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Ventricular septal defect (VSD) is a congenital heart defect characterized by a gap in the interventricular septum, with a prevalence of 20–30% of all cases of congenital heart disease. Based on their location, VSD is divided into perimembrane, muscular, and subarterial. This case report discusses a patient who came to the emergency room of Cut Meutia Hospital with good consciousness (GCS E4M6V5) and complained of shortness of breath, cough, nausea, and chest pain spreading to the neck and hands. The anamnesis showed chronic symptoms in the form of coughing up phlegm for two weeks, accompanied by throbbing headaches, dizziness, flatulence, and sleep disturbances. Physical examination showed vital signs of TD 140/90 mmHg, HR 86 x/min, RR 23 x/min, SpO₂ 37%, and temperature 37°C.  Supporting examinations in the form of chest X-rays showed cardiomegaly of the pulmonary segment, while ECG showed rhythmic sinuses with LAD axis, T-inverted in AVL, V1, V2, RsR' in V2, positive Cornell criteria, anterolateral myocardial infarction, RBBB, and LVH. Echocardiography shows the presence of a bidirectional shunt with a dominant right-to-left shunt. This case confirms the importance of comprehensive diagnosis through clinical and supporting examinations to determine optimal management in patients with VSD, as well as prevent further complications.

Islamic character education has become a central focus of madrasah education; however, its planning is often implemented normatively without adequate managerial and evaluative mechanisms. This study aims to analyz ethe planning of Islamic character educationatMTs Persis 23 by examining the alignment betweent he madrasah’s strategic direction, curriculum, instructional practices, habituation programs, and character evaluation. Using a qualitative case study approach, data were collected through document analysis, classroom and school observations, and in-depth interviews with the head of the madrasah, the vice principal for curriculum, and home room teachers. Data were analyzed thematically to identify patterns of planning, implementation, and evaluation. The findings reveal that the madrasah has established a strong strategic foundation for character education through its vision, mission, and religious school culture, positioning character development as a core educational objective. Character values are integrated in to the Madrasah Operational Curriculum, lessonplans, and daily habituation activities functioning as a hidden curriculum. Nevertheless, the planning of character education remains weak at the operational level, particularly due to the absence of m easurable behavioral indicators, standar dizede valuation instruments, and systematic documentation of students’ character development. This study highlightsthe gap between normativ estrategic intentions and managerial implementation. It recommends the development of simple behavioral indicators, baselineand longitudinal character assessments, ands trengthenedpe dagogical supervision to ensure that character education planning is implemented systematically and sustainably.    

The role of a leader has a relationship with the performance and success of implementing nurses. Effective leaders can influence in various ways with their leadership style. Leaders provide direction and goals to members with their leadership style. Leadership style is able to influence, be smart in encouraging, motivating, and facilitating their subordinates so that their goals are achieved. According to Lippits and K. White, there are 3 leadership styles, namely authoritarian, democratic, and laissez-faire. This leadership style influences the loyalty of a implementing nurse's performance in implementing nursing care which can be seen in the quality of service provided to patients. Quantitative research, correlational design. Cross-sectional approach measuring the independent variable of the ward head's leadership style and the dependent variable of the implementing nurse's performance and the relationship between the ward head's leadership style and the implementing nurse's performance were carried out once at the same time. The results of the research showed that the majority of democratic leadership styles were 116 respondents (81.1%), the performance of the majority of nurses was in the good category as many as 118 respondents (82.5%), and the relationship between the leadership style of the head of the room and the performance of the implementing nurses in the chi square test with a p value of 0.533 > alpha (0.05), then Ho = There is no relationship between the leadership style of the head of the room and the performance of implementing nurses at Santa Elisabeth Hospital Medan. For implementing nurses who still have the performance of implementing nurses in the sufficient category, they should increase their self-motivation to be more responsible in carrying out their duties as nurses which is part of their work profession.

Hospitals have the main responsibility in providing quality, effective, and efficient health services. The performance of the implementing nurse is an important indicator to ensure the quality of service and patient safety. The supervision of the head of the room as part of the managerial function includes planning, organizing, guidance, direction, supervision, evaluation, as well as recording and reporting, all of which are aimed at ensuring that nursing care is carried out according to standards. This study is focused on analyzing the influence of head of room supervision on the performance of implementing nurses in the inpatient room of Wira Husada Kisaran Hospital in 2025. The study used a quantitative approach with a cross sectional design. All 86 implementing nurses were sampled through the total sampling method. Data were collected with questionnaires on supervision and performance, then analyzed using univariate, bivariate with Chi-Square, and multivariate tests through multiple linear regression. The results showed that the functions of planning, supervision, evaluation, and recording and reporting had a significant effect on nurse performance (p<0.05). On the other hand, the organizing and directing functions did not have a significant effect, while guidance showed a negative direction. The most dominant variables were recording and reporting. Thus, it can be concluded that the supervision of the head of the room has a strategic role in improving nurse performance, so it is necessary to implement consistent, structured, and continuous supervision.

