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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: Class II restoration according to the classification of Greene Vardiman Black is one of the procedures in dental conservation that often presents a challenge for operators or dentists during treatment. Class II restorations have their own level of difficulty, particularly during the placement of restorative materials into the cavity. One of the possible failures in Class II restorative treatment is marginal leakage, which can lead to microleakage at the restoration margins. Purpose: To report the success of class II restoration with composite resin using tofflmire matrix. Case report: A 23-year-old female patient came with a complaint of cavities, the complaint was felt since 1 year ago in the lower left back tooth, there was no pain and had never been treated. In the case, preparation and restoration were carried out using composite resin with isolation using tofflmire matrix, applied using an Incremental technique. Discussion: Class II posterior tooth restorations have challenges such as leakage due to the techniques and materials used. Composite resin is chosen because of its good adaptation, esthetics, and wear resistance. Incremental techniques are preferred because they reduce polymerization stress and provide optimal curing results. Tofflemire matrix is ​​used for stability and soft tissue protection.Conclusion: The selection of composite resin with an Incremental technique and the use of a Tofflemire matrix provides more optimal, aesthetic, and minimal risk of failure results for class II posterior tooth restorations.

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.

Gout arthritis is a disease characterized by sudden inflammation of the joints due to high levels of uric acid in the body (hyperuricemia). This condition is marked by acute episodes of joint inflammation, often affecting a single joint and preceded by asymptomatic periods of varying duration. Older adults represent the final stage in the human lifespan and experience the natural aging process. This study employed an analytic survey design with a cross-sectional approach. The purpose of this study was to determine the relationship between gout arthritis pain and the level of independence in activities of daily living among patients at the Helvetia Public Health Center. The results showed that the majority of older adults in the working area of UPT Puskesmas Helvetia experienced high levels of pain, with 73 respondents reporting severe pain. Meanwhile, most respondents demonstrated independence in their daily activities, with 72 categorized as independent. The findings indicate a significant relationship between gout arthritis and the level of independence in activities of daily living among older patients at the Helvetia Public Health Center.

Immunization is a vital public health strategy to prevent infectious diseases and reduce morbidity and mortality. In Indonesia, the Pentabio vaccine protects against diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenzae type b. Despite its effectiveness, post-immunization reactions such as fever and local pain are common, potentially affecting caregiver perceptions and immunization adherence. A descriptive observational study with a cross-sectional design was conducted among infants receiving Pentabio immunization at Posyandu in the UPT Timpah Community Health Center, Central Kalimantan. Data were collected through structured observation and caregiver interviews for infants aged 2–11 months. Fever (≥37.5°C) and local pain (tenderness, redness, or swelling) were assessed. Of the 30 infants, 40% were aged 2–3 months, 33.33% were 4–6 months, and 26.67% were 7–11 months, with slightly more males (53.33%). Post-immunization fever occurred in 60%, and local pain in 70%, with both reactions being mild, transient, and appearing within 24–48 hours. These findings highlight the commonality of mild adverse events, especially in early infancy, and underscore the need for clear caregiver education to maintain confidence in immunization services and ensure adherence to vaccination schedules.

Fine motor skills in preschool children begin to develop, where they can use their fingers to write, draw, and so on. The developmental stages of each child are the same, namely the maturation of motor organs. At this age, it is seen as a very important phase because an individual experiences very rapid development. The purpose of this study was to determine the effect of a combination of finger painting and origami activities on the fine motor development of children aged 4-6 years at Cikal Depok Kindergarten in 2025. The research method used in this study was a Quasy experiment design with one group pre-test-posttest. Data analysis was obtained using a non-parametric test of marginal homogeneity with a p-value of 0.007 <0.05, meaning there is an effect of the combination of finger painting and origami activities on the fine motor development of children aged 4-6 years at Cikal Depok Kindergarten in 2025. The conclusion is that finger painting and origami can provide a stimulus for the motor development of children aged 4-6 years. Suggestion: Children's developmental stages can be stimulated with various other teaching aids, finger painting and origami are effective teaching aids.

