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Medication adherence among the elderly is an important factor in achieving successful therapy, particularly during the month of Ramadan when changes occur in meal patterns and medication schedules. Elderly patients with chronic diseases often experience difficulties in adjusting their medication timing, which may lead to poor adherence. This study aimed to implement a smart pill boxwith educational labels to improve knowledge and medication adherence among elderly individuals during fasting. The study involved 40 elderly respondents in a social care institution. The intervention consisted of training on the use of the smart pill box, educational labeling, and evaluation through observation, interviews, and checklist forms. The results showed that most respondents took medication twice daily (42.5%) and adjusted their medication schedules to sahur and iftar (45%). Before the intervention, 57.5% of respondents had not received information about medication use during fasting. The implementation of the smart pill boxwith educational labels improved the elderly’s understanding of medication use and supported better medication adherence during Ramadan.

Introduction: Appendectomy is a relatively safe surgical procedure. One important aspect of this stage is maintaining the patient's mental stability, especially before administering anesthesia. However, anesthesia often causes anxiety in patients. Mindfulness-based cognitive therapy has been shown to significantly improve quality of life by minimizing anxiety. Objective: This study analyzed the effect of Mindfulness-based cognitive therapy (MCT) in reducing pre-anesthetic anxiety in appendectomy patients. Methods: This study used a case study design with a nursing care process approach. The subjects in this case study were two patients who met the inclusion criteria. The instrument used was an observation sheet according to the Indonesian Society for Anesthesia and Clinical Trials (SLKI). Results: The results of the case study showed that both patients experienced pre-anesthetic anxiety. After receiving Mindfulness-based cognitive therapy, pre-anesthetic anxiety decreased. Conclusion: This case study demonstrated that pre-anesthetic anxiety decreased after Mindfulness-based cognitive therapy.

Introduction: The incidence of ARI in children is estimated at 0.29 cases per child/year in developing countries and 0.05 cases per child/year in developed countries. There are 156 million cases of ISPA and most of them occur in India (43 million), China (21 million) and Pakistan (10 million) as well as Bangladesh, Indonesia and Nigeria with 6 million cases each. Of all ISPA cases that occur in the community, 7-13% are serious cases and require serious cases and require hospital treatment. Method: This research is a pre-experimental research with one group pre-post test design.Results: The results of the study showed that there was an effect of giving water vapor therapy and eucalyptus oil on reducing the frequency of ineffective airway clearance in children at RSIA Sitti Khadijah, Gorontalo City because it was found that the average frequency of coughing was 10.33 times per day before and after giving honey. Of 2.5 cc every day for 3 days, it was found that the average cough frequency decreased to 5.73 times per day so it can be seen that the difference between the cough frequency before and after was 4.6 times per day. Therefore, giving water vapor therapy and eucalyptus oil to children who are experiencing airway clearance is not effective in reducing the frequency of coughing.Conclusion: The conclusion of this study is that there is an effect of giving water vapor therapy and eucalyptus oil on ineffective airway clearance in children at RSIA Sitti Khadijah, Gorontalo City with a significant value of 0.000.

Leprosy remains a significant public health problem in various developing countries, including Indonesia. This disease is caused by Mycobacterium leprae, which attacks the skin and peripheral nerves and can cause long-term physical, psychological, and social impacts if not treated early and adequately. Health-seeking behavior in leprosy patients is also influenced by structural factors such as the availability of health facilities, distance, transportation costs, and the quality of communication between health workers and patients. Research in various endemic countries confirms that friendly, accessible primary health care services that provide comprehensive education can improve early detection and therapy adherence. Patient SA, an 11-year-old child diagnosed with multibacillary (MB) leprosy and has been undergoing treatment for four months. The progression of the disease to MB indicates limitations in early symptom recognition and the family's health-seeking behavior, which may be influenced by low perceptions of disease susceptibility and severity, lack of knowledge, and barriers to accessing health services. However, after the diagnosis was confirmed and education provided by health workers, positive behavioral changes occurred, indicated by the patient's adherence to routine therapy as recommended.