This study aims to describe the transformational leadership strategy implemented in Masohi hospital and analyze its impact on the performance of human resources (HR). The research approach used is qualitative with case study design, which allows researchers to understand the phenomenon in depth in a real context. The Data was collected through in-depth interviews with eight informants, consisting of directors, field heads, room heads, and implementing staff, so that diverse perspectives were obtained from various levels of management and implementers. The data analysis process is carried out through three main stages, namely data reduction, data presentation, and conclusion/verification. The results showed that transformational leadership strategies in Masohi hospital include exemplary, inspirational motivation, innovative thinking encouragement, and attention to individual employee needs. Implementation of this strategy can improve discipline, work ethic, teamwork, and a sense of responsibility of employees in providing services to patients. In addition, it was found that the work culture built through transformational leadership can strengthen organizational commitment and improve overall service quality. However, the implementation of this strategy is not free from challenges. The obstacles that arise include complex bureaucracy, managerial competence gaps between units, as well as resistance to change among staff. This challenge requires an adaptive approach and effective communication so that the strategy can run optimally. Overall, the findings of this study confirm that transformational leadership has a positive impact on strengthening work culture and improving service quality in regional hospitals. This research is expected to be a valuable input for the development of leadership and HR management policies, not only in Masohi hospital, but also in other regional hospitals that face similar challenges.

Pulmonary tuberculosis (pulmonary TB) is an infectious disease that attacks the respiratory system, especially the lungs, and can cause various clinical symptoms, one of which is decreased oxygen saturation (SpO₂). Decreased oxygen saturation can worsen the patient's condition and affect their quality of life. Therefore, effective interventions are needed to increase oxygen levels in the body, especially through safe and easy-to-implement non-pharmacological approaches. One intervention commonly used in nursing practice is the semi-Fowler position, which is a lying position with the head of the bed elevated around 30–45 degrees, which is believed to improve lung expansion and increase ventilation. This study aims to evaluate the effectiveness of implementing the semi-Fowler position on increasing oxygen saturation in pulmonary TB patients. The study was conducted using a descriptive method through a case study approach on three pulmonary TB patients treated in the Mawar Room of Subang District Hospital. Data were collected through direct observation of oxygen saturation using a pulse oximeter at minute 0 (before intervention), minute 10, minute 30, and more than minute 60 after the patient was placed in the semi-Fowler position. The results showed a significant increase in the SpO₂ values of the three patients after 30 minutes in the semi-Fowler position, with an average increase from 92–93% to 95–96%, and these values tended to be stable for more than 60 minutes after the intervention. These findings suggest that the semi-Fowler position can be an effective non-pharmacological nursing intervention option to increase oxygen saturation in pulmonary TB patients. The application of this position is recommended in daily nursing practice to help overcome respiratory disorders, increase comfort, and accelerate the recovery process of pulmonary TB patients.

High stress can have different effects on each person. Changes that arise due to work stress can change behavior and affect mental and physical health. In addition, stress in nurses also affects the quality of hospital services. The purpose of the study was to determine the relationship between work period and workload with work stress of implementing nurses at ASA Depok Hospital in 2024. This study is a quantitative type that is analytical in nature. The research design used is a cross-sectional study. The population in this study were all nurses at RSUD ASA Depok totaling 123 people. The determination of the sample in this study used a purposive sampling technique. The sample in this study was 94 respondents. In this study, the research instrument or tool used to collect data was by using a questionnaire. The researcher used the Chi Square test with a confidence level of 95% or a significance level of 5%. Based on the results of the study, there were more who had a work period of > 5 years, namely 53 respondents or 56.4%, more nurses felt a heavy workload, namely 59 respondents or 62.8% and more nurses felt moderate work stress, namely 36 respondents or 38.3%. The results of the statistical test of the relationship between length of service and work stress with a P value = 0.001 and the relationship between workload and work stress with a P value = 0.000. It is concluded that there is a relationship between work period and workload with work stress of implementing nurses at ASA Depok Hospital in 2024. Suggestions for Nursing Management including the head of the room to add personnel in each room so that it is not too heavy to work and for nurses to be able to apply good coping management in order to prevent work stress.

