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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.

This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

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.

Myofascial pain syndrome (MPS) in the upper trapezius muscle is one of the disorders commonly found in the neck area, characterized by myofascial trigger points (MTrP) in taut bands or tight muscle bands. Kinesio taping (KT) is a non-invasive therapy used in the management of MPS of the upper trapezius to improve neck disability measured using the Neck Disability Index (NDI). However, stronger evidence is still needed regarding the effectiveness of KT in reducing neck disability scores in MPS upper trapezius. This study aims to review and analyze the effectiveness of KT on NDI scores in MPS upper trapezius. The research method used is a systematic review employing PRISMA-P and the PICOS framework. The sample and population of the study consist of articles obtained from databases such as Crossref, Scopus, PubMed, Google Scholar, and Semantic Scholar. Keywords such as "Kinesio Taping," "Myofascial Pain Syndrome," and "Myofascial Trigger Point" were used. The results of the descriptive analysis of the selected articles showed that KT significantly reduced the NDI value in MPS upper trapezius. In conclusion, KT is effective in improving functional disability in the neck caused by MPS upper trapezius, and KT can be a therapeutic option either alone or in combination with other therapies.

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.

Blood sampling is a mildly invasive medical procedure aimed at detecting diseases, assessing organ function, and evaluating the patient's overall health. It often causes pain, which can affect patient comfort. Pain perception during this procedure is influenced by both physiological and psychological factors. Therefore, safe and easily implemented non-pharmacological interventions are essential to alleviate pain intensity, and one such intervention is deep breathing relaxation. This descriptive observational study employed a quantitative one-shot case study design with a posttest-only approach. Pain intensity was measured after the deep breathing relaxation intervention was given, without any pretest. The findings revealed that after the deep breathing relaxation intervention, most respondents experienced mild pain (84 people, 70.6%), moderate pain (32 people, 26.9%), and severe pain (2 people, 1.7%). The results indicate that deep breathing relaxation significantly reduces pain intensity during blood sampling and can be effectively used as a non-pharmacological intervention to enhance patient comfort during medical procedures.

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.

Primary dysmenorrhea is a common reproductive health problem among adolescents and women of reproductive age, significantly affecting quality of life and academic productivity. Psychological stress and dietary patterns are considered important contributing factors influencing the incidence and severity of menstrual pain. This study aimed to analyze the relationship between stress levels and dietary intake with the occurrence of primary dysmenorrhea in adolescents and women of reproductive age. A literature review was conducted using articles published between 2015 and 2025 retrieved from Scopus, PubMed, and Google Scholar. Studies meeting the inclusion criteria were analyzed descriptively and narratively. The findings showed that the prevalence of primary dysmenorrhea ranged from 54.4% to 90.6%. Higher stress levels were significantly associated with increased risk and intensity of menstrual pain (OR up to 4.03). Frequent consumption of sugary foods, fast food, and pro-inflammatory dietary patterns was linked to higher incidence and severity of dysmenorrhea (OR up to 4.8), whereas adequate intake of fruits, vegetables, iron, calcium, and magnesium demonstrated protective effects. Primary dysmenorrhea is multifactorial and significantly associated with stress and dietary intake; therefore, integrated stress management and nutritional education interventions are recommended in adolescent reproductive health programs.

Mothers in Bingkat Village have daily activities as housewives and participate with their husbands as farmers and raise livestock, as well as social activities of village organizations and religion, not to the point of increasing family economy. Making warming cream from natural ingredients, such as nutmeg, lemongrass, and torch ginger or other plants around the house is very easy, simple tools, low cost, and has economic value. The target of the activity is to provide assistance in making body warming cream and relieving aches and pains. Based on this, it is deemed necessary to provide assistance in making body warming cream and aches and pains. Assistance is not only in making, but also in good product packaging and counseling on marketing direction of products made by the people of Bingkat Village. This natural cream product has a selling value, so it is hoped that it can increase family income and welfare.

Mothers in Bingkat Village have daily activities as housewives and participate with their husbands as farmers and raise livestock, as well as social activities of village organizations and religion, not to the point of increasing family economy. Making warming cream from natural ingredients, such as nutmeg, lemongrass, and torch ginger or other plants around the house is very easy, simple tools, low cost, and has economic value. The target of the activity is to provide assistance in making body warming cream and relieving aches and pains. Based on this, it is deemed necessary to provide assistance in making body warming cream and aches and pains. Assistance is not only in making, but also in good product packaging and counseling on marketing direction of products made by the people of Bingkat Village. This natural cream product has a selling value, so it is hoped that it can increase family income and welfare.