Aggressive behavior is one of the manifestations commonly found in individuals with mental disorders, and this can potentially cause harm both to themselves and to their surroundings. To address this condition, one non-pharmacological approach that can be implemented is the use of Mozart classical music therapy. This study aims to evaluate the impact of Mozart classical music therapy on patients who have the potential to exhibit violent behavior at Aceh Mental Hospital. The research activities were conducted from July 2 to 5, 2025. The research design adopted in this study is pre-experimental using the One group pretest-posttest Design method. The study subjects consisted of 15 inpatients who had been identified as being at risk for violent behavior, with sample selection carried out through purposive sampling. The findings of the study showed that the average score of signs and symptoms before the intervention was 5.73, with a score range of 3 to 8. After the intervention in the form of Mozart classical music therapy, the average score of signs and symptoms decreased significantly to 1.60, with a range between 1 and 2. Statistical analysis using the Wilcoxon Signed Rank test showed a Z value of -3.437 with a significance level of P = 0.000 (P < 0.05). Based on these results, it can be concluded that Mozart classical music therapy has a significant effect in reducing the risk of violent behavior in patients. Therefore, Mozart classical music therapy is recommended as an effective supportive intervention and can be routinely integrated into psychiatric care rooms.

Pneumonia caused by extensively drug-resistant (XDR) Pseudomonas aeruginosa is still  clinicaly chalenging, particularly among geriatric patients with neurological comorbidities such as stroke. This report presents a case of XDR P. aeruginosa pneumonia complicated by sepsis in a 73-year-old patient, characterized by persistent leukocytosis until the tenth day of hospitalization despite empirical meropenem therapy. This evidence-based case report aims to analyze clinical outcomes, specifically 28-day and 30-day mortality rates, and to identify mortality predictors in the adult population through a systematic literature search of the PubMed and Google Scholar databases for the 2019–2026 period. Synthesized evidence from six core studies indicates that XDR P. aeruginosa infections carry a profoundly high 28-day mortality rate, ranging from 41% to 51% in cohorts receiving antibiotic monotherapy. Key mortality predictors identified include the presence of sepsis or septic shock, a delay in initiating adequate therapy exceeding 52 hours, advanced age, and the requirement for Intensive Care Unit (ICU) admission. The phenomenon of persistent or worsening leukocytosis during treatment, as observed in this case, serves as a critical clinical indicator associated with antimicrobial response failure and a dismal prognosis. Ultimately, XDR P. aeruginosa pneumonia is associated with poor clinical outcomes, where therapeutic success is strictly contingent upon the timely administration of antibiotic regimens with proven activity against these highly resistant isolates.

Tinea incognito is a dermatophyte fungal infection when the clinical picture becomes unclear due to inappropriate treatment, which is usually caused by the use of topical steroids in cases of skin infections. A 46-year-old woman came with complaints of itchy reddish patches all over her body, experienced for 2 years. The itching worsened when consuming anchovies. The patient said she often took medication bought from a pharmacy without a doctor's prescription, the patient took methylprednisolone tablets and ointment. The itching complaint improved, but after stopping taking the medication, the itching complaint increased, and the patches widened. The patches first appeared on the right leg, initially resembling prickly heat spots then widened and spread to other parts of the body. Currently, the patches appear red in the shape of a ring with a clearer center. The patches were found on the face, neck, chest, abdomen, back, buttocks, left hand, and left foot. The patient noticed within a few months after taking the medication that her body was swollen, her weight increased, and her face looked rounder. A 20% KOH examination found hyphae and spores. Thus, the patient was diagnosed with Tinea Incognito caused by long-term topical steroid use. The patient was prescribed antifungal therapy with Ketoconazole 200 mg tablets once daily and Ketoconazole cream twice daily.