Supervision is part of the directing function carried out by supervisors to improve nurse performance. Falls result in injuries such as broken bones or bleeding and can cause death. This is because nurses' lack of optimal compliance with the implementation of fall risk prevention SOP can increase the incidence of patients falling while being treated. One of the incidents of falls comes from not yet optimal SOP planning in an institution. The purpose of this research is to analyze the relationship between head of room supervision and the implementation of fall risk prevention SOP at the Sultan Agung Islamic Hospital.This research is a quantitative research with a cross-sectional approach. Data collection was carried out using questionnaires and observation sheets. The research sample consisted of 50 respondents. This research uses a total sampling technique and is processed statistically with the correlation test used in this research is the spearman rank test.The results of the spearman rank test on the room head supervision data with the implementation of fall risk prevention SOP obtained a p value of 0.000 (<0.05). For further research, it is recommended to expand the scope of research by involving more respondents and hospital institutions in order to obtain more generalizable results.

Fish growth refers to the growth of body size which includes length and weight, as well as the development of fish body tissues within a certain period of time.Growth does not only occur in a physical sense but also includes biological and physiological changes in the fish body.In an ecological context, fish growth is related to the ability to survive, adapt, and reproduce in an environment with various internal and external factors.The implementation of the practicum of population dynamics and fish stock assessment was carried out in the Nias University building, room 2 of the Faculty of Science and Technology. The morphometric measurements were carried out by measuring the total length, stag length and standard length.The total length was measured from the distance between the tip of the head end and the tip of the caudal fin back.Growth of strange mackerel through the relationship between length and weight using the growth formula expressed in the form of a linear regression equation. The equation obtained from the analysis of measurement data shows the length-weight relationship with the equation Y 2.8771x-1.7473 and R2 value of 0.6688. The coefficient b value of 1.7473 indicates that mackerel has a negative allometric growth pattern, which means weight gain. Mackerel (Rastrelliger sp.) is the main indicator of fish growth and health based on the results of morphometric studies that show variations in length and weight.

Optimal managerial function of the head of the room is an important factor in improving the quality of nursing services. This study aims to analyze the extent to which the managerial function of the head of the room influences the quality of nursing services. The research design used a quantitative approach with simple linear regression analysis. The study population included all nurses in the inpatient room, sufficient in the ER, and less in outpatient care, with a simple random sampling technique of 45 respondents. The results showed a significant influence between the implementation of the managerial function of the head of the room on the quality of nursing services (p value = 0.000 <0.005). The implementation of the managerial function and the quality of nursing services at RSU Melati were categorized as good in the inpatient room, sufficient in the ER, and less in outpatient care. In conclusion, the better the implementation of the managerial function of the head of the room, the better the quality of nursing services.

Background: Leadership is one of the crucial aspects in managing a health care unit, especially in nursing. A leadership style that focuses on attention and empathy, or known as Caring Leadership, has been shown to improve the quality of service and patient satisfaction. This community service aims to improve the understanding and ability of the head of the room in implementing the Caring Leadership style. Methods: This activity is carried out through a series of training and interactive discussions involving the head of the room in various hospitals. Educational materials include an introduction to the concept of Caring Leadership, effective communication techniques, and strategies in supporting the nursing team. Results: The results of this activity show an increase in participants' knowledge and skills in applying Caring Leadership in their work environment. The impact is expected to create a more harmonious work atmosphere and support the improvement of the quality of health services. Conclusion: This activity also contributes to improving the welfare of the nursing team and patient satisfaction.

Nasopharyngeal Carcinoma (NPC) is a squamous cell carcinoma (SCC) originating from the nasopharyngeal epithelium. In Indonesia, NPC is the 4th most common malignancy after breast cancer, cervical cancer, and lung cancer. A 40-year-old woman came to the Emergency Room of Cut Meutia Hospital with complaints of left-sided nosebleeds for approximately 2 weeks before entering the hospital. The results of the physical examination found hair that was easily pulled out, then from the results of the supporting examination in the form of a non-contrast head CT-Scan, an expansion of the mass in the nasopharynx was found. Based on the anamnesis, physical examination and supporting examinations, the patient was diagnosed with nasopharyngeal carcinoma. The management that can be given to patients is non-drug, namely consuming nutritious food, and managing stress and sleep patterns, in addition the patient is also given symptomatic management.

