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Congestive heart failure (CHF) is a cardiovascular disease that frequently causes shortness of breath (dyspnea) and negatively impacts patients’ quality of life. The management of dyspnea involves not only pharmacological approaches but also nonpharmacological interventions, one of which is handheld fan therapy, which works by stimulating sensory receptors in the facial area. This study aims to describe the effect of handheld fan therapy on reducing shortness of breath in patients with CHF. This study employed a descriptive design using a case report method on a single 63-year-old female patient diagnosed with CHF. The intervention was conducted over four days, involving the use of a handheld fan for 10 minutes, held at a distance of 15–30 cm from the face and directed toward the nose and mouth. Measurements were taken before and after the intervention using respiratory rate and oxygen saturation as parameters. The results showed a gradual decrease in respiratory rate from 24 breaths/minute to 18 breaths/minute, as well as an increase in oxygen saturation from 91% to 96% during the intervention period. These findings indicate an improvement in breathing patterns and increased respiratory efficiency in the patient. Handheld fan therapy is effective as a nonpharmacological intervention for reducing shortness of breath and improving oxygenation in patients with CHF. This intervention is safe, easy to use, and can be implemented as a complementary therapy in nursing practice.

Iced tea is a popular beverage due to its accessibility and affordability. However, poor hygiene and sanitation practices can lead to contamination by pathogenic microorganisms such as Escherichia coli, which can potentially cause foodborne diseases. Sanitation practices, including cleanliness of vendors, equipment, and processing facilities, play a crucial role in ensuring the safety of beverages consumed by the public. The research method used was a quantitative study with an observational analytical design using a cross-sectional approach. Total sampling was used, with 21 iced tea vendors as the sample. The independent variable in this study was sanitation hygiene, while the dependent variable was Escherichia coli bacterial contamination in iced tea. The results of the study conducted on 21 respondents showed that iced tea drink sellers with qualified sanitation hygiene practices with a total of 10 respondents, 8 samples of iced tea drinks were negative for Escherichia Coli and 2 samples of iced tea drinks were positive for Escherichia Coli. While iced tea drink sellers who did not meet the requirements for sanitation hygiene practices were 11 respondents, with 11 samples of iced tea drinks positive for Escherichia Coli bacteria. After being analyzed using the IBM SPSS Statistics 24 Application, a p-value of 0.000 (<0.05) was obtained, so H1 was accepted, it was concluded that there was a relationship between sanitation hygiene and Escherichia Coli bacterial contamination of iced tea drinks. Based on the description above it can be concluded that the low sanitation hygiene practices carried out by iced tea drink sellers can increase the risk of Escherichia Coli bacteria contamination in drinks and will affect the quality and safety of drinks that will be consumed by the public.

School snacks are one of the food sources commonly consumed by elementary school children; however, they are at risk of microbiological contamination if not properly managed. One of the pathogenic bacteria that can contaminate food is Salmonella, which can cause diarrheal disease. This study aimed to analyze hygiene and sanitation factors of food handlers on Salmonella bacterial contamination in pentol snacks at elementary schools in Palang District, Tuban Regency. This study used an observational analytic design with a cross-sectional approach. The sample consisted of 20 pentol vendors and 20 pentol snack samples. Data were collected through observation using a hygiene and sanitation checklist and laboratory examination to detect the presence of Salmonella bacteria. Data analysis was initially planned using the Chi-square test; however, due to homogeneous results, the analysis was conducted descriptively. The results showed that most vendors had good hygiene and sanitation (85%) and sufficient (15%). Laboratory examination results showed that all pentol snack samples (100%) were negative for Salmonella bacteria. In conclusion, pentol snacks at elementary schools in Palang District were microbiologically safe from Salmonella contamination.

Immunization is a preventive measure used to protect against Tuberculosis, Diphtheria, Pertussis, Polio, Hepatitis B, and Measles. Immunization administration must be continuous, comprehensive, and conducted according to standards to provide effective health protection. The objective of this study was to determine the correlation between paternal support and the immunization status of children aged 0 to 1 year in the Tamban Baru Community hEalth Center area, Kapuas Regency. This study used a cross-sectional correlation design. The independent variable was paternal support, and the dependent variable was immunization status. The sample was selected using total sampling technique, consisting of 50 respondents. Data collection was performed using a questionnaire. The results showed a significant correlation between paternal support and the immunization status of children aged 0 to 1 year, indicated by p = 0.000017 < 0.005; thus, the null hypothesis (H0) was rejected and the alternative hypothesis (H1) accepted. This means that there is a correlation between paternal support and the immunization status of children aged 0 to 1 year. It is recommended that that cross-sector collaboration and Community Health Center authorities enhance efforts so that every immunization officer provides health education, such as counseling about immunization, and that family involvement in spreading immunization programs is increased to achieve targeted coverage through cooperation with health professionals.

