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Esophageal atresia with tracheoesophageal fistula is a congenital anomaly requiring early diagnosis and prompt surgical correction. Gross type D esophageal atresia, characterized by both proximal and distal tracheoesophageal fistulas, is an exceedingly rare variant that poses significant diagnostic and operative challenges. We report a case of a full-term female neonate with a birth weight of 3,200 grams who presented with hypersalivation since the first day of life, accompanied by coughing and choking during feeding. Orogastric tube insertion failed, with the tube arrested at approximately 15 cm. The patient was referred with a diagnosis of neonatal pneumonia and suspected esophageal atresia with tracheoesophageal fistula. Physical examination revealed tachypnea, chest wall retraction, and respiratory distress requiring ventilatory support. Babygram demonstrated the orogastric tube tip arrested at the proximal esophageal pouch with distal gastrointestinal air. Contrast esophagography confirmed proximal esophageal atresia at the upper thoracic level with suspected proximal fistula. Associated findings included bilateral pneumonia, right upper lobe atelectasis, and vertebral anomalies suggestive of VACTERL association. Intraoperative findings confirmed Gross type D esophageal atresia with proximal and distal tracheoesophageal fistulas. Both fistulas were excised, followed by primary esophageal anastomosis and transanastomotic nasogastric tube placement. Gross type D esophageal atresia is a rare congenital anomaly that should be considered in neonates presenting with hypersalivation, failed orogastric tube insertion, and respiratory distress. Anatomical subtype confirmation relies on intraoperative findings. Early surgical repair can be performed successfully; however, associated anomalies necessitate careful long-term follow-up.

Laporan Keuangan Pemerintah Daerah (LKPD) merupakan instrumen utama pertanggungjawaban pemerintah atas pengelolaan keuangan publik. Kualitasnya tidak hanya ditentukan oleh kepatuhan teknis terhadap Standar Akuntansi Pemerintahan (SAP) berbasis akrual berdasarkan PP No. 71 Tahun 2010, tetapi juga oleh nilai etika yang dipegang aparatur pemerintah. Penelitian ini menganalisis penerapan nilai kejujuran dan tanggung jawab dalam pelaporan keuangan Pemerintah Kota Medan serta kesesuaiannya dengan karakteristik kualitatif LKPD, yang diintegrasikan dengan nilai etika Kristiani. Metode yang digunakan adalah studi literatur dengan pendekatan kualitatif deskriptif, menganalisis data keuangan tahun anggaran 2022–2024. Hasil menunjukkan PAD tumbuh konsisten dari Rp2,23 triliun (2022) menjadi Rp2,44 triliun (2023) dan mencapai Rp2,77 triliun (2024), total realisasi pendapatan daerah mencapai Rp6,29 triliun (2024) dengan capaian 87,84 persen dari target anggaran, surplus APBD Rp36,57 miliar, dan opini Wajar Tanpa Pengecualian (WTP) dari BPK selama tiga tahun berturut-turut. Nilai kejujuran berkorelasi dengan karakteristik keandalan dan relevansi LKPD, sementara nilai tanggung jawab berkorelasi dengan keterbandingan dan kemudahan dipahami. Penguatan kapasitas SDM, SPIP, dan internalisasi nilai etika di tingkat SKPD/OPD tetap menjadi kebutuhan mendesak.