The purpose of this study is to ascertain the connection between the Pagar Merbau District Health Center's performance and the leadership style used in decision-making and problem-solving. In 2024, Deli Serdang. This study is cross-sectional and observational. Fifty individuals made up the sample size. A questionnaire is used as a data gathering tool in this study the test known as chi-square is the analysis that is employed. The study room demonstrates that 25 people (50%) are involved in problem-solving using a leadership style that emphasizes involvement. There are 25 individuals (50%) involved in the Making decisions process, which is more educational in character. Bivariate analysis results show that leadership style and health worker performance Community Health Center Pagar Merbau in Regency of Deli Serdang are associated, with a p-value of 0.001 and a related category since the value is greater than 0.05. The findings of the evaluation indicate that health professionals' performance, which includes their presence, teamwork, excellence of the work, professionalism, and knowledge mastery needs to be in harmony with the educational, consultative, participative, and delegative leadership style of the Pagar Merbau Health Center's chief executive. To maximize the performance of all healthcare professionals in problem-solving, The community health center's head should adopt a leadership style That's more adaptable and flexible to different circumstances.

The head of the ward has a crucial role in supervising health services, especially in supervising nurses regarding documentation of nursing care. This supervision functions to improve nurse performance. This study aims to determine the relationship between the supervision of the head of the room and the performance of nurses in documenting nursing care in the emergency room at Kotamobagu City Hospital.The method used is correlational analytics with a sample of 33 respondents taken by total sampling. Data collection was carried out through questionnaires and observation sheets, and analyzed using the Chi-Square Test with a significance level of 0.05.The research results showed that most of the supervision of room heads was in the good category (72.7%), but most of the documentation of nursing care was still incomplete (69.7%). The Chi-Square test produced a value of p = 0.020, which is smaller than 0.05, indicating a significant relationship between the supervision of the head of the room and the performance of nurses in documentation. In conclusion, there is a positive relationship between the supervision of the head of the room and the documentation performance of nurses. It is hoped that the quality of documentation can be improved through seminars or workshops, as well as supervision and leadership training, so that room heads can become role models for nurses in carrying out their duties.

The quality of health services is the degree of perfection of health services that are in accordance with professional standards and service standards by using the potential resources available in the hospital. The purpose of this study was to determine the Quality of Service in At-Tin Ward Reviewed from Quality Dimensions at PKU Muhammadiyah Hospital Sukoharjo.This research method is qualitative, namely a research procedure that produces descriptive data to determine the Quality of Service in At-Tin Ward Reviewed from Quality Dimensions at PKU Muhammadiyah Hospital Sukoharjo. The population in this study were the Head of PMKP, Head of Inpatient Room, Nursing Officer, IPSRS Officer, CS Officer and patients. The variables used in this study are Service Quality, with three dimensions of tangible quality, reliability, responsiveness. conducted in July 2024 to August 2024. The research instruments include observation guidelines, interview guidelines, Data Collection, Data Reduction, Data Display, Conclusion Drawing.The results of the study show Physical Evidence (Tangible) on the aspect of cleanliness. The cleaning staff carries out their duties well, the Aspect of the Availability of Medical Equipment is considered to be in accordance with the standards set for type C hospitals, the aspect of the condition of the ward room can be said to be not good enough, Reliability of officers has sufficient knowledge regarding the procedures and procedures for serving patients, Responsiveness is good quality of service in terms of communication, speed of service, and friendliness of staff.The conclusion of this study is that the Cleanliness Aspect still needs to be improved, Availability of medical devices for respiratory aids needs to be improved, Room conditions in the adult ward still need to be improved, Accurate and Reliable Service Medical personnel in the adult Inpatient ward have shown good competence in carrying out their duties, but there is no clear SOP regarding service times.

Ritasari. This study aims to analyze the leadership style of the village head in increasing the work motivation of the village head in Tuan Kentang Village. The study used qualitative methods with data collection, namely observation, interviews and documentation. The results showed that the leadership style of the village head of Tuan Kentang village had no signs that indicated an authoritarian leadership style, because in this case the employee was given the freedom to work even though he still had to comply with the main tasks and functions, on the other hand the Lurah was also a leader capable of employee morale. to work. The leadership style of Tuan Kentang Village also includes a delegative leadership style that is able to delegate work and is authorized in accordance with the main tasks and functions. The leadership style of Kelurahan Kentang, which is more participatory, makes employees feel happy to work better, one of which shows that Kelurahan Kentang uses a participatory leadership style, namely discussions, exchanging ideas and meetings held before the activity. Supporting factors in terms of coordination between superiors and staff and related institutions are very good and run as expected, this can be seen from meeting activities. In addition, the village head of Tuan Kentang as a leader is able to set an example and motivate employees to improve their performance for the better. The inhibiting factor for the Lurah's leadership style in motivating employees in Tuan Kentang Village is the lack of performance supporting facilities and infrastructure, namely the work room and service room that is not so, and less supported, such as computers and printers to support administrative services. In principle, the existence of complete facilities and infrastructure can increase employee work motivation for the better.

