Publication Search

Hypertension, often referred to as high blood pressure, is a major global health problem that significantly increases the risk of atherosclerotic cardiovascular disease, heart failure, stroke, and kidney failure. Various complementary and alternative therapies have been explored to support conventional treatments in reducing blood pressure, one of which is smile therapy. This study aimed to analyze the effect of smile therapy on blood pressure among hypertensive patients at RSUI Harapan Anda Tegal. The research employed a quantitative approach with a quasi-experimental design using a one-group pretest-posttest method. A total of sixty hypertensive patients were selected through exhaustive sampling. Data were collected before and after the intervention and analyzed using the Wilcoxon test to determine the statistical significance of changes in blood pressure. The demographic characteristics of participants showed that most were in their early to mid-forties (36 individuals, 60%), predominantly female (38 individuals, 63.3%), with a junior high school education or below (25 individuals, 41.7%), and unemployed (41 individuals, 71.7%). The findings indicated that prior to the intervention, 41 participants (68.3%) had uncontrolled blood pressure. After undergoing smile therapy, 48 participants (80%) demonstrated improvement with more stable blood pressure levels. Statistical analysis revealed a significant effect of smile therapy on reducing blood pressure with a p-value of 0.000. These results suggest that smile therapy can serve as an effective, simple, and low-cost complementary intervention to help hypertensive patients manage their condition and improve overall health outcomes

Stroke patients often experience mobility impairments, which increase the risk of developing pressure ulcers (decubitus). Pressure ulcers are a common complication for patients with limited mobility, especially in the ICU. One intervention that can be used to reduce the risk of pressure ulcers is back massage using olive oil. This study aims to analyze the effect of back massage using olive oil on reducing the risk of pressure ulcers in stroke patients in the ICU at Sultan Agung Hospital. This study used a pre-experimental design with a one-group pretest-posttest approach, involving 17 respondents who received back massage using olive oil. The results showed that most respondents were aged 56-65 years (35.3%), the majority were male (70.6%), with comorbidities such as diabetes mellitus (52.9%), and the length of hospitalization was 3-5 days. Before the intervention, most respondents were categorized as being at moderate risk based on the Braden scale; however, after the intervention, the majority were no longer at risk of pressure ulcers. The Wilcoxon test showed a p-value of 0.001, indicating that back massage using olive oil had a significant effect on reducing the risk of pressure ulcers. In conclusion, back massage using olive oil is effective in reducing the risk of pressure ulcers in stroke patients in the ICU. Therefore, this technique can be used as an alternative intervention to prevent the occurrence of pressure ulcers in stroke patients.

Breast cancer is the leading cause of death globally, following heart disease and stroke. One of the most commonly used treatments is chemotherapy, which offers various benefits but also causes physical and mental side effects. One of the psychological side effects often experienced is anxiety. Extreme fear and the threat of death from cancer can affect adherence to treatment. This study aims to assess the relationship between anxiety levels and medication adherence in breast cancer chemotherapy patients at RSUD Semarang. This research used a quantitative approach with a descriptive correlational method, involving 110 participant samples. The questionnaires used for data collection were DASS-42 to measure anxiety levels and MMAS-8 to assess medication adherence. The study was conducted from June 30 to July 31, 2025, in the Oncology Center room of RSUD Sultan Agung Semarang. Bivariate analysis using Pearson's correlation test showed a p-value of 0.001 < 0.05, indicating a significant relationship between anxiety levels and medication adherence in breast cancer chemotherapy patients. The measured correlation coefficient of -0.325** shows a moderately strong negative relationship, meaning that the higher the anxiety level, the lower the patient's adherence to medication. Based on these findings, it is recommended that nurses in the oncology unit provide additional education and support to patients regarding their anxiety. Effective psychological support can help patients reduce anxiety and increase adherence to treatment, which in turn can improve the outcomes of chemotherapy treatment.