Frozen  shoulder or adhesive capsulitis is a chronic condition that causes pain and limited movement in the shoulder joint. Intervention in the early phase (freezing stage) is crucial to prevent more severe functional disabilities, especially in the elderly population. This case study was conducted on a 60-year-old female patient with complaints of pain and stiffness in the right shoulder for one month. Clinical assessment was conducted using the Numeric Rating Scale (NRS) for pain, Manual Muscle Testing (MMT) for muscle strength, goniometry for joint range of motion, and the Shoulder Pain and Disability Index (SPADI) for functional ability. The therapy program was administered in three intervention sessions. After undergoing three therapy sessions, there was a significant reduction in pain intensity, where movement pain decreased from a score of 7 to 5 and pressure pain from 5 to 2. Muscle strength improved from a value of 3 to 4 on the MMT scale. Additionally, the total SPADI score decreased from 66.1% to 50%, indicating an improvement in the patient's functional capacity in daily activities. The multimodal physiotherapy approach has proven effective in reducing pain, increasing muscle strength, and improving shoulder function in elderly patients with early-stage frozen  shoulder. The combination of electro-physical modalities and manual therapy provides more comprehensive clinical outcomes compared to single interventions.

Sectio caesarea is a common surgical procedure to deliver a baby when normal delivery is not possible or risky. Postoperatively, patients often experience acute pain that can interfere with the recovery process. The benson relaxation technique is a nonpharmacological method that has been shown to be effective in reducing pain through a relaxation and patient confidence approach. This study uses a case study approach on Mrs. T, a post-sectio caesarea patient at Harapan Bunda Hospital, Batam City. Nursing care is carried out comprehensively for three days, including assessment, diagnosis, intervention, implementation, and evaluation. The main intervention was the administration of benzone relaxation techniques for 10–15 minutes every day. After three days of applying the Benson relaxation technique, Mrs. T's pain intensity decreased from a scale of 6 (moderate pain) to a scale of 2 (mild pain). Patients show increased comfort, ability to be active, and decreased expressions of pain such as grimacing. These results support previous findings that benzon relaxation is effective as a nonpharmacological therapy in reducing postoperative pain. This technique can be a safe and easy-to-apply alternative in nursing practice, especially for post-sectio caesarean patients.

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

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.

Cholelithiasis is the formation of hardened bile deposits within the gallbladder due to an imbalance in the chemical composition of bile, which can cause symptoms ranging from abdominal pain to serious complications such as cholecystitis, biliary obstruction, and gallbladder infection. This study aimed to determine the relationship between patient characteristics and the length of hospital stay in cholelithiasis patients at Cut Meutia General Hospital. This study used an analytical observational design with a cross-sectional approach and a retrospective study, employing a total sampling technique with 50 patients. The results showed that most patients were female (52.0%), with the largest age group being late elderly (28.0%). The most common surgical technique was laparoscopic cholecystectomy (42.0%), and the majority of patients received surgical management (60.0%). Bivariate analysis using the Chi-Square test showed significant relationships between age (p=0.000), gender (p=0.044), surgical technique (p=0.029), and management (p=0.045) with the length of hospital stay in cholelithiasis patients. The conclusion of this study is that there is a relationship between patient characteristics and the length of hospital stay in cholelithiasis patients.

A Normocytic normochromic anemia is one of the most common types of anemia found in geriatric patients with chronic diseases or acute bleeding. Upper gastrointestinal bleeding (UGIB) may cause continuous blood loss resulting in decreased hemoglobin levels. This case report discusses a 72-year-old woman who presented to the Emergency Department of Cut Meutia Regional General Hospital with complaints of black stools for four days prior to admission accompanied by epigastric pain, nausea, weakness, and pallor. The patient had a history of long-term use of analgesic and anti-gout medications due to chronic joint pain, which was suspected to be a risk factor for UGIB. Physical examination revealed pale conjunctiva and tachycardia, while laboratory findings showed hemoglobin of 7.1 g/dL, hematocrit of 23.3%, MCV of 82 fL, MCH of 29 pg, and uric acid level of 11.56 mg/dL, leading to the diagnosis of normocytic normochromic anemia caused by UGIB accompanied by gout arthritis. The patient received intravenous fluid therapy, proton pump inhibitors, antifibrinolytic agents, gastroprotective therapy, packed red cell transfusion, and other supportive treatments. During hospitalization, clinical improvement was observed, including cessation of gastrointestinal bleeding, reduced epigastric pain, and increased hemoglobin level to 8.6 g/dL. This case highlights the importance of early diagnosis and comprehensive management in geriatric patients with anemia caused by UGIB and comorbid gout arthritis.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacterium that affects the skin, peripheral nerves, upper respiratory mucosa, and eyes. Type 2 diabetes mellitus (T2DM) is a comorbidity that can worsen the course of leprosy. The female patient, Mrs. D, aged 55 years came to the emergency room of Cut Meutia Hospital with the main complaint of red bumps accompanied by pain on the face, hands, chest, and back since 3 days ago and additional complaints such as fever, joint pain, and numbness and loss of feeling in the legs, weakness, frequent thirst, and frequent urination. Dermatologic status is obtained in the facial region in the form of erythema nodules with firm boundaries with numular size, multiple. Laboratory examination showed anemia and leukocytosis. The therapy given was MDT MB package, ferrous sulfate 1x325 mg and PRC transfusion 3 kolf. Complaints arose acutely after the patient resumed taking MDT (multidrug therapy) leprosy drugs which had previously been stopped for more than 3 months. Based on the time of onset of symptoms, history of leprosy treatment, and the manifestation of systemic inflammatory lesions with signs of neurotropism, it can be suspected that the patient is experiencing a type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL).