Latar Belakang: Kehilangan seluruh gigi (complete edentulism) dapat menyebabkan gangguan fungsi mastikasi, fonetik, estetika, serta menurunkan kualitas hidup dan kepercayaan diri pasien. Gigi tiruan lengkap (GTL) berbahan resin akrilik masih menjadi pilihan rehabilitasi yang banyak digunakan karena memiliki sifat estetik yang baik, mudah dimanipulasi, dan relatif ekonomis. Laporan Kasus: Seorang pasien perempuan berusia 42 tahun datang ke Rumah Sakit Gigi dan Mulut Soelastri Surakarta dengan keluhan kehilangan seluruh gigi pada rahang atas dan rahang bawah sejak tiga tahun yang lalu. Pasien mengalami kesulitan mengunyah, berbicara, dan merasa kurang percaya diri terhadap penampilannya. Pemeriksaan klinis menunjukkan kondisi edentulous lengkap pada kedua rahang disertai penurunan dimensi vertikal wajah. Rencana perawatan berupa pembuatan gigi tiruan lengkap berbahan resin akrilik heat-cured. Tahapan perawatan meliputi pencetakan anatomis dan fisiologis, pembuatan sendok cetak individual, pencatatan hubungan rahang, penyusunan gigi tiruan, try-in, insersi, serta evaluasi pasca pemasangan. Hasil: Setelah pemasangan gigi tiruan lengkap, diperoleh retensi dan stabilisasi yang baik, oklusi yang harmonis, serta perbaikan fungsi mastikasi, fonetik, dan estetika. Pada evaluasi satu minggu pasca-insersi, pasien tidak mengeluhkan rasa sakit maupun ketidaknyamanan, kondisi jaringan pendukung dalam keadaan sehat, dan pasien menyatakan puas terhadap hasil perawatan. Kesimpulan: Rehabilitasi pasien edentulous lengkap menggunakan gigi tiruan lengkap resin akrilik memberikan hasil klinis yang baik dalam mengembalikan fungsi pengunyahan, bicara, dan estetika. Keberhasilan perawatan dipengaruhi oleh ketepatan prosedur klinis, kualitas pembuatan gigi tiruan, serta kerja sama yang baik antara dokter gigi dan pasien.

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

Penelitian ini bertujuan untuk menganalisis pengaruh struktur modal terhadap nilai perusahaan, menganalisis pengaruh profitabilitas terhadap nilai perusahaan, serta menganalisis pengaruh likuiditas terhadap nilai perusahaan pada perusahaan manufaktur sektor makanan dan minuman yang terdaftar di Bursa Efek Indonesia periode 2022–2024. Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan pendekatan asosiatif. Populasi penelitian mencakup seluruh iverusahaan manufaktur sektor makanan dan minuman yang terdaftar di Bursa Efek Indonesia periode 2022–2024 yang berjumlah 83 perusahaan. Sampel penelitian sebanyak 48 perusahaan yang dipilih melalui iverusa purposive sampling berdasarkan kriteria iv erusahaan yang terdaftar secara berturut-turut selama periode penelitian, mempublikasikan laporan keuangan secara lengkap, tidak mengalami kerugian selama periode penelitian, serta memiliki data yang sesuai dengan variabel penelitian. Jenis data yang digunakan adalah data sekunder yang bersumber dari laporan keuangan tahunan perusahaan yang dipublikasikan melalui situs resmi Bursa Efek Indonesia. Teknik pengumpulan data dilakukan melalui metode dokumentasi dengan mengakses dan mencatat data keuangan yang relevan. Analisis data menggunakan analisis regresi data panel dengan bantuan aplikasi Eviews melalui uji pemilihan model yang meliputi uji Chow, uji Hausman, dan uji Lagrange Multiplier untuk menentukan model yang paling sesuai. Hasil penelitian menunjukkan bahwa struktur modal yang diproksikan dengan Debt to Equity Ratio (DER) berpengaruh terhadap nilai perusahaan, yang menunjukkan bahwa komposisi penggunaan utang dan ekuitas dalam pendanaan perusahaan dapat memengaruhi persepsi investor terhadap kinerja dan prospek perusahaan. Profitabilitas yang diproksikan dengan Net Profit Margin (NPM) juga berpengaruh terhadap nilai perusahaan, yang mengindikasikan bahwa semakin tinggi kemampuan iverusahaan dalam menghasilkan laba maka semakin tinggi pula nilai perusahaan karena meningkatnya kepercayaan investor terhadap kinerja perusahaan. Sementara itu, likuiditas yang diproksikan dengan Current Ratio (CR) tidak berpengaruh signifikan terhadap nilai perusahaan, yang menunjukkan bahwa kemampuan perusahaan dalam memenuhi kewajiban jangka pendek belum tentu menjadi pertimbangan utama bagi investor dalam menilai perusahaan pada sektor makanan dan minuman.