Patients admitted to the Intensive Care Unit (ICU) often experience physiological disturbances caused by both medical conditions and intensive treatment procedures. One of the most common problems encountered is sleep disturbance. Several factors contribute to poor sleep quality in ICU patients, including repeated medical procedures, environmental noise from medical equipment and staff activities, discomfort due to body positioning, frequent interactions with health workers, continuous exposure to lighting, pain, and the underlying disease process. Persistent sleep disturbances can delay the healing process, increase blood pressure, and even elevate the risk of stroke. This study aimed to analyze the relationship between anxiety levels and sleep quality in compos mentis patients in the ICU of Sultan Agung Islamic Hospital Semarang. The research design employed a correlational approach with a cross-sectional method. A total of 30 respondents were selected according to the inclusion criteria. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Hamilton Anxiety Rating Scale (HARS) to assess anxiety levels. The Chi-Square test was used for statistical analysis. The results showed an equal distribution of male and female respondents (15 each). Ten respondents had a post-laparotomy medical diagnosis, and the majority belonged to the late elderly age group (10 respondents). Most respondents experienced moderate anxiety (18 respondents), while poor sleep quality was reported by 17 respondents. The Chi-Square test revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, higher anxiety levels were associated with poorer sleep quality among compos mentis patients in the ICU. These findings highlight the importance of nursing interventions that address both the physical and psychological aspects of patients to improve sleep quality and support recovery.

Stroke is a neurological disorder that often causes severe complications, including physical and cognitive impairments. Family involvement is essential in the recovery process, especially in home-based care. This case study aims to describe the application of family nursing care to a patient with hemorrhagic stroke in Purwodadi Village, Tonjong District, Brebes Regency. Data collection methods included interviews, observations, physical examinations, and nursing documentation using the SOAP format. The intervention focused on family support in mobilization, Range of Motion (ROM) exercises, and health education. The results showed an increase in family knowledge and participation, and improvements in the patient's mobility and self-care abilities. This study confirms that family-centered nursing care is effective in improving the quality of recovery and should be integrated into community nursing practice.

Patients admitted to the Intensive Care Unit (ICU) frequently experience physiological disturbances that significantly affect their sleep quality. These disturbances are triggered by various factors, including repeated medical procedures, environmental noise, discomfort from medical devices, intensive interactions with healthcare workers, inappropriate lighting that disrupts circadian rhythms, pain, and the underlying disease process. Sleep disturbances in ICU patients may slow down the healing process, elevate blood pressure, trigger metabolic disorders, and increase the risk of serious complications such as stroke. This study aims to examine the relationship between anxiety levels and sleep quality among compos mentis patients in the ICU of Sultan Agung Islamic Hospital, Semarang. The research employed a correlational design with a cross-sectional method. A total of 30 respondents were included based on specific criteria. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using the Chi-Square test to determine the relationship between the two variables. The findings showed that the distribution of male and female respondents was balanced (15 respondents each). The most common medical diagnosis was post-laparotomy (10 respondents), with the dominant age category being late elderly (10 respondents). Anxiety levels were predominantly in the moderate category (18 respondents), while the majority of respondents demonstrated poor sleep quality (17 respondents). Statistical analysis revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, the study highlights that higher levels of anxiety are associated with poorer sleep quality among compos mentis patients in the ICU. These findings emphasize the importance of nursing interventions aimed at reducing anxiety to improve patient sleep quality and support recovery.

Introduction: The increase in life expectancy among the elderly has directly contributed to the rise in the global elderly population. According to global data, the number of elderly individuals is projected to reach 1.4 billion by 2030. This demographic growth is often accompanied by various health problems associated with aging, such as the decline in vital organ function and the emergence of degenerative diseases. One of the most common degenerative diseases among the elderly is hypertension. Hypertension is widely known as a “silent killer” because it can lead to serious complications, including stroke and heart disease, if not managed properly. A common complaint experienced by individuals with hypertension is headache, particularly in the posterior region, which significantly affects the patient’s quality of life. Management of hypertension can be carried out through pharmacological therapy with antihypertensive drugs as well as non-pharmacological interventions. One of the non-pharmacological approaches increasingly being applied is isometric handgrip exercise, which involves static muscle contractions performed at light to moderate intensity. Method:This study aimed to evaluate the effect of isometric handgrip exercise on pain reduction in patients with hypertension. The research design employed a descriptive case study involving one individual with hypertension who experienced pain complaints. The study was conducted on September 16–18, 2024, at Roujin Home X. The instruments used included observation, interview, and the provision of isometric handgrip exercise therapy. Pain measurement was carried out using a numerical rating scale before and after the intervention. Results:The three-day intervention demonstrated a significant reduction in pain levels. On the first day, the patient reported a pain score of 6, which decreased to 4 on the second day, and further declined to 2 on the third day after the intervention. Conclusion:The findings of this study indicate that isometric handgrip exercise is an effective non-pharmacological method for alleviating acute pain in patients with hypertension. This simple intervention has the potential to be applied as a complementary therapy in elderly care facilities to improve the quality of life of individuals living with hypertension.

