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This study aims to determine the prevalence of refractive errors in children with Down Syndrome in eye examination activities carried out during Down Syndrome Awareness Month 2023 by the East Java Association of Parents of Children with Down Syndrome (PIK POTADS). A total of 30 children with Down Syndrome underwent eye examinations, and the results showed that 18 children (72%) had myopia, 7 children (28%) had astigmatism, and 5 children were indicated to require further referral to a pediatric ophthalmologist. These results indicate that children with Down Syndrome have a high risk of experiencing refractive errors, so regular eye examinations and medical follow-up are needed.

This study aims to determine the prevalence of refractive errors in children with Down Syndrome in eye examination activities carried out during Down Syndrome Awareness Month 2023 by the East Java Association of Parents of Children with Down Syndrome (PIK POTADS). A total of 30 children with Down Syndrome underwent eye examinations, and the results showed that 18 children (72%) had myopia, 7 children (28%) had astigmatism, and 5 children were indicated to require further referral to a pediatric ophthalmologist. These results indicate that children with Down Syndrome have a high risk of experiencing refractive errors, so regular eye examinations and medical follow-up are needed.

Non-hemorrhagic stroke or commonly called ischemic stroke is a functional disorder of the body area due to decreased brain function caused by blockage of cerebral blood vessel flow. One of the modalities in radiology that can diagnose non-hemorrhagic stroke cases is computer tomography (CT). To get good image quality, one of them is by doing increment reconstruction. Increment reconstruction is the distance between reconstruction images in volume data. Increment reconstruction is grouped into three, namely increment overlapping, increment contiguous and increment gap. The type of research used is quantitative research with an experimental approach. The sample of this study used 10 patients who underwent CT scan examination of the head with non-hemorrhagic stroke cases in June-August 2023 in the Radiology Unit of RSAD TK II UDAYANA DENPASAR BALI. The findings of this study indicate that when using different increment reconstruction techniques, anatomical image information will vary. The results of the total Friedman test which shows a p value of 0.000 (<0.05) provide evidence of this. A p value of 0.000 was found (p value <0.05) based on differences in overall anatomical image information, indicating that there is a difference between non-hemorrhagic stroke cases and head CT scans. Of the four variations of increment reconstruction, variation 3 with a reconstruction increment of 2.5 mm has the largest mean rank value (3.23) so it is the most ideal anatomical image information.

Background: Cerebral venous thrombosis (CVT) is a form of stroke when blood clots develop in the (venous sinus) of the brain. This condition causes the blood that flows into the brain to be unable to flow out. This can cause reduced blood flow to the brain and damage or kill brain cells if not treated properly. The research aims to determine the digital subtraction angiography (DSA) examination procedure of cerebral veins with trans-radial access in cases of cerebral venous thrombosis (CVT). Method: This type of research is qualitative research with a case study approach. Data was collected on July 20 2023.The research subjects were doctors, interventional radiology doctors, and scrub nurses. By conducting observations, interviews and documentation of the implementation team involved. Results: From the results of observations, documentation and interviews with the implementing team, results were obtained regarding the Cerebral Vein Digital Subtraction Angiography (DSA) examination procedure with transradial access in cases of Cerebral Venous Thrombosis (CVT), including several sub-topics. The Cerebral Digital Subtraction Angiography (DSA) examination procedure with Transradial access is the right action for patients regarding immobility and shorter hospital stays. Conclusion: The Cerebral Vein Digital Subtraction Angiography (DSA) examination procedure with transradial access in cases of Cerebral Venous Thrombosis (CVT) includes patient preparation, tools and materials, examination techniques and post-action care. The Cerebral Vein Digital Subtraction Angiography (DSA) examination procedure with Transradial access is the right action for patients regarding patient immobility and shorter duration of hospital stay. The implementation team consists of a radiology specialist, a scrub nurse and no radiographers involved in the DSA examination room.

