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According to World Health Organization data in 2015, maternal deaths were 216 per 100,000 live births due to complications during pregnancy and childbirth. While in developing countries the maternal mortality rate jumped 20 times higher than in developed countries, reaching 239 per 100,000 live births. Keywords: Husband's support, Mother's attitude, Infant immunization. The time of the study was April to July at the Negeri Lama Health Center in 2022. The sample in this study who were planning to give birth in the month (TTP) at the time of the study from May to June 2022 at the Negeri Lama Health Center were 15 pregnant women in the control group and 15 pregnant women in the intervention group. After the normality test was carried out and the results were normally distributed, a paired t-test could be carried out. The results of the t-test, namely the results of the paired test-test showed p = 0.011 (p <0.05) and t count = 11,768> from t table = 9,200 which proves that there is an effect of giving deep back massage on the level of labor pain in mothers who are giving birth to reduce labor pain.

Childbirth is a process of expelling the results of conception (fetus and placenta), which can live to the outside world, from the uterus through the birth canal or by other means. During labor, the uterus contracts and pushes the baby down to the cervix. This study aims to determine the Effect of Deep Back Massage on Reducing Pain in the First Stage of Active Labor at BPM Pera, Medan City in 2024. This type of research is Experimental research. A research design used to find a causal relationship with the involvement of research in manipulating the independent variables. The population is 20 mothers giving birth at BPM Pera, Medan City in 2025, namely 10 people in the Treatment Group and 10 people in the Control Group. The data analysis technique uses t-test analysis. The results obtained in this study are the results of the t-test, namely the results of the paired test-test showed p = 0.011 (p <0.05) and t count = 11,768> from t table = 9,200 which proves that there is an effect of giving deep back massage on the level of labor pain in mothers who are giving birth to reduce labor pain.

Childbirth is often perceived as frightening and causing extreme pain. Some mothers also feel traumatized by their first childbirth process because of various difficulties and pain during childbirth so that they are reluctant to plan to have children again. Labor pain is caused by uterine contractions and dilation of the cervix and lower uterine segment. Survey data from PMB Restu Bunda in 2024 on 5 mothers who gave birth, it was found that overall respondents experienced pain, as many as 3 people with a pain scale of 7 (severe pain) and as many as 2 people with a pain scale of 6 (moderate pain). One non-pharmacological therapy that can reduce the intensity of pain is back massage using Virgin Coconut Oil (VCO). The research objective was to determine the effect of back massage with Virgin Coconut Oil (VCO) on the intensity of active labor pain in the first stage of labor at the IMP Restu Bunda Gunung Terang Sub-District of West Tulang Bawang Regency. The quantitative research type is a pre-experimental design, one group pre-test - post-test design. The population in this study were all mothers who were going to give birth, as many as 22 mothers, with a sample of 18 people taken by accidental sampling. The study was conducted at the IMP Restu Bunda of Gunung Terang Sub-District West Tulang Bawang Regency. Data collection used observation sheets. Data analysis was carried out using univariate and bivariate tests (Wilcoxon test). The study results showed that the average labor pain before being given a back massage with virgin coconut oil (VCO) was 7.0 and after being given a back massage with virgin coconut oil (VCO) was 5.2. There was an influence of back massage with virgin coconut oil (VCO) on the intensity of active labor pain in the first stage at the IMP Restu Bunda of Gunung Terang Sub-District of West Tulang Bawang Regency with a p-value = 0.001 (p-value <α = 0.05). Suggestions for health workers can recommend back massage with virgin coconut oil (VCO) can be used as complementary therapy for mothers in the first stage of labor.