Penelitian ini bertujuan untuk menguji pengaruh profesionalisme ASN, independensi ASN, dan komitmen organisasi ASN terhadap kualitas laporan keuangan daerah pada Badan Keuangan dan Aset Daerah (BKAD) Provinsi Sumatera Utara. Penelitian ini menggunakan pendekatan kuantitatif dengan jenis data primer yang diperoleh melalui penyebaran kuesioner kepada 45 responden. Populasi dalam penelitian ini adalah ASN pada BKAD Provinsi Sumatera Utara, dengan teknik pengambilan sampel menggunakan purposive sampling. Hasil penelitian menunjukkan bahwa profesionalisme ASN dan independensi ASN berpengaruh positif dan signifikan terhadap kualitas laporan keuangan daerah. Sementara itu, komitmen organisasi ASN berpengaruh positif tetapi tidak signifikan terhadap kualitas laporan keuangan daerah. Secara simultan, profesionalisme ASN, independensi ASN, dan komitmen organisasi ASN berpengaruh positif dan signifikan terhadap kualitas laporan keuangan daerah pada BKAD Provinsi Sumatera Utara.

Geographic tongue or benign migratory glossitis is a benign disorder of the oral mucosa that is relatively common in dental practice. This condition is characterized by erythematous areas caused by the loss of filiform papillae surrounded by irregular white borders. To understand the clinical characteristics of geographic tongue and the contributing factors involved in the development of the lesion in order to establish an appropriate diagnosis and provide adequate patient education. A 25-year-old female patient presented with complaints of patches on the tongue for approximately two months. The patient had been following an OMAD (One Meal A Day) diet for one year and reported an allergy to white rice. The patient also had a history of psoriasis. Nutritional deficiencies such as vitamin B complex, vitamin B12, folic acid, iron, and zinc may affect the integrity of the oral mucosa and disrupt the regeneration of the lingual epithelium. These conditions may lead to atrophy of the filiform papillae, resulting in the characteristic erythematous appearance of geographic tongue. In addition, immunological and inflammatory factors associated with psoriasis are also suspected to contribute to lesion development. Geographic tongue is a benign inflammatory condition with a multifactorial etiology, including nutritional deficiencies and immunological factors such as psoriasis. Evaluation of systemic conditions and nutritional status is important to support accurate diagnosis and proper patient management.

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.

Pengabdian ini bertujuan memperkuat akuntabilitas pengelolaan dana pembangunan masjid melalui penyusunan informasi keuangan berbasis ISAK 335. Pengabdian menggunakan pendekatan Participatory Action Research (PAR) melalui observasi, wawancara, dan pendampingan penyusunan laporan keuangan. Kegiatan dilakukan melalui klasifikasi transaksi, penyusunan laporan keuangan, serta analisis efisiensi dan partisipasi donatur. Hasil pengabdian berupa tersusunnya laporan keuangan pembangunan masjid yang lebih sistematis dan informatif. Takmir memperoleh pemahaman mengenai efisiensi penggunaan dana dan pola partisipasi masyarakat. Transparansi laporan keuangan juga memperkuat kepercayaan jamaah terhadap pengelolaan dana pembangunan. Pengabdian ini berdampak pada penguatan tata kelola, akuntabilitas, dan keberlanjutan partisipasi masyarakat dalam memakmurkan masjid.

Accountability in preparing financial reports is a crucial instrument for the sustainability of business entities, because inaccurate financial data management can hinder decision-making and harm business performance in the future. For MSME actors in the PKK Tanggamus community, strengthening financial reporting competence is an urgent need so they can map expenditure structures, record income, calculate profit, and evaluate business development periodically. This community service activity aims to improve participants’ financial discipline, particularly in separating personal assets, business capital, and gross profit, while introducing accessible office technology. The training focused on optimizing LibreOffice Calc as an alternative to Microsoft Excel with similar functions for creating transaction tables, cost recapitulations, and simple financial reports. The activity method included material presentation, software demonstrations, report preparation practice, and interactive discussions based on participants’ business needs. Training results showed high enthusiasm, improved understanding, and readiness to use LibreOffice Calc as a more organized, transparent, and sustainable financial recording tool. Thus, this activity provides practical contributions to building an accountable financial administration culture for community-based MSMEs.

Hypertension is one of the most common chronic diseases encountered in primary healthcare and may lead to serious complications if left uncontrolled. This case report aims to describe the management of a 48-year-old female patient with grade II hypertension through a family medicine approach at Nisam Primary Health Center, North Aceh Regency. The patient presented with intermittent headaches for one week, which worsened after physical activity and were accompanied by numbness in both legs. She had a five-year history of hypertension with poor adherence to antihypertensive medication. Physical examination revealed a blood pressure of 165/70 mmHg, leading to a diagnosis of grade II hypertension. Comprehensive management was conducted using patient-centered and family-centered approaches, including education regarding hypertension, lifestyle modification, DASH diet implementation, physical activity, medication adherence, and family support through home visits and family folders. The interventions were expected to improve blood pressure control, prevent complications, and enhance the patient’s quality of life. A family medicine approach plays an important role in comprehensive hypertension management at the primary healthcare level.

