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Background: Labor is a physiological process that is commonly accompanied by pain, causing discomfort, anxiety, and fear that may interfere with maternal well-being and labor progress. Effleurage massage is a complementary, non-pharmacological intervention used to reduce labor pain. Purpose: This study aimed to evaluate the effectiveness of effleurage massage in reducing pain intensity during the first stage of labor. Method: A literature review was conducted using articles retrieved from Google Scholar. An initial search identified 45 articles, and after screening based on publication year (2021–2026), relevance, and inclusion criteria, 10 research articles were included for analysis. Data were extracted and synthesized descriptively. Results: The findings consistently showed that effleurage massage reduced labor pain by promoting relaxation, decreasing muscle tension, improving blood circulation, and stimulating endorphin release through the gate control mechanism. Most studies also reported improved maternal comfort during labor. Conclusion: In conclusion, effleurage massage is an effective, safe, affordable, and easy-to-apply complementary therapy that can be integrated into midwifery care to reduce labor pain and enhance maternal comfort.  

Typhoid fever is a febrile illness that commonly occurs in urban areas with poor sanitation. It is usually caused by the consumption of untreated water and contaminated food. Because the S. typhi bacterium can survive in water for days, contamination of surface water—such as wastewater, freshwater, and groundwater—serves as the primary cause of typhoid fever. The patient presented to the Emergency Department of Cut Meutia General Hospital with complaints of high fever for approximately 4 days prior to admission, which had worsened over the past 2 days. The fever fluctuated and was accompanied by chills. It worsened at night and was not influenced by weather or temperature. These symptoms were accompanied by vomiting every time the patient tried to eat, nausea, abdominal pain, headache, and weakness. The patient reported vomiting the contents of their meal every time they ate, leading to a loss of appetite. These symptoms began when the patient first developed a fever. The patient also experienced abdominal pain. Spontaneous bleeding was denied. On physical examination, the patient appeared weak but was alert and oriented. On neck examination, palpable enlargement of the thyroid glands was found on the right and left sides of the neck, measuring 2x2 cm, mobile, and soft. On abdominal examination, increased bowel sounds were noted. Vital signs were normal except for the patient’s febrile temperature. Laboratory tests revealed a Tubex blood test result of scale 4 and a positive dengue IgG serology result.

Uterine myoma is a benign smooth muscle tumor of the uterus commonly found in women of reproductive age and may cause symptoms related to mass effect and hematologic disturbances. We report the case of a 41-year-old woman presenting with progressive vaginal pain for 3 months, accompanied by low back pain and impaired daily activities, without vaginal bleeding, vaginal discharge, fever, or urinary or defecatory symptoms. Laboratory examination revealed severe microcytic hypochromic anemia with a hemoglobin level of 4.7 g/dL, while ultrasonography demonstrated a 9.93 × 10.32 cm mass described as symmetric, well circumscribed, and hyperechoic, leading to a working diagnosis of uterine myoma with anemia. The patient was managed with general condition monitoring, intravenous fluids, analgesics, transfusion of four units of packed red cells, and laparotomy as definitive intervention. Following transfusion and surgery, the hemoglobin level increased to 9.4 g/dL and subsequently to 11.0 g/dL, accompanied by improvement in postoperative symptoms and clinical condition. This case demonstrates that a large uterine myoma may present predominantly with pelvic pain and functional impairment in the absence of vaginal bleeding. A comprehensive approach involving systematic evaluation, preoperative correction of anemia, appropriate surgical intervention, and postoperative monitoring is essential to improve safety and clinical outcomes in patients with symptomatic pelvic masses.

