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Dysphagia in extremely elderly patients represents a significant clinical challenge because it is frequently associated with frailty, malnutrition, and an increased risk of aspiration. Multifactorial etiologies and atypical clinical manifestations may complicate diagnosis and delay appropriate management. This study aimed to describe the diagnostic evaluation and clinical findings of dysphagia in an extremely elderly patient through a case report supported by a scoping review. A 105-year-old woman with chronic progressive dysphagia underwent comprehensive assessment, including physical examination, upper gastrointestinal endoscopy, histopathological evaluation, and chest radiography. Relevant literature on dysphagia in geriatric populations was reviewed to provide contextual understanding of diagnostic challenges and underlying etiologies. The evaluation revealed chronic active gastritis and a hamartomatous polyp in the gastroesophageal region without evidence of malignancy. Comprehensive assessment successfully excluded malignant and acute obstructive causes, emphasizing the complexity of dysphagia diagnosis in extremely elderly individuals with frailty and aspiration risk. These findings underscore the importance of endoscopic and histopathological examinations in distinguishing benign from malignant etiologies and support early recognition of multifactorial non-malignant causes to optimize clinical management and reduce the risk of adverse outcomes in this vulnerable population

Allergic rhinitis (AR) is an inflammatory process of the nasal mucosa initiated by a hypersensitivity reaction and caused by exposure to allergens mediated by immunoglobulin E (IgE), with several characteristic symptoms including: nasal congestion, a runny nose or watery nasal discharge (rhinorrhea), nasal itching, sneezing, and  postnasal drip (PND). According to the World Health Organization’s Allergic Rhinitis and its Impact on Asthma (WHO-ARIA) guidelines, based on the duration of symptoms, allergic rhinitis is classified into two categories: intermittent allergic rhinitis (symptoms lasting less than 4 days per week or for less than 4 weeks) and persistent allergic rhinitis (symptoms lasting more than 4 days per week and for more than 4 weeks). The prevalence of allergic rhinitis based on a doctor’s diagnosis is approximately 15%; however, it is estimated to reach 30% when considering patients with nasal symptoms. Appropriate management of allergic rhinitis, in addition to alleviating symptoms, is also expected to improve the quality of life of patients whose lives have been disrupted by the condition, as the higher the severity and frequency of allergic rhinitis symptoms, the greater the impact on reduced quality of life.

Tinea favosa is a rare but destructive form of chronic dermatophytosis fungal infection. It is marked by the development of scutules (yellowish, cup-like crusts) and can lead to permanent cicatricial alopecia if not treated appropriately. Although its prevalence is decreasing globally, sporadic cases are still common in areas with poor sanitation. Trichophyton schoenleinii is the primary medical cause of Tinea favosa, but it can also be caused by Trichophyton violaceum or Microsporum gypseum. This report discusses a case involving a 7-year-old boy who exhibited classic clinical signs of favus. Diagnostic procedures included a physical examination, direct microscopic examination with 10-20% KOH solution, and culture on Sabouraud Dextrose Agar (SDA) to identify the fungal species. Microscopic examination revealed branching and fragmented hyphae (arthrospores) and air tunnels within the hair shaft. Culture confirmed Trichophyton schoenleinii as the primary etiologic agent. The patient was treated with oral griseofulvin combined with ketoconazole cream for 8–12 weeks. Follow-up showed resolution of the crusts and cessation of the inflammatory process, although areas of fibrosis showed permanent hair loss.

