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Heart failure is a clinical syndrome characterized by shortness of breath and fatigue resulting from structural or functional abnormalities of the heart.  Acute Decompensated Heart Failure (ADHF), also known as decompensated heart failure, is a condition of worsening chronic heart failure that can occur acutely, subacutely, or insidiously, with symptoms progressively worsening over several days or weeks. A 1-year-old male patient presented to the Dermatology Clinic at Cut Meutia General Hospital with the chief complaint of A 60-year-old female patient was brought to the Cut Meutia Emergency Department with the complaint of shortness of breath that had worsened 1 day prior to admission; the shortness of breath worsened during light activity and when the patient was lying down. She also complained of swelling in both legs for one week prior to admission, which had progressively worsened. On examination, skin turgor was slow to return in the left and right lower extremities; palpation of the neck revealed jugular vein distension. Inspection showed a normal chest contour; auscultation of the lungs revealed rhonchi. Cardiac percussion revealed enlargement of the upper, left, and right borders of the heart, as well as the cardiac border at the level of the waist. Auscultation revealed a murmur at the fourth intercostal space on the left side. Examination of the lower extremities revealed pitting edema on both the left and right sides.  Supportive X-ray examination revealed severe cardiomegaly. An ECG revealed sinus rhythm, an irregular rate of 80 beats per minute, LAD axis, P wave not identifiable, PR interval 0.20 seconds, QRS complex 0.6 seconds, inverted T waves in I and AVL, LVH (+), RVH (-), PVCs, AF, and lateral ischemia. Echocardiography revealed severe aortic stenosis due to RHD and an LVEF of 21%. The patient has been prescribed furosemide, warfarin, bisoprolol, and spironolactone.

Introduction: Bronchopneumonia is an inflammatory lung condition involving one or more lobes, characterized by patchy infiltrates commonly caused by Streptococcus pneumoniae (30–50% of cases), followed by Staphylococcus aureus and Klebsiella pneumoniae in more severe infections. Clinical manifestations include high fever, restlessness, dyspnea, rapid and shallow breathing accompanied by rales, vomiting, and either dry or productive cough. Respiratory infections may trigger inflammatory responses that increase excessive mucus production. Case Illustration: A 1-year-5-month-old girl weighing 7.9 kg presented to RSUD Ir. Soekarno Sukoharjo with shortness of breath and intermittent fever for six days, accompanied by vomiting, decreased appetite and fluid intake, cough, weakness, runny nose, and oral sores. Physical examination revealed a weak general condition, compos mentis consciousness, dyspnea, wheezing, and fine wet rales in both lung bases. Dysmorphic facial features consistent with Down syndrome were observed. Laboratory findings showed leukopenia, eosinopenia, and elevated RDW-CV, while chest radiography indicated bilateral bronchopneumonia. Management included intravenous fluids, antibiotics, antipyretics, antiemetics, and bronchodilators. The patient was diagnosed with sixth-day fever due to bronchopneumonia, mild-to-moderate dehydration, recurrent nausea and vomiting, atrial septal defect, and Down syndrome.

Project scheduling is an important element for shipyard companies to gain more profit. The most frequently used analysis is the Critical Path Method (CPM). However, in reality, planning using the CPM method is considered less efficient because it does not consider the productivity of each job in it and adds safety time which causes the project duration to become longer. In accordance with the above problems, a new method for planning project schedules is now being developed, namely Critical Chain Project Management (CCPM). CCPM is a project planning method that emphasizes the resources needed to carry out existing tasks in the project. This method is carried out by eliminating multitasking, student syndrome, Parkinson's law and providing a buffer at the end of the project. In this final project, a comparison of the duration of the results of applying the CCPM method with the Critical Path Method (CPM) method is carried out in a case study of ship repairs at PT. Galangan Kapal Madura. The initial project scheduling uses the traditional method in the form of a Gantt chart which is then broken down in more detail and completely with the relationship between activities in the form of CPM, and then will be compared with the duration of the results of CCPM scheduling which has eliminated multitasking, eliminated Safety time for each activity and provided a buffer in the work.

Down Syndrome (DS) is a genetic disorder characterized by trisomy of chromosome 21 and is inherently associated with clinical manifestations such as hypotonia, joint laxity, and neuromuscular deficits, all of which collectively contribute to impaired postural control and balance. These balance impairments significantly affect the attainment of motor milestones, performance of daily activities, and increase the risk of falls. This study aims to analyze the effectiveness of core stability training in improving balance among children with DS. A narrative review approach was employed by conducting a literature search across electronic databases including PubMed, Scopus, Google Scholar, and ResearchGate. Inclusion criteria consisted of primary studies (RCTs, quasi-experimental designs) published within the last ten years (2015–2025) that examined core stability interventions targeting balance or postural control in children with DS. A review of 10 relevant studies demonstrated that core stability training, either as a standalone intervention or combined with other modalities (e.g., treadmill training or balance training), resulted in significant improvements in both static and dynamic balance. These improvements are facilitated through the strengthening of deep trunk muscles (such as the multifidus, transversus abdominis, and rectus abdominis), which play a crucial role in proximal stabilization and force transfer to the extremities. In conclusion, core stability training is an effective and recommended intervention modality within physiotherapy rehabilitation programs to enhance the quality of life and motor independence of children with Down Syndrome.