studies met the inclusion criteria. The results of the systematic literature review indicate that opioids are effective in reducing postoperative pain following laparotomy under general anesthesia. The most commonly used opioids are morphine, fentanyl, and oxycodone. Of all the opioids reviewed, oxycodone provided the best pain control, while intrathecal morphine was most effective in reducing the need for supplemental opioids during the early postoperative period. Other opioids, such as extended-release dinalbuphine sebacate and tegileridine, are also effective, but the number of studies is still limited. The most common side effects are nausea, vomiting, pruritus, sedation, and dizziness. Pharmacological pain management using opioids is effective in reducing the intensity of postoperative pain following laparotomy under general anesthesia. Morphine, fentanyl, and oxycodone are the most commonly used opioids. Oxycodone and intrathecal morphine have shown good results in improving pain control and reducing the need for supplemental opioids. The selection of opioid type, dosage, and administration technique must be tailored to the patient’s clinical condition to achieve optimal analgesia with minimal side effects.

Background: Nallaswamy Class III alveolar ridge refers to an edentulous alveolar bone that has undergone resorption, resulting in a moderate ridge height with a knife-edge ridge form. This condition is relatively common and has been reported to reach a prevalence of approximately 89% in edentulous mandibles. Objective: To describe the prosthodontic treatment implications in patients with Nallaswamy Class III alveolar ridge using an acrylic resin removable partial denture (RPD). Case Report: A 22-year-old female patient presented to RSGM Soelastri with complaints of discomfort while chewing due to the loss of several posterior teeth in the mandible. The teeth had been extracted three years earlier due to caries and retained roots. Intraoral examination revealed healthy dentition in the maxillary arch and edentulous areas at teeth 35, 36, 45, and 46 in the mandibular arch. The alveolar ridge in the edentulous area showed a knife-edge form with moderate height, consistent with Nallaswamy Class III. Discussion: The condition was classified as Applegate-Kennedy Class III modification 1P with bilateral bounded saddle areas, which may affect mastication, aesthetics, and speech. Conclusion: Partial edentulism with a knife-edge alveolar ridge can be effectively managed using an acrylic resin removable partial denture.

Malpractice in the health professions is one of the issues that can cause harm to patients, health professionals, and healthcare institutions. A lack of understanding among students as prospective health professionals regarding ethical aspects, legal principles, professional standards, and proper service procedures may increase the risk of malpractice. This Community Service activity aims to provide students of STIKES Pasapua Ambon with an understanding of the concept of malpractice, the factors causing malpractice, and preventive efforts through the implementation of professional ethics, compliance with standard operating procedures, effective communication, and the improvement of professional competence. The activity was carried out through counseling, educational sessions, interactive discussions, and guidance on health law for participants. The results of the activity indicate an increase in students’ knowledge and awareness of the importance of understanding the limits of professional authority, legal responsibility, and preventive measures to avoid malpractice in healthcare practice. This activity is expected to help develop future health professionals who are professional, ethical, and responsible in providing safe and high-quality healthcare services.

Mindfulness intervention therapy is a psychotherapy that can be used to reduce depressive symptoms. This study aims to determine whether mindfulness therapy contributes to reducing the level of depression in patients cancer at the Cipto Mangunkusumo Hospital, Jakarta. The research design used was the experimental design of the one group pretest-posttest design. The total number of samples used for the population was 30 people who met the criteria for depression. Relevant data was collecterd through clinical interviews, observations and psychological test. The Beck Depression Inventory II (BD-II) questionnaire was used to collect data for this study. According to the Wilcoxon analysis, the results were statistically significant p = 0.000, indicating a large effect size in reducing depressive symptoms with mindfulness therapy. These results are supported by improved patients understanding of depression and mindfulness concepts, as well as enhanced abilities in adapting emotional coping strategies. The results of qualitative analysis showed that subjek felt more happy, be positive, not hopeless, effective communication skills and be able to resolve their problems. This research can make a significant contribution to efforts to prevent and treat depression in cancer patients, improving their quality of life through increasing mindfulness.