A Normocytic normochromic anemia is one of the most common types of anemia found in geriatric patients with chronic diseases or acute bleeding. Upper gastrointestinal bleeding (UGIB) may cause continuous blood loss resulting in decreased hemoglobin levels. This case report discusses a 72-year-old woman who presented to the Emergency Department of Cut Meutia Regional General Hospital with complaints of black stools for four days prior to admission accompanied by epigastric pain, nausea, weakness, and pallor. The patient had a history of long-term use of analgesic and anti-gout medications due to chronic joint pain, which was suspected to be a risk factor for UGIB. Physical examination revealed pale conjunctiva and tachycardia, while laboratory findings showed hemoglobin of 7.1 g/dL, hematocrit of 23.3%, MCV of 82 fL, MCH of 29 pg, and uric acid level of 11.56 mg/dL, leading to the diagnosis of normocytic normochromic anemia caused by UGIB accompanied by gout arthritis. The patient received intravenous fluid therapy, proton pump inhibitors, antifibrinolytic agents, gastroprotective therapy, packed red cell transfusion, and other supportive treatments. During hospitalization, clinical improvement was observed, including cessation of gastrointestinal bleeding, reduced epigastric pain, and increased hemoglobin level to 8.6 g/dL. This case highlights the importance of early diagnosis and comprehensive management in geriatric patients with anemia caused by UGIB and comorbid gout arthritis.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacterium that affects the skin, peripheral nerves, upper respiratory mucosa, and eyes. Type 2 diabetes mellitus (T2DM) is a comorbidity that can worsen the course of leprosy. The female patient, Mrs. D, aged 55 years came to the emergency room of Cut Meutia Hospital with the main complaint of red bumps accompanied by pain on the face, hands, chest, and back since 3 days ago and additional complaints such as fever, joint pain, and numbness and loss of feeling in the legs, weakness, frequent thirst, and frequent urination. Dermatologic status is obtained in the facial region in the form of erythema nodules with firm boundaries with numular size, multiple. Laboratory examination showed anemia and leukocytosis. The therapy given was MDT MB package, ferrous sulfate 1x325 mg and PRC transfusion 3 kolf. Complaints arose acutely after the patient resumed taking MDT (multidrug therapy) leprosy drugs which had previously been stopped for more than 3 months. Based on the time of onset of symptoms, history of leprosy treatment, and the manifestation of systemic inflammatory lesions with signs of neurotropism, it can be suspected that the patient is experiencing a type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL).

Cardiovascular dysfunction is a disorder of the blood vessels, such as hypertension, heart failure, and stroke. In 2016, cardiovascular disease was the leading cause of death worldwide, based on data from the World Health Organization (WHO). Coronary Heart Disease (CHD) is the leading cause of death, along with stroke, as shown by the Sample Registration System survey in 2014.This case involves a 64-year-old male, Mr. N, who presented to the emergency department of RSUD dr. Fauziah Bireuen with complaints of chest pain that developed gradually and worsened over the past month. The pain was located across the entire chest and radiated to the back and neck. The pain was described as severe, like being crushed by a heavy load, worsened during strenuous activities such as cutting grass and chopping wood, and relieved when the patient bent forward. The pain could occur at any time, with a Visual Analog Scale (VAS) score of 10 (severe pain). The patient also reported easy fatigue during heavy physical activity over the past month. Laboratory examination revealed elevated leukocytes, mean corpuscular volume (MCV), segmented neutrophils, troponin I, cholesterol, and triglycerides. The patient was diagnosed with extensive anterior ST-elevation myocardial infarction (STEMI) post successful fibrinolytic therapy.