Liver cirrhosis is a pathological condition that describes the end stage of progressive hepatic fibrosis. More than 40% of cirrhosis patients are asymptomatic. Based on research, 4% of patients with fatty liver will develop non-alcoholic steatohepatitis, and 0.3% of these patients will end up experiencing liver cirrhosis. A 48 year old man came to the emergency room at Cut Meutia Hospital with complaints of an enlarged stomach accompanied by pain since ± 2 weeks. The patient also complained of swelling in both legs. The results of the physical examination of the abdomen revealed icteric sclera (+/+), shifting dulness and leg edema (+/+). Based on laboratory examinations, it appeared that there was an increase in liver function, then the ultrasound examination showed the impression of ascites and liver cirrhosis. Based on the history, physical examination and supporting examinations, the patient was diagnosed with hepatic cirrhosis, relative decompensated stage of hepatitis B + CHD. Non-medical management is carried out in the form of bed rest, balanced nutrition and consumption of a low sodium diet. Then the patient's medical management consists of a 500ml hepatic Aminofuscin infusion, symptomatic management and antiviral treatment for the hepatitis he is suffering from.  

Relapsing Pulmonary Tuberculosis is a patient with pulmonary TB who has received TB treatment and has been declared cured or finished treatment, then re-diagnosed as positive pulmonary TB through BTA examination or sputum culture by Mycobacterium tuberculosis. In high incidence settings, this figure is as high as 7850 cases/100000 person-years. A 66 year old patient came to the emergency room at Cut Meutia Hospital with complaints of coughing up blood which had been felt since 3 days SMRS, and worsened after 1 day SMRS, phlegm was fresh red, blood was mixed with phlegm when coughing. Previously the patient had been coughing up phlegm without blood since 2022 coughing felt to come and go. The patient also complained of chest pain on the right side, shortness of breath when doing activities, the patient also complained of night sweats that soaked clothes and bed, denied nausea, vomiting, defecation and urination. there were no complaints, the patient had a history of DM. On physical examination it was found that the patient's general condition appeared to be moderately ill, consciousness was compos smentis, blood pressure was 110/70 mmHg, pulse rate was 66x/minute, respiration was 22x/minute, with a body temperature of 36.7°C and SpO2 98% on room air. Auscultation revealed vesicular breathing sounds (+/+), rhonchi (-/-), wheezing (-/-). Blood laboratory examination: HB decreased (12.00), MCV decreased (76.78 fL), MCH decreased (23.2 pg), MCHC decreased (30.30 thousand/uL).

Childbirth is a natural way that every mother must go through where the results of conception in the form of a baby and placenta are released from the uterus. Normal labor is characterized by uterine contractions that cause thinning, dilation of the cervix and push the fetus out through the birth canal, causing a sensation of pain felt by the mother. The purpose of this study was to determine whether there is an Effect of Murrotal Al-Qur'an Therapy on Reducing the Intensity of Labor Pain in the First Active Phase at the Juliana Dalimunthe Clinic. The research method used was Pre-Experiment One Group Pre and Posttest Design. Samples were taken by Accidental Sampling from mothers in the first active phase of labor who met the inclusion criteria totaling 30 people. Data collection was carried out using a face pain rating scale questionnaire. Data analysis with the Shapiro Wilk test and tested with the Wilcoxon Signed Ranks test statistical test. The results of the study conducted from May to July, found the average pain scale before therapy was 6.83 and the average after therapy was 6.17, the decrease in pain scale from before to after Murottal therapy was 0.66. From the statistical test, the P value = 0.001 was obtained, indicating that there was an effect of Murottal Al-Qur'an therapy on reducing the intensity of labor pain. The conclusion of this study is that the provision of Murottal Al-Qur'an therapy has been proven to be able to reduce labor pain in the first active phase. It is hoped that the provision of Murottal Al-Qur'an therapy will be an alternative intervention in reducing labor pain in the first active phase.

This research is a comprehensive midwifery care case study on Mrs. K from pregnancy to postpartum family planning conducted at the PMB Okta Saprina, S.Tr.Keb and Mrs. K's home from October-December 2023. The assessment during pregnancy found complaints of frequent urination which were addressed by counseling on reducing drinking at night. During labor, Mrs. K experienced severe pain on a scale of 8, which was reduced to moderate pain on a scale of 5 after being given lavender aromatherapy. Labor care stages I-IV were normal according to theory and without complications. The baby was born spontaneously, full-term, without complications. During the postpartum period, Mrs. K experienced breast engorgement which was treated with aloe vera compresses for 7 days until the complaint was resolved. Care for the newborn and postpartum period was according to standards. At 42 days postpartum, Mrs. K chose to use 3-month injectable contraception after being screened with the KLOP wheel. The management provided to Mrs. K was in accordance with evidence-based practice in providing comprehensive midwifery care, namely counseling for frequent urination, lavender aromatherapy for labor pain, and aloe vera compresses for breast engorgement with satisfactory results.