Stroke is one of the leading causes of disability, resulting in a decline in the quality of life of its sufferers. In addition to physical impairments, stroke patients often experience anxiety, which can hinder the recovery process and lower overall quality of life. This study aims to analyze the relationship between anxiety levels and the quality of life of stroke patients. The research design used a correlational descriptive approach with a cross-sectional method. The study population consisted of stroke patients receiving care or rehabilitation in healthcare facilities, with a total sampling technique for sampling. The research instruments included an anxiety questionnaire and a quality of life questionnaire. Data analysis was performed using Somers’ d statistical test. The results showed that most stroke patients experienced moderate anxiety and had low quality of life. The Somers’ d test indicated a significant relationship between anxiety and the quality of life of stroke patients (p < 0.05). These findings suggest that the higher the anxiety level, the lower the quality of life perceived by the patients. Therefore, healthcare providers are expected to not only focus on physical therapy but also provide psychological interventions to reduce anxiety, thus improving the quality of life of stroke patients.

Stroke adalah penyebab kematian nomor dua dan penyebab kecacatan di seluruh dunia. Salah satu cara yang dapat digunakan untuk mencegah stroke pada penderita hipertensi adalah dengan menemukan dan mengendalikan faktor risiko yang dapat dimodifikasi. Tujuan penelitian ini adalah untuk mengidentifikasi gambaran faktor risiko dan tingkat risiko stroke berdasarkan stroke risk score card pada penderita hipertensi di klinik romana tanjung anom tahun 2024. Penelitian ini menggunakan rancangan bersifat deskriptif . Metode pendekatan yang digunakan adalah cross sectional. Teknik pengambilan  sampel yang digunakan accidental sampling dengan jumlah responden penderita hipertensi sebanyak 98 orang. Instrument yang digunakan dalam penelitian ini adalah Stroke Risk Score Card. Hasil penelitian lebih dari setengah penderita hipertensi memiliki tingkat risiko stroke rendah 57 orang (58,2%). Faktor risiko stroke yang dimiliki penderita hipertensi berurutan dari faktor risiko terbanyak yaitu tekanan darah tinggi 66 orang (67,3%), pemalas / tidak pernah olahraga 56 orang (57,1%), hiperkolestrolemia 30 orang (30,6%), Overweight 30 orang (30,6%), atrial fibrilasi tidak teratur 11 orang (11,2%), perokok 9 orang (9,2%), riwayat diabetes mellitus 6 orang (6,1%), dan riwayat stroke dalam keluarga 5 orang (5,1%). Sebagian besar penderita hipertensi memiliki risiko rendah terkena stroke. Pencegahan primer merupakan upaya penting untuk mencegah stroke, sehingga dianjurkan untuk dilakukan secara rutin.

Hypertension is a non-communicable disease (NCD) with a high prevalence in Indonesia and is a major cause of serious complications, such as stroke, kidney failure, and heart disease. The high incidence of hypertension makes this disease a primary focus of NCD control efforts at the primary healthcare level. The Ulee Kareng Community Health Center has implemented a sustainable hypertension control program for the past three years with the aim of reducing the incidence of complications and improving patients' quality of life. This study aims to evaluate the implementation of the hypertension control program using a logic model framework that encompasses five aspects: input, process, output, outcome, and impact. The research method used is descriptive analytic with a mixed methods approach, combining quantitative and qualitative data to obtain a comprehensive overview of program implementation. The results indicate that the hypertension control program at the Ulee Kareng Community Health Center has had a positive impact. In terms of output and outcome, there has been an increase in patient compliance with therapy prescribed by healthcare professionals, a decrease in blood pressure in the majority of patients, and a decrease in the number of hypertension-related complications. This indicates that the program is quite effective in achieving its intended goals. However, several challenges remain. The main problems lie in the suboptimal data recording system and the suboptimal delivery of health education. To improve the program's effectiveness in the future, recommendations include strengthening the monitoring and evaluation system, increasing the capacity of health workers and cadres through training, and developing innovative media and educational strategies to make information more easily understood and applied by the public.