Patients with ANSD may have hearing thresholds that vary from normal to severe hearing loss, but they often have difficulty understanding speech, especially in noisy environments. This condition can be caused by various factors, including genetic mutations (such as in the OTOF gene), preterm birth, perinatal hypoxia, and hyperbilirubinemia. Some adult patients have been reported to develop ANSD following autoimmune disorders such as sensorimotor neuropathy or after chemotherapy with ototoxic agents such as cisplatin. Diagnosis of Auditory Neuropathy Spectrum Disorder (ANSD) begins with a comprehensive medical history to identify risk factors that play a role. A history of preterm birth, severe hyperbilirubinemia requiring exchange transfusion, perinatal hypoxia, ventilator use, and a family history of infection or genetic disorders are major risk factors. In addition, patients or parents often report delayed speech development, inability to understand speech (especially in noisy environments), or a discrepancy between previous hearing test results and the child’s behavioral response. The gold standard for diagnosing ANSD is a combination of: (1) positive OAE and/or CM, (2) absent or abnormal ABR, and (3) absent acoustic reflex. This diagnosis is established only if there is evidence that the cochlea is functioning normally but there is a disruption in auditory nerve transmission. Routine monitoring is conducted to assess hearing and language development and adjust devices and therapy methods according to the patient’s needs. Counseling and education for families are also crucial components to provide optimal support at home and improve the patient’s quality of life. A comprehensive multidisciplinary approach is essential to ensure effective management of ANSD and achieve the best possible outcomes.

Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.

Fracture is a condition characterized by the disruption of bone continuity that often causes acute pain, especially in patients following Open Reduction and Internal Fixation (ORIF). Effective pain management is essential to support the recovery process and improve patient comfort during hospitalization. This study aimed to determine the effectiveness of cold compress therapy (cryotherapy) in reducing pain intensity in post-ORIF patients. This study used a case study method on a patient diagnosed with a right humerus fracture at PKU Muhammadiyah Bantul Hospital. Data were collected through interviews, interventions, and documentation using the PQRST method. Cryotherapy was administered once daily for three consecutive days using an ice bag applied to the painful area. The results showed a gradual decrease in pain intensity from scale 7 to 6 on the first day, 5 on the second day, and 4 on the third day. The patient also reported increased comfort after the intervention. These findings indicate that cryotherapy is effective as a non-pharmacological intervention in reducing postoperative pain and improving patient comfort.

Gastritis is an inflammation of the gastric mucosa that often causes pain in the epigastric area, which can reduce patient comfort and quality of life. This condition requires treatment that is not only pharmacological, but can also be supported by non-pharmacological interventions such as warm compresses that function to provide a relaxing effect and improve blood circulation. This study aims to determine the effect of warm compresses on reducing pain intensity in gastritis patients. The research method used was descriptive with a case study approach on one patient treated in the inpatient ward. Data collection was carried out through interviews, observation, and documentation using the PQRST method to assess pain. The intervention in the form of warm compresses was given for three days with a frequency of once a day for ± 15–20 minutes in the epigastric area. The results showed a gradual decrease in pain intensity from a scale of 6 to a scale of 2 after the intervention, as well as an increase in patient comfort. The implications of this study indicate that warm compresses can be used as an effective, safe, and easy-to-implement independent nursing intervention to help reduce pain in gastritis patients and improve the quality of nursing care.

Abstract. The right to health is an integral part of human rights guaranteed by the Constitution and further reinforced by Law Number 17 of 2023 on Health, which places the state as the party responsible for ensuring the provision of safe, high-quality, and non-discriminatory health services for all citizens. However, in practice, the fulfillment of the right to health continues to face various challenges, particularly in the delivery of health services for participants of BPJS Kesehatan. This study aims to analyze the legal protection of the right to health in Indonesia and to examine the refusal of medical services to BPJS patients that resulted in death in Papua from a human rights perspective. The research employs a normative legal research method using statutory, conceptual, and case approaches. The findings indicate that although the national legal framework has clearly regulated the obligations of the state and health care facilities in providing emergency services, its implementation remains weak due to administrative barriers, unequal access to health services, and inconsistent law enforcement. The refusal of medical services to BPJS patients in Papua reflects a tension between hospitals’ administrative compliance and the professional obligation of medical personnel to save human lives. The implications of this study emphasize the need to strengthen supervision, ensure consistent law enforcement, and improve health service governance so that the right to health is truly protected as part of human dignity within the Indonesian rule of law. 