Stroke is a leading cause of disability that requires long-term rehabilitation. Herbal-based therapies, such as Shengmai San, may complement conventional medical treatments in aiding post-stroke recovery. This quasi-experimental study involved 10 post-stroke patients who received Shengmai San therapy for four weeks, with one session per week. Key parameters measured included blood pressure, muscle strength, motor function, sensory complaints (e.g., tingling, numbness), sleep quality, and Traditional Chinese Medicine diagnostic findings (pulse and tongue). The results showed clinical improvements across all patients, including stabilized blood pressure, enhanced muscle strength and mobility, reduced sensory complaints, better sleep quality, and increased physical stamina. Pulse and tongue diagnostics suggested improved Qi and Xue circulation. No significant side effects were reported. The study concludes that Shengmai San is a promising adjunct therapy for post-stroke rehabilitation, especially for patients with Qi deficiency and impaired blood circulation. However, the study suggests that Shengmai San should not replace conventional treatments but be used as a complementary therapy to support recovery.

Preoperative anxiety can lead to increased blood pressure, accelerated heart rate, and bleeding. One of the non-pharmacological interventions that can be provided is dhikr therapy, particularly tahlil dhikr (repeated recitation of La ilaha illallah). This study aims to determine the effect of tahlil dhikr on reducing anxiety in preoperative patients. This research is a quantitative study with a quasi-experimental design, using a one-group pretest-posttest approach. Data collection was conducted from May 22 to May 27, 2025, at Meuraxa Hospital. The population in this study consisted of 270 patients scheduled for surgery at Meuraxa Hospital, Banda Aceh, with a sample of 73 respondents selected through random sampling. The research instruments used were the Standard Operating Procedure (SOP) for Tahlil Dhikr Therapy and the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire, which had a Cronbach’s Alpha score between 0.6 – 0.7 and was considered reliable with a result > 0.6. The results showed a decrease in the intensity of anxiety after the administration of tahlil dhikr. Data analysis using the Wilcoxon Signed-Rank Test showed a p-value = 0.000 (≤ 0.05), indicating a significant effect of tahlil dhikr on reducing preoperative anxiety among patients at Meuraxa Hospital, Banda Aceh. The study recommends the integration of tahlil dhikr as an alternative method for reducing anxiety in preoperative patients.

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.

This study aims to analyze the potential of eupatorin found in Cat’s Whiskers (Orthosiphon stamineus) as an anticancer agent using in silico methods. Eupatorin was selected due to its promising biological activity reported in previous literature. The research employed compound structure data registered in PubChem, analyzed through PASS Online for pharmacological activity prediction, ProTox-II for toxicity evaluation, and pkCSM for ADMET parameters. The results indicated that eupatorin has a high probability of inhibiting cancer cell proliferation with significant pharmacological activity values. Toxicity predictions showed a safe profile with an LD50 supporting its potential therapeutic use. ADMET analysis demonstrated that eupatorin possesses good bioavailability, adequate absorption and distribution, and minimal metabolic interactions, supporting its efficacy as an anticancer compound. These findings suggest that eupatorin could be an important candidate for herbalbased drug development, particularly for cancer therapy, and provide opportunities for further research through in vitro and in vivo experiments to validate anticancer activity comprehensively.

Hallucinations are one of the symptoms of mental disorders in individuals which are characterized by sensory perception changes, namely feeling false sensations in the form of sounds, sight, tasting, touching or smelling. The application of drawing therapy in patients with auditory hallucination disorder may reduce hallucinogenic stimuli. The goal is to apply and analyze Nursing Care in Patients with Mental Disorders with the implementation of the application of drawing therapy to control auditory hallucinations. The method used in this is descriptive analysis with a case study approach. This study describes the application of drawing therapy to reduce the signs and symptoms of auditory hallucinations. It was also carried out by providing an intervention to apply drawing therapy for 15 minutes every day to three respondents for 7 consecutive days. The application of drawing therapy to the three respondents obtained results in the reduction of hallucinations from a moderate hallucinatory level score (22) to a mild level with a score (9). Brother B experienced a decrease in hallucinations from a moderate hallucination level score (20) to no hallucinations on days 6 and 7 with a score of (0). Brother JS decreased from a moderate hallucination level of score (20) to no hallucination on day 7 with a score of (0). It is hoped that the results of this study can provide an understanding of the application of drawing therapy to control auditory hallucinations.