Smoking behavior is a modifiable risk factor for hypertension, with hypertension prevalence generally increasing alongside higher cigarette consumption and longer smoking duration. Research on hypertension prevalence among productive-age smokers in Indonesia using national-scale data remains scarce in Indonesian publications. This study aims to analyze factors influencing hypertension among productive-age smokers in Indonesia in 2015, utilizing data from the Indonesia Family Life Survey (IFLS) 2015. The research employs a quantitative design with an analytical observational approach using a cross-sectional study. The sample comprises 10,677 productive-age smokers in Indonesia, selected via multi-stage random sampling across 32 provinces in 2015. Independent variables include age, gender, employment status, work region, cigarettes smoked, smoking duration, and daily cigarette consumption, while the dependent variable is hypertension. Hypertension prevalence among productive-age smokers in Indonesia in 2015 reached 8.53%, with significant predictors including age ≥36 years, female gender, employment status, smoking intensity of 21–30 or >31 cigarettes/day, and smoking duration >16 years—reflecting multifactorial interactions of biological, behavioral, and socioeconomic factors. Accordingly, recommendations include routine screening at primary health centers for at-risk groups, tobacco control programs based on dose-duration, economic empowerment for the unemployed, intensive screening with lifestyle counseling by healthcare providers, and longitudinal designs for future causal studies.

This study aims to examine the relationship between family support and depression levels among the elderly in Pejuang Village, Bekasi City, through a descriptive-narrative literature review. The review analyzed relevant scientific articles discussing family support, social support, and depression in older adults. Literature was selected based on the suitability of the elderly population, the presence of family or social support variables, and the measurement of depressive symptoms or depression levels. The analysis compared each article’s objectives, research design, respondent characteristics, instruments, findings, and conclusions. The results indicate that most studies found a relationship between family support or social support and depression among the elderly. Adequate family support, including emotional, instrumental, informational, and appraisal support, helps older adults feel cared for, valued, secure, and better able to adapt to the aging process. Preliminary findings at the Elderly Posyandu in Pejuang Village also show variations in family support and depression levels among elderly participants. Conversely, limited family support may increase loneliness, psychological distress, and depressive symptoms. Therefore, family support functions as a protective factor in reducing depression risk among older adults. Strengthening the involvement of families, health workers, and elderly posyandu cadres is necessary as a promotive and preventive strategy to maintain psychological well-being through education, early detection, and sustainable community-based assistance for vulnerable elderly groups living in community and family environments.

Hypertension is a major public health concern with a high prevalence and a significant risk of complications if left uncontrolled. Effective management requires not only pharmacological treatment but also non-pharmacological approaches and active family involvement. One potential non-pharmacological therapy is the use of celery (Apium graveolens), which is believed to lower blood pressure. This study aimed to evaluate the effectiveness of family education combined with celery decoction administration in reducing blood pressure among patients with hypertension. A descriptive case study design was employed using a family nursing care approach over three home visits, each lasting 30–45 minutes. The intervention included health education on hypertension and a demonstration of how to prepare and administer celery decoction, which was consumed twice daily. Data were collected through interviews, observation, and blood pressure measurements. The results showed a reduction in blood pressure from 159/90 mmHg to 130/80 mmHg, along with a decrease in symptoms such as headaches and dizziness. In addition, there was an improvement in family knowledge, caregiving skills, and the ability to modify the home environment. In conclusion, family-based education combined with the administration of celery decoction appears to be effective in reducing blood pressure and enhancing the family’s role in managing hypertension.