Delivery assistance is a delivery service process that starts from stage I to stage IV of delivery. The achievementcofcmaternal healthc effortsc isc measured through the indicator of the percentage of deliveries assisted by qualified health workers (Ministry of Health of the Republic of Indonesia 2015).Based on the description above, the problem discussed in this research is: to determine the effect of counterpressure massage techniques to reduce labor pain in active phase first stage mothers at Darul Aman Community Health Center, East Aceh. The type of research used is quasi-experimental with a pre-test design and post test control group design, cause or risk and effect variables or cases that occur in the research object are measured or collected simultaneously (at the same time) (Notoatmodjo, 2012) Darul Aman East Aceh Community Health Center is a BPJS Health First Level Health Facility in Aceh Tkmur Regency whose address is Jalan Medan, Gp Kuede Village, Darul Aman District, East Aceh Regency, NAD. The Darul Aman Health Center in East Aceh has the Motto: SIMPATI, namely Smiling and Greeting, Informative, Serving, Professional, Accountable, Transparent, Sincere. Based on the results of the analysis and discussion of research results, conclusions can be drawn regarding the effect of massage techniques to reduce labor pain at the Darul Aman Community Health Center, East Aceh. 1. The level of labor pain before the counterpesure massage was performed, all respondents experienced severe pain. 2. The level of labor pain after the counterpesure massage was performed. Most of the respondents experienced moderate pain. 3. There was an effect of using massage techniques to reduce labor pain in mothers during the first stage of the active phase.

Dengue Hemorrhagic Fever (DHF) is a disease caused by the Dengue virus and has a significant impact on public health, especially in tropical areas. Early diagnosis and prediction of DHF risk are essential to prevent complications and improve medical care. This study aims to develop a DHF risk prediction model using the Decision Tree method based on clinical symptoms and laboratory data. The data used include symptoms such as fever, joint pain, rash, and laboratory results such as platelet count and hematocrit. The Decision Tree model was chosen because of its ability to handle data with various variables and provide easy-to-understand interpretations. The research data were taken from patients diagnosed with DHF in several hospitals during a certain period. The dataset was then analyzed to find relevant patterns that could predict a high risk of DHF. The model training and testing process was carried out using cross-validation techniques to ensure prediction accuracy. The results showed that the Decision Tree model had an accuracy rate of 96.95% and consistent results from cross-validation which produced an average accuracy of 92.8%,, with good sensitivity and specificity in predicting DHF risk based on a combination of clinical symptoms and laboratory data. Factors such as low platelet count and fever symptoms lasting more than three days were found to be significant predictive variables. In conclusion, this Decision Tree model has the potential to be used as a tool in early prediction of DHF risk, which can help medical personnel in clinical decision making and patient management. Further development can be done by adding other variables such as epidemiological data to improve model performance.

Dengue Hemorrhagic Fever (DHF) is a disease caused by the Dengue virus and has a significant impact on public health, especially in tropical areas. Early diagnosis and prediction of DHF risk are essential to prevent complications and improve medical care. This study aims to develop a DHF risk prediction model using the Decision Tree method based on clinical symptoms and laboratory data. The data used include symptoms such as fever, joint pain, rash, and laboratory results such as platelet count and hematocrit. The Decision Tree model was chosen because of its ability to handle data with various variables and provide easy-to-understand interpretations. The research data were taken from patients diagnosed with DHF in several hospitals during a certain period. The dataset was then analyzed to find relevant patterns that could predict a high risk of DHF. The model training and testing process was carried out using cross-validation techniques to ensure prediction accuracy. The results showed that the Decision Tree model had an accuracy rate of 96.95% and consistent results from cross-validation which produced an average accuracy of 92.8%,, with good sensitivity and specificity in predicting DHF risk based on a combination of clinical symptoms and laboratory data. Factors such as low platelet count and fever symptoms lasting more than three days were found to be significant predictive variables. In conclusion, this Decision Tree model has the potential to be used as a tool in early prediction of DHF risk, which can help medical personnel in clinical decision making and patient management. Further development can be done by adding other variables such as epidemiological data to improve model performance.