Diabetes mellitus adalah penyakit metabolik kronis yang ditandai oleh peningkatankadar glukosa darah (hiperglikemia) akibat gangguan sekresi atau kerja insulin. Di Indonesia,diabetes mellitus menjadi perhatian serius dengan jumlah penderita yang diprediksi meningkatdari 19,5 juta pada 2021 menjadi 28,6 juta pada 2045. Penyuluhan ini mengenai pemanfaatan Penyuluhan Pemanfaatan Tanaman Herbal Untuk Pengobatan Diabetes Mellitus DalamMeningkatkan Pengetahuan Kader Posyandu 2 JURAI: Jurnal ABDIMAS Indonesia - VOLUME 1, NO. 2, Juni 2023tanaman herbal sebagai alternatif pengobatan diabetes mellitus dilakukan di Desa Gununglurah,Kecamatan Cilongok, Kabupaten Banyumas. Tujuan untuk meningkatkan pengetahuan kaderposyandu dan masyarakat. Metode penelitian dalam program penyuluhan ini menggunakan duapendekatan utama, yaitu penyuluhan dan pemeriksaan dini.Kegiatan ini meliputi penyuluhantentang etiologi, gejala, pencegahan, dan pengobatan diabetes menggunakan tanaman herbal,serta pemeriksaan kesehatan gratis untuk mengecek kadar gula darah dan tekanan darah. Hasildari 25 peserta yang diperiksa, 15 menunjukkan hasil normal, 8 pra-diabetes, dan 2 terindikasidiabetes. Hasil penyuluhan menunjukkan antusiasme tinggi dari peserta, yang diharapkan dapatmengubah pola hidup sehat dan meningkatkan kesadaran akan pentingnya pengelolaan diabetes.

Multiple diastema is a space or gap between two or more adjacent teeth. Diastema management can be corrected using removable orthodontic treatment and eliminating etiological factors. Treatment in this case shows the progress of successful treatment of multiple diastema in Soelastri General Hospital using removable orthodontic appliances based on the indications and needs of patient care. Case management: A 24-year-old woman came to Soelastri General Hospital Surakarta with complaints of gaps in the teeth between the 4 lower front incisors. The patient's bad habit history is known to be tongue thrusting. Intraoral examination found interdental gaps in the 4 lower incisors measuring 33.32 (1.6mm), 32.31 (1.2mm), 31.41 (1.1mm), 41.42 (1.3mm). Diastema closure with finger spring activation towards the mesial and labial arches of the upper and lower jaws. Activation was carried out gradually at each control so that the diastema at the fourth control on teeth 33-32 (0.5 mm). Conclusion: This shows that removable orthodontic appliances are effective for closing multiple diastema with mild to moderate degrees, with patient compliance in using the appliance and the effect of using a tongue crib in reducing the patient's tongue thrusting habit.

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.

Penyakit asam urat (gout) adalah gangguan metabolik yang sering dialami oleh lansia, yang dapat menyebabkan rasa sakit yang hebat, keterbatasan gerakan, serta penurunan kualitas hidup. Penyakit ini terjadi akibat penumpukan kristal asam urat di persendian, yang dapat menyebabkan peradangan dan nyeri yang parah. Faktor risiko utama termasuk pola makan yang kaya purin, obesitas, gangguan ginjal, serta penggunaan obat-obatan tertentu. Namun, banyak lansia yang kurang memahami penyebab, gejala, dan penanganan penyakit ini dengan baik, sehingga kondisi mereka seringkali memburuk. Untuk itu, kegiatan pengabdian kepada masyarakat ini bertujuan untuk meningkatkan pengetahuan dan keterampilan lansia dalam merawat penyakit asam urat secara mandiri. Program ini diselenggarakan melalui penyuluhan kesehatan yang interaktif, dengan materi yang mencakup etiologi penyakit asam urat, manifestasi klinis, komplikasi yang dapat ditimbulkan, serta berbagai strategi pengelolaan yang efektif. Salah satu aspek penting yang dibahas adalah modifikasi gaya hidup, yang meliputi diet rendah purin, hidrasi yang cukup, serta pentingnya aktivitas fisik. Selain itu, peserta juga diberikan pemahaman mengenai pentingnya kepatuhan terhadap terapi medis yang direkomendasikan oleh tenaga kesehatan. Metode pelaksanaan kegiatan ini meliputi ceramah yang interaktif, sesi tanya jawab, dan distribusi leaflet informatif untuk memperkuat pemahaman peserta. Kegiatan ini dilaksanakan di wilayah RW 05 Srengseng Sawah, Jagakarsa, Jakarta Selatan, yang diikuti oleh sejumlah lansia yang aktif berpartisipasi. Hasil evaluasi menunjukkan adanya peningkatan signifikan dalam pemahaman peserta tentang penyakit asam urat dan bagaimana cara merawatnya. Lansia menunjukkan antusiasme yang tinggi dan mampu mengidentifikasi langkah-langkah praktis yang dapat mereka terapkan dalam kehidupan sehari-hari untuk mengelola kondisi mereka. Melalui kegiatan ini, diharapkan lansia dapat lebih mandiri dalam mengelola asam urat, mengurangi frekuensi serangan, dan meningkatkan kualitas hidup mereka secara keseluruhan.