Stroke is a serious neurological disorder. A stroke is an acute attack that can cause death or disability, both physically and mentally. Muscle weakness is one of the most common clinical signs experienced by stroke patients. One way to prevent permanent disability in stroke patients is to train muscle strength through acupressure therapy. This study aims to analyze the application of nursing care through acupressure therapy in improving muscle strength in stroke patients. The method used is a case study using a descriptive one-group research method with a pre-test-post-test design on three stroke patients with an intervention of 7 consecutive days with a frequency of 2 times a day for a duration of 12 minutes. The results showed that respondent I's muscle strength before therapy was on a scale of 3 and post-therapy was on a scale of 4, respondent II's pre-therapy was on a scale of 1 and post-therapy was on a scale of 1, and respondent III's pre-therapy was on a scale of 3 and post-therapy was on a scale of 4. It was concluded that acupressure therapy is effective as an additional therapy in nursing practice to help improve muscle strength in stroke patients.

This study aims to analyze the phytochemical profile of Sambung Nyawa (Gynura procumbens) leaves as a potential herbal candidate for mild hypertension therapy using in silico methods. Plant samples were examined to identify active compounds documented in the PubChem database. The identified compounds were further analyzed using PASS Online to predict their pharmacological activities, ProTox-II to evaluate toxicity levels, and pkCSM to assess ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) characteristics. The findings reveal that several bioactive compounds present in Sambung Nyawa leaves demonstrate strong predicted anti-hypertensive activity accompanied by minimal toxicological risk. PASS Online analysis indicates potential mechanisms of action, including vascular receptor modulation and mild diuretic properties that may support blood pressure regulation. ProTox-II classification places most compounds in the low-toxicity category, while pkCSM predictions confirm acceptable bioavailability and favorable pharmacokinetic properties. Overall, these results provide a preliminary scientific foundation for the development of Gynura procumbens as an alternative herbal therapy for mild hypertension and support the need for further validation through in vitro and in vivo experimental studies.

Sleep disorders experienced by older people are difficulty falling asleep, maintaining sleep and difficulty returning to sleep after waking up at night, thus affecting sleep quality. One therapy that can improve sleep quality is music therapy. Music therapy is a stimulation that has a slow rhythm, a stable rhythm pattern that stimulates relaxation of the parasympathetic nervous system, thereby creating a relaxed atmosphere that supports increased sleep duration The researcher aims to provide an overview of nursing care for  the elderly with sleep disordes. The design usedin this nursing final scientifik paper ia a case study with clasical musik  therapi intervention. Therer respondent parcipated, and the intervention was conducted from Desember 20-23, art the Bhakti Kasih Siti Anna Pangkalpinang Elderly Home: After Four consecutive days of classical  musik therapi, thr three elderly individuals experienced  changes  in their PSQI scoret at the final meeting: Ms. E’s score increased from 17 to 13, Mrs. A’s ckore decreased from 19 to 12, and Mrs. M’s score decreased from 16 to 13. Classical musik therapi is effective in treating sleep disorders. The implementation of EBP is expected to provide additional information  regarding the provision of musik therapi to elderly individuals experiencing sleep disorders.

Asthma is a heterogeneous disease characterized by chronic inflammation of the airways and respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary over time in both frequency and severity. This condition is accompanied by limitations in expiratory airflow, which can be either reversible or persistent. In asthma patients, especially those treated in the Emergency Department (ED), a common nursing problem is ineffective airway clearance due to mucus accumulation and bronchospasm. One strategy to address this is the administration of warm drinking water, aimed at improving airway clearance. The design used in this final nursing scientific paper is a qualitative case study with an intervention of warm water intake. The subjects of this study consisted of 3 asthma patients in the ED, and the intervention was conducted from January 3-11, 2026, at the Emergency Department of Charitas Hospital Km.7 Palembang. Airway clearance was measured before and after the intervention, which involved giving 200 ml of warm water at 38ºC, without a control group. After the intervention, all three patients showed improved airway clearance, indicated by more effective coughing, decreased sputum production, reduced wheezing, improved breathing patterns, and improved respiratory rate. The implementation of this evidence-based practice (EBP) is expected to provide additional information regarding the use of nonpharmacological therapy, specifically the administration of warm drinking water, in asthma patients with ineffective airway clearance.