Magnetic Resonance Imaging (MRI) with Arterial Spin Labeling (ASL) is a non-invasive technique commonly used to assess cerebral perfusion, especially in stroke patients. However, ASL images often suffer from low contrast and high noise, which can hinder diagnostic accuracy in visualizing perfusion areas and detecting ischemic lesions. Image enhancement techniques, such as the unsharp mask, offer a potential solution to improve image quality. The effectiveness of this enhancement depends on the kernel size used in the unsharp mask filter. This study evaluates the impact of different kernel sizes (3×3, 5×5, and 7×7) on the quality of ASL brain images, focusing on both quantitative and qualitative improvements. A total of 63 ASL brain MRI images from stroke patients were processed using unsharp mask filters with the three kernel sizes. Quantitative analysis measured Signal-to-Noise Ratio (SNR) and Contrast-to-Noise Ratio (CNR), while qualitative assessment involved three radiologists independently evaluating five aspects of image quality: perfusion area clarity, grey-white matter contrast, ischemic lesion boundary visibility, noise level, and overall visual quality. Statistical tests, including Friedman and Wilcoxon, were applied to compare results across the kernel sizes. Results revealed that the 3×3 kernel achieved the best results in both quantitative and qualitative assessments, with the highest SNR, CNR, and visual quality scores. Significant differences (p < 0.05) were found between kernel sizes, confirming the superiority of the 3×3 kernel. The 7×7 kernel reduced noise but caused oversmoothing, negatively impacting image sharpness. In conclusion, the 3×3 kernel provides an optimal balance between noise reduction and edge preservation, enhancing ASL brain image quality for stroke diagnosis.

Hypertension is a global health problem that plays a major role as a leading cause of premature death because it can lead to various serious cardiovascular complications, such as stroke, heart failure, and chronic kidney disease. This condition is often characterized by complaints of severe headaches, especially in the nape of the neck, due to increased blood flow to the brain. In addition to medical therapy in the form of antihypertensive drugs, complementary therapies are also needed to support blood pressure reduction and improve the patient's quality of life. One method that has proven effective is slow deep breathing, a slow, deep breathing technique that helps activate the parasympathetic nervous system, reduce sympathetic activity, improve tissue oxygenation, and produce a relaxation effect that is beneficial in lowering blood pressure and reducing pain. This paper aims to describe the experience of nursing care for hypertensive patients using slow deep breathing therapy. The research method used is a quantitative descriptive with a case report design that is carried out through the stages of assessment, establishing a nursing diagnosis, intervention, implementation, and evaluation. Research data were obtained through interviews, direct observation, and physical examination. The results showed that after three consecutive days of therapy, the patient's pain scale decreased from 5 (moderate pain category) to 2 (mild pain category), while blood pressure, which was initially at 196/122 mmHg, successfully decreased to 140/90 mmHg. These results indicate that slow deep breathing plays an important role in lowering blood pressure and improving the comfort of hypertensive patients. In conclusion, slow deep breathing can be used as a simple, safe, inexpensive, and effective non-pharmacological intervention, and is highly recommended for patients to practice independently in their daily lives to prevent worsening hypertension and optimize disease control efforts.