The problem that is often faced by patients after cesarean section surgery is pain in the operating area, many therapies are used to reduce pain scores in patients. From non-medical mentosa, medical therapy to pain intervention. Two of the methods to reduce postoperative cesarean section pain are intrathecal morphine injections and transversus abdominis muscle blocks (TAP blocks). This study aims to find differences in pain scores after sectio caesaria surgery between patients who received intrathecal morphine and patients who received TAP block. An experimental study used the Post Test Only Control Group Design on Dirgahayu Hospital patients. A total of 108 patients were divided into 3 groups. Group K was not intervened by pain, group B was intervened by TAP block, group M was intervened with intrathecal morphine injection. VAS score was measured at the 4th hour postoperatively. Data were analyzed with the One-Way ANOVA test followed by the Post Hoc Test Bonferroni. Lower pain score was obtained in the group that received pain intervention than the control group with a significant difference (p<0.05). The pain scores of patients who received TAP block were lower than those who received intrathecal morphine with a significant difference (p<0.05). There was a significant difference in pain scores between intrathecal morphine and TAP block. It is hoped that TAP block administration will be used to reduce the pain scale after sectio caesaria surgery. Further research is needed regarding these 2 methods.

Diabetic foot ulcer is a disease of the feet of DM sufferers with the characteristics of sensory, motor, autonomic neuropathy as well as macrovascular and microvascular disorders. Diabetic foot injuries are one of the complications that DM sufferers fear because they can result in amputation. Modern Dressing wound treatment with the Moist Wound Healing method is effective in healing ulcer wounds in DM patients. The wound healing method aims to maintain the moisture of the wound by using a moisture-retaining bandage so that wound healing and tissue growth can occur naturally. To determine nursing care in dm patients with leg injuries the application of Modern Dressing wound care using metcovazin and foam in diabetic ulcer patients. This study presents a descriptive study describing the treatment of ulcer wounds in DM patients with Modern Dressing wound treatment using a case study approach. Based on the results of the application of Evidence Based Practice (EBP) dapart, it is concluded that the application of Modern Dressing wound care is more effective than conventional wound treatment. as evidenced by the change in the decreased score in Mrs. N with 3 intervention processes, namely by decreasing the initial score of 30 down to 22 after Modern Dressing wound treatment. Modern dressing is more effective for diabetic foot ulcer care because it accelerates new tissue growth, reduces pain, and lowers the risk of infection.

Trigeminal neuralgia (TN), sometimes referred to as tic doloureaux or Fothergill disease, is a facial nerve disorder that is widely recognized as one of the most excruciating human ailments. It is characterized by sudden, severe, and recurrent episodes of facial pain that can significantly impair a patient’s quality of life. Oral medications are commonly used as first-line therapy; however, they fail to provide long-term relief in approximately half of patients with trigeminal neuralgia. This condition often leads to repeated clinical visits and the need for alternative therapeutic approaches. A 26-year-old woman presented with complaints of severe, intermittent, and sharp pain localized to her left cheek, consistent with the clinical features of trigeminal neuralgia. Several minimally invasive and surgical treatment options are available for managing this condition, including radiofrequency procedures and microvascular decompression. However, these approaches still carry certain risks and may not be acceptable to all patients. Due to its lower risk profile, ultrasound-guided peripheral nerve block can serve as an effective and safer alternative treatment, particularly for patients who refuse or are not suitable candidates for invasive or surgical interventions.

This study examines visual distortion, the use of emotional color, and expressive composition in Affandi's painting Self-Portrait Smoking a Pipe (1977), focusing on a systematic and contextual visual hermeneutic reading. The research background stems from the need to update the study of Indonesian expressionism through the integration of contemporary theories on visual perception, color psychology, and gestural analysis. This study aims to reveal how anatomical distortion, color dynamics, and non-linear compositional structures function as expressive strategies that reflect the artist's psychological condition and existential reflections in the final period of his life. The research method uses a descriptive qualitative approach and visual hermeneutic analysis through observation of digital documentation and a review of recent literature (2020–2025). The findings indicate that the distortion of shapes in the facial area and the finger-swiping gesture represent emotional tension, while the dominance of red, yellow, and green colors forms an affective spectrum that strengthens the psychological atmosphere in the work. The asymmetrical composition with diagonal lines creates a dynamic visual rhythm and directs the viewer's focus to the center of expression. The implications of the research emphasize that Affandi's works need to be read through a multidimensional approach that combines psychological, aesthetic, and hermeneutic aspects in order to obtain a more comprehensive understanding of his expressionist character.

Dengue fever is a disease commonly found in tropical and subtropical regions. This disease can cause severe symptoms, such as very high fever, accompanied by nausea, vomiting, headache, abdominal pain, and leukopenia (decrease in white blood cells). This infectious disease, known as dengue hemorrhagic fever (DHF), is a viral infection transmitted by the Aedes Aegyppti mosquito. This study aims to classify dengue-prone areas using the K-Means Algorithm, and to classify the factors that cause dengue in Purwodadi District, Grobogan Regency. The clustering results using the K-Means algorithm with Rapidminer tool from 266 data produced 3 clusters: cluster 0 (blue) with 138 patients dominated by Kuripan, Purwodadi, Ngambak villages, cluster 1 (green) with 31 patients in Ngraji, Nambuhan, Cingkrong villages, and cluster 2 (orange) with 97 patients in Danyang, Kalongan, Pulorejo villages. This study is expected to provide additional information for stakeholders in controlling dengue cases and increase awareness of the importance of environmental cleanliness as a preventive measure.