The right to privacy and the right to health are fundamental human rights that are closely interconnected. The protection of privacy for patients with Human Immunodeficiency Virus (HIV) constitutes a critical issue, given that HIV status is classified as highly sensitive health data and is particularly vulnerable to stigma and discrimination. In Indonesia, the legal framework governing the protection of HIV patients’ health data has been normatively strengthened through the Personal Data Protection Law and the Health Law; however, its implementation continues to face various challenges. This article aims to analyze the right to privacy of HIV patients and the obligations of the state in protecting sensitive health data, as well as to examine the limitations and exceptions to the disclosure of HIV-related data within the framework of law and human rights. This study employs a normative legal research method using statutory, conceptual, and human rights-based approaches. Legal materials are analyzed qualitatively through juridical interpretation and prescriptive analysis. The findings indicate that HIV status is legally categorized as sensitive personal data that is entitled to a high level of legal protection. The state bears tripartite obligations to respect, protect, and fulfill the privacy rights of HIV patients. Nevertheless, a gap persists between legal norms and their implementation, particularly in the management of electronic medical records. The protection of HIV patients’ privacy rights requires strengthened legal implementation, regulatory harmonization, and the adoption of a human rights-based approach to ensure that data protection does not conflict with public health interests.

Post section caesarea (SC) and method of operative female sterilization (MOW) are surgical procedures that may cause various problems, such as pain, limited mobility, decreased muscle strength, and risk of postoperative complications. Physiotherapy management through exercise therapy is an important intervention to accelerate the recovery process. Objective this study aimed to determine the effectiveness of exercise therapy in improving the functional condition of patients post SC and MOW in Annisa Ward 32 A at PKU Muhammadiyah Karanganyar Hospital. Method: used was a case report on a 33-year-old female patient following SC and MOW procedures. The physiotherapy interventions included deep breathing exercises, active range of motion exercises of the extremities, light abdominal muscle contractions, gradual early mobilization, as well as breast massage and oxytocin stimulation. The results showed a reduction in pain from a scale of 4–5 to 2–3 based on the Numeric Rating Scale (NRS), improvement in mobility such as independent position changes, and increased activity tolerance, including sitting and walking with minimal assistance. In addition, the patient showed increased confidence in performing daily functional activities. Conclusion: exercise therapy has a positive effect on improving mobility, reducing pain, and accelerating functional recovery in post SC and MOW patients. Therefore, exercise therapy is recommended as an essential component of postoperative physiotherapy management to improve patients' quality of life.

Type 2 diabetes mellitus has now become a widespread health issue with serious implications for public health. In an effort to support non-pharmacological management, the use of aloe vera (Aloe vera) decoction is one option being considered, given that this plant contains bioactive components such as aloin, emodin, and polysaccharides that have the potential to help lower blood glucose levels. This study aims to examine the effect of consuming aloe vera (Aloe vera) decoction on lowering blood sugar levels in patients with type 2 diabetes mellitus in Lampaseh Lhok Village, Montasik Subdistrict, Aceh Besar. The research was conducted from June 19 to 28, 2025, in that area. The study design employed a quantitative research approach using a quasi-experimental design with a one-group pretest-posttest model. The study population consisted of 38 patients with type 2 diabetes mellitus, while the sample comprised 15 respondents. Sampling was conducted using purposive sampling. The measurement tools included a glucometer and an observation sheet. Based on the data analysis results, a decrease in blood glucose levels was observed after the respondents consumed the aloe vera decoction. The Wilcoxon signed-rank test yielded a p-value of 0.001 (< 0.05), leading to the conclusion that the administration of the aloe vera (Aloe vera) decoction has a significant effect on reducing blood glucose levels in the respondents. Therefore, respondents are advised to drink aloe vera tea at least once a day as an alternative measure to help control blood glucose levels.