Elevated blood cholesterol levels are known to be a major risk factor for cardiovascular disease. Hypercholesterolemia can trigger atherosclerosis, which in turn increases the risk of coronary heart disease and stroke. One approach to managing cholesterol levels is through the use of natural ingredients with antihyperlipidemic activity. White turmeric (Curcuma zedoaria Rosc) is an herbal plant long used in traditional medicine and contains bioactive compounds such as curcuminoids and essential oils. These compounds are reported to have antioxidant and anti-inflammatory activities, as well as potential as agents for lowering blood lipid levels. Herbal-based therapies are increasingly considered as safe alternatives to synthetic drugs in managing hyperlipidemia. This study aims to evaluate the effectiveness of a microencapsulated preparation of white turmeric ethanol extract in reducing total cholesterol levels in male rats (Rattus norvegicus) induced by a high-fat diet. The study was conducted experimentally using 25 rats divided into six treatment groups. The groups consisted of normal controls, negative controls, positive controls using simvastatin, and three treatment groups given white turmeric extract microcapsules at concentrations of 0.25%, 0.50%, and 0.75%. The microencapsulation technique was applied to improve the stability and bioavailability of the turmeric extract. Cholesterol levels were measured before and after treatment. The results showed that the treatment group with the 0.25% concentration produced the most significant cholesterol reduction, from 110 mg/dL to 59 mg/dL. These findings indicate that even at a relatively low concentration, microencapsulated turmeric extract can significantly reduce cholesterol levels in vivo. Therefore, it can be concluded that white turmeric extract in microcapsule form is effective in lowering total cholesterol levels, especially at the 0.25% dose. This suggests that Curcuma zedoaria microcapsules hold promise as a natural therapeutic option for managing hypercholesterolemia and reducing cardiovascular risk.  

This Community Service Program is entitled "Health Education Services to Prevent Hypercholesterolemia in Students at the H. Nur Abdullah Al-Qur'an Memorization Islamic Boarding School." Hypercholesterolemia is a medical condition characterized by high blood cholesterol levels, which can increase the risk of heart disease and stroke. This disease can be prevented and managed with lifestyle changes and appropriate medication. The goal of this Community Service Program is to increase students' awareness and knowledge of hypercholesterolemia and provide education on effective prevention and management methods. This Community Service Program is conducted through health counseling, health checks, and education on healthy lifestyles. The target students in this study were students from the H. Nur Abdullah Al-Qur'an Memorization Islamic Boarding School. Prior to the counseling session, 50 students were given a pre-test questionnaire regarding their knowledge of hypercholesterolemia. After the counseling session, a post-test questionnaire on hypercholesterolemia was administered, which showed an increase in knowledge, as evidenced by the post-test results. Following the counseling and health examinations, the students targeted in this study, from the Nur Abdullah Al- Quran memorization Islamic boarding school, showed increased awareness and knowledge about hypercholesterolemia. Most participants also demonstrated healthier lifestyle changes, such as increasing fruit and vegetable consumption and engaging in regular physical activity. This Community Service Program (PKM) demonstrates that health education and counseling can increase the awareness and knowledge of hypercholesterolemia among the students targeted in this study, from the Nur Abdullah Al-Quran memorization Islamic boarding school. Therefore, the students targeted in this community service session, from the Nur Abdullah Al-Quran memorization Islamic boarding school, can effectively implement prev ention and management strategies to reduce the risk of heart disease and stroke.

Dyslipidemia is a lipid metabolism disorder characterized by elevated levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) accompanied by decreased levels of high-density lipoprotein (HDL). This condition is a major risk factor for atherosclerosis, coronary heart disease, and stroke. One plant with potential as an antidyslipidemic agent is bay leaves (Syzygium polyanthum). These leaves are known to contain active compounds such as flavonoids, saponins, tannins, alkaloids, and polyphenols that have antioxidant and hypolipidemic activities. The potential of natural compounds from medicinal plants to reduce blood cholesterol levels has gained significant attention in recent years. This study aims to evaluate the effectiveness of microencapsulated ethanol extract of bay leaves in reducing total cholesterol levels in white rats (Rattus norvegicus) induced by a high-cholesterol diet. The experimental study design employed was a laboratory-based true experimental method with a post-test control group design. A total of 25 male rats were used and divided into six groups: normal control, negative control (high cholesterol diet without therapy), positive control (simvastatin), and three groups treated with bay leaf extract microencapsulates at doses of 0.25%, 0.5%, and 0.75%. The treatment was given for 14 days, then total cholesterol levels were measured using an enzymatic method. The results showed that the group with a dose of 0.75% experienced the highest decrease in total cholesterol levels, namely -70 mg/dL, greater than the simvastatin group (-49 mg/dL). Statistical analysis using One Way ANOVA showed a significant difference compared to the negative control (p < 0.001). These findings indicate that the 0.75% dose of microencapsulated Syzygium polyanthum extract demonstrated an effect equal to or greater than simvastatin. Thus, it can be concluded that bay leaf ethanol extract microencapsulates are effective in reducing total cholesterol levels in hypercholesterolemic rats. This suggests that Syzygium polyanthum microencapsulation has the potential to be developed as an alternative phytotherapy for cholesterol reduction.