Use Of Fat Saturation (FS) Sequences In MRI Knee Joint Examination Of Osteosarcoma Cases At Installation Radiology Hospital In Jakarta. Magnetic Resonance Imaging (MRI) is one of the medical support modalities used by doctors to diagnose a disease. MRI is capable of producing high resolution images of soft tissue and is capable of displaying various cuts (sagittal, axial, coronal and oblique) using high-strength magnetic fields and nuclei resonances of hydrogen atoms. Fat saturation is used to detect or extract signals from adipose tissue. Three methods can be used to achieve leanness: lean saturation, investment mulihan, and leaning phase. Fat sat is an umbrella term that encompasses several techniques, each with its own unique advantages, disadvantages, and strengths. During the MR imaging process, proton lipids and hydrogen protons from the air have different behaviors, and fat suppression techniques.The knee joint is a hinge joint with changes and is formed by both femoral condyles that are jointed with the superior surface of the tibia condyles. The patella is located above the smooth pateller surface of the femur and above that the patella slides as the joint moves. Osteosarcoma is a relatively common middle to high grade malignant soft tissue tumor, often with an early course affecting young patients, and most often involving soft tissue.

The service provided to women during pregnancy is ANC services. The aim of this ANC examination is to reduce the number of deaths and morbidity rates in pregnant women. This study aims to determine the relationship between knowledge and attitudes of pregnant women with antenatal care visits at BPM Sukianti Kec. Sinaboi District. Rokan Hilir 2023. This type of research is an analytical survey with a cross-sectional research design. The population is a total sampling, namely all pregnant women in BPM Sukianti District. Sinaboi District. Rokan Hilir in 2023 as many as 30 people. The data analysis technique uses chi square. The results obtained in this study were mostly good knowledge with 18 people attending antenatal care visits (60%) and positive attitudes of pregnant women with 18 people completing antenatal care visits (60%). Based on the results of the chi square test, there is a relationship between pregnant women's knowledge and antenatal care visits with a P value = 0.002 < 0.05, there is a relationship between pregnant women's attitudes and antenatal care visits with a P value = 0.008 < 0.05. The conclusion is that there is a relationship between knowledge and attitudes of pregnant women and antenatal care visits. It is recommended that pregnant women provide antenatal care services according to standards and in a complete manner so that they can reduce the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia.

Soft Tissue Neck MRI Examination Technique With Liposarcoma Clinical At The Mayapada Hospital Installation, South Jakarta. MRI examination techniques have a very important role in the medical field because of their ability to produce visual images of the body's soft tissue and metabolic processes. Liposarcoma is a malignancy of mature fat cells in the connective tissue space1. Liposarcoma is the most common type of soft tissue sarcoma, appearing slowly, enlarging, painless, non-ulcerated submucosal mass in middle-aged people, some lesions grow rapidly and become ulcerated early, Liposarcoma is a rare malignant tumor. The purpose of this examination is to find out whether the image results produced using the sequence at Mayapada Hospital can produce a firm image in confirming the diagnosis of liposarcoma. This research is a qualitative study with a case study method using 3 patients who underwent an MRI examination of neck soft tissue with clinical liposarcoma. Data was collected using observation, documentation and interviews with radiographers and radiologists. The results of the data that have been collected can be concluded that the results of the soft tissue MRI examination of the neck with clinical liposarcoma carried out at Mayapada Hospital, South Jakarta are good in confirming the diagnosis and the results of a more detailed anatomical picture.

An audit is a systematic, independent examination of financial statements, accounting records, and supporting documents prepared by management, the purpose of which is to form an opinion on the accuracy of financial statements. Financial statements must have relevant characteristics (reliability) and reliability (reliability). Without the services of auditors, management cannot convince outsiders that the financial statements presented by management contain reliable and reliable information. Independence is the auditor's attitude to impartiality. The experience of the examiner contributes to high-quality inspection. The purpose of this study is to analyze the influence of auditor behavior, time pressure, audit experience, and independence on audit quality.   The research was conducted at a Public Accounting Firm (KAP) in Medan City. The number of research samples of 80 people was selected by the nonprobability sampling method. Data collection was carried out by questionnaire through Google form and literature studies that supported this study. The method used in this study is to use the Structural Equation Model (SEM) equation using the Partial Least Square (PLS) tool version 3.0. PLS consists of external relationships (outer model) and internal relationships (inner model), cross-loading> 0.7, Composite Reliability, Convergent Validity, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Based on the results of the analysis, it was found that the first, second, fourth, and seventh hypotheses were rejected where each variable such as auditor behavior, and time pressure,  did not affect audit quality and independence could not moderate the influence between auditor behavior on audit quality,  independence could not moderate audit quality. The third, fifth, and sixth hypotheses are accepted where each variable such as audit experience, independence moderates the effect of time pressure on audit quality, and independence moderates the effect of audit experience on audit quality.