Floods are the most frequent hydrometeorological disasters in Indonesia and significantly contribute to increased trauma cases and disruption of healthcare services, particularly in vulnerable regions such as Aceh Province. These conditions are exacerbated by limited resources, damaged health facilities, and restricted access to referral centers. This study aims to examine the implementation of early emergency surgical management during flood disasters based on damage control surgery principles and international guidelines. A descriptive qualitative approach was employed through a literature review combined with field observations conducted during the emergency response phase of flood disasters in Bireuen Regency. Data were collected from direct clinical observations, brief interviews with healthcare providers, and documentation of trauma cases requiring early surgical intervention. The results indicate that effective patient stabilization can be achieved despite limited resources through airway, breathing, and circulation (ABC) management, hemorrhage control, wound irrigation, and fracture immobilization using simple and improvised equipment. Approximately 90% of patients were successfully stabilized prior to referral to definitive healthcare facilities. In conclusion, adaptive and timely application of damage control surgery principles plays a crucial role in saving lives and strengthening emergency surgical response during flood disasters.

Type 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diaType 2 diabetes mellitus is a chronic condition marked by elevated blood glucose levels resulting from insulin resistance and decreased insulin secretion. Effective glycemic control is crucial to prevent complications, and HbA1c is commonly utilized as an indicator of long-term blood glucose levels. This study aimed to examine the relationship between HbA1c levels and blood glucose levels among patients with type 2 diabetes mellitus at Tilamuta Community Health Center, Boalemo Regency, Gorontalo Province. This study employed an analytical cross-sectional design using a total sampling method, involving 557 patients. Data were collected from laboratory records and analyzed through descriptive statistics, the Shapiro-Wilk test for normality, Spearman correlation, and chi-square test. The findings indicated that the average HbA1c level was 7.39%, while the mean blood glucose level was 205.85 mg/dL. A significant and very strong positive correlation was found between HbA1c and blood glucose levels (p=0.000; r=0.862). Furthermore, medication adherence showed a significant association with HbA1c status (p=0.000). These results underscore the role of HbA1c as a dependable marker for assessing glycemic control and highlight the importance of medication adherence in optimizing the management of type 2 diabetes mellitus.betes mellitus.  

Congestive heart failure (CHF) is a cardiovascular disease that frequently causes shortness of breath (dyspnea) and negatively impacts patients’ quality of life. The management of dyspnea involves not only pharmacological approaches but also nonpharmacological interventions, one of which is handheld fan therapy, which works by stimulating sensory receptors in the facial area. This study aims to describe the effect of handheld fan therapy on reducing shortness of breath in patients with CHF. This study employed a descriptive design using a case report method on a single 63-year-old female patient diagnosed with CHF. The intervention was conducted over four days, involving the use of a handheld fan for 10 minutes, held at a distance of 15–30 cm from the face and directed toward the nose and mouth. Measurements were taken before and after the intervention using respiratory rate and oxygen saturation as parameters. The results showed a gradual decrease in respiratory rate from 24 breaths/minute to 18 breaths/minute, as well as an increase in oxygen saturation from 91% to 96% during the intervention period. These findings indicate an improvement in breathing patterns and increased respiratory efficiency in the patient. Handheld fan therapy is effective as a nonpharmacological intervention for reducing shortness of breath and improving oxygenation in patients with CHF. This intervention is safe, easy to use, and can be implemented as a complementary therapy in nursing practice.

Ventricular septal defect (VSD) is a congenital heart defect characterized by a gap in the interventricular septum, with a prevalence of 20–30% of all cases of congenital heart disease. Based on their location, VSD is divided into perimembrane, muscular, and subarterial. This case report discusses a patient who came to the emergency room of Cut Meutia Hospital with good consciousness (GCS E4M6V5) and complained of shortness of breath, cough, nausea, and chest pain spreading to the neck and hands. The anamnesis showed chronic symptoms in the form of coughing up phlegm for two weeks, accompanied by throbbing headaches, dizziness, flatulence, and sleep disturbances. Physical examination showed vital signs of TD 140/90 mmHg, HR 86 x/min, RR 23 x/min, SpO₂ 37%, and temperature 37°C.  Supporting examinations in the form of chest X-rays showed cardiomegaly of the pulmonary segment, while ECG showed rhythmic sinuses with LAD axis, T-inverted in AVL, V1, V2, RsR' in V2, positive Cornell criteria, anterolateral myocardial infarction, RBBB, and LVH. Echocardiography shows the presence of a bidirectional shunt with a dominant right-to-left shunt. This case confirms the importance of comprehensive diagnosis through clinical and supporting examinations to determine optimal management in patients with VSD, as well as prevent further complications.