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Postherpetic neuralgia (PHN) is a chronic neuropathic pain complication following herpes zoster infection. PHN often leads to persistent pain and facial muscle dysfunction, affecting patients' quality of life. This study aimed to evaluate the physiotherapy management using electrical stimulation and facial exercises in a case of facial PHN. A case report design was used to observe a 36-year-old male patient presenting with facial pain and muscle weakness after herpes zoster infection. The physiotherapy intervention, consisting of electrical stimulation and facial exercises, was conducted over three sessions within two weeks. Assessment tools included NPRS, MMT, and Ugo Fisch Scale. There was a significant reduction in pain from NPRS 5/10 to 0, and improvement in frontal muscle strength from MMT 0 to 3. The Ugo Fisch score increased from 62 to 66, indicating functional improvement of facial muscles, though not yet optimal. Electrical stimulation and facial exercises were effective in reducing pain and improving facial muscle function in a PHN patient. Further research with larger samples is needed to validate these findings.

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.

Background: Low back pain (LBP) is one of the most common musculoskeletal problems that affect the quality of life and productivity of individuals. LBP lasting more than 12 weeks is categorized as chronic LBP and often has no specific cause. Core stability exercise (CSE) is one of the effective rehabilitation methods in managing pain and disability in chronic LBP patients. Objective: This review aims to evaluate the effectiveness of CSE in reducing pain in patients with chronic LBP based on a literature review. Methods: This study used the literature review method by reviewing various relevant studies related to CSE and chronic LBP. Data sources were obtained from databases such as PubMed, ScienceDirect, Google Scholar, and PEDro. Articles used had inclusion criteria in the form of randomized controlled trial (RCT) studies published in the last 10 years (2014-2024), in English, and involving patients with non-specific chronic LBP. Article quality assessment was conducted using the PEDro scale. Results: From the analysis of eight articles that met the inclusion criteria, it was found that CSE has significant effectiveness in reducing pain in patients with chronic LBP. The mean visual analogue scale (VAS) score showed a greater reduction in the group undergoing CSE compared to the control group or other therapeutic methods. Moreover, the combination of CSE with adjunctive therapies such as pain neuroscience education (PNE), interferential therapy (IFC), and myofascial release technique (MRT) showed better results in reducing pain and improving postural stability and physical function. Conclusion: CSE can be an effective rehabilitation method to reduce pain and improve core muscle stability in patients with chronic LBP. Combination with other therapies may provide more optimal results.

Herpes zoster and crusted scabies are dermatological conditions that pose a higher risk and clinical severity in immunocompromised patients, particularly those with chronic comorbidities such as diabetes mellitus and hypertension. This case report presents a 55-year-old woman with painful vesicular eruptions on the right neck and generalized thick, crusted, itchy plaques across the body. She had a longstanding history of type 2 diabetes mellitus and hypertension. Clinical diagnosis of herpes zoster and crusted scabies was confirmed through physical examination and KOH microscopic testing, which identified Sarcoptes scabiei. The patient was treated with oral acyclovir, topical permethrin, and supportive therapy to manage pain and prevent secondary infections. The coexistence of herpes zoster and crusted scabies in a diabetic patient highlights the role of impaired immunity in disease severity and presentation. Early recognition and integrated management are essential to improve prognosis and prevent complications.

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation in the joints, causing pain, swelling, and limited movement. Heat therapy is one of the effective methods to relieve RA symptoms because it can improve blood circulation, relax muscles, and reduce joint stiffness. This study designed and analyzed an Arduino IDE-based rheumatic therapy device with two main features: a waist heater using a DC Heater and a back electrostimulator through the L298N module. The device has three operating modes (Low, Medium, High) that regulate the pulse delay to adjust the patient's comfort. An input temperature of 50°C is programmed to provide optimal warmth. The measurement results showed that the output voltage of the power supply was 4.51 V with an error of 9%, the microcontroller input was 4.98 V with an error of 0.4%, the output of the L298N driver was 23.9 V, and the input of the DC Heater was 4.98 V with an error of 0.4%. All values are within safe tolerance limits. The 15- and 25-minute temperature stability tests show a small difference between the temperature of the appliance and the thermocouple, indicating stable and accurate appliance performance. Based on the results of technical analysis and temperature testing, this rheumatic therapy tool is considered suitable for use as an alternative to non-pharmacological therapy for RA patients.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a widely used class of medications for managing pain and inflammation. However, long-term use of NSAIDs has been associated with an increased risk of gastrointestinal disorders, including Gastroesophageal Reflux Disease (GERD). This study aims to analyze the impact of NSAID use on GERD patients based on recent research findings. The literature search was conducted through national and international databases such as Elsevier, Google Scholar, and the National Institutes of Health (NIH) National Library of Medicine, using keywords including GERD, NSAID, LES (Lower Esophageal Sphincter), gastric acid, reflux, and regurgitation. A total of 25 journal articles published between 2016 and 2024 were used as data sources. The findings indicate that NSAIDs inhibiting cyclooxygenase-1 (COX-1) can reduce prostaglandin production, which plays a protective role in the gastric mucosa, thereby increasing the risk of irritation and acid reflux. Conversely, selective COX-2 NSAIDs have a lower risk of gastrointestinal side effects, making them a safer alternative for patients with chronic pain and inflammation. This study highlights the importance of selecting the appropriate type of NSAID and monitoring its long-term use to minimize the risk of gastrointestinal disorders, particularly in patients with a history of GERD. By considering these factors, it is hoped that complications related to NSAID use in patients with digestive issues can be reduced.