This research aims to describe the effectiveness of mediation as an alternative to out-of-court business dispute resolution. This research was conducted using the literature study method. The results show that the use of mediation as an alternative to out-of-court dispute resolution has effectiveness because in the implementation of non-litigation mediation, the examination of the two parties is carried out behind closed doors (not open to the public). Thus, the positive impact is that the credibility and reputation of the parties to the dispute are maintained. In addition, compared to the litigation process, out-of-court mediation is relatively cheaper, less complicated, and does not take a long time. On the other hand, out-of-court mediation pays great attention to the continuity of the parties' relationship in the future. This is the reason why business people favor out-of-court mediation as an alternative to resolving their business disputes.

Background: CT scans are used for various types of examinations such as examinations of the head, thorax, abdomen and so on. The most frequently performed CT scan is a CT scan of the head. However, in the medical field, especially radiology, CT scans have the highest dose compared to other radiation equipment. Efforts to reduce radiation doses and radiation effects are by estimating the correct dose given to CT Scan patients using an optimization index called DRL (Diagnostic Level Reference), namely by evaluating the values ​​of CTDIvol and DLP on CT scans of the head, which have been determined in accordance with BAPETEN/I-DRL 2021 standards. Method: This research is a descriptive quantitative study with an observational approach which aims to analyze CTDIvol and DLP values ​​based on retrospective data on non-contrast brain CT scans at the Radiology Installation at Hospital X, Central Jakarta. Results: Calculation of the 2nd quartile (50th percentile) value of CTDIvol and DLP in Adult Non-Contrast Brain CT Scan examinations for the January-December 2022 Period at the Radiology Installation at X Hospital, Central Jakarta is CTDIvol 55.51 mGy and DLP 867.00 mGy* cm. Conclusion: The 50 percentile value of CTDIvol and DLP in the Adult Non-Contrast Brain CT Scan examination for the January-December 2022 period at the Radiology Installation at X Hospital, Central Jakarta is in accordance with the standards set by BAPETEN/I-DRL 2021. Where is the value for CT Non-Contrast Head Scan, namely a CTDIvol value of 60 mGy and a DLP value of 1275 mGy*cm.

Kucing merupakan hewan yang sangat banyak di gemari sebagai hewan peliharaan di rumah. Kucing dapat menularkan penyakit zoonosis yaitu toxoplasma yang di sebabkan oleh parasit Toxoplasma gondi. Toxoplasma gondi merupakan parasit intraseluler dari golongan protozoa yang bersifat parasit obligat, di mana kucing berperan sebagai hospes definitive. Fases kucing diambil di perumahan citramas dan kampung tengah, fases kucing selanjutnya dilarutkan kedalam aquadest kemudian dihomogenkan, setelah itu diamati dibawah mikroskop. Hasil pengamatan yang dilakukan di laboratorium menunjukkan di perumahan kampung tengah terdapat 2 kucing yang terinfeksi parasit Toxoplasma gondii dan di perumahan citramas tdk ditemukan kucing yang terinfeksi parasit ini. Terinfeksinya kucing di kampung tengah kemungkinan diakibatkan oleh lingkungan yang kotor dan makanan (daging dan Ikan) dikonsumsi oleh kucing tersebut masi setangah matang. Pada penelitian ini diharapkan dapat menjadi edukasi bagi masyarakat agar dapat memperhatikan lingkungan dan makanan yang di konsumsi oleh kucing tersebut.