Labor pain occurs due to the contraction of uterine muscles, which can cause discomfort and pain for the mother, potentially affecting the labor process. Acupressure is a complementary therapy that involves applying pressure or massage and stimulation at specific points on the body. The purpose of this study is to determine the effectiveness of acupressure point pressure in reducing labor pain for Mrs. N at PMB Silvi Ayu, S.Keb in Pekanbaru. This research used a descriptive method with a case study design. The results of this study indicate that acupressure point pressure is proven to be effective in reducing pain during labor, especially in the active phase. This method is safe and can be used as an alternative or complementary approach to other pain management methods.

The post partum period is divided into three, namely early puerperium (immediate puerperium) or recovery period 0-24 hours after delivery, immediate puerperium (later puerperium) or recovery period 1-7 days after delivery and remote puerperium (later puerperium) or the period to recover and be completely healthy (Rohmah et al, 2022). The purpose of this paper is to find out and provide nursing care to Mrs. S with postpartum in the Nusa Indah ward, dr. Soeselo Hospital, Tegal Regency according to nursing standards. The method used is a descriptive method in the form of interviews, observations, documentation studies, library studies and literature. From the case review, it was found that the patient’s main complaint was pain in the stitches in the birth canal, P: pain when moving, Q: pain like being pressed, R: pain in the stitches in the birth canal, S: pain scale 5, T: intermittent. There were 2 diagnoses found, namely labor pain and knowledge deficit. Interventions are designed based on the theories in SDKI, SLKI and SIKI as well as on the client’s condition and can be implemented.

Comprehensive Care is continuous care from pregnancy to Family Planning (FP). Comprehensive care aims to provide quality services and prevent maternal and child mortality. The purpose of this case study is to provide comprehensive care to mothers from pregnancy, childbirth, postpartum, and newborn care using the documentation of the Seven Steps of Varney and SOAP. This assessment was conducted from January to April 2024 through data collection methods, interviews, and observations. Pregnancy care included three visits with the first day of the last menstrual period on July 12, 2023, and the expected delivery date on April 19, 2024. During the first, second, and third visits, the general condition of the mother was found to be good. Labor care was provided on April 24, 2024, at 11:30 AM when the mother came to the Midwife's Independent Practice, accompanied by her husband, complaining of abdominal pain since 08:00 AM and discharge mixed with blood. An internal examination revealed 4 cm dilation. At 4:00 PM, labor management was carried out. The delivery process was normal with the 60 Steps of Active Management of the Third Stage of Labor (AMTSL), the baby was born normal, male, weighing 2500 grams, with a length of 47 cm, and immediate newborn care was performed. Postpartum and newborn care proceeded smoothly without complications for both mother and baby.

Tuberculosis is one of the world's health problems, especially in developing countries. Treatment regimen with multiple first-line anti-tuberculosis drugs (ATD) such as Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, and Streptomycin remains the most effective for treatment of tuberculosis. Adverse drug reactions (ADRs) to antituberculosis drugs may range from mild gastrointestinal disturbances to serious hepatotoxicity, peripheral neuropathy, and cutaneous adverse effects. We report a 65 year old male patient with a complaint of yellowish discoloration of sclera, nausea and vomiting after three days of initiation of ATD therapy. The patient has been diagnosed with Tuberculosis relapse and has been taking ATD since June 2024. The patient noted epigastric pain. Laboratory examination found an increase in bilirubin level and electrolyte imbalance. The treatment is in the form of discontinuation of ATD, supportive therapy and followed by hepatoprotective supplements. ATD should be discontinued in patients with hepatotoxicity and fixed drug eruption until liver function and clinical symptoms improve. Initiation of ATD administration is carried out by administering one by one regimen. The patient is currently experiencing antituberculosis drug-induced hepatotoxicity, which is managed by providing supportive care and different AT regimens were prescribed.