This case report discusses a 54-year-old female patient diagnosed with Stage V Chronic Kidney Disease (CKD) undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD). The patient presented with clinical symptoms such as nausea, vomiting, abdominal pain, and reduced ultrafiltration volume, raising suspicion of Encapsulated Peritoneal Sclerosis (EPS). EPS is a rare but serious complication in long-term CAPD patients. Management includes discontinuation of CAPD, adequate nutritional support, and symptomatic therapy. This report aims to enhance understanding of the diagnosis and management of EPS in Stage V CKD patients.

Chronic Kidney Disease (CKD) is a condition caused by structural or functional abnormalities characterized by a decrease in the glomerular filtration rate (GFR). One of the treatments for CKD patients is hemodialysis (HD). Sleep disorders are among the complications of hemodialysis. Administering lavender aromatherapy is a method to improve the sleep quality of patients. This study uses a literature review method. Articles were searched on ScienceDirect, PubMed, and Google Scholar using advanced search with the keywords "Chronic Kidney Disease, Hemodialysis, Lavender Aromatherapy," resulting in 10 relevant articles to compile this review. The results showed that lavender aromatherapy was effective in addressing complications such as poor sleep quality, fatigue, pain, and anxiety in hemodialysis patients. In conclusion, lavender aromatherapy has been proven effective in improving the sleep quality of HD patients.

Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disorder, is characterized by persistent synovial inflammation, erosion of bone and cartilage, leading to joint destruction. It can attack the joints and other parts of the body such as tendons, ligaments, and bones.  In serious cases, it can affect other organs such as the lungs, heart, nervous system, and eyes. Foot massage is effective to reduce pain. Before implementation of foot massage, the average pain scale was 6 (moderate pain). After implementation of foot massage  the pain scale decreased to 2 (mild pain). Through empowering the elderly, the elderly are taught and assisted in performing safe and effective foot massage techniques to reduce pain, improve blood circulation, and reduce joint stiffness due to rheumatoid arthritis. The conclusion of this community service activity shows that the use of foot massage is effective for patients with rheumatoid arthritis who experience pain.

Low back pain (LBP) is a common health issue that affects both adolescents and the elderly, impacting their daily activities and overall quality of life. This study aims to identify the causes, risk factors, and preventive measures associated with LBP in these two age groups. Various factors, including posture, physical activity, body weight, and occupational or academic demands, contribute to the prevalence of LBP. In adolescents, prolonged sitting, improper posture, and excessive screen time are significant contributors, while in the elderly, age-related degenerative changes, decreased muscle strength, and chronic conditions such as osteoporosis play a major role. This study utilizes a literature review and observational analysis to explore the similarities and differences in LBP risk factors across different age groups. The findings suggest that early prevention through proper ergonomics, regular exercise, and healthy lifestyle choices can help reduce the incidence of LBP. Additionally, awareness and education about spinal health should be emphasized in both adolescents and the elderly to mitigate future complications. This research highlights the importance of a multidisciplinary approach, including physiotherapy, medical interventions, and lifestyle modifications, in managing and preventing LBP effectively.

Low back pain (LBP) is a common health issue that affects both adolescents and the elderly, impacting their daily activities and overall quality of life. This study aims to identify the causes, risk factors, and preventive measures associated with LBP in these two age groups. Various factors, including posture, physical activity, body weight, and occupational or academic demands, contribute to the prevalence of LBP. In adolescents, prolonged sitting, improper posture, and excessive screen time are significant contributors, while in the elderly, age-related degenerative changes, decreased muscle strength, and chronic conditions such as osteoporosis play a major role. This study utilizes a literature review and observational analysis to explore the similarities and differences in LBP risk factors across different age groups. The findings suggest that early prevention through proper ergonomics, regular exercise, and healthy lifestyle choices can help reduce the incidence of LBP. Additionally, awareness and education about spinal health should be emphasized in both adolescents and the elderly to mitigate future complications. This research highlights the importance of a multidisciplinary approach, including physiotherapy, medical interventions, and lifestyle modifications, in managing and preventing LBP effectively.