Kucing merupakan hewan yang sangat banyak di gemari sebagai hewan peliharaan di rumah. Kucing dapat menularkan penyakit zoonosis yaitu toxoplasma yang di sebabkan oleh parasit Toxoplasma gondi. Toxoplasma gondi merupakan parasit intraseluler dari golongan protozoa yang bersifat parasit obligat, di mana kucing berperan sebagai hospes definitive. Fases kucing diambil di perumahan citramas dan kampung tengah, fases kucing selanjutnya dilarutkan kedalam aquadest kemudian dihomogenkan, setelah itu diamati dibawah mikroskop. Hasil pengamatan yang dilakukan di laboratorium menunjukkan di perumahan kampung tengah terdapat 2 kucing yang terinfeksi parasit Toxoplasma gondii dan di perumahan citramas tdk ditemukan kucing yang terinfeksi parasit ini. Terinfeksinya kucing di kampung tengah kemungkinan diakibatkan oleh lingkungan yang kotor dan makanan (daging dan Ikan) dikonsumsi oleh kucing tersebut masi setangah matang. Pada penelitian ini diharapkan dapat menjadi edukasi bagi masyarakat agar dapat memperhatikan lingkungan dan makanan yang di konsumsi oleh kucing tersebut.

One of the easiest ways to detect cervical cancer early is with a visual examination of acetic acid. Early detection of cervical cancer by visual examination with acetic acid is guaranteed by the government, namely BPJS Kesehatan, and is included in the national health insurance program. The purpose of the study was to determine the low participation of women of childbearing age in acetic acid visual examination by UPT Puskesmas Timpah. The method used in this study is descriptive research. Questionnaires made by purposive sampling technique are used as data collection instruments; The maximum number of samples in the study sample is 30 samples. The respondents of this study were women of childbearing age. The results showed that based on respondents' knowledge of information, 26 respondents were uninformed (86.66%), 20 respondents (93.33%) did not support men. In the field of education, 21 people were found to have elementary and junior high school education as much as 70%, in the support of officers it was found that 20 people did not support (66.67%). Regarding access to information, it is known that 22 people did not get any assistance to get information (73.33%).    

Procedure For Magnetic Resonance Spectroscopy Examination Technique In Brain Tumor Cases At The Radiology Installation Of Pertamina Central Hospital Jakarta. MR spectroscopy is one way of describing metabolites in tumor tissue without being invasive. Single spectroscopic approach, which is used in Magnetic Resonance Spectroscopy and is the most common spectral collection method in MRI modalities. MRi is the establishment of a medical diagnosis based on the principle of magnetic resonance. MRI aircraft produce images in various pieces namely coronal, sagittal, and transverse by not at all using x-rays that produce radiation and also using radioactive substances. Brain tumors are abnormally growing brain tissue cells originating from the brain or meningens, which are benign or malignant tumors that make massive pressure. MRS is a unique non-invasive sequence that helps in the identification of lesion molecules and the difference between malignant and benign lesions. In MRI examination of the brain with tumor cases there are several sequences used, namely Se / Fse Pd / T2, Se / Fse / incoherent spoiled, (DWI) diffusion weighted imaging (1) According to Elmaoglu (2), imaging techniques that can be used for MRI brain tumor cases include axial T1 spin echo, T2 fast recovery fast spin echo, T2 FLAIR, coronal T1 and T1 Axial post contrast injection,  T1 coronal, and T1 sagittal, diffusion weighted imaging (DWI), magnetic resonance angiography, and magnetic resonance spectroscopy. In taking SVS LESION localizer must be precise on tumor tissue not taking part that is not part of the tumor, analyze tumor area and take SVS NORMAL localizer on other healthy tissue.