Vertigo is a sensation or sensation of movement from the body and surrounding environment that is described as a circular sensation, usually accompanied by complaints of nausea and vomiting, and balance disturbances. Vertigo is the third most common complaint by patients who come to general practice, after headaches, and strokes. A 31-year-old man came to the emergency room of Cut Meutia Hospital with complaints of dizziness since 5 days ago and disappeared. Patients also complained of nausea but were not accompanied by vomiting since complaints of dizziness appeared. Dizziness is felt by patients when looking at the surrounding environment and is not triggered by a change in head position. In addition, the patient also has a buzzing tingling tingling tingling along with spinning dizziness attacks. The patient's hearing begins to fade when the patient's ears ring and finally settle down. Based on anamnesis, physical examination and extenuation examination, the patient was treated with peripheral vertigo et causa meniere disease. Governance is carried out in the form of inf. RL 20 gtt/min, inj. Omeprazol 2x1, inj. Ondansetron 2x1 and oral in the form of betahistin 2x1 and hydrochlorothiazide 1x1.    

Liver cirrhosis and nephrolithiasis are significant health problems with different pathophysiological mechanisms. Liver cirrhosis, the final stage of chronic liver disease, is characterized by fibrosis and regenerative nodules, leading to severe complications, including portal hypertension and liver failure. Nephrolithiasis, commonly known as kidney stones, is a common urological condition characterized by the formation of stones in the renal system. Although these conditions are distinct, metabolic and physiological changes in cirrhotic patients may predispose to nephrolithiasis.  It was reported that a man came to the emergency room of RSUD Dr. Suhatman MARS with complaints of left-sided low back pain that had been felt for 1 week. The complaint was accompanied by shortness of breath which was getting worse over time. The patient also felt cough, headache, nausea, fatigue, urine slightly coloured like tea, weight loss. The patient has a history of untreated kidney stones. The patient has a history of hepatitis 31 years ago. The main objective of investigating the coexistence of liver cirrhosis and nephrolithiasis is to understand the relationship between these two conditions and to develop effective management strategies that can address their combined impact on patients.      

This type of research is qualitative research using descriptive methods. The data source in this research is the Head of the Library at SMPN 1 Lubuk Suhuing. The data for this research are the results of interviews with the head of the library at SMPN 1 Lubuk Suhuing. The instrument for this research was the researcher himself using an interview guide, notebook, digital camera and recording device. The data collection technique is carried out in five stages, namely: (1) this observation technique is based on direct experience (2) the observation technique allows you to see and observe yourself, then record behavior and events as they actually occur. (3) observation allows researchers to record events in situations related to proportional knowledge or knowledge directly obtained from data. (4) observation techniques enable researchers to understand complex situations. (5) in certain cases where interview techniques are not possible to carry out, observation becomes a tool. Based on the research results, it was found that: The research results of the library space arrangement according to Lasa HS (2007) amounted to 7 points, 3 points were appropriate while 4 points were not appropriate, thus the research results found that the characteristics of the library room arrangement at SMPN 1 Lubuk Suhuing could it is said to be not fully appropriate or in other words does not meet the spatial planning standards according to Lasa HS (2007).

Immigration Office Class II Non TPI Blitar is an implementation in the field of immigration at the Regional Office of the Ministry of Law and Human Rights of East Java Province which is responsible to the Head of the Regional Office. Passport is a document that contains identity to enter the border of a country. In the implementation of passport making services at the Blitar Class II Non TPI Immigration Office, researchers found obstacles experienced by applicants such as the information provided was not clear, so the applicant had to return to the Blitar Class II Non TPI Immigration Office, because there was no delivery service for applicants who lived outside Blitar, the priority service room was underutilized due to lack of employees. Therefore, effectiveness in the implementation of public services is very necessary, because one of the requirements for implementing a program to improve the quality of public services. This study aims to analyze the making of passports at the Blitar Class II Non TPI Immigration Office. The method used in this research is descriptive qualitative method. Data collection techniques in this study used observation, interviews, and documentation methods. Public services in passport making at the Immigration Office Class II Non TPI Blitar show some positive results. The implementation of this program includes various services such as passport issuance in the office, out-of-office services, as well as special programs such as Sambang Haji and Sambang Sakit Services. However, there are several obstacles such as the lack of employees in the priority service room, unclear information, and instability in the Community Satisfaction Index (IKM).