Hypertension is a Non-Communicable Disease (NCD) whose prevalence continues to increase from year to year, especially in the elderly. This condition is a serious challenge in the field of public health because hypertension can increase the risk of cardiovascular disease, stroke, and kidney failure if not properly managed. The high incidence of hypertension in the community, especially in Grujugan Hamlet, RT. 07–10, Bantul Village, has become a concern in community-based promotive and preventive efforts. Therefore, this community service activity aims to increase the knowledge and awareness of the elderly about hypertension through a direct screening and health education approach. The implementation method includes blood pressure checks (initial screening), counseling using educational media such as leaflets, posters, and interactive presentations, and evaluation of understanding through filling out pre- and post-tests. A total of 24 elderly people participated as respondents in this activity. The screening results showed that the majority of participants (62.5%) were in the Hypertension Level 2 category, while the other 8.3% were in the Hypertension Crisis category. Before the education, pre-test results showed that 58.3% of elderly people had low knowledge about hypertension. However, after the education, 75% experienced an increase to a high level of knowledge. Statistical analysis using the Wilcoxon Signed Rank test showed a significant difference between pre-test and post-test scores (p < 0.001), indicating that the health education provided was effective in improving participants' understanding. This activity has had a positive impact on improving health literacy and can serve as the basis for developing sustainable, community-based, participatory hypertension prevention programs.

ST-Elevation Myocardial Infarction (STEMI) is one of the manifestations of acute coronary syndrome (ACS) and is a leading cause of disability and death worldwide. The mortality rate for STEMI is reported to reach 6%–14% of all ACS deaths. Reperfusion therapy is the primary treatment, with fibrinolytics an important option, especially in healthcare facilities that do not have the capacity to perform primary Percutaneous Coronary Intervention (PCI) in less than 12 hours. The success of fibrinolytics is influenced by various risk factors, such as hypertension, dyslipidemia, diabetes mellitus, a history of heart disease, and the duration of the attack. This study aims to determine the relationship between these factors and the success rate of fibrinolytics in STEMI patients. This study used a retrospective descriptive design with a cross-sectional method. The sampling technique used total sampling of patients diagnosed with STEMI and receiving fibrinolytic therapy according to inclusion and exclusion criteria at Dr. Fauziah Hospital. Statistical analysis was performed using the Chi-Square correlation test to assess the relationship between clinical variables and fibrinolytic success. The results showed no significant association between hyperglycemia (p = 0.823), hypertension (p = 0.240), or a history of heart disease (p = 0.704) and fibrinolytic success. Similarly, the onset of stroke variable did not show a significant association with reperfusion outcomes. In conclusion, classic risk factors such as hyperglycemia, hypertension, and a history of heart disease were not associated with fibrinolytic success in STEMI patients at Dr. Fauziah Hospital. These results suggest that fibrinolytic success is likely influenced by other factors, such as timing of drug administration, protocol adherence, and individual variation in response to therapy. Further research with a larger sample size and a prospective design is recommended to strengthen these findings.