Adolescent nutritional problems are a continuation of childhood nutritional problems such as iron deficiency anemia. Prolonged iron deficiency can cause anemia. Teenagers need more to replace iron lost along with menstrual blood. Anemia in adolescent girls is currently still high, according to WHO, the world prevalence of anemia ranges from 40-88%. The majority of students at SMP Negeri 5 Nekamese are young women who are vulnerable to suffering from anemia, so it is necessary to conduct anemia education and measure hemoglobin (Hb) in young women. The aim of this community service is to increase the knowledge of young women about anemia and school health so that it becomes a healthy and anemia-free school. The empowerment method in this community service activity uses the Question and Answer Lecture method. Counseling was conducted for young women in grades 7, 8 and 9 at SMP Negeri 5 Nekamese on September 9 2023, which was attended by 30 young women. The activity began with preparations for making an examination stand, distributing leaflets, explaining material or counseling using the lecture method of question and answer and evaluation. Before the counseling is carried out, a pre-test is carried out, then after the counseling a post-test is carried out. The implication of this community service activity is an increase in young women's knowledge about anemia and healthy schools. It is hoped that after carrying out this activity, young women can prevent anemia during adolescence by increasing their food consumption patterns to be diverse, nutritious, balanced and safe.

Hemorrhoids are swellings of tissue containing veins located in the walls of the rectum and anus. Mass or bulge in the anal area accompanied by anal bleeding is the main symptom. Proper diagnosis and management of hemorrhoids is very important to reduce morbidity and improve the patient's quality of life. This case report was obtained from primary data through history taking, physical examination and supporting examination. The patient complains of a lump in the anus accompanied by bloody stools since 5 years. Initially the lump came out if the patient strained and could still go in on its own if the patient was not straining anymore. But since 1 year, the lump can't go in on its own, but must be helped to push it with a finger. Heavy bleeding from the anus since 2 months ago. On physical examination the rectal toucher found: good anal sphincter tone, palpable mass with a flat surface, solid, chewy consistency, reddish color, firm boundaries, tenderness (+), lumps can be inserted with fingers, blood on gloves (-), mucus (-), feces (-). Colonoscopy examination revealed grade III internal hemorrhoids. The treatment is hemorrhoidectomy.

Background: Kidney stones (nephrolithiasis) are solid masses formed from urine precipitated crystals. The formation of stones is caused by increased calcium, oxalate and uric acid content in the body, scans to view kidney stones (nephrolithiasis) can be performed with or without contrast. Non-contrast CT urography is the imaging modality of choice for the initial evaluation of patients with suspected urolithiasis, as it has a sensitivity of up to 98% and specificity of 96-98%. Components that affect image quality in CT scans are spatial resolution, contrast resolution, and noise. One of the important parameters in image quality is the selection of slice thickness. Spatial resolution is the ability to show objects or organs with a high level of contrast. Noise is the standard deviation percentage of the sum of pixel values obtained from the waterbath image. Methods; This type of research is quantitative research with an experimental approach to analyze the effect of slice thickness variations on image quality using variations of 2 mm, 3 mm, 4 mm, 5 mm, and 6 m. The data were collected in August 2023 with 10 samples. Data were collected in August 2023 with 10 samples. Researchers took urographic CT scan examination data with a diagnosis of nephrolithiasis. Results and Conclusion: With the results of the research conducted, it can be concluded that in the overall Friedman test results there is an effect of using slice thickness variations on image quality in urographic CT Scan examinations with nephrolithiasis diagnoses. using slice thickness variations. Based on the results of this study, the researcher can recommend on CT Scan urography with nephrolithiasis diagnosis using 4 mm slice thickness to get good and optimal image quality results.

Introduction : Mastoiditis is inflammation that occurs in the mastoid bone located in the temporal bone. Mastoiditis can affect all ages, both children and adults. The most frequent cause of the disease is stressptococcus pneumonia. This disease requires surgery as soon as possible. Mastoiditis can develop into a bezold abscess if left untreated. Case report: This case report is about a 31-year-old male patient complaining of swelling the size of a marble seed on the bone behind the right ear ± 1 week, swelling from the protruding bone behind the right ear to the neck. Swelling is accompanied by pain, redness, fluctuations (+), fever that disappears and decreased hearing function. Conclusion: The patient has a bezold abscess preceded by mastoiditis. The diagnosis in this patient is based on history, physical examination, and supporting examinations in the form of laboratory and mastoid X-rays with stenvers and schuller positions. In patients carried out drainage measures of abscesses as well as pharmacotherapy administration.