Tujuan dari penelitian ini adalah untuk mengevaluasi bagaimana penerapan Standar Akuntansi Pemerintahan (SAP) memengaruhi kualitas laporan keuangan pemerintah daerah. Selain itu, penelitian ini juga menyelidiki peran Sistem Informasi Pemerintahan Daerah (SIPD) sebagai faktor moderasi. Dengan menggunakan teknik purposive sampling, penelitian kuantitatif ini mengumpulkan 31 responden dari Organisasi Perangkat Daerah (OPD) di bawah pemerintah Kota Medan. Data yang digunakan berasal dari data awal yang dikumpulkan melalui kuesioner. Structural Equation Modeling berbasis Partial Least Square (SEM-PLS), yang dibantu oleh SmartPLS, digunakan untuk melakukan analisis data. Hasil penelitian menunjukkan bahwa penggunaan SAP berdampak positif dan signifikan terhadap kualitas laporan keuangan pemerintah daerah, tetapi SIPD tidak dapat mengontrol hubungan antara penggunaan SAP dan kualitas laporan keuangan. Studi ini meningkatkan penelitian teori institusional, terutama tentang bagaimana tekanan regulasi dan normatif membantu meningkatkan kualitas pelaporan keuangan sektor publik dengan menerapkan standar akuntansi. Penelitian ini memiliki manfaat bagi pemerintah daerah untuk meningkatkan konsistensi penerapan SAP dan mengoptimalkan SIPD melalui peningkatan kemampuan sumber daya manusia dan dukungan teknologi informasi. Penelitian ini terbatas pada jumlah sampel yang relatif kecil serta ruang lingkup yang hanya mencakup OPD di satu daerah, sehingga hasil penelitian belum dapat digeneralisasi secara luas.

Raining on the preparation of financial statements based on the Financial Accounting Standards for Micro, Small, and Medium Entities (SAK EMKM) for the management of Village-Owned Enterprises (BUMDes) is one of the community service programs aimed at improving the ability of BUMDes administrators in preparing financial statements in accordance with applicable accounting standards. In this activity, SAK EMKM serves as a guideline in preparing more transparent and accountable financial reports. This program is expected to provide a positive impact on village financial management while strengthening the performance of BUMDes in carrying out its role as a driver of the village economy. The activity was implemented through a practical approach involving BUMDes administrators directly. The training was complemented with simulations and case studies to help participants better understand the process of preparing financial statements based on SAK EMKM. In addition, this training also aimed to increase the awareness of BUMDes administrators regarding the importance of accountability and transparency in financial management as part of efforts to achieve good village governance.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with deceptively benign histological features but significant potential for local recurrence and distant metastasis. Pelvic LGFMS is extremely uncommon and may mimic gynecological malignancies, leading to diagnostic challenges. This report describes a 39-year-old woman presenting with progressive abdominal enlargement, bloating, early satiety, and dyspnea. Physical and ultrasonographic examinations suggested a malignant ovarian tumor. The patient underwent exploratory laparotomy without preoperative CT scan evaluation. Intraoperatively, multiple solid masses involving the intestines, mesentery, omentum, peritoneum, and ovaries were identified, with the largest measuring 20 × 15 cm. Histopathological examination confirmed the diagnosis of LGFMS. The absence of preoperative cross-sectional imaging contributed to diagnostic difficulty in this case. CT scan and MRI are important for evaluating tumor origin, tissue characteristics, and involvement of surrounding structures. Definitive diagnosis requires histopathology supported by immunohistochemistry, particularly MUC4, and molecular confirmation when available. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis, optimize management, and improve long-term outcomes in patients with pelvic LGFMS.