Excessive fat consumption can lead to increased cholesterol levels in the body, which in turn can trigger various serious health problems, including heart disease, blood vessel blockage, and even stroke. Blood cholesterol consists of two main types: LDL (Low-Density Lipoprotein) cholesterol, often referred to as bad cholesterol, and HDL (High-Density Lipoprotein) cholesterol, which plays a role in transporting cholesterol from the blood vessels to the liver for excretion. Elevated LDL cholesterol levels can cause plaque buildup on blood vessel walls, which narrows blood flow and increases the risk of various cardiovascular diseases. One method considered effective for lowering LDL cholesterol levels in the blood is by consuming phytosterols, compounds found naturally in various types of plants. Phytosterols have a structure similar to cholesterol and can compete with cholesterol for absorption in the intestine. This results in a decrease in the amount of cholesterol entering the body, thereby reducing total cholesterol levels and especially LDL cholesterol in the blood. Research shows that giving food or supplements containing about 3 grams of phytosterols per day to human subjects can reduce LDL cholesterol levels by up to 15%. Furthermore, phytosterols directly isolated from plants, such as green beans, have also been shown to significantly lower LDL cholesterol levels. Studies in mice fed phytosterols isolated from green beans showed a reduction in blood LDL cholesterol levels of more than 30%. This demonstrates the potential of phytosterols as a natural ingredient that can be used to support cholesterol management in the body. Although phytosterols have significant potential in lowering cholesterol levels, it is important to remember that consuming supplements or foods containing phytosterols should be done under the supervision and recommendation of a medical professional, especially for individuals with certain medical conditions or who are taking medications.  

Camshaft lift is an important parameter that determines the height of the valve lift, calculated from the valve position when it is completely closed to the fully open position. This component plays a crucial role in regulating the flow of the air and fuel mixture into the combustion chamber. This study aims to improve the performance of a 200cc 4-stroke motorcycle engine through camshaft lift modification, which is expected to affect the characteristics of engine torque and power. Modifications were carried out by designing two types of modified camshafts, namely series A and series B, as a comparison to the standard camshaft. The research method used is experimental testing using a dynamometer to measure engine torque and power at various speeds, ranging from 4,000 to 10,000 RPM. The data obtained were analyzed to determine the effect of each type of camshaft on engine performance. The test results show that the B series camshaft provides the most significant performance improvement compared to the standard and A series camshafts. At 7,500 RPM, the standard camshaft produces an average torque of 19.2 Nm, the A series camshaft 19.6 Nm, while the B series camshaft reaches 21.2 Nm. Meanwhile, at 10,000 RPM, the average power of the standard camshaft is recorded at 22.2 HP, the A series camshaft 24.1 HP, and the B series camshaft reaches 26.3 HP. This increase indicates that the camshaft lift modification is able to optimize the duration and height of the valve opening, so that the supply of the fuel and air mixture to the combustion chamber becomes more efficient. Thus, camshaft modification, especially the B series, is an effective and applicable solution in increasing the performance output of a 200cc motorcycle engine without having to make major changes to the overall engine structure.

Background : Self-management of hyperglycemia refers to a series of efforts carried out independently by individuals suffering from diabetes or hyperglycemia to manage and control their health condition. These efforts include regulating diet, physical activity, medication adherence, blood glucose monitoring, and preventive measures to avoid complications. Such complications may include vascular issues like heart disease and stroke, as well as neuropathic problems such as nerve damage. Proper implementation of self-management practices can help stabilize blood glucose levels and significantly improve the overall quality of life for patients. General Objective : This study aims to examine the effect of self-management on the risk of complications in patients with hyperglycemia in the working area of the Kandangan Health Center, Kediri Regency.Research Method : This research utilized a quasi-experimental design with a one-group pretest-posttest approach accompanied by a control group. The sampling technique applied was probability sampling using simple random sampling, involving a total of 45 respondents. The research instruments included the Diabetes Self-Management Questionnaire (DSMQ) and observation sheets to assess the risk of complications. The study population consisted of all hyperglycemic patients residing in Putuk Hamlet, Banaran Village, Kandangan District, Kediri Regency. Data processing was carried out through editing, coding, and tabulation, followed by data analysis using the Wilcoxon statistical test. Results : The Wilcoxon test results showed a significance value of p = 0.000 (p < 0.05), indicating a significant effect of self-management on reducing the risk of complications in hyperglycemic patients. Therefore, the alternative hypothesis (H1) was accepted. Recommendation : The implementation of self-management in hyperglycemic patients is essential to prevent long-term complications. Thus, healthcare professionals, especially nurses, are encouraged to provide continuous education regarding diabetes self-management. This will enable patients to manage their health conditions independently and reduce the risk of further complications.