Prolactinoma is the most common functional pituitary adenoma, particularly in adolescent females, and is typically characterized by amenorrhea and galactorrhea resulting from hyperprolactinemia. However, in certain cases, serum prolactin levels may appear normal due to the hook effect, an immunoassay measurement error caused by extremely high prolactin concentrations that interfere with antigen–antibody complex formation. We report the case of a 17-year-old female presenting with a five-month history of galactorrhea, accompanied by breast pain, headache, and primary amenorrhea. Brain MRI revealed a pituitary mass measuring 1.4 × 0.8 × 0.5 cm, suspicious for prolactinoma, while serum prolactin was within the normal range (17.33 ng/mL). The discrepancy between clinical manifestations, lesion size, and laboratory findings raised suspicion of the hook effect. The patient was treated with dopamine agonists, bromocriptine and cabergoline, and referred for multidisciplinary management involving endocrinology, neurosurgery, and obstetrics–gynecology. Despite the absence of prolactin dilution testing, MRI findings supported the diagnosis of prolactinoma, and the patient demonstrated a favorable clinical response to therapy. This case highlights the importance of recognizing laboratory variability, performing comprehensive hormonal evaluation, and considering prolactin dilution assays when clinical and laboratory findings are discordant, particularly in adolescent patients with suggestive symptoms.

Background: Comprehensive midwifery care is essential for early detection of complications and reducing maternal and infant mortality rates. In Sleman Regency, despite high access to health services, continuous monitoring remains crucial for ensuring maternal and fetal safety. Objective: To provide comprehensive midwifery care for Mrs. M at Klinik Pratama Shaqi, Sleman, from the third trimester of pregnancy through the postpartum and neonatal periods. Methods: This is a descriptive qualitative study using a case study approach based on Varney's seven-step midwifery management and SOAP documentation. Findings: During pregnancy (37 weeks 6 days), the mother experienced physiological complaints of back pain and shortness of breath, managed through posture education and pregnancy exercises. Labor proceeded normally and spontaneously on October 6, 2024, utilizing "gentle birth" practices such as endorphin massage to reduce pain. A second-degree perineal tear occurred and was treated according to procedure. The baby was born healthy, weighing 3100 grams, with successful Early Initiation of Breastfeeding (EIB). During the postpartum and neonatal periods, uterine involution was normal, breast milk production was adequate, and the infant's growth met standards with no danger signs. Implications: Continuous assistance improves the mother's physical and psychological readiness and ensures a healthy neonatal transition.

Empowering pregnant women in their third trimester through Respectful Maternity Care-based childbirth preparation counseling is a relevant promotive and preventive strategy for improving maternal health. This counseling not only provides knowledge about the signs of labor, stages of labor, pain management options, and birth planning, but also equips mothers with an understanding of their rights in midwifery care. Childbirth preparation education often focuses solely on clinical aspects and fails to fully address the psychosocial aspects and the rights of mothers as service recipients. This has the potential to lead to an unpleasant childbirth experience and even contribute to disrespect and abuse during labor. This counseling can equip mothers with an understanding of their rights in midwifery care. With an empathetic, participatory, and woman-centered approach, pregnant women are expected to be able to recognize their needs, convey their preferences, and communicate effectively with health workers. The purpose of this counseling is to improve pregnant women's knowledge before and after being empowered in their third trimester through Respectful Maternity Care-based childbirth preparation counseling.

The goal of continuous midwifery care is to use the SOAP documentation technique to provide comprehensive care to pregnant women up to birth control according to care standards. From May 2 - July 14, 2025, Mrs.C, G2P1A0, 32 years old received continuous midwifery care from pregnancy until get contraception methods, starting at 34 weeks of gestation. The mother complained of back pain during prenatal check-ups. The labor process went smoothly. With the assistance of a midwife, the baby was born on June 10, 2025. Birth weight: 3000 grams; length: 50 cm; head circumference: 34 cm; chest circumference: 33 cm; received Hb0 vaccine two hours after birth, eye ointment, and vitamin K shortly thereafter. The baby did not experience any problems or complaints during the first visit. Mrs. C received four visits during the postpartum period. The mother did not feel anything during the first visit up to the following visits. She continued to breastfeed exclusively, and her vital signs and fundal height returned to normal. The mother used a three-month injectable contraceptive so as not to interfere with the exclusive breastfeeding program. Mrs.C has received continuous midwifery care during pregnancy and contraceptive use, and her health is normal. It is expected that the midwife will be able to provide continuous midwifery care so that in the event of an emergency, it can be immediately identified and promptly handled.