This review article evaluates the physical characteristics and stability of Oil in Water (O/W) and Water in Oil (W/O) creams through a comparative literature study published between 2021 and 2026. The evaluation focuses on important parameters, including viscosity, spreadability, adhesion, pH, and accelerated stability testing. The findings reveal that O/W creams generally have lower viscosity and greater spreadability, making them more suitable for daily cosmetic and therapeutic applications due to their lighter texture and better aesthetic acceptance. In contrast, W/O creams demonstrate higher physical stability, stronger adhesion, and superior occlusive properties, which are beneficial for protecting sensitive active ingredients and maintaining skin hydration over longer periods. The differences in performance are strongly influenced by the optimization of emulsifier Hydrophilic-Lipophilic Balance (HLB) values and the ratio between oil and water phases. Both cream types show good biocompatibility with skin pH ranging from 4.5 to 6.5, indicating their safety and effectiveness for topical pharmaceutical and cosmetic formulations.

Ibuprofen is an antipyretic and anti-inflammatory drug classified as Biopharmaceutics Classification System (BCS) class II, characterized by low water solubility and high permeability. Its limited solubility may reduce the dissolution rate and influence therapeutic effectiveness. This study aimed to formulate ibuprofen suppositories using cocoa butter (oleum cacao) as the suppository base through the melting method. Each suppository was prepared with a total weight of 2500 mg containing 125 mg ibuprofen, oleum cacao as the base, tween 80 as an emulsifier, and liquid paraffin as a mold lubricant. Before formulation, a displacement value test was performed to determine the exact amount of base required. The prepared suppositories were evaluated through organoleptic examination, weight uniformity, melting time, and dissolution testing. The evaluation results demonstrated that the suppositories possessed acceptable physical characteristics, uniform weight distribution, appropriate melting properties, and satisfactory dissolution behavior. Based on these findings, ibuprofen suppositories formulated with oleum cacao fulfilled pharmaceutical quality requirements in accordance with the Indonesian Pharmacopoeia standards.

Indonesia, as a tropical country, is exposed to high levels of ultraviolet (UV) radiation, increasing the risk of skin damage. Sunscreen is widely used as a protective measure indicated by the Sun Protection Factor (SPF) value. This study aimed to evaluate the effect of active ingredient variations on SPF values and other influencing factors. A literature review with a descriptive-comparative approach was conducted using research articles published between 2021 and 2026 from Google Scholar, PubMed, ScienceDirect, and Elsevier. A total of seven eligible articles were analyzed. The results showed that the type of active ingredients, concentration, combination of ingredients, and dosage form significantly influence SPF values. Natural ingredients generally produce low to moderate SPF values, while combinations of active ingredients result in significantly higher SPF due to synergistic effects. Increasing the concentration of active ingredients also leads to higher SPF values. Additionally, dosage forms such as creams, serums, sunscreen powder and foundations affect sunscreen effectiveness through their film-forming ability on the skin. In conclusion, the combination of active ingredients and higher concentrations provides more optimal protection against UV radiation.

Effervescent granules are a pharmaceutical dosage form that offer advantages in terms of ease of use, improved palatability, and rapid solubility in water. This study aimed to formulate and evaluate the physical properties of vitamin C Effervescent granules using the dry granulation method. The main materials used included ascorbic acid as the active substance, citric acid and tartaric acid as acid sources, and sodium bicarbonate as the base source. Evaluation was carried out on organoleptic properties, flow properties, pH, angle of repose, moisture content, density, compressibility index, and dispersion time. The results showed that the granules met the requirements for organoleptic properties, pH (4–5), angle of repose (38.41°), compressibility index (12.3%), and dissolution time (49.62 seconds). However, the flow property (29.11 seconds) and moisture content (6.47%) did not meet the established standards. These findings indicate that the formulated granules met most of the evaluation parameters but still require optimization, particularly in the drying process and flow properties, to obtain a more stable and high-quality dosage form.

Sweet orange peel (Citrus x aurantium L.) is an agricultural by-product rich in bioactive compounds including flavonoids, phenolics, terpenoids, and vitamin C with antioxidant and moisturizing potential. This study aimed to formulate and evaluate a body lotion using 15% ethanol extract of sweet orange peel obtained by maceration with 96% ethanol. Evaluations included organoleptic, homogeneity, pH, adhesion, spreadability, viscosity, irritation, cycling test, cream type, and DPPH antioxidant activity assessments. The preparation was semisolid, yellow, with a characteristic herbal aroma, homogeneous, pH 8, adhesion time of 4.10 seconds, spreadability of 9.9–11.1 cm, and acceptable viscosity. The preparation caused no skin irritation, remained stable through six cycling test cycles, and formed an oil-in-water (O/W) emulsion. Antioxidant activity showed an IC₅₀ of 284.6 ppm (weak category) compared to vitamin C as positive control (IC₅₀ 4.2 ppm). It was concluded that ethanol extract of sweet orange peel can be formulated into a stable and safe body lotion, though further optimization is needed to enhance its antioxidant activity.