Background: Premenstrual Syndrome (PMS) is a combination of physical, emotional, and behavioral symptoms that occur cyclically before menstruation and are commonly experienced by adolescent girls. Common symptoms include fatigue, abdominal pain, headaches, anxiety, and mood disturbances, which can affect sleep quality, concentration, and academic productivity. This article provides an in-depth examination of the definition, types, prevalence, causes, impacts, and management of PMS in adolescent girls. Based on epidemiological data, the prevalence of PMS is quite high, both globally and nationally, with incidence rates in Indonesia reaching 70–90% among women of reproductive age, and most cases beginning during adolescence. There are four main types of PMS: Type A (anxiety), Type H (hyperhidrosis), Type C (food cravings), and Type D (depression), each with specific characteristics and etiologies. Causes of PMS include hormonal imbalances of estrogen and progesterone, reduced serotonin levels, poor sleep quality, psychological stress, genetic factors, and unhealthy lifestyles. The impact of PMS on adolescents is complex, including decreased academic performance, social relationship disturbances, and reduced psychological well-being. Therefore, PMS management should be approached holistically through pharmacological (such as NSAIDs, antidepressants, and diuretics) and non-pharmacological (physical exercise, relaxation, lifestyle changes, and nutritional education) interventions. Environmental support and reproductive health education are crucial to help adolescents effectively manage PMS symptoms and improve their quality of life. This study is expected to serve as a foundation for promotive and preventive interventions in adolescent health care.

Chronic kidney failure is a pathophysiological condition that can arise due to various etiologies. Hemodialysis patients with chronic kidney failure who experience problems and clinical difficulties can affect anxiety levels, one of the non-pharmacological treatments that can be given to patients is Intradialytic exercise because the movements are simple, do not interfere with the hemodialysis procedure, and are useful in reducing anxiety levels. This study aims to determine the effect of intradialytic exercise on anxiety levels in patients with chronic kidney failure in the hemodialysis room of Tanjungpinang City Hospital. This study uses a quantitative research method with a quasi-experimental design without control design, the design form used is pre and post test. The sample in this study of patients treated at Tanjungpinang City Hospital amounted to 30 people with random sampling techniques. The anxiety level measurement instrument uses the Hamilton Anxiety Rating Scale (HARS) questionnaire. The statistical analysis used was a normality test with a sig value. > 0.005, t paired sample t test and independent t test. There was a significant influence between the average anxiety level score at the pre-test and post-test in the intervention group (intradialytic exercise) (mean pre-test = 24.60 to mean post-test = 18.33) with a p-value of 0.000. Conclusion this study found the effect of intradialytic exercise on anxiety levels in patients with chronic kidney failure in the hemodialysis room of Tanjungpinang City Hospital. Suggestion for Tanjungpinang City Hospital, intradialytic exercise therapy can be considered as a non-pharmacological management in patients with chronic kidney failure in the Hemodialysis room to reduce anxiety levels