Non-hemorrhagic cerebrovascular disease (CVD) results from blood flow obstruction in the brain due to thrombus or embolus formation, often leading to balance disorders that affect standing and walking. This loss of motor function increases the risk of falls and fractures, which are major complications. Additionally, reduced physical activity can lead to depression. Active exercise has been shown to improve motor function in CVD patients, with nurses playing a key role in supporting these exercises. One effective intervention is the bridging exercise (BE), used for lumbopelvic stabilization, which enhances muscle strength and coordination. BE is particularly beneficial for improving balance in post-CVD patients with hemiplegia. This case study examines the effects of evidence-based bridging exercise (EBP) on balance in three hospitalized non-hemorrhagic CVD patients. Over eight 15-minute sessions, balance was assessed using the Berg Balance Scale (BBS). All patients showed significant balance improvement, with an average BBS score increase of 40 points. These results highlight the effectiveness of non-pharmacological bridging exercises in enhancing balance in CVD patients and recommend BE as a routine therapy to continue at home after discharge.

Complementary therapy has recently become an important issue in many countries. Its use has increased due to several factors, including personal beliefs, cost considerations, the side effects of chemical medications, and expectations of recovery. One of the complementary therapies that is often chosen is warm water foot soaking combined with foot massage. This therapy has the potential to reduce blood pressure through relaxation mechanisms and peripheral vasodilation, which have been supported by scientific evidence.This study aimed to analyze the application of Evidence-Based Practice (EBP) of warm water foot soaking and foot massage therapy in hypertensive patients within nursing care. The method used was an EBP-based case study design involving three patients with hypertension. The intervention consisted of warm water foot soaking using approximately 2 liters of water at a temperature of 38–40°C combined with foot massage, administered once daily for three days. Blood pressure was measured before and after the intervention.The results showed a decrease in blood pressure: Mrs. S from 170/100 mmHg to 150/80 mmHg, Mrs. L from 170/80 mmHg to 150/80 mmHg, and Mr. F from 165/90 mmHg to 130/70 mmHg. Warm water foot soaking and foot massage were effective as non-pharmacological interventions to reduce blood pressure and improve comfort in patients with hypertension. ase study design involving three patients with hypertension. The intervention consisted of warm water foot soaking using approximately 2 liters of water at a temperature of 38–40°C combined with foot massage, administered once daily for three days. Blood pressure was measured before and after the intervention.The results showed a decrease in blood pressure: Mrs. S from 170/100 mmHg to 150/80 mmHg, Mrs. L from 170/80 mmHg to 150/80 mmHg, and Mr. F from 165/90 mmHg to 130/70 mmHg. Warm water foot soaking and foot massage were effective as non-pharmacological interventions to reduce blood pressure and improve comfort in patients with hypertension.

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.

Chronic Kidney Disease (CKD) is a structural or functional abnormality of the kidneys that lasts ≥3 months with the criteria of eGFR <60 mL/min/1.73 m² or the presence of kidney damage such as albuminuria and urinary abnormalities (Kidney International, 2024). CKD patients, especially those treated in intensive care units, often experience gastrointestinal disorders such as increased volume of gastric residues. Giving enteral nutrition to patients with NGT can increase the volume of gastric residue which is at risk of causing complications. One of the non-pharmacological interventions that can be carried out is abdominal massage, which is a light massage technique in the abdominal area that can stimulate intestinal peristalsis and improve gastrointestinal motility. The purpose of this case study was to determine the effect of  giving abdominal massage on reducing the volume of gastric residue in CKD patients in the ICU. This scientific paper uses a case study design using abdominal mass therapy. The number of respondents was 3 people, the intervention was carried out for 3 days with a time of 10-15 minutes. The application of abdominal massage therapy in the three respondents showed a decrease in the volume of gastric residue after admixture was carried out  for three consecutive days with an average decrease in the volume of gastric residue, which was 50 cc - 75 cc. Abdominal massage is a safe and effective nonpharmacological nursing intervention to help reduce gastric residue volume and support enteral nutrient tolerance in CKD patients in the ICU.