Introduction: Carpal Tunnel Syndrome (CTS) is the most common neuropathy caused by compression and tension of the median nerve in the carpal tunnel of the wrist. The most common symptoms of CTS include pain and paresthesia (tingling) with or without numbness in the me dian nerve area of ​​the wrist. Method: The method used was a case study on a 72-year-old male patient diagnosed with bilateral CTS who experienced pain (NRS 7/10), tingling, numbness, and limitations in hand movement and functional activity. Physiotherapy interventions provided included Ultrasound therapy (US), Transcutaneous Electrical Nerve Stimulation (TENS), nerve mobilization, and structured exercise therapy in the form of stretching and median nerve gliding. Evaluation was carried out using the Numeric Rating Scale (NRS) for pain and the Boston Carpal Tunnel Questionnaire (BCTQ) for functional activity. Result: The results showed a significant reduction in pain, with motion pain decreasing from a scale of 7 to 3 and pressure pain from 5 to 1 after three therapy sessions. Furthermore, there was an increase in functional activity, as indicated by a decrease in BCTQ scores, namely the Symptom Severity Scale (SSS) from 4 to 2 and the Functional Status Scale (FSS) from 4 to 2. This indicates a gradual improvement from the moderate-severe category to approaching mild. Conclusion: A multimodal physiotherapy approach is effective in reducing pain, reducing paresthesias, and improving hand function in CTS patients. Combining various therapeutic modalities has been shown to be more optimal than single therapies because it can address various pathological aspects simultaneously. Therefore, comprehensive, evidence-based physiotherapy interventions are highly recommended in the conservative management of CTS.

Background: Dysmenorrhea is a problem that women often experience during menstruation, in the form of dull pain in the lower abdomen because the uterine muscles contract. This pain can appear before menstruation, during menstruation, or after menstruation is finished. Dysmenorrhea refers to pain or discomfort that occurs during menstruation and can interfere with daily work. Objective: The aim of this study was to determine the effect of abdominal stretching exercises and deep breathing relaxation techniques on the level of dysmenorrhea pain in adolescent girls. Methods: This type of research is quantitative research using a quasi-experimental design with a pre-test and post-test nonequivalent control group design with a purposive sampling technique, with a sample size of 80 female respondents from class X. The data collection tool used was an observation sheet with an NRS measuring instrument. Data were processed and analyzed using SPSS 23 with intergroup analysis using the Mann-Whitney test. Results: The results of the bivariate analysis of the Wilcoxon test in the experimental group showed a p value of 0.000 where (p<0.05), then the Mann-Whitney test showed a p value of 0.000 where (p<0.05) so that H0 was rejected and Ha was accepted, which means there is a significant influence and difference. Conclusion: This shows that there is an influence of Abdominal Stretching Exercise and Deep Breathing Relaxation Techniques on the Level of Dysmenorrhea Pain in Young Women (Research Study Conducted at SMK Negeri 1 Kubutambahan).

Background: Anxiety can affect physiological functions in patients prior to surgery, including increased heart rate and respiration, changes in blood pressure and temperature, relaxation of smooth muscles in the bladder, cold and clammy skin, and dry mouth, which may reduce the patient’s energy level. Psychologically, anxiety can lead to increased postoperative pain, delayed wound healing, increased physical disability, and decreased quality of life. One effective non-pharmacological intervention to reduce anxiety is Benson relaxation therapy. Objective: This study aimed to determine the effect of benson relaxation therapy on reducing anxiety levels in pre operative. Methods: This study used a case study design involving one preoperative patient with anxiety symptoms in the Teratai Ward of Prof. Dr. Margono Soekarjo Hospital, Purwokerto. Benson relaxation therapy was administered for 3 days, twice daily, with a duration of 15 minutes per session. Anxiety levels were measured using the Zung Self-Rating Anxiety Scale (ZSAS) before and after the intervention. Results: The patient showed a decrease in anxiety score from 55 (moderate anxiety) to 40 (mild anxiety) after receiving Benson relaxation therapy. Subjectively, the patient reported feeling calmer, more accepting, and motivated. Objectively, there was a reduction in heart rate and physical signs of anxiety. Conclusion: Benson relaxation therapy is effective in reducing anxiety levels in preoperative patients. This intervention can be used as a non-pharmacological alternative to support psychological recovery of pre-operative patients.