Nephrotic syndrome is a group of diseases characterized by massive proteinuria that causes hypoalbuminemia, resulting in hyperlipidemia, edema, and various complications. One of the etiologies of nephrotic syndrome itself is primary and secondary glomerulonephritis in the form of infection, malignancy, connective tissue disease, drugs or toxins and due to systemic diseases. The incidence of nephrotic syndrome cases in adults does not have a significant difference between genders, where the cases are 3 per 100,000 population. The broad clinical manifestations of nephrotic syndrome require health workers to conduct anamnesis, physical examination, and supporting examinations carefully. When nephrotic syndrome has been established, management will be carried out. Management that can be given to this disorder is non-pharmacological such as a low protein and salt diet and pharmacological especially for the underlying disease. Non-specific treatment to reduce proteinuria, control edema, and treat complications that may occur. The prognosis for nephrotic syndrome depends on the underlying cause.

Post-laparotomy pain is very intense pain originating in the area of the stomach that has been cut and requires treatment. This pain cannot be classified into an etiological group, because there are many conditions that cause it. Based on a preliminary study conducted at the Tangerang Regency General Hospital, there were 77 patients with a diagnosis of post laparotomy appendicitis starting from November-January 2024. Meanwhile, in the Lower Kemuning ward, it was found that during the assessment there was 1 case of a child with a diagnosis of post laparotomy appendicitis on the 8th. January 2024. The results of this study used deep breathing relaxation techniques to reduce pain in patients with post laparotomy appendicitis. The conclusion of this research is that the deep breathing relaxation technique is a non-pharmacological technique for reducing pain and can be used in patients who experience post-operative pain problems. The suggestion from this research is that intervention can be carried out by medical personnel to reduce the intensity of pain in patients after laparotomy surgery.

Diabetes Mellitus is a chronic metabolic disorder with multiple etiologies characterized by high sugar levels. Patients with chronic illnesses are very susceptible to depression. This can be overcome if the respondent has good enough resilience and self-efficacy so that he can manage self-care and regulate glycemic levels and strive for better health. The aim of the research is to determine the relationship between resilience, self-efficacy and depression with self-care management in patients with diabetes mellitus in the Besuki Community Health Center working area. This research design is cross sectional/analytic correlation. The study population included 38 Diabetes Mellitus patients with Gangrene. The sampling technique uses probability sampling, total sampling. The sampling used was 38 people. The instrument uses a questionnaire sheet. And multiple linear regression statistical tests. The research results showed that the average resilience was 70.02, self-efficacy was 71, mild depression was 17 respondents and the average self-care management score was 72. Resilience increased self-care management with a p value of 0.000 ≤ α 0.005. Self-efficacy increases self-care management with a p value of 0.000 ≤ α 0.005 with an average coefficient of . the results of multiple linear regression obtained a p value of 0.000 ≤ α 0.005. There is a relationship between self-efficacy, resilience and depression with self-care management in patients with diabetes mellitus in the Besuki Community Health Center working area with a p value of 0.000 ≤ α 0.005 with a coefficient value of 0.608 so, Self-efficacy influences self-care 6 times more than other variables. Self-efficacy, good resilience can reduce depression in chronic patients such as gangrene so that patients have adequate self-care management.

Riwayat alamiah infeksi Mycobacterium tuberculosis (Mtb) pada manusia sangat bervariasi, demikian pula respons terhadap pengobatan tuberkulosis aktif. Saat ini tidak ada cara langsung untuk mengidentifikasi individu yang infeksi Mtb-nya telah diberantas, baik melalui respon imun bakterisidal atau kemoterapi antimikroba yang mensterilkan. Dengan menggunakan metode literatur Riview maka kita dapat mengetahui bahwa model matematika dapat membantu dalam keadaan seperti itu dengan mengukur atau memprediksi kejadian yang tidak dapat diamati secara langsung. Model matematika digunakan untuk mengidentifikasi individu dengan resistensi bawaan terhadap infeksi Mtb, menentukan mekanisme etiologi tuberkulosis pada pasien yang diobati dengan penghambat faktor nekrosis tumor, dan memprediksi risiko kambuh pada orang yang menjalani pengobatan tuberkulosis.