Gallbladder disease is associated with a malfunctioning gallbladder and highly concentrated bile, leading to conditions such as the formation of gallstones or cholelithiasis. Cholelithiasis can occur due to high concentrations of cholesterol in the gallbladder. Obstruction of the cystic duct, either by stones or functional issues, can cause acute inflammation of the gallbladder. Acute cholecystitis attacks are often associated with gallstones, or cholelithiasis. Common symptoms include right upper quadrant or epigastric abdominal pain, especially after consuming fatty foods, with additional symptoms such as nausea, vomiting, fever, and diarrhea. The development of this disease is believed to involve many factors and likely arises from complex interactions between various genetic and environmental elements. An imbalance in bile composition, characterized by excessive cholesterol secretion, reduced gallbladder motility, and the accumulation of mucin gel, contributes to the formation of gallstones. Gallbladder disease related to cholesterol results from a biochemical imbalance involving lipids and bile salts in the bile stored in the gallbladder. A 45-year-old patient, Mrs. D, has several risk factors that increase the development of the disease, and the following case report discusses the clinical presentation and laboratory examination results related to the onset of this disease. Laparoscopic cholecystectomy was performed on the patient, and appropriate education was provided, illustrating the importance of intra-professional collaboration and positive outcomes for the patient.

On average, 85-90% of pregnant women in Indonesia experience severe labor pain and 7-15% of those who do not experience labor pain. Labor pain results in increased activity of the sympathetic nervous system which causes an increase in blood pressure, pulse rate, respiration, nausea, vomiting, and diaphoresis. Data shows that 15% of mothers in Indonesia experience birth complications and 21% are caused by experiencing very severe pain. The aim of the research was to analyze the effect of cold compresses on first stage labor pain. The research design used a quasi-experimental one group pre-posttest. The population, namely all mothers giving birth at PMB Andina in May 2024, totaled 30 respondents. The sampling technique uses total sampling. Statistical tests use the Wilcoxon test. The research results obtained were that the average labor pain before the cold compress was 5.13 and the average labor pain after the cold compress was 4.00, meaning there was a decrease in the level of pain by 1.13. The significant value was found to be p: 0.001 < 0.05, meaning that there was an effect of cold compresses on labor pain in mothers giving birth at PMB Andina Palembang. It is hoped that health workers can improve maternal care during childbirth, one of which is by providing complementary services in the form of cold compresses.

Physiological processes such as pregnancy, labor and birth can be difficult and can occur at any time, and can have serious impacts on the mother and fetus. So the SC ERACS method of delivery is an option. ERACS is a SC delivery technique that is becoming increasingly popular in society, especially among pregnant women because it can shorten recovery time after surgery and reduce post-operative pain. This study aims to describe the level of pain in patients post caesarean section using the ERACS method. This research is a quantitative descriptive study, data collection using accidental sampling techniques, namely all SC ERACS patients at H.A Zaky Djunaid Hospital for 1 month, namely 52 respondents. This research instrument uses NRS. The data analysis used is univariate in the form of a frequency distribution. The results showed that the characteristics of the respondents were mostly in the early adulthood category, namely aged 26-35 years, 27 respondents (51.9%), 34 respondents (65.4%) respondents who did not work, 24 respondents (46.2) who indicated a history of SC, and 41 respondents (78.8%) were multiparous. The pain level of post-SC patients using the ERACS method, the majority of mothers experienced mild pain on a scale of 1-3, 47 respondents (90.4%). The conclusion that can be drawn is that the pain level of post-SC patients using the ERACS method is that most mothers experience mild pain.