Services in the health sector are a form of public service that must be implemented properly by the government. In the context of health services, the importance of effective and efficient implementation cannot be ignored because this has a direct impact on people's quality of life. In order for health services to achieve their goals, various requirements must be met, including the availability of adequate facilities and infrastructure, a harmonious relationship between patients and service providers, easy accessibility, and high quality. The aim of this research is to determine the description of the service quality of administrative staff. at the Kelapa Gading Community Health Center. The method used is descriptive with a quantitative approach which produces univariate results. This research was conducted at the Kelapa Gading Community Health Center with a total of 150 respondents. The variables in this research are Service Procedures, Completion Time, Service Costs, Service Products, Facilities and Infrastructure, Accreditation of Service Officers. The population in this study were all 1.216 outpatients with a sample of 150 respondents.

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

Background: Knee osteoarthritis is a degenerative joint disease that often occurs in the geriatric population and causes pain, limited movement, and decreased function. In advanced conditions, management is carried out with Total Knee Replacement (TKR). However, post-surgery patients still experience functional limitations so that physiotherapy intervention is needed. Objective: To determine the effectiveness of static bicycle and quadriceps strengthening exercises on pain, range of motion, muscle strength, functional mobility, and quality of life in post-TKR patients. Methods: This study used a case study design in one patient with post-TKR dextra et causa bilateral knee osteoarthritis. The intervention was given for 3 weeks with a frequency of 2 times per week. Evaluation was carried out using the Numeric Rating Scale (NRS), goniometer, Manual Muscle Testing (MMT), Timed Up and Go Test (TUG), and the Knee Osteoarthritis Outcome Score (KOOS). Results: Results showed a decrease in motion pain from NRS 6 to 4 and stationary pain from 3 to 2. Knee range of motion increased from 75° to 90° of flexion and from -5° to 0° of extension. Muscle strength increased from MMT 3 to 4 in the quadriceps muscle. Functional mobility also improved, with TUG time decreasing from 22 seconds to 18 seconds. However, the KOOS score remained relatively unchanged at 38.84. Conclusion: Static bicycle and quadriceps strengthening exercises were effective in reducing pain, increasing ROM, muscle strength, and functional mobility in post-TKR patients. However, the improvement in quality of life as measured by the KOOS was not significant, requiring a longer rehabilitation period.

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

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

The implementation of Hospital Management Information Systems (HMIS) has become a strategic imperative to enhance operational efficiency amidst the ongoing global digital health transformation era. This study aims to analyze the determinants of successful HMIS implementation and its impact on service efficiency and patient outcome quality. Employing a narrative review approach with thematic synthesis of literature from PubMed, Scopus, and ScienceDirect databases between 2016-2026, the study evaluates the relationship between technology investment and organizational performance. The synthesis results indicate that while HMIS significantly reduces administrative burdens and medication errors, a "digital paradox" exists where technical efficiency may disrupt interpersonal interactions between healthcare providers and patients if systems are not user-centered. Key success factors include data interoperability (HL7/FHIR standards), human resource readiness, and governance policy support. This study concludes that a patient-centered efficiency model is the fundamental basis for ensuring technology investments yield sustainable added value within the healthcare delivery system.

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

Edentulism is a condition of total tooth loss that has a significant impact on the efficiency of mastics, phonetics, and facial aesthetics. This case report presents the rehabilitation of a 72-year-old female patient with a condition of total mandible edentulus using two standard-diameter implants that support the overdenture with a locator retention system. Treatment procedures include clinical evaluation, radiographic analysis, implant placement, prosthesis placement, as well as follow-up evaluation to assess function and comfort. The results of the treatment showed an increase in patient retention, stability, and comfort in daily activities. In addition, patients reported improved confidence and quality of life after the use of implant-based overdentures. These findings confirm that overdenture with mandibular implant support is a predictive, effective, and reliable rehabilitation method in treating total edentulism. The success of this case provides clinical evidence that implant-based approaches are able to overcome the limitations of conventional prostheses, as well as being a solution that supports the functional and psychosocial aspects of elderly patients. Thus, implant-based overdenture can be recommended as the primary therapeutic option in the rehabilitation of mandibular edentulism.