Mitral stenosis (MS) is a heart valve disorder in which the mitral valve (located between the left atrium and left ventricle) becomes narrowed or hardened, blocking blood flow from the left atrium to the left ventricle. Coronary angiography (CAG) is an invasive diagnostic technique used to evaluate the condition of the coronary blood vessels in patients with acute transmural myocardial infarction (MI). Coronary Angiography (CAG) examination in cases of Severe Mitral Stenosis (MS) Severe involves patient preparation, equipment preparation, medical team, examination procedures, post-action care, description of examination results, and its role in the management of Severe (MS) Patient preparation involves patient education about procedures, fasting before examination, renal function checks, medication adjustments, vascular access preparation, discussion of contrast agents, and vital monitoring. Narrowing of the heart's mitral valve is a pathological condition in which this narrowing inhibits blood flow from the left atrium to the left ventricle. Coronary angiography (CAG) plays an important role in clinical evaluation and therapeutic planning. Background: Mitral stenosis (MS) is a heart valve disorder in which the mitral valve (located between the left atrium and left ventricle) becomes narrowed or hardened, blocking blood flow from the left atrium to the left ventricle. This can increase pressure in the left atrium and reduce the amount of blood pumped throughout the body. Because MS is associated with increased left atrial pressure and can affect overall cardiac hemodynamics, it is important to understand how this condition may interact with coronary artery pathology. This research method is a literature review study, where literature exploration is carried out in various databases with keywords such as Coronary Angiography, Severe Mitral Stenosis Cases. Results: Coronary Angiography (CAG) examination in cases of Severe Mitral Stenosis (MS) Severe involves patient preparation, equipment preparation, medical team, examination procedures, post-action care, description of examination results, and their role in the management of (MS) Severe Patient preparation involves patient education about the procedure, fasting before examination, renal function testing, medication adjustments, vascular access preparation, discussion of contrast agents, and vital monitoring. Severe (MS) patients require special attention in this preparation. Equipment preparation includes a stable catheterization table, a fluoroscopic imaging system, various types of catheters, appropriate contrast agents, resuscitation equipment, pre-procedure medications, and hemostasis equipment. The medical team involved in CAG examination in Severe (MS) patients involves an interventional cardiologist, radiological technologist, catheterization nurse, catheterization technician, and additional support personnel such as the anesthesia team and resuscitation team. The examination procedure includes patient preparation, vascular access, catheter insertion into the coronary arteries, evaluation and imaging of the coronary arteries, and completion of the procedure. CAG examination has an important role in the detection of coronary artery disease. CAG examination in patients with (MS) Severe requires careful preparation and involves the collaboration of a well-coordinated medical team to provide optimal results and a significant contribution in the management of (MS) Severe. Conclusion: Narrowing of the mitral valve, severe mitral stenosis (MS) is a pathological condition where this narrowing inhibits blood flow from the left atrium to the left ventricle. This condition is most often caused by rheumatic heart disease, which results in inflammation and ultimately thickening and narrowing of the mitral valve. Coronary Angiography (CAG) examination in Severe Mitral Stenosis (MS) cases has an important role in detecting coronary artery disease.

Supervision and care during pregnancy is something that is important to do for the survival of the mother and the baby to be born. Antenatal care (ANC) is a pregnancy examination to optimize the mental and physical health of pregnant women. So that they are able to deal with childbirth, the postpartum period, preparation for breastfeeding and the return of reproductive health in a natural way. This study was conducted to determine the experience of midwives in providing counseling about ante natal care to pregnant women at the Puskesmas in Padangsidimpuan City. The research design is phenomenology. The method of data collection was carried out by in-depth interviews. Purposive sampling method was used to select participants who met the criteria as participants. Participants involved in this study were midwives who worked at the Puskesmas in Padangsidimpuan City, totaling 3 people. The results of the interviews were transcribed and analyzed using the Collaizi method and obtained 5 themes, namely: 1) The motivation of midwives to provide counseling, 2) Obstacles faced by midwives in providing counseling, 3) Strategies to motivate pregnant women to participate in counseling, 4) Responses of pregnant women after receiving counseling , and 5) Support from health institutions for puskesmas activities. Keywords: Midwife, counseling, pregnant women