Ankle sprain is one of the most common musculoskeletal injuries in sports activities and often results in pain, limited range of motion, muscle weakness, and decreased functional ability. Appropriate physiotherapy management is essential to accelerate recovery and restore ankle function. This study aims to analyze the effectiveness of combining electrotherapy modalities and exercise therapy in the rehabilitation of bilateral grade II ankle sprain caused by sports injury. The research used a case study approach with physiotherapy interventions conducted through several treatment sessions. The interventions consisted of electrotherapy modalities combined with therapeutic exercises designed to reduce pain, improve joint mobility, and increase muscle strength and functional stability of the ankle. Clinical evaluation was carried out through observation of pain levels, range of motion, and functional ability during the therapy period. The findings indicated a gradual improvement in the patient’s condition, including decreased pain, increased ankle range of motion, improved muscle strength, and better functional performance during daily activities. These results suggest that the integration of electrotherapy and exercise therapy can provide a comprehensive rehabilitation approach for ankle sprain injuries. The combined intervention not only supports pain reduction but also enhances joint stability and functional recovery, enabling patients to return safely to their physical activities and reducing the risk of recurrent injury.

Hallucinations are false sensory perceptions unrelated to real external stimuli. Patients will have difficulty distinguishing whether the stimuli they experience originate internally (thoughts or feelings) or externally. This condition may affect any of the five senses. The most common type of hallucination is auditory hallucinations. One way to reduce the signs and symptoms of auditory hallucinations is through Art Therapy: freehand painting. To determine nursing care with the application of free painting therapy in patients with auditory hallucinations at the Mitra Mulia Husada Foundation, Palembang. The design used was a case study describing the cases of four patients with auditory hallucinations. Subjects were selected according to inclusion and exclusion criteria. The intervention provided was free-drawing therapy for four days, each lasting 30 minutes.After the intervention of applying free painting therapy for 4 days with a time of 30 minutes per visit, it was found that there was a decrease in signs and symptoms of hallucinations as shown through the results of the observation sheet in each patient. Mr. A. originally 9 became 3 signs of symptoms, Mr. S originally 7 became 3 signs of symptoms, Mr. AJ originally 9 became 3 signs of symptoms and Mr. M originally 10 became 5 signs of symptoms of auditory hallucinations. There was a decrease in auditory hallucination scores in each patient after being given Art Therapy: free painting. For future researchers, it is hoped that they can conduct research on the application of free painting therapy so that it can be carried out more frequently so that the therapy carried out is more effective in reducing the signs and symptoms of hallucinations and also add respondents so that the application of the therapy given is more effective in reducing the signs and symptoms experienced by patients.

Gout arthritis, or often called gout, is a type of arthritis caused by the accumulation of uric acid crystals in the joints and surrounding tissues. Arthritis itself is a term used to describe inflammation of the joints. The process of gout begins with an increase in uric acid levels in the blood, called hyperuricemia. Gout arthritis sufferers in the world affect approximately 10% to 25% of the world's population, the WHO prevalence of gout arthritis in the world is 34.2%. The type of research used in this study is quantitative research using a quasi-experimental research method, namely the pre-posttest control one group design method. This study is a study conducted on 1 group using an intervention without a comparison. This study has been conducted with a total of 20 elderly people who meet the inclusion and exclusion criteria. It is known that the Sig. (2-tailed) value of 0.00 is greater than 0.05. then there is a significant difference between the results before and after the warm cinnamon water compress. So it can be concluded that there is an effect of warm cinnamon compresses (Cinnamomun Burmannii) on gout arthritis in the elderly at the Sei Pancur Community Health Center.

Cardiovascular dysfunction is a disorder of the blood vessels, such as hypertension, heart failure, and stroke. In 2016, cardiovascular disease was the leading cause of death worldwide, based on data from the World Health Organization (WHO). Coronary Heart Disease (CHD) is the leading cause of death, along with stroke, as shown by the Sample Registration System survey in 2014.This case involves a 64-year-old male, Mr. N, who presented to the emergency department of RSUD dr. Fauziah Bireuen with complaints of chest pain that developed gradually and worsened over the past month. The pain was located across the entire chest and radiated to the back and neck. The pain was described as severe, like being crushed by a heavy load, worsened during strenuous activities such as cutting grass and chopping wood, and relieved when the patient bent forward. The pain could occur at any time, with a Visual Analog Scale (VAS) score of 10 (severe pain). The patient also reported easy fatigue during heavy physical activity over the past month. Laboratory examination revealed elevated leukocytes, mean corpuscular volume (MCV), segmented neutrophils, troponin I, cholesterol, and triglycerides. The patient was diagnosed with extensive anterior ST-elevation myocardial infarction (STEMI) post successful fibrinolytic therapy.