King Royal Hotel Restaurant still applies manual sales transaction recording, causing data management and revenue report preparation to be less than optimal. This study aims to design and implement a Flutter-based sales and revenue reporting application that utilizes local storage as a data storage mechanism on the device. The system development method used is the Waterfall method, which includes the stages of requirements analysis, design, implementation, testing, and maintenance. The application was developed using the Flutter framework with the Dart programming language and utilizes the shared_preferences and hive packages for local data management on the device without requiring an internet connection or external database server. In addition, the application is designed to be easy for restaurant employees to use in recording daily transactions more quickly and accurately. Testing was conducted using the Black Box Testing method, which showed that all application features functioned according to functional requirements. The results of the study indicate that the Flutter-based application with a local storage approach is capable of improving transaction recording efficiency and generating revenue reports automatically at King Royal Hotel Restaurant.

This study aims to investigate the influence of audit committee characteristics—including the proportion of independent audit committee members, audit committee size, and the frequency of audit committee meetings—on the risk of financial statement fraud in companies in the real estate and infrastructure sectors listed on the Indonesia Stock Exchange from 2020 to 2024. This study is grounded in agency theory and signaling theory. The sample was selected using purposive sampling, involving 62 companies or 310 observations. Data analysis was conducted using multiple linear regression via SPSS version 27. The findings of the study indicate that, collectively, the three audit committee characteristic variables, along with the control variables, have a significant impact on financial statement fraud risk. However, when examined individually, the proportion of independent audit committee members, the size of the audit committee, and the frequency of audit committee meetings do not show an influence. Meanwhile, the profitability control variable (ROA) showed an influence on financial statement fraud risk. This study concludes that the extent to which an audit committee can prevent fraud depends not only on quantitative factors such as the number of members or meeting frequency, but is also more influenced by the quality of the audit committee members’ capabilities and commitment in carrying out their oversight duties.

This study aims to analyze the effects of profitability, leverage, liquidity, firm size, and the audit committee on sustainability reporting in energy-sector companies listed on the Indonesia Stock Exchange during the 2020–2024 period. This research is motivated by the increasing demand for corporate transparency and accountability regarding economic, environmental, and social impacts. The study uses secondary data from annual reports and sustainability reports, employing purposive sampling. The data were analyzed using multiple linear regression, corrected with the Newey-West method to account for violations of classical assumption tests. The results show that profitability, firm size, and the audit committee have positive and significant effects on sustainability reporting, while liquidity has a negative and significant effect. Meanwhile, leverage does not affect sustainability reporting. These findings support stakeholder theory, which posits that companies with strong financial performance and effective governance tend to enhance the disclosure of sustainability information. This study is expected to inform management and investors in their decision-making.

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.

This study aims to examine the impact of digital transformation in accounting and the effectiveness of internal control systems on the quality of financial reports in an integrated logistics services company. The method used is a quantitative approach using Structural Equation Modeling-Partial Least Squares (SEM-PLS), with data collected from 35 respondents who are involved in financial and accounting activities within the company. The analysis focuses on evaluating the relationships between digital transformation, internal control systems, and financial reporting quality. The research findings indicate that digital transformation in accounting (coefficient = 0.658; p-value = 0.000) and internal control systems (coefficient = 0.308; p-value = 0.023) have a positive and significant effect on the quality of financial reports. Furthermore, the coefficient of determination (R²) value of 0.822 shows that both independent variables are able to explain 82.2% of the variation in financial report quality, while the remaining percentage is influenced by other factors outside the model. These results confirm that the implementation of digital technology supported by an effective internal control system can significantly improve the accuracy, relevance, timeliness, and reliability of financial reporting in organizations.

This study was conducted to evaluate the impact of financial performance, capital structure, and good corporate governance on entities. The approach used is quantitative with a causal associative method. The research observations utilize secondary data sourced from the financial statements of entities listed on the stock exchange during the 2020–2023 period. The research sample was determined using a purposive sampling technique based on predefined criteria, totaling 160 observations. The analytical method employed is multiple linear regression, preceded by classical assumption tests. The results reveal that financial performance and good corporate governance have a positive and significant effect on the quality of financial statements, while capital structure has a significant negative effect. Simultaneously, the three independent variables are proven to significantly affect the quality of financial statements, with a coefficient of determination of 68%. These findings support agency theory and signaling theory in explaining the financial reporting behavior of entities. The implications of this study indicate that improving financial performance and implementing good corporate governance can enhance the quality of financial statements. Furthermore, optimal management of capital structure is also necessary to reduce the risk of financial statement manipulation.