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Atrophic rhinitis or ozena is a chronic infection of the nasal cavity characterized by progressive atrophy of the nasal mucosa and turbinate bones accompanied by the formation of foul-smelling nasal crusts. This condition is more commonly found in females, particularly during puberty, and is frequently associated with populations of low socioeconomic status and poor environmental sanitation. The exact etiology of atrophic rhinitis remains unclear; however, several factors are believed to contribute, including chronic infection by *Klebsiella ozaenae*, vitamin A and iron deficiency, chronic sinusitis, hormonal imbalance, collagen diseases, trauma, and genetic predisposition. Common clinical manifestations include nasal obstruction, thick greenish nasal discharge, crust formation, epistaxis, anosmia, and *foetor ex nasi*, which is often more noticeable to people around the patient. Anterior rhinoscopy typically reveals widened nasal cavities, turbinate atrophy, thin and dry nasal mucosa, as well as purulent secretions and greenish crusts. Diagnosis is established through history taking, ENT physical examination, and supporting investigations such as microbiological culture, histopathological examination, radiological imaging, and paranasal sinus CT-scan. Management may be conservative with antibiotics, nasal irrigation, nasal drops, vitamin A supplementation, and iron preparations, or surgical in severe cases or those unresponsive to conservative therapy.

Epistaxis, or more commonly known as nosebleeds, is one of the most frequently encountered medical emergencies in the field of ENT. Epistaxis is a condition in which blood flows from the nasal cavity. Although often considered a minor disorder, epistaxis can be a sign of a more serious medical condition, especially if it occurs repeatedly or in large amounts. Globally, the prevalence of epistaxis is estimated to be around 21.7%, with a wide range of variation between countries, namely between 3 and 60 cases per 100,000 population per year. This paper aims to review the aspects of diagnosis and management of epistaxis based on the latest literature. The method used in this study was a search and analysis of various scientific publications, guidelines, and relevant current journals. The discussion covers the identification of types and signs of epistaxis, emergency management, and tampon insertion strategies. Understanding the appropriate and rapid diagnosis and management is essential to prevent the condition from worsening.

Immune Thrombocytopenic Purpura (ITP) is a bleeding disorder characterized by a low platelet count (<100,000/µL) caused by decreased platelet production or opsonization by antibodies, leading to platelet destruction by the reticuloendothelial system. ITP is one of the most common etiologies of bleeding disorders, especially in children. The prevalence of ITP in children is estimated to be around 1.9 to 6.4 cases per 100,000 children annually, while in adults, the prevalence is lower, at about 3.3 cases per 100,000 people per year. In the United States, the incidence of ITP is reported to be around 1.6 per 10,000 people annually. Clinical manifestations of ITP include petechiae, purpura, and/or ecchymosis, which are usually found on the upper and lower extremities. Mucocutaneous bleeding symptoms such as epistaxis and gum bleeding are also common in patients. These symptoms can vary depending on the severity of thrombocytopenia and individual responses to the condition. Diagnosis of ITP is made through a thorough medical history, physical examination, and rapid supportive tests to confirm the diagnosis and differentiate ITP from other conditions with similar symptoms. Proper and timely management is crucial to prevent further complications, including more severe bleeding or organ damage. With effective management, the quality of life of patients can be improved, and the risks associated with ITP can be minimized. Therefore, early detection and optimal management are key in addressing ITP, particularly in children who are more vulnerable to this bleeding disorder.

Epistaxis or commonly called nosebleed is bleeding in the nasal vestibule, nasal cavity, or nasopharynx that is acute. Fainting is an emergency situation where someone experiences a life-threatening condition that requires immediate assistance. This usually occurs in school students who are performing ceremonies, or outdoor activities. The purpose of this community service is to improve first aid skills in epistaxis and syncope management with the DOFLET method in adolescents. The partners of this community service are 21 adolescents at SMK X. This service method uses the DOFLET method (demonstration and leaflet) by providing training to demonstrate/demonstrate how to handle using available tools directly to improve first aid skills in epistaxis and syncope management in adolescents at SMK X. Based on the results obtained, the results before being given first aid training for epistaxis and syncope management were mostly in the sufficient category and after being given training, most were in the good category. The results of the statistical analysis also showed the influence of the strategy for optimizing first aid for epistaxis and syncope management with the ability to provide first aid in adolescents. The strategy for optimizing first aid education for epistaxis and syncope is expected to help students understand how to provide first aid correctly, as well as increase students' insight into preventing epistaxis and syncope.

Introduction: Rinolits are uncommon foreign bodies in the nose, which serve as a nidus for calcium salt deposition. Foreign bodies can be endogenous or exogenous in origin and can be asymptomatic for years before being discovered incidentally. If left untreated, stones can cause unilateral nasal obstruction, rhinorrhea, epistaxis, or in rare cases, progressive damage leading to septal/palatal perforation or oro-antral fistula. Surgical stone removal is an effective intervention with rare reports of complications. Case Report: A case of rinolit in a 72-year-old woman with complaints of left nasal congestion since 2 months ago with thick, smelly snot in the past 2 weeks is reported. History of foreign entry was denied. On examination of the sinistra nasal cavity, it was found that the nasal cavity was narrow, the inferior concha was edematous, there was a yellowish mass between the inferior concha and the septum, the media concha was difficult to assess, septal deviation was present, sekret was present, mucoid. The management given was extraction using forceps under local anesthesia. Conclusion: Rinolit is an uncommon clinical etiology which if undiagnosed can lead to complications; thus it is important to consider for any unilateral nasal symptoms of unclear origin.      

Hypertension is a condition where the systolic pressure is above 140 mmHg, while the diastolic pressure is above 90 mmHg. Some hypertension patients often complain of headache, weakness, fatigue, shortness of breath, restlessness, nausea and vomiting, epistaxis and decreased consciousness. This can cause sleep problems in hypertensive patients. Sleep disorders are a collection of conditions characterized by disturbances in the amount, quality or timing of sleep in an individual. One technique to improve sleep quality is progressive muscle relaxation therapy and murotal Al-Quran.This research method uses Pre-Experimental with one group pre-post test approach. The population is 40 respondents and uses a total sampling (technique).The instrument used was a sleep quality questionnaire, measured by the Indonesian version of the Pittsburgh Sleep Quality Index (PSQI), then data were collected through Editing, Coding, Scoring, and Tabulating processes. The data obtained were analyzed using the Wilcoxon test.The results showed that the average value of sleep quality before progressive muscle relaxation and murotal Al-Quran therapy was performed was 8.30, while after progressive muscle relaxation and murotal Al-Quran the average value of sleep quality was 6.08. The results of the analysis test showed that there was an effect of progressive muscle relaxation therapy and murotal Al-Quran on improving sleep quality of hypertensive patients with -value = 0.000 <α = 0.05. This therapy performs 15 relaxation movements accompanied by the sound of murotal Al-Quran which makes a person relax and calm so that this calmness acts as a pain reliever that makes the patient happy and gives positive energy in a person. this makes the mood to be happy so as to create a good quality sleep.   Keywords: Hypertension, sleep quality, progressive muscle relaxation therapy and murotal Al-Quran.