Law Number 35 of 2009 concerning Narcotics in Indonesia provides a strong legal basis for regulating the use of narcotics in the medical field. This regulation aims to ensure that the use of narcotics is carried out safely, in a controlled manner and in accordance with the interests of health services. This research aims to analyze legal aspects related to the use of illegal drugs in the medical field, identify challenges in implementing regulations, and provide policy recommendations to overcome existing obstacles. The research method used is normative juridical, with a legal approach and literature studies from various legal and health journals. The research results show that although regulations have been prepared comprehensively, their implementation in the field faces obstacles, such as complicated bureaucracy, lack of education for medical personnel, and social stigma against narcotics use. This hampers patient access to treatment, especially for palliative therapy needs and chronic pain management. The conclusions of this research emphasize the need for strategic steps to increase understanding of medical personnel, simplify administrative procedures, and educate the public to reduce stigma. Thus, existing regulations can be implemented optimally to support public health goals without ignoring aspects of supervision. It is hoped that this recommendation can strengthen the legal system and health services in Indonesia, so that patients' rights to health can be fulfilled more effectively.

Osteoarthritis is a degenerative disease and a significant contributor to life years with an imbalance between multifactorial musculoskeletal conditions that is often found in the elderly population, especially those aged over 65 years.  The purpose of this writing is to be able to carry out nursing care for osteoarthritis patients with chronic pain nursing problems to reduce pain.  The method used is to carry out Rheumatic Gymnastics for 10 days in 5 visits, namely on April 22-30 2024. The place where this activity is carried out is in the Mabar Hilir Environment. Based on the evaluation results, it was found that there is an effect of rheumatic gymnastics to help reduce chronic pain  In osteoarthritis patients, the pain scale goes from 7 to 3. The conclusion of this paper shows that the patient is able to do rheumatic exercises and can reduce pain in the knee and waist joints.  It is hoped that the results of this research can be used as a medical intervention to reduce chronic pain in osteoarthritis patients in the community.

Gastroesophageal reflux disease (GERD) is a chronic gastrointestinal disorder characterized by regurgitation of gastric contents into the esophagus, causing a variety of clinical symptoms such as heartburn, regurgitation, and atypical presentations such as chest pain, chronic cough, and asthma. In the elderly, GERD is very common, often with atypical symptoms and has a higher risk of complications, including esophagitis, Barrett's esophagus, and esophageal cancer. Functional dispepsia, another common gastrointestinal disorder, affects more than 20% of the population and is associated with significant negative impacts on quality of life and health care costs. This community service activity aims to screen for GERD and dispepsia in the elderly population through the Plan-Do-Check-Act (PDCA) approach. The activity was carried out at Panti Bina Bhakti, South Tangerang, involving 93 elderly participants aged over 65 years. The results showed that 64 people (68.82%) had a 50% chance of GERD, 21 people (22.58%) had a 79% chance of GERD, and 6 people (6.45%) had an 89% chance of GERD. Screening for GERD and dispepsia in the elderly is very important for early detection and timely intervention, which can prevent disease progression and reduce the risk of complications.

Osteoarthritis is a joint disorder that develops degeneratively due to chronic inflammation in the joint. Symptoms involve the gradual breakdown of cartilage, osteophyte formation, and changes in the synovial membrane. Osteoarthritis sufferers often experience a decrease in daily activities. In particular, Knee Osteoarthritis is the most common type of Osteoarthritis that causes joint pain and limitation of motion in the knee, characterized by damage to the joint cartilage and Diarthrodial structures. In order for people to prevent Osteoarthritis Knee, it is important to identify the risk factors that can lead to the condition. With this understanding, it is hoped that people can avoid the risk factors as part of prevention efforts. By distributing leaflets and conducting Knee Osteoarthritis examinations and daily activity evaluations on patients, the results showed an increase in functional activity in the elderly after undergoing routine exercise therapy. In conclusion, through this counseling activity, increasing public awareness, especially among the elderly, about the importance of preventing Osteoarthritis Knee. Continuous preventive and curative efforts are needed to reduce the incidence rate of Osteoarthritis Knee in the community.