Drug abuse remains a serious social problem, particularly among adolescents and young adults. The spread of drugs into rural areas highlights the urgent need for preventive efforts through continuous and educational approaches. This Community Service (PkM) activity aimed to increase public knowledge and awareness regarding the dangers of drug abuse through an educational program. The study employed a descriptive quantitative and qualitative approach involving 30 adolescents and young adults from a village in Mojokerto Regency. Data were collected through pre-test and post-test questionnaires, observation, and documentation. The results indicated a significant improvement in participants’ knowledge, with the average score increasing from 56.3 in the pre-test to 82.6 in the post-test. These findings demonstrate that drug abuse education is effective in enhancing community knowledge and awareness as a preventive effort against drug abuse. Therefore, similar educational programs should be implemented continuously with support from various stakeholders to promote a healthy and drug-free community.

Hysterectomy is a procedure performed to remove the uterus, either partially or completely. This surgery often causes psychological responses in the form of anxiety. One non-pharmacological therapy that can be used to overcome anxiety is Benson relaxation. The design used in this Final Nursing Scientific Paper is a case study using Benson relaxation intervention. Three respondents participated, and the intervention was carried out for two days preoperatively with three sessions, taking place in the Lukas Charitas Hospital Palembang room. After two days of Benson relaxation, changes in anxiety scores were obtained using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. At the final meeting, Mrs. E's anxiety decreased from 18 to 10, Mrs. H's from 16 to 7, and Mrs. S's from 13 to 7. There was a decrease in anxiety before and after Benson relaxation therapy was administered to all three respondents. The implementation of this EBP is expected to provide additional information regarding the provision of Benson relaxation in preoperative hysterectomy patients.

Hypertension is a non-communicable disease that can lead to cardiovascular complications and requires both pharmacological and non-pharmacological management. One of the non-pharmacological therapies that can be applied is warm water foot soaking and progressive muscle relaxation, which may help reduce blood pressure through peripheral vasodilation, stimulation of the parasympathetic nervous system, and decreased sympathetic nervous system activity. This study aimed to analyze the implementation of nursing care through warm water foot soaking therapy and progressive muscle relaxation to reduce blood pressure in patients with hypertension. The method used was a case study with a pre-experimental design using a one group pre-test post-testapproach involving three hypertensive patients, with the intervention administered once daily for three days. The results showed a decrease in blood pressure in all patients. The average systolic reduction was 5.3 mmHg, 12.3 mmHg, and 5.6 mmHg, while the diastolic reduction was 1.6 mmHg, 2.6 mmHg, and 4 mmHg, respectively. In addition, all patients reported a reduction in pain scale. It can be concluded that warm water foot soaking therapy combined with progressive muscle relaxation is effective as a complementary nursing intervention to help reduce blood pressure in patients with hypertension.

The IV infusion process will cause pain that can be disturbing for children. Pain is a form of uncomfortable sensation that is felt personally by each individual. In addition, there will be changes in vital signs such as increased pulse, blood pressure, and respiration so that it will be an unpleasant experience for children. Non-pharmacological therapy as an intervention to reduce pain perception in children and increase comfort during medical procedures. One form of non-pharmacological technique is audio visual distraction using a smart book. Smart books are fun and interactive play therapy that can support cognitive, fine motor, and sensory aspects in children and to divert children's attention from pain by displaying more pleasant and interesting images and musical sounds so that it can reduce the pain scale after IV installation. The design used in the preparation of this Final Scientific Paper for Nurses is a case study with an intervention in the form of audio visual distraction using a smart book for ± 10 minutes. The number of respondents was 3 people, the intervention was carried out on September 14, October 7, and November 24, 2025, located in the Theresia Charitas Hospital Palembang room. After the smart book audio visual distraction therapy, there was a decrease in the pain scale for 3 respondents, namely in An. A from a pain scale of 7 to a pain scale of 4, An. G from a pain scale of 10 to a pain scale of 4, and An. R from a pain scale of 7 to a pain scale of 4. The application of EBP smart book audio visual distraction therapy can be used to reduce the pain scale in preschoolers after IV installation.