Anisometropia merupakan gangguan penglihatan yang ditandai dengan perbedaan refraksi lensa sferis atau silinder antara mata kanan dan kiri lebih dari 1 dioptri. Prevalensi anisometropia pada populasi sebesar 2-4% dan kondisi ini lebih sering menjadi penyebab gangguan penglihatan unilateral pada orang dewasa di bawah 60 tahun. Berdasarkan penyebabnya, anisometropia dibagi menjadi dua yaitu anisometropia aksial dan anisometropia refraktif sedangkan berdasarkan kekuatan refraksi anisometropia dibagi menjadi dua yaitu anisometropia absolut dan anisometropia relatif. Deteksi dini anisometropia memberikan dokter kesempatan untuk mengintervensi lebih awal, mungkin memperlambat, bahkan mencegah perkembangan penyakit. Retinoskopi sikloplegik terbukti sebagai metode yang paling tepat dan akurat untuk penentuan kesalahan refraksi selama pemeriksaan mata secara komprehensif. Malnutrisi, pemakaian media komunikasi elektronik seperti telepon genggan dan televisi, sampai kelalaian orang tua memerhatikan anaknya merupakan beberapa faktor risiko kelainan refraksi. Hampir seluruh anisometropia dapat menyebabkan kelainan ambliopia. Perawatan konvensional dengan kacamata, lensa penambalan, atau atropin 1% efektif pemakaiannya pada mata dalam mencegah memburuknya kasus ambliopia anisometropik. Artikel ini menggunakan metode literature review dari berbagai rujukan jurnal nasional dan internasional dengan kata kunci pencarian berikut: anisometropia, etiologi, klasifikasi, dan komplikasi.

PGK merupakan suatu proses patofisiologi dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan umumnya berakhir dengan gagal ginjal. Selanjutnya gagal ginjal adalah suatu keadaan klinis yang ditandai dengan penurunan fungsi ginjal yang reversible, pada suatu derajat yang memerlukan terapi pengganti ginjal yang tetap, berupa dialysis atau transplantasi ginjal. Uremia adalah suatu sindroma klinik dan laboratorik yang terjadi pada semua organ, akibat penurunan fungsi ginjal pada penyakit ginjal kronik (Suwitra, 2009).   Gejala sindroma uremia dini ialah gangguan fungsi gastrointestinal. Penderita merasa  mual-mual,  muntah-muntah  dan  tidak  nafsu  makan.  Gejala-gejala  tersebut diduga akibat timbunan metabolit, antara lain: metilguanidin, asam guanidinosuksinat, asam parahidroksi-fenilasetat, fenol, indol, asam-asam aromatik, dan senyawa-senyawa amin. Metabolit-metabolit tersebut berasal dari degradasi protein (Syaifuddin, 2006).   Gejala gastrointestinal  yang lain ialah kerusakan epitel dan perdarahan, mulut kering, lidah terasa pahit, perdarahan gusi, hematemesis, melena. Kerusakan epitel dan gangguan fungsi epitel, diduga karena iritasi oleh timbunan metabolit dan gangguan metabolisme sel-sel- epitel. Gangguaan juga terjadi pada epitel kulit, garukan karena gatal meninggalkan ekskoriasi ditungkai, lengan dan di badan. Rasa gatal diduga akibat timbunan atau endapan kalsium dan ureum di dermis. Gejala kardiovaskuler dapat menyertai PGK, hipertensi, jantung hipertensif, payah jantung kongesif, perikarditis uremik, hemoperikardium, tamponade jantung (Syaifuddin, 2006).