Background: The elderly are vulnerable to chronic diseases and musculoskeletal issues, such as rheumatoid arthritis, which is characterized by pain in the joints and extremities. This disease can lead to persistent pain, fatigue, and an increased risk of injury. One effective non-pharmacological therapy for reducing joint pain in patients with rheumatoid arthritis is rheumatic exercise, which focuses on maintaining range of motion and physical health. Objective: The objective of this research is to describe the comparison of the final results between two respondents before and after the application of rheumatic exercises. Method: This research uses a case study approach with a descriptive method. Descriptive research aims to present or describe the events observed in society. The application of rheumatic exercises was carried out for 4 weeks with a frequency of once a week for 8 minutes. Result: From this study, a decrease in pain levels was found in both respondents, with N. Y's pain level dropping from 5 to 1 and Ny. Y's from 6 to 2. Conclusion: Rheumatic exercise therapy can reduce pain levels in patients with rheumatoid arthritis. (RA).

Gout arthritis, commonly known as gout, is a degenerative disease caused by abnormal purine metabolism, characterized by elevated levels of uric acid in the blood. (hiperurisemia). According to data from the World Health Organization, the number of people suffering from gout reaches 230 million, or 34.2% of all non-communicable diseases. In Indonesia, it is increasing. Gout disease based on age characteristics is particularly high in individuals aged ≥ 75 years (54.8%). Central Java is estimated to be around 2.6 - 47.2%, varying across different populations. The percentage of the population suffering from gout arthritis at Puskesmas Kecipir is 13.67%. The number of people affected is 3,084 out of 22,560 in the productive age group. In the village of Kalibuntu, the percentage of the elderly population suffering from gout arthritis is 9 out of 37. The purpose of this scientific paper is to provide nursing care for Mrs. R's family with musculoskeletal system disorders: gout arthritis in Kalibuntu Village, Rt 04 Rw 01, Losari District, Brebes Regency. The assessment results of Mrs. R's family indicate that they are unaware of gout arthritis, its causes, classification, symptoms, as well as how to prevent and manage gout arthritis when pain occurs. The nursing problems that arise are knowledge deficit and chronic pain.

Palliative care is a treatment approach that aims to improve the quality of life of patients facing serious illnesses, especially when the disease is no longer responsive to curative treatment. Palliative care not only focuses on controlling physical symptoms, but also provides psychological, social, and spiritual support to patients and their families. With this education, health workers are expected to: Increase Knowledge and Skills: Education will increase the knowledge of health workers about pain management, chronic symptom management, and psychosocial and spiritual support for home residents. From the data displayed in the table, it can be concluded that from 30 respondents obtained an N-Gain Score of 64.3, indicating that the method applied by the researcher in this activity is quite effective. In addition, the distribution of N-Gain Score with a value of 0.6 indicates that the strength or category in this study is at a moderate level, the results of the pre-test and post-test that have been carried out by the researcher have increased significantly, which is 50%.

Vulvodynia is a chronic pain condition affecting the vulva that significantly impacts women’s quality of life. Accurate and early diagnosis poses a challenge due to the often-overlapping symptoms with other conditions and the lack of definitive diagnostic tests. This paper proposes the use of expert system methods as a diagnostic tool for vulvodynia in women. The expert system, integrating medical knowledge with inference algorithms, is designed to analyze symptoms, medical history, and test results to provide accurate diagnoses and treatment recommendations. The study involves the development and evaluation of a computer-based expert system prototype that uses clinical data and medical decision-making to enhance the accuracy of vulvodynia diagnosis. Preliminary results indicate that the expert system can improve diagnostic rates and reduce the time required for identifying this condition, offering a potentially valuable tool for medical professionals in clinical practice.  

Cervical root syndrome (CRS) is a clinical condition  caused by compression of the nerve roots in the neck area, often experienced by workers in static positions for long periods such a tailors. CRS can cause significant pain symtomps, affecting daily activities and quality of life. This study aims to determine the effect of a combination of neck calliet exercise and Neuromuscular taping on reducing pain in suffers of cervical root syndrome among tailors in Sragen. This research uses a design quasi-exsperimental with pre-test and post-test. the research subjectsw ere 26 tailor in sragen who where selected based on inclusion and exclusion criteria. The invertion provided is a combination of neck caliet exercise and Neuromuscular taping. pain levels were measured using NRS scale before and after the intervention. Before the intervention 76.9%  of respondens experienced moderate pain (NRS score 4-6). while 23.1% experienced mild pain (NRS score 1-3). After the intervention 69.2% of respondents experienced in pain to the mild category, and only 30.8% still felt moderate pain. data analysis shows a significant reduction in pain levels after being given this combination intervention.The combination of neck calliet exercise and Neuromuscular taping  is effective in reducing pain in sufferers of cervical root syndrome among tailors. this intervention can be an afficient pharmacological alternative treathment for chronic neck pain.