Introduction Osteoarthritis (OA) is the most common articular disease of the developed country and cause of chronic disability, and may cause joint failure.Currently, it is more prevalent than it used to be, and it is predicted that this tendency will continue as life expectancy and the prevalence of obesity increase.OA is related to age, but is associated with a variety of both modifiable and non-modifiable risk factors, including obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma, and gender. It is a major cause of disability in elderly populations around the globe, especially in developed countries. the aim of study to identify Knowledge about osteoarthritis and its related risk factors in fourth grade students in nursing department of Alfarabi collage  and to assess Knowledge about osteoarthritis and its related risk factors in fourth grade students in nursing department of Alfarabi collage . methodology The methodology for studying the knowledge about osteoarthritis and its related risk factors in fourth-grade students in the nursing department of Alfarabi College can be utilize a cross-sectional research design to assess the knowledge of fourth-grade nursing students about osteoarthritis and its related risk factors. A convenience sampling method will be used to select participants from the fourth-grade nursing students at Alfarabi College. The sample size will be determined based on the total number of fourth-grade students in the nursing department. Results The sociodemographic characteristics of 256 students at Al-Farabi College were analyzed. The majority of respondents were male (73.8%), over 22 years old (35.3%), and engaged in manual labor (53.0%). The study found that students had higher knowledge about certain aspects of osteoarthritis, such as postmenopausal women being more at risk for osteoporosis than osteoarthritis (87.5%), while their knowledge about female gender as a risk factor was lower (39.4%). Students also had higher knowledge about joint pain as a symptom of osteoarthritis (82.8%) compared to redness in the joint (53.1%).Finally, while there was a high significance between having a first-degree relative with knee osteoarthritis and knowledge, there was no significance between being clinically diagnosed with osteoarthritis and knowledge among the students. Conclusion  the study of sociodemographic characteristics and knowledge of osteoarthritis among students at Al-Farabi College revealed that there were significant associations between gender, occupation, awareness of knee osteoarthritis as a disease entity, and having a first-degree relative with knee osteoarthritis with knowledge about the condition. However, there was no significant association between age, being clinically diagnosed with osteoarthritis, and knowledge.

Excessive fear, anxiety, stress or anger can cause slow labor progress. Feelings of tiredness, fear and hopelessness are the result of pre-labor or a prolonged latent phase. Women who are not supported emotionally, or have had difficulties in previous births, can feel anxious and afraid to face labor, resulting in labor without significant progress and labor that is very painful. Age that is too young and too old, too much parity and knowledge is suspected to increase anxiety in mothers. The aim of this research is to determine the factors related to postpartum maternal anxiety during childbirth at RSU Vina Estetica Medan in 2023. This type of research is analytical observational with cross-sectional. The population in this study was all postpartum mothers who gave birth at RSU Vina Estetica Medan for the January-April 2023 period, namely 116 people. The sample taken based on the Slovin formula was 54 people. Data analysis was carried out using statistical tests using chi-square, to see the relationship between the independent variable and the dependent variable. The results of the research show that there is a relationship between age and knowledge of postpartum mothers and anxiety during labor at RSU Vina Estetica Medan in 2023. There is no relationship between parity and anxiety of postpartum mothers during labor. It is recommended that health workers at RSU Vina Estetica Medan provide regular counseling to mothers about childbirth starting at the beginning of the pregnancy check-up, in order to reduce postpartum maternal anxiety..

Excessive fear, anxiety, stress or anger can cause slow labor progress. Feelings of tiredness, fear and hopelessness are the result of pre-labor or a prolonged latent phase. Women who are not supported emotionally, or have had difficulties in previous births, can feel anxious and afraid to face labor, resulting in labor without significant progress and labor that is very painful. Age that is too young and too old, too much parity and knowledge is suspected to increase anxiety in mothers. The aim of this research is to determine the factors related to postpartum maternal anxiety during childbirth at RSU Vina Estetica Medan in 2023. This type of research is analytical observational with cross-sectional. The population in this study was all postpartum mothers who gave birth at RSU Vina Estetica Medan for the January-April 2023 period, namely 116 people. The sample taken based on the Slovin formula was 54 people. Data analysis was carried out using statistical tests using chi-square, to see the relationship between the independent variable and the dependent variable. The results of the research show that there is a relationship between age and knowledge of postpartum mothers and anxiety during labor at RSU Vina Estetica Medan in 2023. There is no relationship between parity and anxiety of postpartum mothers during labor. It is recommended that health workers at RSU Vina Estetica Medan provide regular counseling to mothers about childbirth starting at the beginning of the pregnancy check-up, in order to reduce postpartum maternal anxiety..